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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.

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Occupational driving as a risk factor for low back pain in active-duty military service members.

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
  • 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.

Dwell time and psychological screening outcomes among military service members with multiple combat deployments.

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
  • 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.

Diagnostic and psychosocial differences in psychiatrically hospitalized military service members with single versus multiple suicide attempts.

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
  • 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.

Energy drink and energy shot use in the military.

Study

Abstract

Use of energy drinks and energy shots among military personnel is controversial. High amounts of caffeine (the primary active ingredient in these products) may impact performance of military duties. The impact of caffeine overconsumption and potential subsequent side effects that might be experienced by service members with unique roles and responsibilities is a concern. Reported here are the prevalence of use, reasons for use, and side effects associated with consumption of energy drinks and energy shots among several populations of active duty personnel in the US military. A snowball survey was sent to over 10,000 active duty personnel. A total of 586 (∼6% response rate) individuals completed a 30-item electronic survey. Over half of respondents (53%) reported consuming an energy drink at least once in the past 30 days. One in five (19%) reported energy shot consumption in the prior 30 days. One in five (19%) also reported consuming an energy drink in combination with an alcoholic beverage. Age and gender were significantly associated with energy drink consumption. Young male respondents (18-29 years) reported the highest use of both energy drinks and energy shots. Among those reporting energy drink and energy shot use, the most common reasons for consumption were to improve mental alertness (61%) and to improve mental (29%) and physical (20%) endurance. Nearly two-thirds (65%) of users self-reported at least one side effect. The most commonly reported side effects included increased pulse rate/palpitations, restlessness, and difficulty sleeping. Use of energy products among military personnel is common and has the potential to impact warrior health and military readiness.

  • 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: October 01, 2014
  • Citation: Stephens MB, Attipoe S, Jones D, Ledford CJ, Deuster PA. Energy drink and energy shot use in the military. Nutr Rev. 2014 Oct;72 Suppl 1:72-7.

Influence of the severity and location of bodily injuries on post-concussive and combat stress symptom reporting after military-related concurrent mild traumatic brain injuries and polytrauma.

Study

Abstract

Traumatic brain injuries (TBI) sustained in combat frequently co-occur with significant bodily injuries. Intuitively, more extensive bodily injuries might be associated with increased symptom reporting. In 2012, however, French et al. demonstrated an inverse relation between bodily injury severity and symptom reporting. This study expands on that work by examining the influence of location and severity of bodily injuries on symptom reporting after mild TBI. Participants were 579 US military service members who sustained an uncomplicated mild TBI with concurrent bodily injuries and who were evaluated at two military medical centers. Bodily injury severity was quantified using a modified Injury Severity Score (ISSmod). Participants completed the Neurobehavioral Symptom Inventory (NSI) and the Posttraumatic Stress Disorder Checklist (PCL-C), on average, 2.5 months post-injury. There was a significant negative association between ISSmod scores and NSI (r=-0.267, p<0.001) and PCL-C (r=-0.273, p<0.001) total scores. Using linear regression to examine the relation between symptom reporting and injury severity across the six ISS body regions, three body regions were significant predictors of the NSI total score (face; p<0.001; abdomen; p=0.003; extremities; p<0.001) and accounted for 9.3% of the variance (p<0.001). For the PCL-C, two body regions were significant predictors of the PCL-C total score (face; p<0.001; extremities; p<0.001) and accounted for 10.5% of the variance. There was an inverse relation between bodily injury severity and symptom reporting in this sample. Hypothesized explanations include underreporting of symptoms, increased peer support, disruption of fear conditioning because of acute morphine use, or delayed expression of symptoms.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Defense and Veterans Brain Injury Center
  • Congressionally Mandated: No
  • Funding Source: Defense Health Agency (formerly TRICARE Management Activity)
  • Release Date/Publication: October 01, 2014
  • Citation: French LM, et.al . Influence of the severity and location of bodily injuries on post-concussive and combat stress symptom reporting after military-related concurrent mild traumatic brain injuries and polytrauma. J Neurotrauma. 2014 Oct 1;31(19):1607-16.

