Holistic Care in the US Military I—The Epidaurus Project: An Initiative in Holistic Medicine for the Military Health System, 2001–2012

PubMed Central

Bulger, Roger J.; Frampton, Susan B.; Pellegrino, Edmund D.

2012-01-01

This article describes the history and findings of the Epidaurus Project, a Uniformed Services University–affiliated project to bring holistic care and evidence-based design into the Military Health System (MHS). A distinguished group of civilian thought leaders contributed. The 2005 Base Realignment and Closure process offered a chance to implement the Epidaurus agenda. A new integrated healthcare delivery system, centered around the Walter Reed National Military Medical Center at Bethesda, Maryland, was the result. These facilities will be templates for a new generation of MHS “healing environments” and a model for innovative systems of healthcare nationwide. The Epidaurus Project represents a significant collaboration between civilian medicine and the military in times of war. PMID:24278818

Developing Military Health Care Leaders

PubMed Central

Kirby, Sheila Nataraj; Marsh, Julie A.; McCombs, Jennifer Sloan; Thie, Harry J.; Xia, Nailing; Sollinger, Jerry M.

2011-01-01

Abstract The U.S. Department of Defense has highlighted the importance of preparing health care leaders to succeed in joint, performance-based environments. The current wartime environment, rising health care costs, and an increased focus on joint operations have led to recommendations for Military Health System (MHS) transformation. Part of that transformation will involve improving the identification and development of potential MHS leaders. An examination of how candidates are identified for leadership positions, the training and education opportunities offered to them, and the competencies they are expected to achieve revealed both a range of approaches and several commonalities in the military, civilian, and government sectors. A conceptual framework guided a series of interviews with senior health care executives from a wide range of organizations and military health care leaders from the Army, Navy, and Air Force, as well as a case study of the leader development approaches used by the Veterans Health Administration. Several themes emerged in terms of how leaders are developed in each sector, including the importance of mentoring, career counseling, 360-degree feedback, self-development, and formal education and training programs. Lessons learned in the civilian and government sectors hold importance for transforming the way in which MHS identifies and develops health care officers with high leadership potential for senior executive positions. PMID:28083164

Future of Military Health Care Final Report

DTIC Science & Technology

2007-12-20

Population Health Navigator. Service programs are supported by the Military Health System Population Health Portal (MHSPHP), a centralized, secure...planning is due to Congress on March 1, 2008.66 64 Air Force Medical Support Agency, Population Health Support Division. MHS Population Health Portal ...MTFs are monitoring HEDIS metrics using the MHS Population Health Portal and reporting in the service systems and the Tri- Service Business Planning

Military Personnel Who Seek Health and Mental Health Services Outside the Military.

PubMed

Waitzkin, Howard; Cruz, Mario; Shuey, Bryant; Smithers, Daniel; Muncy, Laura; Noble, Marylou

2018-05-01

Although research conducted within the military has assessed the health and mental health problems of military personnel, little information exists about personnel who seek care outside the military. The purpose of this study is to clarify the personal characteristics, mental health diagnoses, and experiences of active duty U.S. military personnel who sought civilian sector services due to unmet needs for care. This prospective, multi-method study included 233 clients, based in the United States, Afghanistan, South Korea, and Germany, who obtained care between 2013 and 2016 from a nationwide network of volunteer civilian practitioners. A hotline organized by faith-based and peace organizations received calls from clients and referred them to the network when the clients described unmet needs for physical or mental health services. Intake and follow-up interviews at 2 wk and 2 mo after intake captured demographic characteristics, mental health diagnoses, and reasons for seeking civilian rather than military care. Non-parametric bootstrap regression analyses identified predictors of psychiatric disorders, suicidality, and absence without leave (AWOL). Qualitative analyses of clients' narratives clarified their experiences and reasons for seeking care. The research protocol has been reviewed and approved annually by the Institutional Review Board at the University of New Mexico. Depression (72%), post-traumatic stress disorder (62%), alcohol use disorder (27%), and panic disorder (25%) were the most common diagnoses. Forty-eight percent of clients reported suicidal ideation. Twenty percent were absence without leave. Combat trauma predicted post-traumatic stress disorder (odds ratio [OR] = 8.84, 95% confidence interval [CI] 1.66, 47.12, p = 0.01) and absence without leave (OR = x3.85, 95% CI 1.14, 12.94, p = 0.03). Non-combat trauma predicted panic disorder (OR = 3.64, 95% CI 1.29, 10.23, p = 0.01). Geographical region was associated with generalized anxiety disorder

HIPAA and the military health system: organizing technological and organizational reform in large enterprises

NASA Astrophysics Data System (ADS)

Collmann, Jeff R.

2001-08-01

The global scale, multiple units, diverse operating scenarios and complex authority structure of the Department of Defense Military Health System (MHS) create social boundaries that tend to reduce communication and collaboration about data security. Under auspices of the Defense Health Information Assurance Program (DHIAP), the Telemedicine and Advanced Technology Research Center (TATRC) is contributing to the MHS's efforts to prepare for and comply with the Health Insurance Portability and Accountability Act (HIPAA) of 1996 through organizational and technological innovations that bridge such boundaries. Building interdisciplinary (clinical, administrative and information technology) medical information security readiness teams (MISRT) at each military treatment facility (MTF) constitutes the heart of this process. DHIAP is equipping and training MISRTs to use new tools including 'OCTAVE', a self-directed risk assessment instrument and 'RIMR', a web-enabled Risk Information Management Resource. DHIAP sponsors an interdisciplinary, triservice workgroup for review and revision of relevant DoD and service policies and participates in formal DoD health information assurance activities. These activities help promote a community of proponents across the MHS supportive of improved health information assurance. The MHS HIPAA-compliance effort teaches important general lessons about organizational reform in large civilian or military enterprises.

The Military Health Care System May Have the Potential to Prevent Health Care Disparities.

PubMed

Pierre-Louis, Bosny J; Moore, Angelo D; Hamilton, Jill B

2015-09-01

The existence of health disparities in military populations has become an important topic of research. However, to our knowledge, this is the first study to examine health disparities, as related to access to care and health status, among active duty soldiers and their families. Specifically, the purpose of this analysis was to evaluate whether health disparities exist in access to care and health outcomes of patient satisfaction, physical health status, and mental health status according to race, gender, and sponsor rank in the population of active duty soldiers and their family members. In this cross-sectional study, active duty army soldiers and family members were recruited from either one particular army health clinic where they received their health care or from an adjacent shopping center frequented by eligible participants. Data were collected using validated measures to assess concepts of access to care and health status. Statistical analysis, including one-way analysis of variance (ANOVA) was performed to investigate differences in study outcome measures across four key demographic subgroups: race, gender, sponsor rank, and component (active soldier or family member). A total of 200 participants completed the study questionnaires. The sample consisted of 45.5 % soldiers and 54.5 % family members, with 88.5 % reporting a sponsor rank in the category of junior or senior enlisted rank. Mean scores for access to care did not differ significantly for the groups race/ethnicity (p = 0.53), gender (p = 0.14), and sponsor rank (p = 0.10). Furthermore, no significant differences were observed whether respondents were active soldiers or their family members (p = 0.36). Similarly, there were no statistically significant subgroup (race/ethnicity, gender, sponsor rank, or component) differences in mean patient satisfaction, physical health, and mental health scores. In a health equity system of care such as the military health care system, active duty

The evolution of a health hazard assessment database management system for military weapons, equipment, and materiel.

PubMed

Murnyak, George R; Spencer, Clark O; Chaney, Ann E; Roberts, Welford C

2002-04-01

During the 1970s, the Army health hazard assessment (HHA) process developed as a medical program to minimize hazards in military materiel during the development process. The HHA Program characterizes health hazards that soldiers and civilians may encounter as they interact with military weapons and equipment. Thus, it is a resource for medical planners and advisors to use that can identify and estimate potential hazards that soldiers may encounter as they train and conduct missions. The U.S. Army Center for Health Promotion and Preventive Medicine administers the program, which is integrated with the Army's Manpower and Personnel Integration program. As the HHA Program has matured, an electronic database has been developed to record and monitor the health hazards associated with military equipment and systems. The current database tracks the results of HHAs and provides reporting designed to assist the HHA Program manager in daily activities.

Review of mobile health technology for military mental health.

PubMed

Shore, Jay H; Aldag, Matt; McVeigh, Francis L; Hoover, Ronald L; Ciulla, Robert; Fisher, Ashley

2014-08-01

Mental health problems pose challenges for military veterans, returning service members, and military family members including spouses and children. Challenges to meeting mental health needs include improving access to care and improving quality of care. Mobile Health, or "mHealth," can help meet these needs in the garrison and civilian environments. mHealth brings unique capabilities to health care provision through the use of mobile device technologies. This report identifies high-priority mHealth technology development considerations in two categories. First, priority considerations specific to mental health care provision include safety, privacy, evidence-based practice, efficacy studies, and temperament. Second, priority considerations broadly applicable to mHealth include security, outcomes, ease of use, carrier compliance, hardware, provider perspectives, data volume, population, regulation, command policy, and reimbursement. Strategic planning for the advancement of these priority considerations should be coordinated with stated Department of Defense capability needs to maximize likelihood of adoption. This report also summarizes three leading, military programs focused on mHealth projects in mental health, The Telemedicine and Advanced Technology Research Center, The Military Operational Medicine Research Program, United States Army Medical Research and Materiel Command, and The National Center for Telehealth and Technology. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

A comparative cost analysis of an integrated military telemental health-care service.

PubMed

Grady, Brian J

2002-01-01

The National Naval Medical Center, Bethesda, Maryland, integrated telemental health care into its primary behavioral health-care outreach service in 1998. To date, there have been over 1,800 telemental health visits, and the service encounters approximately 100 visits per month at this time. The objective of this study was to compare and contrast the costs to the beneficiary, the medical system, and the military organization as a whole via one of the four methods currently employed to access mental health care from remotely located military medical clinics. The four methods include local access via the military's civilian health maintenance organization (HMO) network, patient travel to the military treatment facility, military mental health specialists' travel to the remote clinic (circuit riding) and TeleMental Healthcare (TMH). Interactive video conferencing, phone, electronic mail, and facsimile were used to provide telemental health care from a military treatment facility to a remote military medical clinic. The costs of health-care services, equipment, patient travel, lost work time, and communications were tabulated and evaluated. While the purpose of providing telemental healthcare services was to improve access to mental health care for our beneficiaries at remote military medical clinics, it became apparent that this could be done at comparable or reduced costs.

European military mental health research: benefits of collaboration.

PubMed

Himmerich, Hubertus; Willmund, G D; Wesemann, U; Jones, N; Fear, N T

2017-06-01

Despite joint participation in international military operations, few collaborative military mental health research projects have been undertaken by European countries. From a common perspective of military mental health researchers from Germany and the UK, the lack of shared research might be related not only to the use of different languages but also the different ways in which the two militaries provide mental health and medical support to operations and differences in military institutions. One area that is suitable for military health research collaboration within UK and German forces is mental health and well-being among military personnel. This could include the study of resilience factors, the prevention of mental disorder, mental health awareness, stigma reduction and the treatment of mental disorder. Military mental health research topics, interests and the studies that have been conducted to date in the UK and Germany have considerable overlap and commonality of purpose. To undertake the investigation of the long-term consequences of operational deployment, the specific burdens placed on military families and to further the understanding of the role of factors such as biomarkers for use in military mental health research, it seems advisable to forge international research alliances across European nations, which would allow for researchers to draw transcultural and generalisable conclusions from their work. Such an enterprise is probably worthwhile given the shared research interests of Germany and the UK and the common perspectives on military mental health in particular. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Natural Interaction Based Online Military Boxing Learning System

ERIC Educational Resources Information Center

Yang, Chenglei; Wang, Lu; Sun, Bing; Yin, Xu; Wang, Xiaoting; Liu, Li; Lu, Lin

2013-01-01

Military boxing, a kind of Chinese martial arts, is widespread and health beneficial. In this paper, the authors introduce a military boxing learning system realized by 3D motion capture, Web3D and 3D interactive technologies. The interactions with the system are natural and intuitive. Users can observe and learn the details of each action of the…

The military health system: a community of solutions for medical education, health care delivery, and public health.

PubMed

Lennon, Robert P; Saguil, Aaron; Seehusen, Dean A; Reamy, Brian V; Stephens, Mark B

2013-01-01

Multiple strategies have been proposed to improve health care in the United States. These include the development of communities of solution (COSs), implementation of patient-centered medical homes (PCMHs), and lengthening family medicine residency training. There is scant literature on how to build and integrate these ideal models of care, and no literature about how to build a model of care integrating all 3 strategies is available. The Military Health System has adopted the PCMH model and will offer some 4-year family medicine residency positions starting in 2013. Lengthening residency training to 4 years represents an unprecedented opportunity to weave experiential COS instruction throughout a family physician's graduate medical education, providing future family physicians the skills needed to foster a COS in their future practice. This article describes our COS effort to synergize 3 aspects of modern military medicine: self-defined community populations, the transition to the PCMH model, and the initiation of the 4-year length of training pilot program in family medicine residency training. In this way we provide a starting point and general how-to guide that can be used to create a COS integrated with other current concepts in medicine.

Quality of Care for PTSD and Depression in the Military Health System: Phase 1 Report

DTIC Science & Technology

2016-01-01

Health and General Prevent Med 320 Preventive Medicine Physician 960 Therapy , Physical 706 Physical Therapist 901 Physician Assistant 083 Physician...maintain a physically and psycho- logically healthy, mission-ready force, and the care provided by the Military Health System (MHS) is critical to...and provides physical and PH care worldwide to active-component service mem- bers, Reserve and National Guard members, and retirees, as well as their

Task Force on the Future of Military Health Care

DTIC Science & Technology

2007-12-01

Navigator. Service programs are supported by the Military Health System Population Health Portal (MHSPHP), a centralized, secure, web-based population...Congress on March 1, 2008.66 64 Air Force Medical Support Agency, Population Health Support Division. MHS Population Health Portal Methods. July 2007...HEDIS metrics using the MHS Population Health Portal and reporting in the service systems and the Tri- Service Business Planning tool. DoD has several

The military social health index: a partial multicultural validation.

PubMed

Van Breda, Adrian D

2008-05-01

Routine military deployments place great stress on military families. Before South African soldiers can be deployed, they undergo a comprehensive health assessment, which includes a social work assessment. The assessment focuses on the resilience of the family system to estimate how well the family will cope when exposed to the stress of deployments. This article reports on the development and validation of a new measuring tool, the Military Social Health Index, or MSHI. The MSHI is made up of four scales, each comprising 14 items, viz social support, problem solving, stressor appraisal, and generalized resistance resources. An initial, large-scale, multicultural validation of the MSHI revealed strong levels of reliability (Cronbach a and standard error of measurement) and validity (factorial, construct, convergent, and discriminant).

The military health system's personal health record pilot with Microsoft HealthVault and Google Health.

PubMed

Do, Nhan V; Barnhill, Rick; Heermann-Do, Kimberly A; Salzman, Keith L; Gimbel, Ronald W

2011-01-01

To design, build, implement, and evaluate a personal health record (PHR), tethered to the Military Health System, that leverages Microsoft® HealthVault and Google® Health infrastructure based on user preference. A pilot project was conducted in 2008-2009 at Madigan Army Medical Center in Tacoma, Washington. Our PHR was architected to a flexible platform that incorporated standards-based models of Continuity of Document and Continuity of Care Record to map Department of Defense-sourced health data, via a secure Veterans Administration data broker, to Microsoft® HealthVault and Google® Health based on user preference. The project design and implementation were guided by provider and patient advisory panels with formal user evaluation. The pilot project included 250 beneficiary users. Approximately 73.2% of users were < 65 years of age, and 38.4% were female. Of the users, 169 (67.6%) selected Microsoft® HealthVault, and 81 (32.4%) selected Google® Health as their PHR of preference. Sample evaluation of users reflected 100% (n = 60) satisfied with convenience of record access and 91.7% (n = 55) satisfied with overall functionality of PHR. Key lessons learned related to data-transfer decisions (push vs pull), purposeful delays in reporting sensitive information, understanding and mapping PHR use and clinical workflow, and decisions on information patients may choose to share with their provider. Currently PHRs are being viewed as empowering tools for patient activation. Design and implementation issues (eg, technical, organizational, information security) are substantial and must be thoughtfully approached. Adopting standards into design can enhance the national goal of portability and interoperability.

Implementing collaborative primary care for depression and posttraumatic stress disorder: design and sample for a randomized trial in the U.S. military health system.

PubMed

Engel, Charles C; Bray, Robert M; Jaycox, Lisa H; Freed, Michael C; Zatzick, Doug; Lane, Marian E; Brambilla, Donald; Rae Olmsted, Kristine; Vandermaas-Peeler, Russ; Litz, Brett; Tanielian, Terri; Belsher, Bradley E; Evatt, Daniel P; Novak, Laura A; Unützer, Jürgen; Katon, Wayne J

2014-11-01

War-related trauma, posttraumatic stress disorder (PTSD), depression and suicide are common in US military members. Often, those affected do not seek treatment due to stigma and barriers to care. When care is sought, it often fails to meet quality standards. A randomized trial is assessing whether collaborative primary care improves quality and outcomes of PTSD and depression care in the US military health system. The aim of this study is to describe the design and sample for a randomized effectiveness trial of collaborative care for PTSD and depression in military members attending primary care. The STEPS-UP Trial (STepped Enhancement of PTSD Services Using Primary Care) is a 6 installation (18 clinic) randomized effectiveness trial in the US military health system. Study rationale, design, enrollment and sample characteristics are summarized. Military members attending primary care with suspected PTSD, depression or both were referred to care management and recruited for the trial (2592), and 1041 gave permission to contact for research participation. Of those, 666 (64%) met eligibility criteria, completed baseline assessments, and were randomized to 12 months of usual collaborative primary care versus STEPS-UP collaborative care. Implementation was locally managed for usual collaborative care and centrally managed for STEPS-UP. Research reassessments occurred at 3-, 6-, and 12-months. Baseline characteristics were similar across the two intervention groups. STEPS-UP will be the first large scale randomized effectiveness trial completed in the US military health system, assessing how an implementation model affects collaborative care impact on mental health outcomes. It promises lessons for health system change. Copyright © 2014 Elsevier Inc. All rights reserved.

Twelve month use of mental health services in a nationally representative, active military sample.

PubMed

Fikretoglu, Deniz; Guay, Stéphane; Pedlar, David; Brunet, Alain

2008-02-01

Mental disorders constitute a significant public health problem in active military populations. However, very little is known about patterns of mental health service use in these populations. The primary objective of this study was to examine the patterns and predictors of mental health service use in active Canadian Force members. Additional objectives included identification of barriers to service use. A cross-sectional analysis was conducted using data from the Canadian Community Health Survey-Canadian Forces Supplement. Participants were assessed for mood, anxiety, and substance use disorders using the World Health Organization's Composite International Diagnostic Interview. Those who met criteria for at least 1 disorder in the past year (n = 1220) were included in the analyses. Of military members with a 12-month diagnosis, 42.6% used services in the past year. Predictors of service use included mental health indicators, gender, marital status, and military rank. Of military members who failed to use services, only a small percentage (3.5-16.0%) acknowledged a need for services. These members perceived a number of barriers to services, foremost among which was lack of trust in military health, administrative, and social services. Despite recent efforts to de-stigmatize mental health problems and treatments, unmet need for mental health services remains a significant problem in active militaries. Our findings indicate that military institutions should continue public education campaigns to de-stigmatize mental health problems and should make necessary changes in health delivery systems to gain the trust of military members.

Barriers to mental health treatment for military wives.

PubMed

Lewy, Colleen S; Oliver, Celina M; McFarland, Bentson H

2014-09-01

An Internet-based survey sought information about barriers to mental health services for military wives. On the basis of qualitative work, an Internet-based program was created to identify military wives who may have major depressive disorder. Women (N=569, ages 18 to 56) were recruited from 45 states and eight foreign countries. Most participants (78%) reported mild to severe depression. Many (44%) reported unaddressed mental health needs. Barriers included inability to attend daytime appointments (38%), inability to find a counselor who understands the needs of military spouses (35%), inability to find a counselor the participant could trust (29%), concerns about confidentiality (26%), and lack of knowledge about where to get services (25%). The barriers reported differed markedly from those described by distressed women in the general population. Military wives are an underserved population. Knowledge of military culture is essential for civilian mental health providers working with military wives.

Moving Upstream: Why Rehabilitative Justice in Military Discharge Proceedings Serves a Public Health Interest

PubMed Central

Seamone, Evan R.; McGuire, James; Clark, Sean; Smee, Daniel; Dow, Daniel

2014-01-01

The cultural divide between US military and civilian institutions amplifies the consequences of military discharge status on public health and criminal justice systems in a manner that is invisible to a larger society. Prompt removal of problematic wounded warriors through retributive justice is more expedient than lengthy mental health treatment. Administrative and punitive discharges usually preclude Department of Veterans Affairs eligibility, posing a heavy public health burden. Moving upstream—through military rehabilitative justice addressing military offenders’ mental health needs before discharge—will reduce the downstream consequences of civilian maladjustment and intergenerational transmission of mental illness. The public health community can play an illuminating role by gathering data about community effect and by advocating for policy change at Department of Veterans Affairs and community levels. PMID:25122020

WAR & Military Mental Health

PubMed Central

Pols, Hans; Oak, Stephanie

2007-01-01

Involvement in warfare can have dramatic consequences for the mental health and well-being of military personnel. During the 20th century, US military psychiatrists tried to deal with these consequences while contributing to the military goal of preserving manpower and reducing the debilitating impact of psychiatric syndromes by implementing screening programs to detect factors that predispose individuals to mental disorders, providing early intervention strategies for acute war-related syndromes, and treating long-term psychiatric disability after deployment. The success of screening has proven disappointing, the effects of treatment near the front lines are unclear, and the results of treatment for chronic postwar syndromes are mixed. After the Persian Gulf War, a number of military physicians made innovative proposals for a population-based approach, anchored in primary care instead of specialty-based care. This approach appears to hold the most promise for the future. PMID:17971561

Defense Health Care: Applying Key Management Practices Should Help Achieve Efficiencies within the Military Health System

DTIC Science & Technology

2012-04-01

5. Realign the TRICARE Management Activity and establish a Joint Military Health Service Directorate to consolidate shared services and common...Directorate to consolidate shared services and common functions Realign TRICARE Management Activity and establish a TRICARE Health Plan Agency to...Uniformed Services University of the Health Sciences, (2) TRICARE health plan, (3) Health Management Support, and (4) Shared Services division

Patient Privacy, Consent, and Identity Management in Health Information Exchange: Issues for the Military Health System.

PubMed

Hosek, Susan D; Straus, Susan G

2013-01-01

The Military Health System (MHS) and the Veterans Health Administration (VHA) have been among the nation's leaders in health information technology (IT), including the development of health IT systems and electronic health records that summarize patients' care from multiple providers. Health IT interoperability within MHS and across MHS partners, including VHA, is one of ten goals in the current MHS Strategic Plan. As a step toward achieving improved interoperability, the MHS is seeking to develop a research roadmap to better coordinate health IT research efforts, address IT capability gaps, and reduce programmatic risk for its enterprise projects. This article contributes to that effort by identifying gaps in research, policy, and practice involving patient privacy, consent, and identity management that need to be addressed to bring about improved quality and efficiency of care through health information exchange. Major challenges include (1) designing a meaningful patient consent procedure, (2) recording patients' consent preferences and designing procedures to implement restrictions on disclosures of protected health information, and (3) advancing knowledge regarding the best technical approaches to performing patient identity matches and how best to monitor results over time. Using a sociotechnical framework, this article suggests steps for overcoming these challenges and topics for future research.

The military health system's personal health record pilot with Microsoft HealthVault and Google Health

PubMed Central

Barnhill, Rick; Heermann-Do, Kimberly A; Salzman, Keith L; Gimbel, Ronald W

2011-01-01

Objective To design, build, implement, and evaluate a personal health record (PHR), tethered to the Military Health System, that leverages Microsoft® HealthVault and Google® Health infrastructure based on user preference. Materials and methods A pilot project was conducted in 2008–2009 at Madigan Army Medical Center in Tacoma, Washington. Our PHR was architected to a flexible platform that incorporated standards-based models of Continuity of Document and Continuity of Care Record to map Department of Defense-sourced health data, via a secure Veterans Administration data broker, to Microsoft® HealthVault and Google® Health based on user preference. The project design and implementation were guided by provider and patient advisory panels with formal user evaluation. Results The pilot project included 250 beneficiary users. Approximately 73.2% of users were <65 years of age, and 38.4% were female. Of the users, 169 (67.6%) selected Microsoft® HealthVault, and 81 (32.4%) selected Google® Health as their PHR of preference. Sample evaluation of users reflected 100% (n=60) satisfied with convenience of record access and 91.7% (n=55) satisfied with overall functionality of PHR. Discussion Key lessons learned related to data-transfer decisions (push vs pull), purposeful delays in reporting sensitive information, understanding and mapping PHR use and clinical workflow, and decisions on information patients may choose to share with their provider. Conclusion Currently PHRs are being viewed as empowering tools for patient activation. Design and implementation issues (eg, technical, organizational, information security) are substantial and must be thoughtfully approached. Adopting standards into design can enhance the national goal of portability and interoperability. PMID:21292705

Patient Privacy, Consent, and Identity Management in Health Information Exchange: Issues for the Military Health System

DTIC Science & Technology

2013-01-01

JPC-1b Joint Program Committee-1b on Health Information Technology and Medical Informatics MAeHC Massachusetts eHealth Collaborative MHS Military...efficiency of care. The second study, by the eHealth Initiative (2011), surveyed communities across the United States with initiatives to share health...Simon et al. (2009) conducted focus groups involving 64 participants in several rural towns participating in the Massachusetts eHealth Collaborative

The Military Health System: Redefining the Role of Employers and Improving Cost-Share Parity Among Retirees

DTIC Science & Technology

2014-02-13

program and optional dental plans. Active-duty military members are automatically enrolled into TRICARE Prime and are assigned to a military treatment...registers as a cost consideration in the calculus of the majority of employers in the U.S. who provide health insurance to their employees. Military

The Formation of the Military Medical System of the Korean People's Army and the Military Medical Officer.

PubMed

Kim, Seonho

2017-12-01

The military medical system of the Korean People's Army (KPA) first appeared in August 1946 when a central military hospita was established at the headquarters. Inside the KPA, the military medical and veteran services were first established in February 1948. The military medical officers of the KPA were those who were initially engaged in North Korea's health care sector. Most of the early military medical officers were those who had been trained in the Japanese medical system before liberation and were surgeons. After the establishment of the government in September 1948, Lee Dongwha rapidly introduced the medical system of the Soviet army into the KPA. The KPA military medical system was a mix of Soviet, Japanese and Chinese military medical systems. The medical section of the KPA was similar to that of the Japanese army, and the medical section of the lower army was similar to that of the Soviet army. The stretcher platoon of the KPA were similar to those of the Japanese and Chinese armies. The KPA mainly used Japanese medical equipment at the beginning, and after the establishment of the North Korean regime in September 1948, they were gradually replaced with Soviet products. The military medical office of the KPA were equipped with treatment rooms, laboratories, hospitals, pharmacy, and inpatient rooms. The military medical office purchased medical journals and specimens for medical research and set up a separate research fund. In addition, the military medical office was equipped with a laboratory for medical experiments and raised laboratory animals. The KPA military medical system was specialized in the fields of infectious disease prevention and preventive medicine. At the time, infectious disease in North Korea was mainly caused by bacteria and viruses in unsanitary living environments. The KPA set up a special anti-infectious disease department in consideration of the soldiers living in the collective facilities. The second characteristic of the KPA

Worldwide Survey of Substance Abuse and Health Behaviors among Military Personnel (1988)

DTIC Science & Technology

1989-01-25

military medical per- sonnel. * Almost 40 percent of military personnel report having changed their sexual behavior because of concern about getting...through a comprehensive system of medical care. A concen- trated health promotion program, however, has been a fairly recent phenome- non. In 1986, the...the prevalence of substance use (alcohol use, non- medical drug use, tobacco use) among military personnel, " identify the physical, social and work

The Promise ... The Reality: Military Health Care Management Revisited

DTIC Science & Technology

2000-02-01

using the Military Health Care System and published these monthly for use by hospitals/clinics and senior commanders. Patient satisfaction is among the...quickly. Americans , in and out of uniform, are interested in health care. America�s soldiers expect that our nation will provide health care for them...medical needs for their families and has highlighted inequities among health care options for active and reserve component personnel, retirees and family

Military Parents' Personal Technology Usage and Interest in e-Health Information for Obesity Prevention.

PubMed

Jai, Tun-Min; McCool, Barent N; Reed, Debra B

2016-03-01

U.S. military families are experiencing high obesity rates similar to the civilian population. The Department of Defense's Military Health System (MHS) is one of the largest healthcare providers in the United States, serving approximately 9.2 million active duty service members, retirees, spouses, and children. The annual cost to the MHS for morbidities associated with being overweight exceeds $1 billion. The preschool age has been suggested as an opportune time to intervene for the prevention of obesity. Thus, this study investigated the current level of technology usage by military service member families and assessed their needs and interests in health/nutrition information. This needs assessment is crucial for researchers/educators to design further studies and intervention programs for obesity prevention in military families with young children. In total, 288 military parents (233 Army and 55 Air Force) at two military bases whose children were enrolled in military childcare centers in the southwestern United States participated in a Technology Usage in Military Family (TUMF) survey in 2013. Overall, both bases presented similar technology usage patterns in terms of computer and mobile device usage on the Internet. Air Force base parents had a slightly higher knowledge level of nutrition/health information than Army base parents. The TUMF survey suggested practical ways such as mobile applications/Web sites, social networks, games, etc., that health educators can use to disseminate nutrition/health information for obesity prevention among military families with young children.

Family stress and posttraumatic stress: the impact of military operations on military health care providers.

PubMed

Gibbons, Susanne W; Barnett, Scott D; Hickling, Edward J

2012-08-01

This study uses data from the 2005 Department of Defense Survey of Health-Related Behaviors Among Military Personnel to examine relationships between family stress and posttraumatic stress symptoms across 4 subgroups of Operation Iraqi Freedom-deployed (i.e., war in Iraq) or Operation Enduring Freedom-deployed (i.e., war in Afghanistan) active-duty military service members. Results suggest the following: (a) the greatest positive correlation of family stressors with posttraumatic stress symptoms was found within the military health care officer group, and (b) these military health care officers differed in family stressors mediating posttraumatic stress with divorce and financial problems accounting for significant and unique portions of the variance. Implications for care of service members and their families are discussed. Published by Elsevier Inc.

A CONTENT ANALYSIS OF MILITARY COMMANDER MESSAGES ABOUT TOBACCO AND OTHER HEALTH ISSUES IN MILITARY INSTALLATION NEWSPAPERS: WHAT DO MILITARY COMMANDERS SAY ABOUT TOBACCO?

PubMed Central

Poston, Walker S.C.; Haddock, Christopher K.; Jahnke, Sara A.; Hyder, Melissa L.; Jitnarin, Nattinee

2014-01-01

Military installation newspapers are a primary means used by military commanders to communicate information about topics important to military personnel including leadership, training issues, installation events, safety concerns, and vital health issues. We conducted a content analysis of military commanders’ messages about health issues that were published in online military installation newspapers/newsfeeds. We identified a total of 75 publicly accessible installation newspapers/newsfeeds with commanders’ messages (n=39 Air Force, n=19 Army, n=7 Navy, n=1 Marine, and n=9 Joint Bases). Commander messages published between January 2012–December 2012 were collected, screened, and coded. Coder inter-rater reliability was 98.9%. Among the 2,479 coded commanders’ messages, 132 (5.3%) addressed a health topic as the primary focus. There were no significant differences between service branches in the percentage of health-oriented messages (χ2=5.019, p=0.285). The most commonly addressed health topics were exercise/fitness (23.5%), other mental health concerns (19.7%), alcohol/DUI (13.6%), and suicide (12.1%). Tobacco use was directly addressed as a primary health aim in only two commanders’ messages (1.5%). Health topics, and particularly tobacco-related content, are rarely written about by military commanders. The absence of tobacco-related health messages from line leadership contributes to the perception that tobacco control is a low priority. PMID:26032388

Comparison of health habits of military personnel with civilian populations.

PubMed Central

Ballweg, J A; Li, L

1989-01-01

The relationship between health habits and health status has gained attention in the literature in recent decades. In this report, the health habits of a particular occupational group--the military--are compared with those of the civilian population, and the extent to which the health habits of the military personnel are associated with their health status is examined. Responses to two surveys conducted in 1985 were analyzed by age group, sex, race, and educational level. The comparisons involved six of the seven health habits included in the Alameda study. Military personnel, because they are younger and their lives are more regimented, excel in meeting weight standards for the services and engaging in desirable levels of physical activity. Smoking habits of military personnel were less favorable than those of the civilians. An examination of the health status of the military for the year preceding the survey suggested that some health habits have immediate manifestations, but the impact of others may not be evident until later in life. PMID:2508180

Sleep and Health Resilience Metrics in a Large Military Cohort

PubMed Central

Seelig, Amber D.; Jacobson, Isabel G.; Donoho, Carrie J.; Trone, Daniel W.; Crum-Cianflone, Nancy F.; Balkin, Thomas J.

2016-01-01

Study Objectives: Examine the relationship between self-reported sleep parameters and indicators of resilience in a US military population (n = 55,021). Methods: Longitudinal analyses (2001–2008) were conducted using subjective data collected from Millennium Cohort Study questionnaires and objective data from military records that included demographics, military health, and deployment information. Subjective sleep duration and insomnia symptoms were collected on the study questionnaire. Resilience metrics included lost work days, self-rated health, deployment, frequency and duration of health care utilization, and early discharge from the military. Generalized estimating equations and survival analyses were adjusted for demographic, military, behavioral, and health covariates in all models. Results: The presence of insomnia symptoms was significantly associated with lower self-rated health, more lost work days, lower odds of deployment, higher odds of early discharge from military service early, and more health care utilization. Those self-reporting < 6 h (short sleepers) or > 8 h (long sleepers) of sleep per night had similar findings, except for the deployment outcome in which those with the shortest sleep were more likely to deploy. Conclusions: Poor sleep is a detriment to service members' health and readiness. Leadership should redouble efforts to emphasize the importance of healthy sleep among military service members, and future research should focus on the efficacy of interventions to promote healthy sleep and resilience in this population. Commentary: A commentary on this article appears in this issue on page 963. Citation: Seelig AD, Jacobson IG, Donoho CJ, Trone DW, Crum-Cianflone NF, Balkin TJ. Sleep and health resilience metrics in a large military cohort. SLEEP 2016;39(5):1111–1120. PMID:26951391

Barriers to Seeking Mental Health Services among Adolescents in Military Families

PubMed Central

Becker, Sara J.; Swenson, Rebecca; Esposito-Smythers, Christianne; Cataldo, Andrea; Spirito, Anthony

2014-01-01

Military families with adolescents experience high levels of stress associated with parental deployment, but many of these families do not seek or utilize mental health services. The current qualitative study was designed to better understand barriers to mental health treatment experienced by adolescents in military families. Focus groups and individual interviews were conducted with military adolescents (n = 13), military (non-enlisted) parents (n = 12), and mental health service providers who treat adolescents in military families (n = 20). Discussions primarily explored barriers to seeking treatment, with supplemental questions assessing the ideal elements of mental health services for this population. Seven barriers to engaging in mental health services were identified: four internal (confidentiality concerns, stigma, ethic of self-reliance, lack of perceived relevance) and three external (time and effort concerns, logistical concerns, financial concerns). Challenges engaging military adolescents in mental health services are discussed and several recommendations are offered for service providers attempting to work with this population. PMID:25574070

Sleep and Health Resilience Metrics in a Large Military Cohort.

PubMed

Seelig, Amber D; Jacobson, Isabel G; Donoho, Carrie J; Trone, Daniel W; Crum-Cianflone, Nancy F; Balkin, Thomas J

2016-05-01

Examine the relationship between self-reported sleep parameters and indicators of resilience in a US military population (n = 55,021). Longitudinal analyses (2001-2008) were conducted using subjective data collected from Millennium Cohort Study questionnaires and objective data from military records that included demographics, military health, and deployment information. Subjective sleep duration and insomnia symptoms were collected on the study questionnaire. Resilience metrics included lost work days, self-rated health, deployment, frequency and duration of health care utilization, and early discharge from the military. Generalized estimating equations and survival analyses were adjusted for demographic, military, behavioral, and health covariates in all models. The presence of insomnia symptoms was significantly associated with lower self-rated health, more lost work days, lower odds of deployment, higher odds of early discharge from military service early, and more health care utilization. Those self-reporting < 6 h (short sleepers) or > 8 h (long sleepers) of sleep per night had similar findings, except for the deployment outcome in which those with the shortest sleep were more likely to deploy. Poor sleep is a detriment to service members' health and readiness. Leadership should redouble efforts to emphasize the importance of healthy sleep among military service members, and future research should focus on the efficacy of interventions to promote healthy sleep and resilience in this population. A commentary on this article appears in this issue on page 963. © 2016 Associated Professional Sleep Societies, LLC.

Brief Report: Barriers to mental health treatment for military wives

PubMed Central

Lewy, Colleen; Oliver, Celina; McFarland, Bentson H.

2014-01-01

Objective This Internet-based survey provided information about barriers to mental health services for military wives. Methods Following qualitative work, an Internet-based program was created to identify military wives who may have major depressive disorder. Results Women (N = 569, ages 18 to 56) were recruited from 45 states and 8 foreign countries. Most participants (78%) reported notable depression. Many (44%) reported un-addressed mental health needs. Barriers included inability to attend daytime appointments (38%), inability to find a counselor who understands military spouse needs (35%), inability to find a counselor the participant could trust (29%), concerns about confidentiality (29%), and lack of knowledge about where to get services (25%). Barriers reported by the military wives differed markedly from those described by distressed women in the general population. Conclusions Military wives are an under-served population. Knowledge of military culture is essential for civilian mental health providers working with military wives. PMID:24933260

Current directions in military health-care provider resilience.

PubMed

Lester, Paul B; Taylor, Lauren C; Hawkins, Stacy Ann; Landry, Lisa

2015-02-01

After more than a decade of war, the US military continues to place significant emphasis on psychological health and resilience. While research and programs that focus on the broader military community's resilience continue to emerge, less is known about and until recently little focus has been placed on military medical provider resilience. In this article, we review the literature on military medical provider resilience, provide an overview of the programmatic and technological advances designed to sustain and develop military medical provider resilience, and finally offer recommendations for future research.

The Social Determinants of Health in Military Forces of Iran: A Qualitative Study

PubMed Central

Sanaeinasab, Hormoz; Ghanei, Mostafa; Mehrabi Tavana, Ali; Ravangard, Ramin; Karamali, Mazyar

2015-01-01

Providing effective health interventions and achieving equity in health need to apply the community-based approaches such as social determinants of health. In the military organizations, these determinants have received less attention from the military health researchers and policymakers. Therefore, this study aimed to identify and explain the social determinants affecting the health of military forces in Iran. This was a qualitative study which was conducted in 2014. The required data were collected through semistructured interviews and analyzed through Conventional Content Analysis. The studied sample consisted of 22 military health experts, policymakers, and senior managers selected using purposeful sampling method with maximum variation sampling. MAXQDA.2007 was used to analyze the collected data. After analyzing the collected data, two main contents, that is, “general social determinants of health” and “military social determinants of health,” with 22 themes and 90 subthemes were identified as the social determinants of military forces' health. Main themes were religious rule, spirituality promotion policies, international military factors, military command, and so forth. Given the role and importance of social factors determining the military forces' health, it can be recommended that the military organizations should pay more attention to these determinants in making policies and creating social, economic, and cultural structures for their forces. PMID:26379716

Cigarette Prices in Military Retail: A Review and Proposal for Advancing Military Health Policy

PubMed Central

Haddock, Christopher K.; Jahnke, Sara A.; Poston, Walker S.C.; Williams, Larry N.

2013-01-01

Tobacco use is the leading cause of preventable death in the United States (US) and has been demonstrated to significantly harm the combat readiness of military personnel. Unfortunately, recent research demonstrated that cigarettes are sold at substantial discounts in military retail outlets. In fact, the military is the only retailer which consistently loses money on tobacco. Cheap tobacco prices have been identified by enlisted personnel and Department of Defense health policy experts as promoting a culture of tobacco use in the US Military. This paper provides an analysis of why current military tobacco pricing policy has failed to eliminate cheap tobacco prices as an incentive for use. A rationale for increasing tobacco prices also is presented along with recommendations for improved military tobacco control policy. PMID:23756017

Alcohol use in the military: associations with health and wellbeing.

PubMed

Waller, Michael; McGuire, Annabel C L; Dobson, Annette J

2015-07-28

This study assessed the extent to which alcohol consumption in a military group differed from the general population, and how alcohol affected the military group's health and social functioning. A cross sectional survey of military personnel (n = 5311) collected self-reported data on alcohol use (AUDIT scale) and general health, role limitations because of physical health problems (role physical), and social functioning scores (SF36 subscales). Logistic regression was used to compare drinking behaviours between the military sample and a general population sample, using the categories risky drinkers (>2 units per day), low risk drinkers (≤2 standard drinks per day) and abstainers. Groups in the military sample with the highest levels of alcohol misuse (harmful drinking AUDIT ≥ 16, alcohol dependence AUDIT ≥ 20, and binge drinking) were also identified. Linear regression models were then used to assess the association between alcohol misuse and SF36 scores. There were fewer risky drinkers in the military sample than in the general population sample. There were also fewer abstainers, but more people who drank at a lower risk level (≤2 standard drinks per day), than in a sample of the general population. Harmful drinking and alcohol dependence were most commonly observed in men, younger age groups, non-commissioned officers and lower ranks as well as reserve and ex-serving groups. Alcohol misuse was clearly associated with poorer general health scores, more role limitations because of physical health problems, and lower social functioning. Although risky drinking was lower in the military group than in the general population, drinking was associated with poorer health, more limitations because of physical health problems, and poorer social functioning in Defence members. These results highlight the potential benefits for Defence forces in reducing alcohol use among members, in both those groups identified at highest risk, and across the military

A Prognostic Model to Predict Mortality among Non-Small-Cell Lung Cancer Patients in the U.S. Military Health System.

PubMed

Lin, Jie; Carter, Corey A; McGlynn, Katherine A; Zahm, Shelia H; Nations, Joel A; Anderson, William F; Shriver, Craig D; Zhu, Kangmin

2015-12-01

Accurate prognosis assessment after non-small-cell lung cancer (NSCLC) diagnosis is an essential step for making effective clinical decisions. This study is aimed to develop a prediction model with routinely available variables to assess prognosis in patients with NSCLC in the U.S. Military Health System. We used the linked database from the Department of Defense's Central Cancer Registry and the Military Health System Data Repository. The data set was randomly and equally split into a training set to guide model development and a testing set to validate the model prediction. Stepwise Cox regression was used to identify predictors of survival. Model performance was assessed by calculating area under the receiver operating curves and construction of calibration plots. A simple risk scoring system was developed to aid quick risk score calculation and risk estimation for NSCLC clinical management. The study subjects were 5054 patients diagnosed with NSCLC between 1998 and 2007. Age, sex, tobacco use, tumor stage, histology, surgery, chemotherapy, peripheral vascular disease, cerebrovascular disease, and diabetes mellitus were identified as significant predictors of survival. Calibration showed high agreement between predicted and observed event rates. The area under the receiver operating curves reached 0.841, 0.849, 0.848, and 0.838 during 1, 2, 3, and 5 years, respectively. This is the first NSCLC prognosis model for quick risk assessment within the Military Health System. After external validation, the model can be translated into clinical use both as a web-based tool and through mobile applications easily accessible to physicians, patients, and researchers.

Sexual health in the French military: a multidimensional and gendered perspective.

PubMed

Duron, Sandrine; Bohet, Aline; Panjo, Henri; Bajos, Nathalie; Migliani, René; Marimoutou, Catherine; Le Strat, Yann; Meynard, Jean Baptiste; Moreau, Caroline

2018-06-18

Sexual health in the military comprises a range of concerns including sexually transmitted infections (STI), unintended pregnancy, sexual violence and sexual dysfunction. This study aims to estimate the prevalence of sexual health concerns by gender in the French military and compare these prevalences to estimates in the general population. COSEMIL, the first sexual health survey in the French military comprises a probability sample of 1500 military personnel. Chi-square tests were used to compare lifetime abortion, STIs and sexual assault, and recent sexual dysfunction and sexual satisfaction by gender and explore the association between these indicators and current sexual risk (condom use at last intercourse). Women were more likely than men to declare negative sexual health outcomes, with the greatest difference related to sexual assault (24.3% versus 5.1% of males, p < 0.001) and sexual dysfunction hindering sexuality (15.2% of females versus 5.3% of males, p < 0.001). Women were also twice as likely to report ever having an STI (6.7% versus 3.4%, p = 0.03). Comparison with the French general population indicates lower percentages of STIs among military men (2.9% versus 4.9%) and higher percentages of abortion (17.6% versus 14.3%) forced sex (10.6% versus 7.4%) and sexual dysfunction (14.2% versus 9.3%) among military women. These results highlight gendered pattern of sexual health in the French military with women suffering greater sexual risks than men. Military health services should include women's health services to address the sexual and reproductive health gender gap.

