Study
Abstract
OBJECTIVES: 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.
METHODS: 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.
FINDINGS: 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.
CONCLUSION: 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.
- Publication Status: Published
- Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
- Sponsoring Office: Uniformed Services University of Health Sciences
- Congressionally Mandated: No
- Funding Source: Undetermined
- Release Date/Publication: May 01, 2014
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Citation: Donelan K, Romano C, DesRoches C, Applebaum S, Ward JR, Schoneboom BA, Hinshaw AS. National surveys of military personnel, nursing students, and the public: drivers of military nursing careers. Mil Med. 2014 May;179(5):565-72.
Study
Abstract
INTRODUCTION: The objective of this study was to determine if race is associated with vaginal birth after cesarean delivery (VBAC) success in a military population.
METHODS: A retrospective cohort study was conducted examining women with a history of at least one prior cesarean delivery who delivered at a single tertiary care military treatment facility. Data were collected pertaining to maternal demographics, medical and obstetric history, antepartum complications, intrapartum course, delivery mode, and maternal outcomes. Univariable and multivariable analyses were used to determine the association of race and VBAC success.
RESULTS: Four hundred seventy-six charts were reviewed from 2004 to 2011. African American women were more likely to require a cesarean delivery (P<.05) even after adjusting for potentially confounding factors. There was no difference in maternal morbidity between the racial groups.
CONCLUSIONS: In a health care system with equal access, racial disparities remain. The effect of social factors that may influence such a disparity are thought to be attenuated in a military population. However, in our study, African American women were still significantly more likely to fail a VBAC attempt as compared with non-African American women. Race had no influence on morbidity, although this study was not powered to examine morbidity as a primary outcome.
- Publication Status: Published
- Sponsoring Organization: Navy
- Sponsoring Office: Naval Medical Center San Diego
- Congressionally Mandated: No
- Funding Source: Undetermined
- Release Date/Publication: May 01, 2014
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Citation: Brankin C, Stratton S, Piszczek C, You W. Race and vaginal birth after cesarean delivery in a military population. Obstet Gynecol. 2014 May;123 Suppl 1:139S.
Study
Abstract
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.
- Publication Status: Published
- Sponsoring Organization: Air Force
- Sponsoring Office: United States Air Force Medical Support Agency
- Congressionally Mandated: No
- Funding Source: Air Force
- Release Date/Publication: May 01, 2014
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Citation: Eilerman PA, Herzog CM, Luce BK, Chao SY, Walker SM, Zarzabal LA, Carnahan DH. A comparison of obesity prevalence: military health system and United States populations, 2009-2012. Mil Med. 2014 May;179(5):462-70.
Study
Abstract
OBJECTIVE: Parental deployment is associated with children's increased mental health needs. Attention Deficit Hyperactivity Disorder (ADHD) is the most common pediatric mental health diagnosis. We hypothesize children with ADHD will have increased mental health and medication needs during parental deployment.
METHODS: Rtrospective cohort study of children with ADHD aged 4-8 years in the Military Health System.
RESULTS: Of 413,665 children aged 4-8 years, 34,205 (8.3%) had ADHD and 19,123 (55.9%) of these were prescribed ADHD medications. During parental deployments, children with ADHD had a 13% increased rate of mental and behavioral health care visits (IRR 1.13 [95% CI 1.12-1.14; p < 0.00001]) and a decreased rate of medication changes (IRR 0.94 [95% CI 0.91-0.96; p < 0.00001]) compared to when parents were at home. Medication changes related to deployment varied by age; school-aged children had decreased medication events (IRR 0.88 [95% CI 0.86-0.91; p < 0.00001]) and preschool-aged children had increased medication events (IRR 1.05 [95% CI 1.02-1.10; p = .006]) during parental deployment.
CONCLUSIONS: Dring parental deployment, children with ADHD aged 4-8 years have increased mental health visits and decreased ADHD medication changes. Younger children have increased medication changes, whereas older children have decreased changes during a parent's deployment.
