Is Achilles tendon structure associated with functional ability and chronic ankle instability in military recruits?

OBJECTIVE: To determine the relationship between Achilles tendon (AT) structure, functional ability and chronic ankle instability (CAI) in military recruits. METHODS: Three hundred and sixty newly recruited infantry male soldiers recruited in April 2022 were assessed for AT structure by Ultrasound Tissue Characterization (UTC), for functional abilities (included proprioception ability, heel-raise test, dynamic postural balance, and hopping agility ability) and for CAI (recurrent sprains and a positive perceived instability). RESULTS: Soldiers that were identified with disorganized tendon had significantly lower heel-raise and agility scores compared to those with organized tendon structures (33.6 ± 18.1(n) vs. 49.9 ± 28.9(n), p < 0.001; and 5.39 ± 2.12(n) vs. 6.16 ± 1.90(n), p = 0.002, respectively). The best discriminator between soldiers with organized vs. disorganized structure, was heel-raise test (AUC = 0.741). Moreover, soldiers with disorganized AT structure had a higher prevalence of CAI compared with those with organized tendon structures (p < 0.05). CONCLUSION: Recruits with disorganized tendon structures displayed reduced heel-raise score, agility ability and dynamic postural-balance and greater ankle instability. Inferior tendon quality at the onset of military service is an important physical indicator to consider when seeking to manage future injuries and potential for physical performance. Pre-recruitment screening of the AT structure, CAI, and functional abilities, especially in high-intensity infantry programs, needs to be considered.

Burnout and moral injuries after foreign deployment among medical personnel of the German armed forces: a pre-post study.

Introduction: Given a high amount of workplace stressors, burnout syndrome, as a depression-related syndrome, is highly relevant for medical service soldiers. This study aims to examine their effects with regard to moral injuries and personal values following foreign deployment. Materials and methods: This longitudinal study included 91 soldiers of the German Armed Forces Medical Service. Participants completed the Maslach Burnout Inventory (MBI) and the Portrait-Value-Questionnaire (PVQ) before and after a foreign deployment as well as the Moral Injury Scale (SMBE) after deployment. Analysis has been conducted using t-tests to assess potential changes in MBI and PVQ scales between pre-test - t1 (2-4 weeks before deployment) and post-test - t2 (up to 6 months after deployment). In addition, correlations were examined between moral injuries (MI) after deployment and MBI scores at t1 and t2 as well as between personal values (PVQ t1) and MBI scores at t1 and t2. Results: The MBI subscales showed mild to moderate burnout symptoms at both pre- and post-tests, with a slight deterioration during the study period, albeit not significant. There were no significant mean differences in PVQ between measurement points. Nevertheless, PVQ self-direction and tradition at t1 correlated negatively with MBI INV at t2 (PVQ SD r = -.21, p = .043) and MBI PA at t2 (PVQ TR r = -.23, p = .027). Furthermore, the subscale PVQ power at t1 correlated positively with MBI PA at t2 (PVQ PO r = .28, p = .006), meanwhile PVQ universalism at t1 correlated positively with MBI INV at t1 (PVQ UN r = .25, p = .018). Furthermore, positive correlations were found between moral injuries at t2 (SMBE total score, SMBE_Sub1, SMBE_Sub2) and MBI subscales Emotional Exhaustion (EE; r = -.54, p = .001), Depersonalization (DP; r = .38, p = .001), and Involvement (INV; r = .30, p = .004) before and after the deployment period. No correlation was found between MI and MBI subscale Personal Accomplishment (PA). Conclusion: The results indicate that medical service soldiers exhibit mild to moderate burnout symptoms even before deployment. Significant associations between moral injuries and burnout were found in 3 out of 4 MBI subscales (EE, DP, INV). There was a significant association with a stronger moral injury and higher burnout levels, persisting both before and after the study period. Furthermore, our results suggest that personal value orientations might be meaningful predictors of burnout. Hence, causal questions regarding general work stress among medical service soldiers should be further explored in more detailed studies. Further research could lay the foundation for future approaches in psychotherapy as well as primary and secondary prevention in this field.

Evaluation of Soldiers' Knowledge and Sense of Threats Regarding Exposure to Biological Risk Factors at the Place of Service.

