Search Results (116)

Jet fuels are a complex mixture of hydrocarbons and performance additives, including some compounds with established human toxicity. They represent a significant occupational hazard for military personnel; however, little is known about possible long-term health effects, particularly following cessation of exposure. In response to United States (US) Veterans’ concerns, the US Department of Veterans Affairs (VA) and the Department of Defense (DoD) launched a large retrospective cohort study to assess the impact of military occupational jet fuel exposure on Veterans’ health. The Long-Term Impact of Fuel Exposure (LIFE) cohort consists of over 1.3 million Veterans who entered service on or after 1 January 1995, including both individuals with jet fuel-exposed occupations in their service history and a random sample of unexposed Veterans. Data from multiple VA and DoD administrative datasets were linked to evaluate morbidity, disability, and mortality endpoints. Analyses are underway to assess associations between jet fuel exposure and adverse health outcomes in multiple body systems. This study represents the largest effort to date to investigate these effects, with the intention of informing policies affecting Veterans for years to come. Full article

Equine-assisted services (EAS) are used for civilian and military trauma survivors to reduce depression and posttraumatic stress symptoms. While early scientific evidence supports the benefits of EAS, the neurophysiological mechanisms underlying these benefits are unknown. The specific aims of this exploratory study were to determine (1) whether functional near-infrared spectroscopy (fNIRS) neuroimaging can be used to explore neural responses of EAS veteran participants and (2) the correlation between neural responses and psychological outcomes of the participants interacting with equines. Fifteen veterans participated in a 2-day EAS program consisting of four randomized activities. An fNIRS sensor cap was used to measure the oxygenated (O₂Hb), deoxygenated (hHb), and total hemoglobin (tHb) of the participants during each activity. The results indicated no significant differences for O₂Hb and tHb across the visits or activities, however, a significant difference in hHb was observed. There was an increase in hHb during the activities that included an equine, which indicated a greater cognitive load and attention. Further, data from pre-/post-psychometric assessments showed a significant improvement in participants’ trait anxiety, psychological flexibility, and positive and negative affect after interacting with the horse. Preliminary data revealed a potential association between the cognitive attention and psychological health of participants during an EAS session. Full article

Background: Cardiovascular diseases (CVD) remain the leading cause of death in both Poland and worldwide. Despite a decline in CVD-related mortality observed in Poland since 1991, national rates still exceed the European Union average. Methods: The aim of this study was to assess the prevalence of cardiovascular risk factors and the level of health awareness among Polish Armed Forces personnel, including both soldiers and civilian employees. A total of 308 participants (82.00% soldiers) underwent anthropometric measurements, lipid profile testing, and completed a structured questionnaire. Results: The results indicate a high prevalence of modifiable risk factors, such as overweight (30.30%), low physical activity (21.20%), and tobacco use (21.20%). Additionally, 54.00% of respondents reported experiencing stress, and 17.00% had elevated cholesterol levels. Statistically significant associations were found between selected parameters and gender, age, service corps, and occupational status. Despite a moderate level of knowledge regarding CVD, the majority of participants expressed a willingness to expand their understanding. Conclusions: The findings highlight the importance of early prevention and health education on cardiovascular diseases, especially in military environments where stress and lifestyle factors may contribute to increased risk. Full article

Background/Objectives: Military Service Members (SMs) require optimal nutrition to support health, readiness, and job performance. However, they often fall short of meeting nutrition guidelines. This study aimed to determine the impact and feasibility of implementing the U.S. Marine Corps (USMC) “Fueled to Fight^®” (F2F) nutrition program in non-appropriated fund (NAF) food venues. Objectives included evaluating changes in Military Nutrition Environment Assessment Tool (mNEAT) scores, feasibility of implementing and maintaining F2F strategies, and influence on customer purchasing patterns. Methods: Researchers conducted a pre-post interventional study from January to December 2024 at three NAF food venues across two USMC bases. F2F strategies, including identifying items using a stoplight color coding system (Green = healthy, Yellow = less healthy, Red = least healthy), menu revisions, food placement, promotion, and marketing, were implemented. Data included mNEAT assessments, sales reports, and stakeholder focus groups. Generalized Estimating Equations models were used to analyze sales data. Results: mNEAT scores increased across all venues post-intervention. Availability and sales of Green items increased, while sales of Red items decreased in some venues. Profit increased at all three food venues. Focus groups revealed feasibility and provided insights for future interventions. Conclusions: F2F interventions in NAF food venues are feasible and can positively impact the food environment and customer purchasing patterns without negatively affecting profit. This study highlights the importance of integrating nutrition programs into all military food venues, not just government-funded dining facilities, to support the nutritional fitness and readiness of SMs. Full article

