Years Of Active Duty Research Articles

Companion interview

Abstract Neale Roach is one of the BSAVA’s unsung heroes toiling behind the scenes to keep the Association on the road. After more than 25 years of active duty in the service of the North West region, he has decided to stand down. He told John Bonner about some of the highlights…

Health Conditions Among Navy Submariners at the End of Active Duty; A Retrospective Cohort Study.

Maintaining healthy, well-trained, and highly qualified armed forces is critical for ensuring military readiness. The purpose of this article is to contribute to the body of research focused on the health of U.S. Navy submariners and to identify the health conditions of U.S. Navy submariners during their final year of active duty service. In this retrospective cohort study, we examined medical records and personnel files of separating U.S. Navy sailors who were: (1) active duty between 2009 and 2018; (2) separated before 2019; and (3) were assigned to a submarine for at least 30 days. Both officers and enlisted service members were included. We linked, described, and analyzed data from the Defense Health Agency, Military Health System Data Repository (MDR), and the Bureau of Naval Personnel (BUPERS). International Classification of Diseases (ICD) diagnoses codes were obtained from MDR. Data collected from BUPERS include age, sex, and rank. We determined the number of individuals who had at least one diagnosed condition (identified as a three-digit ICD code). We report the number of diagnoses and calculate prevalence rates and confidence intervals per condition, as well as prevalence rates per year, using standard formulas. The study was approved by the Naval Submarine Medical Research Laboratory Institutional Review Board. During the study period, 26,014 submariners separated from the Navy. The average number of separations per year was 2,601. About a third of the separating submariners were in the 25 to 29 age group and over 50% were under 30 years of age. Of the three-digit individual ICD codes, some of the highest operationally relevant rates over the 10-year study period (2009-2018) were for joint disorders (prevalence rate [PR] = 180 per 1,000 submariners), back disorders (PR = 128), and sleep disorders (PR = 134). Three mental-health-related conditions were also among the 20 conditions with the highest rates. High rates of specific diagnoses such as joint disorders indicate the need for additional study to examine causal relationships, to determine which conditions may contribute to lost work time, early separations, or low rates of reenlistment and which conditions might be a result of specific military occupations or duties. Study strengths are the large number of subjects and the long period of observations. A study weakness was the inability to identify submariners who separated because of health conditions. The overall impact of the study is that it identifies urgent health risks and establishes a way to prioritize future research. Future research should include a focus on medically separated personnel; compare rates for submariners to other military groups including all-Navy and all-Department of Defense; and determine specific and relative risks as a necessary precursor to developing, implementing, and testing risk reduction and health improvement interventions.

Deborah Zimmermann, DNP, RN, NEA-BC, FAAN

Deborah Zimmermann, DNP, RN, NEA-BC, FAAN, is chair of the American Organization for Nursing Leadership (AONL) Foundation.

Physical performance, demographic, psychological, and physiological predictors of success in the U.S. Army Special Forces Assessment and Selection course

This study assessed predictors of successful selection in the very challenging and stressful United States Army Special Forces Assessment and Selection (SFAS) course among 800 Soldiers. A battery of measures were collected during the course and their ability to predict selection were assessed using logistic regression and chi-square tests. Physical performance measures were most predictive, including road march times, land navigation coordinates found, run times, fitness test score, obstacle course score, and pull-ups (p < .05). Soldiers that were officers or 18× enlisted (fast-tracked to SFAS), had <1 year of active duty, ≥ bachelor degree, no children, were not married, and were Ranger school graduates were more likely to be selected (p < .05). Several psychological measures were predictive, including intelligence quotient, grade level equivalents, resilience score, military aptitude score, and grit (p < .05). Basal serum physiological markers weakly predicted selection and were weakly associated with behavioral assessments. Lower C-reactive protein (< 9.5 nmol/L) and higher cortisol and sex-hormone binding globulin (SHBG) predicted selection (p < .05). Higher C-reactive protein (≥ 9.5 nmol/L) was associated with lower fitness test scores and slower road march time (p < .05). Cortisol was correlated with higher grit and resilience scores (p < .05). SHBG correlated with higher grade level equivalents and better performance on pull-ups, land navigation, obstacle course, and the fitness test (p < .05). Testosterone was correlated with faster run and road march times (p < .05). Dehydroepiandrosterone-sulfate (DHEA-S) correlated with lower resilience scores, and DHEA-S, epinephrine, and norepinephrine correlated with worse performance on several physical events (p < .05). These findings suggest measures that could be targeted in interventions to monitor and enhance performance and resilience.