Exposure to harmful biological agents and the level of knowledge about specific risk factors are extremely important topics, especially among military personnel. This study evaluates the knowledge and perceptions of soldiers regarding exposure to biological risk factors during their service. This research was conducted using an online survey distributed through the WBBS research panel, in which 1331 soldiers from various demographic groups and ranks participated. The survey assessed awareness of biological threats, the level of knowledge about preventive measures, and the perceived adequacy of occupational health and safety training. The findings reveal that over 80% of respondents possess some level of knowledge about the types of biological agents they may encounter, yet significant gaps remain, particularly in training related to region-specific infectious diseases, with more than 75% of participants having not received such training. Additionally, approximately 5% of respondents reported high exposure, and around 4% reported very high exposure to harmful biological agents, highlighting the need for enhanced educational programs and preventive measures in military contexts. The study underscores the importance of continuous education and training to mitigate risks associated with biological hazards in military environments.

Association between changes in serum bone metabolism markers and bone microarchitecture changes during basic combat training - The ARMI study.

IMPORTANCE: U.S. Army Basic Combat Training (BCT) improves tibial volumetric bone mineral density (BMD) and structure in most, but not all soldiers. Few studies have investigated whether changes in serum bone biomarkers during BCT are associated with changes in tibial BMD and bone structure following BCT. OBJECTIVE: To characterize bone biomarker changes during BCT and to investigate the relationship between changes in bone biomarkers and changes in tibial BMD and bone structure. METHODS: We enrolled 235 trainees entering BCT in this ten-week prospective observational study. Trainees provided fasted blood samples and questionnaires weekly throughout BCT. Procollagen type 1 N-terminal propeptide (PINP) and C-terminal telopeptide of type 1 collagen (CTX) were measured by enzyme-linked immunoabsorbent assays every two weeks during BCT. We evaluated body composition and mass via dual-energy X-ray absorptiometry and bone structure, microarchitecture, and mineral density at the distal tibia via high-resolution peripheral quantitative computed tomography at baseline and post-BCT. RESULTS: Both male (n = 110) and female trainees (n = 125) were young (20.9 ± 3.7 and 20.7 ± 4.3 years, respectively), with normal to overweight BMIs (25.2 ± 4.1 and 24.2 ± 3.6 kg/m2, respectively). In female trainees, PINP increased during and post-BCT compared to baseline, with the greatest increase in PINP at week four (45.4 % ± 49.6, p < 0.0001), whereas there were no changes in CTX. PINP also increased in male trainees, but only at weeks two and four (21.9 % ± 24.5, p = 0.0027 and 35.9 % ± 35.8, p < 0.0001, respectively). Unlike female trainees, in males, CTX was lower than baseline at weeks four, eight, and post-BCT. The change in PINP from baseline to week four of BCT was positively associated with changes in tibial BMD, Tb.BMD, Tb.Th, Tb.BV/TV, Ct.Th, Ct.Ar, and Ct.Po from the baseline to post-BCT. CONCLUSION: The bone formation marker PINP increases during U.S. Army BCT, especially during the first four weeks. Increases in PINP, but not CTX, were correlated with improved BMD and bone structure in the distal tibia.

Limitations associated with transcranial direct current stimulation for enhancement: considerations of performance tradeoffs in active-duty Soldiers.

Introduction: Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation method, popular due to its low cost, ease-of-application, and portability. As such, it has gained traction in examining its potential for cognitive enhancement in a diverse range of populations, including active-duty military. However, current literature presents mixed results regarding its efficacy and limited evaluations of possible undesirable side-effects (such as degradation to cognitive processes). Methods: To further examine its potential for enhancing cognition, a double-blind, randomized, sham-controlled, within-subjects design, was used to evaluate both online active-anodal and -cathodal on several cognitive tasks administered. Potential undesirable side effects related to mood, sleepiness, and cognitive performance, were also assessed. Active tDCS was applied for 30 min, using 2 mA, to the left dorsolateral prefrontal cortex with an extracephalic reference placed on the contralateral arm of 27 (14 males) active-duty Soldiers. Results: We report mixed results. Specifically, we found improvements in sustained attention (active-anodal) for males in reaction time (p = 0.024, ηp 2 = 0.16) and for sensitivity index in females (p = 0.013, ηp 2 = 0.18). In addition, we found faster reaction time (p = 0.034, ηp 2 = 0.15) and increased accuracy (p = 0.029, ηp 2 = 0.16) associated with executive function (active-anodal and -cathodal), and worsened working memory performance (active-cathodal; p = 0.008, ηp 2 = 0.18). Additionally, we found increased risk-taking with active-anodal (p = 0.001, ηp 2 = 0.33). Discussion: tDCS may hold promise as a method for cognitive enhancement, as evidenced by our findings related to sustained attention and executive function. However, we caution that further study is required to better understand additional parameters and limitations that may explain results, as our study only focused on anode vs. cathode stimulation. Risk-taking was examined secondary to our main interests which warrants further experimental investigation isolating potential tradeoffs that may be associated with tDCS simulation.

