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Sports Health 2019Vitamin D supplementation is important in military research because of its role in musculoskeletal health.
CONTEXT
Vitamin D supplementation is important in military research because of its role in musculoskeletal health.
OBJECTIVE
This systematic review examined the effects of vitamin D supplementation on serum 25-hydroxyvitamin D (25(OH)D) concentrations and musculoskeletal health outcomes in military personnel.
DATA SOURCES
A comprehensive search was conducted using MEDLINE, EMBASE, CINAHL, SportDiscus, and the Cochrane Library databases and the reference lists of existing review articles and relevant studies.
STUDY SELECTION
Reviewers independently screened titles, abstracts, and full texts of the articles using predefined criteria.
STUDY DESIGN
Systematic review of randomized controlled trials (RCTs) using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement.
LEVEL OF EVIDENCE
Level 3.
DATA EXTRACTION
Three reviewers independently extracted data and assessed the methodological quality. Mean differences with 95% CI in serum 25(OH)D concentrations between the vitamin D and placebo arms were calculated.
RESULTS
Four RCTs were included in the qualitative analyses. The 25(OH)D concentrations were improved with 2000 IU/d supplementation (mean difference, 3.90 ng/mL; 95% CI, 0.22-7.58). A trial on female Navy recruits showed a significant decrease in stress fractures (risk ratio, 0.77; 95% CI, 0.62-0.95), particularly tibial fractures, from daily supplementation of 800 IU vitamin D and 2000 mg calcium.
CONCLUSION
There was a positive trend in 25(OH)D concentrations from higher doses of supplementary vitamin D in military submariners and a possible benefit to bone health when vitamin D was combined with calcium.
Topics: Calcium, Dietary; Dietary Supplements; Fractures, Stress; Humans; Military Personnel; Musculoskeletal System; Randomized Controlled Trials as Topic; Vitamin D
PubMed: 31268835
DOI: 10.1177/1941738119857717 -
Military Medicine Jul 2023Feeding and eating disorders can be difficult to treat and frequently co-occur with other mental health conditions. The last systematic review of eating disorders in a...
INTRODUCTION
Feeding and eating disorders can be difficult to treat and frequently co-occur with other mental health conditions. The last systematic review of eating disorders in a military and veteran population was published in 2015. An updated review is warranted to re-examine the current literature on eating disorders in the active duty and veteran populations.
MATERIALS AND METHODS
A systematic review that described the prevalence, co-occurrence of other disorders and/or events, and health care utilization of U.S. active duty members and veterans was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Databases and Medical Subject Headings (MeSH) terms used are listed in Appendix A. Each category of the literature was extracted and graded using the Oxford Centre for Evidence-Based Medicine Levels of Evidence.
RESULTS
Twenty-one studies revealed prevalence estimates with varying rates based on demographic information. Trauma exposure is consistently associated with eating disorder development. Individuals diagnosed with eating disorders had greater health care utilization.
CONCLUSIONS
Research on eating disorders in the military and veteran populations has expanded in recent years. Limitations of the evidence included in this review stem from the use of self-reported questionnaires, changes to medical record systems, and limited generalizability to the overall population of patients with eating disorders. Further research should investigate the impact of demographic factors and trauma exposure on the development of an eating disorder within the military and veteran populations.
Topics: Humans; Feeding and Eating Disorders; Veterans; Military Personnel; United States; Prevalence
PubMed: 35788384
DOI: 10.1093/milmed/usac180 -
Military Medicine Aug 2022Physical training is important to prepare soldiers for the intense occupational demands in the military. However, current physical training may not address all fitness... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Physical training is important to prepare soldiers for the intense occupational demands in the military. However, current physical training may not address all fitness domains crucial for optimizing physical readiness and reducing musculoskeletal injury. The effects of nontraditional military physical training on fitness domains have been inconsistently reported, which limits the design of the ideal training program for performance optimization and injury prevention in the military. The aim of this systematic review was to identify the effects of exercise training on various fitness domains (i.e., aerobic fitness, flexibility, muscular endurance, muscular power, muscular strength, and occupationally specific physical performance) that contribute to occupational performance and musculoskeletal injury risk in military personnel.
METHODS
An extensive literature search was conducted in January 2021 and was subsequently updated in July 2021 and December 2021. Included studies consisted of comparative groups of healthy military personnel performing traditional and nontraditional military physical training with at least one assessment representative of a fitness domain. Study appraisal was conducted using the PEDro scale. Meta-analysis was conducted via forest plots, standard mean difference (SMD, effect size), and intertrial heterogeneity (I2).