Enhanced Multi-Service Markets: An Evolution in Military Health System Governance.

PubMed

Hudak, Ronald P; Russell, Rebecca; Toland, P Paul

2018-02-06

The evolution of governance models for the Military Health System's (MHS) large hospitals, called medical treatment facilities (MTFs), has culminated with the effort to implement Enhanced Multi-Service Markets (eMSM). The term eMSM refers to two separate concepts. First, MSM refers to those geographic areas, that is, markets, which have the following characteristics: they have MTFs that are operated by two or more Department of Defense (DoD) Services, that is, Army, Navy, or Air Force; there is a large beneficiary population; there is a substantial amount of direct care (i.e., beneficiaries are treated at MTFs instead of TRICARE's purchased care from civilian providers); and there is a substantial readiness and training platform. Second, the term "enhanced" refers to an increase in management authority over clinical and business operations, readiness, and MTF workload. A retrospective review was conducted to study the evolution of military and civilian health care delivery models for the purpose of understanding how governance models have changed since the 1980s to design and manage MTFs with overlapping catchments areas. Primary and secondary data sources were analyzed through a comprehensive literature review. Since the 1980s, the MHS governance models have evolved from testing various managed care models to a regionally focused TRICARE model and culminating with an overlapping catchment area model entitled eMSMs. The eMSM model partially fulfills the original vision because the eMSM leaders have limited budgetary and resource allocation authority. The various models sought to improve governance of overlapping catchment areas with the intent to enhance medical readiness, community health, and individual health care while reducing costs. However, the success of the current model, that is, eMSMs, cannot be fully assessed because the eMSM model was not fully implemented as originally envisioned. Instead, the current eMSM model partially implements the eMSM model. As

Prior Military Service, Identity Stigma, and Mental Health Among Transgender Older Adults

PubMed Central

Hoy-Ellis, Charles P.; Shiu, Chengshi; Sullivan, Kathleen M.; Kim, Hyun-Jun; Sturges, Allison M.; Fredriksen-Goldsen, Karen I.

2017-01-01

Purpose of the Study: Converging evidence from large community-based samples, Internet studies, and Veterans Health Administration data suggest that transgender adults have high rates of U.S. military service. However, little is known about the role of prior military service in their mental health later in life, particularly in relation to identity stigma. In this article, we examine relationships between prior military service, identity stigma, and mental health among transgender older adults. Design and Methods: We used a subsample of transgender older adults (n = 183) from the 2014 survey of Aging with Pride: National Health, Aging, and Sexuality/Gender Study (NHAS). We employed weighted multivariate linear models to evaluate the relationships between psychological health-related quality of life (HRQOL), depressive symptomatology (Center for Epidemiological Studies Depression Scale [CES-D] scores), identity stigma, and prior military service, controlling for background characteristics. Results: Identity stigma was significantly related with higher depressive symptomatology and lower psychological HRQOL. Having a history of prior military service significantly predicted lower depressive symptomatology and higher psychological HRQOL. The relationships between psychological HRQOL, identity stigma, and prior military service were largely explained by depressive symptomatology. Prior military service significantly attenuated the relationship between identity stigma and depressive symptomatology. Implications: By identifying the role of military service in the mental health of transgender older adults, this study provides insights into how prior military service may contribute to resilience and positive mental health outcomes. Directions for future research are discussed. PMID:28087796

Benzodiazepine Use Among Low Back Pain Patients Concurrently Prescribed Opioids in the Military Health System Between 2012 and 2013

DTIC Science & Technology

2017-06-16

Prescribed Opioids in the Militarv Health System Between 2010 or 2013 presented at/published to San Antonio Militan1 Health Svstem and Universities...NO 1 D. 13 THIS M/\\TERlhL Slf5JECT TC> AN’f LEGAL REBTRICTIONB FOR PVSLICA TIO.N OR PRESENTATION THROUGH /\\ CCUA5𔃺AATl’JE RESEAACH .A.ND DEV...CUil:RENITL Y IN UBE CAN BE VS-ED BENZODIAZEPINE USE AMONG LOW BACK PAIN PATIENTS CONCURRENn Y PRESCRJBED OPIOIDS IN THE MILITARY HEAL TH SYSTEM BETWEEN

Satellite power system (SPS) military implications

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bain, C.N.

1978-10-01

This study was conducted to examine military implications of the NASA Reference SPS and to identify important military related study tasks that could be completed during fiscal year 1979. Primary areas of investigation were the potential of the SPS as a weapon, for supporting U.S. military preparedness and for affecting international relations. In addition, the SPS's relative vulnerability to overt military action, terrorist attacks, and sabotage was considered. The SPS could act as an electronic warfare weapon and, with modification, as a marginally effective energy-beaming weapon. The system could support military preparedness by providing energy for a strong and stablemore » U.S. economy and by providing a powered platform for military systems, system segments, and operations. The SPS would be vulnerable to military action, terrorism and sabotage unless hardened against these attacks by design, security, and a self-defense system. Tasks identified for completion in fiscal year 1979 include (a) a detailed vulnerability study, (b) evaluation of an SPS self-defense system concept, (c) determination of the effect of SPS flexibility to deliver different sized electrical loads on the ability to gain SPS support from individual nations, and (d) investigation of the effect of SPS deployment schedule on obtaining needed agreements, providing security, and controlling risks of armed conflict. A fifth and long-term task would consist of a worldwide survey identifiying military implications of the SPS that result from the specific requirements of potential SPS power customers.« less

Health, SES, and the Timing of Education among Military Retirees

ERIC Educational Resources Information Center

Edwards, Ryan D.

2016-01-01

The timing of education across the life cycle is differentially associated with older age health outcomes and socioeconomic status among military retirees, a subpopulation with common levels of adolescent health, but variation in educational timing. A year of education obtained before military service lowers the probability of poor health in…

Food and housing insecurity and health status among U.S. adults with and without prior military service.

PubMed

Schure, Marc B; Katon, Jodie G; Wong, Edwin; Liu, Chuan-Fen

2016-12-01

Food and housing insecurity may contribute to poorer mental and physical health. It is unclear as to whether those with prior military service, compared to those without, are more vulnerable to these current stressors. The objective of this study was to use U.S. population-based data to determine whether prior military service moderates the association of food and housing insecurity with poor mental and physical health. We analyzed data from nine states administering the Social Context module from the 2011 and 2012 Behavioral Risk Factor Surveillance System. Multivariable logistic regression was used to examine the associations of housing and food insecurity with poor mental and physical health and potential modification by military service. Compared with those with a history of military service, those without had higher prevalence of food insecurity (23.1% versus 13.7%) and housing insecurity (36.0% versus 22.5%). Food insecurity was associated with poor mental and physical health (mental health: odds ratio (OR)=3.47, 95% confidence interval (CI)=[3.18-3.77]; physical health: OR=3.21, 95% CI=[2.92-3.53]). Similar associations were observed between housing insecurity and poor mental and physical health. Prior military service was significantly associated with poor physical health. Interaction terms of prior military service with food and housing were not statistically significant. Food and housing insecurity does not appear to differentially impact mental and physical health among those with and without military service.

Spouse Psychological Well-Being: A Keystone to Military Family Health

PubMed Central

Green, Sara; Nurius, Paula S.; Lester, Patricia

2013-01-01

Understanding predictors of military spouse psychosocial vulnerability informs efforts to assess, identify, and support at-risk spouses and families. In this analysis we test the effects of family stress and strain on military spouse psychological health, using a sample of female civilian spouses (n=161). Regression findings confirm expectations of the significant contribution of family stressors, strain, and resources in explaining variation in spouses' psychological health, controlling for deployment and socioeconomic factors. Identifying the effects of family stress on military spouse psychological health supports the need for family-centered interventions and prevention programs. PMID:24415897

Prior Military Service, Identity Stigma, and Mental Health Among Transgender Older Adults.

PubMed

Hoy-Ellis, Charles P; Shiu, Chengshi; Sullivan, Kathleen M; Kim, Hyun-Jun; Sturges, Allison M; Fredriksen-Goldsen, Karen I

2017-02-01

Converging evidence from large community-based samples, Internet studies, and Veterans Health Administration data suggest that transgender adults have high rates of U.S. military service. However, little is known about the role of prior military service in their mental health later in life, particularly in relation to identity stigma. In this article, we examine relationships between prior military service, identity stigma, and mental health among transgender older adults. We used a subsample of transgender older adults (n = 183) from the 2014 survey of Aging with Pride: National Health, Aging, and Sexuality/Gender Study (NHAS). We employed weighted multivariate linear models to evaluate the relationships between psychological health-related quality of life (HRQOL), depressive symptomatology (Center for Epidemiological Studies Depression Scale [CES-D] scores), identity stigma, and prior military service, controlling for background characteristics. Identity stigma was significantly related with higher depressive symptomatology and lower psychological HRQOL. Having a history of prior military service significantly predicted lower depressive symptomatology and higher psychological HRQOL. The relationships between psychological HRQOL, identity stigma, and prior military service were largely explained by depressive symptomatology. Prior military service significantly attenuated the relationship between identity stigma and depressive symptomatology. By identifying the role of military service in the mental health of transgender older adults, this study provides insights into how prior military service may contribute to resilience and positive mental health outcomes. Directions for future research are discussed. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Changing Families in a Changing Military System.

ERIC Educational Resources Information Center

Hunter, Edna J., Ed.

Recently, the military system has begun to feel the impact of the military family. Whenever sudden dramatic changes or transitions occur, crises may result either for the individual or for the institution. At present both the military system and the military family are in a period of rapid transition. Perhaps one of the most important changes that…

Finding a balance: health promotion challenges of military women.

PubMed

Agazio, Janice Griffin; Buckley, Kathleen M

2010-09-01

In this study, we explored what may determine, or predict, United States military women's health promotion behaviors. Using a descriptive correlational design grounded in Pender's Health Promotion model, 491 military women completed instruments measuring their demographic variables, perception of health, definition of health, self-efficacy, and interpersonal influences to determine the significant factors affecting participation in health promotion activities. The outcome indicated that self-efficacy and interpersonal influences were the most influential in determining health promotion. This research illuminates some of the challenges working women face in meeting health promotion activities and how best to support their ability to participate in healthy behaviors.

Costs for Breast Cancer Care in the Military Health System: An Analysis by Benefit Type and Care Source.

PubMed

Eaglehouse, Yvonne L; Manjelievskaia, Janna; Shao, Stephanie; Brown, Derek; Hofmann, Keith; Richard, Patrick; Shriver, Craig D; Zhu, Kangmin

2018-04-11

Breast cancer care imposes a significant financial burden to U.S. healthcare systems. Health services factors, such as insurance benefit type and care source, may impact costs to the health system. Beneficiaries in the U.S. Military Health System (MHS) have universal healthcare coverage and access to a network of military facilities (direct care) and private practices (purchased care). This study aims to quantify and compare breast cancer care costs to the MHS by insurance benefit type and care source. We conducted a retrospective analysis of data linked between the MHS data repository administrative claims and central cancer registry databases. The institutional review boards of the Walter Reed National Military Medical Center, the Defense Health Agency, and the National Institutes of Health Office of Human Subjects Research reviewed and approved the data linkage. We used the linked data to identify records for women aged 40-64 yr who were diagnosed with breast cancer between 2003 and 2007 and to extract information on insurance benefit type, care source, and cost to the MHS for breast cancer treatment. We estimated per capita costs for breast cancer care by benefit type and care source in 2008 USD using generalized linear models, adjusted for demographic, pathologic, and treatment characteristics. The average per capita (n = 2,666) total cost for breast cancer care was $66,300 [standard error (SE) $9,200] over 3.31 (1.48) years of follow-up. Total costs were similar between benefit types, but varied by care source. The average per capita cost was $34,500 ($3,000) for direct care (n = 924), $96,800 ($4,800) for purchased care (n = 622), and $60,700 ($3,900) for both care sources (n = 1,120), respectively. Care source differences remained by tumor stage and for chemotherapy, radiation, and hormone therapy treatment types. Per capita costs to the MHS for breast cancer care were similar by benefit type and lower for direct care compared with purchased care. Further

A comparison of obesity prevalence: military health system and United States populations, 2009-2012.

PubMed

Eilerman, Patricia A; Herzog, Catherine M; Luce, Beverly K; Chao, Susan Y; Walker, Sandra M; Zarzabal, Lee A; Carnahan, David H

2014-05-01

Overweight and obesity prevalence has increased over the past 30 years. Few studies have looked at the enrolled Military Health System (MHS) population (2.2 million per year). This descriptive study examined trends in overweight and obesity in both children and adults from fiscal years 2009 to 2012 and compared them to the U.S. population. Prevalence in MHS children decreased over time for overweight (14.2-13.8%) and obesity (11.7-10.9%). Active duty adults showed an increase in overweight prevalence (52.7-53.4%) and a decrease in obesity prevalence (18.9-18.3%). For nonactive duty, both overweight and obesity prevalence remained relatively unchanged around 33%. For both children and adults, overweight and obesity prevalence increased with age, except for obesity in the nonactive duty ≥ 65 subgroup. When compared to the United States by gender and age, MHS children generally had a lower overweight and obesity prevalence, active duty adults had higher overweight and lower obesity prevalence, and nonactive duty adults had comparable overweight and obesity prevalence, except for obesity in both men in the 40 to 59 subgroup and women in ≥ 60 subgroup. More research on the MHS population is needed to identify risk factors and modifiable health behaviors that could defeat the disease of obesity. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

A Review of Military Health Research Using a Social-Ecological Framework.

PubMed

Lubens, Pauline; Bruckner, Tim A

2018-05-01

We aim to contextualize the growing body of research on the sequelae of military service in the wars in Afghanistan and Iraq. We employ a social-ecological (SE) framework for the taxonomy of military health research and classify risk as arising from the individual, family, community, and the institutional levels. We intend for this review to inform enhanced health promotion efforts in military communities. Articles reviewed were extracted from Web of Science, PubMed, and Scopus. Research focused on somatic and psychological sequelae of combat deployment published from 2001-the year the war in Afghanistan began-through the end of 2014. We excluded studies of non-US military personnel, other systematic reviews, meta-analyses, book chapters, and theoretical papers. We examined and summarized the aims, participants, methods, study design, SE framework tier, risk factors, and health outcomes. Studies were categorized according to SE tier, whether they focused on somatic, behavioral, or psychological outcomes, and by risk factor. Of the 352 peer-reviewed papers, 84% focused on war's sequelae on the index military personnel, and 75% focused on mental or behavioral health outcomes-mostly on post-traumatic stress disorder. We find comparatively little research focusing on the family, community, or institutional tiers. We know relatively little about how family and community respond to the return of personnel from combat deployment; how family resources affect the health of returning military personnel; and how a war's persistence presents challenges for federal, state, and local agencies to meet military health-care needs. Such work is especially salient as US troops return home from war-particularly in communities where there are substantial military populations.

Creating and sustaining a military women's Health Research Interest Group.

PubMed

Wilson, Candy; Trego, Lori; Rychnovsky, Jacqueline; Steele, Nancy; Foradori, Megan

2015-01-01

In 2008, four doctorate military nurse scientists representing the triservices (Army, Navy, and Air Force) identified a common interest in the health and care of all women in the armed forces. For 7 years, the team's shared vision to improve servicewomen's health inspired them to commit to a rigorous schedule of planning, developing, and implementing an innovative program that has the capability of advancing scientific knowledge and influencing health policy and practice through research. The ultimate goal of the Military Women's Health Research Interest Group (MWHRIG) is to support military clinicians and leaders in making evidence-based practice and policy decisions. They developed a 4-pronged approach to cultivate the science of military women's healthcare: evaluate the existing evidence, develop a research agenda that addresses gaps in knowledge, facilitate the collaboration of multidisciplinary research, and build the bench of future researchers. The MWHRIG has been a resource to key leaders; its value has been validated by multiservice and multidisciplinary consultations. However, the journey to goal attainment has only been achieved by the enduring commitment of these MWHRIG leaders and their passion to ensure the health and wellbeing of the many women who serve in the United States military. This article describes their journey of dedication.

Satellite Power System (SPS) military implications

NASA Technical Reports Server (NTRS)

Bain, C. N.

1978-01-01

The military implications of the reference satellite power system (SPS) were examined is well as important military related study tasks. Primary areas of investigation were the potential of the SPS as a weapon, for supporting U.S. military preparedness, and for affecting international relations. In addition, the SPS's relative vulnerability to overt military action, terrorist attacks, and sabotage was considered.

Cost associated with being overweight and with obesity, high alcohol consumption, and tobacco use within the military health system's TRICARE prime-enrolled population.

PubMed

Dall, Timothy M; Zhang, Yiduo; Chen, Yaozhu J; Wagner, Rachel C Askarinam; Hogan, Paul F; Fagan, Nancy K; Olaiya, Samuel T; Tornberg, David N

2007-01-01

To estimate medical and indirect costs to the Department of Defense (DoD) that are associated with tobacco use, being overweight or obese, and high alcohol consumption. Retrospective, quantitative research. Healthcare provided in military treatment facilities and by providers participating in the military health system. The 4.3 million beneficiaries under age 65 years who were enrolled in the military TRICARE Prime health plan option in 2006. The findings come from a cost-of-disease model developed by combining information from DoD and civilian health surveys and studies; DoD healthcare encounter data for 4.1 million beneficiaries; and epidemiology literature on the increased risk of comorbidities from unhealthy behaviors. DoD spends an estimated $2.1 billion per year for medical care associated with tobacco use ($564 million), excess weight and obesity ($1.1 billion), and high alcohol consumption ($425 million). DoD incurs nonmedical costs related to tobacco use, excess weight and obesity, and high alcohol consumption in excess of $965 million per year. Unhealthy lifestyles are significant contributors to the cost of providing healthcare services to the nation's military personnel, military retirees, and their dependents. The continued rise in healthcare costs could impact other DoD programs and could potentially affect areas related to military capability and readiness. In 2006, DoD initiated Healthy Choices for Life initiatives to address the high cost of unhealthy lifestyles and behaviors, and the DoD continues to monitor lifestyle trends through the DoD Lifestyle Assessment Program.

Analysis of Factors Influencing Inpatient and Outpatient Satisfaction with the Chinese Military Health Service.

PubMed

Lv, Yipeng; Xue, Chen; Ge, Yang; Ye, Feng; Liu, Xu; Liu, Yuan; Zhang, Lulu

2016-01-01

Relatively few articles have focused on exploring factors influencing soldiers' overall satisfaction and differences between inpatients' and outpatients' satisfaction, particularly in the Chinese army. Elucidating factors influencing military inpatient and outpatient care separately and analyzing their differences may provide more information for the health system. The Revised China National Health Service Survey questionnaire was used in the survey. The questionnaire included 5 sections and 32 items concerning demographic, inpatient, and outpatient characteristics and perception variables for both inpatients and outpatients. Bivariate and multivariate techniques were used to reveal relationships between satisfaction and the variables assessed. Outpatients' and inpatients' overall satisfaction rates were 19.0% and 18.5%, respectively. The strongest determinant of outpatients' satisfaction was satisfaction with doctor's communication regarding therapeutic regimen followed by length of military service, level of trust in medical staff, and disease severity. Determinants of inpatients' satisfaction included staff categories, satisfaction with environment, and satisfaction with medical quality. The factors influencing military outpatients' satisfaction differed from those of inpatients. Exploring the causes of satisfaction and dissatisfaction with military health institutions is important in their fulfillment of their responsibility to maintain soldiers' health.

[Delivery of health care for military veterans abroad. The USA and Great Britain models].

PubMed

Bolekhan, V N; Ivanov, V V; Ivchenko, E V; Krassiĭ, A B; Morovikova, T V; Nagibovich, O A; Rezvantsev, M V

2013-03-01

The present review is dedicated to organization and management of military veteran's health care system of the US and UK. It is shown that despite the differences in health care systems of both countries their veterans receive the stat-of-the-art medical service which is readily available and financially affordable.

Military Experience Directed into Health Careers. Final Report.

ERIC Educational Resources Information Center

Health Research and Educational Fund of New Jersey, Princeton, NJ.

Operation MEDIHC's (Military Experience Directed into Health Careers) final report is presented which firmly establishes the need for its purpose, which is providing a meaningful career continuation for medical personnel who were trained while serving in the military service. It is reported that the New Jersey MEDIHC Program experienced a…

Deployment, Mental Health Problems, Suicidality, and Use of Mental Health Services Among Military Personnel.

PubMed

Chu, Carol; Stanley, Ian H; Hom, Melanie A; Lim, Ingrid C; Joiner, Thomas E

2016-01-01

Following deployment, soldiers may struggle to cope with the after-effects of combat service and experience increased suicidality. Therefore, connection to mental health services is vital. Research regarding the relationship between deployment, suicidality, and mental health connections has been equivocal, with some studies finding a link between deployment history and mental health outcomes, and others not. The purpose of this study was to examine the effects of military deployment on mental health and service utilization outcomes using a longitudinal design. Deployment history, mental health visits, symptoms of suicidality, and various mental health outcomes were assessed in a sample of 1,566 Army recruiters at study entry and 18-months follow-up. Deployment history was positively associated with mental health visits, number of major depressive episodes, and acquired capability for suicide at baseline; however, no significant relationship between deployment, mental health visits, and any other suicide or mental health-related outcomes emerged at baseline or follow-up. Findings suggest a disconnection from mental health services among military personnel. Implications for treatment and suicide prevention efforts among military personnel are discussed.

Studying Military Community Health, Well-being, and Discourse through the Social Media Lens

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pavalanathan, Umashanthi; Datla, Vivek V.; Volkova, Svitlana

Social media can provide a resource for characterizing communities and targeted populations through activities and content shared online. For instance, studying the armed forces‚Äô use of social media may provide insights into their health and wellbeing. In this paper, we address three broad research questions: (1) How do military populations use social media? (2) What topics do military users discuss in social media? (3) Do military users talk about health and well-being differently than civilians? Military Twitter users were identified through keywords in the profile description of users who posted geotagged tweets at military installations. These military tweets were comparedmore » with the tweets from remaining population. Our analysis indicate that military users talk more about military related responsibilities and events, whereas non-military users talk more about school, work, and leisure activities. A significant difference in online content generated by both populations was identified, involving sentiment, health, language, and social media features.« less

A national assessment of children with special health care needs: prevalence of special needs and use of health care services among children in the military health system.

PubMed

Williams, Thomas V; Schone, Eric M; Archibald, Nancy D; Thompson, Joseph W

2004-08-01

Children are frequently perceived to be healthy, low-risk individuals with a majority of clinical services devoted to health maintenance and preventive clinical services. However, a subset of children have unique needs that require specialized care to achieve optimal health outcomes. The purpose of this research was to use survey tools that have been developed to identify children with special health care needs (CSHCN) to measure prevalence and resource needs of these children in the military health system (MHS). The US Department of Defense manages the MHS, which is one of the largest integrated health care systems in the world and provides care to almost 2,000000 children. We incorporated the CSHCN survey screener and assessment questions into the annual health care survey of beneficiaries who are eligible for benefits within the MHS. In addition, we used claims information available from inpatient and outpatient services. We used parent reports from the survey to estimate the prevalence of CSHCN. Incorporating claims data and restricting our analyses to those who were enrolled continuously in a military health maintenance organization (TRICARE Prime), we described utilization of different types of health care resources and compared CSHCN with their healthy counterparts. Finally, we examined alternative types of special needs and performed regression analyses to identify the major determinants of health needs and resource utilization to guide system management and policy development. CSHCN compose 23% of the TRICARE Prime enrollees who are younger than 18 years and whose parents responded to the survey. The needs of a majority of these children consist of prescription medications and services targeting medical, mental health, and educational needs. CSHCN experience 5 times as many admissions and 10 times as many days in hospitals compared with children without special needs. CSHCN are responsible for nearly half of outpatient visits for enrolled children and more

Integrative Health and Healing as the New Health Care Paradigm for the Military

PubMed Central

2015-01-01

Abstract Background: The field of integrative health and healing (IH2) is emerging out of the dark recesses of “voodoo” stereotypes and into the light as a new and much needed health care paradigm. It is a philosophy of health and healing that seeks to place patients as the preeminent players in health management, disease prevention, and injury recovery. There is an emphasis of patient responsibility, which includes a holistic approach that merges allopathic with complementary medicine. Objective: The aim of this article is to explore the historical origins of integrative medicine and investigate the future role of the IH2 paradigm. Methods: This article reviews current available data and information regarding complementary and alternative medicine utilized in civilian and military populations as the basis for a new paradigm for a system of care—a system that empowers patients. Conclusions: The current U.S. health care system is reactive and disease-based, with a focus on reductionism. This system is not serving us well. IH2 is a new model of cost-effective patient-centered health care. PMID:26543516

Chiropractic practice in military and veterans health care: The state of the literature

PubMed Central

Green, Bart N.; Johnson, Claire D.; Lisi, Anthony J.; Tucker, John

2009-01-01

Objective To summarize scholarly literature that describes practice, utilization, and/or policy of chiropractic services within international active duty and/or veteran health care environments. Data Sources PubMed, the Cumulative Index to Nursing and Allied Health Literature, and the Index to Chiropractic Literature were searched from their starting dates through June 2009. Review Methods All authors independently reviewed each of the articles to verify that each met the inclusion criteria. Citations of included papers and other pertinent findings were logged in a summary table. Results Thirteen articles were included in this study. Integration of chiropractic care into military or veteran health care systems has been described in 3 systems: the United States Department of Defense, the United States Department of Veterans Affairs, and the Canadian Forces. Conclusion Chiropractic services seem to be included successfully within military and veteran health care facilities. However, there is a great need for additional written evaluation of the processes, policies, practices, and effectiveness of chiropractic services in these environments. PMID:19714234

[Marketing in the system of military-medical facilities].

PubMed

Kostiuchenko, O M; Sviridova, T B

2014-02-01

Military medical facilities of the Ministry of Defence of the Russian, have received the right to provide additional services and have been involved in the sphere of market relations. The strong influence of market relations - an objective reality that must be used for the development of military medical institutions and improving quality of care.Effective commercial activity can improve capabilities of the military medical institutions. This requires constant study of market mechanisms to implement and develop their competitive advantage. The paper substantiates the need for the participation of military medical institutions in the provision of health services to the public on the terms of compensation incurred by financial institutions costs (paid medical services, medical assistance program of compulsory and voluntary health insurance). Taking into account the specifics of military medical institutions set out basic principles and recommendations have been implementing marketing approach in their management, the practical application of which will not only increase efficiency, but also create conditions to improve the financial and economic indicators. This knowledge will help the mechanism of functioning health care market and the rules of interaction of market counterparties.

Developing a military nurse scientist program of research: A military women's health exemplar.

PubMed

Trego, Lori Lyn

Developing a feasible, fundable, and sustainable program of research (POR) is an essential career goal in research. Nurse scientists can lay the foundation for a salient POR as early as during their doctoral studies. The ensuing years of postdoctoral experiences are informative as they expand their research skills and knowledge around their research area of interest. Following graduation from a doctoral research program, novice military nurse scientists (MNS) are placed in positions that are conducive to fostering a POR. Military organizational support and the rich experiences of peers and mentors facilitate early career development of MNS. The purpose of this article is to present a conceptual framework for research career development of the novice MNS. Using an exemplar POR in military women's health, the concepts are operationalized to illustrate how the military environment enhances the development of a successful POR. Copyright © 2017 Elsevier Inc. All rights reserved.

Discourse, Health and Well-being of Military Populations through the Social Media Lens

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pavalanathan, Umashanthi; Datla, Vivek V.; Volkova, Svitlana

Social media can provide a resource for characterizing communities and small populations through activities and content shared online. For instance, studying the language use in social media within military populations may provide insights into their health and wellbeing. In this paper, we address three research questions: (1) How do military populations use social media? (2) What do military users discuss in social media? And (3) Do military users talk about health and well-being differently than civilians? Military Twitter users were identified through keywords in the profile description of users who posted geo-tagged tweets at military installations. The data was anonymizedmore » for the analysis. User profiles that belong to military population were compared to the nonmilitary population. Our results indicate that military users talk more about events in their military life, whereas nonmilitary users talk more about school, work, and leisure activities. We also found that the online content generated by both populations is significantly different, including health-related language and communication behavior.« less

Use of Integrative Medicine in the United States Military Health System

PubMed Central

Vaughan, Megan; Koehlmoos, Tracey Pérez

2017-01-01

Integrative medicine (IM) is a model of care which uses both conventional and nonconventional therapies in a “whole person” approach to achieve optimum mental, physical, emotional, spiritual, and environmental health, and is increasingly popular among patients and providers seeking to relieve chronic or multifactorial conditions. The US Department of Defense (DoD) shows particular interest in and usage of IM for managing chronic conditions including the signature “polytrauma triad” of chronic pain, traumatic brain injury (TBI), and posttraumatic stress disorder (PTSD) among its beneficiaries in the Military Health System (MHS). These modalities range from conventional nondrug, nonsurgical options such as cognitive-behavioral therapy to nonconventional options such as acupuncture, chiropractic, and mind-body techniques. These are of particular interest for their potential to relieve symptoms without relying on opiates, which impair performance and show high potential for abuse while often failing to provide full relief. This review describes the use of IM in the MHS, including definitions of the model, common therapies and potential for use, and controversy surrounding the practice. More research is needed to build a comprehensive usage analysis, which in turn will inform sound clinical and financial practice for the MHS and its beneficiaries. PMID:28690665

Visualizing Patterns of Drug Prescriptions with EventFlow: A Pilot Study of Asthma Medications in the Military Health System

DTIC Science & Technology

2013-06-01

1 Visualizing Patterns of Drug Prescriptions with EventFlow: A Pilot Study of Asthma Medications in the...asthmatics within the Military Health System (MHS). Visualizing the patterns of asthma medication use surrounding a LABA prescription is a quick way to...random sample of 100 asthma patients under age 65 with a new LABA prescription from January 1, 2006-March 1, 2010 in MHS healthcare claims. Analysis was

A service evaluation of self-referral to military mental health teams

PubMed Central

Kennedy, I.; Jones, N.; Sharpley, J.; Greenberg, N.

2016-01-01

Background The UK military runs a comprehensive mental health service ordinarily accessed via primary care referrals. Aims To evaluate the feasibility of self-referral to mental health services within a military environment. Methods Three pilot sites were identified; one from each service (Royal Navy, Army, Air Force). Socio-demographic information included age, rank, service and career duration. Clinical data included prior contact with general practitioner (GP), provisional diagnosis and assessment outcome. Results Of the 57 self-referrals, 69% (n = 39) had not previously accessed primary care for their current difficulties. After their mental health assessment, 47 (82%) were found to have a formal mental health problem and 41 (72%) were offered a further mental health clinician appointment. The data compared favourably with a large military mental health department that reported 87% of primary care referrals had a formal mental health condition. Conclusions The majority of self-referrals had formal mental health conditions for which they had not previously sought help from primary care; most were offered further clinical input. This supports the view that self-referral may be a useful option to encourage military personnel to seek professional care over and above the usual route of accessing care through their GP. PMID:27121634

Postdeployment military mental health training: cross-national evaluations.

PubMed

Foran, Heather M; Garber, Bryan G; Zamorski, Mark A; Wray, Mariane; Mulligan, Kathleen; Greenberg, Neil; Castro, Carl Andrew; Adler, Amy B

2013-05-01

Deployments increase risk for adjustment problems in service members. To mitigate this increased risk, mental health training programs have been developed and implemented in several nations. As part of a coordinated effort, three nations adapted a U.S. mental health training program that had been validated by a series of group randomized trials demonstrating improvement in postdeployment adjustment. Implementation of evidence-based programs in a new context is challenging: How much of the original program needs to remain intact in order to retain its utility? User satisfaction rates can provide essential data to assess how well a program is accepted. This article summarizes service member ratings of postdeployment mental health training and compares ratings from service members across four nations. The participating nations (Canada, New Zealand, United Kingdom, and the United States) administered mental health training to active duty military personnel in their respective nations. Following the training, military personnel completed an evaluation of the training. Overall, across the four nations, more than 70% of military personnel agreed or strongly agreed that they were satisfied with the mental health training. Although some differences in evaluations were observed across nations, components of training that were most important to overall satisfaction with the training were strikingly similar across nations. Fundamentally, it appears feasible that despite cultural and organizational differences, a mental health training program developed in one nation can be successfully adapted for use in other nations. PsycINFO Database Record (c) 2013 APA, all rights reserved.

The Veterans Health Administration and military sexual trauma.

PubMed

Kimerling, Rachel; Gima, Kristian; Smith, Mark W; Street, Amy; Frayne, Susan

2007-12-01

We examined the utility of the Veterans Health Administration (VHA) universal screening program for military sexual violence. We analyzed VHA administrative data for 185,880 women and 4139888 men who were veteran outpatients and were treated in VHA health care settings nationwide during 2003. Screening was completed for 70% of patients. Positive screens were associated with greater odds of virtually all categories of mental health comorbidities, including posttraumatic stress disorder (adjusted odds ratio [AOR]=8.83; 99% confidence interval [CI] = 8.34, 9.35 for women; AOR = 3.00; 99% CI = 2.89, 3.12 for men). Associations with medical comorbidities (e.g., chronic pulmonary disease, liver disease, and for women, weight conditions) were also observed. Significant gender differences emerged. The VHA policies regarding military sexual trauma represent a uniquely comprehensive health care response to sexual trauma. Results attest to the feasibility of universal screening, which yields clinically significant information with particular relevance to mental health and behavioral health treatment. Women's health literature regarding sexual trauma will be particularly important to inform health care services for both male and female veterans.

A service evaluation of self-referral to military mental health teams.

PubMed

Kennedy, I; Whybrow, D; Jones, N; Sharpley, J; Greenberg, N

2016-07-01

The UK military runs a comprehensive mental health service ordinarily accessed via primary care referrals. To evaluate the feasibility of self-referral to mental health services within a military environment. Three pilot sites were identified; one from each service (Royal Navy, Army, Air Force). Socio-demographic information included age, rank, service and career duration. Clinical data included prior contact with general practitioner (GP), provisional diagnosis and assessment outcome. Of the 57 self-referrals, 69% (n = 39) had not previously accessed primary care for their current difficulties. After their mental health assessment, 47 (82%) were found to have a formal mental health problem and 41 (72%) were offered a further mental health clinician appointment. The data compared favourably with a large military mental health department that reported 87% of primary care referrals had a formal mental health condition. The majority of self-referrals had formal mental health conditions for which they had not previously sought help from primary care; most were offered further clinical input. This supports the view that self-referral may be a useful option to encourage military personnel to seek professional care over and above the usual route of accessing care through their GP. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Health-Related Coping Behaviors and Mental Health in Military Personnel.

PubMed

Morgan, Jessica Kelley; Hourani, Laurel; Tueller, Stephen

2017-03-01

Our previous research has highlighted the important link between coping behaviors and mental health symptoms in military personnel. This study seeks to extend these findings by examining each coping behavior and mental health issue individually. This study has four specific aims: (1) test cross-sectional relationships between coping and mental health at baseline and follow-up, (2) examine stability of each variable over time, (3) determine the predictive nature of baseline mental health and coping on subsequent mental health and coping, (4) assess the magnitude of each effect to evaluate the differential predictive value of coping behaviors and mental health symptoms. A convenience sample of U.S. Army platoons of the 82nd Airborne was surveyed. We used a two-wave, cross-lagged autoregression design with structural equation modeling to disentangle elements of temporality and to examine the predictive value of mental health status vis-à-vis coping behaviors and vice versa. Separate analyses were performed with each coping strategy and each set of mental health symptoms. This design allowed for the analysis of two synchronous associations (i.e., cross-sectional correlations between the coping strategy and mental health symptoms at each time point), two autoregressive effects (i.e., baseline mental health predicting mental health at follow-up and baseline coping predicting coping at follow-up), and two cross-lagged effects (i.e., baseline coping strategy predicting mental health at follow-up and baseline mental health predicting follow-up coping). Results of descriptive statistics revealed that the most frequently reported coping behavior was thinking of a plan to solve the problem, followed by talking to a friend, engaging in a hobby, and exercising or playing sports. The least often endorsed coping behaviors were smoking marijuana or using illicit drugs and thinking about hurting or killing oneself, followed by having a drink or lighting up a cigarette. We verified

Pregnancy in the Military: Importance of Psychosocial Health to Birth Outcomes

DTIC Science & Technology

2016-05-11

Pearson et al., 2013). Studies within the military community are limited. Purpose: Describe findings across a program of research dedicated to prenatal maternal psychosocial health to birth outcomes for a military population.

UK military doctors; stigma, mental health and help-seeking: a comparative cohort study.

PubMed

Jones, Norman; Whybrow, D; Coetzee, R

2018-03-09

Studies suggest that medical doctors can suffer from substantial levels of mental ill-health. Little is known about military doctors' mental health and well-being; we therefore assessed attitudes to mental health, self-stigma, psychological distress and help-seeking among UK Armed Forces doctors. Six hundred and seventy-eight military doctors (response rate 59%) completed an anonymous online survey. Comparisons were made with serving and ex-military personnel (n=1448, response rate 84.5%) participating in a mental health-related help-seeking survey. Basic sociodemographic data were gathered, and participants completed measures of mental health-related stigmatisation, perceived barriers to care and the 12-Item General Health Questionnaire. All participants were asked if in the last three years they had experienced stress, emotional, mental health, alcohol, family or relationship problems, and whether they had sought help from formal sources. Military doctors reported fewer mental disorder symptoms than the comparison groups. They endorsed higher levels of stigmatising beliefs, negative attitudes to mental healthcare, desire to self-manage and self-stigmatisation than each of the comparison groups. They were most concerned about potential negative effects of and peer perceptions about receiving a mental disorder diagnosis. Military doctors reporting historical and current relationship, and alcohol or mental health problems were significantly and substantially less likely to seek help than the comparison groups. Although there are a number of study limitations, outcomes suggest that UK military doctors report lower levels of mental disorder symptoms, higher levels of stigmatising beliefs and a lower propensity to seek formal support than other military reference groups. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Self-rated health and health care utilization after military deployments.

PubMed

Trump, David H

2006-07-01

Self-rated general health is one element of the standard health assessment required of U.S. military service members upon completion of major deployments. A cohort study of 22,229 male U.S. Army and Air Force personnel returning from Europe or Southwest Asia in 2000 used survival analysis methods and Cox proportional hazard models to examine postdeployment self-rated health (SRH) status and subsequent hospitalization, separation, and ambulatory care visits. Self-rated health was fair/poor for 1.5% and good for 20.4%; 11% documented at least one health concern. During 30,433 person-years of follow-up (median, 1.5 person-years), there were 22.8 hospitalizations per 1,000 person-years and 4.0 ambulatory care visits per person-years. After adjustment, deployers with fair/poor SRH had an increased risk for hospitalization (hazard ratio [HRI, 1.6; 95% confidence interval [CI], 1.0,2.7); the risk was lower for those with good SRH (HR, 1.3; 95% CI,1.1,1.5). Deployers with fair/poor SRH health had an increased risk for illness-related ambulatory care visits (HR, 1.8, 95%; CI, 1.6,2.1) and administrative visits (HR, 1.4; 95% CI, 1.1,1.7), but not injury-related visits (HR, 1.2; 95% CI, 0.8,1.7). Self-reported low health status and other health concerns identify military members with higher levels of health care needs following return from major deployments.

U.S. military mental health care utilization and attrition prior to the wars in Iraq and Afghanistan.

PubMed

Garvey Wilson, Abigail L; Messer, Stephen C; Hoge, Charles W

2009-06-01

visit in 2000. Data were obtained from the Defense Medical Surveillance System. The total number of individuals who utilized behavioral health services in 2000 was just over 115 per 1,000 person-years, almost 12% of the military population. Out of every 1,000 person-years, 57.5 individuals received care from behavioral health providers involving an ICD-9 290-319 mental disorder diagnosis, and an additional 26.7 per 1,000 person-years received care in behavioral health clinics only for V-code diagnoses. Attrition from service was correlated with both categories of mental health-related diagnoses. After 1 year, approximately 38% of individuals who received a mental disorder diagnosis left the military, compared with 23% of those who received mental health V-code diagnoses and 14% of those who received health care for any other reason (which included well visits for routine physicals). This study establishes baseline rates of pre-war behavioral healthcare utilization among military service members, and the relationship of mental health care use and attrition from service. The research indicates that in the military population the burden of mental illness in outpatient clinics is significantly greater when V-code diagnoses are included along with conventional mental disorder diagnostic codes.

The Veterans Health Administration and Military Sexual Trauma

PubMed Central

Kimerling, Rachel; Gima, Kristian; Smith, Mark W.; Street, Amy; Frayne, Susan

2007-01-01

Objectives. We examined the utility of the Veterans Health Administration (VHA) universal screening program for military sexual violence. Methods. We analyzed VHA administrative data for 185 880 women and 4139888 men who were veteran outpatients and were treated in VHA health care settings nationwide during 2003. Results. Screening was completed for 70% of patients. Positive screens were associated with greater odds of virtually all categories of mental health comorbidities, including posttraumatic stress disorder (adjusted odds ratio [AOR]=8.83; 99% confidence interval [CI] = 8.34, 9.35 for women; AOR = 3.00; 99% CI = 2.89, 3.12 for men). Associations with medical comorbidities (e.g., chronic pulmonary disease, liver disease, and for women, weight conditions) were also observed. Significant gender differences emerged. Conclusions. The VHA policies regarding military sexual trauma represent a uniquely comprehensive health care response to sexual trauma. Results attest to the feasibility of universal screening, which yields clinically significant information with particular relevance to mental health and behavioral health treatment. Women’s health literature regarding sexual trauma will be particularly important to inform health care services for both male and female veterans. PMID:17971558

Future trends in commercial and military systems

NASA Astrophysics Data System (ADS)

Bond, F. E.

Commercial and military satellite communication systems are addressed, with a review of current applications and typical communication characteristics of the space and earth segments. Drivers for the development of future commercial systems include: the pervasion of digital techniques and services, growing orbit and frequency congestion, demand for more entertainment, and the large potential market for commercial 'roof-top' service. For military systems, survivability, improved flexibility, and the need for service to small mobile terminals are the principal factors involved. Technical trends include the use of higher frequency bands, multibeam antennas and a significant increase in the application of onboard processing. Military systems will employ a variety of techniques to counter both physical and electronic threats. The use of redundant transmission paths is a particularly effective approach. Successful implementation requires transmission standards to achieve the required interoperability among the pertinent networks. For both the military and commercial sectors, the trend toward larger numbers of terminals and more complex spacecraft is still persisting.

Satellite Power System (SPS) military applications

NASA Technical Reports Server (NTRS)

Ozeroff, M. J.

1978-01-01

The potential military role, both offensive and defensive, of a Satellite Power System (SPS) is examined. A number of potential military support possibilities are described. An SPS with military capabilities may have a strong negative impact on international relations if it is not internationalized. The SPS satellite would be vulnerable to military action of an enemy with good space capability, but would experience little or no threat from saboteurs or terrorists, except via the ground controls. The paper concludes with an outline of some of the key issues involved, and a number of recommendations for future study, including some areas for long term efforts.

International military operations and mental health--A review.

PubMed

Kaikkonen, Noora M; Laukkala, Tanja

2016-01-01

Volunteering in international military missions has been scrutinized for its effects on mental health. Different kinds of exposures to traumatic events are associated with a variety of mental disorders, mainly heightened rates of post-traumatic stress disorder (PTSD) and alcohol abuse. Based on the literature we discuss risk and protective factors concerning the psychological well-being of soldiers attending to international military operations. A systematic literature search was carried out using relevant search terms to identify the articles for this review. The ability to recognize and treat acute stress reactions during deployments is important. Post-deployment psychosocial support and services have a role in lowering barriers to care, diminishing stigma and also in recognizing individuals who suffer from psychological distress or psychiatric symptoms, to connect them with appropriate care. Further investigation of gender differences and the role of stigmatization is warranted. Most of those participating in international military operations are repatriated without problems, but repeated exposure to combat situations and other stressors may affect mental health in various ways. Stigmatization is still a barrier to care.

Military youth and the deployment cycle: emotional health consequences and recommendations for intervention.

PubMed

Esposito-Smythers, Christianne; Wolff, Jennifer; Lemmon, Keith M; Bodzy, Mary; Swenson, Rebecca R; Spirito, Anthony

2011-08-01

The United States military force includes over 2.2 million volunteer service members. Three out of five service members who are deployed or are preparing for deployment have spouses and/or children. Stressors associated with the deployment cycle can lead to depression, anxiety, and behavior problems in children, as well as psychological distress in the military spouse. Further, the emotional and behavioral health of family members can affect the psychological functioning of the military service member during the deployment and reintegration periods. Despite widespread acknowledgment of the need for emotional and behavioral health services for youth from military families, many professionals in a position to serve them struggle with how to best respond and select appropriate interventions. The purpose of this paper is to provide an empirically based and theoretically informed review to guide service provision and the development of evidence based treatments for military youth in particular. This review includes an overview of stressors associated with the deployment cycle, emotional and behavioral health consequences of deployment on youth and their caretaking parent, and existing preventative and treatment services for youth from military families. It concludes with treatment recommendations for older children and adolescents experiencing emotional and behavioral health symptoms associated with the deployment cycle.