Effects of 34 Weeks of Military Service on Body Composition and Physical Fitness in Military Cadets of Angola.

Military personnel need physical fitness to effectively carry out operational military activities within their specific field of operation. This research investigates the effects of a 34-week training program on Angolan cadets' body composition, muscle strength, and cardiorespiratory fitness. Seventy-four volunteer recruits, aged 18 to 26 years, were monitored during their eight-month military service, following an exercise program protocol comprising 12 weeks of strength training followed by 24 weeks of endurance training. Anthropometric variables, including body mass, body mass index, and fat mass, were assessed, along with cardiorespiratory fitness (VO2max), sprint performance, countermovement jump (CMJ), medicine ball throw, push-ups, and curl-ups. The physical training protocol encompassed running sessions, strength exercises, agility drills, and flexibility exercises. The initial assessment revealed gender differences in various parameters such as body mass, body fat percentage, VO2max, sprinting, countermovement jump (CMJ), medicine ball throw, and push-ups. Following the training program, changes were observed in all variables (effect size between 0.48 and 2.33, p < 0.01) for the participants. Significant interactions (sex × time) were found in body mass (F = 5.18, p = 0.03, ηp2 = 0.06), body fat percentage (F = 5.31, p < 0.01, ηp2 = 0.14), and medicine ball throw (F = 10.84, p < 0.01, ηp2 = 0.13). Specifically, males exhibited a greater reduction in body mass (females: 2.70%, males: 3.47%, p < 0.05) and a substantial improvement in ball throwing performance (females: 7.74%, males: 11.47%, p < 0.01), while females experienced a greater reduction in fat mass (females: 5.34%, males: 3.15%, p < 0.01). The physical training regimen effectively influenced body composition, particularly in enhancing strength performance among males. The integration of exercise programs with military service led to a notable reduction in fat tissue and an increase in lean tissue. Hence, the development of tailored training protocols is imperative to enhance the physical capacity and overall health of military recruits, considering sex-specific characteristics and physical attributes.

The nature and impacts of deployment-related encounters with children among Canadian military Veterans: a qualitative analysis.

Background: As armed conflict grows increasingly complex, the involvement of children in armed violence across diverse roles is rising. Consequently, military personnel are more likely to encounter children during deployment. However, little is known about deployment-related encounters with children and their impact on the mental health of military personnel and Veterans.Objective: This study qualitatively examines the nature and impacts of deployment-related encounters with children.Methods: We conducted semi-structured interviews with 16 Canadian Armed Forces Veterans, eliciting rich information on the nature of child encounters on deployment, the psycho-social-spiritual impacts of these encounters, and perceptions of support. Interview transcripts were analysed using thematic analysis.Results: Six primary themes were identified: types of encounters (i.e. factual aspects of deployment-related encounters with children), contextual factors (i.e. aspects of the mission, environment, and personal context relevant to one's experience of the encounter), appraisals of encounters (i.e. sensory or sense-making experiences relevant to the encounter), impacts of encounters (i.e. psycho-social, existential, and occupational impacts), coping strategies engaged in both during and after deployment, and support experiences, describing both formal and informal sources of support.Conclusions: Encounters with children are diverse and highly stressful, resulting in impacts pertinent to mental health, including psychological and moral distress, and difficulties with identity, spirituality, and relationships. These impacts are prompted by complex interactions among appraisals, expectations of morality, cultural norms, and professional duties and are amplified by various personal factors (e.g. childhood maltreatment history, parenthood), feelings of unpreparedness, and lack of post-deployment support. Implications for prevention, intervention, and policy are discussed with the aim of informing future efforts to safeguard and support military personnel facing a high likelihood of encounters with children.

