Military Members Research Articles

Association of Blood Biomarkers of Inflammation With Acute Concussion in Collegiate Athletes and Military Service Academy Cadets.

The objective was to characterize the acute effects of concussion (a subset of mild traumatic brain injury) on serum interleukin (IL)-6 and IL-1 receptor antagonist (RA) and 5 additional inflammatory markers in athletes and military service academy members from the Concussion Assessment, Research, and Education Consortium and to determine whether these markers aid in discrimination of concussed participants from controls. Athletes and cadets with concussion and matched controls provided blood at baseline and postinjury visits between January 2015 and March 2020. Linear models investigated changes in inflammatory markers measured using Meso Scale Discovery assays across time points (baseline and 0-12, 12-36, 36-60 hours). Subanalyses were conducted in participants split by sex and injury population. Logistic regression analyses tested whether acute levels of IL-6 and IL-1RA improved discrimination of concussed participants relative to brain injury markers (glial fibrillary acidic protein, tau, neurofilament light, ubiquitin c-terminal hydrolase-L1) or clinical data (Sport Concussion Assessment Tool-Third Edition, Standardized Assessment of Concussion, Balance Error Scoring System). Participants with concussion (total, N = 422) had elevated IL-6 and IL-1RA at 0-12 hours vs controls (n = 345; IL-6: mean difference [MD] (standard error) = 0.701 (0.091), p < 0.0001; IL-1RA: MD = 0.283 (0.042), p < 0.0001) and relative to baseline (IL-6: MD = 0.656 (0.078), p < 0.0001; IL-1RA: MD = 0.242 (0.038), p < 0.0001), 12-36 hours (IL-6: MD = 0.609 (0.086), p < 0.0001; IL-1RA: MD = 0.322 (0.041), p < 0.0001), and 36-60 hours (IL-6: MD = 0.818 (0.084), p < 0.0001; IL-1RA: MD = 0.317 (0.040), p < 0.0001). IL-6 and IL-1RA were elevated in participants with sport (IL-6: MD = 0.748 (0.115), p < 0.0001; IL-1RA: MD = 0.304 (0.055), p < 0.0001) and combative-related concussions (IL-6: MD = 0.583 (0.178), p = 0.001; IL-1RA: MD = 0.312 (0.081), p = 0.0001). IL-6 was elevated in male (MD = 0.734 (0.105), p < 0.0001) and female participants (MD = 0.600 (0.177), p = 0.0008); IL-1RA was only elevated in male participants (MD = 0.356 (0.047), p < 0.0001). Logistic regression showed the inclusion of IL-6 and IL-1RA at 0-12 hours improved the discrimination of participants with concussion from controls relative to brain injury markers (χ2(2) = 17.855, p = 0.0001; area under the receiver operating characteristic curve [AUC] 0.73 [0.66-0.80] to 0.78 [0.71-0.84]), objective clinical measures (balance and cognition; χ2(2) = 40.661, p < 0.0001; AUC 0.81 [0.76-0.86] to 0.87 [0.83-0.91]), and objective and subjective measures combined (χ2(2) = 13.456, p = 0.001; AUC 0.97 [0.95-0.99] to 0.98 [0.96-0.99]), although improvement in AUC was only significantly relative to objective clinical measures. IL-6 and IL-1RA (male participants only) are elevated in the early-acute window postconcussion and may aid in diagnostic decisions beyond traditional blood markers and common clinical measures. IL-1RA results highlight sex differences in the immune response to concussion which should be considered in future biomarker work.

Post-Traumatic Stress Disorder and Blast Exposure in Active-Duty Military Service Members