- Publication Status: Published
- Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
- Sponsoring Office: Uniformed Services University of Health Sciences
- Congressionally Mandated: No
- Funding Source: Defense Health Agency (formerly TRICARE Management Activity)
- Release Date/Publication: May 01, 2014
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Citation: Hisle-Gorman E, Eide M, Coll EJ, Gorman GH. Attention deficit hyperactivity disorder and medication use by children during parental military deployments. Mil Med. 2014 May;179(5):573-8.
Study
Abstract
This report examines trends in health record documentation of the treatment for mental disorders of active component U.S. military service members from January 2000 through September 2013. Inpatient and outpatient records were used to estimate the numbers and proportions of service members who received such treatment and the durations and intensities of courses of treatment. Annual numbers of service members who received treatment for mental disorders and the annual numbers of treatment courses increased steadily from 2004-2012. More than half of service members who received such treatment had only one treatment course, but the annual numbers of such single treatment courses increased by 60% during the 13-year surveillance period. Annual numbers of treatment courses that consisted of more than 30 encounters increased 5.6-fold between 2001 and 2012 and the mean number of days per treatment course markedly increased during the last half of the period. The proportion of overall service time contributed by members who were in treatment for mental disorders increased from about 1% in 2000 to 3.5% in 2012. The methods and findings of this analysis are compared and contrasted with other published studies and reports about mental health problems in the Armed Forces since the beginning of the wars in Afghanistan and Iraq.
- Publication Status: Published
- Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
- Sponsoring Office: Armed Forces Health Surveillance Center
- Congressionally Mandated: No
- Funding Source: Defense Health Agency (formerly TRICARE Management Activity)
- Release Date/Publication: May 01, 2014
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Citation: AFHSC. Numbers and proportions of U.S. military members in treatment for mental disorders over time, active component, January 2000-September 2013. MSMR. 2014 May;21(5):2-7.
Study
Abstract
Eosinophilic esophagitis (EoE) is a rapidly emerging chronic immune-mediated condition affecting children and adults, both genders, and all races. A large variation in the prevalence of EoE exists in the literature. The aim of this study is to establish the prevalence of EoE in a military health-care population in the United States using a comprehensive electronic medical record search. Using the International Classification for Diseases-9 code for EoE (530.13), the total number of EoE patients enrolled in the military health-care system from October 1, 2008 to September 30, 2009 including active-duty military, dependents of military personnel, and retirees were identified. For each case of EoE identified, demographic data (age, gender, and race) and geographic location was obtained. The overall prevalence of EoE was calculated as well as the prevalence within subgroups. The geographic regional locations were reported per the U.S. Census Bureau regions (Northeast, South, Midwest, and West). A total of 987 EoE patients were identified from 10 180 515 military health-care beneficiaries, establishing an overall prevalence of 9.7 per 100 000 (95% confidence interval [CI] 9.1-10.3). Seven hundred twenty-eight out of 7 707 372 adult patients were identified, establishing a prevalence of 9.5 per 100 000 (95% CI 8.8-10.1). Two hundred fifty-nine out of 2 473 143 pediatric patients were identified, establishing a prevalence of 10.5/100 000 (95% CI 9.2-11.8). EoE was more prevalent in males (odds ratio [OR] 2.03 [95% CI 1.78-2.32]) and higher in Caucasian versus African Americans (18.1 vs. 5.2/100 000, OR 3.47 [95% CI 2.40-5.03]). EoE was more prevalent in the Western region of the United States compared with the Northeast, South, and Midwest regions, with a prevalence of 11.9 versuss 5.2, 9.6, and 9.2 per 100 000, respectively. When comparing Northern with Southern states, there was an increased prevalence in the North (10.9 vs. 7.2/100 000, P < 0.05). In this large nationwide study, increase in prevalence of EoE was seen in younger adults, with a higher prevalence in Caucasians. Geographically, the western United States had a significantly higher prevalence with a slightly higher prevalence in the Northern latitude.
