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Military Health System Studies Inventory Tool

Welcome to the Military Health System Studies Inventory Tool (MSIT). Military Health System (MHS) data are used by Department of Defense, Veterans Administration, and academic health professionals and scientists to implement health care studies. These studies reflect the MHS interest to rigorously assess and improve our beneficiaries’ access to the high quality health care services they need. Additionally, these studies are frequently used to develop or improve MHS policy and often adopt useful, relevant comparisons to the national health care experience.

The MSIT allows easy review of recent studies that are either conducted or sponsored by the MHS, or accomplished using datasets developed or maintained by the Defense Health Agency for administrative, operational, or research purposes. The studies within this website represent important contributions of the MHS to the national health care dialogue and reflect our capacity to tackle the challenging issues needed to support evidence-informed health policy. Thank you for your interest in them.

We found 213 items resulting from your search.

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Changes in Meeting Vigorous Physical Activity Guidelines After Discharge From the Military.

Study

Abstract

BACKGROUND: Understanding physical activity (PA) after discharge from the military can inform theory on the role of habit and reinforcement in behavior maintenance and has implications for this population's future health. METHODS: Using data from 28,866 Millennium Cohort Study participants (n=3782 of whom were discharged during the years between assessments), we: 1) investigated changes in meeting federal PA Guidelines for moderate-to-vigorous activity (MVPA) following military discharge, and 2) determined predictors of meeting these Guidelines after discharge. RESULTS: MVPA declined more in those who were discharged than those who were not (-17.8 percentage points vs. -2.7 percentage points), with greater declines in former active-duty personnel, those who had deployed with combat exposures, had 14-25 years of service, and had been discharged more recently (>2 years prior). In those who were discharged, being normal or overweight (vs. obese), and a nonsmoker or former smoker (vs. current smoker) were positively associated with meeting MVPA Guidelines at follow-up, while meeting MVPA Guidelines at baseline and depression were inversely associated. CONCLUSIONS: Reductions in MVPA were substantial and unexpected. Increased understanding of transitional periods that may benefit from interventions to mitigate declines in PA will help prevent excess weight gain and physical inactivity-associated health consequences.

  • Publication Status: Published
  • Sponsoring Organization: Undetermined
  • Sponsoring Office:
  • Congressionally Mandated: No
  • Funding Source: Undetermined
  • Release Date/Publication: May 01, 2014
  • Citation: Littman A, Jacobson IG, Boyko EJ, Smith TC. Changes in Meeting Vigorous Physical Activity Guidelines After Discharge From the Military. J Phys Act Health. 2014 May 9.

Attention deficit hyperactivity disorder and medication use by children during parental military deployments.

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
  • 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.

A retrospective cohort study of military deployment and postdeployment medical encounters for respiratory conditions.

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
  • 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.

Numbers and proportions of U.S. military members in treatment for mental disorders over time, active component, January 2000-September 2013.

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
  • 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.

Military Beliefs and PTSD in Active Duty U.S. Army Soldiers.

Study

Abstract

Post-traumatic distress after military combat is a major cost of war. One under-investigated factor potentially associated with PTSD symptoms is specific beliefs about one's military service. This study examined post-deployment self-reports from 272 active-duty U.S. Army soldiers, to investigate potential associations between military-related PTSD symptom severity and three beliefs about the military: the importance and value ascribed to one's own work in the Army, to current military operations in Iraq and Afghanistan, and to military service in general. Higher scores on these three beliefs were negatively correlated with military-related PTSD symptom severity. However, in a combined regression model that controlled for recent combat exposure, only the belief about current military operations had a significant, unique association with PTSD symptom severity. That is, more positive beliefs about the value of operations in Iraq or Afghanistan were associated with lower PTSD symptoms.

  • Publication Status: Published
  • Sponsoring Organization: Undetermined
  • Sponsoring Office:
  • Congressionally Mandated: No
  • Funding Source: Undetermined
  • Release Date/Publication: November 01, 2014
  • Citation: Loew B, Carter S, Allen E, Markman H, Stanley S, Rhoades G. Military Beliefs and PTSD in Active Duty U.S. Army Soldiers. Traumatology (Tallahass Fla). 2014 Sep 1;20(3):150-153. PubMed PMID: 25530729.