Objective: Active-duty military personnel in the current wars have experienced unique stressors that deviate from standard PTSD assessment and diagnosis. This situation calls for a refinement of military-related PTSD assessment. To this end, this study assessed the utility of the Trauma Symptom Inventory (TSI) in diagnosing PTSD among active-duty military personnel. The past literature has validated the TSI using populations with a small sample size. Hence, this study aimed to fill the gap by using a large sample size of 670 military members to examine whether the TSI is useful for military populations. Setting: Participants were referred to Carolina Psychological Health Services, in Jacksonville, North Carolina by military neurologists and other qualified medical officers from the Naval Hospital in Camp Lejeune, a military base located in Jacksonville, NC, for neuropsychological evaluation due to reported cognitive deficits related to military deployment (i.e., head injury due to exposure to blast injuries). Participants: Based on clinical diagnosis, comprehensive neuropsychological testing, and self-reported data, personnel were classified into four groups: blast exposure (n = 157), PTSD diagnosis (n = 90), both blast exposure and PTSD (n = 283), and neither blast exposure nor PTSD (n = 140), which helps provide a comprehensive picture of the utility of the TSI. Results: The TSI’s 10 clinical scales could distinguish between all groups. Discriminant function analysis showed that an optimally weighted combination of scales correctly predicted 66.67% of PTSD-positive cases and 35.11% of PTSD-negative cases. Conclusion: These findings provide support for the use of the TSI in the assessment of PTSD in active-duty military personnel. Due to the release of TSI-2, there is a need to replicate this data. However, the validity data has indicated a high concordance between the TSI and TSI-2, bolstering confidence in the current findings of the study.

Refractory Osteomyelitis in a Military Service Member Resolved With Adjunctive Hyperbaric Oxygen Therapy.

Refractory osteomyelitis is typically defined as a chronic infection that persists or recurs despite definitive surgical management and antibiotic therapy. Cases often involve complex wounds or fractures and can be challenging to treat, resulting in multiple courses of broad-spectrum antibiotic therapy and numerous surgeries over periods of months to years. Adjuncts to improve resolution of these complicated infections are sorely needed. Here, we describe the case of a 47-year-old active duty military member who sustained an open right ankle fracture during a skydiving accident that was subsequently complicated by refractory osteomyelitis. The patient failed more than three courses of combined medical and surgical management over a 9-month period before undergoing adjunctive hyperbaric oxygen therapy (HBOT), ultimately resulting in resolution of the infection. Adjunctive HBOT for treatment of conditions such as refractory osteomyelitis may be an underutilized resource in part because of a general paucity of high-quality data in the literature supporting its use, as well as a relative lack of availability of this resource. Nonetheless, the overall accumulating body of evidence indicates that the use of adjunctive HBOT in select patients with refractory osteomyelitis is safe and effective and further research may be warranted given its relevance and potential impact to military populations.

Canada’s varying approach to compensating disabled Reserve Force members and Veterans since 1866

LAY SUMMARY This article examines the different levels of liability Canada has assumed for disabled serving military members and Veterans from 1866 to 2020. Throughout Canada’s history, the first consideration for financial compensation has been the enrolment component of the casualty, that is, Regular, Reserve, or Special Force. Since 1883, disabled serving Regular Force members have received full pay and benefits while recovering from service-related injuries. Whether through the Militia Act, the Pension Act, long-term disability insurance, or the current Veterans Well-being Act (VWA), disabled Regular Force Veterans received financial compensation based on lost earnings. Before 1914, Canada’s military was a predominantly part-time militia, and if a member was disabled or killed due to a service-related injury or illness, lost civilian earnings and family circumstances were considered in financial compensation. From the First World War until the 1970s, serving reservists were eligible for military pay and benefits while recovering from service-related injuries. Currently, subject to an investigation clearing them of fault or malfeasance, they may apply for an allowance equivalent to military pay with no benefits. Between 1919 and 1999, the government accepted less and less liability for disabled Reserve Force Veterans until recent changes to Veterans benefits legislation incrementally improved this.

Divergent trends in accidental deaths since return from an Afghanistan/Iraq deployment among army soldiers