The Millennium Cohort Family Study: a prospective evaluation of the health and well-being of military service members and their families.

Study

Abstract

The need to understand the impact of war on military families has never been greater than during the past decade, with more than three million military spouses and children affected by deployments to Operations Iraqi Freedom and Enduring Freedom. Understanding the impact of the recent conflicts on families is a national priority, however, most studies have examined spouses and children individually, rather than concurrently as families. The Department of Defense (DoD) has recently initiated the largest study of military families in US military history (the Millennium Cohort Family Study), which includes dyads of military service members and their spouses (n > 10,000). This study includes US military families across the globe with planned follow-up for 21+ years to evaluate the impact of military experiences on families, including both during and after military service time. This review provides a comprehensive description of this landmark study including details on the research objectives, methodology, survey instrument, ancillary data sets, and analytic plans. The Millennium Cohort Family Study offers a unique opportunity to define the challenges that military families experience, and to advance the understanding of protective and vulnerability factors for designing training and treatment programs that will benefit military families today and into the future.

  • Publication Status: Published
  • Sponsoring Organization: Navy
  • Sponsoring Office:
  • Congressionally Mandated: No
  • Funding Source: Undetermined
  • Release Date/Publication: October 01, 2014
  • Citation: Crum-Cianflone NF, Fairbank JA, Marmar CR, Schlenger W. The Millennium Cohort Family Study: a prospective evaluation of the health and well-being of military service members and their families. Int J Methods Psychiatr Res. 2014 Sep;23(3):320-30.

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

Study

Abstract

BACKGROUND: 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. OBJECTIVE: Describe the design and sample for a randomized effectiveness trial of collaborative care for PTSD and depression in military members attending primary care. METHODS: 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. Findings Military members attending primary care were referred to care management with suspected PTSD, depression or both were recruited for the trial (2,592) and 1,041 gave permission to contact for research participation. Of those, 666 (64%) met eligibility criteria, completed baseline assessments, and were randomized to 12months 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. CONCLUSIONS: 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.

  • 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: October 01, 2014
  • Citation: Engel CC, et.al. Implementing collaborative primary care for depression and posttraumatic stress disorder: Design and sample for a randomized trial in the U.S. military health system. Contemp Clin Trials. 2014 Oct 10

Use and Abuse of Prescribed Opioids, Central Nervous System Depressants, and Stimulants Among U.S. Active Duty Military Personnel in FY 2010

Study

Abstract

OBJECTIVES: This study establishes rates of use/abuse of Schedule II-IV prescription medications in U.S. active duty military personnel, and characterizes correlates of such use/abuse. METHODS: All active duty personnel serving for 12 months during fiscal year 2010 were included. Data were obtained from medical and pharmacy claims and drug screening results. Logistic regression models were used to examine predictors of drug use, along with bivariate analyses to compare abuse of prescribed and illegal drugs. RESULTS: Nearly one-third of active duty service members received at least one prescription for opioids, central nervous system depressants, or stimulants, with 26.4% having received at least one prescription for opioids. About 0.7%, 1.4%, and 0.6% of the total force received >90-day prescriptions for opioids, central nervous system depressants, or stimulants, respectively. Battlefield injury, receipt of psychotropic medications, and substance abuse adverse events were predictive of >90-day supply of opioids. About 0.7% of the total force had documented known drug abuse for prescribed drugs compared to 0.4% for illegal drug abuse. CONCLUSIONS: We recommend systematic monitoring of prescriptions for controlled substances which may carry serious consequences, evaluation of the impact of controlled substances on military readiness, and examination of the rationale for prescribing controlled drugs.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Defense Health Agency (formerly TRICARE Management Activity)
  • Congressionally Mandated: No
  • Funding Source: Undetermined
  • Release Date/Publication: October 01, 2014
  • Citation: Jeffery DD, May L, Luckey B, Balison BM, Klette KL. Use and Abuse of Prescribed Opioids, Central Nervous System Depressants, and Stimulants Among U.S. Active Duty Military Personnel in FY 2010. Mil Med. 2014 Oct;179(10):1141-8

Female military medical school graduates entering surgical internships: are we keeping up with national trends?