RESULTS
From a total of 7,350 records, 15 studies were identified as eligible for inclusion in this review, with a total of 1,613 participants. The average study quality via the PEDro score was good (5.3/10; range 4/10 to 6/10). Nontraditional military physical training resulted in greater posttraining values for muscular endurance (SMD = 0.46; P = .004; I2 = 68%), power (SMD = 1.57; P < .0001; I2 = 90%), strength via repetition maximum testing (SMD = 1.95; P < .00001; I2 = 91%), and occupationally specific physical performance (SMD = 0.54; P = .007; I2 = 66%) compared to the traditional group. There was no significant difference for aerobic fitness (SMD = -0.31; P = .23; I2 = 86%), flexibility (SMD = 0.58; P = .16; I2 = 76%), and muscular strength via maximal voluntary contraction (SMD = 0.18; P = .28; I2 = 66%) between training groups.
CONCLUSIONS
The current systematic review identified that nontraditional military physical training had a greater posttraining effect on muscular endurance, power, strength measured via repetition maximum, and occupationally specific physical performance compared to traditional military physical training. Overall, these findings suggest that nontraditional military physical training may be beneficial in optimizing occupational performance while potentially reducing musculoskeletal injury risk.
Topics: Exercise; Health Status; Humans; Military Personnel; Muscle Strength; Physical Endurance; Physical Fitness; Resistance Training
PubMed: 35247052
DOI: 10.1093/milmed/usac040 -
International Journal of Environmental... Jan 2022Firefighters and military personnel are public safety personnel who protect the safety of individuals and their properties. They are usually exposed to traumatic events... (Review)
Review
A Scoping Review on the Prevalence and Determinants of Post-Traumatic Stress Disorder among Military Personnel and Firefighters: Implications for Public Policy and Practice.
INTRODUCTION
Firefighters and military personnel are public safety personnel who protect the safety of individuals and their properties. They are usually exposed to traumatic events leaving them at risk of developing mental health conditions such as post-traumatic stress disorder (PTSD). Increasing concern is being raised regarding the mental health impacts, specifically PTSD, among military personnel and firefighters.
OBJECTIVE
There is an increased exposure of firefighters and military personnel to traumatic events and the attendant risk of developing post-traumatic stress disorder. It is crucial to ascertain the level of PTSD amongst this cohort and determinants to formulate policies and practices that mitigate the risk and protect public safety personnel. This scoping review sought to determine the prevalence of PTSD among this cohort globally and to explore determinants of this mental health condition.
METHODS
A literature search in databases including MEDLINE, CINAHL, PubMed, PsycINFO, and EMBASE was conducted electronically from May 2021 to 31 July 2021. Two reviewers independently assessed full-text articles according to the predefined inclusion criteria and screening process undertaken to identify studies for the review. Articles were screened with a third reviewer, resolving conflicts where necessary and further assessing them for eligibility. During article selection, the PRISMA checklist was adopted, and with the Covidence software, a total of 32 articles were selected for the final examination. For the eligible studies, data extraction was conducted, information was collated and summarized, and the findings were reported. Original qualitative and quantitative data on the prevalence and predictors of PTSD among veterans, military, and firefighters were reported.
RESULTS
The prevalence of PTSD was 57% for firefighters and 37.8% for military personnel. Demographic factors, job factors, social support, injuries, physical and psychological factors, and individual traits were the main predictors of PTSD in this cohort.
CONCLUSION
This information is vital for developing and implementing prevention and intervention strategies for PTSD in military personnel and firefighters. Recognizing and addressing factors that predict PTSD will help to improve mental wellbeing and increase productivity. More peer-reviewed studies are needed on the prevalence of PTSD amongst these cohorts.
Topics: Firefighters; Humans; Military Personnel; Prevalence; Public Policy; Stress Disorders, Post-Traumatic
PubMed: 35162587
DOI: 10.3390/ijerph19031565 -
Current Developments in Nutrition Jan 2023The prevalence of overweight and obesity among tactical populations is estimated at 70%-75%, which may negatively impact health and performance. The relationship between... (Review)
Review
The prevalence of overweight and obesity among tactical populations is estimated at 70%-75%, which may negatively impact health and performance. The relationship between BMI and health and performance is well established among the general population, however, literature on such relationships among tactical populations has yet to be reviewed and evaluated. The purpose of this study was to systematically review available literature on the relationship between BMI and health and occupational performance among law enforcement officer, firefighters, and military personnel. After reviewing the literature, 27 articles were included. Nine studies found BMI was positively associated with cardiovascular disease (CVD) risk factors. Studies involving BMI and cancer were lacking. One study found BMI was positively associated with type 2 diabetes (T2DM) risk. Five studies on occupational/physical performance and 12 studies on injury found a higher BMI was often indicative of decreased performance and increased risk of injury in general, but protective against stress fractures. Overall, higher BMI was often associated with negative health and performance outcomes among tactical populations, especially when beyond the overweight classification. Public health practitioners should focus efforts on improving nutrition and physical activity to promote a healthy BMI among these individuals.