PurposeAccidental death is a leading cause of mortality among military members and Veterans; however, knowledge is limited regarding time-dependent risk following deployment and if there are differences by type of accidental death. MethodsLongitudinal cohort study (N = 860,930) of soldiers returning from Afghanistan/Iraq deployments in fiscal years 2008–2014. Accidental deaths (i.e., motor vehicle accidents [MVA], accidental overdose, other accidental deaths), were identified through 2018. Crude and age-adjusted mortality rates, rate ratios, time-dependent hazard rates and trends postdeployment were compared across demographic and military characteristics. ResultsDuring the postdeployment observation period, over one-third of deaths were accidental; most were MVA (46.0 %) or overdoses (37.9 %). Across accidental mortality categories (all, MVA, overdose), younger soldiers (18–24, 25–29) were at higher risk compared to older soldiers (40+), and females at lower risk than males. MVA death rates were highest immediately postdeployment, with a significant decreasing hazard rate over time (annual percent change [APC]: –6.5 %). Conversely, accidental overdose death rates were lowest immediately following deployment, with a significant increasing hazard rate over time (APC: 9.9 %). ConclusionsObserved divergent trends in risk for the most common types of accidental deaths provide essential information to inform prevention and intervention planning for the immediate postdeployment transition and long-term.

Balance Training and Shooting Performance: The Role of Load and the Unstable Surface.

Military and law enforcement members' shooting ability is influenced by their postural balance, which affects their performance and survivability. This study aimed to investigate the effects of a proprioception training program (standing or walking on unstable surfaces) on postural balance and shooting performance. Twenty participants, divided into two groups, completed 60 shots in a shooting simulator while standing, before and after a 4-week proprioception training program. One group (n = 10) followed the training program (EXP), while the other group followed the regular military academy program (CON). The shooting was conducted under four conditions: without load on a stable surface, with load on a stable surface, without load on an unstable surface, and with load on an unstable surface. The findings reveal that the training program had a significant impact on the EXP, improving their balance (p < 0.01). Additionally, only in the EXP, shooting score and the percentage center of gravity increased (p < 0.01) and the stability of the shots, measured by holding time on the target, doubled from 2.2 to 4.5 s (p < 0.01). These improvements were more pronounced when participants had a load and/or were on an unstable surface. In conclusion, a proprioception training program could be beneficial for improving postural balance and shooting performance.

COVID-19 MANDATORY VACCINATION OF SPECIAL STATUS PUBLIC SECTOR EMPLOYEES. AN ANALYSIS OF REQUESTS FOR EXEMPTION IN THE US AIR FORCE

One of the largest public sector operations in the world is within the United States of America military, with over 2 million service members and approximately 1.4 million full-time equivalent civilian workers, with bases and operations in at least 80 different nations. The US military made COVID-19 vaccinations (COVAX) mandatory among all members but allows for requests to accommodate refusals for reasons of personal beliefs. These can be beliefs of conscience, personal morality or religious expression, whether from organized or individual tenets. Multiple articles have been produced during the COVID-19 pandemic identifying willingness to receive COVAX or reasons for COVAX reluctance and refusal, but almost all data has been obtained from short-response surveys. Taking a departure from that, this study reviews the qualitative data from over 100 extensive interviews conducted with individual military members (from the US Air Force) who requested COVAX exemption. Their reasons given to refuse vaccination are also provided in a letter written by the member, regardless of rank, directly to the general at the top of their particular command. Examination of the reasons given provides unique insights into the thought processes of requestors. Regardless of the request’s outcome, this data demonstrates the administrative and policy importance placed by the US military on at least considering personal beliefs, even in a pandemic, and protecting individual freedoms, even of military members with curtailed rights. By far, disproportionate requests came from lower ranks with some mid-level leadership making formal requests to refuse the COVAX. In this sample, no top leadership requested exemptions. The analysis finds evidence for pressure exerted on members to not submit an exemption request. For those who did, the 111 requests were not a static or set doctrinal view. Arising from at least 29 distinct religious traditions, all requests showed signs of an emerging or developing sense of belief praxis in the face of new situations. Other dominant patterns also emerged. The study found critical objections to the use of fetal stem lines in developing available vaccines and concerns about potential vaccine side effects to the requestor’s body. Trust in the process and a sense of autonomy in participation also were found to be critically import to most requests.