Study

Abstract

BACKGROUND: Ratios of women graduating from the only US military medical school and entering surgical internships were reviewed and compared with national trends. METHODS: Data were obtained from the Uniformed Services University of the Health Sciences graduation announcements from 2002 to 2012. RESULTS: There were 1,771 graduates from 2002 to 2012, with 508 female (29%) and 1,263 male (71%) graduates. Female graduates increased over time (21% to 39%; P = .014). Female general surgery interns increased from 3.9% to 39% (P = .025). Female overall surgical subspecialty interns increased from 20% in 2002 to 36% in 2012 (P = .046). Women were represented well in obstetrics (57%), urology (44%), and otolaryngology (31%), but not in neurosurgery, orthopedics, and ophthalmology (0% to 20%). CONCLUSIONS: The sex disparity between military and civilian medical students occurs before entry. Once in medical school, women are just as likely to enter general surgery or surgical subspecialty as their male counterparts. Increased ratio of women in the class is unlikely to lead to a shortfall except in specific subspecialties.

  • 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: October 01, 2014
  • Citation: Vertrees A, Laferriere N, Elster E, Shriver CD, Rich NM. Female military medical school graduates entering surgical internships: are we keeping up with national trends? Am J Surg. 2014 Oct;208(4):550-5.

A Multisite Study of the Relationships between Blast Exposures and Symptom Reporting in a Post-Deployment Active Duty Military Population with Mild Traumatic Brain Injury

Study

Abstract

Explosive devices have been the most frequent cause of traumatic brain injury (TBI) among deployed contemporary U.S. service members. The purpose of this study was to examine the influence of previous cumulative blast exposures (that did or did not result in TBI) on later post-concussion and post-traumatic symptom reporting after sustaining a mild TBI (MTBI). Participants were 573 service members who sustained MTBI divided into four groups by number of blast exposures (1, 2, 3, and 4-10) and a nonblast control group. Post-concussion symptoms were measured using the Neurobehavioral Symptom Inventory (NSI) and post-traumatic stress disorder (PTSD) symptoms using the Post-traumatic Checklist-Civilian version (PCL-C). Results show groups significantly differed on total NSI scores (p<0.001), where symptom endorsement increased as number of reported blast exposures increased. Total NSI scores were significantly higher for the 3- and 4-10 blast groups compared with the 1- and 2-blast groups with effect sizes ranging from small to moderate (d=0.31 to 0.63). After controlling for PTSD symptoms using the PCL-C total score, NSI total score differences remained between the 4-10-blast group and the 1- and 2-blast groups, but were less pronounced (d=0.35 and d=0.24, respectively). Analyses of NSI subscale scores using PCL-C scores as a covariate revealed significant between-blast group differences on cognitive, sensory, and somatic, but not affective symptoms. Regression analyses revealed that cumulative blast exposures accounted for a small but significant amount of the variance in total NSI scores (4.8%; p=0.009) and total PCL-C scores (2.3%; p<0.001). Among service members exposed to blast, post-concussion symptom reporting increased as a function of cumulative blast exposures. Future research will need to determine the relationship between cumulative blast exposures, symptom reporting, and neuropathological changes

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Defense and Veterans Brain Injury Center
  • Congressionally Mandated: No
  • Funding Source: Defense Health Agency (formerly TRICARE Management Activity)
  • Release Date/Publication: October 01, 2014
  • Citation: Reid MW, et.al., A Multisite Study of the Relationships between Blast Exposures and Symptom Reporting in a Post-Deployment Active Duty Military Population with Mild Traumatic Brain Injury. J Neurotrauma. 2014 Dec 1;31(23):1899-906.