An outbreak of Campylobacter enteritis associated with a community water supply on a U.S. military installation.

Study

Abstract

An outbreak of acute gastroenteritis involving 249 persons, 32% of whom were hospitalized, occurred on a U.S. Army installation in 1990. Campylobacter jejuni was isolated from 81 of 163 (50%) persons cultured. Seventeen isolates of C. jejuni available for serotyping were Lior serotype 5. The outbreak remained restricted to one recruit barracks area and adjacent Junior Reserve Officer Training Corps cadet barracks. Infection of sequential cohorts of recruits over an interval of 3 weeks suggested a continuing or intermittent common source. Contaminated food was not implicated because affected persons ate at separate dining facilities and other facilities with the same food sources had no associated illnesses. There was a strong association between the amount of water consumed by recruits and risk of diarrhea (chi-square test for trend, p<0.001). Samples of drinking water collected in the affected area had no residual chlorine and when cultured yielded greater than 200 colonies of coliform bacteria per 100 mL of water sampled. Although Campylobacter was not isolated from water, living and dead birds were found in an elevated water storage tank providing drinking water to the affected area. This and other similar outbreaks indicate that contamination of water storage tanks can lead to large outbreaks of Campylobacter enteritis.

  • Publication Status: Published
  • Sponsoring Organization: Army
  • Sponsoring Office:
  • Congressionally Mandated: No
  • Funding Source: Army
  • Release Date/Publication: November 01, 2014
  • Citation: DeFraites RF, Sanchez JL, Brandt CA, Kadlec RP, Haberberger RL, Lin JJ, Taylor DN. An outbreak of Campylobacter enteritis associated with a community water supply on a U.S. military installation. MSMR. 2014 Nov;21(11):10-5.

PTSD symptom severity is associated with increased recruitment of top-down attentional control in a trauma-exposed sample.

Study

Abstract

BACKGROUND: Recent neuroimaging work suggests that increased amygdala responses to emotional stimuli and dysfunction within regions mediating top down attentional control (dorsomedial frontal, lateral frontal and parietal cortices) may be associated with the emergence of anxiety disorders, including posttraumatic stress disorder (PTSD). This report examines amygdala responsiveness to emotional stimuli and the recruitment of top down attention systems as a function of task demands in a population of U.S. military service members who had recently returned from combat deployment in Afghanistan/Iraq. Given current interest in dimensional aspects of pathophysiology, it is worthwhile examining patients who, while not meeting full PTSD criteria, show clinically significant functional impairment. METHODS: Fifty-seven participants with sub-threshold levels of PTSD symptoms completed the affective Stroop task while undergoing fMRI. Participants with PTSD or depression at baseline were excluded. RESULTS: Greater PTSD symptom severity scores were associated with increased amygdala activation to emotional, particularly positive, stimuli relative to neutral stimuli. Furthermore, greater PTSD symptom severity was associated with increased superior/middle frontal cortex response during task conditions relative to passive viewing conditions. In addition, greater PTSD symptom severity scores were associated with: (i) increased activation in the dorsolateral prefrontal, lateral frontal, inferior parietal cortices and dorsomedial frontal cortex/dorsal anterior cingulate cortex (dmFC/dACC) in response to emotional relative to neutral stimuli; and (ii) increased functional connectivity during emotional trials, particularly positive trials, relative to neutral trials between the right amygdala and dmFC/dACC, left caudate/anterior insula cortex, right lentiform nucleus/caudate, bilateral inferior parietal cortex and left middle temporal cortex. CONCLUSIONS: We suggest that these data may reflect two phenomena associated with increased PTSD symptomatology in combat-exposed, but PTSD negative, armed services members. First, these data indicate increased emotional responsiveness by: (i) the positive relationship between PTSD symptom severity and amygdala responsiveness to emotional relative to neutral stimuli; (ii) greater BOLD response as a function of PTSD symptom severity in regions implicated in emotion (striatum) and representation (occipital and temporal cortices) during emotional relative to neutral conditions; and (iii) increased connectivity between the amygdala and regions implicated in emotion (insula/caudate) and representation (middle temporal cortex) as a function of PTSD symptom severity during emotional relative to neutral trials. Second, these data indicate a greater need for the recruitment of regions implicated in top down attention as indicated by (i) greater BOLD response in superior/middle frontal gyrus as a function of PTSD symptom severity in task relative to view conditions; (ii) greater BOLD response in dmFC/dACC, lateral frontal and inferior parietal cortices as a function of PTSD symptom severity in emotional relative to neutral conditions and (iii) greater functional connectivity between the amygdala and inferior parietal cortex as a function of PTSD symptom severity during emotional relative to neutral conditions.