PubMed: 37181120
DOI: 10.1016/j.cdnut.2022.100020 -
Nutrients Oct 2021Tactical personnel (including military, law enforcement, and fire and rescue) are responsible for ensuring national and public safety. Dietary intake is an important...
Tactical personnel (including military, law enforcement, and fire and rescue) are responsible for ensuring national and public safety. Dietary intake is an important consideration to support optimal health and performance. The aims of this systematic review were to: (1) describe the reported free-living dietary intake (energy and macronutrients) of tactical personnel, and (2) describe the practical implications of reported dietary intakes to support the physical and dietary requirements of tactical personnel. A systematic search of databases (MEDLINE, EMBASE, CINAHL and Web of Science) was conducted following the PRISMA guidelines. English and full text research articles were identified and screened against inclusion and exclusion criteria. Demographic and dietary intake data were extracted, tabulated, and synthesized narratively. The quality of the studies was assessed using the Academy of Nutrition and Dietetics Quality Criteria Checklist. Twenty-two studies (15 military, 4 law enforcement, and 2 fire and rescue) were eligible to inform this review. The volume of evidence suggested that tactical personnel met dietary protein and exceeded dietary fat recommendations but failed to meet energy and carbohydrate recommendations. Therefore, practical approaches to support optimized energy, fat and carbohydrate intake in tactical personnel is important.
Topics: Adult; Diet; Dietetics; Eating; Emergency Responders; Female; Guideline Adherence; Humans; Male; Middle Aged; Military Personnel; Occupational Health; Recommended Dietary Allowances; Work Performance
PubMed: 34684503
DOI: 10.3390/nu13103502 -
BMJ Military Health Jun 2021Harmful or risky-single occasion drinking (RSOD) alcohol use in the military is a significant problem. However, most studies of interventions have focused on veterans,...
INTRODUCTION
Harmful or risky-single occasion drinking (RSOD) alcohol use in the military is a significant problem. However, most studies of interventions have focused on veterans, representing a missed opportunity for intervention with active military personnel. Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework, the aim of this systematic review was to analyse and synthesise the evidence related to workplace-based interventions for reducing alcohol use in active-duty military personnel.
METHODS
Four electronic databases and reference lists of relevant articles were searched from database inception until 20 January 2020. This review focused on experimental and quasi-experimental studies of active-duty military personnel. Data extraction and methodological quality assessment were independently performed by two reviewers using a standardised checklist. A third reviewer was used to arbitrate the disputed studies for final selection.
RESULTS
The search yielded seven studies from an initial 1582 records identified. A range of interventions were used in these studies (four randomised controlled trials, two non-randomised trials and one before and after cohort study), including web-based approaches, telephone-delivered interventions and individual and group-based face-to-face interventions. Seven studies found decreased drinking, measured using a range of outcomes, following the intervention. However, this was not sustained in the longer term in any of the studies.
CONCLUSIONS
The low methodological rigour of most studies limited the capacity to demonstrate the efficacy of the interventions studied. Given the importance of reducing harmful or RSOD use of alcohol in the military, future studies would benefit from improved methodological rigour including ensuring adequate study power, randomisation, selection of validated outcome measures, including measures other than consumption (eg, attitudinal measures), and longer-term follow-up. There is also a need to develop methods that ensure participant loss to follow-up is minimised.