Military Youth and the Deployment Cycle: Emotional Health Consequences and Recommendations for Intervention

PubMed Central

Esposito-Smythers, Christianne; Wolff, Jennifer; Lemmon, Keith M.; Bodzy, Mary; Swenson, Rebecca R.; Spirito, Anthony

2011-01-01

The United States military force includes over 2.2 million volunteer service members. Three out of five service members who are deployed or are preparing for deployment have spouses and/or children. Stressors associated with the deployment cycle can lead to depression, anxiety, and behavior problems in children, as well as psychological distress in the military spouse. Further, the emotional and behavioral health of family members can affect the psychological functioning of the military service member during the deployment and re-integration periods. Despite widespread acknowledgement of the need for emotional and behavioral health services for youth from military families, many professionals in a position to serve them struggle with how to best respond and select appropriate interventions. The purpose of this paper is to provide an empirically-based and theoretically informed review to guide service provision and the development of evidence based treatments for military youth in particular. This review includes an overview of stressors associated with the deployment cycle, emotional and behavioral health consequences of deployment on youth and their caretaking parent, and existing preventative and treatment services for youth from military families. It concludes with treatment recommendations for older children and adolescents experiencing emotional and behavioral health symptoms associated with the deployment cycle. PMID:21707172

School Climate, Deployment, and Mental Health among Students in Military-Connected Schools

ERIC Educational Resources Information Center

De Pedro, Kris Tunac; Astor, Ron Avi; Gilreath, Tamika D.; Benbenishty, Rami; Berkowitz, Ruth

2018-01-01

Research has found that when compared with civilian students, military-connected students in the United States have more negative mental health outcomes, stemming from the stress of military life events (i.e., deployment). To date, studies on military-connected youth have not examined the role of protective factors within the school environment,…

[History of medicine and military health service in doctorate's and habilitation theses written in Military Medicine Academy in Lodz-retrospective bibliography against the background of medicine and military medicine bibliographies].

PubMed

Walczewski, K; Jesman, C; Kocur, J

2000-01-01

The work introduces the subject of medicine history, military health service history and medicine bibliographies with particular attention to Polish accents. It remembers the beginnings of medicine history education in Poland in the 19th century, in the II Polish Republic and after 1945. It discusses widely the achievements of Military Medicine Academy in the range of medicine history military health service together with bibliography. It points out the necessity of dealing with this subject in didactic and scientific activity of the Academy.

Impact of ammunition and military explosives on human health and the environment.

PubMed

Lima, Débora R S; Bezerra, Marcio L S; Neves, Eduardo B; Moreira, Fátima R

2011-01-01

To review the literature concerning the risks associated with the main xenobiotics contained in military ammunition and explosive residues and damage to human and environmental health. Using "ammunition", "military", "environmental", "health", "explosive", "metal", "TNT", "RDX", "pollution", and "contamination" as search terms, a large database, namely ISI Web of Knowledge and PubMed, was searched for studies on military ammunition and explosive residues from 1989 to 2010. Other sources used to conduct the search included the library of the Toxicology Laboratory of the Center for Workers' Health and Human Ecology (CESTEH) at the National School of Public Health. In total, 15 different combinations were used with the search words above and 708 papers were found. Among them, 76 papers concerned this review. More than 12 references of interest were discovered in the library of the CESTEH. The results were organized into metals, dinitrotoluene, trinitrotoluene (TNT), and royal demolition explosive (RDX), showing their main uses, occurrence in the environment, the current toxic effects to human and environmental health, and remediation possibilities. Because military activities can cause the acute and chronic exposure of human beings, the public administration must aim politics towards suitable environmental management.

CDC Screening Recommendation for Baby Boomers and Hepatitis C Virus Testing in the US Military Health System.

PubMed

Manjelievskaia, Janna; Brown, Derek; Shriver, Craig D; Zhu, Kangmin

Chronic hepatitis C virus (HCV) is the most common blood-borne infection in the United States, with an estimated 2.7 to 3.9 million cases as of 2014. In August 2012, the Centers for Disease Control and Prevention (CDC) recommended 1-time HCV testing of all baby boomers. The objectives of this study were to (1) determine the proportion of people screened for HCV in the US Department of Defense Military Health System before and after the CDC screening recommendation for baby boomers and (2) assess whether certain patient or system factors were associated with screening for HCV before and after August 2012. We used a dataset containing 5% of beneficiaries randomly selected from the Military Health System Data Repository medical claims database for the period July 2011 through September 2013. Of 108 223 people eligible for HCV screening during the first period (July 2011 through July 2012), 1812 (1.7%) were screened. Of 109 768 people eligible during the second period (September 2012 through September 2013), 2599 (2.4%) were screened. HCV screening receipt was related to benefit type (Prime before August 2012: adjusted odds ratio [aOR] = 2.16; 95% confidence interval [CI], 1.89-2.46; Prime after August 2012: aOR = 1.93; 95% CI, 1.73-2.16) and care source (direct care before August 2012: aOR = 1.80; 95% CI, 1.57-2.07; direct care after August 2012: aOR = 2.45; 95% CI, 2.18-2.75); male sex (aOR = 1.17; 95% CI, 1.06-1.29) and black race (aOR = 1.20; 95% CI, 1.05-1.37) were associated with HCV testing only before August 2012. Interventions should be implemented to increase awareness and knowledge of the current national HCV testing recommendation among baby boomers to seek out testing and health care providers to perform screening.

Health in the news: an analysis of magazines coverage of health issues in veterans and military service organizations.

PubMed

Jitnarin, Nattinee; Poston, Walker S C; Haddock, Christopher K; Jahnke, Sara

2015-05-01

The purpose of this study was to conduct a content analysis of Veterans and Military Service Organizations (VMSOs) magazines to determine what health-related topics VMSOs target and how they inform their constituencies about health issues. Health-related topics in 288 VMSOs' magazines from 21 VMSOs published in 2011 and 2012 were coded by trained raters using a standardized manual. The top three most addressed health topics were Health Services (Health care, Insurance), Disability and Disability benefits, and post-traumatic stress disorder. Topics least frequently covered were Tobacco and Smoking cessation, Illegal drugs, Alcohol, Gulf War Syndrome, and Weight and Body composition. VMSOs are concerned about the health and well-being of their members given the considerable amount of content devoted to certain health topics such as health insurance concerns, disability, and post-traumatic stress disorder. However, other health concerns that affect a considerable number of both current military personnel and veterans and cost both the Department of Veterans Affairs and the Department of Defense millions annually, such as drug and alcohol problems, and tobacco use and smoking cessation, are infrequently covered. The results of this study improve our understanding of the health-related information that reaches the military and veteran populations through this important media outlet. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Determinants of health-promoting behaviors in military spouses during deployment separation.

PubMed

Padden, Diane L; Connors, Rebecca A; Agazio, Janice G

2011-01-01

The purpose of this research was to describe predictors of participation in health-promoting behaviors among military spouses. A total of 105 female spouses of currently deployed active duty military members were surveyed to determine their perceived stress and participation in the health-promoting behaviors of exercise, diet, checkups, substance use/avoidance, social behaviors, stress management/rest, and safety/environmental behaviors. Demographic and deployment information was also collected. Regression analyses showed perceived stress was predictive of several health behaviors including exercise, social behaviors, stress management/rest, and safety/environmental behaviors. Increased perceived stress was associated with decreased participation in these behaviors. Deployment factors predicted only dietary behaviors and stress management/rest. As the minimum anticipated length of the deployment increased, healthy dietary behavior decreased. Likewise, as the number of deployments experienced increased, stress management and rest decreased. Stress brought on by military deployment may have detrimental effects upon participation in a health-promoting lifestyle.

Influence of childhood adversity on health among male UK military personnel.

PubMed

Iversen, Amy C; Fear, Nicola T; Simonoff, Emily; Hull, Lisa; Horn, Oded; Greenberg, Neil; Hotopf, Matthew; Rona, Roberto; Wessely, Simon

2007-12-01

Exposure to childhood adversity may explain why only a minority of combatants exposed to trauma develop psychological problems. To examine the association between self-reported childhood vulnerability and later health outcomes in a large randomly selected male military cohort. Data are derived from the first stage of a cohort study comparing Iraq veterans and non-deployed UK military personnel. We describe data collected by questionnaire from males in the regular UK armed forces (n=7937). Pre-enlistment vulnerability is associated with being single, of lower rank, having low educational attainment and serving in the Army. Pre-enlistment vulnerability is associated with a variety of negative health outcomes. Two main factors emerge as important predictors of ill health: a 'family relationships' factor reflecting the home environment and an 'externalising behaviour' factor reflecting behavioural disturbance. Pre-enlistment vulnerability is an important individual risk factor for ill health in military men. Awareness of such factors is important in understanding post-combat psychiatric disorder.

The Deployment Health Surveillance Program: vision and challenges of health surveillance for Australian military cohorts.

PubMed

Barton, Christopher A; Dobson, Annette; Treloar, Susan A; McClintock, Christine; McFarlane, Alexander C

2008-12-01

The Australian Government has supported the establishment of a Deployment Health Surveillance Program for the Australian Defence Force. Although some health screening mechanisms already exist for Australian Defence Force personnel, until now health data have been used largely for clinical management at an individual level and have not been aggregated to identify trends in health and risk factors in the shorter or longer term. We identify challenges for and potential benefits of health surveillance in the military context, describe features of the Program and progress to date. Retrospective and cross-sectional projects based on deployments to the Near North Area of Influence since 1997 are under way. A planned prospective model of health surveillance for those deploying to the Middle East promises more timely attention to any emerging health problems for military personnel and veterans.

Mental Health and Turnover Following an Initial Term of Military Service

DTIC Science & Technology

2012-07-01

enlistments reached such levels that the Marine Corps was forced to significantly increase its selective re-enlistment bonuses .’^ These findings indicate a...Their Consequences and Services to Assist Recov- ery. Santa Monica, CA, RAND Corporation, Center for Military Health Policy Research, 2008. 4. Carbone ...Assess 1999; 72: 256-65. 5. Cigrang JA, Carbone EG, Todd S, Fielder E: Mental health attrition from Air Force basic military training. Mil Med 1999; 163

Mental Health Among Military Personnel and Veterans.

PubMed

Pickett, Treven; Rothman, David; Crawford, Eric F; Brancu, Mira; Fairbank, John A; Kudler, Harold S

2015-01-01

This commentary describes the prevalence of mental health problems affecting military service members and veterans in North Carolina and the rest of the nation, with a special emphasis on those who served in the recent wars in Iraq and Afghanistan. Approximately 1.9 million of these veterans have become eligible for Veterans Affairs health care since 2002, and an estimated 1.16 million veterans have registered for this care.

A Proposed Conceptual Model of Military Medical Readiness

DTIC Science & Technology

2007-05-01

critical role in complex military operations in which Medical Readiness 22 technological and information demands necessitate a multi-operator environment...Analysis 33 Coding 34 Data Collection 35 Medical Readiness 6 Boundaries 36 Researcher’s Role and Approach 37 Literature Review 37 The Military Health...Within the external environment, strategic shifts, technological advancements, and changing demographics affect how the Military Health System delivers

Annual Surveillance Summary: Methicillin-Resistant Staphylococcus aureus (MRSA) Infections in the Military Health System (MHS), 2015

DTIC Science & Technology

2017-03-01

Center (DMDC) rosters to determine burden among Department of Defense (DOD) active duty (AD) service members, and the DMDC Contingency Tracking System...populations with intense physical activity and skin-to-skin contact, such as military recruits, prison inmates, and athletic teams. 16 The CDC has...occasionally occurred among military trainees. 32 Although rates of HA MRSA infection among active duty (AD) personnel have declined in recent

Psychological morbidity, quality of life, and self-rated health in the military personnel

PubMed Central

Chou, Han-Wei; Tzeng, Wen-Chii; Chou, Yu-Ching; Yeh, Hui-Wen; Chang, Hsin-An; Kao, Yu-Cheng; Tzeng, Nian-Sheng

2014-01-01

Objective The mental health of military personnel varies as a result of different cultural, political, and administrative factors. The purpose of this study was to evaluate the psychological morbidity and quality of life of military personnel in Taiwan. Materials and methods This cross-sectional study utilized the World Health Organization Quality of Life Instrument, brief version, Taiwan version, the General Health Questionnaire-12, Chinese version, and the Visual Analog Scale (VAS) in several military units. Results More than half of the subjects (55.3%) identified themselves as mentally unhealthy on the General Health Questionnaire-12, Chinese version; however, a higher percentage of officers perceived themselves as healthy (57.4%) than did noncommissioned officers (38.5%) or enlisted men (42.2%). Officers also had higher total quality of life (QOL) scores (83.98) than did enlisted men (79.67). Scores on the VAS also varied: officers: 72.5; noncommissioned officers: 67.7; and enlisted men: 66.3. The VAS and QOL were positively correlated with perceived mental health among these military personnel. Conclusion Our subjects had higher rates of perceiving themselves as mentally unhealthy compared to the general population. Those of higher rank perceived themselves as having better mental health and QOL. Improving mental health could result in a better QOL in the military. The VAS may be a useful tool for the rapid screening of self-reported mental health, which may be suitable in cases of stressful missions, such as in disaster rescue; however, more studies are needed to determine the optimal cut-off point of this measurement tool. PMID:24570587

Unit cohesion, traumatic exposure and mental health of military personnel.

PubMed

Kanesarajah, J; Waller, M; Zheng, W Y; Dobson, A J

2016-06-01

The benefit of military unit cohesion to morale and psychological resilience is well established. But it remains unclear whether unit cohesion modifies the association between deployment-related traumatic exposure and mental health problems. To examine the association between unit cohesion, traumatic exposure and poor mental health [symptoms of post-traumatic stress disorder (PTSD), psychological distress and alcohol dependency] and assess whether the relationship between traumatic exposure and poor mental health differs by level of unit cohesion. A self-reported cross-sectional survey of Australian military personnel deployed to Iraq or Afghanistan between 2001 and 2009. Among 11411 participants, those with low levels of unit cohesion had higher odds of PTSD symptoms [aOR (95% CI): 2.54 (1.88, 3.42)], very high psychological distress [aOR (95% CI): 4.28 (3.04, 6.02)] and a high level of alcohol problems [aOR (95% CI): 1.71 (1.32, 2.22)] compared with those reporting high unit cohesion on deployment. Higher exposure to traumatic events on deployment was associated with greater risk of PTSD symptoms, very high levels of psychological distress and high levels of alcohol problems in this cohort. However, there was no evidence of a statistically significant interaction between unit cohesion and traumatic exposures in influencing poor mental health. Our findings suggest that both unit cohesion and traumatic exposure are independently associated with poor mental health. Efforts to improve military unit cohesion may help to improve the mental health resilience of military personnel, regardless of their level of traumatic exposure. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Health impact of US military service in a large population-based military cohort: findings of the Millennium Cohort Study, 2001-2008

PubMed Central

2011-01-01

Background Combat-intense, lengthy, and multiple deployments in Iraq and Afghanistan have characterized the new millennium. The US military's all-volunteer force has never been better trained and technologically equipped to engage enemy combatants in multiple theaters of operations. Nonetheless, concerns over potential lasting effects of deployment on long-term health continue to mount and are yet to be elucidated. This report outlines how findings from the first 7 years of the Millennium Cohort Study have helped to address health concerns related to military service including deployments. Methods The Millennium Cohort Study was designed in the late 1990s to address veteran and public concerns for the first time using prospectively collected health and behavioral data. Results Over 150 000 active-duty, reserve, and National Guard personnel from all service branches have enrolled, and more than 70% of the first 2 enrollment panels submitted at least 1 follow-up survey. Approximately half of the Cohort has deployed in support of operations in Iraq and Afghanistan. Conclusion The Millennium Cohort Study is providing prospective data that will guide public health policymakers for years to come by exploring associations between military exposures and important health outcomes. Strategic studies aim to identify, reduce, and prevent adverse health outcomes that may be associated with military service, including those related to deployment. PMID:21281496

Health-related quality of life and related factors of military police officers

PubMed Central

2014-01-01

Purpose The present study aimed to determine the effect of demographic characteristics, occupation, anthropometric indices, and leisure-time physical activity levels on coronary risk and health-related quality of life among military police officers from the State of Santa Catarina, Brazil. Methods The sample included 165 military police officers who fulfilled the study’s inclusion criteria. The International Physical Activity Questionnaire and the Short Form Health Survey were used, in addition to a spreadsheet of socio-demographic, occupational and anthropometric data. Statistical analyses were performed using descriptive analysis followed by Spearman Correlation and multiple linear regression analysis using the backward method. Results The waist-to-height ratio was identified as a risk factor low health-related quality of life. In addition, the conicity index, fat percentage, years of service in the military police, minutes of work per day and leisure-time physical activity levels were identified as risk factors for coronary disease among police officers. Conclusions These findings suggest that the Military Police Department should adopt an institutional policy that allows police officers to practice regular physical activity in order to maintain and improve their physical fitness, health, job performance, and quality of life. PMID:24766910

Health-related quality of life and related factors of military police officers.

PubMed

da Silva, Franciele Cascaes; Hernandez, Salma Stéphany Soleman; Arancibia, Beatriz Angélica Valdivia; Castro, Thiago Luis da Silva; Filho, Paulo José Barbosa Gutierres; da Silva, Rudney

2014-04-27

The present study aimed to determine the effect of demographic characteristics, occupation, anthropometric indices, and leisure-time physical activity levels on coronary risk and health-related quality of life among military police officers from the State of Santa Catarina, Brazil. The sample included 165 military police officers who fulfilled the study’s inclusion criteria. The International Physical Activity Questionnaire and the Short Form Health Survey were used, in addition to a spreadsheet of socio-demographic, occupational and anthropometric data. Statistical analyses were performed using descriptive analysis followed by Spearman Correlation and multiple linear regression analysis using the backward method. The waist-to-height ratio was identified as a risk factor low health-related quality of life. In addition, the conicity index, fat percentage, years of service in the military police, minutes of work per day and leisure-time physical activity levels were identified as risk factors for coronary disease among police officers. These findings suggest that the Military Police Department should adopt an institutional policy that allows police officers to practice regular physical activity in order to maintain and improve their physical fitness, health, job performance, and quality of life.

Answering the call to address chronic pain in military service members and veterans: Progress in improving pain care and restoring health.

PubMed

Schoneboom, Bruce A; Perry, Susan M; Barnhill, William Keith; Giordano, Nicholas A; Wiltse Nicely, Kelly L; Polomano, Rosemary C

2016-01-01

Chronic noncancer pain (CNCP) in military and veteran populations mirrors the experience of chronic pain in America; however, these two populations have unique characteristics and comorbid conditions such as traumatic brain injuries, postconcussive syndrome, posttraumatic stress disorder, and behavioral health disorders that complicate the diagnosis and treatment of chronic pain. Military members and veterans may also be stigmatized about their conditions and experience problems with integration back into healthy lifestyles and society as a whole following deployments and after military service. The military and veteran health care systems have made chronic pain a priority and have made substantial strides in addressing this condition through advances in practice, education, research, and health policy. Despite this progress, significant challenges remain in responding to the wide-spread problem of chronic pain. The purpose of this article is to: (a) examine the state of CNCP in military and veteran populations; (b) discuss progress made in pain practice, education, research, and health policy; and (c) examine research, evidence-based practice guidelines, and expert consensus reports that are foundational to advancing pain care and improving health for military service members and veterans with CNCP. In addition, recommendations are proposed to address this widespread health problem through the expanded use of advanced practice registered nurses, the implementation of models of care, and use of national resources to educate health care providers, support practice, and promote effective pain care. Copyright © 2016 Elsevier Inc. All rights reserved.

Prevalence and Trends of Cigarette Smoking Among Military Personnel in Taiwan: Results of 10-Year Anti-Smoking Health Promotion Programs in Military.

PubMed

Chu, Nain-Feng; Lin, Fu-Huang; Wu, Yi-Chang

2017-07-01

The purpose of this study is to evaluate the prevalence and trends of cigarette smoking among young military conscripts, military officers, and military university students during recently 10 years in Taiwan. Repeated cross-sectional surveys were conducted annually among young military conscripts and military university students from 2006 to 2014. All the young conscripts were reviewed within 1 month at the military training center and before retiring after 1 year of military services. The military officers were included using purposive sampling from 2004 to 2008 and 2013 to 2014 in different military services. Military university students were included in this study. Freshman and senior students were random sampled as the study subjects. Participants completed a structured questionnaire that included questions on general demographics and health-related behaviors. Current smokers is defined as subjects who smoked ≥1 cigarette/day during the past 30 days or had smoked ≥100 cigarettes in their lifetime or still have the habit of smoking during study. We used a χ 2 test to examine the difference between the prevalence of cigarette smoking among different groups. The Cochran-Armitage test for trend was applied to examine the change of prevalence of smoking after repeated cross-sectional surveys among populations. The prevalence of cigarette smoking within military training center and after 1-year military services was 48.6% and 48.1% on 2006, which became 39.2% and 38.6% on 2010, and then further declined to 31.0% and 30.1% on 2014. For military officers, the trends of prevalence of smoking among different military services showed slight decline from 2004 to 2008, but decreased significantly between 2013 and 2014. The prevalence of smoking in 2014 was 32.1%, 32.8%, and 32.4% for the Army, Navy, and Air Force, respectively. More interestingly, the prevalence of smoking of freshman and senior students increased during the first 5 years (2007-2011) of survey and then

[Approaches to development and implementation of the medical information system for military-medical commission of the multidisciplinary military-medical organisation].

PubMed

Kuvshinov, K E; Klipak, V M; Chaplyuk, A L; Moskovko, V M; Belyshev, D V; Zherebko, O A

2015-06-01

The current task of the implementation of medical information systems in the military and medical organizations is an automation of the military-medical expertise as one of the most important activities. In this regard, noteworthy experience of the 9th Medical Diagnostic Centre (9th MDC), where on the basis of medical information system "Interi PROMIS" for the first time was implemented the automation of the work of military medical commission. The given paper presents an algorithm for constructing of the information system for the military-medical examination; detailed description of its elements is given. According to military servicemen the implementation of the Military Medical Commission (MMC) subsystem of the medical information system implemented into the 9th MDC has reduced the time required for the MMC and paperwork, greatly facilitate the work of physicians and medical specialists on military servicemen examination. This software can be widely applied in ambulatory and hospital practice, especially in case of mass military-medical examinations.

Use of Ubiquitous Technologies in Military Logistic System in Iran

NASA Astrophysics Data System (ADS)

Jafari, P.; Sadeghi-Niaraki, A.

2013-09-01

This study is about integration and evaluation of RFID and ubiquitous technologies in military logistic system management. Firstly, supply chain management and the necessity of a revolution in logistic systems especially in military area, are explained. Secondly RFID and ubiquitous technologies and the advantages of their use in supply chain management are introduced. Lastly a system based on these technologies for controlling and increasing the speed and accuracy in military logistic system in Iran with its unique properties, is presented. The system is based on full control of military logistics (supplies) from the time of deployment to replenishment using sensor network, ubiquitous and RFID technologies.

Overview of 'Omics Technologies for Military Occupational Health Surveillance and Medicine.

PubMed

Bradburne, Christopher; Graham, David; Kingston, H M; Brenner, Ruth; Pamuku, Matt; Carruth, Lucy

2015-10-01

Systems biology ('omics) technologies are emerging as tools for the comprehensive analysis and monitoring of human health. In order for these tools to be used in military medicine, clinical sampling and biobanking will need to be optimized to be compatible with downstream processing and analysis for each class of molecule measured. This article provides an overview of 'omics technologies, including instrumentation, tools, and methods, and their potential application for warfighter exposure monitoring. We discuss the current state and the potential utility of personalized data from a variety of 'omics sources including genomics, epigenomics, transcriptomics, metabolomics, proteomics, lipidomics, and efforts to combine their use. Issues in the "sample-to-answer" workflow, including collection and biobanking are discussed, as well as national efforts for standardization and clinical interpretation. Establishment of these emerging capabilities, along with accurate xenobiotic monitoring, for the Department of Defense could provide new and effective tools for environmental health monitoring at all duty stations, including deployed locations. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Systematic review of mental health disorders and intimate partner violence victimisation among military populations.

PubMed

Sparrow, Katherine; Kwan, Jamie; Howard, Louise; Fear, Nicola; MacManus, Deirdre

2017-09-01

There is growing awareness of the problem of intimate partner violence (IPV) among military populations. IPV victimisation has been shown to be associated with mental disorder. A better understanding of the link between IPV and mental disorder is needed to inform service development to meet the needs of military families. We aimed to systematically review the literature on the association between IPV victimisation and mental health disorders among military personnel. Searches of four electronic databases (Embase, Medline, PsycINFO, and Web of Science) were supplemented by reference list screening. Heterogeneity among studies precluded a meta-analysis. Thirteen studies were included. There was stronger evidence for an association between IPV and depression/alcohol problems than between IPV and PTSD. An association between IPV and mental health problems was more frequently found among veterans compared to active duty personnel. However, the link between IPV and alcohol misuse was more consistently found among active duty samples. Finally, among active duty personnel psychological IPV was more consistently associated with depression/alcohol problems than physical/sexual IPV. The review highlighted the lack of research on male IPV victimisation in the military. There is evidence that the burden of mental health need may be significant among military personnel who are victims of IPV. The influence of attitudes towards gender in the military on research in this area is discussed. Further research is needed to inform development of services and policy to reduce IPV victimisation and the mental health consequences among military personnel.

Military Interprofessional Health Care Teams: How USU is Working to Harness the Power of Collaboration.

PubMed

D'Angelo, Matthew R; Saperstein, Adam K; Seibert, Diane C; Durning, Steven J; Varpio, Lara

2016-11-01

Despite efforts to increase patient safety, hundreds of thousands of lives are lost each year to preventable health care errors. The Institute of Medicine and other organizations have recommended that facilitating effective interprofessional health care team work can help address this problem. While the concept of interprofessional health care teams is known, understanding and organizing effective team performance have proven to be elusive goals. Although considerable research has been conducted in the civilian sector, scholars have yet to extend research to the military context. Indeed, delivering the highest caliber of health care to our service men and women is vitally important. This commentary describes a new initiative as the Uniformed Services University of the Health Sciences aimed at researching the characteristics of successful military interprofessional teams and why those characteristics are important. It also describes the interprofessional education initiative that Uniformed Services University is launching to help optimize U.S. military health care. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Screening for Complicated Grief in a Military Mental Health Clinic.

PubMed

Delaney, Eileen M; Holloway, Kathryn J; Miletich, Derek M; Webb-Murphy, Jennifer A; Lanouette, Nicole M

2017-09-01

Bereavement is one of the most common and stressful life experiences one can endure. Typical grief reactions follow a course of recovery in which individuals come to terms with the loss and resume functioning within weeks to months. However, for some, grief remains indefinitely distressing. Complicated Grief (CG) refers to significant chronic impairment that stems from bereavement. Military service members experience myriad factors that likely increase their risk for developing CG. Such factors include unique bonds between service members, exposure to constant and extreme levels of stress, multiple losses, separation from family and loved ones, witnessing/learning about sudden violent and traumatic deaths, and handling human remains. The aim of this project was to explore the practicality and efficiency of screening for CG within a busy military mental health clinic, and also explore relationships between contextual variables related to a death that might be associated with screening positive for CG. As part of a clinical needs assessment, patients from a single mental health clinic at Naval Medical Center San Diego completed a brief grief survey that asked if they experienced a death of a person close to them, collected metrics related to losses they have experienced and included validated screeners for CG (The Brief Grief Questionnaire [BGQ] and the Inventory for Complicated Grief [ICG]). No data concerning gender, age, marital status, socioeconomic status, diagnosis, or purpose of visit (i.e., initial or follow-up visit) were collected. Institutional review board approval was obtained. In our sample of service members presenting to an adult outpatient military mental health clinic, 43.5% reported having experienced a loss that still impacts them. Of that group, 61.7% screened positive on the BGQ, 59.2% screened positive on the ICG using a cutoff of 25, and 46.1% screened positive on the ICG using the cutoff of 30. These findings suggest that military service

Health Care Providers’ Attitudes and Practices Regarding the use of Advance Directives in a Military Health Care Setting

DTIC Science & Technology

1998-10-02

PROVIDERS’ ATTITUDES AND PRACTICES REGARDING THE USE OF ADVANCE DIRECTIVES IN A MILITARY HEALTH CARE SETTING by Bridget L. Larew, Maj, USAF, NC Thesis...entitled: "HEALTH CARE PROVIDER’S ATTITUDES AND PRACTICES REGARDING THE PURPOSE AND USE OF ADVANCE DIRECTIVES IN A MILITARY HEALTH CARE SETTING" beyond...health care, recognized under State law (whether statutory or as recognized by the courts of the State) and relating to the provision of such care

Senior military officers' educational concerns, motivators and barriers for healthful eating and regular exercise.

PubMed

Sigrist, Lori D; Anderson, Jennifer E; Auld, Garry W

2005-10-01

The increasing trend of overweight in the military, the high cost of health care associated with overweight, and the failure to meet some Healthy People 2000 objectives related to diet identify the need for more appropriate nutrition and fitness education for military personnel. The purpose of this study was to assess senior military officers' concerns on various health topics, educational preferences for nutrition and health topics, eating habits, and barriers and motivators for eating healthfully and exercising regularly. The survey was completed by 52 resident students at the U.S. Army War College. Fitness, weight, and blood cholesterol were top health concerns, and respondents wanted to know more about eating healthfully on the run. The primary barrier to eating healthfully and exercising regularly was lack of time, whereas health and appearance were top motivators. Health interventions for this population should include their topics of concern and should address perceived barriers and motivators.

[Commune prison camp's health care and Versailles military hospital share].

PubMed

Delahaye, R P

1995-01-01

Between June 1871 and December 1872, about five thousand prisoners were kept in Versailles among some places of detention. This high death rate was indebted for worst hygienic states (individual or collective) and food wretched quality during first weeks. Military Health Service, under Hippolyte Larrey's management with Adolphe Thiers and staff assent involved living conditions owing to tubs and toilets not forgiving accurate clothes and well-balanced food. In every prison was fitted and infirmary managed by a military physician. Sick people were sent into hospital. Versailles city's archives show that, during 1871, 154 insurgent people died in the military hospital while the number dropped to 55 during 1872.

Transitioning Former Military Medics to Civilian Health Care Jobs: A Novel Pilot Program to Integrate Medics Into Ambulatory Care Teams for High-Risk Patients.

PubMed

Watts, Brook; Lawrence, Renée H; Schaub, Kimberley; Lea, Erin; Hasenstaub, Mary; Slivka, Judy; Smith, Todd I; Kirsh, Susan

2016-11-01

Despite their medical training, record of military service, and the unmet needs within the health care sector, numerous challenges face veterans who seek to leverage their health care skills for employment after leaving the military. Creative solutions are necessary to successfully leverage these skills into jobs for returning medics that also meet the needs of health care systems. To achieve this goal, we created a novel ambulatory care health technician position on the basis of existing literature and modeled after a program which incorporates former military medics in emergency departments. Through a quality improvement approach, a position description, interview process, training program with clinical competencies, and team integration plan were developed and implemented. To date, two medics have been hired, successfully trained on relevant skill sets, and are currently caring for medical outpatients (under the supervision of licensed clinical personnel) as crucial interdisciplinary team members. Taken together, a multifaceted approach is required to effectively harness military medics' skills and experiences to meet identified health delivery needs. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

US Military Service Members' Reasons for Deciding to Participate in Health Research.

PubMed

Cook, Wendy A; Melvin, Kristal C; Doorenbos, Ardith Z

2017-06-01

Researchers have reported challenges in recruiting US military service members as research participants. We explored their reasons for participating. Eighteen US military service members who had participated in at least one health-related research study within the previous 3 years completed semi-structured individual interviews in person or by telephone, focused on the service members' past decisions regarding research participation. Service members described participation decisions for 34 individual research experiences in 27 separate studies. Service members' reasons for participation in research clustered in three themes: others-, self-, and fit-focused. Each decision included reasons characterized by at least two themes. Reasons from all three themes were apparent in two-thirds of individual participation decisions. Reasons described by at least half of the service members included a desire to make things better for others, to improve an organization, to help researchers, and to improve one's health; understanding how they fit in studies; and convenience of participation. Findings may help researchers, study sponsors, ethicists, military leaders, and military decision-makers better understand service members' reasons for participating in research and improve future recruitment of service members in health research. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

US Military Service Members’ Reasons for Deciding to Participate in Health Research

PubMed Central

Cook, Wendy A.; Melvin, Kristal C.; Doorenbos, Ardith Z.

2017-01-01

Researchers have reported challenges in recruiting US military service members as research participants. We explored their reasons for participating. Eighteen US military service members who had participated in at least one health-related research study within the previous 3 years completed semi-structured individual interviews in person or by telephone, focused on the service members’ past decisions regarding research participation. Service members described participation decisions for 34 individual research experiences in 27 separate studies. Service members’ reasons for participation in research clustered in three themes: others-, self-, and fit-focused. Each decision included reasons characterized by at least two themes. Reasons from all three themes were apparent in two-thirds of individual participation decisions. Reasons described by at least half of the service members included a desire to make things better for others, to improve an organization, to help researchers, and to improve one’s health; understanding how they fit in studies; and convenience of participation. Findings may help researchers, study sponsors, ethicists, military leaders, and military decision-makers better understand service members’ reasons for participating in research and improve future recruitment of service members in health research. PMID:28185285

Military and VA telemedicine systems for patients with traumatic brain injury.

PubMed

Girard, Philip

2007-01-01

Telemedicine plays a critical role within the Department of Veterans Affairs (VA) Veterans Health Administration by allowing the surveillance and care of patients who are isolated by geography, poverty, and disability. In military settings, telemedicine is being widely used to identify injury and illness and aid in the treatment, rehabilitation, and recovery of combat-wounded soldiers in theater. Rapid advances in both domains are transforming the way clinicians provide care, education, and support to patients with traumatic brain injury (TBI) and their families. This article discusses the military and VA telemedicine capabilities that are supporting the care of service members and veterans with TBI. These capabilities include new technologies that enhance the identification of TBI, management of symptoms in theater, and application of proven technologies (interactive video, Internet, and World Wide Web) to improve overall care coordination throughout military and VA systems. The impact of distance learning, teleconsultation, telerehabilitation, and home telehealth programs is also described within this context.

Associations of military divorce with mental, behavioral, and physical health outcomes.

PubMed

Wang, Lawrence; Seelig, Amber; Wadsworth, Shelley MacDermid; McMaster, Hope; Alcaraz, John E; Crum-Cianflone, Nancy F

2015-06-19

Divorce has been linked with poor physical and mental health outcomes among civilians. Given the unique stressors experienced by U.S. service members, including lengthy and/or multiple deployments, this study aimed to examine the associations of recent divorce on health and military outcomes among a cohort of U.S. service members. Millennium Cohort participants from the first enrollment panel, married at baseline (2001-2003), and married or divorced at follow-up (2004-2006), (N = 29,314). Those divorced were compared to those who remained married for mental, behavioral, physical health, and military outcomes using logistic regression models. Compared to those who remained married, recently divorced participants were significantly more likely to screen positive for new-onset posttraumatic stress disorder, depression, smoking initiation, binge drinking, alcohol-related problems, and experience moderate weight gain. However, they were also more likely be in the highest 15(th) percentile of physical functioning, and be able to deploy within the subsequent 3-year period after divorce. Recent divorce among military members was associated with adverse mental health outcomes and risky behaviors, but was also associated with higher odds of subsequent deployment. Attention should be given to those recently divorced regarding mental health and substance abuse treatment and prevention strategies.

Knowledge mapping visualization analysis of the military health and medicine papers published in the web of science over the past 10 years.

PubMed

Zhang, Xuan-Ming; Zhang, Xuan; Luo, Xu; Guo, Hai-Tao; Zhang, Li-Qun; Guo, Ji-Wei

2017-01-01

Military medicine is a research field that seeks to solve the medical problems that occur in modern war conditions based on public medicine theory. We explore the main research topics of military health and medical research in the web of science™ core collection (WoSCC) from 2007 to 2016, and the goal of this work is to serve as a reference for orientation and development in military health and medicine. Based on CiteSpace III, a reference co-citation analysis is performed for 7921 papers published in the WoSCC from 2007 to 2016. In addition, a cluster analysis of research topics is performed with a comprehensive analysis of high-yield authors, outstanding research institutions and their cooperative networks. Currently, the research topics in military health and medicine mainly focus on the following seven aspects: mental health diagnoses and interventions, an army study to assess risk and resilience in service members (STARRS), large-scale military action, brain science, veterans, soldier parents and children of wartime, and wound infection. We also observed that the annual publication rate increased with time. Wessely S, Greenberg N, Fear NT, Smith TC, Smith B, Jones N, Ryan MAK, Boyko EJ, Hull L, and Rona RJ were the top 10 authors in military health and medicine research. The top 10 institutes were the Uniformed Services University of the Health Sciences, the United States Army, the United States Navy, Kings College London, Walter Reed National Military Medical Center, Boston University, Walter Reed Army Institute of Research, Walter Reed Army Medical Center, Naval Health Research Center, and the VA Boston Healthcare System. We are able to perform a comprehensive analysis of studies in military health and medicine research and summarize the current research climate and the developmental trends in the WoSCC. However, further studies and collaborations are needed worldwide. Overall, our findings provide valuable information and new perspectives and shape

Promoting health during the American occupation of Japan the public health section, Kyoto Military Government Team, 1945-1949.

PubMed

Nishimura, Sey

2008-03-01

During the American occupation of Japan (1945-1952), young public health officers from the US Army Medical Corps were posted in local US Army military government teams. These young doctors (aged 25 to 27 years), who had not absorbed the strong anti-Japanese tradition of the US military during World War II, seem to have alleviated the initial resentment felt by the Japanese toward the new governors of their homeland. The case of the Kyoto Military Government Team illustrates the Kyoto citizenry's positive view of some American-directed public health measures. The team's services helped to counter widely held negative views on colonialism, occupation, and public health; lessened resentment toward the unilateral command structure of the occupation forces; and contributed to improved relations between the United States and Japan at the local level.

The mental health of U.S. military women in combat support occupations.

PubMed

Lindstrom, Krista E; Smith, Tyler C; Wells, Timothy S; Wang, Linda Z; Smith, Besa; Reed, Robert J; Goldfinger, Wendy E; Ryan, Margaret A K

2006-03-01

The proportion of women in the U.S. military is increasing, and they are being selected into jobs that are more combat related. However, the mental health effects of working in combat support occupations among military women have not been previously evaluated. Active-duty enlisted Navy and Marine Corps women in combat support (n = 10,299) and noncombat support (n = 63,478) occupations were followed for 2 years between January 1, 1994, and August 31, 2001. Hospitalization diagnoses were examined and organized into eight categories of mental disorders; Cox proportional hazards modeling was used to describe these outcomes. Women in combat support occupations were found to be significantly less likely to be hospitalized for a mental disorder than women in all other military occupations. These results are reassuring but may be confounded by a healthy worker selection effect. Further studies are needed to assess how service in combat support occupations affects the long-term health of U.S. military women.

Leveraging the Partnership for Patients' Initiative to Improve Patient Safety and Quality Within the Military Health System.

PubMed

King, Heidi B; Kesling, Kimberly; Birk, Carmen; Walker, Theodore; Taylor, Heather; Datena, Michael; Burgess, Brittany; Bower, Lyndsay

2017-03-01

Partnership for Patients (PfP) was a national initiative sponsored by the Department of Health and Human Services, Centers for Medicare and Medicaid Services, to reduce preventable hospital acquired conditions (HACs) by 40% and readmissions (within 30 days) by 20%, by the end of 2013 (as compared to the baseline of CY2010). Along with partners across the nation, the Assistant Secretary of Defense for Health Affairs, Dr. Jonathan Woodson, pledged to support PfP in June 2011. Participation of the Military Health System (MHS) in PfP marked the implementation of the first enterprise-wide patient safety initiative. Three phases of the MHS initiative were developed to meet the aims of the national PfP initiative: (1) Planning and Design, (2) Implementation, and (3) Monitoring and Sustainment. The Planning and Design phase focused on the identification of evidence-based practices (Table III); the development of implementation guides; the implementation of various communication, education, and improvement strategies; and the development of methods by which to track progress and share successes. The implementation phase focused on identifying roles and responsibilities across all levels of care; creating, disseminating, and implementing evidence-based practices at participating military treatment facilities; and establishing a structured learning action network. Finally, during the monitoring and sustainment phase, per the guidance of the Agency for Healthcare Research and Quality, an overall HAC rate was developed for quarterly analysis. The HAC rate per 1,000 dispositions (i.e., discharges) was an aggregate of all PfP HACs. Using the HAC rate, the improvement rate was calculated by comparing the current quarter's HAC rate to the baseline (CY2010). This allowed the MHS to track the overall progress across the enterprise. The MHS achieved a number of accomplishments, including a 15.8% cumulative reduction in HACs by the end of 2013, an 11.1% reduction in readmissions

Sexual harassment and assault experienced by reservists during military service: prevalence and health correlates.

PubMed

Street, Amy E; Stafford, Jane; Mahan, Clare M; Hendricks, Ann

2008-01-01

The current investigation identified the gender-specific prevalence of sexual harassment and assault experienced during U.S. military service and the negative mental and physical health correlates of these experiences in a sample of former reservists. We surveyed a stratified random sample of 3,946 former reservists about their experiences during military service and their current health, including depression, posttraumatic stress disorder, somatic symptoms, and medical conditions. Prevalence estimates and confidence intervals of sexual harassment and assault were calculated. A series of logistic regressions identified associations with health symptoms and conditions. Both men and women had a substantial prevalence of military sexual harassment and assault. As expected, higher proportions of female reservists reported sexual harassment (60.0% vs 27.2% for males) and sexual assault (13.1% vs 1.6% for males). For both men and women, these experiences were associated with deleterious mental and physical health conditions, with sexual assault demonstrating stronger associations than other types of sexual harassment in most cases. This investigation is the first to document high instances of these experiences among reservists. These data provide further evidence that experiences of sexual harassment and assault during military service have significant implications for the healthcare needs of military veterans.

Overview of the Affordable Care Act's impact on military and veteran mental health services: nine implications for significant improvements in care.

PubMed

Russell, Mark C; Figley, Charles R

2014-01-01

On March 23, 2010, President Barack Obama signed the Affordable Care Act (ACA) into law. Implications of the ACA on mental health care for 9.7 million military active-duty, reserve, and family members and 22.2 million veterans, as well as 1.3 uninsured veterans, is reviewed in light of a major crisis. The authors trace historical roots of the ACA to the World War II generation and efforts to transform the mental health care system by implementing hard-won war trauma lessons. The authors posit 9 principles reflected in the ACA that represent unfulfilled generational war trauma lessons and potential transformation of the military and national mental health care systems.

A Systems Approach to Biometrics in the Military Domain.

PubMed

Wilson, Lauren; Gahan, Michelle; Lennard, Chris; Robertson, James

2018-02-21

Forensic biometrics is the application of forensic science principles to physical and behavioral characteristics. Forensic biometrics is a secondary sub-system in the forensic science "system of systems," which describes forensic science as a sub-system in the larger criminal justice, law enforcement, intelligence, and military system. The purpose of this paper is to discuss biometrics in the military domain and integration into the wider forensic science system of systems. The holistic system thinking methodology was applied to the U.S. biometric system to map it to the system of systems framework. The U.S. biometric system is used as a case study to help guide other countries to develop military biometric systems that are integrated and interoperable at the whole-of-government level. The aim is to provide the system of systems framework for agencies to consider for proactive design of biometric systems. © 2018 American Academy of Forensic Sciences.

Prevalence, health care utilization, and costs of fibromyalgia, irritable bowel, and chronic fatigue syndromes in the military health system, 2006-2010.

PubMed

Jeffery, Diana D; Bulathsinhala, Lakmini; Kroc, Michelle; Dorris, Joseph

2014-09-01

We compared prevalence, health care utilization, and costs over time for nonelderly adults diagnosed with fibromyalgia syndrome (FMS), irritable bowel syndrome (IBS), and chronic fatigue syndrome (CFS) in relation to timing of federal approvals for FMS drugs. We used military health care claims from October 2006 to September 2010. Retrospective, multiple-year comparisons were conducted using trend analyses, and time series regression-based generalized linear models. Over 5 years, FMS prevalence rates increased from 0.307% to 0.522%, whereas IBS and CFS prevalence rates remained stable. The largest increase in FMS prevalence occurred between 2007 and 2008. Health care utilization was higher for FMS cases compared to IBS and CFS cases. Over 5 years, the total cost for FMS-related care increased $163.2 million, whereas IBS costs increased $14.9 million and CFS cost increased $3.7 million. Between 2006 and 2010, total pharmacy cost for FMS cases increased from $55 million ($3,641/person) to $96.3 million ($3,557/person). Although cause and effect cannot be established, the advent of federally approved drugs for FMS in concert with pharmaceutical industry marketing of these drugs coincide with the observed changes in prevalence, health care utilization, and costs of FMS relative to IBS and CFS. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Sexual trauma in the military: Exploring PTSD and mental health care utilization in female veterans.