Deployment-related encounters with children result in diverse impacts, including psychological and moral distress, along with disruptions in identity, spirituality, and interpersonal relationships.Encounters with children during military deployments are diverse and highly stressful, characterized by complex interactions among appraisals and expectations of morality, cultural norms, and professional duties.Emphasis on feeling unprepared for encounters with children highlights the need for future efforts to safeguard and support military personnel facing such situations.

Assessing the psychometric properties of the Army STARRS' vertical unit cohesion scale: A large-scale, longitudinal study.

Unit cohesion is the extent to which military service members feel committed to and supported by their military unit or, conversely, feel overlooked, neglected, and/or alienated. Unit cohesion reflects an important aspect of military social support and can act as a protective factor against mental health challenges, particularly in challenging situations. Theoretical suppositions and emerging evidence suggest that different types of unit support, specifically, vertical unit cohesion and horizontal unit cohesion, uniquely matter for service member well-being. Vertical unit cohesion (support from leaders in the unit and other higher-ranking positions) may be of universal importance to service members with implications for career progression and personal wellbeing, while horizontal unit cohesion (support from fellow unit members and peers) may be of importance under certain circumstances. Informed by the psychometric theory of scale development and validation, the dimensionality of unit cohesion theory, and the need for brief, sound measurement tools, this study first examined the psychometric properties of the Army STARRS four-item Vertical Unit Cohesion Scale in a longitudinal analysis with a large, diverse sample of Soldiers from the Pre/Post Deployment Study component of the Army STARRS dataset (N = 10,116). Then, exploratory analyses were conducted to examine the properties of the Horizontal Unit Cohesion Scale and understand the relationship between vertical and horizontal unit cohesion. Strong evidence for the Vertical Unit Cohesion Scale's psychometric soundness was established regarding factor structure, measurement invariance overtime, and construct validity. Conversely, preliminary evidence suggests that the three-item measure of Horizontal Unit Cohesion should be used with caution. Implications for researchers and military leadership are provided.

Examining the mediating role of personality traits in the relationship between psychological empowerment and mental health in soldiers.

PURPOSE: Paying attention to the psychological characteristics of soldiers is a matter of concern for planners and senior commanders. Therefore, this study was conducted to investigate the mediating role of personality traits in the relationship between psychological empowerment and mental health in soldiers stationed in the Kerman Province barracks. METHOD: In this cross-sectional study, 604 soldiers serving in Kerman Province barracks in the year 2021 were examined. The soldiers were selected from a cluster sampling of two barracks. Data were collected using a demographic information checklist, the Sportzier Psychological Empowerment Questionnaire (PEQ), the General Health Questionnaire (GHQ), and the NEO Personality traits (NEO). Pearson's correlation coefficient and structural equation modeling were used for data analysis. The Judd and Kenny's framework was also employed to investigate the mediating role. RESULTS: Of these individuals, 390 (46.6%) had completed their military training, while 433 (71.7%) were single. The correlation between PEQ and GHQ was inverse and non-significant (P = 0.348), between PEQ and NEO was direct and significant (P = 0.002), and between NEO and GHQ was inverse and significant (P < 0.001). In the structural equation model, the PEQ variable had a significant impact on NEO (P = 0.002), but it did not significantly affect the GHQ variable (P = 0.850). The NEO variable also had a significant impact on GHQ. CONCLUSION: The NEO variable has a full mediation effect on the relationship between PEQ and GHQ. Therefore, the use of psychologists and clinical physicians for appropriate interventions to enhance mental health, such as education, counseling, and psychotherapy, appears to be necessary.

Master resilience trainer course quality improvement evaluation.

The Master Resilience Training (MRT) course is the U.S. Army's resilience program of record to develop soldiers as resilience trainers within their home units. The Walter Reed Army Institute of Research (WRAIR) recently conducted an MRT Quality Improvement Evaluation (QIE) to understand perceptions of the MRT course, determine the effectiveness of the course, and provide revision recommendations for the next iteration of the course. Soldiers who were completing the MRT course were invited to take surveys and participate in interviews. Results from quantitative and qualitative data suggest that most participants felt satisfied with the training and that it was relevant for soldiers. Most participants also agreed that the training would help them become better soldiers and leaders. Along with positive feedback about the course, participants also identified areas that could be improved. Soldier feedback along with program evaluators' observation informed recommendations for improving the overall MRT course and its implementation. Program evaluators recommend MRT participants learn fewer and less complex skills, focus on coach education throughout the course, and highlight leader development by promoting motivation and enhancing effective communication. Program evaluators recommendations for ways to improve buy-in from leaders and graduated MRTs are also discussed.