Advancing Knowledge of Soil Fertility and Nutrient Management—Leo Walsh Lectureship

Advancing Knowledge of Soil Fertility and Nutrient Management—Leo Walsh Lectureship

Cortisol response to an experimental stress paradigm prospectively predicts long-term distress and resilience trajectories in response to active police service

Heterogeneity in glucocorticoid response to experimental stress conditions has shown to differentiate individuals with healthy from maladaptive real-life stress responses in a number of distinct domains. However, it is not known if this heterogeneity influences the risk for developing stress related disorders or if it is a biological consequence of the stress response itself. Determining if glucocorticoid response to stress induction prospectively predicts psychological vulnerability to significant real life stressors can adjudicate this issue. To test this relationship, salivary cortisol as well as catecholamine responses to a laboratory stressor during academy training were examined as predictors of empirically identified distress trajectories through the subsequent 4 years of active duty among urban police officers routinely exposed to potentially traumatic events and routine life stressors (N = 234). During training, officers were exposed to a video vignette of police officers exposed to real-life trauma. Changes in salivary 3-methoxy-4-hydroxyphenylglycol (MHPG) and cortisol in response to this video challenge were examined as predictors of trajectory membership while controlling for age, gender, and baseline neuroendocrine levels. Officers who followed trajectories of resilience and recovery over 4 years mounted significant increases in cortisol in response to the experimental stressor, while those following a trajectory of chronic increasing distress had no significant cortisol change in response to the challenge. MHPG responses were not associated with distress trajectories. Cortisol response prospectively differentiated trajectories of distress response suggesting that a blunted cortisol response to a laboratory stressor is a risk factor for later vulnerability to distress following significant life stressors.

Positive and negative emotion prospectively predict trajectories of resilience and distress among high-exposure police officers.

Responses to both potentially traumatic events and other significant life stressors have been shown to conform to discrete patterns of response such as resilience, anticipatory stress, initial distress with gradual recovery, and chronic distress. The etiology of these trajectories is still unclear. Individual differences in levels of negative and positive emotion are believed to play a role in determining risk and resilience following traumatic exposure. In the current investigation, we followed police officers prospectively from academy training through 48 months of active duty, assessing levels of distress every 12 months. Using latent class growth analysis, we identified 4 trajectories closely conforming to prototypical patterns. Furthermore, we found that lower levels of self-reported negative emotion during academy training prospectively predicted membership in the resilient trajectory compared with the more symptomatic trajectories following the initiation of active duty, whereas higher levels of positive emotion during academy training differentiated resilience from a trajectory that was equivalently low on distress during academy training but consistently grew in distress through 4 years of active duty. These findings emerging from a prospective longitudinal design provide evidence that resilience is predicted by both lower levels of negative emotion and higher levels of positive emotion prior to active duty stressor exposure.

THE CLASSIC: Socket Wear in Charnley Low Friction Arthroplasty of the Hip

THE CLASSIC: Socket Wear in Charnley Low Friction Arthroplasty of the Hip

Obesity and Cardiovascular Disease Risk Factors in Firefighters: A Prospective Cohort Study

Obesity, despite being a significant determinant of fitness for duty, is reaching epidemic levels in the workplace. Firefighters' fitness is important to their health and to public safety. We examined the distribution of BMI and its association with major cardiovascular disease (CVD) risk factors in Massachusetts firefighters who underwent baseline (1996) and annual medical examinations through a statewide medical surveillance program over 5 years of follow-up. We also evaluated firefighters' weight change over time. The mean BMI among 332 firefighters increased from 29 at baseline to 30 at the follow-up examination (2001), and the prevalence of obesity increased from 35% to 40%, respectively (p < 0.0001). In addition, the proportion of firefighters with extreme obesity increased 4-fold at follow-up (from 0.6% to 2.4%, p < 0.0001). Obese firefighters were more likely to have hypertension (p = 0.03) and low high-density lipoprotein-cholesterol (p = 0.01) at follow-up. Firefighters with extreme obesity had an average of 2.1 CVD risk factors (excluding obesity) in contrast to 1.5 CVD risk factors for normal-weight firefighters (p = 0.02). Finally, on average, normal-weight firefighters gained 1.1 pounds, whereas firefighters with BMI > or = 35 gained 1.9 pounds per year of active duty over 5 years of follow-up. Obesity is a major concern among firefighters and shows worsening trends over time. Periodic medical evaluations coupled with exercise and dietary guidelines are needed to address this problem, which threatens firefighters' health and may jeopardize public safety.