Адміністративно-правове регулювання соціального захисту військовослужбовців та членів їх сімей: швейцарська модель

Background. The relevance of studying the experience of administrative and legal regulation of social protection of military personnel in the leading democratic countries of the world is of great importance for its consideration and implementation in the period of formation of modern social rights of military personnel and members of their families in the context of a full-scale war in Ukraine. This paper examines the Swiss model of military service, which is based on the absolute unity of the people and the army, the citizen and the State, and the purposeful work of the administrative and legal mechanism for the comprehensive protection of human rights, including those of military personnel. The purpose of the article is to study the experience of leading democratic countries, in particular, the Swiss model of military service, with a view to creating a modern administrative and legal regulation of social protection of military personnel and their families in the context of a full-scale war in Ukraine, and to formulate practical proposals for the introduction of a fair and transparent mechanism of social guarantees for military personnel and their families based on the national traditions of the Cossacks and democratic achievements. Methods. The research was conducted using general scientific methods of analysis, synthesis and formal legal method. The use of the above methodological tools made it possible to analyze and highlight the information from the sources and legal acts, to clarify the content of the legal provisions of these acts and to obtain new knowledge reflected in the material presented. Results. The analysis resulted in the identification of information on the administrative and legal regulation of social protection of military personnel and their families in the Swiss model of military service, which is based on the police principle, as well as the issue of fulfillment of civil duty by members of Swiss society regarding compulsory military service, the basis of which is a comprehensive, fair and understandable mechanism of administrative and legal support by the state for the social rights of military personnel. Conclusions. Several conclusions and proposals aimed at improving the regulation of administrative and legal support for the social rights of military personnel and their families in Ukraine have been developed. In the context of a full-scale war, Ukraine needs to create an army that will become an integral and essential part of Ukrainian society.

Mental Health and Other Factors Associated with COVID-19 Vaccination Intention toward Children of Military Parents in Lambayeque, Peru.

There is evidence that vaccine acceptability is strongly associated with mental health. However, no studies assessing intention to vaccinate (ITV) intention toward children of military parents have been documented. The current research aimed to establish the prevalence and factors of ITV children against COVID-19 in military parents in Lambayeque-Peru, 2021. Analysis was conducted with the dependent variable ITV children reported by military parents. The independent variables were history of mental health, searching for mental health support, food insecurity, resilience, anxiety, depression, burnout, posttraumatic stress, and suicidal risk. Prevalence ratios and 95% confidence intervals were estimated. Of 201 military personnel evaluated, 92.5% were male, 82.5% were of the Catholic faith, and the median age was 40.9% of respondents reported seeking mental health help during the COVID-19 pandemic. It was reported anxiety (20.3%), depression (6.5%), and posttraumatic stress disorder (6.5%). Most reported ITV in children against COVID-19 (93%). In the multiple models, we found that Catholics had a 23% higher prevalence of ITV in the children where PR = prevalence ratios and CI = confidence intervals (PR = 1.23; 95% CI: 1.01-1.50). Likewise, seeking mental health support increased the prevalence of ITV by 8% (PR = 1.08; 95% CI: 1.00-1.15). Seeking mental health support and belonging to the Catholic faith had a higher ITV of children of Peruvian military personnel. Finding mental health support, experiencing burnout syndrome, having a relative who suffers from mental health problems, and being part of the Catholic religion were associated with a higher willingness to immunize the children of Peruvian military members.

Military Vaccine Mandates: Thirty-Five Navy SEALs Believe Fighting for Religious Exemptions is A Shot Worth Taking

Abstract Americans take great pride in their constitutional freedoms, especially the renowned First Amendment, which states that “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.” (U.S. Const. amend. I) The free exercise of religion is safeguarded by the First Amendment’s Free Exercise Clause; yet, in the face of a public health crisis – how far does this protection extend? Moreover, does the Free Exercise Clause cover all Americans equally? In 2020, the Corona virus (COVID-19) pandemic began testing the limits of the First Amendment. President Joseph Biden and Secretary of Defense Lloyd Austin mandated that all active and reserve military members take the newly developed COVID-19 vaccinations. Failing to comply would leave service members with no other option than to be dishonorably discharged from military service. This paper seeks to analyze the current case of thirty-five Navy SEALs who were denied religious exemptions from the COVID-19 vaccines, and examines the implications this has on First Amendment protections for military servicemembers.

