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Stress and Health : Journal of the... Sep 2023Military personnel experience training and operational demands that are different from civilian populations, including frequent deployment, exposure to austere... (Review)
Review
Military personnel experience training and operational demands that are different from civilian populations, including frequent deployment, exposure to austere environments, and dislocation from family. These unique occupational demands may result in negative impacts on health, performance, and career success. As such, resilience, defined as a system's capacity to resist, recover, recover better, or adapt, to perturbation from a challenge or stressor, is a critical factor in assuring the health and safety of military personnel. In recent years, the Department of Defense (DoD) has funded research programs assessing the physiological basis of resilience. This review will overview research programs, review salient findings from recent studies, and highlight potential future areas of research. Physiological factors influencing or predicting resilience in US military populations, including physical performance, anthropometrics and body composition, nutrition and dietary supplements, and other biomarkers will be highlighted. Finally, this manuscript will detail potential future studies, including interventions, aimed at optimising physiological resilience in military personnel.
Topics: Humans; Military Personnel; Resilience, Psychological
PubMed: 37395310
DOI: 10.1002/smi.3271 -
Occupational Medicine (Oxford, England) Dec 2018Military service can be a traumatic experience and cause mental health problems in a minority of personnel, such as post-traumatic stress disorder (PTSD), which is... (Review)
Review
BACKGROUND
Military service can be a traumatic experience and cause mental health problems in a minority of personnel, such as post-traumatic stress disorder (PTSD), which is linked to negative long-term outcomes. As a result, PTSD has received significant research attention. However, post-traumatic growth (PTG) is a newer construct, with comparatively little known about its presentation and development.
AIMS
To qualitatively examine the experience of (PTG) in military and ex-military personnel.
METHODS
A qualitative systematic search of electronic databases was conducted, with studies assessed for methodological quality and data analysed using thematic analysis. Nine qualitative studies, carried out between 2011 and 2016, met the inclusion criteria with 195 participants in total, including both military and ex-military personnel.
RESULTS
Six themes were identified: appreciation for life, re-evaluating sense of purpose, improvement of personal human traits, bonding and connecting with others, integrating into society, and being proud of heritage and feeling valuable to society.
CONCLUSIONS
The results of this review illustrate that military personnel may experience PTG due to deployment-related trauma exposure, and the presentation of PTG in this population is not dissimilar to that of civilians. This study highlights the need for additional research to quantify the long-term psychological impact of PTG and whether a focus on PTG may be helpful in psychological treatment for (ex-) military personnel.
Topics: Adaptation, Psychological; Adult; Combat Disorders; Female; Humans; Male; Mental Disorders; Middle Aged; Military Personnel; Posttraumatic Growth, Psychological; Qualitative Research; Veterans
PubMed: 30590773
DOI: 10.1093/occmed/kqy140 -
Current Psychiatry Reports May 2018We review the prevailing evidence surrounding treatment of substance use disorder (SUD), with specific focus on alcohol, tobacco, and prescription opiates, and how it... (Review)
Review
PURPOSE OF REVIEW
We review the prevailing evidence surrounding treatment of substance use disorder (SUD), with specific focus on alcohol, tobacco, and prescription opiates, and how it informs guidelines for treating active duty military. We survey the evidence regarding preventive screening, treatment, and relapse prevention in substance misuse as it pertains to patient-centered care of the service member.
RECENT FINDINGS
Holistic, patient-centered care with an emphasis on identifying maladaptive use or dependence prior to progression to chronic disease is now recognized as the evidenced approach to treating substance use disorders. Early patient-guided intervention with combined behavioral and pharmacologic therapies leads to better outcomes, including greater functional status, lower relapse rates, and decreased rate of psychiatric and other comorbidities. The military has prioritized a patient-centered approach to screening, assessing, and treating SUD. Recent guideline updates represent a progressive, patient-centered approach in delivering unprecedented access to care, serving as a positive example in treating what is widely accepted as one of the country's most pressing public health concerns.
Topics: Female; Humans; Male; Military Personnel; Patient-Centered Care; Secondary Prevention; Substance-Related Disorders; United States
PubMed: 29779198
DOI: 10.1007/s11920-018-0911-1 -
Journal of the Royal Army Medical Corps Apr 2019Military psychology is a specialist discipline within applied psychology. It entails the application of psychological science to military operations, systems and...