Opiate-related dependence/abuse and PTSD exposure among the active-component U.S. military, 2001 to 2008.

Study

Abstract

BACKGROUND: Over the past 5 years, diagnoses for opiate abuse or dependency and post-traumatic stress disorder (PTSD) have increased across all U.S. military services. Moreover, in the United States, opiate prescription dependence and abuse has now surpassed all other illicit drugs of abuse with the exception of marijuana. Some research indicates that PTSD is predictive of substance dependence and abuse, while other research suggests that substance dependence and abuse may lead to events that trigger PTSD. This dichotomy has not been extensively explored within a military population. METHODS: Using conditional multiple logistic regression analysis, a matched case-control study with 18,606 active-component U.S. military service members was conducted to examine the relationship between opiate dependence or abuse and PTSD. RESULTS: Among the 18,606 service members included in the analysis, 21% were cases and 79% were controls. Thirteen percent of service members with substance dependence or abuse diagnosis had a prior PTSD diagnosis compared to 1% of controls. After, adjusting for sociodemographic and military characteristics, the odds of having a prior diagnosis of PTSD was 28 (95% CI: 21.24-37.78) times greater for service members with opiate abuse/dependency compared to controls. CONCLUSION: These findings suggest active duty military personnel diagnosed with PTSD should be closely monitored to reduce the likelihood of future morbidity because of opiate dependence or abuse.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Armed Forces Health Surveillance Center
  • Congressionally Mandated: No
  • Funding Source: Army
  • Release Date/Publication: August 01, 2014
  • Citation: Dabbs C, Watkins EY, Fink DS, Eick-Cost A, Millikan AM. Opiate-related dependence/abuse and PTSD exposure among the active-component U.S. military, 2001 to 2008. Mil Med. 2014 Aug;179(8):885-90.

Stress and Resilience in Military Mortuary Workers: Care of the Dead From Battlefield to Home.

Study

Abstract

The death of a military service member in war provokes feelings of distress and pride in mortuary workers who process the remains. To further understand their reactions, the authors interviewed 34 military and civilian personnel to learn more about their work stresses and rewards. They review stresses of anticipation, exposure, and experience in handling the dead and explore the personal, supervisory, and leadership strategies to reduce negative effects and promote personal growth. These results can be applied to many other situations requiring planning, implementing, and supervising mortuary operations involving mass death.

  • 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: August 01, 2014
  • Citation: Flynn BW, McCarroll JE, Biggs QM. Stress and Resilience in Military Mortuary Workers: Care of the Dead From Battlefield to Home. Death Stud. 2014 Aug 20:1-7.

Health-related quality of life within the first 5 years following military-related concurrent mild traumatic brain injury and polytrauma.

Study

Abstract

This study examined health-related quality of life within the first 5 years following concurrent mild traumatic brain injury (MTBI) and polytrauma. Participants were 167 U.S. service members who had sustained a MTBI who had completed a brief neurobehavioral evaluation within 3 months postinjury and at least one telephone follow-up interview at 6 (n = 46), 12 (n = 89), 24 (n = 54), 36 (n = 42), 48 (n = 30) or 60 months (n = 25) postinjury. Within the first 5 years postinjury, service members reported ongoing headaches (67.4% to 92.0%), bodily pain (66.7% to 88.9%), medication use (71.7% to 92.0%), mental health treatment (28.3% to 60.0%), and the need for help with daily activities (18.5% to 40.0%). Problematic alcohol consumption was common within the first 24 months postinjury (23.9% to 29.2%). Many service members were working for pay (36.0% to 70.8%) though many reported a decline in work quality (16.0% to 30.4%). Despite ongoing symptom reporting, many service members reported that their medications were effective (43.3% to 80.0%), good/excellent health status (68.0% to 80.0%), and life satisfaction (79.6% to 90.5%). A minority reported suicidal or homicidal ideation (5.6% to 14.8%). Recovery from MTBI in a military setting is complex and multifaceted. Continued support and care for all service members who sustain a combat-related MTBI with polytrauma is recommended, regardless of the presence or absence of symptom reporting within the first few months postinjury.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Defense and Veterans Brain Injury Center
  • Congressionally Mandated: No
  • Funding Source: Defense Health Agency (formerly TRICARE Management Activity)
  • Release Date/Publication: August 01, 2014
  • Citation: Brickell TA, Lange RT, French LM. Health-related quality of life within the first 5 years following military-related concurrent mild traumatic brain injury and polytrauma. Mil Med. 2014 Aug;179(8):827-38.