PubMed

Kintzle, Sara; Schuyler, Ashley C; Ray-Letourneau, Diana; Ozuna, Sara M; Munch, Christopher; Xintarianos, Elizabeth; Hasson, Anthony M; Castro, Carl A

2015-11-01

Sexual trauma remains a pervasive problem in the military. The deleterious mental health outcomes related to incidents of sexual assault have been well-documented in the literature, with particular attention given to the development of posttraumatic stress disorder (PTSD) and utilization of mental health services. Much effort has focused on addressing issues of sexual trauma in the military. The purpose of this study was to examine the incidences of sexual assault in female veterans, the relationship to PTSD and mental health care utilization. The research explored differences in pre- and post-9/11 veterans. Data were collected using a 6-prong recruitment strategy to reach veterans living in Southern California. A total of 2,583 veterans completed online and in-person surveys, of which 325 female veterans were identified for inclusion in the analysis. Forty percent of the sample reported experiencing sexual assault during their military service. A history of military sexual trauma was found to be a substantial contributor to symptoms of PTSD. A majority of female veterans who indicated being sexually assaulted during their military service met the cutoff for a diagnosis of PTSD. Although only a minority of participants who indicated being a victim of sexual assault reported receiving immediate care after the incident, most had received mental health counseling within the past 12 months. Findings point to the need for additional prevention programs within the military and opportunities for care for victims of military sexual assault. (c) 2015 APA, all rights reserved).

Uncovering the relationships between military community health and affects expressed in social media

DOE PAGES

Volkova, Svitlana; Charles, Lauren E.; Harrison, Josh; ...

2017-06-08

Military populations present a small, unique community whose mental and physical health impacts the security of the nation. Recent literature has explored social media's ability to enhance disease surveillance and characterize distinct communities with encouraging results. We present a novel analysis of the relationships between influenza-like illnesses (ILI) clinical data and affects (i.e., emotions and sentiments) extracted from social media around military facilities. Our analyses examine (1) differences in affects expressed by military and control populations, (2) affect changes over time by users, (3) differences in affects expressed during high and low ILI seasons, and (4) correlations and cross-correlations betweenmore » ILI clinical visits and affects from an unprecedented scale –171M geo-tagged tweets across 31 global geolocations. Key findings include: Military and control populations dier in the way they express affects in social media over space and time. Control populations express more positive and less negative sentiments and less sadness, fear, disgust, and anger emotions than military. However, affects expressed in social media by both populations within the same area correlate similarly with ILI visits to military health facilities. We have identified potential responsible co-factors leading to location variability, e.g., region or state locale, military service type and/or the ratio of military to civilian populations. For most locations, ILI proportions positively correlate with sadness and neutral sentiment, which are the affects most often expressed during high ILI season. The ILI proportions negatively correlate with fear, disgust, surprise, and positive sentiment. These results are similar to the low ILI season where anger, surprise, and positive sentiment are highest. Finally, cross-correlation analysis shows that most affects lead ILI clinical visits, i.e. are predictive of ILI data, with affect-ILI leading intervals dependent on geo

Uncovering the relationships between military community health and affects expressed in social media

DOE Office of Scientific and Technical Information (OSTI.GOV)

Volkova, Svitlana; Charles, Lauren E.; Harrison, Josh

Military populations present a small, unique community whose mental and physical health impacts the security of the nation. Recent literature has explored social media's ability to enhance disease surveillance and characterize distinct communities with encouraging results. We present a novel analysis of the relationships between influenza-like illnesses (ILI) clinical data and affects (i.e., emotions and sentiments) extracted from social media around military facilities. Our analyses examine (1) differences in affects expressed by military and control populations, (2) affect changes over time by users, (3) differences in affects expressed during high and low ILI seasons, and (4) correlations and cross-correlations betweenmore » ILI clinical visits and affects from an unprecedented scale –171M geo-tagged tweets across 31 global geolocations. Key findings include: Military and control populations dier in the way they express affects in social media over space and time. Control populations express more positive and less negative sentiments and less sadness, fear, disgust, and anger emotions than military. However, affects expressed in social media by both populations within the same area correlate similarly with ILI visits to military health facilities. We have identified potential responsible co-factors leading to location variability, e.g., region or state locale, military service type and/or the ratio of military to civilian populations. For most locations, ILI proportions positively correlate with sadness and neutral sentiment, which are the affects most often expressed during high ILI season. The ILI proportions negatively correlate with fear, disgust, surprise, and positive sentiment. These results are similar to the low ILI season where anger, surprise, and positive sentiment are highest. Finally, cross-correlation analysis shows that most affects lead ILI clinical visits, i.e. are predictive of ILI data, with affect-ILI leading intervals dependent on geo

A Case for Telestroke in Military Medicine: A Retrospective Analysis of Stroke Cost and Outcomes in U.S. Military Health-Care System.

PubMed

Dave, Ajal; Cagniart, Kendra; Holtkamp, Matthew D

2018-06-07

The development of primary stroke centers has improved outcomes for stroke patients. Telestroke networks have expanded the reach of stroke experts to underserved, geographically remote areas. This study illustrates the outcome and cost differences between neurology and primary care ischemic stroke admissions to demonstrate a need for telestroke networks within the Military Health System (MHS). All adult admissions with a primary diagnosis of ischemic stroke in the MHS Military Mart database from calendar years 2010 to 2015 were reviewed. Neurology, primary care, and intensive care unit (ICU) admissions were compared across primary outcomes of (1) disposition status and (2) intravenous tissue plasminogen activator administration and for secondary outcomes of (1) total cost of hospitalization and (2) length of stay (LOS). A total of 3623 admissions met the study's parameters. The composition was neurology 462 (12.8%), primary care 2324 (64.1%), ICU 677 (18.7%), and other/unknown 160 (4.4%). Almost all neurology admissions (97%) were at the 3 neurology training programs, whereas a strong majority of primary care admissions (80%) were at hospitals without a neurology admitting service. Hospitals without a neurology admitting service had more discharges to rehabilitation facilities and higher rates of in-hospital mortality. LOS was also longer in primary care admissions. Ischemic stroke admissions to neurology had better outcomes and decreased LOS when compared to primary care within the MHS. This demonstrates a possible gap in care. Implementation of a hub and spoke telestroke model is a potential solution. Published by Elsevier Inc.

Military and mental health correlates of unemployment in a national sample of women veterans.

PubMed

Hamilton, Alison B; Williams, Lindsay; Washington, Donna L

2015-04-01

The unemployment rate is currently higher among women Veterans than among male Veterans and civilian women. Employment is a key social determinant of health, with unemployment being strongly associated with adverse health. To identify military-related and health-related characteristics associated with unemployment in women Veterans. Secondary analysis of workforce participants (n=1605) in the National Survey of Women Veterans telephone survey. Demographics, mental health conditions, health care utilization, and military experiences and effects. Unemployment was defined as being in the labor force but unemployed and looking for work. The χ analyses to identify characteristics of unemployed women Veterans; logistic regression to identify independent factors associated with unemployment. Ten percent of women Veterans were unemployed. Independent correlates of unemployment were screening positive for depression [odds ratio (OR)=4.7; 95% confidence interval [CI], 1.8-12.4], military service during wartime (OR=2.9; 95%, CI 1.1-7.3), and service in the regular military (vs. in the National Guards/Reserves only) (OR=6.8; 95% CI, 2.2-20.5). Two postactive duty perceptions related to not being respected and understood as a Veteran were each independently associated with unemployment. Whether depression underlies unemployment, is exacerbated by unemployment, or both, it is critical to identify and treat depression among women Veterans, and also to investigate women Veterans' experiences and identities in civilian life. Community-based employers may need education regarding women Veterans' unique histories and strengths. Women who served in the regular military and during wartime may benefit from job assistance before and after they leave the military. Gender-specific adaptation of employment services may be warranted.

Promoting Health During the American Occupation of Japan The Public Health Section, Kyoto Military Government Team, 1945-1949

PubMed Central

Nishimura, Sey

2008-01-01

During the American occupation of Japan (1945–1952), young public health officers from the US Army Medical Corps were posted in local US Army military government teams. These young doctors (aged 25 to 27 years), who had not absorbed the strong anti-Japanese tradition of the US military during World War II, seem to have alleviated the initial resentment felt by the Japanese toward the new governors of their homeland. The case of the Kyoto Military Government Team illustrates the Kyoto citizenry’s positive view of some American-directed public health measures. The team’s services helped to counter widely held negative views on colonialism, occupation, and public health; lessened resentment toward the unilateral command structure of the occupation forces; and contributed to improved relations between the United States and Japan at the local level. PMID:18235076

Cooperative Efforts within the US Military Health Services System

DTIC Science & Technology

1985-05-01

sultation provi’dtd in the diagnosis of disease. The Center for Advanced Pathology includes such specialized areas as forensic , radiologic, dental and...medical entomology programs within the three Military Medical- Services were-reorganized into a single Department of Defense Organizational Board

Stigma as a barrier to seeking health care among military personnel with mental health problems.

PubMed

Sharp, Marie-Louise; Fear, Nicola T; Rona, Roberto J; Wessely, Simon; Greenberg, Neil; Jones, Norman; Goodwin, Laura

2015-01-01

Approximately 60% of military personnel who experience mental health problems do not seek help, yet many of them could benefit from professional treatment. Across military studies, one of the most frequently reported barriers to help-seeking for mental health problems is concerns about stigma. It is, however, less clear how stigma influences mental health service utilization. This review will synthesize existing research on stigma, focusing on those in the military with mental health problems. We conducted a systematic review and meta-analysis of studies between 2001 and 2014 to examine the prevalence of stigma for seeking help for a mental health problem and its association with help-seeking intentions/mental health service utilization. Twenty papers met the search criteria. Weighted prevalence estimates for the 2 most endorsed stigma concerns were 44.2% (95% confidence interval: 37.1, 51.4) for "My unit leadership might treat me differently" and 42.9% (95% confidence interval: 36.8, 49.0) for "I would be seen as weak." Nine studies found no association between anticipated stigma and help-seeking intentions/mental health service use and 4 studies found a positive association. One study found a negative association between self-stigma and intentions to seek help. Counterintuitively, those that endorsed high anticipated stigma still utilized mental health services or were interested in seeking help. We propose that these findings may be related to intention-behavior gaps or methodological issues in the measurement of stigma. Positive associations may be influenced by modified labeling theory. Additionally, other factors such as self-stigma and negative attitudes toward mental health care may be worth further attention in future investigation. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Occupational health and safety issues in military field hospitals.

PubMed

Bricknell, M C

2001-10-01

This paper considers the occupational health and safety issues that apply within a military field hospital. It considers NHS occupational health and safety activities and examines how these might be applied within an Army Medical Services unit. Areas that are unique to field hospitals are highlighted in comparison with a static NHS hospital. Some issues for future work are also considered.

The stigma of mental health problems in the military.

PubMed

Greene-Shortridge, Tiffany M; Britt, Thomas W; Castro, Carl Andrew

2007-02-01

The present review addresses the perceived stigma associated with admitting a mental health problem and seeking help for that problem in the military. Evidence regarding the public stigma associated with mental disorders is reviewed, indicating that the public generally holds negative stereotypes toward individuals with psychological problems, leading to potential discrimination toward these individuals. The internalization of these negative beliefs results in self-stigma, leading to reduced self-esteem and motivation to seek help. Even if soldiers form an intention to seek help for their psychological difficulty, barriers to mental health care may prevent the soldier from receiving the help they need. An overall model is proposed to illustrate how the stigma associated with psychological problems can prevent soldiers getting needed help for psychological difficulties and proposed interventions for reducing stigma in a civilian context are considered for military personnel.

Military Versus Civilian Murder-Suicide.

PubMed

Patton, Christina L; McNally, Matthew R; Fremouw, William J

2015-07-03

Previous studies have implicated significant differences between military members and civilians with regard to violent behavior, including suicide, domestic violence, and harm to others, but none have examined military murder-suicide. This study sought to determine whether there were meaningful differences between military and civilian murder-suicide perpetrators. Using data from the Center for Disease Control's (CDC) National Violent Death Reporting System (NVDRS), military (n = 259) and civilian (n = 259) murder-suicide perpetrators were compared on a number of demographic, psychological, and contextual factors using chi-square analyses. Logistic regression was used to determine which variables predicted membership to the military or civilian perpetrator groups. Military murder-suicide perpetrators were more likely to be older, have physical health problems, be currently or formerly married, less likely to abuse substances, and to exhibit significantly different motives than civilian perpetrators. Logistic regression revealed that membership to the military, rather than the civilian, perpetrator group was predicted by age, physical health problems, and declining heath motive-reflecting the significance of a more than 15-year difference in mean age between the two groups. Findings point to the need to tailor suicide risk assessments to include questions specific to murder-suicide, to assess attitudes toward murder-suicide, and to the importance of assessing suicide and violence risk in older adult military populations. © The Author(s) 2015.

“It’s Not a Priority When We’re in Combat”: Public Health Professionals and Military Tobacco Control Policy

PubMed Central

Grundy, Quinn; Malone, Ruth E.

2015-01-01

Tobacco use is prevalent among service members, but civilian public health groups have not effectively addressed military tobacco control policy issues. We conducted focus groups in 2010 and 2012 with participants from public health and tobacco control organizations regarding their understanding of the military and of tobacco use in that context. Misperceptions were common. Military personnel were believed to be young, from marginalized populations, and motivated to join by lack of other options. Tobacco use was considered integral to military life; participants were sometimes reluctant to endorse stronger tobacco control policies than those applied to civilians, although some believed the military could be a social policy leader. Engaging public health professionals as effective partners in tobacco-free military efforts may require education about and reframing of military service and tobacco control policy. PMID:25713938

Should We End Military Recruiting in High Schools as a Matter of Child Protection and Public Health?

PubMed Central

Barker, Kathy

2011-01-01

Recruiters for the various US armed forces have free access to our nation's high schools, as mandated by the No Child Left Behind Act. Military recruiter behaviors are disturbingly similar to predatory grooming. Adults in the active military service are reported to experience increased mental health risks, including stress, substance abuse, and suicide, and the youngest soldiers consistently show the worst health effects, suggesting military service is associated with disproportionately poor health for this population. We describe the actions of a high school parent teacher student association in Seattle, Washington, which sought to limit the aggressive recruitment of children younger than 18 years into the military. PMID:21088269

Military Emergency Medical Service System Assessment: Application of the National Park Service Needs Assessment and Program Audit to Objectively Evaluate the Military EMS System of Okinawa, Japan.

PubMed

Ross, Elliot M; Harper, Stephen A; Cunningham, Cord; Walrath, Benjamin D; DeMers, Gerard; Kharod, Chetan U

2017-03-01

As part of a Military Emergency Medical Services (EMS) system process improvement initiative, the authors sought to objectively evaluate the U.S. military EMS system for the island of Okinawa. They applied a program evaluation tool currently utilized by the U.S. National Park Service (NPS). A comprehensive needs assessment was conducted to evaluate the current Military EMS system in Okinawa, Japan. The NPS EMS Program Audit Worksheet was used to get an overall "score" of our assessment. After all the data had been collected, a joint committee of Military EMS physicians reviewed the findings and made formal recommendations. From 2011 to 2014, U.S. military EMS on Okinawa averaged 1,345 ± 137 patient transports annually. An advanced life support (ALS) provider would have been dispatched on 558 EMS runs (38%) based on chief complaint in 2014 had they been available. Over 36,000 man-hours were expended during this period to provide National Registry Emergency Medical Technician (EMT)-accredited instruction to certify 141 Navy Corpsman as EMT Basics. The NPS EMS Program Audit Worksheet was used and the program scored a total of 31, suggesting the program is well planned and operating within standards. This evaluation of the Military EMS system on Okinawa using the NPS program assessment and audit worksheet demonstrates the NPS evaluation instruments may offer a useful assessment tool for the evaluation of Military EMS systems. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

Economic analysis of the military health professions scholarship program for neurosurgeons.

PubMed

Ragel, Brian T; Klimo, Paul; Grant, Gerald A; Taggard, Derek A; Nute, David; McCafferty, Randall R; Ellenbogen, Richard G

2011-09-01

The 4-year military Health Professions Scholarship Program (HPSP) provides funds for medical school tuition, books, and a monthly stipend in exchange for a 4-year military commitment (to receive all physician bonuses, an additional 3 months must be served). To analyze the economics of the HPSP for students with an interest in neurosurgery by comparing medical school debt and salaries of military, academic, and private practice neurosurgeons. Salary and medical school debt values from the American Association of Medical Colleges, salary data from the Medical Group Management Association, and 2009 military pay tables were obtained. Annual cash flow diagrams were created to encompass 14.25 years that spanned 4 years (medical school), 6 years (neurosurgical residency), and the first 4.25 years of practice for military, academic, and private practice neurosurgeons. A present value economic model was applied. Mean medical school loan debt was $154,607. Mean military (adjusted for tax-free portions), academic, and private practice salaries were $160,318, $451,068, and $721,458, respectively. After 14.25 years, the cumulative present value cash flow for military, academic, and private practice neurosurgeons was $1 193 323, $2 372 582, and $3 639 276, respectively. After 14.25 years, surgeons with medical student loans still owed $208 761. The difference in cumulative annual present value cash flow between military and academic and between military and private practice neurosurgeons was $1,179,259 and $2,445,953, respectively. The military neurosurgeon will have little to no medical school debt, whereas the calculated medical school debt of a nonmilitary surgeon was approximately $208,000.

Mental health-related beliefs as a barrier to service use for military personnel and veterans: a review.

PubMed

Vogt, Dawne

2011-02-01

Although military personnel are at high risk of mental health problems, research findings indicate that many military personnel and veterans do not seek needed mental health care. Thus it is critical to identify factors that interfere with the use of mental health services for this population, and where possible, intervene to reduce barriers to care. The overarching goal of this review was to examine what is known with regard to concerns about public stigma and personal beliefs about mental illness and mental health treatment as potential barriers to service use in military and veteran populations and to provide recommendations for future research on this topic. Fifteen empirical articles on mental health beliefs and service use were identified via a review of the military and veteran literature included in PsycINFO and PubMed databases. Although results suggest that mental health beliefs may be an important predictor of service use for this population, several gaps were identified in the current literature. Limitations include a lack of attention to the association between mental health beliefs and service use, a limited focus on personal beliefs about mental illness and mental health treatment, and the application of measures of mental health beliefs with questionable or undocumented psychometric properties. Studies that attend to these important issues and that examine mental health beliefs in the broader context within which decisions about seeking health care are made can be used to best target resources to engage military personnel and veterans in health care.

Primary health care utilization prior to suicide: a retrospective case-control study among active-duty military personnel.

PubMed

Hochman, Eldar; Shelef, Leah; Mann, J John; Portugese, Shirly; Krivoy, Amir; Shoval, Gal; Weiser, Mark; Fruchter, Eyal

2014-08-01

About 45% of civilians who died by suicide had contact with a doctor within 1 month of death. Thus, educating primary care physicians (PCP) to detect and mitigate depression is an important suicide-prevention strategy. However, the PCP consulting rate before suicide has not been examined in a military population. We investigated the utilization of primary health care and mental health services by active-duty military personnel suicide cases prior to death in comparison to matched military controls. All suicides (N = 170) were extracted from a cohort of all active-duty Israeli military male personnel between 2002 and 2012. Applying a retrospective, nested case-control design, we compared primary care services utilization by suicide cases with demographic and occupationally matched military controls (N = 500). Whereas 38.3% of suicide cases contacted a PCP within the last month before death, only 27.6% of suicide cases contacted a mental health specialist during their entire service time. The PCP contact rate within 1 month before death or index day did not differ between suicide cases and military controls (38.3% vs. 33.8%, χ²₁ = 1.05, P = .3). More suicide cases contacted a mental health specialist within service time than did military controls (27.6% vs. 13.6%, χ²₁ = 10.85, P = .001). Even though PCP contact rate by military personnel who died by suicide is slightly lower than that reported for civilians who died by suicide prior to their death, it is higher than mental health specialist contact rate and higher than that by age-matched civilians who died by suicide. These results imply that PCPs education is a viable approach to suicide prevention in a military setting. © Copyright 2014 Physicians Postgraduate Press, Inc.

Mental Illness-Related Stigma in Canadian Military and Civilian Populations: A Comparison Using Population Health Survey Data.

PubMed

Weeks, Murray; Zamorski, Mark A; Rusu, Corneliu; Colman, Ian

2017-07-01

This study sought to compare the prevalence and impacts of mental illness-related stigma among Canadian Armed Forces personnel and Canadian civilians. Data were from two highly comparable, population-based, cross-sectional surveys of Canadian military personnel and Canadian civilians: the 2013 Canadian Forces Mental Health Survey (N=6,696) and the 2012 Canadian Community Health Survey-Mental Health (N=25,113), respectively. Perceived stigma was assessed among those who reported care seeking for a mental health problem in the past 12 months. Follow-up questions assessed the impact of stigma in various domains. Modified Poisson regression and linear regression were used to examine population differences (military versus civilian) in terms of care seeking, stigma, and stigma impact, with adjustments for sociodemographic characteristics and the need for care. Military personnel were significantly more likely than civilians to have perceived stigma (adjusted prevalence ratio [PR]=1.70, 95% confidence interval [CI]=1.11-2.60). Stigma had a greater impact on military personnel, particularly in terms of work or school life (b=1.01, CI=.57-1.47). However, military personnel were also significantly more likely than civilians to have sought care (PR=1.86, CI=1.53-2.25). Military personnel reported a disproportionate amount of mental illness-related stigma, compared with Canadian civilians, and a greater impact of stigma. Nevertheless, military personnel were more likely to seek care, pointing to a complex relationship between stigma and care seeking in the military.

Proposal of a framework for evaluating military surveillance systems for early detection of outbreaks on duty areas

PubMed Central

Meynard, Jean-Baptiste; Chaudet, Herve; Green, Andrew D; Jefferson, Henry L; Texier, Gaetan; Webber, Daniel; Dupuy, Bruce; Boutin, Jean-Paul

2008-01-01

Background In recent years a wide variety of epidemiological surveillance systems have been developed to provide early identification of outbreaks of infectious disease. Each system has had its own strengths and weaknesses. In 2002 a Working Group of the Centers for Disease Control and Prevention (CDC) produced a framework for evaluation, which proved suitable for many public health surveillance systems. However this did not easily adapt to the military setting, where by necessity a variety of different parameters are assessed, different constraints placed on the systems, and different objectives required. This paper describes a proposed framework for evaluation of military syndromic surveillance systems designed to detect outbreaks of disease on operational deployments. Methods The new framework described in this paper was developed from the cumulative experience of British and French military syndromic surveillance systems. The methods included a general assessment framework (CDC), followed by more specific methods of conducting evaluation. These included Knowledge/Attitude/Practice surveys (KAP surveys), technical audits, ergonomic studies, simulations and multi-national exercises. A variety of military constraints required integration into the evaluation. Examples of these include the variability of geographical conditions in the field, deployment to areas without prior knowledge of naturally-occurring disease patterns, the differences in field sanitation between locations and over the length of deployment, the mobility of military forces, turnover of personnel, continuity of surveillance across different locations, integration with surveillance systems from other nations working alongside each other, compatibility with non-medical information systems, and security. Results A framework for evaluation has been developed that can be used for military surveillance systems in a staged manner consisting of initial, intermediate and final evaluations. For each stage

Utilization Management in Department of Defense Military Treatment Facilities

DTIC Science & Technology

1992-07-01

Health Affairs) Mendez (1992) clearly states that his plan is for the military health services system’s quality assessment and criteria to become more...also worthy of note that second surgical opinions are not part of Assistant Secretary of Defense (Health Affairs) Mendez ’ (1992) memonrandur on...Affairs) Mendez ’ (1992) quality management policy already states that military medical treatment facilities will begin to implement utilization

Architecting the Future U.S. Military Psychological Health Enterprise via Policy and Procedure Analysis.

PubMed

Glover, Wiljeana J; Plmanabhan, Jayaprasad; Rhodes, Donna; Nightingale, Deborah

2015-08-01

Although researchers suggest that a systems approach is required to make meaningful advances in the U.S. psychological health care system for service members, limited research has considered such an approach. This research uses an enterprise architecting framework to identify the system's strengths and areas for opportunity as they relate to the Ecosystem, Stakeholders, Strategy, Process, Organization, Knowledge, Information, and Infrastructure. Codifying qualitative data from publicly available U.S. Defense Health Agency and U.S. Service Branch doctrine, policy guidance, and concepts of operations, our findings indicate that the psychological health care system is strongly process-oriented and mentions a variety of key stakeholders and their roles and responsibilities in the enterprise. Potential opportunities of improvement for the system include a stronger emphasis on the development and transfer of knowledge capabilities, and a stronger information-based infrastructure. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Medical Insurance Practices of the Military Elderly: Supplements to Medicare

DTIC Science & Technology

1992-05-16

population concerning their health insurance practices. Medicare Supplements 3 Introduction Persons 65 years of age and older represent 12 percent of the...nation’s expenditures for health care. Nine percent of the military, medical beneficiary population are age 65 or older (Review of the Military... Health Service System had on possession of sufficient supplemental health insurance for elderly beneficiaries. A total of 274 Medicare-eligible

Reinventing Military Retirement.

DTIC Science & Technology

1995-12-01

private sector retirement plan principles to the military retirement system. The increasing cost and generosity of military retirement coupled with political pressures to reduce federal spending have focused attention on reforming the military retirement system. Previous studies of the military retirement system are addressed and critiqued. Private retirement options are reviewed and a 401(k) plan is proposed to replace the current military retirement system. The new retirement system would eventually reduce federal outlays for military retirement by 66 percent while

Pain management and opioid risk mitigation in the military.

PubMed

Sharpe Potter, Jennifer; Bebarta, Vikhyat S; Marino, Elise N; Ramos, Rosemarie G; Turner, Barbara J

2014-05-01

Opioid analgesics misuse is a significant military health concern recognized as a priority issue by military leadership. Opioids are among those most commonly prescribed medications in the military for pain management. The military has implemented opioid risk mitigation strategies, including the Sole Provider Program and the Controlled Drug Management Analysis and Reporting Tool, which are used to identify and monitor for risk and misuse. However, there are substantial opportunities to build on these existing systems to better ensure safer opioid prescribing and monitor for misuse. Opioid risk mitigation strategies implemented by the civilian sector include establishing clinical guidelines for opioid prescribing and prescription monitoring programs. These strategies may help to inform opioid risk mitigation in the military health system. Reducing the risk of opioid misuse and improving quality of care for our Warfighters is necessary. This must be done through evidence-based approaches with an investment in research to improve patient care and prevent opioid misuse as well as its sequelae. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Survey of health literacy level and related influencing factors in military college students in Chongqing, China: A cross-sectional analysis.

PubMed

Rong, Honghui; Cheng, Xin; Garcia, Jose M; Zhang, Ling; Lu, Lu; Fang, Jian; Le, Mingshan; Hu, Peng; Dong, Xinlu; Yang, Junli; Wang, Ya; Luo, Ting; Liu, Jun; Chen, Ji-An

2017-01-01

Health literacy (HL) has become an important public health issue and is receiving growing attention. However, the HL levels of military college students in China have never been analyzed. This study aimed to investigate the HL and related associate factors in military college students in Chongqing, China. Data was obtained with the "Chinese Citizen Health Literacy Questionnaire (2012 edition)" from 3183 military college students aged 16-28 years at Chongqing in December 2015. A total score of ≥80 points determined adequate HL, and HL level was defined as the proportion of students who had adequate HL out of the total number of participants. Multiple logistic regression analysis with a stepwise forward likelihood ratio (LR) method was used to determine the effects of sociodemographic characteristics, health-related behaviors, and family-related factors on HL level. The mean score of HL was 68.56, and the HL level of military college students was 21.05%; the overall knowledge rate was 71.33%. The independent factors that were associated with HL level were years in college, educational system, time playing online games, annual household income and father's education level. Senior (odds ratio [OR] = 1.229, 95% confidence interval [CI] 1.018∼1.484), undergraduate (OR = 1.509, 95% CI 1.151∼1.978), time played games more than 5 hours each week (OR = 0.638, 95% CI 0.486∼0.837), annual household incomes more than 50,000 yuan (OR = 1.231, 95% CI 1.027∼1.476) and father's education level (high school: OR = 2.327, 95% CI 1.186∼4.565; university: OR = 2.450, 95% CI 1.244∼4.825), were independently associated with higher HL level. HL levels of military college students in Chongqing need to be improved across the board. Our data suggests that special emphasis should be placed on students in junior and those in the specialist educational system. School departments may also benefit from incorporating health literacy into their curricula and helping students manage the

Design and methodology of a randomized clinical trial of home-based telemental health treatment for U.S. military personnel and veterans with depression.

PubMed

Luxton, David D; Pruitt, Larry D; O'Brien, Karen; Stanfill, Katherine; Jenkins-Guarnieri, Michael A; Johnson, Kristine; Wagner, Amy; Thomas, Elissa; Gahm, Gregory A

2014-05-01

Home-based telemental health (TMH) treatments have the potential to address current and future health needs of military service members, veterans, and their families, especially for those who live in rural or underserved areas. The use of home-based TMH treatments to address the behavioral health care needs of U.S. military healthcare beneficiaries is not presently considered standard of care in the Military Health System. The feasibility, safety, and clinical efficacy of home-based TMH treatments must be established before broad dissemination of home-based treatment programs can be implemented. This paper describes the design, methodology, and protocol of a clinical trial that compares in-office to home-based Behavioral Activation for Depression (BATD) treatment delivered via web-based video technology for service members and veterans with depression. This grant funded three-year randomized clinical trial is being conducted at the National Center for Telehealth and Technology at Joint-base Lewis-McChord and at the Portland VA Medical Center. Best practice recommendations regarding the implementation of in-home telehealth in the military setting as well as the cultural and contextual factors of providing in-home care to active duty and veteran military populations are also discussed. Published by Elsevier Inc.

Health in Argentina under the Military Junta.

PubMed

Bermann, S; Escudero, J C

1978-01-01

The socioeconomic policies of Argentina's Military Junta, in power since March 1976, have led to a sharp impoverishment of the vast majority of the population. In the health sector, facilities which previously were public are being transferred to the private sector, and public hospitals formerly providing free services to the population now charge patients for the care received. As a necessary counterpart to these unpopular measures, a regime of terror has been waged against members of the health team--both those politically active and those considered potentially subversive, particularly the psychiatrists and workers in community health. Differences between the Argentinian situation and previous European fascist patterns are noted, and the possibility of use of the "Argentinian model" in other capitalist countries in crisis is discussed.

Understanding military families who have dependents with special health care and/or educational needs.

PubMed

Aronson, Keith R; Kyler, Sandee J; Moeller, Jeremy D; Perkins, Daniel F

2016-07-01

Little is known about military families who have a dependent with special health care and/or educational needs. The Exceptional Family Member Program (EFMP) is designed to link these families to military/community support services through family support provider (FS providers). The aim of this study was to understand FS providers' perspectives on the kinds of current challenges the families with whom they work face. This is the first study to ascertain the perspectives of professionals FS providers. FS providers (N = 160) completed a survey either on the phone or via the web. The survey consisted of four areas regarding EFMP: (1) background information; (2) caseload and work composition; (3) perceptions of Military Family needs; and (4) adequacy of community support services. The most commonly encountered diagnoses in military families were Autism (94%) and Attention-Deficit Hyperactivity Disorder (93%). Between 80% and 90% of FS providers reported working with families dealing with Emotional/Behavioral Disorders, Speech & Language Disorders, Asthma, Developmental Delays, and Mental Health Problems. FS providers noted that relocations are particularly challenging for military families in the EFMP. Training and programming of social service professionals working with military families who have a dependent with special health care and/or educational needs should focus on commonly occurring challenges seen in this population. As much as possible, FS providers should be familiar with evidence-based programs and practices designed to address these pressing problems. The process and execution of relocations should be streamlined so as to enhance continuity of care. Copyright © 2016 Elsevier Inc. All rights reserved.

Stress, mental health, and job performance among active duty military personnel: findings from the 2002 Department of Defense Health-Related Behaviors Survey.

PubMed

Hourani, Laurel L; Williams, Thomas V; Kress, Amii M

2006-09-01

This study examined the extent to which high levels of occupational and family stress were associated with mental health problems and productivity loss among active duty military personnel. We analyzed data from the 2002 Department of Defense Survey of Health-Related Behaviors among Military Personnel, which provided extensive population-based information on 12,756 active duty personnel in all branches of the military worldwide. Military personnel reported higher levels of stress at work than in their family life. The personnel reporting the highest levels of occupational stress were those 25 or younger, those who were married with spouses not present, and women. Personnel with high levels of stress had significantly higher rates of mental health problems and productivity loss than those with less stress. We recommend that prevention and intervention efforts geared toward personnel reporting the highest levels of stress be given priority for resources in this population.

MilitaryKidsConnect: Web-based prevention services for military children.

PubMed

Blasko, Kelly A

2015-08-01

Military children often present with psychological health concerns related to their experience of deployments, reintegration, and frequent moves common in military life. MilitaryKidsConnect is a Department of Defense (DoD) Web site designed to enhance the coping of military children in the context of their military life experience. The purpose of this paper is to describe the development of the Web site as a resource that provides psychoeducation, coping strategies, and peer support to military children. (c) 2015 APA, all rights reserved).

Stigma, American military personnel and mental health care: challenges from Iraq and Afghanistan.

PubMed

Schreiber, Michael; McEnany, Geoffry Phillips

2015-02-01

Since 2001, more than 2.5 million United States military personnel have been deployed for combat. Over one million have served multiple deployments. Combat generally involved repeated exposure to highly traumatic events. Personnel were also victims of military sexual trauma (MST), a major risk factor for psychiatric illness. Most survivors do not seek or receive mental health care. Stigma is one of the main barriers to that care. To explore the impact of stigma on personnel with psychiatric illness, and suggest some innovative ways to potentially reduce stigma and improve care. Cinahl and PubMed databases were searched from 2001 to 2014. Anonymity, the use of non-stigmatizing language, peer-to-peer, and stigma-reduction programs help military personnel receive mental health care. Technology offers the opportunity for effective and appropriate education and treatment. Although stigma is formidable, several innovative services are available or being developed for military victims of trauma. Commitment of resources for program development and further research to explore which interventions offer the best clinical outcomes are needed to increase efforts to combat stigma and ensure quality care.

Childhood adversity and traumatic exposures during deployment as predictors of mental health in Australian military veterans.

PubMed

Zheng, Wu Yi; Kanesarajah, Jeeva; Waller, Michael; McGuire, Annabel C; Treloar, Susan A; Dobson, Annette J

2016-02-01

To examine whether the relationship between traumatic exposure on deployment and poor mental health varies by the reported level of childhood adversity experienced in Australian military veterans deployed to the Bougainville or East Timor military operations. Cross-sectional self-reported survey data were collected in 2008 from 3,564 Australian military veterans who deployed to East Timor or Bougainville on their deployment experiences, health and recall of childhood events. Multivariable logistic regression was used to investigate the association between childhood adversity, deployment exposures and mental health. The most common childhood adversity reported was 'not having a special teacher, youth worker or family friend who looked out for them while growing up'. On average, responders reported experiencing 3.5 adverse childhood experiences (SD 2.7) and averaged 5.3 (SD 4.9) traumatic exposures on deployment. Both childhood adversity and traumatic exposures on deployment were associated with higher odds of poorer mental health. However, there was no evidence that level of childhood adversity modified the association between traumatic exposure and mental health. These findings suggest that military personnel who recalled a higher level of childhood adversity may need to be monitored for poor mental health and, if required, provided with appropriate support. © 2015 Public Health Association of Australia.

[Is a military hospital needed in the Republic of Croatia?].

PubMed

Sosić, Z; Kovacić, L

1992-01-01

The paper is an attempt to answer the question whether the military hospital is necessary or not in such a small country. Some arguments (and contra-arguments) are listed and discussed. Between the others are: (1) the necessity of developing "war" medical skills and knowledge (cannot be developed during peace-time neither in the military nor civil hospitals, and civilian health services are capable to adapt and to fulfill specific war tasks as it was shown in war in Croatia in 1991), (2) the possibility to develop specific, even peculiar, specialties as hyperbaric or space medicine (these are necessary at the airports, navy bases etc, not in military hospitals), (3) specific health needs of the population of soldiers, officers, and their families (as a rule this population is younger and positively selected i. e. healthier than the general population), (4) security reasons (the data are more accessible from the military service in one place than from the scattered civilian health services), (5) privileges in health care for population of soldiers, officers, and their families due to their particular merits (military forces themselves deny this reason; also, separate military health services is not really the privilege due to bureaucracy, and rather narrow choice of services, (6) separate services could be less expensive and more efficient than the civilian one (experiences from the other countries are completely opposite). The conclusion is that, for such expensive parts of health services, as hospital care (spending between 40% and 70% of the total health expenditure), there is the growing need for rational and planned development within the comprehensive and integral healthcare system. Inside such comprehensive system the military hospital does not look like a rational solution.

Population mental health among U.S. military veterans: results of the Veterans Health Module of the Behavioral Risk Factor Surveillance System, 2011-2012.

PubMed

Blosnich, John R; Brenner, Lisa A; Bossarte, Robert M

2016-08-01

To examine mental health indicators, in aggregate and stratified by sex, among a population-based sample of U.S. military veterans. Data are from veteran who completed the Veterans Health Module (VHM) of the 2011 and 2012 Behavioral Risk Factor Surveillance System (n = 10,406). VHM items included lifetime diagnoses of mental illnesses, service in a combat zone, sources of mental health care, and past 12-month suicidal ideation and attempt. We used weighted, multiple logistic regression models, adjusted for sociodemographics, to examine differences in suicidal ideation and attempt among men and women. Overall, 5.0% of the sample reported recent suicidal ideation and 1.0% reported attempting suicide. Among men, unemployment was positively associated with suicidal ideation, and combat exposure was negatively associated with suicidal ideation. Being separated, divorced, or widowed was positively associated with suicidal ideation among women. After adjusting for sociodemographic and VHM variables, veterans who sought mental health treatment from both Veterans Affairs (VA) and non-VA facilities had more than fourfold increased odds of suicidal ideation than veteran who sought mental health treatment from only VA facilities (adjusted odds ratio = 4.02; 95% confidence interval 1.23-13.13). Correlates of suicidal ideation differ between male and female veterans. Veterans who use both non-VA and VA facilities for mental health services may have greater risk of self-directed violence. Published by Elsevier Inc.

Associations of sexual and gender minority status with health indicators, health risk factors, and social stressors in a national sample of young adults with military experience.

PubMed

Blosnich, John R; Gordon, Adam J; Fine, Michael J

2015-09-01

To assess the associations of self-identified lesbian, gay, bisexual, and questioning sexual orientation or transgender status (LGBTQ) and military experience with health indicators. We used data from the Fall 2012 National College Health Assessment. The survey included self-identified sociodemographic characteristics, mental (e.g., depression) and physical (e.g., human immunodeficiency virus) conditions, health risk behaviors (e.g., smoking), and social stressors (e.g., victimization). We used modified Poisson regression models, stratified by self-reported military service, to examine LGBTQ-related differences in health indicators, whereas adjusting for sociodemographic characteristics. Of 27,176 in the sample, among the military-experienced group, LGBTQ individuals had increased adjusted risks of reporting a past-year suicide attempt (adjusted risk ratio [aRR] = 4.37; 95% confidence interval [CI] = 1.39-13.67), human immunodeficiency virus (aRR = 9.90; 95% CI = 1.04-79.67), and discrimination (aRR = 4.67; 95% CI = 2.05-10.66) than their non-LGBTQ peers. Among LGBTQ individuals, military experience was associated with a nearly four-fold increased risk of reporting a past-year suicide attempt (aRR = 3.61; 95% CI = 1.46-8.91) adjusting for age, sex, race and ethnicity, marital status, depression, and other psychiatric diagnoses. Military experience may moderate health indicators among LGBTQ populations, and likewise, LGBTQ status likely modifies health conditions among military-experienced populations. Results suggest that agencies serving military populations should assess how and if the health needs of LGBTQ individuals are met. Published by Elsevier Inc.

A Concept Analysis of Stigma Perceived by Military Service Members Who Seek Mental Health Services.

PubMed

Hernandez, Stephen H A; Morgan, Brenda J; Parshall, Mark B

2017-07-01

The aim of this concept analysis is to clarify military service members' stigma associated with seeking mental health services (MHS). Since 2001, over 2 million military service members have been deployed for or assigned to support military operations. Many service members develop a mental health concern during or after a deployment. Although researchers have assessed perceptions of stigma associated with accessing MHS, defining stigma is difficult, and conceptual clarity regarding stigma is lagging behind studies focused on its effects. Stigma was explored using Walker and Avant's method of concept analysis. Thirty articles were found in the PsycARTICLES, PsycINFO, and PubMed databases and selected for inclusion and synthesis. Military service member stigma is a set of beliefs, based on the member's military and prior civilian enculturation, that seeking MHS would be discrediting or embarrassing, cause harm to career progression, or cause peers or superiors to have decreased confidence in the member's ability to perform assigned duties. Nurses are ideally suited and situated to play an important role in decreasing stigma inhibiting service members from seeking MHS. Healthcare providers and civilian and uniformed leaders must communicate the value of seeking MHS to ensure service members' health, unit readiness, and overall force preparedness. © 2016 Wiley Periodicals, Inc.

Changes in Healthcare Use Across the Transition From Civilian to Military Life

DTIC Science & Technology

2014-01-01

Naval Health Research Center Changes in Healthcare Use Across the Transition from Civilian to Military Life Stephanie K. McWhorter...Library (wileyonlinelibrary.com) DOI: 10.1002/hpm.2176Changes in healthcare use across the transition from civilian to military life Stephanie K...entry into the Military Health System (MHS). Entrance into the MHS was marked by increased use of preventive care. Although few systematic differences

Designing Web-based Telemedicine Training for Military Health Care Providers.

ERIC Educational Resources Information Center

Bangert, David; Doktor, Boert; Johnson, Erik

2001-01-01

Interviews with 48 military health care professionals identified 20 objectives and 4 learning clusters for a telemedicine training curriculum. From these clusters, web-based modules were developed addressing clinical learning, technology, organizational issues, and introduction to telemedicine. (Contains 19 references.) (SK)

Investigating the respiratory health of deployed military personnel.

PubMed

Morris, Michael J; Zacher, Lisa L; Jackson, David A

2011-10-01

Recent news media articles have implied a direct relationship between environmental exposures such as burn pits during current deployments and the development of serious and debilitating chronic pulmonary disease. These articles suggest that the military is superficially investigating evidence that establishes a link between deployment and development of chronic lung disease. Anecdotal cases of military personnel with lung disease are detailed to suggest a systemic problem with undiagnosed and untreated pulmonary disease in deployed service members. Despite these contentions, the U.S. Army Medical Department and other agencies have been actively pursuing numerous scientific investigations into deployment-related lung disease to define the severity and prevalence of the issue. This article will review relevant research efforts by the U.S. military in the existing medical literature and address the current efforts planned by the services to systematically investigate the possibility of deployment-related pulmonary disease.

Search and detection modeling of military imaging systems

NASA Astrophysics Data System (ADS)

Maurer, Tana; Wilson, David L.; Driggers, Ronald G.

2013-04-01

For more than 50 years, the U.S. Army RDECOM CERDEC Night Vision and Electronic Sensors Directorate (NVESD) has been studying the science behind the human processes of searching and detecting, and using that knowledge to develop and refine its models for military imaging systems. Modeling how human observers perform military tasks while using imaging systems in the field and linking that model with the physics of the systems has resulted in the comprehensive sensor models we have today. These models are used by the government, military, industry, and academia for sensor development, sensor system acquisition, military tactics development, and war-gaming. From the original hypothesis put forth by John Johnson in 1958, to modeling time-limited search, to modeling the impact of motion on target detection, to modeling target acquisition performance in different spectral bands, the concept of search has a wide-ranging history. Our purpose is to present a snapshot of that history; as such, it will begin with a description of the search-modeling task, followed by a summary of highlights from the early years, and concluding with a discussion of search and detection modeling today and the changing battlefield. Some of the topics to be discussed will be classic search, clutter, computational vision models and the ACQUIRE model with its variants. We do not claim to present a complete history here, but rather a look at some of the work that has been done, and this is meant to be an introduction to an extensive amount of work on a complex topic. That said, it is hoped that this overview of the history of search and detection modeling of military imaging systems pursued by NVESD directly, or in association with other government agencies or contractors, will provide both the novice and experienced search modeler with a useful historical summary and an introduction to current issues and future challenges.

Designing Web-based telemedicine training for military health care providers.