Military psychology is a specialist discipline within applied psychology. It entails the application of psychological science to military operations, systems and personnel. The specialty was formally founded during World War I in the UK and the USA, and it was integral to many early concepts and interventions for psychological and neuropsychological trauma. It also established a fundamental basis for the psychological assessment and selection of military personnel. During and after World War II, military psychology continued to make significant contributions to aviation psychology, cognitive testing, rehabilitation psychology and many models of psychotherapy. Military psychology now consists of several subspecialties, including clinical, research and occupational psychology, with the latter often referred to in the USA as industrial/organisational psychology. This article will provide an overview of the origins, history and current composition of military psychology in the UK, with select international illustrations also being offered.
Topics: History, 20th Century; Humans; Military Medicine; Military Personnel; Military Psychiatry; Psychology, Military; World War I; World War II
PubMed: 30415213
DOI: 10.1136/jramc-2018-001048 -
Annals of Epidemiology Oct 2009
Review
Topics: Adult; Humans; Iraq War, 2003-2011; Military Personnel; Suicide; United States; Veterans; Vietnam Conflict; Young Adult
PubMed: 19628411
DOI: 10.1016/j.annepidem.2009.05.004 -
The American Journal of Psychiatry Jan 1995Homosexuality has remained a focus of military concern despite society's increasing acceptance of homosexual men and women and evidence that homosexuals have served and... (Review)
Review
OBJECTIVE
Homosexuality has remained a focus of military concern despite society's increasing acceptance of homosexual men and women and evidence that homosexuals have served and currently serve in the U.S. armed forces. President Clinton has stated a determination to end discrimination against homosexuals in the military and reverse the exclusionary policy on homosexuals serving in the armed forces. The authors review the history of the policy of the U.S. military to exclude homosexuals from serving in the armed forces.
METHOD
The data for this study were drawn from military archives and court cases that have shaped U.S. policy excluding homosexuals from serving in the armed forces. The three main arguments are addressed: 1) homosexuality is a mental disorder rendering a person unstable, 2) homosexual service members are a source of poor morale for military units, and 3) homosexual service members are poor security risks.
RESULTS
Considerable evidence demonstrates that homosexuals in the military pose no documented threat to national security and show no evidence of poor work performance.
CONCLUSIONS
Although issues of morale and fraternization in the military remain challenges, no evidence in this review supports the exclusion of homosexuals from service in the U.S. armed forces.
Topics: Adult; Coercion; Female; Homosexuality; Humans; Jurisprudence; Male; Military Personnel; Morale; Prejudice; United States; Work
PubMed: 7802115
DOI: 10.1176/ajp.152.1.16 -
Military Medicine Dec 2019Global health engagement missions are conducted to improve and protect the health of populations worldwide. Recognizing the strong link between health and security, the...
INTRODUCTION
Global health engagement missions are conducted to improve and protect the health of populations worldwide. Recognizing the strong link between health and security, the Armed Forces have increased the number of global health engagement missions over the last decade to support force health protection, medical readiness, enhance interoperability, improve host nation capacity building, combat global health threats (i.e., emerging infectious diseases), support humanitarian assistance and disaster relief efforts, as well as build trust and deepen professional medical relationships worldwide. These missions additionally support the US Global Health Security Agenda, US National Security Strategy, US National Defense Strategy and National Military Strategy.Although global health engagement missions are conducted by armed forces with numerous military units and geographical locations, military healthcare personnel assigned to US Naval hospital ships also perform a wide range of these missions. These missions comprise some of the largest global health engagement missions conducted, encompassing hundreds of subject matter expert exchanges, community health exchanges, medical symposiums, and side-by-side partnered healthcare in countries around the world. Military healthcare personnel who have completed past missions possess valuable knowledge related to ship-based global health engagement missions. Capturing and transferring this knowledge to future deployed personnel is important for future successful missions, but has remained a significant challenge. The purpose of this study was to capture and examine first-person accounts of experiential learning among active duty physicians, nurses, and hospital corpsmen who had participated in recent hospital ship-based global heath engagement missions.