Three-year outcome following moderate-to-severe TBI in U.S. military service members: a descriptive cross-sectional study.

Study

Abstract

This study examined the prospective course of neurobehavioral symptom reporting and health-related quality of life within the first 3 years following moderate-to-severe traumatic brain injury (TBI). Participants were 52 U.S. service members who were evaluated following a moderate-to-severe TBI sustained in the combat theater during Operations Iraqi and Enduring Freedom (90.4%), or from other noncombat-related incidents. Participants completed the Neurobehavioral Symptom Inventory and Post-Traumatic Stress Disorder-Checklist within 3 months postinjury, and at least one follow-up telephone interview at 12 (n = 27), 24 (n = 31), or 36 months (n = 22) postinjury. Approximately half of the sample (41.9%-63.0%) reported "persistent" symptoms from baseline to follow-up. A substantial minority also "improved" (22.2%-31.8%) or "developed" new symptoms (3.7%-16.1%). Ongoing physical and mental health problems were also reported. The number of service members receiving mental health treatment significantly reduced between 12 and 36 months postinjury (48.1%-18.2%), while complaints of bodily pain significantly increased (40.7%-68.2%). Despite ongoing symptom reporting, few reported suicidal/homicidal ideation (6.5%-9.1%), and a substantial majority reported good/excellent health status (74.1%-90.9%) and satisfaction with their life (81.5%-90.9%). Continued support and care for all service members who sustain a combat-related moderate-to-severe TBI is recommended, regardless of the presence or absence of symptom reporting within the first few months postinjury.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Defense and Veterans Brain Injury Center
  • Congressionally Mandated: No
  • Funding Source: Defense Health Agency (formerly TRICARE Management Activity)
  • Release Date/Publication: August 01, 2014
  • Citation: Brickell TA, Lange RT, French LM. Three-year outcome following moderate-to-severe TBI in U.S. military service members: a descriptive cross-sectional study. Mil Med. 2014 Aug;179(8):839-48.

Update: Routine screening for antibodies to human immunodeficiency virus, civilian applicants for U.S. military service and U.S. Armed Forces, active and reserve components, January 2009-June 2014.

Study

Abstract

This report contains an update through June 2014 of the results of routine screening for antibodies to the human immunodeficiency virus (HIV) among civilian applicants for military service and among members of the active and reserve components of the U.S. Armed Forces. Seroprevalences among civilian applicants in 2013 and the first half of 2014 (0.19 and 0.15 per 1,000 tested, respectively) were markedly lower than in 2012 (0.27 per 1,000 tested). In nearly every component of every service, seroprevalences in 2013 and 2014 were either similar or lower than in prior years; however, in the Army National Guard, seroprevalences increased each year and approximately doubled from 2010 (0.18 per 1,000 tested) to 2013-2014 (0.35-0.41 per 1,000 tested). Among active and reserve component service members, seroprevalences continue to be higher among Army and Navy members and males than their respective counterparts.

  • 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: August 01, 2014
  • Citation: AFHSC. Update: Routine screening for antibodies to human immunodeficiency virus, civilian applicants for U.S. military service and U.S. Armed Forces, active and reserve components, January 2009-June 2014. MSMR. 2014 Aug;21(8):16-22.
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