PubMed

Bangert, D; Doktor, R; Johnson, E

2001-01-01

The purpose of the study was to ascertain those learning objectives that will initiate increased use of telemedicine by military health care providers. Telemedicine is increasingly moving to the center of the health care industry's service offerings. As this migration occurs, health professionals will require training for proper and effective change management. The United States Department of Defense (DoD) is embracing the use of telemedicine and wishes to use Web-based training as a tool for effective change management to increase use. This article summarizes the findings of an educational needs assessment of military health care providers for the creation of the DoD Web-based telemedicine training curriculum. Forty-eight health care professionals were interviewed and surveyed to capture their opinions on what learning objectives a telemedicine training curriculum should include. Twenty learning objectives were found to be needed in a telemedicine training program. These 20 learning objectives were grouped into four learning clusters that formed the structure for the training program. In order of importance, the learning clusters were clinical, technical, organizational, and introduction to telemedicine. From these clusters, five Web-based modules were created, with two addressing clinical learning needs and one for each of the other learning objective clusters.

Family problems among recently returned military veterans referred for a mental health evaluation.

PubMed

Sayers, Steven L; Farrow, Victoria A; Ross, Jennifer; Oslin, David W

2009-02-01

Existing evidence suggests that military veterans with mental health disorders have poorer family functioning, although little research has focused on this topic. To test whether psychiatric symptoms are associated with family reintegration problems in recently returned military veterans. Cross-sectional survey of a clinical population. Respondents who were referred to behavioral health evaluation from April 2006 through August 2007 were considered for the survey. Philadelphia Veterans Affairs Medical Center, Pa. 199 military veterans who served in Iraq or Afghanistan after 2001 and were referred for behavioral health evaluation from primary care (mean age = 32.7 years, SD = 9.1). Measures included the Mini-International Neuropsychiatric Interview for psychiatric diagnoses, the 9-item Patient Health Questionnaire for depression diagnosis and severity, and screening measures of alcohol abuse and illicit substance use. A measure of military family readjustment problems and a screening measure of domestic abuse were developed for this study. Three fourths of the married/cohabiting veterans reported some type of family problem in the past week, such as feeling like a guest in their household (40.7%), reporting their children acting afraid or not being warm toward them (25.0%), or being unsure about their family role (37.2%). Among veterans with current or recently separated partners, 53.7% reported conflicts involving "shouting, pushing, or shoving," and 27.6% reported that this partner was "afraid of them." Depression and posttraumatic stress disorder symptoms were both associated with higher rates of family reintegration problems. Mental health problems may complicate veterans' readjustment and reintegration into family life. The findings suggest an opportunity to improve the treatment of psychiatric disorders by addressing family problems. Copyright 2009 Physicians Postgraduate Press, Inc.

A Randomized Control Trial Of A community Mental Health Intervention For Military Personnel

DTIC Science & Technology

2011-10-01

findings for this study for this reporting period. Mental health literacy , Mental Health First Aid (MHFA), curriculum adaptation 6 DMohatt@wiche.edu 3...collection instruments to assess impact of mental health literacy program in the military setting. REPORTABLE OUTCOMES: None at this time

The Impact of Pre-Existing Mental Health Disorders on the Diagnosis, Treatment and Survival among Lung Cancer Patients in the U.S. Military Health System

PubMed Central

Lin, Jie; McGlynn, Katherine A.; Carter, Corey A.; Nations, Joel A.; Anderson, William F.; Shriver, Craig D.; Zhu, Kangmin

2018-01-01

Background Higher cancer-related mortality has been observed among people with mental health disorders than in the general population. Both delay in diagnosis and inadequate treatment due to health care access have been found to explain the higher mortality. The U.S. Military Health System (MHS), in which all beneficiaries have equal access to health care, provides an ideal system to study this disparity where there are no or minimal barriers to health care access. This study assessed pre-existing mental health disorders and stage at diagnosis, receipt of cancer treatment and overall survival among non-small cell lung cancer (NSCLC) patients in the U.S. MHS. Methods The study used data from the linked database from the Department of Defense’s Central Cancer Registry and the MHS Data Repository (MDR). The study subjects included 5,054 patients with histologically confirmed primary NSCLC diagnosed between 1998 and 2007. Results Patients with a pre-existing mental disorder did not present with more advanced disease at diagnosis than those without. There were no significant differences in receiving cancer treatments between the two groups. However, patients with a mental health disorder had a higher mortality than those without (Adjusted Hazard ratio (HR) =1.11, 95% CI=1.03 to 1.20). Conclusions Poor survival in NSCLC in patients with a pre-existing mental health disorder is not necessarily associated with delay in diagnosis and/or inadequate cancer treatment. Impact This study contributes to the current understanding that health care access is not sufficient to explain the poor survival among NSCLC patients with pre-existing mental health disorder. PMID:27566418

Challenges Faced by Undergraduate Military Students at American Public University System

ERIC Educational Resources Information Center

Machuca, Ana; Torres, Karin; Morris, Pamela; Whitley, William

2014-01-01

This paper will summarize some of challenges faced by military students enrolled in an associate and bachelors online program at American Public University System (APUS). The survey results on which the study is based exposed the following problems faced by military personnel: 48.7% had difficulties working around military obligations, 33.3%…

Utilization of military support in the response to hurricane Marilyn: implications for future military-civilian cooperation.

PubMed

Weddle, M; Prado-Monje, H

1999-01-01

The past decade has been a period of evolution for the Federal disaster response system within the United States. Two domestic hurricanes were pivotal events that influenced the methods used for organizing Federal disaster assistance. The lessons of Hurricane Hugo (1989) and Hurricane Andrew (1992) were incorporated into the successful response to Hurricane Marilyn in the U.S. Virgin Islands in 1995. Following each of these storms, the Department of Defense was a major component of the response by the health sector. Despite progress in many areas, lack of clear communication between military and civilian managers and confusion among those requesting Department of Defense health resources may remain as obstacles to rapid response. This discussion is based on an unpublished case report utilizing interviews with military and civilian managers involved in the Hurricane Marilyn response. The findings suggest that out-of-channel pathways normally utilized in the warning and emergency phase of the response remained operational after more formal civilian-military communication pathways and local assessment capability had been established. It is concluded that delays may be avoided if the system in place was to make all active pathways for the request and validation of military resources visible to the designated Federal managers located within the area of operations.

Cohesion, leadership, mental health stigmatisation and perceived barriers to care in UK military personnel.

PubMed

Jones, Norman; Campion, Ben; Keeling, Mary; Greenberg, Neil

2018-02-01

Military research suggests a significant association between leadership, cohesion, mental health stigmatisation and perceived barriers to care (stigma/BTC). Most studies are cross sectional, therefore longitudinal data were used to examine the association of leadership and cohesion with stigma/BTC. Military personnel provided measures of leadership, cohesion, stigma/BTC, mental health awareness and willingness to discuss mental health following deployment (n = 2510) and 4-6 months later (n = 1636). At follow-up, baseline leadership and cohesion were significantly associated with stigma/BTC; baseline cohesion alone was significantly associated with awareness of and willingness to discuss mental health at follow-up. Over time, changes in perceived leadership and cohesion were significantly associated with corresponding changes in stigma/BTC levels. Stigma/BTC content was similar in both surveys; fear of being viewed as weak and being treated differently by leaders was most frequently endorsed while thinking less of a help-seeking team member and unawareness of potential help sources were least common. Effective leadership and cohesion building may help to reduce stigma/BTC in military personnel. Mental health awareness and promoting the discussion of mental health matters may represent core elements of supportive leader behaviour. Perceptions of weakness and fears of being treated differently represent a focus for stigma/BTC reduction.

Mental health problems, use of mental health services, and attrition from military service after returning from deployment to Iraq or Afghanistan.

PubMed

Hoge, Charles W; Auchterlonie, Jennifer L; Milliken, Charles S

2006-03-01

The US military has conducted population-level screening for mental health problems among all service members returning from deployment to Afghanistan, Iraq, and other locations. To date, no systematic analysis of this program has been conducted, and studies have not assessed the impact of these deployments on mental health care utilization after deployment. To determine the relationship between combat deployment and mental health care use during the first year after return and to assess the lessons learned from the postdeployment mental health screening effort, particularly the correlation between the screening results, actual use of mental health services, and attrition from military service. Population-based descriptive study of all Army soldiers and Marines who completed the routine postdeployment health assessment between May 1, 2003, and April 30, 2004, on return from deployment to Operation Enduring Freedom in Afghanistan (n = 16,318), Operation Iraqi Freedom (n = 222,620), and other locations (n = 64,967). Health care utilization and occupational outcomes were measured for 1 year after deployment or until leaving the service if this occurred sooner. Screening positive for posttraumatic stress disorder, major depression, or other mental health problems; referral for a mental health reason; use of mental health care services after returning from deployment; and attrition from military service. The prevalence of reporting a mental health problem was 19.1% among service members returning from Iraq compared with 11.3% after returning from Afghanistan and 8.5% after returning from other locations (P<.001). Mental health problems reported on the postdeployment assessment were significantly associated with combat experiences, mental health care referral and utilization, and attrition from military service. Thirty-five percent of Iraq war veterans accessed mental health services in the year after returning home; 12% per year were diagnosed with a mental health

Military Applicability of Interval Training for Health and Performance.

PubMed

Gibala, Martin J; Gagnon, Patrick J; Nindl, Bradley C

2015-11-01

Militaries from around the globe have predominantly used endurance training as their primary mode of aerobic physical conditioning, with historical emphasis placed on the long distance run. In contrast to this traditional exercise approach to training, interval training is characterized by brief, intermittent bouts of intense exercise, separated by periods of lower intensity exercise or rest for recovery. Although hardly a novel concept, research over the past decade has shed new light on the potency of interval training to elicit physiological adaptations in a time-efficient manner. This work has largely focused on the benefits of low-volume interval training, which involves a relatively small total amount of exercise, as compared with the traditional high-volume approach to training historically favored by militaries. Studies that have directly compared interval and moderate-intensity continuous training have shown similar improvements in cardiorespiratory fitness and the capacity for aerobic energy metabolism, despite large differences in total exercise and training time commitment. Interval training can also be applied in a calisthenics manner to improve cardiorespiratory fitness and strength, and this approach could easily be incorporated into a military conditioning environment. Although interval training can elicit physiological changes in men and women, the potential for sex-specific adaptations in the adaptive response to interval training warrants further investigation. Additional work is needed to clarify adaptations occurring over the longer term; however, interval training deserves consideration from a military applicability standpoint as a time-efficient training strategy to enhance soldier health and performance. There is value for military leaders in identifying strategies that reduce the time required for exercise, but nonetheless provide an effective training stimulus.

A Systems Thinking Approach to Engineering Challenges of Military Systems-of-Systems

DTIC Science & Technology

2016-09-01

UNCLASSIFIED UNCLLASIFIED A Systems Thinking Approach to Engineering Challenges of Military Systems -of- Systems Pin Chen and Mark...Unewisse Joint & Operations Analysis Division Defence Science and Technology Group DST-Group-TR-3271 ABSTRACT System (s)-of- Systems (SoS...their products and outcomes. This report introduces a systems thinking-based approach, SoS thinking, which offers a language and a thoughtful process

War, its aftermath, and U.S. health policy: toward a comprehensive health program for America's military personnel, veterans, and their families.

PubMed

Jackonis, Michael J; Deyton, Lawrence; Hess, William J

2008-01-01

This essay discusses the challenges faced by veterans returning to society in light of the current organization and structure of the military, veterans', and overall U.S. health care systems. It also addresses the need for an integrated health care financing and delivery system to ensure a continuum of care for service members, veterans, dependents, and other family members. The health care systems of both the Department of Defense and the Department of Veterans Affairs execute their responsibilities to active duty service members, while their families and retirees/veterans are under separate legal authorities. Although they perform their mandates with extraordinary commitment and demonstrably high quality, both systems need to explore improved communication, coordination, and sharing, as well as increased collaboration with the Department of Health and Human Services programs serving the same populations, far beyond current efforts. The health care-related missions and the locus of health care delivery of each agency are admittedly unique, but their distinctions must not be permitted to impede system integration and coordination of a continuum of care provided to the men and women who serve the nation, and their families.

Analysis of Unmanned Systems in Military Logistics

DTIC Science & Technology

2016-12-01

opportunities to employ unmanned systems to support logistic operations. 14. SUBJECT TERMS unmanned systems, robotics , UAVs, UGVs, USVs, UUVs, military...Industrial Robots at Warehouses / Distribution Centers .............................................................................. 17 2. Unmanned...Autonomous Robot Gun Turret. Source: Blain (2010)................................................... 33 Figure 4. Robot Sentries for Base Patrol

Survey of health literacy level and related influencing factors in military college students in Chongqing, China: A cross-sectional analysis

PubMed Central

Rong, Honghui; Cheng, Xin; Garcia, Jose M.; Zhang, Ling; Lu, Lu; Fang, Jian; Le, Mingshan; Hu, Peng; Dong, Xinlu; Yang, Junli; Wang, Ya; Luo, Ting; Liu, Jun

2017-01-01

Health literacy (HL) has become an important public health issue and is receiving growing attention. However, the HL levels of military college students in China have never been analyzed. This study aimed to investigate the HL and related associate factors in military college students in Chongqing, China. Data was obtained with the “Chinese Citizen Health Literacy Questionnaire (2012 edition)” from 3183 military college students aged 16–28 years at Chongqing in December 2015. A total score of ≥80 points determined adequate HL, and HL level was defined as the proportion of students who had adequate HL out of the total number of participants. Multiple logistic regression analysis with a stepwise forward likelihood ratio (LR) method was used to determine the effects of sociodemographic characteristics, health-related behaviors, and family-related factors on HL level. The mean score of HL was 68.56, and the HL level of military college students was 21.05%; the overall knowledge rate was 71.33%. The independent factors that were associated with HL level were years in college, educational system, time playing online games, annual household income and father's education level. Senior (odds ratio [OR] = 1.229, 95% confidence interval [CI] 1.018∼1.484), undergraduate (OR = 1.509, 95% CI 1.151∼1.978), time played games more than 5 hours each week (OR = 0.638, 95% CI 0.486∼0.837), annual household incomes more than 50,000 yuan (OR = 1.231, 95% CI 1.027∼1.476) and father's education level (high school: OR = 2.327, 95% CI 1.186∼4.565; university: OR = 2.450, 95% CI 1.244∼4.825), were independently associated with higher HL level. HL levels of military college students in Chongqing need to be improved across the board. Our data suggests that special emphasis should be placed on students in junior and those in the specialist educational system. School departments may also benefit from incorporating health literacy into their curricula and helping students

Mental health outcomes in US and UK military personnel returning from Iraq.

PubMed

Sundin, Josefin; Herrell, Richard K; Hoge, Charles W; Fear, Nicola T; Adler, Amy B; Greenberg, Neil; Riviere, Lyndon A; Thomas, Jeffrey L; Wessely, Simon; Bliese, Paul D

2014-03-01

Research of military personnel who deployed to the conflicts in Iraq or Afghanistan has suggested that there are differences in mental health outcomes between UK and US military personnel. To compare the prevalence of post-traumatic stress disorder (PTSD), hazardous alcohol consumption, aggressive behaviour and multiple physical symptoms in US and UK military personnel deployed to Iraq. Data were from one US (n = 1560) and one UK (n = 313) study of post-deployment military health of army personnel who had deployed to Iraq during 2007-2008. Analyses were stratified by high- and low-combat exposure. Significant differences in combat exposure and sociodemographics were observed between US and UK personnel; controlling for these variables accounted for the difference in prevalence of PTSD, but not in the total symptom level scores. Levels of hazardous alcohol consumption (low-combat exposure: odds ratio (OR) = 0.13, 95% CI 0.07-0.21; high-combat exposure: OR = 0.23, 95% CI 0.14-0.39) and aggression (low-combat exposure: OR = 0.36, 95% CI 0.19-0.68) were significantly lower in US compared with UK personnel. There was no difference in multiple physical symptoms. Differences in self-reported combat exposures explain most of the differences in reported prevalence of PTSD. Adjusting for self-reported combat exposures and sociodemographics did not explain differences in hazardous alcohol consumption or aggression.

Examining Associations Between Relocation, Continuity of Care, and Patient Satisfaction in Military Spouses.

PubMed

Gleason, Jessica L; Beck, Kenneth H

2017-05-01

The purpose of this study was to determine how frequent permanent change of station moves and turnover in primary care providers are associated with continuity of care and patient satisfaction in military spouses. These domains have been studied extensively in civilian populations, but this study seeks to begin filling a gap in the literature surrounding military spouses and their experiences with the military health system. Spouses were recruited via social media to complete a brief online questionnaire to examine factors related to continuity of care and satisfaction with military health care. Results were analyzed using analysis of variance and χ 2 tests, and through logistic regression. Continuity of care scores were significantly lower as the number of moves and providers increased. Patient satisfaction was also significantly associated with continuity. In logistic regression analyses, patient-provider relationship and health status were the only significant predictors across two measures of patient satisfaction. Respondents with higher relationship scores were nearly two times more likely to report being satisfied than those with lower scores. Qualitative results indicated that the majority of dissatisfied spouses were unhappy with their military providers, which supported quantitative findings related to patient-provider relationship. No studies have previously been conducted to determine why military health system beneficiaries are less satisfied with care than their civilian counterparts. Discontinuous care is an ongoing issue for military families, which can impact satisfaction and potentially lead to poorer health outcomes. Although the military culture may not allow for fewer relocations, these results indicate that taking steps to promote enduring, trusting relationships with primary care providers may improve patient satisfaction. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

Self-reported mental health among US military personnel prior and subsequent to the terrorist attacks of September 11, 2001.

PubMed

Smith, Tyler C; Smith, Besa; Corbeil, Thomas E; Riddle, James R; Ryan, Margaret A K

2004-08-01

There is much concern over the potential for short- and long-term adverse mental health effects caused by the terrorist attacks on September 11, 2001. This analysis used data from the Millennium Cohort Study to identify subgroups of US military members who enrolled in the cohort and reported their mental health status before the traumatic events of September 11 and soon after September 11. While adjusting for confounding, multivariable logistic regression, analysis of variance, and multivariate ordinal, or polychotomous logistic regression were used to compare 18 self-reported mental health measures in US military members who enrolled in the cohort before September 11, 2001 with those military personnel who enrolled after September 11, 2001. In contrast to studies of other populations, military respondents reported fewer mental health problems in the months immediately after September 11, 2001.

Pulmonary Function and Respiratory Health of Military Personnel Before Southwest Asia Deployment.

PubMed

Skabelund, Andrew J; Rawlins, Frederic A; McCann, Edward T; Lospinoso, Joshua A; Burroughs, Lorraine; Gallup, Roger A; Morris, Michael J

2017-09-01

Significant concern exists regarding the respiratory health of military personnel deployed to Southwest Asia, given their exposures to numerous environmental hazards. Although the deployed military force is generally assumed to be fit, the pre-deployment respiratory health of these individuals is largely unknown. Soldiers deploying to Southwest Asia were recruited from the pre-deployment processing center at Fort Hood, Texas. Participants completed a general and respiratory health questionnaire and performed baseline spirometry. One thousand six hundred ninety-three pre-deployment evaluations were completed. The average age of the participants was 32.2 y, and 83.1% were male. More than one third of surveyed solders had a smoking history, 73% were overweight or obese, and 6.2% reported a history of asthma. Abnormal spirometry was found in 22.3% of participants. Soldiers with abnormal spirometry reported more asthma (10.1% vs 5.1%, P < .001), failed physical fitness tests (9.0% vs 4.6%, P = .02), and respiratory symptoms (32.8% vs 24.3%, P = .001). This is the first prospective pre-deployment evaluation of military personnel that delineates factors potentially associated with the development of pulmonary symptoms and/or disease. This study suggests that deploying soldiers are older, heavier, frequently smoke, and may have undiagnosed pre-deployment lung disease. Abnormal spirometry is common but may not represent underlying disease. Self-reported asthma, wheezing, and slower 2-mile run times were predictive of abnormal spirometry. Pre-deployment evaluation of military personnel identified numerous soldiers with active pulmonary symptoms and abnormal spirometry. When combined with questions regarding asthma history, wheezing and exercise intolerance, spirometry may identify individuals at risk for deployment-related respiratory complaints. Copyright © 2017 by Daedalus Enterprises.

TRICARE, Military Health System

MedlinePlus

... Doctor All Provider Directories Change My Primary Care Manager Book Appointments Getting Care When Traveling Costs Health ... Authorizations Download a Form Change My Primary Care Manager File or Check a Claim Get Proof of ...

Fit for purpose quality management system for military forensic exploitation.

PubMed

Wilson, Lauren Elizabeth; Gahan, Michelle Elizabeth; Robertson, James; Lennard, Chris

2018-03-01

In a previous publication we described a systems approach to forensic science applied in the military domain. The forensic science 'system of systems' describes forensic science as a sub-system in the larger criminal justice, law enforcement, intelligence, and military systems, with quality management being an important supporting system. Quality management systems help to ensure that organisations achieve their objective and continually improve their capability. Components of forensic science quality management systems can include standardisation of processes, accreditation of facilities to national/international standards, and certification of personnel. A fit for purpose quality management system should be balanced to allow organisations to meet objectives, provide continuous improvement; mitigate risk; and impart a positive quality culture. Considerable attention over the last decades has been given to the need for forensic science quality management systems to meet criminal justice and law enforcement objectives. More recently, the need for the forensic quality management systems to meet forensic intelligence objectives has been considered. This paper, for the first time, discusses the need for a fit for purpose quality management system for military forensic exploitation. Crown Copyright © 2018. Published by Elsevier B.V. All rights reserved.

Experiences of sexual harassment and sexual assault in the military among OEF/OIF veterans: implications for health care providers.

PubMed

Bell, Margret E; Reardon, Annemarie

2011-01-01

Given the frequent occurrence and significant health impact of sexual harassment and sexual assault in the military, it is important that for health care providers working with Veterans to have at least some basic knowledge in this area. Targeting providers addressing mental health and psychosocial issues, but also applicable to clinicians working with survivors in a variety of capacities, this article provides an overview of clinical care with survivors of sexual trauma in the military, particularly those who are OEF/OIF Veterans. We cover basic background information, focusing primarily on the impact of sexual trauma in the military, how survivor's reactions are shaped by various aspects of the military context, and general principles to assist clinicians in working effectively with survivors, whatever their role.

Potentials of Advanced Database Technology for Military Information Systems

DTIC Science & Technology

2001-04-01

UNCLASSIFIED Defense Technical Information Center Compilation Part Notice ADP010866 TITLE: Potentials of Advanced Database Technology for Military... Technology for Military Information Systems Sunil Choennia Ben Bruggemanb a National Aerospace Laboratory, NLR, P.O. Box 90502, 1006 BM Amsterdam...application of advanced information tech- nology, including database technology , as underpin- actions X and Y as dangerous or not? ning is

The prevalence of mental health disorders in (ex-)military personnel with a physical impairment: a systematic review

PubMed Central

Stevelink, S A M; Malcolm, E M; Mason, C; Jenkins, S; Sundin, J; Fear, N T

2015-01-01

Background Having a visual, hearing or physical impairment (defined as problems in body function or structure) may adversely influence the mental well-being of military personnel. This paper reviews the existing literature regarding the prevalence of mental health problems among (ex-)military personnel who have a permanent, predominantly, physical impairment. Method Multiple electronic literature databases were searched for relevant studies (EMBASE (1980–January 2014), MEDLINE (1946–January 2014), PsycINFO (2002–January 2014), Web of Science (1975–January 2014)). Results 25 papers were included in the review, representing 17 studies. Studies conducted among US military personnel (n=8) were most represented. A range of mental health disorders were investigated; predominately post-traumatic stress disorder (PTSD), but also depression, anxiety disorder (excluding PTSD), psychological distress and alcohol misuse. The findings indicate that mental health disorders including PTSD (range 2–59%), anxiety (range 16.1–35.5%), depression (range 9.7–46.4%) and psychological distress (range 13.4–36%) are frequently found whereby alcohol misuse was least common (range 2.2–26.2%). Conclusions Common mental health disorders were frequently identified among (ex-)military personnel with a physical impairment. Adequate care and support is necessary during the impairment adaptation process to facilitate the psychosocial challenges (ex-)military personnel with an impairment face. Future research should be directed into factors impacting on the mental well-being of (ex-)military personnel with an impairment, how prevalence rates vary across impairment types and to identify and act on specific needs for care and support. PMID:25227569

Health Potential of Female Candidates to the Professional Military Service

ERIC Educational Resources Information Center

Kaiser, Alicja; Sokolowski, Marek

2011-01-01

Study aim: To assess health and social characteristics of female candidates for professional officers and non-commissioned officers of Polish Army. Material and methods: All female students of officer and non-commissioned officer Military Academies (16 each) were studied in 2009. Two questionnaires were applied in the study: IPAQ (short) for…

Military chemical warfare agent human subjects testing: part 2--long-term health effects among participants of U.S. military chemical warfare agent testing.

PubMed

Brown, Mark

2009-10-01

Military chemical warfare agent testing from World War I to 1975 produced thousands of veterans with concerns about how their participation affected their health. A companion article describes the history of these experiments, and how the lack of clinical data hampers evaluation of long-term health consequences. Conversely, much information is available about specific agents tested and their long-term health effects in other populations, which may be invaluable for helping clinicians respond effectively to the health care and other needs of affected veterans. The following review describes tested agents and their known long-term health consequences. Although hundreds of chemicals were tested, they fall into only about a half-dozen pharmaceutical classes, including common pharmaceuticals; anticholinesterase agents including military nerve agents and pesticides; anticholinergic glycolic acid esters such as atropine; acetylcholine reactivators such as 2-PAM; psychoactive compounds including cannabinoids, phencyclidine, and LSD; and irritants including tear gas and riot control agents.

An electronic health record based model predicts statin adherence, LDL cholesterol, and cardiovascular disease in the United States Military Health System

PubMed Central

Lucas, Joseph E.; Bazemore, Taylor C.; Alo, Celan; Monahan, Patrick B.

2017-01-01

HMG-CoA reductase inhibitors (or “statins”) are important and commonly used medications to lower cholesterol and prevent cardiovascular disease. Nearly half of patients stop taking statin medications one year after they are prescribed leading to higher cholesterol, increased cardiovascular risk, and costs due to excess hospitalizations. Identifying which patients are at highest risk for not adhering to long-term statin therapy is an important step towards individualizing interventions to improve adherence. Electronic health records (EHR) are an increasingly common source of data that are challenging to analyze but have potential for generating more accurate predictions of disease risk. The aim of this study was to build an EHR based model for statin adherence and link this model to biologic and clinical outcomes in patients receiving statin therapy. We gathered EHR data from the Military Health System which maintains administrative data for active duty, retirees, and dependents of the United States armed forces military that receive health care benefits. Data were gathered from patients prescribed their first statin prescription in 2005 and 2006. Baseline billing, laboratory, and pharmacy claims data were collected from the two years leading up to the first statin prescription and summarized using non-negative matrix factorization. Follow up statin prescription refill data was used to define the adherence outcome (> 80 percent days covered). The subsequent factors to emerge from this model were then used to build cross-validated, predictive models of 1) overall disease risk using coalescent regression and 2) statin adherence (using random forest regression). The predicted statin adherence for each patient was subsequently used to correlate with cholesterol lowering and hospitalizations for cardiovascular disease during the 5 year follow up period using Cox regression. The analytical dataset included 138 731 individuals and 1840 potential baseline predictors

Satisfaction among soldiers with secondary medical services within military and civilian clinical settings.

PubMed

Goldberg, Avishay; Pliskin, Joseph S; Peterburg, Yitzhak

2002-08-01

The medical services system of the Israel Defense Forces (IDF) is founded on a principle that by definition considers it the military's role to maintain the health of its personnel in uniform. The 1994 Compulsory Health Insurance Law, Section 55 addresses health services for soldiers, stating that a soldier is entitled to health services from the Medical Corps of the IDF or an agent operating on its behalf. In the implementation of its responsibilities, the IDF Medical Corps operates an array of medical services, including secondary care. This study deals with the scope of utilization of secondary medical services by IDF personnel visiting military medical clinics and civilian hospital outpatient clinics: their character, the subjective health status of the respondents, and their degree of satisfaction with medical services. The results indicate that most of those seeking medical treatment at military and civilian clinics are not chronically ill. Most consider their health status to be good to excellent, but many of those referred for secondary care--more than half of the respondents who visited military specialist clinics-visited the clinics many times and even visited other clinics. No problem of access to clinics was found, but availability was problematic. There was a marked preference among patients to receive secondary health sevices from outside civilian agents rather than the military system.

Staff Attitudes Regarding the Impact of a Therapy Dog Program on Military Behavioral Health Patients.

PubMed

Brisson, Sara; Dekker, Anthony H

Human-animal interactions in the form of animal-assisted therapy (AAT) have become common in both civilian and military health care facilities. Evidence supports AAT as a beneficial therapeutic alternative for patients with physical disabilities and psychological disorders. Few studies have been conducted in the civilian health care setting to evaluate staff attitudes regarding the impact of an AAT program on behavioral health (BH) patients. To our knowledge, no research has examined staff attitudes on the impact and effectiveness of AAT on active-duty Servicemembers in a BH program at a military facility. At the completion of a year-long AAT dog program and after institutional review board exemption, an anonymous, six-question survey was used to examine staff attitudes (n = 29) regarding the impact and continuation of the program with military BH patients. Most staff members (86%) believed the AAT dog program had a positive impact on the BH patients, including improved patient mood, greater patient relaxation, improved patient attitude toward therapy, and increased social interactions among patients. All the staff reported a desire to continue the program at the military facility. Most BH staff thought the year-long AAT dog program had a positive impact on patients. All staff supported continuation of the program. 2017.

SYSTEMS ANALYSIS - MILITARY PERSONNEL AUTHORIZED VERSUS ON HAND

DTIC Science & Technology

The purpose of the report is to describe the systems analysis required to produce information on ’Military Personnel, Authorized Versus On Hand,’ for LMI R1 during the period of manual operation of the USAREUR Logistics Management Information System.

U.S. military enlisted accession mental health screening: history and current practice.

PubMed

Cardona, Robert Andrew; Ritchie, Elspeth Cameron

2007-01-01

Through the stimulus of war and concerns about neuropsychiatric disability, the U.S. military developed methods to rapidly screen the mental health of World War I and II draftees. Intelligence testing and brief psychiatric screening expanded the accession physical examination and underwent revision to identify only gross mental health disability. Supplemental psychiatric evaluations and written psychological screening tools were abandoned after postwar assessments; they demonstrated poor predictive power in evaluating recruit service capacity for combat environments. Currently, only three mental health accession tools are used to screen applicants before their entrance into military service, namely, educational achievement, cognitive testing, and a cursory psychiatric evaluation. The Navy and Air Force use a fourth screening measure during entry-level training. Educational attainment with high school graduation has been the strongest predictor of finishing a service term. The purpose of this article is to provide both a historical review and a review of testing efforts.

Healthcare for Military Retirees Task Group. Recommendations Regarding Improvements to the Military Health Systems and Specifically Healthcare of Military Retirees.

DTIC Science & Technology

2005-12-01

Business Board Utilize specially trained care managers to proactively attend to/assist high-risk population. Customize a comprehensive...ADDRESS(ES) Defense Business Board,1155 Defense Pentagon,Washington,DC,20301-1155 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING...c. THIS PAGE unclassified Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 Defense Business Board HEALTHCARE FOR MILITARY RETIREES

Reforming the American Military Officer Personnel System: Addendum: Thoughts on Contractors

DTIC Science & Technology

2016-05-24

Testimony Reforming the American Military Officer Personnel System Addendum: Thoughts on Contractors Bernard D. Rostker CT-446/1 Document...1 Reforming the American Military Officer Personnel System Addendum: Thoughts on Contractors Testimony of Bernard D. Rostker 1 The RAND...Reform and Strengthening the All-Volunteer Force” on December 2, 2015, comment on the need to understand when contractors are being utilized and

An Analysis of Personal Technology Use by Service Members and Military Behavioral Health Providers.

PubMed

Edwards-Stewart, Amanda; Smolenski, Derek J; Reger, Greg M; Bush, Nigel; Workman, Don E

2016-07-01

Personal technology use is ubiquitous in the United States today and technology, in general, continues to change the face of health care. However, little is known about the personal technology use of military service members and the behavioral health care providers that treat them. This study reports the technology use of 1,101 active duty service members and 45 behavioral health care providers at a large military installation. Participants reported Internet usage; ownership of smartphones, tablets, and e-readers; usage of mobile applications (apps); and basic demographic information. Compared with providers, service members reported higher rates of smartphone ownership, were more likely to own Android smartphones than iPhones, and spent more time gaming. Both groups spent a comparable amount of time using social media. With the exception of gaming, however, differences between service members and providers were not statistically significant when demographics were matched and controlled. Among service members, younger respondents (18-34) were statistically more likely than older respondents (35-58) to own smartphones, spend time gaming, and engage in social media. Our findings can help inform provider's technology-based education and intervention of their patients and guide the development of new technologies to support the psychological health of service members. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

The prevalence of mental health disorders in (ex-)military personnel with a physical impairment: a systematic review.

PubMed

Stevelink, S A M; Malcolm, E M; Mason, C; Jenkins, S; Sundin, J; Fear, N T

2015-04-01

Having a visual, hearing or physical impairment (defined as problems in body function or structure) may adversely influence the mental well-being of military personnel. This paper reviews the existing literature regarding the prevalence of mental health problems among (ex-)military personnel who have a permanent, predominantly, physical impairment. Multiple electronic literature databases were searched for relevant studies (EMBASE (1980-January 2014), MEDLINE (1946-January 2014), PsycINFO (2002-January 2014), Web of Science (1975-January 2014)). 25 papers were included in the review, representing 17 studies. Studies conducted among US military personnel (n=8) were most represented. A range of mental health disorders were investigated; predominately post-traumatic stress disorder (PTSD), but also depression, anxiety disorder (excluding PTSD), psychological distress and alcohol misuse. The findings indicate that mental health disorders including PTSD (range 2-59%), anxiety (range 16.1-35.5%), depression (range 9.7-46.4%) and psychological distress (range 13.4-36%) are frequently found whereby alcohol misuse was least common (range 2.2-26.2%). Common mental health disorders were frequently identified among (ex-)military personnel with a physical impairment. Adequate care and support is necessary during the impairment adaptation process to facilitate the psychosocial challenges (ex-)military personnel with an impairment face. Future research should be directed into factors impacting on the mental well-being of (ex-)military personnel with an impairment, how prevalence rates vary across impairment types and to identify and act on specific needs for care and support. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Requirements and applications for robotic servicing of military space systems

NASA Technical Reports Server (NTRS)

Ledford, Otto C., Jr.; Bennett, Rodney G.

1992-01-01

The utility of on-orbit servicing of spacecraft has been demonstrated by NASA several times using shuttle-based astronaut EVA. There has been interest in utilizing on-orbit servicing for military space systems as well. This interest has been driven by the increasing reliance of all branches of the military upon space-based assets, the growing numbers, complexity, and cost of those assets, and a desire to normalize support policies for space-based operations. Many military satellites are placed in orbits which are unduly hostile for astronaut operations and/or cannot be reached by the shuttle. In addition, some of the projected tasks may involve hazardous operations. This has led to a focus on robotic systems, instead of astronauts, for the basis of projected servicing systems. This paper describes studies and activities which will hopefully lead to on-orbit servicing being one of the tools available to military space systems designers and operators. The utility of various forms of servicing has been evaluated for present and projected systems, critical technologies have been identified, and strategies for the development and insertion of this technology into operational systems have been developed. Many of the projected plans have been adversely affected by budgetary restrictions and evolving architectures, but the fundamental benefits and requirements are well understood. A method of introducing servicing capabilities in a manner which has a low impact on the system designer and does not require the prior development of an expensive infrastructure is discussed. This can potentially lead to an evolutionary implementation of the full technology.

The Association Between Mental Health and Cigarette Smoking in Active Duty Military Members

DTIC Science & Technology

2011-02-01

depression evaluation, reception of mental health treatment in the past 12 months, perceived need for mental health counseling in the past 12 months...and prescription of medications for depression or anxiety. The study population consisted of 16,146 active duty military members who responded to...who may have a need for further depression evaluation, who have received mental health counseling, who felt they needed mental health counseling

Associations of Military Divorce with Mental, Behavioral, and Physical Health Outcomes

DTIC Science & Technology

2015-06-19

recent divorce re - ported subsequent poor health and military outcomes compared to those who remained married during the same time frame. We...determined using DMDC re - cords and were backfilled with self-reported data to reduce missing values. Baseline functional health was eval- uated with the...4.8 %, 3.0 %, and 3.0 % developing each of these conditions, re - spectively, between baseline and follow-up. Smoking initi- ation and recidivism

A Comprehensive Evaluation System for Military Hospitals' Response Capability to Bio-terrorism.

PubMed

Wang, Hui; Jiang, Nan; Shao, Sicong; Zheng, Tao; Sun, Jianzhong

2015-05-01

The objective of this study is to establish a comprehensive evaluation system for military hospitals' response capacity to bio-terrorism. Literature research and Delphi method were utilized to establish the comprehensive evaluation system for military hospitals' response capacity to bio-terrorism. Questionnaires were designed and used to survey the status quo of 134 military hospitals' response capability to bio-terrorism. Survey indicated that factor analysis method was suitable to for analyzing the comprehensive evaluation system for military hospitals' response capacity to bio-terrorism. The constructed evaluation system was consisted of five first-class and 16 second-class indexes. Among them, medical response factor was considered as the most important factor with weight coefficient of 0.660, followed in turn by the emergency management factor with weight coefficient of 0.109, emergency management consciousness factor with weight coefficient of 0.093, hardware support factor with weight coefficient of 0.078, and improvement factor with weight coefficient of 0.059. The constructed comprehensive assessment model and system are scientific and practical.

Depleted uranium: properties, military use and health risks.

PubMed

Fairlie, Ian

2009-01-01

This article describes uranium and depleted uranium (DU), their similar isotopic compositions, how DU arises, its use in munitions and armour-proofing, and its pathways for human exposures. Particular attention is paid to the evidence of DU's health effects from cell and animal experiments and from epidemiology studies. It is concluded that a precautionary approach should be adopted to DU and that there should be a moratorium on its use by military forces. International efforts to this end are described.

Suicide and the Military Justice System.

ERIC Educational Resources Information Center

Lande, Raymond G.

1992-01-01

Notes that U.S. military policies emphasize humanitarian approach to issue of suicide, yet military law may view suicidal behavior as deviant and may prosecute suicide attempters. Cites convictions of soldiers for attempted and assisted suicides. Reviews recent court decisions and suggests revisions in military law. (Author/NB)

Resilient Military Systems and the Advanced Cyber Threat

DTIC Science & Technology

2013-01-01

systems; intelligence, surveillance, and reconnaissance systems; logistics and human resource systems; and mobile as well as fixed- infrastructure ...significant portions of military and critical infrastructure : power generation, communications, fuel and transportation, emergency services, financial...vulnerabilities in the domestic power grid and critical infrastructure systems.4,5 DoD, and the United States, is extremely reliant on the

DOD Military Retirement Health Benefits Liability for FY 1997.

DTIC Science & Technology

1998-10-13

Management Act of 1994 (Public Law 103-356). Public Law 103-356 requires DoD and other Government agencies to prepare consolidated financial statements for...eligible beneficiaries through private sector health care providers and DoD military treatment facilities. The DoD-wide consolidated financial statements for...series of reports addressing selected accounts of the DoD-wide consolidated financial statements for FY 1997 and beyond. Audit Objectives. The objective

Long-term military work outcomes in soldiers who become mental health casualties when deployed on operations.

PubMed

Jones, Norman; Fear, Nicola T; Jones, Margaret; Wessely, Simon; Greenberg, Neil

2010-01-01

little is known about longer term military work outcomes in UK military personnel who develop mental health problems when operationally deployed. Deployed Field Mental Health Teams (FMHTs) who support them follow the principles of "Forward Psychiatry," aiming to treat psychiatric casualties close to the front line to maximize operational effectiveness and occupational retention. to examine the short- and long-term military work outcomes in soldiers deployed to Iraq between 2003 and 2007 who were referred to the FMHT. FMHT clinical records were linked to occupational records with 825 resulting matches. 71.6% of the referred soldiers with a documented short-term military work outcome returned to their operational unit, and 73.5% of those who had a documented long-term military work outcome served on for a period in excess of two years. Adjusting for potential confounders, a shorter service length and removal from the operational theatre were both strongly associated with premature discharge; however, it was not possible to determine the severity of the presenting mental health problem and assess whether this impacted outcome. the results of this study support the use of the Forward Psychiatry principles in achieving good short-term military work outcomes. Utilizing these principles, three-quarters of those referred to the FMHT were returned to their deployed unit and approximately three-quarters of those assessed by the FMHT remained in service two years after referral. We suggest that these are positive work outcomes; however, being evacuated out of the operational environment and having a short service length were both associated with premature discharge, though we were unable to examine the role of illness severity.

Military clouds: utilization of cloud computing systems at the battlefield

NASA Astrophysics Data System (ADS)

Süleyman, Sarıkürk; Volkan, Karaca; İbrahim, Kocaman; Ahmet, Şirzai

2012-05-01

Cloud computing is known as a novel information technology (IT) concept, which involves facilitated and rapid access to networks, servers, data saving media, applications and services via Internet with minimum hardware requirements. Use of information systems and technologies at the battlefield is not new. Information superiority is a force multiplier and is crucial to mission success. Recent advances in information systems and technologies provide new means to decision makers and users in order to gain information superiority. These developments in information technologies lead to a new term, which is known as network centric capability. Similar to network centric capable systems, cloud computing systems are operational today. In the near future extensive use of military clouds at the battlefield is predicted. Integrating cloud computing logic to network centric applications will increase the flexibility, cost-effectiveness, efficiency and accessibility of network-centric capabilities. In this paper, cloud computing and network centric capability concepts are defined. Some commercial cloud computing products and applications are mentioned. Network centric capable applications are covered. Cloud computing supported battlefield applications are analyzed. The effects of cloud computing systems on network centric capability and on the information domain in future warfare are discussed. Battlefield opportunities and novelties which might be introduced to network centric capability by cloud computing systems are researched. The role of military clouds in future warfare is proposed in this paper. It was concluded that military clouds will be indispensible components of the future battlefield. Military clouds have the potential of improving network centric capabilities, increasing situational awareness at the battlefield and facilitating the settlement of information superiority.

Traumatic Brain Injury Incidence, Clinical Overview, and Policies in the US Military Health System Since 2000.

PubMed

Swanson, Thomas M; Isaacson, Brad M; Cyborski, Cherina M; French, Louis M; Tsao, Jack W; Pasquina, Paul F

Exposure to explosive armaments during Operation Iraqi Freedom and Operation Enduring Freedom contributed to approximately 14% of the 352 612 traumatic brain injury (TBI) diagnoses in the US military between 2000 and 2016. The US Department of Defense issued guidelines in 2009 to (1) standardize TBI diagnostic criteria; (2) classify TBI according to mechanism and severity; (3) categorize TBI symptoms as somatic, psychological, or cognitive; and (4) systematize types of care given during the acute and rehabilitation stages of TBI treatment. Polytrauma and associated psychological and neurologic conditions may create barriers to optimal rehabilitation from TBI. Given the completion of recent combat operations and the transition of TBI patients into long-term care within the US Department of Veterans Affairs system, a review of the literature concerning TBI is timely. Long-term follow-up care for patients who have sustained TBI will remain a critical issue for the US military.

Role of Human Health Care Providers and Medical Treatment Facilities in Military Working Dog Care and Accessibility Difficulties with Military Working Dog Blood Products.

PubMed

Giles Iii, James T

2016-01-01

The use of military working dogs (MWDs) in support of military operations has increased dramatically over recent years, as they have proven to be our most reliable deterrent to improvised explosive devices. Healthcare delivery for MWDs in combat presents unique challenges and requires extensive collaboration between veterinarians and human health care providers (HCPs). A successful example is the incorporation of MWD emergency care for nonveterinary HCPs into the Joint Trauma System Clinical Practice Guidelines, which has proven to be a helpful product. Additional challenges that need further solutions include MWDs as patients in human medical treatment facilities (MTFs) and the procurement of appropriate canine blood components in an operational environment. It is often necessary for MWDs to be treated as patients in human MTFs, however, there is no Department of Defense guidance to support this activity. Access to MWD blood products is limited to collection of fresh whole blood in the operational setting. Similar to humans, specific blood component therapy, such as fresh frozen plasma, is often indicated for sick or injured MWDs. Currently there is no formal system in place to deliver any blood products for MWDs or to facilitate collection in theater.

Health Care in the Military. Feasibility and Desirability of a Health Enrollment System,

DTIC Science & Technology

1984-06-01

Statistics ........................ 131 B.2. Comparison of Military and Civilian Hospital Days for Age/Sex itdrie Beneficiary Population, by Service Branch...it does not exist. The MTF hospital must be used by inpatients living within a 40 mile radius (catchment ares). Uf care is not available, a...Certificate of Nonavailability is issue and the patient must find civilian hospital care. (The MW staff an not alwedW to refer the patient to any specific

Modularity: An Application of General Systems Theory to Military Force Development

DTIC Science & Technology

2005-01-01

1999). Context, modularity, and the cultural constitution of development. In P. Lloyd & C. Fernyhough (Eds.), Lev Vygotsky : Critical assessments...of General Systems Theory to Military Force Development 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT...Prescribed by ANSI Std Z39-18 MODULARITY: AN APPLICATION OF GENERAL SYSTEMS THEORY TO MILITARY FORCE DEVELOPMENT 279 R SEARCH MODULARITY: AN APPLICATION OF

Outpatient Mental Health Treatment Utilization and Military Career Impact in the United States Marine Corps

PubMed Central

Ghahramanlou-Holloway, Marjan; LaCroix, Jessica M.; Koss, Kari; Perera, Kanchana U.; VanSickle, Marcus R.; Novak, Laura A.