Topics: Alcoholism; Humans; Military Personnel; Workplace
PubMed: 33361438
DOI: 10.1136/bmjmilitary-2020-001584 -
European Journal of Psychotraumatology 2022Many countries pay special attention to the transition of their military personnel from deployment to home via post-deployment adaptation programmes (PDAPs). This... (Review)
Review
UNLABELLED
Many countries pay special attention to the transition of their military personnel from deployment to home via post-deployment adaptation programmes (PDAPs). This systematic review aims to provide a structured analysis of structure, process, and outcomes based on available empirical evidence for PDAPs. A systematic literature search was performed to identify original peer-reviewed studies on PDAP in six databases (MEDLINE, Embase, PsycINFO, Cochrane Central Register of Controlled Trials, PTSDPubs, and OpenGrey). The overall risk of bias of the articles was assessed using GRADE guidelines. The literature was analysed in its description of PDAP structure, process, and outcomes. In addition, when effects were reported, these were extracted. The search resulted in 1535 unique records that were screened for eligibility; 16 articles were included, of which only three showed low risk of bias according to GRADE. Few studies clearly described and investigated PDAP structure elements (i.e. combat exposure), process elements (i.e. who delivered the intervention), and other outcome elements (i.e. adjustment issues). Most articles included some form of third location decompression ( = 10; psychoeducation and time to rest and relax on a location that is not in the mission theatre or at home) and Battlemind ( = 4; interactive training focusing on how to adapt skills and cognitions after deployment at home). The results suggest positive mental health effects and satisfaction of these two types of PDAP, although the evidence is poor. Empirical, high-quality evidence for PDAP is scarce. In addition, the existing literature reveals a lack of systematic method in describing the goals of PDAP and the ways of achieving these. This leads to incomparability between studies and hinders the building of a knowledge base on PDAPs. A structure is proposed for describing the structure, process, and outcomes of PDAPs with measured effects.
HIGHLIGHTS
High -quality evidence for post-deployment adaptation programmes is scarce.Programme structure, process, and aims with measured effects are not delineated.Positive mental health effects are reported for Battlemind and third location decompression.
Topics: Humans; Mental Health; Military Deployment; Military Personnel; Psychosocial Support Systems
PubMed: 35957632
DOI: 10.1080/20008198.2022.2073111 -
Journal of Manipulative and... 2022This systematic review aimed to assess whether there is a difference in neck strength between military pilots and aircrew with and without chronic neck pain. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
This systematic review aimed to assess whether there is a difference in neck strength between military pilots and aircrew with and without chronic neck pain.
METHODS
The PubMed, Embase, and Scopus databases were searched. Two independent reviewers selected relevant full articles comparing neck strength between military pilots and aircrew with and without chronic neck pain. Two independent reviewers extracted the data from the full articles selected. A meta-analysis was used to assess standardized mean differences in neck strength based on a random-effects model.
RESULTS
The search returned 3554 results; 5 articles were included in the study. Military pilots and aircrew with chronic neck pain showed no difference in neck strength from military pilots and aircrew without chronic neck pain for flexion and extension, but did show a neck strength reduction for right and left lateral flexion -0.29 (95% confidence interval, -0.52 to -0.06; I² = 3%) and -0.23 (95% confidence interval, -0.45 to 0.00; I² = 0%), respectively.
CONCLUSION
Based on this meta-analysis with a 3a level of evidence, military pilots and aircrew with chronic neck pain have reduced neck strength for coronal head movement, but not sagittal movement compared with military pilots and aircrew without chronic neck pain.
Topics: Humans; Neck Pain; Head Movements; Military Personnel; Neck; Chronic Pain
PubMed: 36336484
DOI: 10.1016/j.jmpt.2022.09.006 -
International Journal of Psychology :... Apr 2022By exposing individuals to trauma, wars can cause a host of psychiatric disorders. This study aimed to collect and compare the studies conducted to estimate the... (Meta-Analysis)
Meta-Analysis Review
By exposing individuals to trauma, wars can cause a host of psychiatric disorders. This study aimed to collect and compare the studies conducted to estimate the prevalence of depression among veterans, former prisoners of war (POWs) and military personnel in the Iran-Iraq war (1980-1988). In this systematic review, a search was conducted using relevant keywords in major national and international databases, personal archives and national academic libraries. We screened 135 records using their abstracts and selected a total of 56 studies for full-text review. Eventually, 19 studies were included in our systematic review and meta-analysis. The estimated pooled prevalence of depression among Iranian veterans and POWs was 22.4% (95% confidence interval = 15.0-32.0). Although the results indicated disparities in the prevalence of depression among veterans and POWs, the aggregate estimated prevalence was much higher than what has been reported for military personnel. Effective policies and strategies are required for prevention and treatment of depression and related psychiatric complications among veterans and former POWs.
Topics: Depression; Humans; Iran; Iraq; Prevalence; Prisoners; Prisoners of War; Stress Disorders, Post-Traumatic; Veterans
PubMed: 34608645
DOI: 10.1002/ijop.12813