WEDNESDAY, Nov. 11 (HealthDay News) -- The tragedy last week at Fort Hood, Texas, where an Army psychiatrist anticipating active duty has been blamed for killing 13 people and wounding 29 others in a shooting rampage, has sharpened the nation's focus not just on the conflicts in Afghanistan and Iraq, but also on another casualty of war: soldiers' mental health.

The ruptures wrought by post-traumatic stress disorder, or PTSD, certainly seem more pronounced in the present-day conflicts than in previous wars. But as the nation pauses to honor its soldiers past and present this Veterans Day, experts are unclear whether there is an actual increase in PTSD or just a perception of increase due to more awareness about the condition.

Still, soldiers battling on today's front lines confront different stressors than in wars past -- some of them demographic in nature and some exacerbated by technology that is supposed to bring people together but, instead, can push them apart.

For instance, soldiers serving in Afghanistan and Iraq tend to be older than their counterparts during Vietnam, which means many have spouses and children.

"Most of the people I served with in the Marine Corps during Vietnam, maybe 85 to 90 percent, were young, out of high school, so they didn't have the pressures of family life, of leaving a family behind, of being responsible for their well-being," noted Chuck Arnold, who served two tours of duty in Vietnam and Cuba and is now coordinator of the veterans program at the University of Medicine and Dentistry of New Jersey.

Today, Arnold pointed out, many of those older soldiers serve as part of the National Guard, and they have families and those families often suffer "vicarious trauma" that only adds to the soldiers' own trauma.

This is compounded by the fairly frequent contact soldiers can now have with family and friends back home, thanks to modern technology.

U.S. soldiers in Vietnam got letters from home, but, by the time they arrived at the front line, the news -- good or bad -- had "softened up," Arnold said. Today's troops get news from home -- not all of it good -- instantaneously via e-mail and cell phone.

"This can add to the stress level," Arnold said. "[Soldiers] are helpless to do anything. If you call me and tell me there's a major problem, I'm not concentrating on my job."

The instantaneous nature of modern life also may hamper people's problem-solving skills as well, Arnold said. "Everything comes so easy and instantaneous to them, they're used to getting everything they want when they want it and I think that's also an issue," he said. "They don't know how to struggle and suffer and work through issues."

This is especially true when trying to work out marriages, he said.

Added to this the fact that many U.S. troops are serving three or four or more tours of duty in combat zones, largely because the nation now has an all-volunteer Army. There aren't enough shoulders to take on this great a burden, Arnold said.

"We've downsized our military, causing people to be deployed much more than they should be," he said.

"People did get deployed multiple times to Vietnam but I don't think it was like this. I think that has contributed as well [to high levels of PTSD]," said Keith Young, vice chairman for research at Texas A&M Health Science Center College of Medicine in College Station, who also works with the VA Center of Excellence for Research on Returning War Veterans.

More tours of duty mean more chances for PTSD to develop.

"What we've learned is that people still continue to develop PTSD in each deployment, so it's an additive effect," Young explained.

Once people show signs of severe PTSD, Young said, they usually receive treatment and aren't sent back to the fighting.

The good news is that awareness of PTSD has increased dramatically from previous wars, and with it a better understanding of the disorder and better treatments.

"We're much more attuned to PTSD than we were n the past," Young said.

Arnold added: "Certainly we're realizing that PTSD is a reality. I don't know if we grasped that prior to Iraq and Afghanistan. We have more of an understanding of the impact of things. We didn't realize how trauma impacted us. The idea of trauma is a relatively new one in the mental health field."

And even if awareness had been better in the 1960s and '70s, there weren't any treatments to help, he said.

Now, researchers understand much better what brain processes are involved in flashbacks and other hallmarks of PTSD, said Jack Nitschke, an professor of psychiatry and psychology at the University of Wisconsin-Madison, who has research underway trying to identify brain differences that might explain why some people have severe PTSD while others escape relatively unscathed.

"We have learned a tremendous amount about PTSD and other anxiety disorders, the key brain regions that are involved," he said. "We're looking at particular processes involved in anxiety, in the process of anticipating bad things happening ... when people are reminded somehow that they're back in the war theater and that's leading them to shut down, not to reach out."