2018-01-01

Service members (SM) are at increased risk of psychiatric conditions, including suicide, yet research indicates SMs believe seeking mental health treatment may negatively impact their military careers, despite a paucity of research examining actual career impacts. This study examined the link between seeking outpatient mental health (MH) treatment and military career impacts within the United States Marine Corps. In Phase 1, a retrospective medical record review of outpatient MH treatment-seeking Marines (N = 38) was conducted. In Phase 2, a sample of outpatient MH treatment-seeking Marines (N = 40) was matched to a non-treatment-seeking sample of Marines (N = 138) to compare career-progression. In Phase 1, there were no significant links between demographic, military, and clinical characteristics and referral source or receipt of career-affecting treatment recommendations. In Phase 2, MH treatment-seeking Marines in outpatient settings were more likely than matched controls to be separated from the military (95.0% versus 63.0%, p = 0.002), but no more likely to experience involuntary separation. MH treatment-seeking Marines were more likely to have documented legal action (45.0% versus 23.9%, p = 0.008) and had a shorter time of military service following the index MH encounter than matched controls (p < 0.001). Clinical, anti-stigma, and suicide prevention policy implications are discussed. PMID:29690594

Outpatient Mental Health Treatment Utilization and Military Career Impact in the United States Marine Corps.

PubMed

Ghahramanlou-Holloway, Marjan; LaCroix, Jessica M; Koss, Kari; Perera, Kanchana U; Rowan, Anderson; VanSickle, Marcus R; Novak, Laura A; Trieu, Theresa H

2018-04-23

Service members (SM) are at increased risk of psychiatric conditions, including suicide, yet research indicates SMs believe seeking mental health treatment may negatively impact their military careers, despite a paucity of research examining actual career impacts. This study examined the link between seeking outpatient mental health (MH) treatment and military career impacts within the United States Marine Corps. In Phase 1, a retrospective medical record review of outpatient MH treatment-seeking Marines ( N = 38) was conducted. In Phase 2, a sample of outpatient MH treatment-seeking Marines ( N = 40) was matched to a non-treatment-seeking sample of Marines ( N = 138) to compare career-progression. In Phase 1, there were no significant links between demographic, military, and clinical characteristics and referral source or receipt of career-affecting treatment recommendations. In Phase 2, MH treatment-seeking Marines in outpatient settings were more likely than matched controls to be separated from the military (95.0% versus 63.0%, p = 0.002), but no more likely to experience involuntary separation. MH treatment-seeking Marines were more likely to have documented legal action (45.0% versus 23.9%, p = 0.008) and had a shorter time of military service following the index MH encounter than matched controls ( p < 0.001). Clinical, anti-stigma, and suicide prevention policy implications are discussed.

Tuberculosis as a force health protection threat to the United States military.

PubMed

Sanchez, Jose L; Sanchez, Joyce L; Cooper, Michael J; Hiser, Michelle J; Mancuso, James D

2015-03-01

Tuberculosis (TB) is a communicable disease that poses a threat to force health protection to the U.S. military. The rate of TB disease in the military is low; however, there are unique challenges for its control in this setting. As a low-risk population, TB testing in the U.S. military can be scaled back from the universal testing approach used previously. Reactivation of latent TB infection (LTBI) present at accession into service is the most important factor leading to TB disease; therefore, its diagnosis and treatment among recruits should be given a high priority. Deployment and overseas military service is an uncommon but important source of TB infection, and rigorous surveillance should be ensured. Case management of TB disease and LTBI can be improved by the use of cohort reviews at the service and installation levels and case finding and delays in the diagnosis of TB disease can be improved by education of providers, as well as increased use of molecular diagnostic tests. Program outcomes can be improved by making LTBI treatment compulsory, offering shorter treatment regimens, and increasing accountability through oversight and evaluation. The diagnosis of LTBI can be improved by implementing targeted testing in all settings and reducing confirmatory interferon-gamma release assay testing. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Extreme health sensing: the challenges, technologies, and strategies for active health sustainment of military personnel during training and combat missions

NASA Astrophysics Data System (ADS)

Buller, Mark; Welles, Alexander; Chadwicke Jenkins, Odest; Hoyt, Reed

2010-04-01

Military personnel are often asked to accomplish rigorous missions in extremes of climate, terrain, and terrestrial altitude. Personal protective clothing and individual equipment such as body armor or chemical biological suits and excessive equipment loads, exacerbate the physiological strain. Health, over even short mission durations, can easily be compromised. Measuring and acting upon health information can provide a means to dynamically manage both health and mission goals. However, the measurement of health state in austere military environments is challenging; (1) body worn sensors must be of minimal weight and size, consume little power, and be comfortable and unobtrusive enough for prolonged wear; (2) health states are not directly measureable and must be estimated; (3) sensor measurements are prone to noise, artifact, and failure. Given these constraints we examine current successful ambulatory physiological status monitoring technologies, review maturing sensors that may provide key health state insights in the future, and discuss unconventional analytical techniques that optimize health, mission goals, and doctrine from the perspective of thermal work strain assessment and management.

Patient Care Outcomes: Implications for the Military Health Services Systems

DTIC Science & Technology

1991-05-05

understanding the crisis in health care costs is a sense of the effects of the aging population in the United States on the health care system. People ...are living longer. Consequently, the time o,,r which people 2 qualify for health care coverage under Medicare has also increased. Not surprisingly, the...increased life span has two concomitant health care implications. First, people are more likely to develop and live with chronic diseases that

Evaluation and comparison of health care Work Environment Scale in military settings.

PubMed

Maloney, J P; Anderson, F D; Gladd, D L; Brown, D L; Hardy, M A

1996-05-01

The purpose of this study was to describe health care providers' perceptions of their work environment at a large U.S. Army medical center, and to compare the findings to other military medical centers. The sample (N = 112) consisted of the professional nursing staff working on the nine inpatient units. The Work Environmental Scale (WES) was used to measure perceptions of the workplace relative to gender, position (head nurses, staff nurses, and agency nurses), specialty nursing (intensive care unit [ICU] versus non-ICU), education (MSN, BSN, and ADN), and patterns of differences between the WES subscales of four military medical centers. Results of the study indicate that there were no significant gender differences. Head nurses, non-ICU nurses, and MSN nurses perceived their environment more positively. There were significant differences in the WES subscales between the military hospitals. Implications for nursing using the WES were recommended.

Toward Innovative, Cost-Effective, and Systemic Solutions to Improve Outcomes and Well-Being of Military Families Affected by Autism Spectrum Disorder

PubMed Central

Klin, Ami; Wetherby, Amy M.; Woods, Juliann; Saulnier, Celine; Stapel-Wax, Jennifer; Klaiman, Cheryl; Jones, Warren; Rubin, Emily; Scahill, Lawrence; Call, Nathan; Bearss, Karen; Gunter, Chris; Courtemanche, Charles J.; Lemieux, Anthony; Cox, James C.; Mandell, David S.; Van Decar, James P.; Miller, Ronald A.; Shireman, Cherri L.

2015-01-01

The burdens faced by military families who have a child with autism are unique. The usual challenges of securing diagnostic, treatment, and educational services are compounded by life circumstances that include the anxieties of war, frequent relocation and separation, and a demand structure that emphasizes mission readiness and service. Recently established military autism-specific health care benefits set the stage for community-viable and cost-effective solutions that can achieve better outcomes for children and greater well-being for families. Here we argue for implementation of evidence-based solutions focused on reducing age of diagnosis and improving access to early intervention, as well as establishment of a tiered menu of services, individualized to the child and family, that fit with the military ethos and system of health care. Absence of this new model of care could compromise the utility and sustainability of the autism-specific benefit. PMID:25745376

Traumatic Brain Injury Incidence, Clinical Overview, and Policies in the US Military Health System Since 2000

PubMed Central

Isaacson, Brad M.; Cyborski, Cherina M.; French, Louis M.; Tsao, Jack W.; Pasquina, Paul F.

2017-01-01

Exposure to explosive armaments during Operation Iraqi Freedom and Operation Enduring Freedom contributed to approximately 14% of the 352 612 traumatic brain injury (TBI) diagnoses in the US military between 2000 and 2016. The US Department of Defense issued guidelines in 2009 to (1) standardize TBI diagnostic criteria; (2) classify TBI according to mechanism and severity; (3) categorize TBI symptoms as somatic, psychological, or cognitive; and (4) systematize types of care given during the acute and rehabilitation stages of TBI treatment. Polytrauma and associated psychological and neurologic conditions may create barriers to optimal rehabilitation from TBI. Given the completion of recent combat operations and the transition of TBI patients into long-term care within the US Department of Veterans Affairs system, a review of the literature concerning TBI is timely. Long-term follow-up care for patients who have sustained TBI will remain a critical issue for the US military. PMID:28135424

National surveys of military personnel, nursing students, and the public: drivers of military nursing careers.

PubMed

Donelan, Karen; Romano, Carol; Buerhaus, Peter; DesRoches, Catherine; Applebaum, Sandra; Ward, Johanna Rm; Schoneboom, Bruce A; Hinshaw, Ada Sue

2014-05-01

The U.S. health care system is facing a projected nursing shortage of unprecedented magnitude. Although military nursing services recently have been able to meet their nursing recruitment quotas, national studies have predicted a long-term nursing shortage that may affect future recruitment for the Nurse Corps of the three military services. Data are needed to plan for recruitment incentives and the impact of those incentives on targeted populations of likely future nurses. Data are drawn from three online surveys conducted in 2011-2012, including surveys of 1,302 Army, Navy, and Air Force personnel serving on major military bases, 914 nursing students at colleges with entry Bachelor of Science in Nursing programs located nearby major military bases, and a qualitative survey of 1,200 young adults, age 18-39, in the general public. The three populations are different in several demographic characteristics. We explored perceptions of military careers, nursing careers and barriers, and incentives to pursue military nursing careers in all populations. Perceptions differ among the groups. The results of this study may help to inform strategies for reaching out to specific populations with targeted messages that focus on barriers and facilitators relevant to each to successfully recruit a diverse Nurse Corps for the future. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Health Professionals Special Pays Study: Report to Congress on Armed Forces Health Professionals Special Pays -- Other Health Care Providers

DTIC Science & Technology

1988-12-01

of its force in those years, while others were able to maintain their size fairly well. Various factors have contributed to the relative health of each...specialized health care providers. These factors have particular significance for health care in the Military Health Services System (MHSS). The Military...system. Many factors interrelate to cause major changes in health care delivery since the early 1970s. And health care is continuing to evolve as a result

Moral injury: a mechanism for war-related psychological trauma in military family members.

PubMed

Nash, William P; Litz, Brett T

2013-12-01

Recent research has provided compelling evidence of mental health problems in military spouses and children, including post-traumatic stress disorder (PTSD), related to the war-zone deployments, combat exposures, and post-deployment mental health symptoms experienced by military service members in the family. One obstacle to further research and federal programs targeting the psychological health of military family members has been the lack of a clear, compelling, and testable model to explain how war-zone events can result in psychological trauma in military spouses and children. In this article, we propose a possible mechanism for deployment-related psychological trauma in military spouses and children based on the concept of moral injury, a model that has been developed to better understand how service members and veterans may develop PTSD and other serious mental and behavioral problems in the wake of war-zone events that inflict damage to moral belief systems rather by threatening personal life and safety. After describing means of adapting the moral injury model to family systems, we discuss the clinical implications of moral injury, and describe a model for its psychological treatment.

Evaluation of military field-water quality: Volume 9, Data for assessing health risks in potential theaters of operation for US military forces: (Final report)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Daniels, J.I.; Layton, D.W.

1988-02-01

Data are presented in this volume for assessing the health risks in populations of military personnel that could result as a consequence of exposure to field waters containing constituents or infectious organisms of military concern, which are from natural and anthropogenic sources, at levels above those recommended as field-water-quality standards (i.e., above safe levels). Turbidity and color are the physical properties that are of military concern in field water. The other constituents that are of military concern in field water are (1) total dissolved solids, (2) chloride, (3) magnesium, (4) sulfate, (5) arsenic, (6) cyanide, (7) the pesticide lindane, andmore » (8) metabolites of algae and associated bacteria. Bacteria, viruses, and parasites (e.g., protozoa and helminths) are categories of water-related infectious organisms that are of military concern. Figures were developed from dose-response data to enable military risk managers to quickly assess the potential performance-degrading effects in personnel exposed to a measured concentration of a particular constituent in field water. The general physical, chemical, and biological quality of field waters in geographic regions worldwide, representing potential theaters of operation for U.S. military forces, also are evaluated. This analysis is based on available water-quality monitoring data and indicators of likely water-quality conditions (e.g., geohydrology, climate, sanitation, industrialization, etc.). Accompanying our evaluation are maps and tables alerting military planners and risk managers to the physical, chemical, or biological quality of field water that can be expected generally in geographic regions of concern.« less

A conceptual model of the psychological health system for U.S. active duty service members: an approach to inform leadership and policy decision making.

PubMed

Wang, Judy Y; Glover, Wiljeana J; Rhodes, Alison M; Nightingale, Deborah

2013-06-01

The influence of individual-level factors such as pretraumatic risk and protective factors and the availability of unit-level and enterprise-level factors on psychological health outcomes have been previously considered individually, but have not been considered in tandem across the U.S. Military psychological health system. We use the existing literature on military psychological health to build a conceptual system dynamics model of the U.S. Military psychological health system "service-cycle" from accession and deployment to future psychological health screening and treatment. The model highlights a few key observations, challenges, and opportunities for improvement for the system that relate to several topics including the importance of modeling operational demand combined with the population's psychological health as opposed to only physical health; the role of resilience and post-traumatic growth on the mitigation of stress; the positive and negative effects of pretraumatic risk factors, unit support, and unit leadership on the service-cycle; and the opportunity to improve the system more rapidly by including more feedback mechanisms regarding the usefulness of pre- and post-traumatic innovations to medical leaders, funding authorities, and policy makers. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

CE: Original Research: Primary Care Providers and Screening for Military Service and PTSD.

PubMed

Mohler, Kristin Michelle; Sankey-Deemer, Cydnee

2017-11-01

: Background: Most veterans have the option of receiving their health care from the Veterans Health Administration or through primary care providers in the private sector. However, there is some evidence that fewer than half of community-based, private sector primary care and mental health providers screen their patients for military service, particularly in rural areas, leaving these veterans less likely to be screened for posttraumatic stress disorder (PTSD) and other military service-related conditions. To determine whether primary care providers in the private sector are screening patients for military service and subsequent PTSD. We designed and piloted a survey to determine whether primary care providers in a rural Pennsylvania region routinely screen for military service and service-related PTSD. We distributed the survey to a convenience sample of more than 250 primary care providers in central and western Pennsylvania through the U.S. Postal Service, via Facebook, and via work e-mails for those who worked in a local health system. Among 50 eligible respondents, only four (8%) said they screen all their patients for military service, and 20 (40%) reported screening none; only two respondents (4%) screened all their patients who have served in the military for PTSD, and 30 (60%) screened none. Veterans who rely on private sector providers may not receive evidence-based care for military service-related health problems, including PTSD. To improve care for these patients, providers in the private sector should be educated on why all patients should be screened for military service, how to conduct such screening properly, and veterans' general health concerns.

Military veterans with mental health problems: a protocol for a systematic review to identify whether they have an additional risk of contact with criminal justice systems compared with other veterans groups.

PubMed

Taylor, James; Parkes, Tessa; Haw, Sally; Jepson, Ruth

2012-11-06

There is concern that some veterans of armed forces, in particular those with mental health, drug or alcohol problems, experience difficulty returning to a civilian way of life and may subsequently come into contact with criminal justice services and imprisonment. The aim of this review is to examine whether military veterans with mental health problems, including substance use, have an additional risk of contact with criminal justice systems when compared with veterans who do not have such problems. The review will also seek to identify veterans' views and experiences on their contact with criminal justice services, what contributed to or influenced their contact and whether there are any differences, including international and temporal, in incidence, contact type, veteran type, their presenting health needs and reported experiences. In this review we will adopt a methodological model similar to that previously used by other researchers when reviewing intervention studies. The model, which we will use as a framework for conducting a review of observational and qualitative studies, consists of two parallel synthesis stages within the review process; one for quantitative research and the other for qualitative research. The third stage involves a cross study synthesis, enabling a deeper understanding of the results of the quantitative synthesis. A range of electronic databases, including MEDLINE, PsychINFO, CINAHL, will be systematically searched, from 1939 to present day, using a broad range of search terms that cover four key concepts: mental health, military veterans, substance misuse, and criminal justice. Studies will be screened against topic specific inclusion/exclusion criteria and then against a smaller subset of design specific inclusion/exclusion criteria. Data will be extracted for those studies that meet the inclusion criteria, and all eligible studies will be critically appraised. Included studies, both quantitative and qualitative, will then undergo

Information Technologies in the System of Military Engineer Training of Cadets

ERIC Educational Resources Information Center

Khizhnaya, Anna V.; Kutepov, Maksim M.; Gladkova, Marina N.; Gladkov, Alexey V.; Dvornikova, Elena I.

2016-01-01

The necessity of enhancement of the information component in the military engineer training is determined by the result of a comparative analysis of global and national engineering education standards. The purpose is to substantiate the effectiveness and relevance of applying information technology in the system of military engineer training of…

The Millennium Cohort Family Study: A Prospective Evaluation of the Health and Well-Being of Military Service Members and Their Families

DTIC Science & Technology

2014-06-10

psychology , family, military, epidemiology, mental health, deployments Correspondence Nancy Crum-Cianflone, Deployment Health Research Department...American Psychological Association, 2007; Siegel et al., 2013; US Army Medical Research and Materiel Command, 2013). Although studies on military...functional health Modules on common types of mental disorders: depression, anxiety, panic syndrome, somatoform symptoms, alcohol abuse, bulimia nervosa

[Health status and fitness of the young men for military service].

PubMed

Korenev, N M; Bulaga, L P; Komlik, P V; Nemirova, O A; Kalmykov, K K; Sidorenko, T P

2002-01-01

Submitted in the article are medical causes of unfitness of those men called up for military service in peace-time. These include psychic dysfunctions (22%), traumata (18.5%), disorders of the nervous system and sensory organs (14.5%), of the osteomuscular system and connective tissue (13.3%), digestive diseases (8.6%). Mental disorders, those of the nervous system and sensory organs, the endocrine system and digestive organs rank first among causes of striking the serviceman off the register, coming up to 40.9%, 31.2%, and 6.8% respectively. Age has been established at which disease manifestations causing unfitness for military service come to reveal themselves: in 58.4 percent of registrants the above manifestations were first diagnosed in childhood, in 5.4 percent--at 16 to 17 years of age, in 36.2 percent--at call-up age.

The Influence of Social Support on Dyadic Functioning and Mental Health Among Military Personnel During Postdeployment Reintegration.

PubMed

Cederbaum, Julie A; Wilcox, Sherrie L; Sullivan, Kathrine; Lucas, Carrie; Schuyler, Ashley

Although many service members successfully cope with exposure to stress and traumatic experiences, others have symptoms of depression, posttraumatic stress disorder (PTSD), and anxiety; contextual factors may account for the variability in outcomes from these experiences. This work sought to understand mechanisms through which social support influences the mental health of service members and whether dyadic functioning mediates this relationship. We collected cross-sectional data as part of a larger study conducted in 2013; 321 military personnel who had at least 1 deployment were included in these analyses. Surveys were completed online; we collected data on demographic characteristics, social support, mental health measures (depression, PTSD, and anxiety), and dyadic functioning. We performed process modeling through mediation analysis. The direct effects of social support on the mental health of military personnel were limited; however, across all types of support networks, greater social support was significantly associated with better dyadic functioning. Dyadic functioning mediated the relationships between social support and depression/PTSD only when social support came from nonmilitary friends or family; dyadic functioning mediated social support and anxiety only when support came from family. We found no indirect effects of support from military peers or military leaders. Findings here highlight the need to continue to explore ways in which social support, particularly from family and nonmilitary-connected peers, can bolster healthy intimate partner relationships and, in turn, improve the well-being of military service members who are deployed.

The Influence of Social Support on Dyadic Functioning and Mental Health Among Military Personnel During Postdeployment Reintegration

PubMed Central

Wilcox, Sherrie L.; Sullivan, Kathrine; Lucas, Carrie; Schuyler, Ashley

2016-01-01

Objectives: Although many service members successfully cope with exposure to stress and traumatic experiences, others have symptoms of depression, posttraumatic stress disorder (PTSD), and anxiety; contextual factors may account for the variability in outcomes from these experiences. This work sought to understand mechanisms through which social support influences the mental health of service members and whether dyadic functioning mediates this relationship. Methods: We collected cross-sectional data as part of a larger study conducted in 2013; 321 military personnel who had at least 1 deployment were included in these analyses. Surveys were completed online; we collected data on demographic characteristics, social support, mental health measures (depression, PTSD, and anxiety), and dyadic functioning. We performed process modeling through mediation analysis. Results: The direct effects of social support on the mental health of military personnel were limited; however, across all types of support networks, greater social support was significantly associated with better dyadic functioning. Dyadic functioning mediated the relationships between social support and depression/PTSD only when social support came from nonmilitary friends or family; dyadic functioning mediated social support and anxiety only when support came from family. We found no indirect effects of support from military peers or military leaders. Conclusion: Findings here highlight the need to continue to explore ways in which social support, particularly from family and nonmilitary-connected peers, can bolster healthy intimate partner relationships and, in turn, improve the well-being of military service members who are deployed. PMID:28005474

Requirements for the Military Message System (MMS) Family: Data Types and User Commands.

DTIC Science & Technology

1986-04-11

AD-A167 126 REQUIREMENTS FOR THE MILITARY MESSASE SYSTEM (NHS) i FRILY: DATA TYPES AND USER CONNNDS(U) NAVAL RESEARCH LAB WASHINGTON DC C L HEITHEVER... System (MMS) Family: Data Types and User Commands CONSTANCE L. HEITMEYER Computer Science and Systems Branch I Information Technology Division April 11...Security Classification) Requirements for the Military Message System (MMS) Family: Data Types and User Commands 12. PERSONAL AUTHOR(S) Heitmeer, Constance

Military chemical warfare agent human subjects testing: part 1--history of six-decades of military experiments with chemical warfare agents.

PubMed

Brown, Mark

2009-10-01

Military chemical warfare agent testing from World War I to 1975 produced thousands of veterans with concerns of possible long-term health consequences. Clinical and research evaluation of potential long-term health effects has been difficult because the exposures occurred decades ago, the identity of troops exposed and exposure magnitudes are uncertain, and acute effects during experiments poorly documented. In contrast, a companion article describes the large amount of information available about the specific agents tested and their long-term health effects. This short history describes U.S. military chemical-agent experiments with human subjects and identifies tested agents. Finally, the demonstrated need to anticipate future health concerns from military personnel involved in such military testing suggests current and future military researchers should be required, by law and regulation, to fully record the identity of those exposed, relevant exposure magnitude, and complete medical information for all subjects. New study protocols and institutional review board approvals for research involving military personnel should reflect this need.

Well-being and suicidal ideation of secondary school students from military families.

PubMed

Cederbaum, Julie A; Gilreath, Tamika D; Benbenishty, Rami; Astor, Ron A; Pineda, Diana; DePedro, Kris T; Esqueda, Monica C; Atuel, Hazel

2014-06-01

The mental health of children is a primary public health concern; adolescents of military personnel may be at increased risk of experiencing poorer well-being overall and depressive symptoms specifically. These adolescents experience individual and intrafamilial stressors of parental deployment and reintegration, which are directly and indirectly associated with internalizing behaviors. The present study sought to better understand the influence of parental military connectedness and parental deployment on adolescent mental health. Data from the 2011 California Healthy Kids Survey examined feeling sad or hopeless, suicidal ideation, well-being, and depressive symptoms by military connectedness in a subsample (n = 14,299) of seventh-, ninth-, and 11th-grade California adolescents. Cross-classification tables and multiple logistic regression analyses were used. More than 13% of the sample had a parent or sibling in the military. Those with military connections were more likely to report depressive symptoms and suicidal ideation. Controlling for grade, gender, and race/ethnicity, reporting any familial deployment compared with no deployments was associated with increasing odds of experiencing sadness or hopelessness, depressive symptoms, and suicidal ideation. Findings emphasize the increased risk of mental health issues among youth with parents (and siblings) in the military. Although deployment-related mental health stressors are less likely during peace, during times of war there is a need for increased screening in primary care and school settings. Systematic referral systems and collaboration with community-based mental health centers will bolster screening and services. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Does the Military Child Care System Serve Its Purpose? Research Brief

ERIC Educational Resources Information Center

Zellman, Gail L.; Gates, Susan M.; Cho, Michelle; Shaw Rebecca

2008-01-01

This research brief summarizes research suggesting that the U.S. Department of Defense may wish to consider expanding its child care benefits to cover more military families and a broader set of child care needs. [For "Options for Improving the Military Child Care System. Occasional Paper Summary", see ED502782. For the full paper, see ED502783.

Operation United Assistance: infectious disease threats to deployed military personnel.

PubMed

Murray, Clinton K; Yun, Heather C; Markelz, Ana Elizabeth; Okulicz, Jason F; Vento, Todd J; Burgess, Timothy H; Cardile, Anthony P; Miller, R Scott

2015-06-01

As part of the international response to control the recent Ebola outbreak in West Africa, the Department of Defense has deployed military personnel to train Liberians to manage the disease and build treatment units and a hospital for health care volunteers. These steps have assisted in providing a robust medical system and augment Ebola diagnostic capability within the affected nations. In order to prepare for the deployment of U.S. military personnel, the infectious disease risks of the regions must be determined. This evaluation allows for the establishment of appropriate force health protection posture for personnel while deployed, as well as management plans for illnesses presenting after redeployment. Our objective was to detail the epidemiology and infectious disease risks for military personnel in West Africa, particularly for Liberia, along with lessons learned from prior deployments. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

The Soviet Higher Military Educational System

DTIC Science & Technology

1982-02-01

higher military educational system pre- sents a simple hierarchial pattern that looks something like the chart on the following page. The decade...combat officers in response to desperate need . They were short on theory and long on teaching how to wage war with the weapons at hand. They...logically sound proletarians and communists. The nagging fear of further foreign intervention, how- ever, caused an increase in the need for better

Engine health monitoring: An advanced system

NASA Technical Reports Server (NTRS)

Dyson, R. J. E.

1981-01-01

The advanced propulsion monitoring system is described. The system was developed in order to fulfill a growing need for effective engine health monitoring. This need is generated by military requirements for increased performance and efficiency in more complex propulsion systems, while maintaining or improving the cost to operate. This program represents a vital technological step in the advancement of the state of the art for monitoring systems in terms of reliability, flexibility, accuracy, and provision of user oriented results. It draws heavily on the technology and control theory developed for modern, complex, electronically controlled engines and utilizes engine information which is a by-product of such a system.

Trajectories of alcohol use in the UK military and associations with mental health.

PubMed

Goodwin, L; Norton, S; Fear, N T; Jones, M; Hull, L; Wessely, S; Rona, R J

2017-12-01

There are higher levels of alcohol misuse in the military compared to the general population. Yet there is a dearth of research in military populations on the longitudinal patterns of alcohol use. This study aims to identify group trajectories of alcohol consumption in the UK military and to identify associations with childhood adversity, deployment history and mental disorder. Data on weekly alcohol consumption across an eight year period and three phases of a UK military cohort study (n=667) were examined using growth mixture modelling. Five alcohol trajectory classes were identified: mid-average drinkers (55%), abstainers (4%), low level drinkers (19%), decreasing drinkers (3%) and heavy drinkers (19%). Alcohol consumption remained stable over the three periods in all classes, other than in the small decreasing trajectory class. Individuals in the heavy drinking class were more likely to have deployed to Iraq. Abstainers and heavy drinkers were more likely to report post-traumatic stress disorders at baseline compared to average drinkers. Heavy drinkers in the UK military did not change their drinking pattern over a period of eight years. This highlights the need to develop effective preventive programmes to lessen the physical and psychological consequences of long-term heavy alcohol use. Individuals with a mental health problem appeared more likely to either be drinking at a high level or to be abstaining from use. Copyright © 2017 Elsevier Ltd. All rights reserved.

Families in the Military

MedlinePlus

... parent in the military is deployed. Visit AACAP's Military Families Resource Center . For additional information see: Center ... like to make good mental health a reality, consider donating to the Campaign for America’s Kids . Your support will help us continue to ...

SHM reliability and implementation - A personal military aviation perspective

NASA Astrophysics Data System (ADS)

Lindgren, Eric A.

2016-02-01

Structural Health Monitoring has been proposed as a solution to address the needs of military aviation to reduce the time and cost to perform nondestructive inspections. While the potential to realize significant benefits exist, there are considerations that have to be addressed before such systems can be integrated into military platforms. Some considerations are pervasive to all aviation, such as how to assess the reliability and reproducible capability of these systems. However, there are other challenges unique to military aviation that must be overcome before these types of systems can be used. This presentation and paper are intended as a complement to the review of the outcome of the SAE G-11 SHM committee special workshop on SHM reliability in April of 2015. It will address challenges unique to military aviation that stem from different approaches to managing structural integrity (i.e. safety), frequency of use, design differences, various maintenance practices, and additional descriptions addressing differences in the execution of inspections. The objective of this presentation is to improve the awareness of the research and development community to the different and unique requirements found in military aviation, including the differences between countries, services, and aircraft type. This information should assist the research and development community in identifying and attacking key challenges. It is not intended to be comprehensive overview of all stakeholders' perspectives, but to serve as a launch point for additional discussion and exploration of opportunities to realize the potential of Structural Health Monitoring to assist in the management of military aviation assets. The views expressed in this publication are those of the author and do not reflect the official policy or position of the United States Air Force, Department of Defense, or the United States Government.

The role of chaplains in maintaining the psychological health of military personnel: an historical and contemporary perspective.

PubMed

Seddon, Rachel L; Jones, Edgar; Greenberg, Neil

2011-12-01

For many hundred of years, military forces have included chaplains of various faiths. Although these personnel mainly concentrate on providing for the religious and spiritual needs of the armed forces, they also contribute to the mental health of service personnel. This article provides a historical overview of military chaplains, examines their contributions to the psychological health of allied forces in World War I and World War II, and offers an overview of the scope of their present and future mental health related activities. The importance of the relationship between medical officers and chaplains in diagnosing and treating mental health problems is also discussed. We conclude that chaplains are capable of contributing significantly to the mental health of armed forces personnel if they are able to do so in informal and collaborative way.

Military personnel recognition system using texture, colour, and SURF features

NASA Astrophysics Data System (ADS)

Irhebhude, Martins E.; Edirisinghe, Eran A.

2014-06-01

This paper presents an automatic, machine vision based, military personnel identification and classification system. Classification is done using a Support Vector Machine (SVM) on sets of Army, Air Force and Navy camouflage uniform personnel datasets. In the proposed system, the arm of service of personnel is recognised by the camouflage of a persons uniform, type of cap and the type of badge/logo. The detailed analysis done include; camouflage cap and plain cap differentiation using gray level co-occurrence matrix (GLCM) texture feature; classification on Army, Air Force and Navy camouflaged uniforms using GLCM texture and colour histogram bin features; plain cap badge classification into Army, Air Force and Navy using Speed Up Robust Feature (SURF). The proposed method recognised camouflage personnel arm of service on sets of data retrieved from google images and selected military websites. Correlation-based Feature Selection (CFS) was used to improve recognition and reduce dimensionality, thereby speeding the classification process. With this method success rates recorded during the analysis include 93.8% for camouflage appearance category, 100%, 90% and 100% rates of plain cap and camouflage cap categories for Army, Air Force and Navy categories, respectively. Accurate recognition was recorded using SURF for the plain cap badge category. Substantial analysis has been carried out and results prove that the proposed method can correctly classify military personnel into various arms of service. We show that the proposed method can be integrated into a face recognition system, which will recognise personnel in addition to determining the arm of service which the personnel belong. Such a system can be used to enhance the security of a military base or facility.

Correlates of perceived need for mental health care among active military personnel.

PubMed

Sareen, Jitender; Belik, Shay-Lee; Stein, Murray B; Asmundson, Gordon J G

2010-01-01

There is increasing concern about mental health problems and need for mental health care among soldiers after deployment. This study examined correlates of self-perceived need for mental health care among active military personnel. Data were from a 2002 cross-sectional population-based survey of 8,441 active Canadian military personnel (2,592 women) aged 16 to 54 (response rate 81%). A fully structured lay-administered interview for past-year DSM-IV mental disorders and perceived need for mental health care was conducted. Five domains of self-perceived need were assessed: information, medication, counseling, social intervention, and skills training. Several deployment factors were assessed (length of deployment, number of deployments, and exposure to deployment-related traumatic events), as were long-term restriction in activities because of disability and suicidal ideation. Multiple logistic regression models were used to determine correlates of perceived need. After adjustment for mental disorders, the strongest and most consistent correlates of perceived need were long-term restriction in activities, suicidal ideation, female gender, and regular service status (versus reserve status) (adjusted odds ratios ranging from 1.28 to 4.37). Deployment and exposure to combat and witnessing atrocities were moderately associated with an increase in self-perceived need for mental health care. The findings suggest that a range of issues beyond the presence of common mental disorders need to be considered in understanding the factors that contribute to a sense of need for mental health treatment. Postdeployment screening programs should consider systematically assessing self-perceived need for mental health treatment.

Deployment of military mothers: supportive and nonsupportive military programs, processes, and policies.

PubMed

Goodman, Petra; Turner, Annette; Agazio, Janice; Throop, Meryia; Padden, Diane; Greiner, Shawna; Hillier, Shannon L

2013-07-01

Military mothers and their children cope with unique issues when mothers are deployed. In this article, we present mothers' perspectives on how military resources affected them, their children, and their caregivers during deployment. Mothers described beneficial features of military programs such as family readiness groups and behavioral health care, processes such as unit support, and policies on length and timing of deployments. Aspects that were not supportive included inflexibility in family care plans, using personal leave time and funds for transporting children, denial of release to resolve caretaker issues, and limited time for reintegration. We offer recommendations for enhanced support to these families that the military could provide. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

Military Internal Medicine Resident Decision to Apply to Fellowship and Extend Military Commitment.

PubMed

Barsoumian, Alice E; Hartzell, Joshua D; Bonura, Erin M; Ressner, Roseanne A; Whitman, Timothy J; Yun, Heather C

2018-02-06

Nationally, the number of internal medicine physicians practicing in primary care has decreased amidst increasing interest in hospitalist medicine. Current priorities in the Military Health System include access to primary care and retention of trained personnel. Recently, we have conducted a study of military internal medicine residents' decision to enter infectious disease. As part of our larger effort, we saw an opportunity to characterize factors impacting decision making of internal medicine residents' desire to apply for subspecialty training and to extend active duty service obligations. Questions were developed after discussion with various military graduate medical education and internal medicine leaders, underwent external review, and were added to a larger question set. The survey link was distributed electronically to all U.S. military affiliated residencies' graduating internal medicine residents in December 2016-January 2017. Data were analyzed by decision to apply to fellowship and decision to extend military obligation using Fisher's exact test or Pearon's chi-square test. Sixty-eight residents from 10 of 11 military residency programs responded, for a response rate of 51%. The majority (62%) applied to fellowship to start after residency completion. Reasons cited for applying to fellowship included wanting to become a specialist as soon as possible (74%), wishing to avoid being a general internist (57%), and because they are unable to practice as a hospitalist in the military (52%). Fellowship applicants were more likely to plan to extend their military obligation than non-applicants, as did those with longer duration of military commitments. No other factors, including Uniformed Services University attendance or participation in undergraduate military experiences, were found to impact plan to extend active duty service commitment. The majority of graduating internal medicine residents apply for fellowship and report a desire to avoid being a

Winning without Fighting: Military/Ngo Interaction Development

DTIC Science & Technology

2015-12-01

Military Coordination in the Emergency Response in Indonesia,” Military Medicine 171, no. 10 (2006): 67, http://search.proquest.com/docview/217075123...Public Health Response: Policy and Strategic Coordination Considerations.” Military Medicine 171, no. 10 (10, 2006): 15. http://search.proquest.com...Haiti Earthquake: Recommendations for Change,” Disaster Medicine and Public Health Preparedness, vol. 6, no. 3 (October, 2012), 203. 28 B. STATE

Do black-white racial disparities in breastfeeding persist in the military community?

PubMed

Lundquist, Jennifer; Xu, Zhun; Barfield, Wanda; Elo, Irma

2015-02-01

We conduct a comparative analysis of breastfeeding behavior between military and civilian-affiliated mothers. Our focus is on African American mothers among whom breastfeeding rates are lowest. The military context may mitigate conditions associated with low breastfeeding prevalence by (a) providing stable employment and educational opportunities to populations who face an otherwise poor labor market and (b) providing universal healthcare that includes breastfeeding consultation. Using pregnancy risk assessment monitoring system (PRAMS) data for which we received special permission from each state to flag military affiliation, we analyze civilians and military affiliate in breastfeeding initiation using logistic regression and breastfeeding duration using Cox proportional hazard analysis. We find that breastfeeding is more prevalent among all women in the military setting and that the black-white gap in breastfeeding duration common among civilians is significantly reduced among military affiliates. Breastfeeding is a crucial component of maternal and child health and eliminating racial disparities in its prevalence is a public health priority. This study is the first to identify the military as an important institutional context that deserves closer examination to glean potential policy implications for civilian society.

Childhood vaccination coverage rates among military dependents in the United States.

PubMed

Dunn, Angela C; Black, Carla L; Arnold, John; Brodine, Stephanie; Waalen, Jill; Binkin, Nancy

2015-05-01

The Military Health System provides universal coverage of all recommended childhood vaccinations. Few studies have examined the effect that being insured by the Military Health System has on childhood vaccination coverage. The purpose of this study was to compare the coverage of the universally recommended vaccines among military dependents versus other insured and uninsured children using a nationwide sample of children. The National Immunization Survey is a multistage, random-digit dialing survey designed to measure vaccination coverage estimates of US children aged 19 to 35 months old. Data from 2007 through 2012 were combined to permit comparison of vaccination coverage among military dependent and all other children. Among military dependents, 28.0% of children aged 19 to 35 months were not up to date on the 4:3:1:3:3:1 vaccination series excluding Haemophilus influenzae type b vaccine compared with 21.1% of all other children (odds ratio: 1.4; 95% confidence interval: 1.2-1.6). After controlling for sociodemographic characteristics, compared with all other US children, military dependent children were more likely to be incompletely vaccinated (odds ratio: 1.3; 95% confidence interval: 1.1-1.5). Lower vaccination coverage rates among US military dependent children might be due to this population being highly mobile. However, the lack of a military-wide childhood immunization registry and incomplete documentation of vaccinations could contribute to the lower vaccination coverage rates seen in this study. These results suggest the need for further investigation to evaluate vaccination coverage of children with complete ascertainment of vaccination history, and if lower immunization rates are verified, assessment of reasons for lower vaccination coverage rates among military dependent children. Copyright © 2015 by the American Academy of Pediatrics.

[Cancer incidence in the military: an update].

PubMed

Peragallo, Mario Stefano; Urbano, Francesco; Sarnicola, Giuseppe; Lista, Florigio; Vecchione, Alfredo

2011-01-01

An abnormally elevated rate of Hodgkin's lymphoma was reported in 2001 among Italian soldiers in Bosnia and Kosovo since 1995: a surveillance system was therefore set up for the military community. Preliminary results for a longer period (1996-2007) have shown incidence rates lower than expected for all malignancies. No significant difference was registered between observed and expected cases of Hodkin's lymphoma: the excess of reported cases for this malignancy in 2001-2002 was probably due to a peak occurred in 2000 among the whole military; it is therefore unrelated to deployment in the Balkans, and probably represents a chance event. Moreover, a significant excess of thyroid cancer was reported among the whole military.The estimated number of incident cases, including those missed by the surveillance system, was not significantly higher than expected for all cancers; conversely, the estimated incidence rate of thyroid cancer was significantly increased; this excess, however, is probably due to a selection bias.These data concerning cancer surveillance in the Italian military are consistent with lacking evidence of an increased cancer incidence among troops of other countries deployed in the areas of Iraq, Bosnia, and Kosovo, where armour penetrating depleted uranium shells have been used. However, a comprehensive assessment of cancer morbidity in the military requires a revision of the privacy regulations, in order to link individual records of military personnel and data bases of the National Health Service.

[Role of researchers and employees of the Military Medical Academy in development of the system of military medical supply].

PubMed

Miroshnichenko, Iu V; Kononov, V N; Perfil'ev, A B

2013-12-01

The Military Medical Academy has been solving theoretical and practical issues, concerning development of military medical supply, for 215 years. At different time periods and according to needs of military medicine and pharmacy researches and employees of the Academy aimed efforts to: development of the theory and practice of medical supply organization, regulatory basis of the system of medical supply, development of new samples of medical equipment, development of medicine manufacturing technologies and methods of quality control, researches in the area of medicine radiochemistry, forensic chemistry and toxicology, herbal and mineral water analysis and etc. At the present time there are the following education programs at the Academy: "Pharmacy", magister program "Management of medical supply", program for resident physicians "Management and economics of pharmacy".

Understanding and preventing military suicide.

PubMed

Bryan, Craig J; Jennings, Keith W; Jobes, David A; Bradley, John C

2012-01-01

The continual rise in the U.S. military's suicide rate since 2004 is one of the most vexing issues currently facing military leaders, mental health professionals, and suicide experts. Despite considerable efforts to address this problem, however, suicide rates have not decreased. The authors consider possible reasons for this frustrating reality, and question common assumptions and approaches to military suicide prevention. They further argue that suicide prevention efforts that more explicitly embrace the military culture and implement evidence-based strategies across the full spectrum of prevention and treatment could improve success. Several recommendations for augmenting current efforts to prevent military suicide are proposed.

Psychological health of military children: longitudinal evaluation of a family-centered prevention program to enhance family resilience.

PubMed

Lester, Patricia; Stein, Judith A; Saltzman, William; Woodward, Kirsten; MacDermid, Shelley W; Milburn, Norweeta; Mogil, Catherine; Beardslee, William

2013-08-01

Family-centered preventive interventions have been proposed as relevant to mitigating psychological health risk and promoting resilience in military families facing wartime deployment and reintegration. This study evaluates the impact of a family-centered prevention program, Families OverComing Under Stress Family Resilience Training (FOCUS), on the psychological adjustment of military children. Two primary goals include (1) understanding the relationships of distress among family members using a longitudinal path model to assess relations at the child and family level and (2) determining pathways of program impact on child adjustment. Multilevel data analysis using structural equation modeling was conducted with deidentified service delivery data from 280 families (505 children aged 3-17) in two follow-up assessments. Standardized measures included service member and civilian parental distress (Brief Symptom Inventory, PTSD Checklist-Military), child adjustment (Strengths and Difficulties Questionnaire), and family functioning (McMaster Family Assessment Device). Distress was significantly related among the service member parent, civilian parent, and children. FOCUS improved family functioning, which in turn significantly reduced child distress at follow-up. Salient components of improved family functioning in reducing child distress mirrored resilience processes targeted by FOCUS. These findings underscore the public health potential of family-centered prevention for military families and suggest areas for future research. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

Research and Development for Health and Environmental Hazard Assessment. Task Order 1. Development of Data Base Requirements for Human Health Based Water Quality Criteria for Military Recycle/Reuse Applications.

DTIC Science & Technology

1980-06-01

Environmental Hazard Assessment -. .’.’ASK ORDER I j EVELOPMENT OF DATA BASE REQUIREMENTS I . .oR HUMAN HEALTH BASED WATER QUALITY CRITERIA | COR MILITARY...Requirements for Human Sep a -1979- June 89 Health Based Water Quality Criteria for Military -%4,o ER Reevcle/ Reuse Applications Is 8_ 3.7𔃾__=1_...KEY WORDS (Continue on reverse aide If neceseary and Identify by block number) Water Reuse, Water Recycle, Water Quality Criteria, Human Health

Obesity and associated adverse health outcomes among US military members and veterans: Findings from the millennium cohort study.

PubMed

Rush, Toni; LeardMann, Cynthia A; Crum-Cianflone, Nancy F

2016-07-01

To assess the prevalence of obesity and associated health outcomes among US service members and veterans. Data from three survey cycles (2001-2008) of the Millennium Cohort Study were used to examine the prevalence of obesity and associated health outcomes. Of the 42,200 individuals, 25% were of normal weight in 2007/2008. Rates of obesity were significantly higher among veterans (32%) compared with service members (20%). Over a 7-year period, obesity rates doubled among both service members (10%-20%) and veterans (14%-32%). Participants with obesity were significantly more likely to be male, older, less educated, in the Army or Navy, and separated/retired from the military. Hypertension, diabetes, and sleep apnea were significantly more common among individuals with obesity compared with participants with normal weight (all P < 0.05). Individuals with obesity also had significantly higher rates of depression and post-traumatic stress disorder than individuals with normal weight and had lower mental and physical functional scores (all P < 0.05). These findings indicate an urgent need to enhance strategies for preventing and reducing excess weight gain within the military and veteran populations. Such strategies should aim to ensure a fit military force and promote health after military service. © 2016 The Obesity Society.