Do payday lending bans protect or constrain regional economies? Evidence from the Military Lending Act's final rule

AbstractThe 2007 Military Lending Act attempted to ban high‐interest loans to U.S. military members and the 2017 “Final Rule” further restricted access, causing regional shocks in payday lending exposure in counties with a military base. Difference‐in‐differences and dynamic estimators provide mixed evidence on the effect of this payday lending access shock on regional economic outcomes and local business outcomes. However, we consistently find statistically significant reduced entry and exit of firms. Given payday lenders congregate around low‐income and minoritized populations analogously to how they congregated around military bases, these results provide policy implications for more general usury bans.

Human Resources in the Structure of the Reintegrative Educational Environment of the University

The article examines the peculiarities of implementation of integration activities with military personnel and members of their families in the conditions of educational resources of the university. The results of a practical study implemented in the form of a survey of pedagogical workers, who are the personnel resource of the project “Retraining and social adaptation of military personnel, veterans and members of their families in Ukraine. Integration of the model of the project “Norway — Ukraine” into the state system” based on Chernihiv Polytechnic National University, are presented and the project participants themselves. In the presented results of the study, attention is focused on the general human and professional competencies of teachers involved in reintegration activities with a certain social category. The purpose of the article is to create a competency profile of educational workers as the main reintegration resource in working with former military personnel and veterans within the framework of reintegration work in the educational environment of the university. The main tasks of the research were aimed at actualizing the problem of selection of specialists involved in the process of reintegration of military personnel, veterans and their family members in the conditions of an educational environment. The conclusions confirm that work on the reintegration of servicemen in the direction of their professional retraining requires teachers to have key professional and general human competencies, the significance of these competencies is not the same and is determined by the characteristics of the social group in relation to which the reintegration program is implemented. The novelty of the research lies in the study of the possibilities of social reintegration of military personnel precisely in the plane of the educational environment of the university. The practical significance of the study lies in the creation of a competence characteristic of representatives of the university’s pedagogical community, as the main reintegration resource in working with military personnel

The current state of Ukrainian legislation on social protection of military personnel and their family members

The article examines the current state of Ukrainian legislation on social protection of military personnel and their family members. It is noted that to date, Ukraine has developed a system of normative legal acts of various legal force, which regulate the issues of social and legal protection of military personnel, their constitutional rights and freedoms, and guarantees regarding their implementation. At the same time, despite the fact that legislation in this area is constantly developing and improving, many issues still need to be resolved. Since a significant number of normative legal acts do not always indicate the provision of integral and comprehensive social protection. In particular, a conclusion was made about the non-systematic and scattered nature of the norms that define specific types of social protection for servicemen and their family members. That is, there is no single approach to the legal regulation of social protection of servicemen and their family members, there is a lack of a single legislative act, according to which consolidated and mutually agreed standards and principles of building the entire structure of social security in the researched area would be determined. Therefore, the existing system of social protection needs radical reorganization. In particular, it is necessary to create a clear system of guarantees of social (material) support for military personnel and members of their families, to ensure their observance and implementation by the state, thereby stimulating citizens to military service. It was noted that an important direction of state policy, which should become the focus of attention during the war and after its end, should be the social security of servicemen and their families, as well as raising the status of servicemen in the state. Because today there is no more important task in Ukraine than protecting and ensuring the rights of servicemen of the Armed Forces of Ukraine and other military formations who defend our borders, sovereignty and integrity of our state, who with their courageous struggle effectively protect the Ukrainian state and the Ukrainian people. At the same time, it is noted that despite the limited economic opportunities, the state still tries to provide adequate social protection to military personnel and their families, pays out monetary support and rewards, provides medical treatment and rehabilitation. Attention was also drawn to the fact that the regulatory and legal settlement of issues of ensuring social protection of servicemen and their family members should be closer to international standards, in particular, NATO member countries.

Examining the Tim Hetherington Collection Through Visually-Led Public Engagement Workshops

War photography scholarship tends to focus attention on photographers’ lives and the thematic content of images. This study shifts the spotlight onto how varied members of the public respond to a body of work, in this case the photography and filmmaking of Tim Hetherington (1970-2011), whose archive the Imperial War Museum (IWM) obtained in 2017. We discuss findings from a number of visually-led focus groups with refugees, veterans, military family members, photography students and museum volunteers. Together we examined his image-making process with the groups to discover how they discussed notions such as intimacy, masculinity, the ‘good’ conflict photograph, and ethical dilemmas. We argue that engaging with multiple public perspectives through visual elicitation methods enhances curatorial knowledge and understanding of image-making practices in this specific context, whilst also offeringt insights for national museums more broadly on how dialogue with diverse communities can enrich the handling and display of new collections.