  • 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: Agency, office or organization under authority of the Sec Def (not affiliated to Army, Navy, or Air Force)
  • Release Date/Publication: November 01, 2014
  • Citation: White SF, Costanzo ME, Blair JR, Roy MJ. PTSD symptom severity is associated with increased recruitment of top-down attentional control in a trauma-exposed sample. Neuroimage Clin. 2014 Nov 18;7:19-27.

Overweight and Obesity Trends Among Active Duty Military Personnel: A 13-Year Perspective.

Study

Abstract

BACKGROUND: The U.S. population has shown increasing rates of overweight and obesity in recent years, but similar analyses do not exist for U.S. military personnel. It is important to understand these patterns in the military because of their impact on fitness and readiness. PURPOSE: To assess prevalence and trends in overweight/obesity among U.S. service members and to examine the associations of sociodemographic characteristics, exercise, depression, and substance use with these patterns. METHODS: Analyses performed in 2013 used five large population-based health-related behavior surveys conducted from 1995 to 2008. Main outcome measures were overweight and obesity among active duty military personnel based on BMI. RESULTS: Combined overweight and obesity (BMI≥25) increased from 50.6% in 1995 to 60.8% in 2008, primarily driven by the rise in obesity (BMI≥30) from 5.0% to 12.7%. For overweight, military women showed the largest increase. For obesity, all sociodemographic groups showed significant increases, with the largest among warrant officers, senior enlisted personnel, and people aged 36-45 years. Adjusted multinomial logit analyses found that servicemembers aged 26 years and older, men, non-Hispanic blacks and Hispanics, enlisted personnel, married personnel, and heavy drinkers had the highest risk both for overweight and obesity. CONCLUSIONS: Combined overweight and obesity in active duty personnel rose to more than 60% between 1995 and 2008, primarily because of increased obesity. The high prevalence of overweight and obesity needs attention and has implications for DoD efforts to improve the health, fitness, readiness, and quality of life of the Active Forces.

  • Publication Status: Published
  • Sponsoring Organization: Undetermined
  • Sponsoring Office:
  • Congressionally Mandated: No
  • Funding Source: Undetermined
  • Release Date/Publication: November 01, 2014
  • Citation: Reyes-Guzman CM, Bray RM, Forman-Hoffman VL, Williams J. Overweight and Obesity Trends Among Active Duty Military Personnel: A 13-Year Perspective. Am J Prev Med. 2014 Nov 6. pii: S0749-3797(14)00505-4. doi: 10.1016/j.amepre.2014.08.033.

Mental health among a nationally representative sample of United States Military Reserve Component Personnel.

Study

Abstract

PURPOSE: Estimate prevalence of lifetime, current year, and current month depression and post-traumatic stress disorder (PTSD) among US military reservists. METHODS: Structured interviews were performed with a nationally representative military reserve sample (n = 2,003). Sociodemographic characteristics, military experiences, lifetime stressors, and psychiatric conditions were assessed. Depression was measured with the PHQ-9, and PTSD (deployment and non-deployment related) was assessed with the PCL-C. RESULTS: Depression (21.63 % lifetime, 14.31 % current year, and 5.99 % current month) was more common than either deployment-related PTSD (5.49 % lifetime, 4.98 % current year, and 3.62 % current month) or non-deployment-related PTSD (5.40 % lifetime, 3.91 % current year, and 2.32 % current month), and branch-related differences were found. Non-deployment-related trauma was associated with non-deployment-related PTSD and depression in a dose-response fashion; deployment-related trauma was associated with deployment-related PTSD and depression in a dose-response fashion. CONCLUSIONS: The study reveals notable differences in PTSD and depression prevalence by service branch that may be attributable to a combination of factors including greater lifetime trauma exposures and differing operational military experiences. Our findings suggest that service branch and organizational differences are related to key protective and/or risk factors, which may prove useful in guiding prevention and treatment efforts among reservists.