The Postconcussion Syndrome and Posttraumatic Headaches in Civilians, Soldiers, and Athletes.

Posttraumatic headaches are one of the most common and controversial secondary headache types. After a mild traumatic brain, an estimated 11% to 82% of people develop a postconcussion syndrome, which has been controversial for more than 160 years. Headache is estimated as present in 30% to 90% of patients after a mild head injury. Most headaches are tension-type-like or migraine-like. Headaches in civilians, soldiers, athletes, and postcraniotomy are reviewed. The treatments are the same as for the primary headaches. Persistent posttraumatic headaches can continue for many years.

Typology of reasons why a person kills in a war context: The case of rebel/nationalist army combatants in the Spanish Civil War.

European historiography on wars has embarked on a study of a matter of crucial significance: the involvement of ordinary individuals as perpetrators of mass casualties. This article aims to provide insights and hypotheses concerning the underlying motives behind such actions, focusing on the unique context of the Spanish Civil War. The data utilized for this study are drawn from a sample of 112 oral interviews conducted with former combatants of the Spanish Civil War, all born between 1905 and 1920. During these interviews, 112 men participated a semi structured discussion. Individual perceptions and variables of interest relevant to acts of violence were subjected to qualitative analysis. Our analysis suggests that instances of aggression often arise because of emotional triggers, alignment with fascist ideological convictions, societal pressures and a sense of duty-driven obedience. Our results refute the notion that ideological factors alone suffice as explanations.

Predicting soldier retention from army spouse characteristics and attitudes: Soldiering on with spouse support.

The U.S. Army has a vested interest in retaining the skilled personnel necessary to achieve its mission and strategic goals. A wealth of research has investigated the retention process and what influences service member decisions to stay in the military. While families are an important influence on soldier retention decisions, research on the mechanism by which this happens is lacking. This report explores the relationship between spouse attitudes and perceptions, resource use, and soldier retention almost two years later, using a proposed theoretical model. Our results generally support our model, with the important change that resource use and unmet needs and stress were not directly associated with specific attitudes toward staying in the military as we had expected. Instead, the association was accounted for by relationship with general attitudes toward the military. Spouses whose needs were unmet after seeking help from available resources experienced greater stress, and spouse unmet needs and reports of greater stress were associated with worse general attitudes toward the military; worse general attitudes toward the military were associated with less inclination to stay a military family; which in turn predicted soldier turnover almost two years later. As the research in this report shows, providing benefits to military spouses is also associated with a tangible and important outcome for the military: improved service member retention.

Evaluation of Knowledge and Self-Awareness of Polish Soldiers Regarding Exposure to Chemical and Physical Factors in Their Place of Service/Work.

INTRODUCTION: Soldiers constitute a professional group carrying out their duties in variable, often challenging environmental conditions, including harmful and burdensome ones. MATERIALS AND METHODS: This study was conducted on a nationwide sample of 1331 soldiers. The research tool was an anonymous questionnaire comprising 48 questions. Descriptive statistics were used to describe the characteristics of the studied group. The chi-square test was employed to examine the relationship between variables. A 95% confidence interval was adopted, with a significance level of p = 0.05. RESULTS: One in four soldiers work with low and one in five with moderate exposure to harmful chemical factors. Almost 10% of respondents lack knowledge about the types of chemical factors present during their service. One in five soldiers work with low and one in eight with moderate exposure to ionizing radiation. Approximately 5% of survey participants lack knowledge about the types of physical factors. One in three soldiers are unaware of the carcinogenic and mutagenic effects of the aforementioned factors. CONCLUSIONS: The systematic enhancement of knowledge and awareness among army members will help minimize the consequences of exposure to harmful conditions.

Association between availability of direct access to army occupational therapy with return to duty in active-duty soldiers.