Overview: Multilateral/Extended Reach (July 2005)

Ret-ro-spec-tion (n): the act or process of surveying the past. What does retrospection have to do with multilateral (ML) and extended reach (ER) wells? By the time this issue of JPT is published, I will have retired from 31 years of active duty in the oil patch. Reaching this milestone made me think about the past and the advances in drilling technology and practices. Approximately 25 years ago, directional drilling was used predominantly to develop reserves, mostly offshore, that could not be accessed any other way. Around 1980, horizontal wells changed that mindset and directional drilling became a reservoir-management tool. The idea of horizontal wells or drain holes was not new; successful applications of the technique were reported as early as 1929.1 Instead of discussing why horizontal wells took 50 years to catch on, let us look at some key well-construction technologies that made it a reality. By the late 1980s, several technologies—measurement while drilling, steerable motors, top drives, and polycrystalline diamond compact bits2—combined to increase drilling efficiency and reduce drilling and reservoir risk. When first introduced, these technologies were sold as time savers—through connections, surveys, trips, or increased rate of penetration. We know these efficiencies are tangible, but the real value is the drilling system that made horizontal wells an effective reservoir-development tool. The industry first considered ER technology in the early 1980s to access reserves beyond the original development area from offshore platforms—many of these developments were based on pre-1980s directional-drilling limits of 60°. In these cases, ER wells were more cost-effective than a second platform or subsea completions. However, it was not long before ER wells became an option in the development of offshore reserves from an onshore pad or the basis of a new development plan. The one-trip retrievable whipstock is considered an enabling technology for MLs. Introduced in the early 1990s, it was considered a timesaving tool. But when combined with Technology Advancement of Multilaterals Level 1, 2, or 3 junctions, this technology resulted in the economical development of several heavy-oil projects. Once again, the real value was in effectiveness, not efficiency. World-class wells of 10 years ago are considered routine today. What will a world-class well look like 10 years from now? I cannot answer that question. But I am confident that value-adding technologies will be those that break current paradigms, not those that enable us to do things faster or cheaper. I will be watching these pages for the answer.

Burden of disease associated with overweight and obesity among U.S. military retirees and their dependents, aged 38–64, 2003

Purpose The prevalence of overweight and obesity is increasing in the general US population and in beneficiaries of the Department of Defense (DoD) Military Healthcare System. The purpose of this study was to describe the prevalence and correlation of overweight, obesity and associated co-morbidities in the DoD beneficiary population. Methods A cross-sectional analysis was preformed on data from the DoD's 2003 Population Health Survey. Prevalence odds ratios (POR) were used to describe the association between overweight and obesity categories and prevalence of co-morbidities. Results Eighty percent of men and 60% of women were overweight or obese and 33% of men and 29% of women were obese. The PORs increased in magnitude corresponding to increasing BMI categories for all co-morbidities. The percent of individuals reporting between 2 and 4 co-morbidities also increased with increasing weight class. Conclusions Overweight, obesity and associated co-morbidities are prevalent among DoD beneficiaries. Overweight and obese individuals have an increased prevalence of co-morbidities compared to normal weight individuals. Twenty plus years of active duty in the military does not confer any long-term protection against overweight, obesity or the associated co-morbidities. The DoD should emphasize prevention in order to reduce healthcare costs and the disease burden in this cohort.

Are Overweight and Obese Airmen at Greater Risk of Discharge from the United States Air Force?

This study examined whether overweight or obesity results in greater discharge risk from basic military training (BMT) or during the first year of service in the U.S. Air Force (USAF). Participants were 32,144 male and female airmen who underwent BMT from August 1995 to August 1996 and were classified as underweight (body mass index [BMI] < 18), normal range (BMI = 18-24.9), overweight (BMI = 25-29.9), or obese (BMI > or = 30). Underweight airmen were 63% more likely and overweight airmen were 24% more likely to be medically discharged during BMT compared with individuals in the normal range. Underweight airmen were 22% more likely to be discharged within the first year of service compared with those in the normal range, whereas overweight airmen were 15% less likely to be discharged. These findings do not support overweight or obesity as being major causes for discharge from the USAF within the first year of active duty.