  • 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: November 01, 2014
  • Citation: Russell DW, Cohen GH, Gifford R, Fullerton CS, Ursano RJ, Galea S. Mental health among a nationally representative sample of United States Military Reserve Component Personnel. Soc Psychiatry Psychiatr Epidemiol. 2014 Nov 25.

The impact of deployment on COPD in active duty military personnel.

Study

Abstract

PURPOSE: To identify trends in chronic obstructive pulmonary disease (COPD) diagnoses among active duty U.S. military personnel based on deployment history and whether International Classification of Disease, 9th edition (ICD-9) coding meet criteria for the diagnosis of COPD. METHODS: A retrospective chart review using the electronic medical system was conducted for military personnel diagnosed with COPD based on ICD-9 codes for emphysema or chronic obstructive lung disease with at least three qualifying outpatient COPD-coded encounters. Clinical symptoms, smoking history, pulmonary function testing, and radiographs obtained during the diagnostic workup were reviewed. The established diagnosis of COPD was analyzed in relation to deployment. RESULTS: A total of 371 patients were identified during the study period (2005-2009). Of these patients, 194 (52.3%) deployed, whereas 177 (47.7%) did not deploy to Southwest Asia since 2003. Thirty-four percent had no documented smoking history despite the diagnosis of COPD. Airway obstruction was identified by spirometry in only 67% of individuals diagnosed with COPD. No statistically significant differences in pulmonary function testing values were identified between those deployed and nondeployed individuals. CONCLUSION: Despite evidence of increased respiratory symptoms in deployed military personnel, the impact of deployment on increased diagnosis of COPD or severity of disease appears minimal.

  • Publication Status: Published
  • Sponsoring Organization: Army
  • Sponsoring Office:
  • Congressionally Mandated: No
  • Funding Source: Army
  • Release Date/Publication: November 01, 2014
  • Citation: Matthews T, Abraham J, Zacher LL, Morris MJ. The impact of deployment on COPD in active duty military personnel. Mil Med. 2014 Nov;179(11):1273-8.

Predicting Suicides After Psychiatric Hospitalization in US Army Soldiers: The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS).