Certain talk therapies have been shown to ease symptoms and help people reconnect, as have some antidepressants, Young said. And there's a greater recognition of how the family can take part in healing.

"Father comes back and he's changed. We are very, very keenly aware of the important role that the family plays in the treatment of PTSD now," Young said.

More information

Visit the National Center for PTSD for more on this disorder.

WEDNESDAY, Nov. 11 (HealthDay News) -- Sharing prescription medication with a family member or friend who needs care may seem like the right thing to do, even an act of kindness. But new research highlights the potential hazards of passing these medicines around.

Of people who borrowed a medicine prescribed for someone else, 25.1 percent experienced some sort of side effect, researchers reported Wednesday at the American Public Health Association annual meeting in Philadelphia.

While 77.3 percent of prescription borrowers said they had bummed medicine rather than see a health-care provider, for many it merely delayed the inevitable. That's because one in three ended up seeking medical care, anyway.

A lot of people have focused on "recreational medication sharing," or abuse of prescription drugs "for a buzz," explained lead investigator Richard C. Goldsworthy, director of research and development at The Academic Edge, a Bloomington, Ind.-based developer of educational media.

"What people haven't looked at is what we started to call 'altruistic medication sharing,'" he said. "It's 'You're not feeling so well,' and a friend happens to have some extra medicine of a certain kind that treats symptoms similar to what you're having, and they let you borrow it."

In an earlier study, Goldsworthy and colleagues reported that 20 percent of U.S. teens say they swap prescription drugs such as antibiotics and allergy medicines with friends. The new study corroborates the frequency of drug-sharing in America, with one in five admitting to borrowing drugs.

Many people just think it's "no big deal," he explained.

Yet depending on the drug, the dosage and other factors, it can be a very big deal, one expert cautioned.

"There's always been an issue, especially with medications such as pain medications," said Allen J. Vaida, executive vice president at the Institute for Safe Medication Practices (ISMP), in Horsham, Pa.

Painkillers come in different dosages and some combine, say, an opioid with acetaminophen (the active ingredient in Tylenol), he said. If the borrower is already taking an over-the-counter pain reliever, such as Tylenol, he or she could be doubling the dose of acetaminophen, Vaida said.

In one tragic case, a 6-year-old with neck pain was found unconscious in bed the day after her foster mother placed a leftover fentanyl patch on the girl's neck, ISMP reported. The child died before reaching the emergency room.

But pain medications are not the sole cause of unintentional consequences. Sharing eye-drops can result in the spread of infection, Vaida noted. Doling out leftover antibiotics can result in unnecessary treatment or treatment with the wrong antibiotic, he said. And taking someone else's anti-anxiety medicine without the proper warnings can cause unanticipated dizziness or sleepiness behind the wheel of a car.

A week ago, the U.S. Food and Drug Administration (FDA) launched a new campaign aimed at reducing "preventable harm" from medication use. Taking medication meant for other people is among the potential dangers it highlighted.

"Too many people suffer unnecessary injuries from avoidable medication misuse, errors, and other problems," FDA Commissioner Dr. Margaret A. Hamburg said in a statement. FDA is launching the Safe Use Initiative to develop targeted solutions for reducing these injuries.

To find out whether drug sharing is putting people in harm's way, Goldsworthy had trained field agents conduct one-on-one interviews of almost 2,800 people in 11 different markets.

Of those who admitted to borrowing prescription medicines, many never got written (54.6 percent) or verbal (38.2 percent) warnings or instructions from the person loaning the medicine.

Among people who delayed seeking care, half of them never told their health-care provider that they had taken a borrowed medication.

"On the side effects, we don't actually know the severity. It's actually a limitation of the study," Goldsworthy said. "And we also don't know, in the analysis we've done so far, how many of those are actually people who sought a side effect."

Still, the prevalence of side effects suggests that the risk for harm is a real possibility.

Avoiding unintended health consequences begins with education, Vaida said. Physicians, pharmacists and nurses need to tell patients not to share their medicines with family or friends, he explained.