Prediction of police officer performance with the inwald personality inventory

The Inwald Personality Inventory (IPI) was administered to police officer applicants during pre-employment psychological screening. Scores were used to predict applicant performance, as rated by supervisors, after one year of active duty and change in performance over a 10-month period. Performance was significantly predicted by IPI scales, including Family Conflicts, Guardedness, and Driving Violations. These findings support the predictive validity of the IPI and identify specific characteristics of applicants that may influence performance in the field.

Health Status of Women in the Armed Forces

This article examines a study of the health status and attrition rates of three 5-year cohorts of U.S. Navy women (n = 119,167) who enlisted between 1973 and 1987. Comparisons also were conducted with women's data from other branches of the military. Results show that pregnancy-related conditions, primarily childbirth, were the leading reasons for a hospitalization, followed by genitourinary conditions and mental disorders. The most frequently occurring reasons for a premature separation were for pregnancy/parenthood and unsuitability. The time interval of greatest vulnerability for a hospitalization or separation tended to be after the first year of active duty. Such findings support the need for further research on the psychosocial correlates of early active-duty pregnancies as well as for the implementation of such training programs as planned parenthood.

Thank You, Uncle Sam: Letters of a World War II Army Nurse From North Africa and Italy

Eugenia Kielar graduated from Temple University Hospital School of Nursing in 1942. Like so many other health care workers caught up in the patriotism of the war effort, she enlisted in 1943. This book is a collection of letters written to her parents during her two years of active duty. Through her chatty correspondence the reader becomes involved in the daily activities of those dedicated professionals who cared for the wounded in the less than ideal environments of war-torn North Africa and Italy. Entire hospital staffs were organized stateside and transported to areas close to the battlefields. Hospitals were often crude tent structures or were set up in abandoned buildings. Leaking tents, dirt floors, inadequate heating, and outside toilets added elements of adventure as well as frustration. Field hospitals and clearing stations were closer to the action and even more primitive. For history buffs or those who lived during World

Epilogue: The pathologist

The pathologist writing an epilogue on postoperative pediatric cardiology reflects in an inverse way on the striking progress that has been made in this field. Mary Allen Engle and Joseph Perloff, who invited me to write this piece, suggested that I concentrate on personal experiences. Thus, I review some experiences of the past 35 years as a pathologist whose work involved the field of congenital heart disease. I shall concentrate on my own experiences and, in doing so, I shall not refer to the specific and significant contributions of others to our present knowledge of the pathology of congenital heart disease. Nevertheless, it would be inappropriate to omit the names of others who, during the period involved, have provided numerous additions to our understanding of the pathologic complexities of the area simply called congenital heart disease. Particular recognition should paid to Maurice Lev, whose work in the field antedates my own. Properly added to Lev’s name are those of Richard Van Praagh, Robert Van Mierop, William Roberts, Jack Titus and Saroja Bharati. In 1946, after almost 4 years of active duty as a pathologist in the Army during and after World War II, I was invited to join the Mayo Clinic staff. Here I found adequate material, a willingness of the institution to aid one in his work and, in particular, an accumulation of people from whom a team, without committee planning, naturally developed. I found those people involved in cardiovascular disease to be generous in sharing their special knowledge and skills with those in other subspecialties, recognizing that interchange of ideas is a stimulus for progress-progress to the point where the total effect is greater than the sum of its parts. Also, the time was ripe for progress.

Organizational Conditions Affecting Withdrawal Intentions and Decisions as Moderated by Work Experience

Numerous studies of withdrawal from work organizations have considered demographic and other personal history characteristics of leavers. Relatively few of these studies have incorporated dynamic situational characteristics in their designs. In the present effort, the relationship between perceived characteristics of the work environment and stated intentions to reenlist were examined for two groups of first-term Navy enlistees: 198 with less than one year of active duty and less than six months of sea duty, and 516 personnel with more than one year of active duty and more than six months of sea time. It was hypothesized that: (a) the relationship between organizational conditions and intent to reenlist would be weaker for new members than for experienced men, (b) that new personnel would be most likely to change their intentions over time, and (c) that new personnel would quickly assimilate the beliefs, values, and perspectives of their more experienced co-workers. Hypothesis 1 was not supported although the pattern of relationships was in the predicted direction. Hypotheses 2 and 3 were supported. The authors discuss the need for research which emphasizes the impact of initial expectation and organizational socialization on the withdrawal decision process.