Study

Abstract

IMPORTANCE: The US Army experienced a sharp increase in soldier suicides beginning in 2004. Administrative data reveal that among those at highest risk are soldiers in the 12 months after inpatient treatment of a psychiatric disorder. OBJECTIVE: To develop an actuarial risk algorithm predicting suicide in the 12 months after US Army soldier inpatient treatment of a psychiatric disorder to target expanded posthospitalization care. DESIGN, SETTING, AND PARTICIPANTS: There were 53 769 hospitalizations of active duty soldiers from January 1, 2004, through December 31, 2009, with International Classification of Diseases, Ninth Revision, Clinical Modification psychiatric admission diagnoses. Administrative data available before hospital discharge abstracted from a wide range of data systems (sociodemographic, US Army career, criminal justice, and medical or pharmacy) were used to predict suicides in the subsequent 12 months using machine learning methods (regression trees and penalized regressions) designed to evaluate cross-validated linear, nonlinear, and interactive predictive associations. MAIN OUTCOMES AND MEASURES: Suicides of soldiers hospitalized with psychiatric disorders in the 12 months after hospital discharge. RESULTS: Sixty-eight soldiers died by suicide within 12 months of hospital discharge (12.0% of all US Army suicides), equivalent to 263.9 suicides per 100 000 person-years compared with 18.5 suicides per 100 000 person-years in the total US Army. The strongest predictors included sociodemographics (male sex [odds ratio (OR), 7.9; 95% CI, 1.9-32.6] and late age of enlistment [OR, 1.9; 95% CI, 1.0-3.5]), criminal offenses (verbal violence [OR, 2.2; 95% CI, 1.2-4.0] and weapons possession [OR, 5.6; 95% CI, 1.7-18.3]), prior suicidality [OR, 2.9; 95% CI, 1.7-4.9], aspects of prior psychiatric inpatient and outpatient treatment (eg, number of antidepressant prescriptions filled in the past 12 months [OR, 1.3; 95% CI, 1.1-1.7]), and disorders diagnosed during the focal hospitalizations (eg, nonaffective psychosis [OR, 2.9; 95% CI, 1.2-7.0]). A total of 52.9% of posthospitalization suicides occurred after the 5% of hospitalizations with highest predicted suicide risk (3824.1 suicides per 100 000 person-years). These highest-risk hospitalizations also accounted for significantly elevated proportions of several other adverse posthospitalization outcomes (unintentional injury deaths, suicide attempts, and subsequent hospitalizations). CONCLUSIONS AND RELEVANCE: The high concentration of risk of suicide and other adverse outcomes might justify targeting expanded posthospitalization interventions to soldiers classified as having highest posthospitalization suicide risk, although final determination requires careful consideration of intervention costs, comparative effectiveness, and possible adverse effects.

  • Publication Status: Published
  • Sponsoring Organization: Army
  • Sponsoring Office:
  • Congressionally Mandated: No
  • Funding Source: Undetermined
  • Release Date/Publication: November 01, 2014
  • Citation: Kessler RC, et. al., Predicting Suicides After Psychiatric Hospitalization in US Army Soldiers: The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). JAMA Psychiatry. 2014 Nov 12.

Utilization of telemedicine in the U.S. military in a deployed setting.

Study

Abstract

BACKGROUND: A retrospective evaluation of the Department of Defense teledermatology consultation program from 2004 to 2012 was performed, focusing on clinical application and outcome measures such as consult volume, response time, and medical evacuation status. METHODS: A retrospective review of the teledermatology program between 2004 and 2012 was evaluated based on defined outcome measures. In addition, 658 teledermatology cases were reviewed to assess how the program was utilized by health care providers from 2011 to 2012. RESULTS: As high as 98% of the teledermatology consults were answered within 24 hours, and 23% of consults within 1 hour. The most common final diagnoses included eczematous dermatitis, contact dermatitis, and evaluation for nonmelanoma skin cancer. The most common medications recommended included topical corticosteroids, oral antibiotics, antihistamines, and emollients. Biopsy was most commonly recommended for further evaluation. Following teleconsultation, 46 dermatologic evacuations were "avoided" as the patient was not evacuated based on the consultants' recommendation. Consultants' recommendations to the referring provider "facilitated" 41 evacuations. CONCLUSION: Telemedicine in the U.S. military has provided valuable dermatology support to providers in remote locations by delivering appropriate and timely consultation for military service members and coalition partners. In addition to avoiding unnecessary medical evacuations, the program facilitated appropriate evacuations that may otherwise have been delayed.

  • Publication Status: Published
  • Sponsoring Organization: Army
  • Sponsoring Office:
  • Congressionally Mandated: No
  • Funding Source: Army
  • Release Date/Publication: November 01, 2014
  • Citation: Hwang JS, Lappan CM, Sperling LC, Meyerle JH. Utilization of telemedicine in the U.S. military in a deployed setting. Mil Med. 2014 Nov;179(11):1347-53.

Surveillance snapshot: states with the most pertussis diagnoses among service members and other beneficiaries of the Military Health System, January 2012-June 2014.