The Role of Digital Communication and Coordination in Work Effectiveness at Soekarno-Hatta International Airport

Introduction: Airports are public facilities that provides air transportation for people and goods domestically and internationally. Coordination supported by digital communication plays an important role in improving work effectiveness at Soekarno-Hatta International Airport. Theoretical Reference Framework: According to Ku &amp; Chen (2016), many airports have implemented digital communication to provide comfort to serve users which aiming effectiveness. According to Steers (2015) that defines effectiveness as doing something accurately, on time, objectively and thoroughly in accordance with organizational goals. Method: This study uses a quantitative method approach with stratified random sampling techniques. This research involves Military and Non-Military members who work at Soekarno-Hatta International Airport in task units with a total of 2,000 officers from Military, Police, Immigration, Customs, Avsec and Airport Authorities. Results: The results of this study show that the synergy of Military and Non-Military has improved work effectiveness at Soekarno-Hatta International Airport. Discussion: Descriptive analysis aims to provide a general overview of the respondents’ answers related to the research variables and their dimensions. The variables in this study include coordination, digital communication, and work effectiveness. Conclusion: Digital communication has a positive and significant effect on work effectiveness. Coordination has a positive and significant effect on work effectiveness. Digital communication has a positive and significant effect on coordination. Digital communication mediated by coordination has a positive and significant effect on work effectiveness.

Does Suicide Risk Screening Improve the Identification of Primary Care Patients Who Will Attempt Suicide Versus Depression Screening Alone?

The effectiveness of suicide risk screening relative to depression screening alone among primary care patients has not been tested rigorously. This study compared the performance of multiple depression screening methods (Patient Health Questionnaire [PHQ]-2, PHQ-8, and PHQ-9) and multiple suicide risk screening methods (PHQ-9 item 9 and suicide-focused screening of "thoughts of killing yourself" during the entire lifespan, within the past month, and within the past week) in a convenience sample of primary care patients. A total of 2,744 patients (military personnel, family members, and retirees) from six military primary care clinics completed the PHQ-9 and screening for suicidal ideation (SI) during routine clinic visits. Follow-up phone interviews were conducted for one year post-baseline to assess the incidence of suicide attempts, the study's primary outcome. Sensitivity, specificity, accuracy, and F1 statistics were calculated for each screening method for identifying patients who attempted suicide. More than 65% of patients who screened positive for SI also screened positive for depression on the PHQ-9. Depression screening with the PHQ-9 correctly identified more patients who attempted suicide during follow-up than the PHQ-2, past week SI, and past month SI. The PHQ-9 correctly identified more patients who attempted suicide within 3 months than lifetime SI, but lifetime SI correctly identified more patients who attempted suicide within 6 and 12 months. Depression screening with the PHQ-9 was the most effective strategy for identifying patients who attempted suicide in the near term. Universal suicide risk screening is unlikely to meaningfully improve identification of higher-risk patients beyond PHQ-9 depression screening.

“Fine dining” in the Roman provinces: an interdisciplinary study of a peristyle house kitchen at the legionary camp of Vindonissa, Switzerland

AbstractThe peristyle house kitchen in the legionary camp at Vindonissa is one of the few examples of a Mediterranean-style kitchen with a raised hearth in the northwestern provinces. The exceptional preservation of the kitchen made possible an interdisciplinary investigation combining archaeological, archaeobiological, and micromorphological analyses in order to reconstruct dietary and food-processing practices, kitchen maintenance, and waste disposal management in a 1st-c. CE legionary camp household in Germania Superior. The kitchen infrastructure, the large ceramic inventory, and the amphorae finds together indicate a sophisticated cuisine and also food preparation for a large number of people, most likely by servants. The archaeobiological finds provide evidence that the diet was strongly Roman influenced and luxurious. These results confirm that the diet and in general the whole lifestyle of military members was strongly determined by military rank. The house was most likely inhabited by a high-ranking officer of the 11th legion.