- Publication Status: Published
- Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
- Sponsoring Office: Walter Reed National Military Medical Center/Uniformed Services University of Health Sciences
- Congressionally Mandated: No
- Funding Source: Defense Health Agency (formerly TRICARE Management Activity)
- Release Date/Publication: May 01, 2014
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Citation: Ally MR, Maydonovitch CL, Betteridge JD, Veerappan GR, Moawad FJ. Prevalence of eosinophilic esophagitis in a United States military health-care population. Dis Esophagus. 2014 May 15.
Study
Abstract
Deployed military personnel are exposed to inhalational hazards that may increase their risk of chronic lung conditions. This evaluation assessed associations between Operation Iraqi Freedom (OIF) deployment and postdeployment medical encounters for respiratory symptoms and medical conditions. This retrospective cohort study was conducted among military personnel who, between January 2005 and June 2007, were deployed to either of two locations with burn pits in Iraq, or to either of two locations without burn pits in Kuwait. Incidence rate ratios (IRRs) were estimated using two nondeployed reference groups. Rates among personnel deployed to burn pit locations were also compared directly to those among personnel deployed to locations without burn pits. Significantly elevated rates of encounters for respiratory symptoms (IRR = 1.25; 95% confidence interval [CI]: 1.20-1.30) and asthma (IRR = 1.54; 95% CI: 1.33-1.78) were observed among the formerly deployed personnel relative to U.S.-stationed personnel. Personnel deployed to burn pit locations did not have significantly elevated rates for any of the outcomes relative to personnel deployed to locations without burn pits. These results are consistent with the hypothesis that OIF deployment is associated with subsequent risk of respiratory conditions. Elevated medical encounter rates were not uniquely associated with burn pits.
- Publication Status: Published
- Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
- Sponsoring Office: Armed Forces Health Surveillance Center/ Uniformed Services University of Health Sciences
- Congressionally Mandated: No
- Funding Source: Undetermined
- Release Date/Publication: May 01, 2014
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Citation: Abraham JH, Eick-Cost A, Clark LL, Hu Z, Baird CP, DeFraites R, et.al. A retrospective cohort study of military deployment and postdeployment medical encounters for respiratory conditions. Mil Med. 2014 May;179(5):540-6.
Study
Abstract
Recent studies have found that longer dwell times, or the period of time between deployments, may be protective against combat-related psychological outcomes. The purpose of this study was to examine the association between dwell time and psychological morbidity, while accounting for combat exposure. U.S. Marines with two combat deployments between 2005 and 2008 were identified from electronic deployment records. Those who screened positive for post-traumatic stress disorder and depression, and who were referred for mental health services were identified from the Post-Deployment Health Assessment. For the final study sample of 3,512 Marines, dwell time was calculated as time between deployments, and was analyzed as a ratio over length of first deployment. After adjustment for all covariates, there was an interaction (p = 0.01) between dwell time and combat exposure on mental health referral outcome. For personnel with maximum reported combat exposure, longer dwell times were associated with a 49% to 92% reduced odds of mental health referral. Longer dwell times may be protective against combat-related psychological outcomes. Because multiple deployments are likely to be the norm in future military operations, regulating dwell time, particularly for those with greater risk of combat exposure, should continue to be explored.
- Publication Status: Published
- Sponsoring Organization: Navy
- Sponsoring Office: Naval Health Research Center
- Congressionally Mandated: No
- Funding Source: Navy
- Release Date/Publication: April 01, 2014
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Citation: MacGregor AJ, Heltemes KJ, Clouser MC, Han PP, Galarneau MR. Dwell time and psychological screening outcomes among military service members with multiple combat deployments. Mil Med. 2014 Apr;179(4):381-7.
Study
Abstract
Individuals who are eligible for care through the Military Health System (MHS) (“beneficiaries”) include family members of active component service members, family members of National Guard and Reserve service members, and retirees and eligible family members of retirees. In 2013, there were approximately 1.98 million active component family members, 550,000 Guard/Reserve family members, and 5.29 million retirees and their family members eligible for medical care from the MHS. Some beneficiaries of MHS care do not enroll in the healthcare plans provided by the MHS (e.g., if they use insurance through their own employment); also, some of those who are enrolled do not seek care through the MHS. MHS beneficiaries may receive care from resources provided directly by the Uniformed Services (i.e., military medical treatment facilities [MTFs]) or from civilian healthcare resources (i.e., outsourced [purchased] care) that supplement direct military medical care.