Vegetable intake among military Service Members (SMs) is well below public health guidelines, with only 12.9% meeting the Dietary Guidelines for Americans (DGAs). Low vegetable consumption negatively impacts diet quality as measured by the Healthy Eating Index (HEI), and poses risks to health and performance. Given the high physical and mental demands of military life, improving diet quality, including through increased vegetable intake, is crucial for optimizing health and readiness. Providing meal kits may help improve vegetable intake by reducing access-related barriers for SMs living or working on a military base. Furthermore, the addition of spices and herbs is a readily modifiable accompanying approach to address taste-related barriers and increase intake that has shown promise in other populations with poor diet quality. Background/Objectives: This study aimed to evaluate whether heat-and-serve meal kits with spices and herbs could increase vegetable intake and liking among active-duty SM by simultaneously targeting barriers to healthy eating and modifiable sensory factors. Methods: Conducted at Naval Support Activity Bethesda, the study randomly distributed heat-and-serve meal kits (n = 400) featuring either spiced (n = 200) or plain versions (n = 200) of four vegetables (broccoli, carrots, cauliflower, and kale). Each kit contained a quick response (QR) code for participants to upload post-consumption photos and rate vegetable liking on a nine-point Likert scale. Food photography (SmartIntake^®) was used to estimate vegetable consumption. Paired t-tests were used to determine differences between the intake of plain and spiced vegetables. Results: Intake of the heat-and-serve vegetables was very high for both the spiced and plain preparations (1.73 out of 2 cups, 87%). There was minimal difference (p = 0.87) between the consumption of spiced (1.75 cups) and plain (1.725 cups) vegetables, suggesting that both were well accepted. Overall, convenient and accessible meal options, alongside sensory-driven strategies, appear to improve some barriers to vegetable consumption in SM populations. Conclusions: Future studies should explore long-term outcomes and adaptability across different military environments, while considering additional factors, including convenience and time constraints, that influence dietary choices in the military. Full article

Background: Headache disorders, particularly migraine, are a leading cause of disability among active-duty military personnel, significantly affecting operational readiness and fitness for duty. Despite their high prevalence, limited data exist on how headache disorders are managed within military primary care systems. This study aimed to evaluate diagnostic confidence, treatment strategies, and structural challenges in the management of headache disorders from the perspective of military primary care physicians. Methods: A prospective, nationwide cross-sectional survey was conducted between May and July 2023 among all active-duty military physicians in primary care roles. An anonymous 15-item questionnaire assessed diagnostic practices, therapeutic approaches, referral pathways, perceived knowledge gaps, and suggestions for system improvements. The survey was distributed across military medical centers and outpatient clinics in Germany. Results: Ninety military physicians participated. Migraine and tension-type headache were commonly encountered, with 70% having treated at least one headache patient in the week prior to the survey. Diagnostic confidence was high for migraine (83.4%) and tension-type headache (77.8%) but lower for medication-overuse headache (65.5%) and cluster headache (47.8%). Acute treatment was widely implemented, but only 27.8% of respondents regularly initiated preventive therapies. Awareness of clinical guidelines was limited: only 23.3% were familiar with the ICHD-3, and just 58.9% with national headache treatment guidelines. Respondents expressed strong demand for targeted education, practical diagnostic tools, and improved interdisciplinary coordination. Conclusions: Headache disorders are a prevalent and clinically significant issue in military primary care. While military physicians show high engagement, important gaps exist in preventive treatment, guideline familiarity, and access to specialist care. Structured training, standardized treatment protocols, and system-level improvements are essential to optimize headache care and maintain operational readiness. Full article

