Military medicine
-
Because of the rigorous mental and physical health requirements for Naval Aviation, all applicants and designated personnel must meet physical standards, including initial and periodic screening for anemia. Most standards, including for accession to the U.S. Navy, use hemoglobin as the standard marker to screen for anemia. Moreover, previous literature generally supports the assertion that hemoglobin is more reliable and accurate than hematocrit. However, the U.S. Navy Aeromedical Reference and Waiver Guide uses a hematocrit standard for anemia screening. The purpose of this study was to determine whether hemoglobin or hematocrit correlates better with clinical anemia and evaluate which index is a more accurate indicator for anemia screening in Naval Aviation personnel. ⋯ This study found that hemoglobin correlates better with the diagnosis of anemia than hematocrit. When three samples are analyzed, hemoglobin is equally sensitive and more specific than hematocrit. Based on these results and the U.S. Navy accession standards using hemoglobin as the standard index for anemia, the U.S. Navy Aeromedical Reference and Waiver Guide should consider using hemoglobin instead of hematocrit to screen for anemia. Future research should focus on prospective research to determine whether hemoglobin or hematocrit is a better indicator of anemia in screening military personnel.
-
Military deployments cause stress for both service members and their families. Returning Veterans often report significant trauma exposure, and experience increased stress and mental health problems following deployment. These factors can in turn increase family problems and parenting strain among Veterans who are parents, exacerbating mental health symptoms. Men are generally less likely to seek treatment for mental health problems, and male Veterans, in particular, report lower rates of mental health treatment use. Interventions that target fathering or parenting skills may be more acceptable and less stigmatizing to male Veterans while serving the dual function of improving parental relationships and reducing mental health symptoms. However, it is unclear whether Veteran fathers will engage in these services. ⋯ Returning Veteran fathers demonstrate interest in and willingness to participate in fathering programs suggesting that parenting programs may be a way to engage Veterans in mental health care following deployment.
-
Family members are important supports for veterans with Posttrauamtic Stress Disroder (PTSD), but they often struggle with their own distress and challenges. The Veterans Affairs-Community Reinforcement and Family Training (VA-CRAFT) website was designed to teach family members of veterans with PTSD effective ways to interact with their veterans to encourage initiation of mental health services as well as to care for themselves and improve their relationships. This article presents a pilot investigation of VA-CRAFT. ⋯ Results from this pilot trial suggest that VA-CRAFT holds initial promise in reducing caregiver burden and as such it could be a useful resource for family members of veterans with PTSD. However, VA-CRAFT does not enhance veteran treatment initiation. It may benefit from enhancements to increase effectiveness and caregiver engagement.
-
Military mental health personnel (MMHP) have increasingly engaged in deployment-related roles in closer proximity to combat environments. Although studies examining deployment-related outcomes among military health care personnel have found combat exposure (CE) positively related to psychological problems, no studies of MMHP have investigated CE or its association with psychological outcomes. This study seeks to provide descriptive data on CE and perceived impacts associated with deployment, as well as explore how CE, perceptions of preparedness for deployment, difficulties during deployment (DDD), and meaningful work during deployment relate to appraisal of problems after deployment (ie, sleep problems, interpersonal withdrawal, depressive symptoms, and work problems). ⋯ This is the first study of MMHP reporting CE rates and examining relationships between perceived outcomes and CE, deployment preparation, difficulties during deployment, and meaningful work. The vast majority of MMHP were exposed to more than one combat-related event; however, this rate of CE appears lower than what has been reported among a similar sample of military health care personnel. Although CE predicted difficulties, appraisals of difficulties during deployment experience predicted the highest rates of postdeployment difficulties, accounting for nearly a quarter or more of the outcome variance. The lack of relationship between deployment preparation and meaningful work is inconsistent with prior research and may be because of the limited response range in our sample. Additionally, other methodological limitations include: (1) cross-sectional study design, (2) lack of validated measures, and (3) the long-term retrospective nature of the assessment. Future research should incorporate more rigorous methodologies and assess constructs absent in this archival data set. Despite these limitations, this study provides important preliminary data to support future research development and funding. Additionally, the results may be used to normalize associated impacts and promote help seeking among MMHP.
-
Acute exposure to high-levels of ambient fine particulate matter while exercising results in airway narrowing, but the long-term effects of repeated exposure on exercise-induced bronchoconstriction (EIB) are not well known. The goal of this preliminary study is to determine the rate of EIB among a sample of non-treatment seeking veterans deployed to Iraq and Afghanistan. ⋯ Approximately 17% of our sample of non-treatment seeking deployed Iraq and Afghanistan veterans demonstrated EIB, similar to the general population prevalence. However, persistent respiratory symptoms and alternative indices of probable EIB supports continued monitoring of this population.