People should also get in the habit of cleaning out their medicine cabinets and turning over leftover and unused drugs to community "take-back" programs, he added.

"That's probably something that should be done all the time in every community," Vaida said.

More information

There's more on preventing medication errors at the Institute for Safe Medication Practices  .

TUESDAY, Nov. 10 (HealthDay News) -- For chronically ill patients, giving up the hope that they will get better may actually lead to more happiness, U.S. researchers suggest.

"Hope is an important part of happiness, but there's a dark side of hope. Sometimes, if hope makes people put off getting on with their life, it can get in the way of happiness," Dr. Peter A. Ubel, director of the Center for Behavioral and Decision Sciences in Medicine at the University of Michigan Health System, said in a university news release.

He and his colleagues studied patients who'd just had a colostomy, which means their colons were removed and they had to have bowel movements in a pouch outside the body. At the time of the surgery, some patients were told the procedure was reversible and they'd have a second operation in a few months to reconnect their bowels. Other patients were told the colostomy was permanent.

The patients were followed for six months, and the researchers found that those without hope of regaining normal bowel function were happier than those with reversible colostomies.

"We think they were happier because they got on with their lives. They realized the cards they were dealt, and recognized that they had no choice but to play with those cards," Ubel said. "The other group was waiting for their colostomy to be reversed. They contrasted their current life with the life they hoped to lead, and didn't make the best of their current situation."

The study, published in the November edition of Health Psychology, also may explain why people whose spouse dies often recover better emotionally over time than those who get divorced, the researchers said.

That's because people whose husband or wife dies have closure, while those who get divorced may still have hope for some chance of reconciliation, they explained.

More information

The American Psychological Association has more about chronic illness and mental health  .

FRIDAY, Nov. 6 (HealthDay News) -- Poor cleaning of restrooms aboard cruise ships raises the risk of norovirus-caused gastrointestinal illness outbreaks, a new study finds.

Norovirus causes about 95 percent of acute gastroenteritis outbreaks that occur on cruise ships. Between 2003 and 2008, norovirus outbreaks occurred on 66 ships monitored by the U.S. Centers for Disease Control and Prevention.

In this study, U.S. researchers checked 273 cruise-ship restrooms on 1,546 occasions and found that only 37 percent of them were cleaned daily. Overall, toilet seats were the best-cleaned objects in the restrooms, while baby changing tables were the least thoroughly cleaned objects. On three ships, none of the baby changing tables were cleaned during the study period.

The researchers also found that 19 restroom objects in 13 ships weren't cleaned at all during the entire five- to-seven-day monitoring period. Toilet area handholds were largely neglected and accounted for more than half of the uncleaned objects on 11 ships.

The thoroughness of restroom cleaning didn't differ by cruise line, the study said.

The findings are important because five of the six evaluated restroom objects are easily contaminated by pathogens during regular use.

"Although hand hygiene with soap after toileting may diminish the transmission of enteric pathogens via bathroom door knobs or pulls, hand washing is unlikely to mitigate the potential for any of the other toilet area contact surfaces to serve as a source of transmission of enteric pathogens," study author Dr. Philip Carling, a professor of clinical medicine at the Boston University School of Medicine, said in a school news release.

"Furthermore, there was substantial potential for washed hands to become contaminated while the passenger was exiting the restroom, given that only 35 percent of restroom exit knobs or pulls were cleaned daily. Only disinfection cleaning by cruise ship staff can reasonably be expected to mitigate these risks," he said.

The Cruise Lines International Association on Friday issued a response to the findings.

"The cruising industry takes the sanitation of its vessels and the mitigation of all gastrointestinal illnesses, including norovirus, very seriously," the statement read. "Our comprehensive public health and sanitation procedures -- which go above and beyond this study's focus on public restrooms -- are highly effective in maintaining healthy settings for families on vacation. In fact, according to the Centers for Disease Control and Prevention, the vast majority of norovirus outbreaks take place at land-based locations, such as schools, daycare centers, hospitals and nursing homes."

The study appears in the Nov. 1 issue of the journal Clinical Infectious Diseases.

More information

The U.S. National Institute of Allergy and Infectious Diseases has more about norovirus.