Background: This study examined the incidence of acute complications within the first year following combat-related lower extremity injuries in United States (U.S.) Service members (SMs). The research compared outcomes between primary amputation (PA), limb salvage (LS), and non-threatening limb trauma (NTLT) groups, and conducted a subgroup analysis within the LS group, differentiating between SM who underwent a secondary amputation (LS-SA) and those who did not (LS-NA). Methods: A retrospective analysis of combat-related lower extremity injuries sustained between January 2001 and October 2015 was performed using data from the Military Health System Medical Data Repository. Chi-square tests and adjusted logistic regression analysis were used to compare complication frequencies by injury severity. Results: The analysis of the 4275 SM revealed that 21% had undergone PA, 47% LS (with 13% experiencing LS-SA and 87% LS-NA), and NTLT was observed in 32% of cases. The PA group exhibited higher rates of most acute complications compared to other groups, with three exceptions—i.e., non-union fractures, compartment syndrome, and orthopedic device complications were more prevalent in the LS group than the PA group. The LS-SA group had higher complication rates than the LS-NA group for most complications. Notably, the PA group was associated with the highest rates of post-hemorrhagic anemia and heterotopic ossification, while the LS-SA group exhibited the highest rates of osteomyelitis, non-union fractures, non-healing wounds, and compartment syndrome. Conclusions: Individuals with amputation (PA or LS-SA) were more likely to experience acute complications compared to their counterparts (PA vs. LS and NTLT; LS-SA vs. LS-NA), with the exception of non-union fractures, which were more frequent in the LS group than the PA group. These findings highlight the need for close monitoring and targeted interventions to address post-surgical complications in Service members with limb salvage. Full article

Firework-related injuries remain a serious public health issue in Germany, especially during New Year’s Eve. While many injuries are minor, the misuse of illegal or homemade fireworks can cause severe trauma resembling military combat injuries and can heavily burden emergency services. Notably, injury rates declined during the COVID-19 firework bans, underscoring the impact of preventive measures. We report two cases of young males with severe injuries from illicit fireworks. The first is a case of a 16-year-old that detonated an illegal Polish firework ball bomb, sustaining 9% total body surface area (TBSA) burns (second- to third-degree), hand fractures, compartment syndrome of the hand, and soft-tissue trauma. He underwent multiple surgeries, including fasciotomy, osteosynthesis, and skin grafting. The other case presented is a 19-year-old man who was injured by a homemade device made of bundled firecrackers, suffering deep facial and bilateral hand burns. He required prolonged ventilation, surgical debridement, and treatment with Kerecis^® fish skin and Epicite^® dressings. Both required intensive ICU care, interdisciplinary management, and lengthy rehabilitation. Total hospital costs amounted to €58,459.52 and €94,230.23, respectively, as calculated according to the standardized German DRG. These cases illustrate the devastating impact of illegal fireworks. The devastating consequences of explosive trauma are often difficult to treat and may lead to long-term functional and psychological impairments. Prevention through public education, stricter regulations, and preparedness is essential. Pandemic-era injury reductions support sustained policy efforts. Full article

Post-traumatic stress disorder (PTSD) is a complex, debilitating condition prevalent among military personnel exposed to traumatic events, necessitating biomarkers for early detection and intervention. Using data from the Millennium Cohort Study, the largest and longest-running military health study initiated in 2001, our objective was to identify specific microRNA (miRNA) expression patterns associated with distinct PTSD symptom trajectories among service members and veterans and assess their potential for predicting resilience and symptom severity. We analyzed 1052 serum samples obtained from the Department of Defense Serum Repository and linked with survey data collected at baseline and across three follow-up waves (2001–2011), using miRNA sequencing and statistical modeling. Our analysis identified five PTSD trajectories—resilient, pre-existing, new-onset moderate, new-onset severe, and adaptive—and revealed significant dysregulation of three key miRNAs (miR-182-5p, miR-9-5p, miR-204-5p) in participants with PTSD compared to resilient individuals. These miRNAs, which inhibit brain-derived neurotrophic factor (BDNF) and target pathways like NFκB, Notch, and TGF-alpha, were associated with neuronal plasticity, inflammation, and tissue repair, reflecting PTSD pathophysiology. These findings suggest that miRNA profiles could serve as biomarkers for early identification of PTSD risk and resilience, guiding targeted interventions to improve long-term health outcomes for military personnel. Full article