Study

Abstract

According to the Centers for Disease Control and Prevention, so far in 2014, reported cases of pertussis in the U.S. have increased 24% over the previous year; by June 16, a total of 9,964 cases of pertussis had been reported by 50 states and the District of Columbia. On June 13, the California Department of Public Health announced that the state was experiencing a pertussis (“whooping cough”) epidemic. As of June 10, a total of 3,458 cases had been reported in the state; this number of pertussis cases exceeds the number of cases reported in the entire year in 2013. Th e MSMR has previously reported on spatiotemporal clusters of pertussis in the military that were associated with outbreaks in neighboring non-military communities; this association was clearly demonstrated during a previous 2010 outbreak in California. Between January 2012 and June 2014, the greatest number of pertussis cases (both confi rmed and probable) diagnosed in military benefi ciaries occurred in California, Texas, Washington, Virginia, and Florida (Figure); 90 cases have been diagnosed in California since January 2014, which is more than was reported in all of 2012 (n=68) or 2013 (n=89).

  • 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: June 01, 2014
  • Citation: Armed Forces Health Surveillance Center (AFHSC). Surveillance snapshot: states with the most pertussis diagnoses among service members and other beneficiaries of the Military Health System, January 2012-June 2014. MSMR. 2014 Jun;21(6):18.

Effects of personal and occupational stress on injuries in a young, physically active population: a survey of military personnel.

Study

Abstract

The aim of this study was to document risk factors for any injury and sports- and exercise-related injuries, including personal and occupational stress among active duty service members (SMs) in the Air Force, Army, Marine Corps, and Navy. A total of 10,692 SMs completed the April 2008 Status of Forces Survey of Active Duty Members. The survey asked about demographics, personal stress and occupational stress, injuries from any cause, and participation in sports- and exercise- related activities in the past year. The survey used a complex sampling procedure to create a representative sample of SMs. Logistic regression was used to examine the associations of injury outcomes with potential risk factors. 49% of SMs sought medical care for an injury in the past year and 25% sustained a sports- and exercise-related activities injury. Odds of injury were higher for the Army and Marine Corps than for the Air Force or Navy. This survey showed that higher personal and occupational stress was associated with higher risks of injury. SMs who experienced higher levels of personal or occupational stress reported higher risks of injuries. The effects of stress reduction programs on injury risks should be evaluated in military and other young physically active populations.

  • 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: November 01, 2014
  • Citation: Bedno S, Hauret K, Loringer K, Kao TC, Mallon T, Jones B. Effects of personal and occupational stress on injuries in a young, physically active population: a survey of military personnel. Mil Med. 2014 Nov;179(11):1311-8.

REPORT TO CONGRESS, NATIONAL DEFENSE AUTHORIZATION ACT FOR FISCAL YEAR 2013 (HR-4310), SECTION 737, STUDY ON INCIDENCE OF BREAST CANCER AMONG MEMBERS OF ARMED FORCES SERVING ON ACTIVE DUTY

Study

Abstract

The Department of Defense (DoD), Defense Health Agency submits this report in accordance with the National Defense Authorization Act for Fiscal Year 2013 (HR 4310), section 737, that calls on The Secretary of Defense to conduct a study on the incidence of breast cancer among members of the Armed Forces. The findings from this study indicate that breast cancer incidence among active service members is a rare event. The female breast cancer incidence rate among this population has not changed significantly across the study period, 2000 through 2010, and the age-adjusted incidence rate is significantly lower over that time period when compared with national incidence rates reported by the National Cancer Institute (NCI). Approximately 72% of all breast cancer patients are first diagnosed at stages 0, I or II, which suggests that the Department’s outreach efforts to promote awareness and use of screening services have been effective for detecting tumors early. Upon detection, the service member has access to robust treatment options that reflect evidenced-based clinical practices and cutting-edge technologies offered in nationally-accredited cancer programs within the Military Health System. Since TRICARE has a process to assimilate emerging cancers technologies, medications, and practice into the benefit, the need for changes to law or policy are not apparent for the DoD to sustain a high level of commitment to quality cancer care.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Defense Health Agency (formerly TRICARE Management Activity)
  • Congressionally Mandated: Yes
  • Funding Source: Defense Health Agency (formerly TRICARE Management Activity)
  • Release Date/Publication: June 01, 2014
  • Citation: Williams TV, AFHSC, JPC, NMCPHC, WRNMMC, Brandeis University, Axiom Resource Management, Inc.
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