Caring for children and youth from Canadian military families: Special considerations

PubMed Central

Rowan-Legg, Anne

2017-01-01

Abstract Military families experience a number of life stressors, such as frequent geographical moves, long periods of separation within the family, geographic isolation from extended family support systems and deployments to high-risk areas of the world. While children and youth in military families experience all the same developmental and motivational trajectories as their civilian counterparts, they must also contend with more unusual developmental pressures and stressors placed on them by the unique demands of military life. The effects of the military life on families and children are beginning to be recognized and characterized more fully. Understanding the unique concerns of children and youth from military families and mobilizing specific resources to support them are critical for meeting the health care needs of this population. PMID:29479192

Air Traffic Management: Civil/Military Systems and Technologies.

DTIC Science & Technology

1980-02-01

consi-~derably Anthropo- Fig. 8 Increas of System Capcity versus Usable Gain in Traffic Flow Controllable ul R 5. The Future of ATC If we think of...years from 2,000 on we must think of an integrated system, integrating * the ATC-system of the Structure X (Fig. 7) * the aircraft, by improving flight...both civil and military traffic with a range of potential link applications and other information that could be helpful in their future thinking . No

The influence of gender on suicidal ideation following military sexual trauma among Veterans in the Veterans Health Administration.

PubMed

Monteith, Lindsey L; Bahraini, Nazanin H; Matarazzo, Bridget B; Gerber, Holly R; Soberay, Kelly A; Forster, Jeri E

2016-10-30

No studies have examined whether military sexual trauma, as measured and defined within the Veterans Health Administration (VHA), is associated with suicidal ideation among Veterans in VHA care, when taking prior suicide attempts into account. Research regarding the role of gender in this association is also limited. The present study examined: (1) whether military sexual trauma was associated with the presence of past-week suicidal ideation among 354 Veterans in VHA (310 men, 44 women); (2) whether gender moderated the association between military sexual trauma and suicidal ideation. Information regarding military sexual trauma, suicidal ideation, suicide attempt, and psychiatric diagnoses was obtained from self-report instruments and medical records. Adjusting for age, gender, combat, posttraumatic stress disorder, depressive disorders, negative affect, and lifetime suicide attempt, Veterans with military sexual trauma were significantly more likely to report suicidal ideation, compared to Veterans without military sexual trauma. Furthermore, the association between military sexual trauma and suicidal ideation was stronger for men compared to women. These results contribute to a growing literature identifying military sexual trauma as a risk factor for suicidal thoughts and behaviors among Veterans in VHA care and emphasize the importance of screening for suicidal ideation among survivors of military sexual trauma. Published by Elsevier Ireland Ltd.

Military-civilian cooperative emergency response to infectious disease prevention and control in China.

PubMed

Ma, Hui; Dong, Ji-Ping; Zhou, Na; Pu, Wei

2016-01-01

In recent years, the incidence of severe infectious diseases has increased, and the number of emerging infectious diseases continues to increase. The Chinese government and military forces have paid a great deal of attention to infectious disease prevention and control, and using military-civilian cooperation, they have successfully prevented numerous severe epidemic situations, such as severe acute respiratory syndrome (SARS), influenza A (H1N1), avian influenza H5N1 and H7N9, and Ebola hemorrhagic fever, while actively maintained public health, economic development, and national construction. This paper focuses on the mechanisms of the military-cooperative emergency response to infectious diseases--the joint working mechanism, the information-sharing mechanism, the research collaboration mechanism, and the joint disposal mechanism--and presents a sorted summary of the practices and experiences of cooperative emergency responses to infectious diseases. In the future, the Chinese military and the civilian sector will further strengthen the cooperative joint command system and emergency rescue force and will reinforce their collaborative information-sharing platform and technical equipment system to further improve military-civilian collaborative emergency infectious diseases disposal, advance the level of infectious disease prevention and control, and maintain public health.

About Military Sexual Trauma

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Operational Stress and Correlates of Mental Health Among Joint Task Force Guantanamo Bay Military Personnel.

PubMed

Webb-Murphy, Jennifer A; De La Rosa, Gabriel M; Schmitz, Kimberly J; Vishnyak, Elizabeth J; Raducha, Stephanie C; Roesch, Scott C; Johnston, Scott L

2015-12-01

Military personnel deployed to Joint Task Force Guantanamo Bay (JTF-GTMO) faced numerous occupational stressors. As part of a program evaluation, personnel working at JTF-GTMO completed several validated self-report measures. Personnel were at the beginning, middle, or end of their deployment phase. This study presents data regarding symptoms of posttraumatic stress disorder, alcohol abuse, depression, and resilience among 498 U.S. military personnel deployed to JTF-GTMO in 2009. We also investigated individual and organizational correlates of mental health among these personnel. Findings indicated that tenure at JTF-GTMO was positively related to adverse mental health outcomes. Regression models including these variables had R2 values ranging from .02 to .11. Occupation at JTF-GTMO also related to mental health such that guards reported poorer mental health than medical staff. Reluctance to seek out mental health care was also related to mental health outcomes. Those who reported being most reluctant to seek out care tended to report poorer mental health than those who were more willing to seek out care. Results suggested that the JTF-GTMO deployment was associated with significant psychological stress, and that both job-related and attitude-related variables were important to understanding mental health symptoms in this sample. Copyright © 2015 International Society for Traumatic Stress Studies.

Effect of Multiple Deployments on Military Families: A Cross-Sectional Study of Health and Well-Being of Partners and Children.

PubMed

McGuire, Annabel C L; Kanesarajah, Jeeva; Runge, Catherine E; Ireland, Renee; Waller, Michael; Dobson, Annette J

2016-04-01

This study explored the impact of multiple deployments on the health and well-being of the partners (married or de facto) and children of Australian military personnel who have deployed frequently. Permission to contact military partners was sought from a sample of Australian Defence Force (ADF) members. Partners provided data on deployment history, physical health, mental health, and their children's emotions, and behaviors. Associations between multiple deployments and health and well-being of partners and children were assessed using logistic regression. Data were collected from 1,332 Australian Defence Force partners (response rate 36%) with 1,095 children aged between 4 and 17 years. Almost half (47%) of partners had experienced more than one deployment, mainly to Timor-Leste, Iraq, and Afghanistan. There was little evidence of associations between numbers of deployments and the health of the partner. In contrast, more behavioral problems were reported for children who experienced two or more deployments with odds ratios generally greater than 2 and significant trends with increasing numbers of deployment. Although military families who experience multiple deployments may, by selection, be more resilient than those who have fewer deployments, these results suggest that adverse impacts on the children may accrue with increasing parental absences because of deployment. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

The influence of sexual harassment on mental health among female military personnel of the Republic of Korea Armed Forces

PubMed Central

Kim, Tae Kyung; Lee, H-C; Lee, S G; Han, K-T; Park, E-C

2017-01-01

Introduction Reports of sexual harassment are becoming more frequent in Republic of Korea (ROK) Armed Forces. This study aimed to analyse the impact of sexual harassment on mental health among female military personnel of the ROK Armed Forces. Methods Data from the 2014 Military Health Survey were used. Instances of sexual harassment were recorded as ‘yes’ or ‘no’. Analysis of variance (ANOVA) was carried out to compare Kessler Psychological Distress Scale 10 (K-10) scores. Multiple logistic regression analysis was performed to identify associations between sexual harassment and K-10 scores. Results Among 228 female military personnel, 13 (5.7%) individuals experienced sexual harassment. Multiple logistic regression analysis revealed that sexual harassment had a significantly negative impact on K-10 scores (3.486, p<0.04). Higher K-10 scores among individuals experiencing sexual harassment were identified in the unmarried (including never-married) group (6.761, p<0.04), the short-term military service group (12.014, p<0.03) and the group whose length of service was <2 years (11.067, p<0.02). Conclusions Sexual harassment has a negative impact on mental health. Factors associated with worse mental health scores included service classification and length of service. The results provide helpful information with which to develop measures for minimising the negative psychological effects from sexual harassment and promoting sexual harassment prevention policy. PMID:27084842

Lower health related quality of life in U.S. military personnel is associated with service-related disorders and inflammation.

PubMed

Gill, Jessica; Lee, Hyunhwa; Barr, Taura; Baxter, Tristin; Heinzelmann, Morgan; Rak, Hannah; Mysliwiec, Vincent

2014-04-30

Military personnel who have combat exposures are at increased risk for the service-related disorders of post-traumatic stress disorder (PTSD), depression, sleep disturbances and decreased health related quality of life (HRQOL). Those with a traumatic brain injury (TBI) are at even greater risk. Inflammation is associated with these disorders and may underlie the risk for health declines. We evaluated 110 recently deployed, military personnel presenting with sleep disturbances for service-related disorders (TBI, PTSD, and depression) as well as HRQOL. ANOVA models were used to examine differences among military personnel with two or more service-related disorders (high comorbid group), or one or no disorders (low comorbid group). Logistic regression models were used to determine associations among interleukin-6 (IL-6) to HRQOL and service-related disorders. Approximately one-third of the sample had two or more service-related disorders. HRQOL was lower and IL-6 concentrations were higher in military personnel with PTSD or depression, with the most profound differences in those with more service-related disorders, regardless of sleep disorder. Having symptoms of depression and PTSD resulted in a 3.5-fold risk to be in the lower quartile of HRQOL and the highest quartile of IL-6. In a linear regression model, 41% of the relationship between HRQOL and IL-6 concentrations was mediated by PTSD and depression. Military personnel with PTSD and depression are at high risk for lower HRQOL, and higher IL-6 concentrations. Comprehensive treatment is required to address co-occurring service-related disorders in military personnel to promote health and well-being. Copyright © 2014. Published by Elsevier Ireland Ltd.

A systematic review of help-seeking and mental health service utilization among military service members.

PubMed

Hom, Melanie A; Stanley, Ian H; Schneider, Matthew E; Joiner, Thomas E

2017-04-01

Research has demonstrated that military service members are at elevated risk for a range of psychiatric problems, and mental health services use is a conduit to symptom reduction and remission. Nonetheless, there is a notable underutilization of mental health services in this population. This systematic review aimed to identify and critically examine: (1) rates of service use; (2) barriers and facilitators to care; and (3) programs and interventions designed to enhance willingness to seek care and increase help-seeking behaviors among current military personnel (e.g., active duty, National Guard, Reserve). Overall, 111 peer-reviewed articles were identified for inclusion. Across studies, the rate of past-year service use among service members with mental health problems during the same time frame was 29.3% based on weighted averages. Studies identified common barriers to care (e.g., concerns regarding stigma, career impact) and facilitators to care (e.g., positive attitudes toward treatment, family/friend support, military leadership support) among this population. Although programs (e.g., screening, gatekeeper training) have been developed to reduce these barriers, leverage facilitators, and encourage service use, further research is needed to empirically test the effectiveness of these interventions in increasing rates of service utilization. Critical areas for future research on treatment engagement among this high-risk population are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Psychological distress in the active duty military spine patient.

PubMed

Brooks, D Ethan; Agochukwu, Uzondu F; Arrington, Edward D; Mok, James M

2013-10-01

Disorders of the spine are a substantial burden to the military health care system that degrades readiness in the overall force. Because treatment outcomes are affected by psychosocial factors, assessment of psychological distress is important for patients with spine complaints. The incidence of psychological distress in the unique military population is not well described. The purpose of this retrospective case-control study was to determine the rate of psychological distress and identify associated patient characteristics among many variables collected in the military health system. A consecutive cohort of active duty service members presenting to a spine specialty clinic was assessed as Normal, At Risk, or Distressed using the Distress and Risk Assessment Method. Of 74 active duty patients (63 male, 11 female), 43 (58%) had some level of psychological distress: 29 (39%) At Risk, 12 (16%) Distressed-Depressive, and 2 (3%) Distressed-Somatic. Multivariate regression analysis identified female gender (odds ratio [OR] 7.90), higher disability as measured by Oswestry Disability Index/Neck Disability Index (OR 8.0 per 13.8 point increase), and assignment to a Warrior Transition Unit or Medical Evaluation Board (OR 7.35) as statistically significant variables. The results indicate that active duty patients are subject to similarly high levels of psychological distress as their civilian counterparts. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

ADP SYSTEMS ANALYSIS - COMMITTED VS. AVAILABLE MILITARY TRANSPORTATION (LMI T1).

DTIC Science & Technology

LOGISTICS , * MANAGEMENT ENGINEERING), (*DATA PROCESSING, LOGISTICS), INFORMATION RETRIEVAL, SYSTEMS ENGINEERING, MILITARY TRANSPORTATION, CARGO VEHICLES, SCHEDULING, COMPUTER PROGRAMMING, MANAGEMENT PLANNING AND CONTROL

Options for Improving the Military Child Care System

DTIC Science & Technology

2008-01-01

kind subsidy. As a system of employer-sponsored care, however, DoD child care ultimately must be assessed in terms of its contribution to military...considered a compensa- tion issue, and the potential of this paradigm is assessed from a broader, more employer-based perspective. This paper will be...52 Recommendations for Assessing

Trends in suicidal behaviour and use of mental health services in Canadian military and civilian populations.

PubMed

Sareen, Jitender; Afifi, Tracie O; Taillieu, Tamara; Cheung, Kristene; Turner, Sarah; Bolton, Shay-Lee; Erickson, Julie; Stein, Murray B; Fikretoglu, Deniz; Zamorski, Mark A

2016-08-09

In the context of the Canadian mission in Afghanistan, substantial media attention has been placed on mental health and lack of access to treatment among Canadian Forces personnel. We compared trends in the prevalence of suicidal behaviour and the use of mental health services between Canadian military personnel and the general population from 2002 to 2012/13. We obtained data for respondents aged 18-60 years who participated in 4 nationally representative surveys by Statistics Canada designed to permit comparisons between populations and trends over time. Surveys of the general population were conducted in 2002 (n = 25 643) and 2012 (n = 15 981); those of military personnel were conducted in 2002 (n = 5153) and 2013 (n = 6700). We assessed the lifetime and past-year prevalence of suicidal ideation, plans and attempts, as well as use of mental health services. In 2012/13, but not in 2002, military personnel had significantly higher odds of both lifetime and past-year suicidal ideation than the civilian population (lifetime: adjusted odds ratio [OR] 1.32, 95% confidence interval [CI] 1.17-1.50; past year: adjusted OR 1.34, 95% CI 1.09-1.66). The same was true for suicidal plans (lifetime: adjusted OR 1.64, 95% CI 1.35-1.99; past year: adjusted OR 1.66, 95% CI 1.18-2.33). Among respondents who reported past-year suicidal ideation, those in the military had a significantly higher past-year utilization rate of mental health services than those in the civilian population in both 2002 (adjusted OR 2.02, 95% CI 1.31-3.13) and 2012/13 (adjusted OR 3.14, 95% CI 1.86-5.28). Canadian Forces personnel had a higher prevalence of suicidal ideation and plans in 2012/13 and a higher use of mental health services in 2002 and 2012/13 than the civilian population. © 2016 Canadian Medical Association or its licensors.

Trends in suicidal behaviour and use of mental health services in Canadian military and civilian populations

PubMed Central

Sareen, Jitender; Afifi, Tracie O.; Taillieu, Tamara; Cheung, Kristene; Turner, Sarah; Bolton, Shay-Lee; Erickson, Julie; Stein, Murray B.; Fikretoglu, Deniz; Zamorski, Mark A.

2016-01-01

Background: In the context of the Canadian mission in Afghanistan, substantial media attention has been placed on mental health and lack of access to treatment among Canadian Forces personnel. We compared trends in the prevalence of suicidal behaviour and the use of mental health services between Canadian military personnel and the general population from 2002 to 2012/13. Methods: We obtained data for respondents aged 18–60 years who participated in 4 nationally representative surveys by Statistics Canada designed to permit comparisons between populations and trends over time. Surveys of the general population were conducted in 2002 (n = 25 643) and 2012 (n = 15 981); those of military personnel were conducted in 2002 (n = 5153) and 2013 (n = 6700). We assessed the lifetime and past-year prevalence of suicidal ideation, plans and attempts, as well as use of mental health services. Results: In 2012/13, but not in 2002, military personnel had significantly higher odds of both lifetime and past-year suicidal ideation than the civilian population (lifetime: adjusted odds ratio [OR] 1.32, 95% confidence interval [CI] 1.17–1.50; past year: adjusted OR 1.34, 95% CI 1.09–1.66). The same was true for suicidal plans (lifetime: adjusted OR 1.64, 95% CI 1.35–1.99; past year: adjusted OR 1.66, 95% CI 1.18–2.33). Among respondents who reported past-year suicidal ideation, those in the military had a significantly higher past-year utilization rate of mental health services than those in the civilian population in both 2002 (adjusted OR 2.02, 95% CI 1.31–3.13) and 2012/13 (adjusted OR 3.14, 95% CI 1.86–5.28). Interpretation: Canadian Forces personnel had a higher prevalence of suicidal ideation and plans in 2012/13 and a higher use of mental health services in 2002 and 2012/13 than the civilian population. PMID:27221270

Robust fusion-based processing for military polarimetric imaging systems

NASA Astrophysics Data System (ADS)

Hickman, Duncan L.; Smith, Moira I.; Kim, Kyung Su; Choi, Hyun-Jin

2017-05-01

Polarisation information within a scene can be exploited in military systems to give enhanced automatic target detection and recognition (ATD/R) performance. However, the performance gain achieved is highly dependent on factors such as the geometry, viewing conditions, and the surface finish of the target. Such performance sensitivities are highly undesirable in many tactical military systems where operational conditions can vary significantly and rapidly during a mission. Within this paper, a range of processing architectures and fusion methods is considered in terms of their practical viability and operational robustness for systems requiring ATD/R. It is shown that polarisation information can give useful performance gains but, to retained system robustness, the introduction of polarimetric processing should be done in such a way as to not compromise other discriminatory scene information in the spectral and spatial domains. The analysis concludes that polarimetric data can be effectively integrated with conventional intensity-based ATD/R by either adapting the ATD/R processing function based on the scene polarisation or else by detection-level fusion. Both of these approaches avoid the introduction of processing bottlenecks and limit the impact of processing on system latency.

Early Childhood Military Education?

ERIC Educational Resources Information Center

Pelo, Ann

2011-01-01

Does the country's national security rely on top-quality early childhood education? Yes, say the military leaders of Mission: Readiness, an organization led by retired military commanders that promotes investment in education, child health, and parenting support. Actually, the generals are right, but for all the wrong reasons. The generals' aim is…

Physicochemical characterization and failure analysis of military coating systems

NASA Astrophysics Data System (ADS)

Keene, Lionel Thomas

Modern military coating systems, as fielded by all branches of the U.S. military, generally consist of a diverse array of organic and inorganic components that can complicate their physicochemical analysis. These coating systems consist of VOC-solvent/waterborne automotive grade polyurethane matrix containing a variety of inorganic pigments and flattening agents. The research presented here was designed to overcome the practical difficulties regarding the study of such systems through the combined application of several cross-disciplinary techniques, including vibrational spectroscopy, electron microscopy, microtomy, ultra-fast laser ablation and optical interferometry. The goal of this research has been to determine the degree and spatial progression of weathering-induced alteration of military coating systems as a whole, as well as to determine the failure modes involved, and characterizing the impact of these failures on the physical barrier performance of the coatings. Transmission-mode Fourier Transform Infrared (FTIR) spectroscopy has been applied to cross-sections of both baseline and artificially weathered samples to elucidate weathering-induced spatial gradients to the baseline chemistry of the coatings. A large discrepancy in physical durability (as indicated by the spatial progression of these gradients) has been found between older and newer generation coatings. Data will be shown implicating silica fillers (previously considered inert) as the probable cause for this behavioral divergence. A case study is presented wherein the application of the aforementioned FTIR technique fails to predict the durability of the coating system as a whole. The exploitation of the ultra-fast optical phenomenon of femtosecond (10-15S) laser ablation is studied as a potential tool to facilitate spectroscopic depth profiling of composite materials. Finally, the interferometric technique of Phase Shifting was evaluated as a potential high-sensitivity technique applied to the

Gastrointestinal illnesses among French forces deployed to Djibouti: French military health surveillance, 2005-2009.

PubMed

Ollivier, Lénaïck; Decam, Christophe; Pommier de Santi, Vincent; Darar, Houssein Y; Dia, Aïssata; Nevin, Remington L; Romand, Olivier; Bougère, Jacques; Deparis, Xavier; Boutin, Jean-Paul

2010-10-01

Despite an increase in foreign tourism and in the numbers of foreign military personnel deployed to Djibouti, little is known about the risk of gastrointestinal illness in this country in eastern Africa. To assess risk and to describe common features of gastrointestinal illnesses, reports of illness derived from military health surveillance data collected during 2005-2009 among French service members deployed to Djibouti were reviewed. Diarrhea was the most common problem; it had an annual incidence ranging from 260 to 349 cases per 1,000 person-years. The risk was higher among soldiers deployed short-term (four months) than among soldiers deployed long-term (two years). This five-year review of French health surveillance data documents a significant burden of diarrhea among French soldiers in Djibouti. The identification of factors associated with risk may permit efficient targeting of interventions to reduce morbidity from gastrointestinal illness.

1992 Worldwide Survey of Substance Abuse and Health Behaviors Among Military Personnel

DTIC Science & Technology

1992-12-01

heavy alcohol use and heavy smoking, effects of Operations Desert Shield and Desert Storm on substance use, and pathological gambling in the military...2-17 2.6.3 Tobacco Use ................................ 2-18 2.6.4 Negative Effects ............................. 2-19...25 3 RVIEW OF TRENDS IN SUBSTANCE USE, NEGATIVE EFFECTS , AND HEALTH PRACTICES ................... 3-1 3.1 Trends in Substance Use

Enhancing Resilience in Active Duty Military Personnel.

PubMed

Crabtree-Nelson, Sonya; DeYoung, Lcdr Peter

2017-02-01

A systematic, evidence-based training program to support active duty military personnel through building unit-level resiliency in preparation for anticipated individual times of crisis is needed. Mental health nurses and social workers in the military possess critical training and expertise in identifying and supporting individual and community resilience factors. Their knowledge of the protective aspects of resilience can and should be used to educate all active duty military personnel, ensure military leaders are knowledgeable in how best to support their units, and provide research on the effectiveness of pre-combat resilience training. [Journal of Psychosocial Nursing and Mental Health Services, 55(2), 44-48.]. Copyright 2017, SLACK Incorporated.

Psychosocial Factors that Shape Substance Abuse and Related Mental Health of Women Military Veterans who Use Community-Based Services.

PubMed

Evans, Elizabeth A; Glover, Dawn L; Washington, Donna L; Hamilton, Alison B

2018-02-27

Women Veterans who use the Veterans Health Administration (VA) have high rates of substance abuse and poorer health than non-Veteran women. Less is known about the psychosocial needs of women Veterans who seek care in non-VA settings. We provide a grounded description of factors that impact substance abuse, mental health, and related quality of life of women Veterans who use non-VA community-based health and social services. Utilizing a mixed methods design, we conducted semi-structured in-person interviews with 22 women Veterans in Los Angeles in 2013-2015. The current health of these women Veterans was shaped by substance abuse and several other factors, including: histories of trauma (in childhood, during military service) and discrimination, and associated mental health conditions; post-military socio-economic stressors; shifting social roles and adverse social support; and lost personal identity after military service. Psychosocial factors collectively underscore areas in which delivery of health and social services to women Veterans being treated in non-VA settings could be improved: (1) diffuse, implement, and sustain evidence-based gender-sensitive substance abuse treatment; (2) address traumas contributing to poor health; (3) recognize stress proliferation processes erode women's capacity to access healthcare or cope with stressors in healthy ways; (4) champion women Veterans who embody resilience and thereby can help others to form empowered personal identities of health and wellness. Findings can inform interventions and services that ameliorate vulnerability to substance abuse and other health risks among women Veterans.

Suicide Among Military Personnel and Veterans Aged 18-35 Years by County-16 States.

PubMed

Logan, Joseph E; Fowler, Katherine A; Patel, Nimeshkumar P; Holland, Kristin M

2016-11-01

Suicide among military personnel and young Veterans remains a health concern. This study examined stateside distribution of suicides by U.S. county to help focus prevention efforts. Using 2005-2012 National Violent Death Reporting System data from 16 states (963 counties, or county-equivalent entities), this study mapped the county-level distribution of suicides among current military and Veteran decedents aged 18-35 years. This study also compared incident circumstances of death between decedents in high-density counties (i.e., counties with the highest proportion of deaths) versus those in medium/low-density counties to better understand the precipitators of suicide in counties most affected. Last, this study identified potential military and Veteran Health Administration intervention sites. All analyses were conducted in 2015. Within the National Violent Death Reporting System participating states, an estimated 262 (33%) current military suicides occurred in just ten (1.0%) counties, and 391 (33%) Veteran suicides occurred in 33 (3.4%) counties. Mental health and intimate partner problems were common precipitating circumstances, and some circumstances differed between cases in high- versus those in medium/low-density counties. Multiple potential intervention sites were identified in high-density counties. These findings suggest that military and Veteran suicides are concentrated in a small number of counties. Increased efforts at these locales might be beneficial. Published by Elsevier Inc.

Psychological health of military children: Longitudinal evaluation of a family-centered prevention program to enhance family resilience

PubMed Central

Lester, Patricia; Stein, Judith A.; Saltzman, William; Woodward, Kirsten; MacDermid, Shelley W.; Milburn, Norweeta; Mogil, Catherine; Beardslee, William

2014-01-01

Family-centered preventive interventions have been proposed as relevant to mitigating psychological health risk and promoting resilience in military families facing wartime deployment and reintegration. This study evaluates the impact of a family-centered prevention program, Families OverComing Under Stress Family Resilience Training (FOCUS), on the psychological adjustment of military children. Two primary goals include: 1) Understanding the relationships of distress among family members using a longitudinal path model to assess relations at the child and family level, and 2) Determining pathways of program impact on child adjustment. Multilevel data analysis using structural equation modeling was conducted with de-identified service delivery data from 280 families (505 children ages 3-17) in two follow-up assessments. Standardized measures included Service Member and Civilian parental distress (Brief Symptom Inventory, PTSD Checklist – Military), child adjustment (Strengths and Difficulties Questionnaire), and family functioning (McMaster Family Assessment Device). Distress was significantly related among the service member parent, civilian parent and children. FOCUS improved family functioning, which in turn significantly reduced child distress at follow-up. Salient components of improved family functioning in reducing child distress mirrored resilience processes targeted by FOCUS. These findings underscore the public health potential of family-centered prevention for military families, and suggest areas for future research. PMID:23929043

Patient satisfaction and loyalty among military healthcare beneficiaries enrolled in a managed care program.

PubMed

Jennings, B M; Loan, L A

1999-11-01

A study was performed to evaluate military beneficiaries' motivation for choosing to change from a civilian managed care system to the military managed care system. Concerns about healthcare cost, quality, and access underpin major reform in military healthcare. The military health system (MHS) is implementing managed care through an initiative known as TRICARE. Patient choice and satisfaction are highly relevant to all healthcare delivery systems; they are being explored aggressively in the MHS as TRICARE evolves. This descriptive study was conducted using a telephone survey consisting of 63 items derived from four pre-existing instruments as well as five facility-specific questions and demographics. The population of interest targeted military beneficiaries on a TRICARE waiting list who, at the time of enrollment, indicated a desire to receive care at the military facility. Consumers were inclined to return to the military system because of loyalty. Also, this study provided evidence that staff courtesy is important to those who seek healthcare. Good quality and accessibility were verified as essential elements in sustaining a consumer's positive view of and attraction to a particular healthcare system. Cost was proven to be a less substantial factor of consumer decision making. Surveys such as this give healthcare providers more information about aspects of care, such as patient loyalty and interpersonal dynamics, that attract people to their healthcare delivery systems. For healthcare systems to thrive, consumer influence and the power of patient dissatisfaction must be understood.

RESPECT-Mil: feasibility of a systems-level collaborative care approach to depression and post-traumatic stress disorder in military primary care.

PubMed

Engel, Charles C; Oxman, Thomas; Yamamoto, Christopher; Gould, Darin; Barry, Sheila; Stewart, Patrice; Kroenke, Kurt; Williams, John W; Dietrich, Allen J

2008-10-01

U.S. military ground forces report high rates of war-related traumatic stressors, posttraumatic stress disorder (PTSD), and depression following deployment in support of recent armed conflicts in Iraq and Afghanistan. Affected service members do not receive needed mental health services in most cases, and they frequently report stigma and significant structural barriers to mental health services. Improvements in primary care may help address these issues, and evidence supports the effectiveness of a systems-level collaborative care approach. To test the feasibility of systems-level collaborative care for PTSD and depression in military primary care. We named our collaborative care model "Re-Engineering Systems of Primary Care for PTSD and Depression in the Military" (RESPECT-Mil). Key elements of RESPECT-Mil care include universal primary care screening for PTSD and depression, brief standardized primary care diagnostic assessment for those who screen positive, and use of a nurse "care facilitator" to ensure continuity of care for those with unmet depression and PTSD treatment needs. The care facilitator assists primary care providers with follow-up, symptom monitoring, and treatment adjustment and enhances the primary care interface with specialty mental health services. We report assessments of feasibility of RESPECT-Mil implementation in a busy primary care clinic supporting Army units undergoing frequent Iraq, Afghanistan, and other deployments. Thirty primary care providers (family physicians, physician assistants, and nurse practitioners) were trained in the model and in the care of depression and PTSD. The clinic screened 4,159 primary care active duty patient visits: 404 screens (9.7%) were positive for depression, PTSD, or both. Sixty-nine patients participated in collaborative care for 6 weeks or longer, and the majority of these patients experienced clinically important improvement in PTSD and depression. Even although RESPECT-Mil participation was

Initiation and continuation of long-acting reversible contraception in the United States military healthcare system.

PubMed

Chiles, Daniel P; Roberts, Timothy A; Klein, David A

2016-09-01

Long-acting reversible contraception is more effective for pregnancy prevention than shorter-acting contraceptive methods and has the potential to reduce healthcare disparities and costs. However, long-acting reversible contraception is underused in the United States. One population of interest is beneficiaries of the United States military healthcare system who have access to universal healthcare, including no-cost, no-copay contraception with unlimited method switching, and comprise a large, actual use cohort. Efforts to increase long-acting reversible contraception initiation and continuation in this population may improve health outcomes and mitigate the profound consequences of unintended or mistimed pregnancy on readiness and cost to the military. We aimed to determine long-acting reversible contraception initiation and continuation rates among the diverse population with universal healthcare who are enrolled in the US military healthcare system. This study is a retrospective cohort of >1.7 million women, aged 14-40 years, who were enrolled in the US military healthcare system, TRICARE Prime, between October 2009 and September 2014. Individuals were assessed for long-acting reversible contraception initiation and continuation with the use of medical billing records. Method continuation and factors that were associated with early method discontinuation were evaluated with the Kaplan-Meier estimator and Cox proportional hazard models. During the study dates, 188,533 women initiated long-acting reversible contraception. Of these, 74.6% women selected intrauterine contraceptives. Method initiation rates remained relatively stable (41.7-50.1/1000 women/year) for intrauterine methods, although the rate for subdermal implants increased from 6.1-23.0/1000 women/year. In analysis of women who selected intrauterine contraceptives, 61.2% continued their method at 36 months, and 48.8% continued at 60 months. Among women who selected the implant, 32.0% continued their

An Analysis of Messages About Tobacco in Military Installation Newspapers

PubMed Central

Haddock, C. Keith; Parker, L. Carrie; Taylor, Jennifer E.; Poston, Walker S.C.; Lando, Harry; Talcott, G. Wayne

2005-01-01

Objectives. We sought to gauge the relative attention that tobacco control receives in military newspapers by comparing coverage of tobacco use with that of other health topics of importance to the military. Methods. We examined tobacco-related articles and industry advertisements in 793 newspapers published during 1 year at 16 representative military installations (4 Air Force, 6 Army, 2 Marine, 4 Navy). Newspaper content was coded with a standardized coding manual developed through previous research. Results. Tobacco use received the fewest instances of coverage and the least print space in military installation newspapers of all the health topics examined. The primary “message frame” used in tobacco control articles was that smokers are putting themselves at health risk, a theme that has not been found to have a strong effect on smokers. Nearly 10% of the newspapers contained tobacco advertisements. Conclusions. Tobacco control messages are underrepresented in military installation newspapers compared with other health issues. Furthermore, military newspapers send mixed messages to military personnel by providing advertisements for tobacco while also claiming that tobacco use is harmful. PMID:16043672

An analysis of messages about tobacco in military installation newspapers.

PubMed

Haddock, C Keith; Parker, L Carrie; Taylor, Jennifer E; Poston, Walker S C; Lando, Harry; Talcott, G Wayne

2005-08-01

We sought to gauge the relative attention that tobacco control receives in military newspapers by comparing coverage of tobacco use with that of other health topics of importance to the military. We examined tobacco-related articles and industry advertisements in 793 newspapers published during 1 year at 16 representative military installations (4 Air Force, 6 Army, 2 Marine, 4 Navy). Newspaper content was coded with a standardized coding manual developed through previous research. Tobacco use received the fewest instances of coverage and the least print space in military installation newspapers of all the health topics examined. The primary "message frame" used in tobacco control articles was that smokers are putting themselves at health risk, a theme that has not been found to have a strong effect on smokers. Nearly 10% of the newspapers contained tobacco advertisements. Tobacco control messages are underrepresented in military installation newspapers compared with other health issues. Furthermore, military newspapers send mixed messages to military personnel by providing advertisements for tobacco while also claiming that tobacco use is harmful.

Helping military children cope with parental deployment: role of attachment theory and recommendations for mental health clinicians and counselors.

PubMed

Miller, Laurence; Miller, Halle B; Bjorklund, David

2010-01-01

Military deployment of a parent carries with it a number of stresses for children, all centering around uncertainty, instability and unpredictability. This article conceptualizes military deployment and relocation stress in the context of attachment theory, and describes the types of adverse outcomes that can occur as the result of impaired attachment. It then presents a set of practical recommendations for mental health clinicians and counselors for helping children and families cope productively and negotiate the developmental hurdles associated with maintaining healthy attachment and family stability in the face of military deployment.

The mental health needs of military service members and veterans.

PubMed

Lazar, Susan G

2014-09-01

The prevalence in active duty military service members of 30-day DSM-IV psychiatric disorders, including posttraumatic stress disorders and major depressive disorder, is greater than among sociodemographically-matched civilians. Only 23-40% of returning military who met strict criteria for any mental health problem in 2004 had received professional help in the past year. One-fourth of Regular Army soldiers meet criteria for a 30-day DSM-IV mental disorder, two-thirds of whom report a pre-enlistment age of onset. Both pre- and post-enlistment age of onset are predictors of severe role impairment which was reported by 12.8% of respondents. In addition, three-fifths of those with severe role impairment had at least one psychiatric diagnosis. The number of deployments, especially three or more, is positively correlated with all disorders, especially major depressive disorder, bipolar disorder, generalized anxiety disorder, posttraumatic stress disorder, and intermittent explosive disorder. Patients with posttraumatic stress disorder and major depressive disorder frequently have comorbidity with other psychiatric diagnoses and an increased death rate from homicide, injury, and cardiovascular disease, and are at increased risk of medical illness, smoking and substance abuse, decreased employment and work productivity, marital and family dysfunction and homelessness. Active duty suicides have increased from a rate lower than among civilians to one exceeding that in civilians in 2008. Suicides among veterans climbed to 22 per day in 2010 with male veterans having twice the risk of dying from suicide as their civilian counterparts. Associated extremely high costs of psychiatric illness in decreased productivity and increased morbidity and mortality can be ameliorated with appropriate treatment which is not yet fully available to veterans in need. In addition, Veterans Administration/Department of Defense treatment guidelines to date do not recognize the need for intensive

Active coatings technologies for tailorable military coating systems

NASA Astrophysics Data System (ADS)

Zunino, J. L., III

2007-04-01

The main objective of the U.S. Army's Active Coatings Technologies Program is to develop technologies that can be used in combination to tailor coatings for utilization on Army Materiel. The Active Coatings Technologies Program, ACT, is divided into several thrusts, including the Smart Coatings Materiel Program, Munitions Coatings Technologies, Active Sensor packages, Systems Health Monitoring, Novel Technology Development, as well as other advanced technologies. The goal of the ACT Program is to conduct research leading to the development of multiple coatings systems for use on various military platforms, incorporating unique properties such as self repair, selective removal, corrosion resistance, sensing, ability to modify coatings' physical properties, colorizing, and alerting logistics staff when tanks or weaponry require more extensive repair. A partnership between the U.S. Army Corrosion Office at Picatinny Arsenal, NJ along with researchers at the New Jersey Institute of Technology, NJ, Clemson University, SC, University of New Hampshire, NH, and University of Massachusetts (Lowell), MA, are developing the next generation of Smart Coatings Materiel via novel technologies such as nanotechnology, Micro-electromechanical Systems (MEMS), meta-materials, flexible electronics, electrochromics, electroluminescence, etc. This paper will provide the reader with an overview of the Active Coatings Technologies Program, including an update of the on-going Smart Coatings Materiel Program, its progress thus far, description of the prototype Smart Coatings Systems and research tasks as well as future nanotechnology concepts, and applications for the Department of Defense.

Conceptual model of male military sexual trauma.

PubMed

Elder, William B; Domino, Jessica L; Rentz, Timothy O; Mata-Galán, Emma L

2017-08-01

Male sexual trauma is understudied, leaving much to be known about the unique mental health needs of male survivors. This study examined veteran men's perceptions of the effects of military sexual trauma. Military sexual trauma was defined as physically forced, verbally coerced, or substance-incapacitated acts experienced during military service. Interviews were conducted with 21 male veterans who reported experiencing military sexual trauma. Data were drawn together using a grounded theory methodology. Three categories emerged from data analysis, including (a) types of military sexual trauma (being touched in a sexual way against their will [N = 18]; sexual remarks directed at them [N = 15]; being physically forced to have sex [N = 13]); (b) negative life effects (difficulty trusting others [N = 18]; fear of abandonment [N = 17]; substance use [N = 13]; fear of interpersonal violence [N = 12]; conduct and vocational problems [N = 11]; irritability/aggression [N = 8]; insecurity about sexual performance [N = 8]; difficulty managing anger [N = 8]); and (c) posttraumatic growth (N = 15). Results from this study suggest sexual trauma in the military context may affect systems of self-organization, specifically problems in affective, self-concept, and relational domains, similar to symptoms of those who have experienced prolonged traumatic stressors. This model can be used by clinicians to select treatments that specifically target these symptoms and promote posttraumatic growth. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

A Preliminary Analysis of Noise Exposure and Medical Outcomes for Department of Defense Military Musicians.

PubMed

Smith, Cindy; Beamer, Sharon; Hall, Shane; Helfer, Thomas; Kluchinsky, Timothy A

2015-01-01

Noise exposure is a known occupational health hazard to those serving in the military. Previous military epidemiology studies have identified military occupations at risk of noise induced hearing loss (NIHL); however, musicians have not been specifically mentioned. The focus of military NIHL studies is usually on those service members of the combat arms occupations. This project was a preliminary examination of Department of Defense (DoD) active duty military musicians in regard to their noise exposure, annual hearing test rates, and hearing injury rates using available data sources. The analysis concluded that DoD military musicians are an underserved population in terms of hearing conservation efforts. Noise surveillance data extracted from the Defense Occupational and Environmental Health Readiness System-Industrial Hygiene showed that every musician similar exposure group (SEG) with noise survey data from 2009 to 2013 exceeded the occupation exposure level adopted by DoD Instruction 6055.12. However, only a small percentage of all DoD active duty military musicians (5.5% in the peak year of 2012) were assigned to a SEG that was actually surveyed. Hearing test data based on Current Procedural Terminology coding extracted from the Military Health System revealed that the percentage of musicians with annual hearing tests increased over the 5 years studied in all services except the Air Force. During 2013, the data showed that the Navy had the highest percentage of musicians with annual hearing tests at 70.9%, and the Air Force had the lowest at 11.4%. The Air Force had the highest percentage of hearing injuries of those musicians with annual hearing tests for all 5 years analyzed. Although noise surveillance and annual hearing tests are being conducted, they occur at a much lower rate than required for a population that is known to be overexposed to noise.

The Death of Military Justice

DTIC Science & Technology

2010-01-01

Military Court of Appeals ruled in United States v. Beeker that “the use or possession of marihuana was service connected because the use or...possession . . . of marihuana and narcotics has a special military significance since their use has ‘disastrous effects on the health, morale and fitness

Oral health survey of the military personnel deployed to the southernmost provinces of Thailand.

PubMed

Sutthavong, Sirikarn; Ukritchon, Supak; Rangsin, Ram

2014-02-01

Dental problems are some of the major health problems of deployed miilitaly personnel. There have been no systematically reports of oral health information survey among the deployed military personnel in Thailand. The present study was to determine the oral health problems of the deployed military personnel and effects on personnel fitness. A cross-sectional study and a cluster sampling were conducted during April 2011 and March 2013. The Royal Thai Army (RTA) personnel 12 out of21 task forces in southern most provinces were invited to participate in the study. A standardized questionnaire was used. In total, 2,884 RTA deployed personnel voluntarily participated and completed the questionnaire infonnrmation. Their mean age was 27.8 +/- 9.4 years old. Fifty percent admitted that they had oral problems during the past six months and the most common ones were toothache/hypersensitivity (32.4%), and dental caries (21.5%). The majority of the participants (60.7%) reported that they experienced oral health problems less than 3 times and 2.8% reported sick leave during deployment because of oral conditions. 64.4% reported that their oral problems affected their quality of life and disturbed their duties. A relatively high prevalence oforal health problems was reported by the deployed RTA personnel. The problems affected their quality of life and assigned duties. Most ofthe problems were neglected. In order to keep the RTApersonnel fit for deployment, an effective dental health program should be developed.

Military Engineers and Chemical Warfare Troops (Inzhenernye Voiska Khimicheskie Voiska),

DTIC Science & Technology

MILITARY FORCES(FOREIGN), *MILITARY ORGANIZATIONS, MILITARY ENGINEERING , INFANTRY, AMPHIBIOUS OPERATIONS, MINELAYING, ARMORED VEHICLES, NUCLEAR...RADIATION, DOSIMETERS, CHEMICAL WARFARE, PROTECTIVE CLOTHING, DECONTAMINATION, HEALTH PHYSICS.

SupportNet for Frontline Behavioral Health Providers

DTIC Science & Technology

2015-07-01

and job burnout among military behavioral health providers and to provide a pilot support system for providers working at with military trauma...survivors. In the fourth year of the project, we completed the RCT and data analysis of behavioral health. Job burnout and secondary trauma are serious...issues for military behavioral health providers who are continually exposed to extensive traumatic material on an on-going basis. Job burnout and STS

Online Reporting of Military Sexual Trauma.

PubMed

Burgess, Ann W; Lee, Wendy J; Carretta, Carrie M

2016-04-01

Case finding and treatment of military sexual trauma (MST) remains a serious problem in military and veteran populations as well as in the civilian population. This report provides descriptive examples, with statistics, of persons serving in the military or while living/working on a military base when they experienced unwanted sex. Males, more than females, never disclosed MST before online survey, had more physical injuries as a result and reported chronic disturbing thoughts of the experience. Undisclosed and unreported intrafamilial childhood sexual experiences were cited before an MST by some respondents. Interprofessional collaboration is recommended between military nurse practitioners and behavioral health clinicians as well as innovative strategies using telecommunication and online counseling. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

The influence of sexual harassment on mental health among female military personnel of the Republic of Korea Armed Forces.

PubMed

Kim, Tae Kyung; Lee, H-C; Lee, S G; Han, K-T; Park, E-C

2017-04-01

Reports of sexual harassment are becoming more frequent in Republic of Korea (ROK) Armed Forces. This study aimed to analyse the impact of sexual harassment on mental health among female military personnel of the ROK Armed Forces. Data from the 2014 Military Health Survey were used. Instances of sexual harassment were recorded as 'yes' or 'no'. Analysis of variance (ANOVA) was carried out to compare Kessler Psychological Distress Scale 10 (K-10) scores. Multiple logistic regression analysis was performed to identify associations between sexual harassment and K-10 scores. Among 228 female military personnel, 13 (5.7%) individuals experienced sexual harassment. Multiple logistic regression analysis revealed that sexual harassment had a significantly negative impact on K-10 scores (3.486, p<0.04). Higher K-10 scores among individuals experiencing sexual harassment were identified in the unmarried (including never-married) group (6.761, p<0.04), the short-term military service group (12.014, p<0.03) and the group whose length of service was <2 years (11.067, p<0.02). Sexual harassment has a negative impact on mental health. Factors associated with worse mental health scores included service classification and length of service. The results provide helpful information with which to develop measures for minimising the negative psychological effects from sexual harassment and promoting sexual harassment prevention policy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Key performance indicators in British military trauma.