In 2013, approximately 6.8 million individuals utilized inpatient or outpatient services provided by the MHS. In the population of MHS care recipients in 2013, there were more females (58%) than males (42%) and more infants, children, and adolescents (<20 years: n=1.9 million; 28.9%) and more seniors (65 years or older: n=1.8 million; 26.1%) than younger (20–44 years: n=1.4 million; 20.1%) or older (45–64 years: n=1.7 million; 24.9%) adults. Since 1998, the MSMR has published annual summaries of the numbers and rates of hospitalizations and outpatient medical encounters to assess the healthcare “burdens” of 16 categories of illnesses and injuries among active component military members. This year, for the first time and using similar methodology, this report quantifies the illnesses and injuries among non-service members who received care in the MHS in 2013. Healthcare burden estimates are stratified by direct versus outsourced care and across four age groups of healthcare recipients.
- Publication Status: Published
- Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
- Sponsoring Office: Armed Forces Health Surveillance Center
- Congressionally Mandated: No
- Funding Source: Defense Health Agency (formerly TRICARE Management Activity)
- Release Date/Publication: April 01, 2014
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Citation: AFHSC. Absolute and relative morbidity burdens attributable to various illnesses and injuries, non-service member beneficiaries of the Military Health System, 2013. MSMR. 2014 Apr;21(4):23-30; discussion 30.
Study
Abstract
OBJECTIVES: We studied military health care provider (HCP) practices regarding reporting of adverse events following immunization (AEFI).
METHODS: A convenience sample of HCP was surveyed to assess familiarity with Vaccine Adverse Event Reporting System (VAERS), AEFI they were likely to report, methods used and preferred for reporting, and perceived barriers to reporting. We analyzed factors associated with HCP reporting AEFI to VAERS.
RESULTS: A total of 547 surveys were distributed with 487 completed and returned for an 89% response rate. The percentage of HCP aware of VAERS (54%) varied by occupation. 47% of respondents identified knowledge of at least one AEFI with only 34% of these indicating that they had ever reported to VAERS. More serious events were more likely to be reported. Factors associated with HCP reporting AEFIs in bivariate analysis included HCP familiarity with filing a paper VAERS report, HCP familiarity with filing an electronic VAERS report, HCP familiarity with VAERS, and time spent on immunization tasks. In a multivariable analysis, only HCP familiarity with filing a paper VAERS report was statistically significant (Odds ratio = 115.3; p < 0.001).
CONCLUSIONS: Specific educational interventions targeted to military HCP likely to see AEFIs but not currently filing VAERS reports may improve vaccine safety reporting practices.
- Publication Status: Published
- Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
- Sponsoring Office: Walter Reed National Military Medical Center
- Congressionally Mandated: No
- Funding Source: Undetermined
- Release Date/Publication: April 01, 2014
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Citation: Li R, McNeil MM, Pickering S, Pemberton MR, Duran LL, Collins LC, Nelson MR, Engler RJ. Military healthcare providers reporting of adverse events following immunizations to the vaccine adverse event reporting system. Mil Med. 2014 Apr;179(4):435-41
Study
Abstract
The relationship between Graves disease and race/ethnicity is undefined. Based on thyroid antibody prevalence, the rates of Hashimoto thyroiditis may be highest in whites and lowest in blacks. Using a large and comprehensive data set of medical diagnoses for all US active duty service personnel, we calculated age-standardized incidence rates for Graves disease and Hashimoto thyroiditis by race/ethnicity. Compared with whites, the IRR for Graves disease was significantly elevated in black women (IRR, 1.92; 95% CI, 1.56-2.37) and men (IRR, 2.53; 95% CI, 2.01-3.18) and Asian/Pacific Islander women (IRR, 1.78; 95% CI, 1.20-2.66) and men (IRR, 3.36; 95% CI, 2.57-4.40) (Figure). In contrast, Hashimoto thyroiditis incidence was highest in whites and lowest in black women (IRR, 0.33; 95% CI, 0.21-0.51) and men (IRR, 0.22; 95% CI, 0.11-0.47) and Asian/Pacific Islander women (IRR, 0.31; 95% CI, 0.17-0.56) and men (IRR, 0.23; 95% CI, 0.07-0.72). The differences in incidence by race/ethnicity may be due to different environmental exposures, genetics, or a combination of both. Our results are not easily attributable to the strongest known environmental risk factor, cigarette smoking.
