Epidemiologic reviews
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Epidemiologic reviews · Jan 2015
Review Meta Analysis Comparative StudyAlcohol use and substance use disorders in Gulf War, Afghanistan, and Iraq War veterans compared with nondeployed military personnel.
Although recent veterans have been found to be at increased risk of psychiatric disorders, limited research has focused on alcohol or substance use disorders. This systematic review and meta-analysis examined whether alcohol or substance use disorders were more common in Gulf War, Afghanistan, and Iraq War veterans compared with military comparison groups nondeployed to the corresponding conflict, including never deployed personnel. Literature was searched (1990-2014) in multiple electronic databases. ⋯ Eighteen studies (1997-2014) met inclusion criteria. Pooled analysis based on a random-effects model yielded a summary odds ratio of 1.33 (95% confidence interval (CI): 1.22, 1.46) for alcohol (7 studies) and 2.13 (95% CI: 0.96, 4.72) for substance use (3 studies) disorders among Gulf War veterans, as well as 1.36 (95% CI: 1.11, 1.66) for alcohol (7 studies) and 1.14 (95% CI: 1.04, 1.25) for substance use (4 studies) disorders among Iraq/Afghanistan veterans; meta-regressions found no statistically significant association between theater of war and alcohol use or substance use disorders. Our findings indicate that Gulf and Iraq/Afghanistan war veterans are at higher alcohol use disorder risk than nondeployed veterans, but further studies with increased power are needed to assess substance use disorder risk in Gulf War veteran populations.
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Epidemiologic reviews · Jan 2015
Review Meta AnalysisAggressive and violent behavior among military personnel deployed to Iraq and Afghanistan: prevalence and link with deployment and combat exposure.
A systematic review and meta-analyses were conducted on studies of the prevalence of aggressive and violent behavior, as well as of violent offenses and convictions, among military personnel following deployment to Iraq and/or Afghanistan; the relationship with deployment and combat exposure; and the role that mental health problems, such as post-traumatic stress disorder (PTSD), have on the pathway between deployment and combat to violence. Seventeen studies published between January 1, 2001, and February 12, 2014, in the United States and the United Kingdom met the inclusion criteria. ⋯ The majority of studies suggested a small-to-moderate association between combat exposure and postdeployment physical aggression and violence, with a pooled estimate of the weighted odds ratio = 3.24 (95% CI: 2.75, 3.82), with several studies finding that violence increased with intensity and frequency of exposure to combat traumas. The review's findings support the mediating role of PTSD between combat and postdeployment violence and the importance of alcohol, especially if comorbid with PTSD.
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Epidemiologic reviews · Jan 2015
ReviewHearing impairment and tinnitus: prevalence, risk factors, and outcomes in US service members and veterans deployed to the Iraq and Afghanistan wars.
Hearing loss and tinnitus are the 2 most prevalent service-connected disabilities among veterans in the United States. Veterans of Operations Enduring Freedom, Iraqi Freedom, and New Dawn have been exposed to multiple hazards associated with these conditions, such as blasts/explosions, ototoxic chemicals, and most notably high levels of noise. We conducted a systematic literature review of evidence on 1) prevalence of, 2) risk and protective factors for, and 3) functional and quality-of-life outcomes of hearing impairment and tinnitus in US Operations Enduring Freedom, Iraqi Freedom, and New Dawn veterans and military personnel. ⋯ Of these, 13 studies presented data on prevalence and 4 on risk/protective factors, respectively. There were no included studies reporting on outcomes. Findings from this systematic review will help inform clinicians, researchers, and policy makers on future resource and research needs pertaining to hearing impairment and tinnitus in this newest generation of veterans.
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Epidemiologic reviews · Jan 2014
Review Meta AnalysisLow birth weight in the offspring of women with anorexia nervosa.
A growing body of literature has investigated the association between maternal anorexia nervosa and pregnancy outcomes. Infant low birth weight is associated with a number of neurodevelopmental and physical sequelae; however, consistent results on its association with maternal anorexia nervosa are scant. Therefore, a systematic review and meta-analysis of the existing literature were undertaken. ⋯ Results showed a standardized mean difference of -0.19 kg (95% confidence interval: -0.25, -0.15; P = 0.01) in the birth weight of children of mothers with anorexia nervosa, and some bias in favor of papers presenting lower birth weight results for exposed mothers was detected. However, the small power of the analysis due to the small number of available studies and, thus, chance could partially account for this result. Our results confirm that maternal anorexia nervosa predicts lower birth weight and, despite some limitations, they have important clinical implications for prevention of adverse child outcomes.
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Dysmenorrhea is a common menstrual complaint with a major impact on women's quality of life, work productivity, and health-care utilization. A comprehensive review was performed on longitudinal or case-control or cross-sectional studies with large community-based samples to accurately determine the prevalence and/or incidence and risk factors of dysmenorrhea. Fifteen primary studies, published between 2002 and 2011, met the inclusion criteria. ⋯ Inconclusive evidence was found for modifiable factors such as cigarette smoking, diet, obesity, depression, and abuse. Dysmenorrhea is a significant symptom for a large proportion of women of reproductive age; however, severe pain limiting daily activities is less common. This review confirms that dysmenorrhea improves with increased age, parity, and use of oral contraceptives and is positively associated with stress and family history of dysmenorrhea.