PubMed

Stannard, Adam; Tai, Nigel R; Bowley, Douglas M; Midwinter, Mark; Hodgetts, Tim J

2008-08-01

Key performance indicators (KPI) are tools for assessing process and outcome in systems of health care provision and are an essential component in performance improvement. Although KPI have been used in British military trauma for 10 years, they remain poorly defined and are derived from civilian metrics that do not adjust for the realities of field trauma care. Our aim was to modify current trauma KPI to ensure they more faithfully reflect both the military setting and contemporary evidence in order to both aid accurate calibration of the performance of the British Defence Medical Services and act as a driver for performance improvement. A workshop was convened that was attended by senior, experienced doctors and nurses from all disciplines of trauma care in the British military. "Speciality-specific" KPI were developed by interest groups using evidence-based data where available and collective experience where this was lacking. In a final discussion these were streamlined into 60 KPI covering each phase of trauma management. The introduction of these KPI sets a number of important benchmarks by which British military trauma can be measured. As part of a performance improvement programme, these will allow closer monitoring of our performance and assist efforts to develop, train, and resource British military trauma providers.

"Throwing a rock at their armored tank": civilian authority and military tobacco control.

PubMed

Grundy, Quinn; Smith, Elizabeth A; Malone, Ruth E

2014-12-17

Tobacco use is a major cause of chronic disease, disability and death among military personnel and veterans. However, civilian public health and tobacco control advocates have been relatively silent on the issue. Research on the tobacco industry shows a long history of interference in military tobacco policy through relationships with the United States (US) Congress. The military cannot autonomously implement tobacco control, but is subject to Congressional oversight. Thus, the primary obstacles to effective tobacco control in the military are Congressional political opposition and tobacco industry influence, and by extension, a lack of civilian awareness and support in the policy arena. As part of a larger project to explore the topic of civilian support for military tobacco control, we analyzed data from focus groups with public health professionals to better understand their sense of agency and authority in regards to military tobacco control. Researchers conducted 4 focus groups with a total of 36 public health professionals at key conferences for those working in public health and tobacco control. Data were coded and the research team developed an interpretive account that captured patterns and variations in the data. Public health and tobacco control participants shared a sense of futility regarding civilian efforts to engage in military tobacco control. This stemmed from feeling ignorant of military culture and structure, identifying powerful discourses that opposed tobacco control, particularly in a military context, and the very-real presence of the tobacco industry lobby throughout the policy process. A strong public health voice on military tobacco control might serve to begin problematizing the tobacco industry's influence in the military policy arena. As the military moves to institute stronger tobacco control policy, public health and tobacco control professionals should work to engage with and aid its efforts from the outside. Only with such civilian

Mental Health, Quality of Life, and Health Functioning in Women Veterans: Differential Outcomes Associated with Military and Civilian Sexual Assault

ERIC Educational Resources Information Center

Suris, Alina; Lind, Lisa; Kashner, T. Michael; Borman, Patricia D.

2007-01-01

The present study examined psychiatric, physical, and quality-of-life functioning in a sample of 270 women veterans receiving outpatient treatment at a Veterans Affairs medical center. Participants were interviewed regarding their civilian (CSA) and military sexual assault (MSA) histories, and data regarding quality of life and health outcomes…

Gastrointestinal Illnesses among French Forces Deployed to Djibouti: French Military Health Surveillance, 2005–2009

PubMed Central

Ollivier, Lénaïck; Decam, Christophe; de Santi, Vincent Pommier; Darar, Houssein Y.; Dia, Aïssata; Nevin, Remington L.; Romand, Olivier; Bougère, Jacques; Deparis, Xavier; Boutin, Jean-Paul

2010-01-01

Despite an increase in foreign tourism and in the numbers of foreign military personnel deployed to Djibouti, little is known about the risk of gastrointestinal illness in this country in eastern Africa. To assess risk and to describe common features of gastrointestinal illnesses, reports of illness derived from military health surveillance data collected during 2005–2009 among French service members deployed to Djibouti were reviewed. Diarrhea was the most common problem; it had an annual incidence ranging from 260 to 349 cases per 1,000 person-years. The risk was higher among soldiers deployed short-term (four months) than among soldiers deployed long-term (two years). This five-year review of French health surveillance data documents a significant burden of diarrhea among French soldiers in Djibouti. The identification of factors associated with risk may permit efficient targeting of interventions to reduce morbidity from gastrointestinal illness. PMID:20889897

Gender Dysphoria in the Military.

PubMed

Ford, Shannon; Schnitzlein, Carla

2017-11-07

With the announcement that members of the military who identify as transgender are allowed to serve openly, the need for Department of Defense behavioral health providers to be comfortable in the assessment, diagnosis, and treatment of this population becomes quickly evident. This population has been seeking care in the community and standards have been developed to help guide decision-making, but a comparable document does not exist for the military population. Previously published papers were written in anticipation of the policy allowing for open service. The civilian sector has treatment guidelines and evidence supporting the same for reference. There is no similar document for the military population, likely due to the recent change and ongoing development. This paper attempts to provide an overview of the recent Department of Defense policy and walks the reader through key considerations when providing care to a transgender member of the military as it relates to those who are currently serving in the military through the use of a case example. The military transgender population faces some unique challenges due to the need to balance readiness and deployability with medically necessary health care. Also complicating patient care is that policy development is ongoing-as of this publication, the decision has not yet been made regarding how people who identify as transgender will access into the military nor is there final approval regarding coverage for surgical procedures. Unique circumstances of this population are brought up to generate more discussion and encourage further evaluation and refinement of the process.

Biosurveillance Using Clinical Diagnoses and Social Media Indicators in Military Populations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Corley, Courtney D.; Volkova, Svitlana; Rounds, Jeremiah

U.S. military influenza surveillance uses electronic reporting of clinical diagnoses to monitor health of military personnel and detect naturally occurring and bioterrorism-related epidemics. While accurate, these systems lack in timeliness. More recently, researchers have used novel data sources to detect influenza in real time and capture nontraditional populations. With data-mining techniques, military social media users are identified and influenza-related discourse is integrated along with medical data into a comprehensive disease model. By leveraging heterogeneous data streams and developing dashboard biosurveillance analytics, the researchers hope to increase the speed at which outbreaks are detected and provide accurate disease forecasting among militarymore » personnel.« less

Military Medicine: One Profession Not Two

DTIC Science & Technology

2013-12-13

MEDEVAC Medical evacuation MHS Military health system MRI Magnetic resonance imaging PA Physician’s assistant PCOS Polycystic ovarian syndrome PTSD...affecting society and soldiers. Many patients with back pain request magnetic resonance imaging ( MRI ) to evaluate their symptoms, though most times...imaging is not clinically indicated. In the last 10 years the use of MRIs has skyrocketed, increasing over 300 percent, but without improvement in

Transferability of Military-Trained Medical Personnel to the Civilian Sector.

ERIC Educational Resources Information Center

Nathan (Robert R.) Associates, Inc., Washington, DC.

This study addresses itself to the problem of what should be done to increase the civilian medical/health field utilization of men who have received medical training and experience while in military service. It was found that military men were influenced in their decision for or against a civilian health career by: military service branch, length…

Job stress, depression, work performance, and perceptions of supervisors in military personnel.

PubMed

Pflanz, Steven E; Ogle, Alan D

2006-09-01

Recent studies have identified high levels of job stress in military personnel. This study examined the relationship among job stress, depression, work performance, types of stressors, and perceptions about supervisors in military personnel. Eight hundred nine military personnel answered a 43-item survey on work stress, physical and emotional health, work performance, perceptions about leadership, job stressors, and demographics. More than one- quarter (27.4%) of this military population reported suffering from significant job stress. Both the report of work stress and depression were significantly related to impaired work performance, more days of missed work, poorer physical health, and negative perceptions about the abilities of supervisors and commanders. Depression and job stress were significantly and positively related to each other. These results support accumulating data indicating that work stress is a significant occupational health hazard in the routine military work environment. Targeting and eliminating sources of job stress should be a priority for the U.S. military to preserve and protect the mental health of military personnel.

5 CFR 842.306 - Military service.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Military service. 842.306 Section 842.306... EMPLOYEES RETIREMENT SYSTEM-BASIC ANNUITY Credit for Service § 842.306 Military service. (a) Except as...' Retirement System Act of 1986, an employee's or Member's military service is creditable if it was performed...

Prevalence of mental health symptoms in Dutch military personnel returning from deployment to Afghanistan: a 2-year longitudinal analysis.

PubMed

Reijnen, A; Rademaker, A R; Vermetten, E; Geuze, E

2015-02-01

Recent studies in troops deployed to Iraq and Afghanistan have shown that combat exposure and exposure to deployment-related stressors increase the risk for the development of mental health symptoms. The aim of this study is to assess the prevalence of mental health symptoms in a cohort of Dutch military personnel prior to and at multiple time-points after deployment. Military personnel (n=994) completed various questionnaires at 5 time-points; starting prior to deployment and following the same cohort at 1 and 6 months and 1 and 2 years after their return from Afghanistan. The prevalence of symptoms of fatigue, PTSD, hostility, depression and anxiety was found to significantly increase after deployment compared with pre-deployment rates. As opposed to depressive symptoms and fatigue, the prevalence of PTSD was found to decrease after the 6-month assessment. The prevalence of sleeping problems and hostility remained relatively stable. The prevalence of mental health symptoms in military personnel increases after deployment, however, symptoms progression over time appears to be specific for various mental health symptoms. Comprehensive screening and monitoring for a wide range of mental health symptoms at multiple time-points after deployment is essential for early detection and to provide opportunities for intervention. This project was funded by the Dutch Ministry of Defence. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

42 CFR 70.8 - Members of military and naval forces.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false Members of military and naval forces. 70.8 Section 70.8 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES QUARANTINE, INSPECTION, LICENSING INTERSTATE QUARANTINE § 70.8 Members of military and naval forces. The provisions of...

42 CFR 70.8 - Members of military and naval forces.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false Members of military and naval forces. 70.8 Section 70.8 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES QUARANTINE, INSPECTION, LICENSING INTERSTATE QUARANTINE § 70.8 Members of military and naval forces. The provisions of...

42 CFR 70.8 - Members of military and naval forces.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Members of military and naval forces. 70.8 Section 70.8 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES QUARANTINE, INSPECTION, LICENSING INTERSTATE QUARANTINE § 70.8 Members of military and naval forces. The provisions of...

Health hazards in areas of military operations conducted in different climatic and sanitary conditions.

PubMed

Korzeniewski, Krzysztof

2011-01-01

This paper reviews the most common health hazards occurring among personnel of peacekeeping and stabilization missions functioning within armed conflicts in the contemporary world. Military operations have been executed in diverse climatic and sanitary conditions, which are frequently unfamiliar for their participants. Some of them, e.g. the UN peacekeeping missions in the Middle East (Lebanon, the Golan Heights), have been carried out in a relatively stable geopolitical environment; whereas, stabilization missions in Iraq and Afghanistan, which are actually combat activities, undoubtedly fall into the group of the most perilous military operations in the world. Hot or cold climate, poor sanitary and hygienic conditions along with warfare facilitate the occurrence of numerous diseases and body injuries not only among the local people but also among peacekeepers, who represent the population of immigrants. Health hazards which pose major epidemiological threats in combat zones are arthropod-borne, food and water-borne, respiratory tract diseases, sexually transmitted diseases, enzootic diseases, battle injuries, and non- -battle injuries, e.g. traffic accidents. Another considerable health problem are psychiatric disorders, which can either appear directly after the occurrence of a traumatic event in a combat zone or indirectly, after some time had elapsed. In addition to the health hazards listed above, environmental factors such as changeable weather conditions and local fauna may also be life threatening.

The Millennium Cohort: A 21-Year Contribution to the Understanding of Military and Veterans’ Health

DTIC Science & Technology

2009-12-10

syndrome (15 items) • Other anxiety syndrome (6 items) • Eating disorders (4 items; binge and bulimia nervosa) Has your doctor or other health...The Millennium Cohort: a 21-Year Contribution to the Understanding of Military and Veterans’ Health Second Annual Trauma Stress Disorders ...AVAILABILITY STATEMENT Approved for public release; distribution unlimited 13. SUPPLEMENTARY NOTES Presented at The Second Annual Trauma Spectrum Disorders

Problems of Military Cemeteries Greenery - Case Study of the Military Cemetery in Zvolen

NASA Astrophysics Data System (ADS)

Halajová, Denisa; Petreková, Denisa; Bihuňová, Mária

2017-10-01

The intention of this work is to highlight the importance of understanding military cemeteries as objects of cultural and historical heritage and as a part of garden design history. The design and maintenance of cemeteries and graves is a manifestation of the national culture. This is even more evident in military cemeteries, the maintenance of which is regulated by international agreements. Objects of military cemeteries are important places not only from the historical and architectural point of view, but also as green space. Most military cemeteries in Slovakia originated from World War I and II. In Slovakia, 160,000 soldiers were buried, 75,206 of them lost their lives in World War I and 93,000 in World War II. 32,495 war graves are registered by The Ministry of the Interior of the Slovak Republic - 23,316 war graves from World War I and 9,179 from World War II. From the period of World War II, there are 22 cemeteries and graveyards in Slovakia, established for soldiers of the Soviet, German, Romanian and Czechoslovak army. Military cemeteries and memorials are mostly high quality works of architecture and art. This paper focuses on the current situation and restoration issues of military cemeteries by examining the Military Cemetery in Zvolen. In the context of its planned reconstruction, a comprehensive tree assessment has been started in 2016. The Military Cemetery in Zvolen, being one of the largest military cemeteries in Slovakia, consists of The Cemetery of the Soviet Army with 17,628 buried soldiers and The Romanian Cemetery with 11,000 buried soldiers. The Romanian Cemetery is one of the largest cemeteries of the Romanian Army in Europe. Both cemeteries were declared national cultural monuments in 1963. In the cemetery, dendrometrical parameters and the health condition of trees were evaluated. In total, there are 825 woody plants. In both cemeteries, coniferous trees prevail, mainly individuals of the genus Thuja (49.4 %). Moreover, the maintenance of

A Study to Determine Military Office Manpower at WRAMC (Walter-Reed Army Medical Center) that is Diverted from Patient Care

DTIC Science & Technology

1986-01-01

related groups (DRG) with weighted "pass throughs" (i.e., training, research, consulting, etc.), these studies may enable Health 3 Services Command to...proposed military equivalent to diagnostic related groups (DRG). 45 FOOTNOTES 1U.S. Department of the Army, Health Care Studies and Clinical Investigation...performed by patient care providers within the military health care system is limited to activities that are directly related to patient care.1 The

Military Social Work: Opportunities and Challenges for Social Work Education

PubMed Central

Wooten, Nikki R.

2015-01-01

Military social work is a specialized field of practice spanning the micro-macro continuum and requiring advanced social work knowledge and skills. The complex behavioral health problems and service needs of Iraq and Afghanistan veterans highlight the need for highly trained social work professionals who can provide militarily-relevant and culturally-responsive evidence-informed services. Responding to the military behavioral health workforce and service needs of recently returned veterans presents both opportunities and challenges for military social work education. This article discusses the rationale for a military social work specialization, the need for military social work education, and opportunities and challenges for social work education. An integrated model of intellectual capital is proposed to guide strategic planning for future military social work education. PMID:26089628

Supporting our military families: a case for a larger role for occupational therapy in prevention and mental health care.

PubMed

Cogan, Alison M

2014-01-01

More than 2 million U.S. military servicemembers have deployed to Afghanistan or Iraq since September 11, 2001. Unlike during prior conflicts, many servicemembers leave spouses and children behind. Long, multiple deployments cause strain on family at home, with new challenges arising when servicemembers return from combat and reintegrate into family and civilian life. In World Wars I and II, occupational therapy practitioners played a significant role in supporting servicemember reintegration. However, their presence in program delivery in this practice area is limited. Occupational therapy researchers and practitioners can make a valuable contribution by helping families tailor daily activities and routines to address challenges and optimize health and wellness. However, barriers such as reimbursement for services, workforce availability, and access to military families have limited the profession's full engagement. Advocacy is needed to help establish occupational therapy as a key component of the mental and preventive health care teams serving military servicemembers. Copyright © 2014 by the American Occupational Therapy Association, Inc.

The role of the military in post-conflict situations.

PubMed

Court, Bruce V

2004-11-01

This article considers the possible role of the military in relation to 'post-conflict situations' and helping to improve the health of affected civilian populations. The opinions expressed are personal reflections which draw upon the author's recent military medical experience in southern Iraq in 2004. The perspective of humanitarian aid agencies that have strong reservations about any involvement with the military is recognised, as they seek to maintain neutrality and the safety of their staff. The environment itself, however, may represent an unacceptable level of threat to humanitarian aid agencies, if their personnel are at risk of serious intimidation, e.g. kidnap or murder. Where terrorist and insurgent para-military groups emerge in a post-war fighting phase, it may be that the military is best placed to help co-ordinate efforts to ensure public health and health care provision until a satisfactory level of security is attained and humanitarian aid agencies are able to operate with confidence.

Building communities of care for military children and families.

PubMed

Kudler, Harold; Porter, Rebecca I

2013-01-01

Military children don't exist in a vacuum; rather, they are embedded in and deeply influenced by their families, neighborhoods, schools, the military itself, and many other interacting systems. To minimize the risks that military children face and maximize their resilience, write Harold Kudler and Colonel Rebecca Porter, we must go beyond clinical models that focus on military children as individuals and develop a public health approach that harnesses the strengths of the communities that surround them. In short, we must build communities of care. One obstacle to building communities of care is that at many times and in many places, military children and their families are essentially invisible. Most schools, for example, do not routinely assess the military status of new students' parents. Thus Kudler and Porter's strongest recommendation is that public and private institutions of all sorts--from schools to clinics to religious institutions to law enforcement--should determine which children and families they serve are connected to the military as a first step toward meeting military children's unique needs. Next, they say, we need policies that help teachers, doctors, pastors, and others who work with children learn more about military culture and the hardships, such as a parent's deployment, that military children often face. Kudler and Porter review a broad spectrum of programs that may help build communities of care, developed by the military, by nonprofits, and by academia. Many of these appear promising, but the authors emphasize that almost none are backed by strong scientific evidence of their effectiveness. They also describe new initiatives at the state and federal levels that aim to break down barriers among agencies and promote collaboration in the service of military children and families.

Understanding Primary Care Behavioral Health Across Military Settings: A Preliminary Comparison Between Deployed and In-Garrison Care.

PubMed

Landoll, Ryan R; Nielsen, Matthew K; Waggoner, Kathryn K

2017-03-01

Integrated primary care behavioral health (PCBH) is a growing trend in health care delivery, particularly in the Department of Defense and the Department of Veterans Affairs. This consultative model has been applied within the U.S. Air Force for over 15 years and has demonstrated positive health impacts and patient satisfaction. With extended conflicts and engagements, including Operation Enduring Freedom and Operation Iraqi Freedom, deployment behavioral health care has expanded and positively received, but there is less empirical support of particular models of care in a deployed environment. Brief, solution-focused strategies commonly utilized in PCBH are likely to be particularly good candidates for the deployed environment. One key feature the Air Force's PCBH program is the collaborative team-based approach to care centered around a patient and driven by a primary care manager. This study expands the evaluation of the Air Force's PCBH program to include its novel application in a combat setting. A retrospective review of 516 archival patient satisfaction surveys across Air Force military treatment facilities utilizing a PCBH program compared patient satisfaction surveys collected in a deployed environment at a large combat support hospital to noncombat facilities. Results indicated that patient satisfaction in theater was comparable to satisfaction at Air Force military treatment facilities in noncombat environments, with one exception; patients seen in garrison rated higher satisfaction with the treatment plan than those seen in a deployed setting, F(509) = 5.36, p < 0.01, consistent with limited resources available in theater. Given patient satisfaction across settings was found to be relatively equivalent, results suggests that the PCBH consultation model may be an appropriate model of care to meet a majority of the population's needs for a deployed environment. This pilot study has implications not only for military combat environments, but other austere

Analysis of the Change of Health Status Among the Republic of Korea Air Force Soldiers During Military Service

PubMed Central

Yoo, Seok-Ju; Park, Won-Ju; Lee, Kwan; Lim, Hyun-Sul; Kim, Hyun-Jin; Lee, Suk-Ho

2014-01-01

Objectives: The aim of this study was to investigate whether the health status of Republic of Korea Air Force (ROKAF) soldiers changed after one year of military service. Methods: We selected 483 ROKAF soldiers from the 11 749 recruits who participated in the 2011 physical examination. The selected soldiers underwent another physical examination in 2012 for advancement to senior airman. Data from 2011 and 2012 were merged. To collect data on lifestyle, a questionnaire was sent to all included subjects via the military intranet e-mail service. Results: The percentage of recruits with an abnormal alanine transaminase level (normal range <40 IU/L) decreased from recruitment (13.7%) to the following year (2.7%). Moreover, the percentage of obese soldiers (body mass index ≥25 kg/m2) decreased from recruitment (20.5%) to the following year (10.4%). There was a significant change in mean duration of exercise carried out each day before (0.8±1.3 hours) and after (1.0±0.7 hours) joining the ROKAF service. Conclusions: These ROKAF soldiers were generally in good health before and after joining the armed service. After one year of military service, the health status of most soldiers improved, especially with respect to body mass index and alanine transaminase level. PMID:25139169

Military Medicine Interest Groups in U.S. Medical Schools.

PubMed

Guenther, Timothy M; Coker, Timothy J; Chen, Steve I; Carlson, Mark A

2016-11-01

Medical student interest groups are organizations that help expose students to different medical specialties and fields of medicine while in medical school. Military medicine interest groups (MMIGs) are a particular type of interest group that spreads information about military medicine, fosters mentorship, and camaraderie between students and military faculty, and increases the opportunities for leadership while in medical school. Surveys were sent to all U.S. medical schools to determine how many schools had an MMIG. If a medical school had a group, a second survey was sent to the student leader to determine more information about how their group operated (such as type of participants, funding sources, activities, faculty involvement, military health care provider involvement, etc.). Fifty-six percent of U.S. medical schools who responded were found to have an MMIG and most participants were students in the Health Professions Scholarship Program. Information about military medicine was found to be the biggest impact of having a group at a medical school and student leaders expressed they wished to have more military health care provider involvement. The results of this study could help start MMIGs at other medical schools, as well as give ideas to current MMIGs on how other groups operate. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

The role of the community health nurse in military humanitarian operations: lessons from operation sea signal--Guantanamo Bay, Cuba.

PubMed

Samuels, G L; Sommer, M D

1997-01-01

The military humanitarian mission is an "Operation-Other-Than-War" with a goal of restoring or promoting the ability of a population to care for themselves (U.S. Army, 1990b). One of the primary foci of these operations is the medical care of the target populace. The elements and techniques of primary health care have been used for this purpose, especially as the situation of a population stabilizes and demands a community base for health care programs (Downing, 1989). The knowledge and expertise of a community health nurse is indispensable in both acute and chronic humanitarian situations in performing a comprehensive community needs assessment for the formulation of a community base for health care programs while facilitating a health care system that meets the overall needs of the population. The contributions of community health nurses assigned to Joint Task Force 160, during Operation Sea Signal, bear testimony as to the efficacy of such a "specialized" role in the care of displaced populations.

Be All That We Can Be: Lessons from the Military for Improving Our Nation's Child Care System.

ERIC Educational Resources Information Center

Campbell, Nancy Duff; Appelbaum, Judith C.; Martinson, Karin; Martin, Emily

In response to increasing demands for military child care and lack of comprehensive care standards, the Military Child Care Act of 1989 (MCCA) mandated improvements in military child care. Today, the Department of Defense runs a model child care system serving over 200,000 children daily at over 300 locations worldwide. Noting that most of the…

How can policy strengthen community support for children in military families?

PubMed

Boberiene, Liepa V; Hornback, Bradley J

2014-09-01

The extraordinary demands of recent wars have increased burdens on many military families and existing systems of care. The sacrifices made by service members are made also by their children and families, and these sacrifices can have long-term consequences. Therefore, military children and families cannot go unrecognized and unsupported. Policy responses should be less about diagnosing and treating individuals and more about recognizing and supporting families' and communities' resilience in the face of wartime deployment. Policy should focus on identifying military children in diverse communities and supporting them where they live, learn, and receive care. A range of community-based prevention strategies could decrease stress before it escalates into serious mental health issues. Efforts to develop family resilience during deployment and reintegration are extremely important in facilitating children's healthy development and veterans' recovery. Military personnel should partner with community leaders to implement effective programs providing emotional, social, and practical support to families. Emphasizing family cohesion, community social support, and comprehensive programs through education and health care organizations would go a long way in fostering families' resilience. At the same time, pro- grams should be monitored and evaluated, and military and civilian researchers should share data on family risk and resilience to improve evidence- based approaches. Such efforts would benefit not only military children, but also larger populations as programs improve family and community capacity to support thriving and mitigate challenges in the face of adversity.

32 CFR 154.15 - Military appointment, enlistment, and induction.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 1 2010-07-01 2010-07-01 false Military appointment, enlistment, and induction... Requirements § 154.15 Military appointment, enlistment, and induction. (a) General. The appointment, enlistment... tendered to immigrant alien health professionals, chaplains, and attorneys. (e) Mobilization of military...

Analysis of the Parameters Required for Performance Monitoring and Assessment of Military Communications Systems by Military Technical Controller

DTIC Science & Technology

1975-12-01

139 APPENDIX A* BASIC CONCEPT OF MILITARY TECHNICAL CONTROL.142 6 APIENDIX Es TEST EQUIPMENI REQUIRED FOR lEASURF.4ENr OF 1AF’AMETE RS...Control ( SATEC ) Automatic Facilities heport Army Automated Quality Monitoring Reporting System (AQMPS) Army Autcmated Technical Control-Semi (ATC-Semi...technical control then beco.. es equipment status monitoring. All the major equipment in a system wculd have internal sensors with properly selected parameters

Military Retirement: Background and Recent Developments

DTIC Science & Technology

2014-05-28

DOD Office of the Actuary , May 2011. 3 Department of Defense, Valuation of the Military Retirement System, September 30, 2010, Office of the Actuary ...January 2012, p. 13. 4 Department of Defense, Fiscal Year 2010 DOD Statistical Report on the Military Retirement System, Office of the Actuary , May... Actuary , FY2012 DOD Statistical Report on the Military Retirement System, May 2013. Statistical documents available by fiscal year for FY2005-FY2011 at

[Military psychiatry in Israel: a 50-year perspective].

PubMed

Bleich, A

2000-05-01

The history of military psychiatry in Israel may be divided into 2 main periods. The first extended from the War of Independence in 1948, through the Sinai, Six Day and Yom Kippur Wars. Its outstanding feature was avoidance of the issue of combat stress reaction (CSR). The Yom Kippur War made the recognition of CSR inescapable, assisted in breaking up denial, and served as a stimulus for development of the next phase of the system. This second phase was characterized by impressive progress in all areas of military psychiatry. The rich experience accumulated during the wars, together with the assimilation of a research culture which began blooming, especially in the wake of the Lebanon War, aided the development and crystallization of concepts related to combat and non-combat military psychiatry alike. The build-up of the mental health organization overlapped field deployment of the Medical Corps.

HomeFront Strong (HFS): Building Resiliency in Military Families

DTIC Science & Technology

2016-09-01

2. Train community providers to disseminate HomeFront Strong at their community sites; and 3. Evaluate the mental health outcomes of Group vs. Web...in each of these areas. 15. SUBJECT TERMS Military spouses; Resilience; Psychology health intervention; Mental health 16. SECURITY CLASSIFICATION... mental health outcomes of Group vs. Web-based HFS in a sample of 360 military and veteran spouses/partners and their children. The current proposal

[Effectiveness of the Military Mental Health Promotion Program].

PubMed

Woo, Chung Hee; Kim, Sun Ah

2014-12-01

This study was done to evaluate the Military Mental Health Promotion Program. The program was an email based cognitive behavioral intervention. The research design was a quasi-experimental study with a non-equivalent control group pretest-posttest design. Participants were 32 soldiers who agreed to participate in the program. Data were collected at three different times from January 2012 to March 2012; pre-test, post-test, and a one-month follow-up test. The data were statistically analyzed using SPSS 18.0. The effectiveness of the program was tested by repeated measures ANOVA. The first hypothesis that the level of depression in the experimental group who participated in the program would decrease compared to the control group was not supported in that the difference in group-time interaction was not statistically significant (F=2.19, p=.121). The second and third hypothesis related to anxiety and self-esteem were supported in group-time interaction, respectively (F=7.41, p=.001, F=11.67, p<.001). Results indicate that the program is effective in improving soldiers' mental health status in areas of anxiety and self-esteem.

Optimizing the utility of military injury surveillance systems: a qualitative study within the Australian Defence Force.

PubMed

McKinnon, Adam D; Ozanne-Smith, Joan; Pope, Rodney

2009-05-01

Injury prevention guided by robust injury surveillance systems (ISS's) can effectively reduce military injury rates, but ISS's depend on human interaction. This study examined experiences and requirements of key users of the Australian Defence Force (ADF) ISS to determine whether the operation of the ISS was optimal, whether there were any shortcomings, and if so, how these shortcomings might be addressed. Semistructured interviews were conducted with 18 Australian Defence Department participants located throughout Australia. Grounded theory methods were used to analyze data by developing an understanding of processes and social phenomena related to injury surveillance systems within the military context. Interviews were recorded and professionally transcribed and information contained in the transcripts was analyzed using NVivo. Key themes relating to the components of an injury surveillance system were identified from the analysis. A range of processes and sociocultural factors influence the utility of military ISS's. These are discussed in detail and should be considered in the future design and operation of military ISS's to facilitate optimal outcomes for injury prevention.

Preventing Suicides in the Military | NIH MedlinePlus the Magazine

MedlinePlus

... this page please turn Javascript on. Feature: Preventing Suicides Preventing Suicides in the Military Past Issues / Winter 2010 Table ... National Institute of Mental Health aims to reduce suicides among America's military and military veterans. "The suicide ...

CE: Military Sexual Trauma in Male Service Members.

PubMed

Eckerlin, Denise M; Kovalesky, Andrea; Jakupcak, Matthew

2016-09-01

: The experience of military sexual trauma (MST), which can result from assault, battery, or harassment of a sexual nature, may jeopardize the mental health of service members as well as that of their family members, colleagues, and community members. Although a greater proportion of female than male service members are subjected to MST, the Department of Defense estimates that the absolute numbers of affected men and women, across all ranks and branches of military service, are nearly equal because roughly 85% of military members are men. Little research has explored the effects of MST on men. This article discusses the unique ways in which men may experience MST, and examines how social stereotypes of masculinity, myths surrounding sexual assault, and military culture and structure often influence a man's interpretation of an attack and his likelihood of reporting the incident or seeking treatment. It describes current treatments for MST-related mental health conditions and addresses implications for nurses and other health care professionals.

Potential and Actual Health Hazards in the Dense Urban Operational Environment: Critical Gaps and Solutions for Military Occupational Health.

PubMed

Patterson, Steven L; Dancy, Blair C R; Ippolito, Danielle L; Stallings, Jonathan D

2017-11-01

: This paper presents environmental health risks which are prevalent in dense urban environments.We review the current literature and recommendations proposed by environmental medicine experts in a 2-day symposium sponsored by the Department of Defense and supported by the Johns Hopkins University Applied Physics Laboratory.Key hazards in the dense urban operational environment include toxic industrial chemicals and materials, water pollution and sewage, and air pollution. Four critical gaps in environmental medicine were identified: prioritizing chemical and environmental concerns, developing mobile decision aids, personalized health assessments, and better real-time health biomonitoring.As populations continue to concentrate in cities, civilian and military leaders will need to meet emerging environmental health concerns by developing and delivering adequate technology and policy solutions.

Responsibilities of Army Health Nurses and Services Presently Being Furnished to the Military Member and His Family

DTIC Science & Technology

1962-04-01

THE UNIVEltSITY OF MICHIGA6N SCHOOL OF PUBLAC HEAL7K RESPOItMIBITIES OF AM4Y HEALH N URES AND SERVICES PRESENTLY BKL1G FURNISHE) TO THE MILITARY MDME...without public health training, who share the responsibility of the Army health nursing program did not demonstrate the same concepts of health nursing as...improved relations--working on it now" and "al- though accepting of the health nurse, had a poor concept of health nursing work". D le " •on of

Military Interoperable Digital Hospital Testbed (MIDHT) Phase III

DTIC Science & Technology

2014-10-01

silently changed, it is common knowledge  that some  Java  Development  Kit (JDK) implementations create slightly differently  formatted PEM and  DER...tracking software  JKS  Java  KeyStore  LDAP  Lightweight Directory Access Protocol  MHS  Military Health System  MIMC  Conemaugh Miners Medical... MySQL ~ Conemaugh Health System ’-J Common Access Layer (CAL) Interface I I t J J AIIScripts I I McKe-n J Sunque.st Horizon EHR Lab Patient

Construction of an evaluation index system for determining the academic impact of military medical scholars.

PubMed

Li, Xuan; Hao, J Y

2018-01-13

Academic papers are an essential manner for describing new ideas and consolidating existing concepts in the field of military medicine. The academic impact of military medical publications reflects the extent and depth of recognition, acceptance and utilisation of the concepts transmitted in these publications. The aim of this research was to construct an evaluation index system suitable for evaluating the academic influence of scholars in the field of military medicine. Using the Delphi consensus methodology, 30 experts from the field of military medicine, military medical information and library and information science were asked during three rounds of questioning to score the feasibility and importance of indicators that could be used to determine academic impact. An analytic hierarchy process method was used to calculate the relative weighting of each indicator in determining the final level of academic impact. Eight evaluation indicators were agreed on to potentially determine academic impact. These comprised: 'Web of Science documents', 'Citation impact', 'h-index', 'Percentage of international collaborations', 'Percentage of the top 10% of the cited frequency', 'Category normalised citation impact', 'Percentage of documents cited' and 'The number of F1000 Recommended papers'. The evaluation index system determined from this study combines the advantages of both qualitative and quantitative recognised evaluation indicators, which are subsequently weighted according to their importance in the field of military medicine. It is hoped that this framework will provide a manner in the future for comparing the potential academic impact of military medical scholars. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Restructuring Military Medical Care

DTIC Science & Technology

1995-07-01

providers, perhaps under an approach such as the Federal Employees Health Benefits (FEHB) program , discussed later in this chapter. Effects on DoD’s...CARE July 1995 Military Family Association, would give beneficiaries access to care through the Federal Employees Health Benefits program as well as...enrollment levels and BOX 6. THE FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM The Federal Employees Health Benefits (FEHB) program is the source of health

Women in the Military: An Historical Perspective on the Nursing Corps.

ERIC Educational Resources Information Center

Steffel, Marilyn L.; Kaczmarek, Margaret G.

1987-01-01

Presents an overview of the role women have performed in the military nursing corps. Reviews the history of women in the military nursing corps; their struggle to gain officer rank, status, and pay; military family policies; and nurses' contribution to military health care. (Author/ABB)

42 CFR 71.34 - Carriers of U.S. military services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Carriers of U.S. military services. 71.34 Section... Carriers of U.S. military services. (a) Carriers belonging to or operated by the military services of the... regulations of the military services which also meet the requirements of the regulations in this part. (For...

The Wellbeing of Army Personnel in Dual-Military Marriages

DTIC Science & Technology

2013-06-01

experience both negative health and lower subjective feelings of wellbeing . The first year of this study has been focused on research lab development...findings to report. 15. SUBJECT TERMS Dual-Military Marriages, Wellbeing , Health , Work-family Conflict 16. SECURITY CLASSIFICATION OF: 17...However there have been very few studies that have examined the health and wellbeing of individuals in dual-military marital relationships. The

Cost drivers and resource allocation in military health care systems.

PubMed

Fulton, Larry; Lasdon, Leon S; McDaniel, Reuben R

2007-03-01

This study illustrates the feasibility of incorporating technical efficiency considerations in the funding of military hospitals and identifies the primary drivers for hospital costs. Secondary data collected for 24 U.S.-based Army hospitals and medical centers for the years 2001 to 2003 are the basis for this analysis. Technical efficiency was measured by using data envelopment analysis; subsequently, efficiency estimates were included in logarithmic-linear cost models that specified cost as a function of volume, complexity, efficiency, time, and facility type. These logarithmic-linear models were compared against stochastic frontier analysis models. A parsimonious, three-variable, logarithmic-linear model composed of volume, complexity, and efficiency variables exhibited a strong linear relationship with observed costs (R(2) = 0.98). This model also proved reliable in forecasting (R(2) = 0.96). Based on our analysis, as much as $120 million might be reallocated to improve the United States-based Army hospital performance evaluated in this study.

Veterans Caregiving for Others: Caregiving as a Factor in the Health of America's Military Veterans.

PubMed

Manley, Natalie A; Hicken, Bret L; Rupper, Randall W

2018-06-13

Caregiving has become an important world-wide concern due to the increasing number of people living to old age who need day to day functional support. Many caregivers report moderate to high levels of caregiver burden, which has been associated with increased morbidity and mortality for both the caregiver and care recipient. There are numerous research publications on people who are caregivers for military veterans. However, there is little information on military veterans who are themselves caregivers. This study proposed to determine if there are differences in health and health behaviors between veterans who are caregiving for others (VCOs) and veterans who are not caregiving for others (VNCOs). Data were analyzed from a population-based observational cross-section involving persons who identified as veterans in the 2009 Center for Disease Control and Prevention's (CDC) Behavioral Risk Factor Surveillance System (BRFSS) national telephone survey. Those identifying as veterans were then grouped by those who also identified as caregivers and those who did not identify as caregivers. Data were weighted using the CDC's weighting equation. Group differences were analyzed using Chi-square and t-tests. We used multinomial logistic regression with a 95% confidence interval (1 = VCO; 0 = VNCO) to determine if caregiving status among veterans was independently correlated with clinically relevant and explanatory variables. Of 432,607 BRFSS participants, 12,629 were VCOs (23.4% of veterans; 10.7% of caregivers) and 44,356 were VNCOs (76.6% of veterans). Veterans who were caregivers reported similar proportions of hypertension, diabetes, coronary heart disease, history of stroke, and cancer compared with VNCOs, even though VCOs were younger than the VNCOs (57 vs. 59 yr, p < 0.01). Additionally, VCOs more often report current smoking (35% vs. 28%, p < 0.01), frequent insufficient sleep (29% vs. 21%, p < 0.01), and frequent mental distress (12% vs. 8%, p < 0.01). Veterans who

The Benefits of High-Intensity Functional Training Fitness Programs for Military Personnel.

PubMed

Haddock, Christopher K; Poston, Walker S C; Heinrich, Katie M; Jahnke, Sara A; Jitnarin, Nattinee

2016-11-01

metabolic conditioning and muscular strength, less systemic inflammation or oxidative damage compared to sustained aerobic activity, and promoting general physical preparedness (GPP) for the unpredictable physical demands of combat. Given the unique benefits of HIFT, we recommend that these programs become the standard for military physical training. Despite the promise of HIFT fitness programs, questions remain about implementing these programs in the military context. For instance, no large scale randomized trials comparing traditional military physical training with HIFT programs on both health and injury outcomes have been conducted. Such a trial could identify key elements from both types of programs which should be incorporated in future approaches to military fitness training. Also, research regarding the optimal ways of implementing HIFT to maximize both GPP and combat oriented physical skills is lacking. It is likely that an approach to HIFT training which promotes GPP for all personnel along with specialized elements selected on the basis of individual occupation demands would be maximally disseminable in the military. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Preparing MSW Students to Provide Mental and Behavioral Health Services to Military Personnel, Veterans, and Their Families in Rural Settings

ERIC Educational Resources Information Center

Rishel, Carrie W.; Hartnett, Helen P.

2015-01-01

The prevalence of mental health disorders constitutes a nationwide public health crisis. Estimates suggest that more than 90 million people live in areas designated mental health professional shortage areas, with almost 6,000 additional practitioners needed to meet the service needs in these areas. Military personnel and veterans have greater…

Stress management training for military trainees returned to duty after a mental health evaluation: effect on graduation rates.

PubMed

Cigrang, J A; Todd, S L; Carbone, E G

2000-01-01

A significant proportion of people entering the military are discharged within the first 6 months of enlistment. Mental health related problems are often cited as the cause of discharge. This study evaluated the utility of stress inoculation training in helping reduce the attrition of a sample of Air Force trainees at risk for discharge from basic military training. Participants were 178 trainees referred for a psychological evaluation from basic training. Participants were randomly assigned to a 2-session stress management group or a usual-care control condition. Compared with past studies that used less rigorous methodology, this study did not find that exposure to stress management information increased the probability of graduating basic military training. Results are discussed in terms of possible reasons for the lack of treatment effects and directions for future research.

Relationship Education for Military Couples: Recommendations for Best Practice.

PubMed

Bakhurst, Melissa G; Loew, Benjamin; McGuire, Annabel C L; Halford, W Kim; Markman, Howard J

2017-06-01

Military couples have a number of distinctive strengths and challenges that are likely to influence their relationship adjustment. Military couples' strengths include stable employment, financial security, and subsidized health and counseling services. At the same time, military couples often experience long periods of separation and associated difficulties with emotional disconnect, trauma symptoms, and reintegrating the family. This paper describes best practice recommendations for working with military couples, including: addressing the distinctive challenges of the military lifestyle, ensuring program delivery is seen as relevant by military couples, and providing relationship education in formats that enhance the accessibility of programs. © 2016 Family Process Institute.

Main and interactive effects of social support in predicting mental health symptoms in men and women following military stressor exposure.

PubMed

Smith, Brian N; Vaughn, Rachel A; Vogt, Dawne; King, Daniel W; King, Lynda A; Shipherd, Jillian C

2013-01-01

Evidence across a multitude of contexts indicates that social support is associated with reduced risk for mental health symptoms. More information is needed on the effectiveness of different sources of support, as well as sex differences in support. Associations between social support from two sources - the military unit and friends and family - and mental health symptoms were examined in a study of 1571 Marine recruits assessed at the beginning and end of a highly stressful 13-week training program. Military social support buffered the stressor exposure-posttraumatic stress symptomatology (PTSS) relationship, whereas the relationship between stressor exposure and PTSS was highest when civilian social support was high. Further inspection of the interactions revealed that military support was most important at high levels of stressor exposure. Sex differences in the relationship between social support and symptoms were found, such that support from military peers was associated with lower levels of PTSS for men, whereas civilian support was associated with lower PTSS for women. While civilian social support was associated with lower levels of depression symptom severity in both women and men, the relationship was stronger for women. Reviewed implications focus on the importance of considering the recipient, source, and context of social support.

The Role of the U.S. Army in Health System Reconstruction and Development During Counterinsurgency

DTIC Science & Technology

2012-06-08

freedom. — Amartya Sen Development as Freedom Military medical personnel involved in health system reconstruction and development in Iraq and...Afghanistan. New York: W.W. Norton and Company, 2009. Sen , Amartya . Development as Freedom. New York: Anchor Books, 2000. Special Inspector General for

[Problems of military medical examination of military servicemen suffering from chronic obstructive pulmonary disease].

PubMed

Chapliuk, A L; Brovkin, S G; Kal'manov, A S; Bulavin, V V

2015-02-01

The authors showed that at the present time military much more servicemen, suffering from obstructive pulmonary disease, may receive medical examination in outpatient conditions. Series of researches allow us to perform a medical examination on an outpatient basis. The calculation of the cost-effectiveness of health services to such patients during a military medical examination in the hospital and clinics was made. Savings during the examination in the clinic for 1 patient was 2829 rubbles.

Military Manpower Training Report for FY 1979.

DTIC Science & Technology

1978-03-01

intermediate, and senior. Ed..cation in the military school system is fundamental to trw development of military officers who are fully qualified to perforr...of training inputs and loads, the Services are able to adapt the training system to changing conditions. However, it should be clear that extended...each Service maintains a system of professional military education which is progressive in nature. This education is related more to the increasing

Department of Defense Birth and Infant Health Registry: select reproductive health outcomes, 2003-2014.

PubMed

Bukowinski, Anna T; Conlin, Ava Marie S; Gumbs, Gia R; Khodr, Zeina G; Chang, Richard N; Faix, Dennis J

2017-11-01

Established following a 1998 directive, the Department of Defense Birth and Infant Health Registry (Registry) team conducts surveillance of select reproductive health outcomes among military families. Data are compiled from the Military Health System Data Repository and Defense Manpower Data Center to define the Registry cohort and outcomes of interest. Outcomes are defined using ICD-9/ICD-10 and Current Procedural Terminology codes, and include: pregnancy outcomes (e.g., live births, losses), birth defects, preterm births, and male:female infant sex ratio. This report includes data from 2003-2014 on 1,304,406 infants among military families and 258,332 pregnancies among active duty women. Rates of common adverse infant and pregnancy outcomes were comparable to or lower than those in the general US population. These observations, along with prior Registry analyses, provide reassurance that military service is not independently associated with increased risks for select adverse reproductive health outcomes. The Registry's diverse research portfolio demonstrates its unique capabilities to answer a wide range of questions related to reproductive health. These data provide the military community with information to identify successes and areas for improvement in prevention and care.

Culture: what is its effect on stress in the military?