Objectives: With the advancement of modern society, people in cognitively demanding jobs are increasingly exposed to occupational stress. Prolonged and high-intensity cognitive activities are prone to inducing mental fatigue (MF), which adversely affects both psychological and physiological well-being, as well as task performance. Existing methods for inducing MF often demonstrate limited effectiveness due to insufficient cognitive load from overly simplistic tasks and the potential emotional disturbance caused by prolonged task duration. This study aims to explore a comprehensive cognitive task paradigm that integrates task complexity and time pressure, thereby developing a novel and effective method for inducing MF based on high mental workload (HMW) and the effects of time on task (ToT). Methods: Using convenience sampling, university students from a medical college were recruited as participants. The study was conducted in three steps. In the first step, we constructed a 1-back Stroop (BS) task paradigm by designing tasks with varying levels of complexity and incorporating time pressure through experimental manipulation. In the second step, the efficacy of the BS task paradigm was validated by comparing it with the traditional 2-back cognitive task in inducing HMW. In the third step, an MF induction protocol was established by combining the BS task paradigm with the ToT effect (i.e., a continuous 30 min task). Effectiveness was assessed using validated subjective measures (NASA Task Load Index [NASA-TLX] and Visual Analog Scale [VAS]) and objective behavioral metrics (reaction time and accuracy). Statistical analyses were performed using analysis of variance (ANOVA) and t-tests. Results: The BS task paradigm, which integrates complex cognitive abilities such as attention, working memory, inhibitory control, cognitive flexibility, and time pressure, demonstrated significantly higher NASA-TLX total scores, as well as elevated scores in mental demand, temporal demand, performance, and frustration scales, compared to the 2-back task. Additionally, the BS task paradigm resulted in longer reaction times and lower accuracy. As the BS task progressed, participants exhibited significant increases in mental fatigue (MF), mental effort (ME), mental stress (MS), and subjective feelings of fatigue, while the overall number of correct trials and accuracy showed a significant decline. Furthermore, reaction times in the psychomotor vigilance test (PVT) were significantly prolonged, and the number of lapses significantly increased between pre- and post-task assessments. Conclusions: The BS task paradigm based on complex cognitive abilities and time pressure could effectively induce an HMW state. Combined with the ToT effect, the BS paradigm demonstrated effective MF induction capabilities. This study provides a novel and reliable method for inducing HMW and MF, offering a valuable tool for future research in related fields. Full article

Background: There is currently no study examining the mental health consequences of deployed German service members in Iraq. The aim is, therefore, to determine the cumulative incidence and latency period until the first diagnosis of deployment-related mental disorders. We hypothesized a lower rate than for Afghanistan with 2.4%. Methods: All registered N = 1635 German military personnel who were deployed to the mission “Training support contingent Northern Iraq” between 2015 and 2018 were included. Individuals with mental disorders attributed to this deployment were identified in a central database. Differences in latency between diagnoses were calculated by t-tests for independent samples. Results: By January 2024, n = 55 (3.4%) individuals had been recorded who developed a mental disorder as a result of this deployment. Most of them (54.5%) had a post-traumatic stress disorder (PTSD) as the main or comorbid diagnosis. There were no gender differences in the cumulative incidence (male 3.6%; female 2.9). The latency period between the onset of disease and initial diagnosis was, on average, 1.0 years (standard deviation 1.1 years; Q₂₅ < 1 year, Q₅₀ = 1 year and Q₇₅ = 2 years). With 1.3 vs. 0.6 years, the latency was significantly longer for individuals with PTSD. Conclusions: The cumulative incidence appears to be higher after the Iraq deployment than after most other Bundeswehr deployments. This is attributed to particular threats. The latency period is higher for those affected with PTSD than with other disorders. This could be due to a higher degree of stigmatization. It is, therefore, worthwhile to compare the different deployments in order to be able to derive better preventive and aftercare measures as well as destigmatization programs to prevent chronification. Full article

The 2021 military coup in Myanmar triggered a severe humanitarian crisis, forcing many to flee through regular and irregular channels to neighboring countries like Thailand. This study explores the resulting migration patterns and precarious situation of Myanmar nationals seeking refuge in Thailand. Drawing on contemporary sources, it highlights how the crisis, worsened by military conscription laws, displaced many citizens. Refugees face constant fear of incarceration and forced repatriation while struggling with limited access to basic services in Thailand, which worsens mental health and reduces quality of life. The military’s revenue tactics, such as taxing overseas workers and remittances, have contributed to their hardships. In response, Thailand introduced a cabinet resolution to legalize work and residence for irregular migrants for four years. However, ongoing detentions and deportations risk forced military enlistment upon return, raising doubts about the resolution’s effectiveness, accessibility, and affordability. The study concludes with policy recommendations to address the humanitarian needs of Myanmar’s displaced population both at home and abroad. It also suggests ways to implement protective measures effectively, such as the Thai Cabinet resolution, to safeguard the dignity and rights of Myanmar’s people. Full article