The Fate of School Dropouts in the Marine Corps

A group of 3,731 marines on whom age and educational status at enlistment were available were studied. At the end of two years of active duty, subjects were classed as Non‐success if they presented evidence of unsatisfactory adjustment to the Corps. All other subjects were classed as Success. The Success rates of different classes of subjects by educational grouping are shown. The hypothesis that subjects who complete high school before enlistment have higher Success rates than do those who drop out of school, and that, of the dropouts, those completing their education after enlistment have a higher Success rate than those who do not complete their education, was supported.

MARINE ENGINEERING NOTES FROM THE SOVIET PRESS

Naval Engineers JournalVolume 74, Issue 4 p. 733-740 MARINE ENGINEERING NOTES FROM THE SOVIET PRESS COMMANDER BERNARD M. KASSELL, COMMANDER BERNARD M. KASSELL USN (RET.) The author enlisted in the Navy in 1931, and served continuously until his retirement. He attended Cornell University and Maryland University, obtaining his B.S. degree in Military Science from the latter institution. He has had a wide range of duty assignments, including tours as Engineer Officer and Repair Officer on various ships and tenders. He was recently stationed in Casablanca, Morocco as Commanding Officer, Military Sea Transport Service and retired after 29 years of active duty. His last duty station was in the Office of the Chief of Naval Operations. Is now engaged in consulting and independent research on Soviet affairs.Search for more papers by this author COMMANDER BERNARD M. KASSELL, COMMANDER BERNARD M. KASSELL USN (RET.) The author enlisted in the Navy in 1931, and served continuously until his retirement. He attended Cornell University and Maryland University, obtaining his B.S. degree in Military Science from the latter institution. He has had a wide range of duty assignments, including tours as Engineer Officer and Repair Officer on various ships and tenders. He was recently stationed in Casablanca, Morocco as Commanding Officer, Military Sea Transport Service and retired after 29 years of active duty. His last duty station was in the Office of the Chief of Naval Operations. Is now engaged in consulting and independent research on Soviet affairs.Search for more papers by this author First published: November 1962 https://doi.org/10.1111/j.1559-3584.1962.tb05407.x AboutPDF ToolsExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Volume74, Issue4November 1962Pages 733-740 RelatedInformation

MARINE ENGINEERING NOTH FROM THE SOVIET UNION

Naval Engineers JournalVolume 74, Issue 3 p. 571-581 MARINE ENGINEERING NOTH FROM THE SOVIET UNION COMMANDER BERNARD M. KASSELL USN (RET), THE AUTHOR enlisted in the Navy in 1931, and served continuously until his retirement. He attended Cornell University and Maryland University, obtaining his B.S. degree in Military Science from the latter institution. He has had a wide range of duty assignments, including tours as Engineer Officer and Repair Officer on various ships and tenders. He was recently stationed in Casablanca, Morocco as Commanding Officer, Military Sea Transport Service and retired after 29 years of active duty. His last duty station was in the Office of the Chief of Naval Operations. Is now engaged in consulting and independent research on Soviet affairsSearch for more papers by this author COMMANDER BERNARD M. KASSELL USN (RET), THE AUTHOR enlisted in the Navy in 1931, and served continuously until his retirement. He attended Cornell University and Maryland University, obtaining his B.S. degree in Military Science from the latter institution. He has had a wide range of duty assignments, including tours as Engineer Officer and Repair Officer on various ships and tenders. He was recently stationed in Casablanca, Morocco as Commanding Officer, Military Sea Transport Service and retired after 29 years of active duty. His last duty station was in the Office of the Chief of Naval Operations. Is now engaged in consulting and independent research on Soviet affairsSearch for more papers by this author First published: August 1962 https://doi.org/10.1111/j.1559-3584.1962.tb04854.x AboutPDF ToolsExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinked InRedditWechat Volume74, Issue3August 1962Pages 571-581 RelatedInformation