- Publication Status: Published
- Sponsoring Organization: Undetermined
- Sponsoring Office:
- Congressionally Mandated: No
- Funding Source: Government, academic, or industry source other than Federal Government
- Release Date/Publication: April 01, 2014
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Citation: McLeod DS, Caturegli P, Cooper DS, Matos PG, Hutfless S. Variation in rates of autoimmune thyroid disease by race/ethnicity in US military personnel. JAMA. 2014 Apr 16;311(15):1563-5.
Study
Abstract
We sought to evaluate whether residence at high altitude is associated with the development of obesity among those at increased risk of becoming obese. Obesity, a leading global health priority, is often refractory to care. A potentially novel intervention is hypoxia, which has demonstrated positive long-term metabolic effects in rats. Whether or not high altitude residence confers benefit in humans, however, remains unknown. Using a quasi-experimental, retrospective study design, we observed all outpatient medical encounters for overweight active component enlisted service members in the U.S. Army or Air Force from January 2006 to December 2012 who were stationed in the United States. We compared high altitude (>1.96 kilometers above sea level) duty assignment with low altitude (<0.98 kilometers). The outcome of interest was obesity related ICD-9 codes (278.00-01, V85.3x-V85.54) by Cox regression. We found service members had a lower hazard ratio (HR) of incident obesity diagnosis if stationed at high altitude as compared to low altitude (HR 0.59, 95% confidence interval [CI] 0.54-0.65; p<0.001). Using geographic distribution of obesity prevalence among civilians throughout the U.S. as a covariate (as measured by the Centers for Disease Control and Prevention and the REGARDS study) also predicted obesity onset among service members. In conclusion, high altitude residence predicts lower rates of new obesity diagnoses among overweight service members in the U.S. Army and Air Force. Future studies should assign exposure using randomization, clarify the mechanism(s) of this relationship, and assess the net balance of harms and benefits of high altitude on obesity prevention.
- Publication Status: Published
- Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
- Sponsoring Office: Uniformed Services University of Health Sciences/Armed Forces Health Surveillance Center
- Congressionally Mandated: No
- Funding Source: Defense Health Agency (formerly TRICARE Management Activity)
- Release Date/Publication: April 01, 2014
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Citation: Voss JD, Allison DB, Webber BJ, Otto JL, Clark LL. Lower obesity rate during residence at high altitude among a military population with frequent migration: a quasi experimental model for investigating spatial causation. PLoS One. 2014 Apr 16;9(4):e93493
Study
Abstract
Energy drinks (EDs) are highly caffeinated beverages usually containing herbal ingredients promoted and consumed for purported improvements in attention and athletic performance. The popularity of EDs among adolescents and young adults has steadily increased for more than a decade. Reports suggest U.S. military populations consume EDs with greater frequency as compared to age-matched civilian populations. This article reviews the literature and outlines the current body of evidence evaluating the human performance benefits and potential harms associated with ED use.
- Publication Status: Published
- Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
- Sponsoring Office: Uniformed Services University of Health Sciences
- Congressionally Mandated: No
- Funding Source: Undetermined
- Release Date/Publication: April 01, 2014
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Citation: Johnson LA, Foster D, McDowell JC. Energy drinks: review of performance benefits, health concerns, and use by military personnel. Mil Med. 2014 Apr;179(4):375-80.
Study
Abstract
BACKGROUND CONTEXT: Although occupational driving has been associated with low back pain, little has been reported on the incidence rates for this disorder.
PURPOSE: To determine the incidence rate and demographic risk factors of low back pain in an ethnically diverse and physically active population of US military vehicle operators.