Background: Rescue teams and emergency services face high levels of mental health problems due to their frequent exposure to traumatic situations. Critical incident stress debriefing (CISD) is widely used as a psychological intervention for emergency responders and military personnel exposed to traumatic events. However, its effectiveness remains controversial, with systematic reviews yielding mixed results and some evidence of negative and harmful outcomes. This systematic review, conducted according to PRISMA guidelines, evaluates the evidence on the efficacy of CISD in mitigating psychological distress and preventing post-traumatic stress disorder (PTSD). Methods: A systematic search was conducted in PubMed and PsycINFO from inception to November 2024. Eligibility criteria included randomized controlled trials (RCTs) and cohort studies assessing the impact of CISD on PTSD, anxiety, depression, and psychological distress. Two independent reviewers screened studies, extracted data, and assessed the risk of bias using the PEDro scale. Data narrative synthesis was applicable. Results: A total of 6 out of 371 studies were included, comprising 4751 participants. The PEDro scale showed that one study was of high methodological quality, four were of acceptable quality, and two had deficiencies. The findings revealed mixed outcomes: while some studies reported a reduction in PTSD symptoms, others found no significant effect or even potential harm. Heterogeneity in intervention implementation, population characteristics, and study quality influenced the results. Risk of bias was moderate to high in several studies, with limitations in sample size and follow-up duration. No specific effects have been studied in mountain rescue teams. Conclusions: Current evidence does not unequivocally support the efficacy of CISD in preventing PTSD and psychological distress. Given methodological concerns and potential adverse effects, alternative debriefing methods, such as Battlemind debriefing, warrant further exploration. Future research should focus on well-powered RCTs with standardized intervention protocols to enhance reliability. Full article

Disempowering experiences of military service and transition for women veterans exist within an established, dominant, masculinised culture, in which their presence is highly visible, challenged, and often subject to institutional prejudice. Sexual abuse of women in the military, in particular, is a persistent finding in contemporary international research and national inquiries into military culture in countries such as Australia, the United Kingdom (UK), the United States (US), and Canada. This study sought to understand military service, transition to civilian life, and post-military experiences of Australian women veterans, specifically their experiences of discrimination, military sexual harassment and assault, and consequent military sexual trauma (MST). In-depth qualitative interviews were undertaken with 22 Australian women veterans that examined how women veterans manage their identity as women in the military. Issues included gender-based challenges in conforming to a masculinised culture, experiences of misogyny, sexual harassment and assault, systemic failures to recognize women’s specific health needs, and experiences of separation from the military and transition, including help-seeking and engagement with services to address their experiences of MST. Women veterans’ adverse experiences largely stemmed from an entrenched masculinised military culture, in which military sexual assault was enabled, ignored, and condoned. Military and veteran support services have been slow to recognize, acknowledge, and address this significant issue. Full article

Despite expanded mental health services and outreach within the military, most active-duty members who endorse mental health problems do not seek services. Little is known about why this is the case, but cognitions may play a key role. In this study, cognitions relevant to service seeking were compared among three subgroups of active-duty members: those who endorse one or more mental health problems and sought services, those who endorse problems and do not seek services, and those who do not endorse problems. To examine differences and similarities among these groups, a stratified random sample of 162,340 was drawn from all active-duty members of the U.S. Department of the Air Force serving at 91 installations around the world. Each selected member was invited to anonymously complete the Air Force Community Assessment, and 63,227 members (39% of those invited) participated. Of these, one in five reported at least one mental health problem, and one in three reported receiving services within the past two years. Participants reporting problems and who had not sought services perceived more peer and institutional stigma, reported more knowledge and logistic barriers, reported more negative attitudes towards mental health services, and reported fewer attractors to mental health services compared with those who did not report problems. Those who reported problems and sought services reported more problems and more negative attitudes than those reporting problems who had not sought services. Nine of ten who reported problems but had not received services indicated they had no intention to seek them. Full article