Working Together for a Common Goal: The International Armed Forces Community Nursing Research Collaboration

Over the past 19 years, millions of military service members from the United States (U.S.) and United Kingdom (U.K.) served alongside each other in Iraq and Afghanistan. The U.S. and U.K. clearly recognize the sacrifices that the members of their armed forces have made for their respective countries. Sir Winston Churchill described the special relationship which has facilitated cooperation between the U.S. and U.K. in economic activities (trade and commerce), intelligence sharing, and the planning and execution of military operations and military medicine. It would be to the benefit of all, especially the military members, veterans, and family members, if nursing also joined in this collaborative effort. Ensuring the efforts of NATO nurse scientists and educators working to advance military, veteran, and their families’ health are aligned requires outlining key priorities across nations and identifying resources that can facilitate collaborations. To that end, with the support of the American Academy of Nursing (AAN), the International Armed Forces Community Nursing Research Collaboration (IAFNRC) was established. This manuscript provides detailed insight into the work of the IAFNRC.

Correlates of cannabis use in a sample of mental health treatment-seeking Canadian armed forces members and veterans

ObjectiveCanadian Armed Forces (CAF) members and Veterans are more likely to experience mental health (MH) conditions, such as posttraumatic stress disorder (PTSD), than the general Canadian population. Previous research suggests that an increasing number of individuals are employing cannabis for MH symptom relief, despite a lack of robust evidence for its effectiveness in treating PTSD. This research aimed to: (1) describe the prevalence of current cannabis use among MH treatment-seeking CAF members and Veterans; and (2) estimate the association between current cannabis use and a number of sociodemographic, military, and MH-related characteristics.MethodUsing cross-sectional intake data from 415 CAF members and Veterans attending a specialized outpatient MH clinic in Ontario, Canada, between January 2018 and December 2020, we estimated the proportion of CAF members and Veterans who reported current cannabis use for either medical or recreational purposes. We used multivariable logistic regression to estimate adjusted odds ratios for a number of sociodemographic, military, and MH-related variables and current cannabis use.ResultsAlmost half of the study participants (n = 187; 45.1%) reported current cannabis use. Respondents who reported current cannabis use for medical purposes had a higher median daily dose than those who reported current cannabis use for recreational purposes. The multivariable logistic regression identified younger age, lower income, potentially hazardous alcohol use, and increased bodily pain as statistically significant correlates of current cannabis use among our MH treatment-seeking sample. PTSD severity, depressive severity, sleep quality, and suicide ideation were not statistically associated with current cannabis use.ConclusionsAlmost half of our treatment-seeking sample reported current cannabis use for medical or recreational purposes, emphasizing the importance of screening MH treatment-seeking military members and Veterans for cannabis use prior to commencing treatment. Future research building upon this study could explore the potential impact of cannabis use on MH outcomes.

Benchmarking secondary outcomes to posttraumatic stress disorder symptom change in response to cognitive processing and written exposure therapy for posttraumatic stress disorder

Posttraumatic stress disorder (PTSD) has high comorbidity with other psychiatric conditions, including depression, generalized anxiety, and suicidality. Evidence-based treatments (EBTs) for PTSD are effective at reducing PTSD symptoms. However, evidence on the impact of PTSD EBTs on comorbid conditions is mixed and often uses pre-post analyses, which disregards PTSD symptom response. This study replicated and extended prior work on benchmarking quality of life to PTSD symptom response to a broader range of secondary outcomes using a research-based metric of clinically meaningful PTSD symptom change. Ninety-five active duty military members seeking treatment for PTSD participated in a randomized noninferiority trial examining two cognitive behavioral therapies for PTSD: Written Exposure Therapy and Cognitive Processing Therapy. Participants completed clinician-administered and self-rating assessments at baseline and 10 weeks post-first treatment session and were classified as PTSD treatment responders or nonresponders. Data were analyzed using generalized linear mixed effects models with repeated measures with fixed effects of time and PTSD symptom response category. PTSD treatment responders experienced significant improvements in secondary outcomes; nonresponders demonstrated statistically significant, but not clinically meaningful, comorbid symptom change. Our findings provide evidence that successfully treating PTSD symptoms may also positively impact psychiatric comorbidity.