MATERIALS AND METHODS
We used the interpretive, ethnographic method of interviewing and data analysis described by Benner. Interviews elicited detailed, narrative examples of experiences from military health care personnel who had participated in previous global health engagement missions aboard hospital ships (N = 141). Our approach to gaining meaning from these narratives was guided by three central strategies: (1) identify paradigm cases, (2) identify themes within and across participant narratives of meaningful patterns, and (3) identify exemplars to represent common patterns of meaning and common situations. Additionally, we collected demographic information.
RESULTS
Our findings provide firsthand descriptions of five essential elements to prepare military healthcare personnel for shipboard global health engagement missions. These essential elements are mission clarity, preparedness, experiential knowledge, lessons learned, and flexibility/adaptability.
CONCLUSIONS
Widespread dissemination of the lessons learned from military global health engagement missions is crucial to shaping forces that operate effectively in a rapidly changing global environment. Sharing lessons learned increases efficiency, adaptability, and agility, while decreasing variance in processes and the need to relearn mission-specific lessons.
Topics: Global Health; Health Personnel; Humans; Military Personnel; Naval Medicine; Relief Work; Ships; United States
PubMed: 31141136
DOI: 10.1093/milmed/usz113 -
The American Journal of Nursing Sep 2019Former Army nurse Elizabeth-Mann Salinas has improved burn care worldwide.
Former Army nurse Elizabeth-Mann Salinas has improved burn care worldwide.
Topics: Burns; Humans; Military Medicine; Military Personnel; Nursing Care
PubMed: 31449132
DOI: 10.1097/01.NAJ.0000580296.75954.e3 -
Journal For Nurses in Professional... 2017
Topics: Career Mobility; Education Department, Hospital; Female; Humans; Middle Aged; Military Personnel; Staff Development
PubMed: 28891886
DOI: 10.1097/NND.0000000000000380 -
American Journal of Preventive Medicine Apr 2000Musculoskeletal physical training-related injuries are a major problem in military populations. Injuries are important in terms of loss of time from work and training... (Review)
Review
BACKGROUND
Musculoskeletal physical training-related injuries are a major problem in military populations. Injuries are important in terms of loss of time from work and training and decreased military readiness. The implications of these injuries in terms of patient morbidity, attrition rates, and training costs for military personnel are staggering. This article reviews: (1) pertinent epidemiologic literature on musculoskeletal injury rates; (2) injury type and location; and (3) risk factors for military populations. Suggestions for injury surveillance and prevention are also offered.
METHODS
Existing military and civilian epidemiologic studies were used to estimate and compare the size of the injury problem, identify risk factors, and test preventive measures. Most of the military research data obtained was from Marine and Army recruits, Army Infantry soldiers, and Naval Special Warfare candidates. Additional studies conducted in operational forces provided documentation of the injury problem in these populations as well.
RESULTS
Injury rates during military training are high, ranging from 6 to 12 per 100 male recruits per month during basic training to as high as 30 per 100 per month for Naval Special Warfare training. Data collected show a wide variation in injury rates that are dependent largely on the following risk factors: low levels of current physical fitness, low levels of previous occupational and leisure time physical activity, previous injury history, high running mileage, high amount of weekly exercise, smoking, age, and biomechanical factors. (Data are contradictory with respect to age.)
CONCLUSION
Considering the magnitude of training injuries in military populations, there is a substantial amount of work that remains to be performed, especially in the areas of surveillance, prevention, and treatment. Modifiable risk factors have been identified suggesting that overuse and other training injuries could be decreased with proper interventions. Outpatient surveillance systems are available to capture musculoskeletal injury data but need to be refined. Given the size of the problem, a systematic process of prevention should be initiated starting with routine surveillance to identify high-risk populations for the purpose of prioritizing research and prevention. Properly planned interventions should then be implemented with the expectation of dramatically reduced lost work/training time, attrition, and medical costs, while increasing military readiness.
Topics: Adult; Causality; Female; Humans; Male; Military Personnel; Musculoskeletal System; Physical Education and Training; Population Surveillance; Risk Factors; Wounds and Injuries
PubMed: 10736541
DOI: 10.1016/s0749-3797(00)00114-8