STUDY DESIGN/SETTING: Retrospective database analysis.
PATIENT SAMPLE: All active-duty military service members between 1998 and 2006.
OUTCOME MEASURES: Low back pain requiring visit to a health-care provider.
METHODS: A query was performed using the US Defense Medical Epidemiology Database for the International Classification of Diseases, Ninth Revision, Clinical Modification code for low back pain (724.20). Multivariate Poisson regression analysis was used to estimate the rate of low back pain among military vehicle operators and control subjects per 1,000 person-years, while controlling for sex, race, rank, service, age, and marital status.
RESULTS: A total of 8,447,167 person-years of data were investigated. The overall unadjusted low back pain incidence rate for military members whose occupation is vehicle operator was 54.2 per 1,000 person-years. Compared with service members with other occupations, motor vehicle operators had a significantly increased adjusted incidence rate ratio (IRR) for low back pain of 1.15 (95% confidence interval [CI] 1.13-1.17). Female motor vehicle operators, compared with males, had a significantly increased adjusted IRR for low back pain of 1.45 (95% CI 1.39-1.52). With senior enlisted as the referent category, the junior enlisted rank group of motor vehicle operators had a significantly increased adjusted IRR for low back pain: 1.60 (95% CI 1.52-1.70). Compared with Marine service members, those motor vehicle operators in both the Army, 2.74 (95% CI 2.60-2.89), and the Air Force, 1.98 (95% CI 1.84-2.14), had a significantly increased adjusted IRR for low back pain. The adjusted IRRs for the less than 20-year and more than 40-year age groups, compared with the 30- to 39-year age group, were 1.24 (1.15-1.36) and 1.23 (1.10-1.38), respectively.
CONCLUSIONS: Motor vehicle operators have a small but statistically significantly increased rate of low back pain compared with matched control population.
- Publication Status: Published
- Sponsoring Organization: Army
- Sponsoring Office:
- Congressionally Mandated: No
- Funding Source: Undetermined
- Release Date/Publication: April 01, 2014
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Citation: Knox JB, Orchowski JR, Scher DL, Owens BD, Burks R, Belmont PJ Jr. Occupational driving as a risk factor for low back pain in active-duty military service members. Spine J. 2014 Apr;14(4):592-7.
Study
Abstract
INTRODUCTION: Individuals with multiple versus single suicide attempts present a more severe clinical picture and may be at greater risk for suicide. Yet group differences within military samples have been vastly understudied.
PURPOSE: The objective is to determine demographic, diagnostic, and psychosocial differences, based on suicide attempt status, among military inpatients admitted for suicide-related events.
METHOD: A retrospective chart review design was used with a total of 423 randomly selected medical records of psychiatric admissions to a military hospital from 2001 to 2006.
RESULTS: Chi-square analyses indicated that individuals with multiple versus single suicide attempts were significantly more likely to have documented childhood sexual abuse (p =.025); problem substance use (p=.001); mood disorder diagnosis (p=.005); substance disorder diagnosis (p =.050); personality disorder not otherwise specified diagnosis (p =.018); and Axis II traits or diagnosis (p=.038) when compared to those with a single attempt history. Logistic regression analyses showed that males with multiple suicide attempts were more likely to have problem substance use (p=.005) and a mood disorder diagnosis (p =.002), while females with a multiple attempt history were more likely to have a history of childhood sexual (p =.027).
DISCUSSION: Clinically meaningful differences among military inpatients with single versus multiple suicide attempts exist. Targeted Department of Defense suicide prevention and intervention efforts that address the unique needs of these two specific at-risk subgroups are additionally needed.
- Publication Status: Published
- Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
- Sponsoring Office: Uniformed Services University of Health Sciences
- Congressionally Mandated: No
- Funding Source: Defense Health Agency (formerly TRICARE Management Activity)
- Release Date/Publication: April 01, 2014
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Citation: Kochanski-Ruscio KM, et.al., Diagnostic and psychosocial differences in psychiatrically hospitalized military service members with single versus multiple suicide attempts. Compr Psychiatry. 2014 Apr;55(3):450-6.
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