BACKGROUND: Upper extremity musculoskeletal injuries are common with active-duty Army Soldiers and result in increased limited duty days. Patient satisfaction and surgery rates improve with direct access to occupational therapy in the civilian community. PURPOSE: Examine the amount of time from initial evaluation following an upper extremity musculoskeletal injury (MSKI) to return to full duty plus occupational therapy (OT) utilization in Army Soldiers. STUDY DESIGN: Retrospective observational. METHODS: Electronic health records and profiles from 18,206 US active-duty Army soldiers with MSKI and OT evaluation between 2017-2018 were examined. Repeated measures generalized estimating equations provided the rate ratios (RRs) for OT healthcare utilization (total number of OT evaluations and treatment visits) by days to first OT evaluation and limited duty profile (total days on profile). RESULTS: Soldiers were on average 32.0 (SD = 8.9) y/o, predominantly senior enlisted (45.7%), white (58.0%), male (81.4%), 10.0 (SD = 8.4) years of service, and high school or less educated (51.3%). There were 22,617 UE MSKIs with an OT evaluation and 4936 UE MSKIs with profiles. Compared with UE MSKIs with an OT evaluation on the same day, there was a significant increase in rates of OT utilization for 1-7 days (RR: 1.4, 95% CI: 1.3, 1.5), 8-14 days (RR: 1.3, 95% CI: 1.2, 1.4), 15-30 days (RR: 1.4, 95% CI: 1.3, 1.5), 31-60 days (RR: 1.5, 95% CI: 1.4, 1.6), and +60 days later (RR: 1.6, 95% CI: 1.5, 1.7). Similar differences in rates for limited duty profiles were found. CONCLUSION: A greater number of days between diagnosis of UE MSKI and OT evaluation results in greater rates of OT utilization and longer temporary profile. Results suggest that earlier intervention by OT may decrease recovery and healthcare utilization of soldiers.

Being a parent of a soldier is a challenging experience - stress, anxiety, and depression among parents of Israeli soldiers.

At any given moment, a notable proportion of parents worldwide have at least one child serving in the military. The aim of this study is to assess the prevalence of depression, anxiety, and stress in the sample of parents of Israeli soldiers and to assess the difference in this prevalence by type of service (combat vs. non-combat) and other demographic characteristics of parents and soldiers. A cross-sectional study of a convenience sample of 202 Israeli parents who were interviewed during January-September 2023. Depression Anxiety Stress Scale (DASS-21) was used to measure the emotional states of depression, anxiety, and stress (with cut-off points of ≥5, ≥4, and ≥8, respectively). Having depression, anxiety, or stress was defined as psychological distress. Parents' demographics and child's service characteristics were included in the multivariable logistic regression model, with psychological distress as a dependent variable. Almost a quarter (22.8%) of parents experienced distress, defined as having high depression, anxiety, or stress score. In a multivariable model, combat service (vs. non-combat) was significantly associated with distress: parents of combat soldiers were four times more likely to report distress than parents of non-combat soldiers (OR = 3.9; 95% CI: 1.3-11.8). Highly classified service preventing the child from sharing information with the parents was significantly associated with distress (OR = 2.6; 95% CI: 1.2-5.3). Most distressed parents (78.3%) did not seek professional help, with the vast majority of those seeking assistance were female. Given the substantial proportion of parents suffering from mental distress found in this study, especially parents of combat soldiers and those serving in highly classified positions, healthcare professionals should be aware of parents' difficulties, be proactive in gathering information about their mental well-being, and be prepared to provide professional help.

Evaluating an oral health education program for Korean soldiers during the COVID-19 era: Applying quantitative light-induced fluorescent technology-A pilot study.

PURPOSE: This study aimed to provide a basis for the development of a remote oral health education program for soldiers enlisted during the COVID-19 era(August-September 2021) by conducting oral health education using quantitative light-induced fluorescent technology and then comparing Quigley-Hein Plaque Index (QHPI) and oral health knowledge, awareness, and behavior. METHODS: Thirty soldiers serving in a military hospital in South Korea were classified into two groups using simple random sampling. The experimental group implemented oral health education and self-managed using quantitative light-induced fluorescent technology, whereas the control group implemented oral health education alone. It was performed for 8 weeks at 2-week intervals. Thereafter, oral health knowledge, awareness, and behavior were surveyed, and QHPI was measured. Changes between and within groups over time were analyzed. RESULTS: QHPI was statistically significantly reduced in the experimental group over time. Oral health knowledge, awareness, and behavior scores were higher in the experimental group than in the control group, with statistically significant differences. Oral health education considering the characteristics of soldiers, who utilized quantitative light-induced fluorescent technology, was shown to be effective, and this effect requires further research through a longitudinal study. CONCLUSION: This study demonstrated that oral health education based on quantitative light-induced fluorescent technology should be a useful tool for improving the oral hygiene status, oral health knowledge, awareness, and behavior of Korean soldiers.

Study on difference in blood cell analysis of male officers and soldiers between at high altitude station and low altitude station in summer / 重庆医学

Objective To study the differences in the blood cell analysis of male officers and soldiers be-tween in the high altitude area station and low altitude area station in summer.Methods A total of 239 male officers and soldiers in the high altitude area(Amdo Xizang,average altitude 4 800 m)and 336 male officers and soldiers in the low altitude area(Nanjing,Jiangsu,average altitude 30 m)from July 18 to 24,2022 were selected as the study subjects and the differences in blood cell analysis parameters of male officers and soldiers stationed between at high altitude and low altitude areas were retrospectively analyzed.Results The eosino-phils percentage(EDS％),eosinophils count(EOS)in the high altitude group were significantly lower than thosein the low altitude group(P＜0.05),and the basophillic granulocyte percentage(BASO％),basophillic granulo-cyte count(BASO)and monocyte percentage(MONO％)were significantly higher than those in the low alti-tude group,and the differences were statistically significant(P＜0.05),but which in the both groups were in the normal reference ranges.The red blood cell count(RBC)hemoglobin(Hb)and hematocrit(HCT)in the high altitude group were significantly higher than those in the low altitude group(P＜0.05),moreover Hb and HCT in the high altitude group were in the upper limit of the medical reference range.The mean corpus-cular volume(MCV),mean corpuscular hemoglobin(MCH),mean corpuscular hemoglobin concentration(MCHC)and red blood cell distribution width-standard diviation(RDW-SD)in the high altitude group were lower than those in the low-altitude group(P＜0.05),but the both groups were in the normal reference ran-ges;there was no statistically significant difference in the erythrocyte distribution width coefficient of variation(RDW-CV)between the two groups(P＞0.05).The platelet(PLT)and thrombocytocrit(PCT)in the high altitude group were higher than those in the low altitude group,the platelet distribution width(PDW),mean platelet volume(MPV)and platelet large cell ratio(P-LCR)were lower than those in the low altitude group,and the differences were statistically significant(P＜0.05);PDW in the low-altitude group was at the upper limit of the medical reference range,and the other platelet-related indexes were in the normal range.Conclusion There are obvious differences in the blood cell analysis indicators of male officers and soldiers be-tween the high altitude area and low altitude area.

[Factors influencing patient competency and health care of service members of the German armed forces with deployment-related mental illness: A patient interview study]. / Einflussfaktoren auf die Patientenkompetenz und die Versorgung einsatzgeschädigter, psychisch erkrankter Soldat*innen der Bundeswehr: eine Interviewstudie mit Betroffenen.

BACKGROUND: The number of service members of the German armed forces suffering from deployment-related mental health problems is steadily rising. Preliminary studies have shown that less than 50 % seek professional help. There is little knowledge about the factors influencing the development of an adequate level of patient competence to cope with the complexity of the clinical picture and the care of people with operational disabilities in the interprofessional network. METHODS: The article presents data gathered by semi-structured, guided interviews from 14 affected individuals analyzing salient beliefs about the perceived factors influencing their patient competence and care through the interprofessional network of supporters inside and outside the German armed forces. Data evaluation was carried out by means of content-structuring, qualitative content analysis using the method of deductive-inductive category formation. FINDINGS: Based on the interviews conducted, we identified four groups of salient beliefs having an influence on patient competence: identify changes and limitations, recognize illness, redirect one's life, help shape one's life again, and four groups of salient beliefs having an influence on care: intangible / material support, medical supplies, psychosocial support, third-party support. All main topics could be assigned to three levels of influence (individual, individual-contextual, contextual) and stored with a total of 70 topics (codes). INTERPRETATION: The development of an effective "social structure" was named by those affected as an important influencing factor. Family members, comrades, superiors, and military GPs appear to have a significant impact on patient competence and care. The respondents' opinions about the importance of internal factors such as the soldier's self-image and fear of stigmatization are consistent with previous findings. Structural factors like supply procedures were mentioned as specific German armed forces phenomena.

Selected Exogenous (Occupational and Environmental) Risk Factors for Cardiovascular Diseases in Military and Aviation.

Cardiovascular diseases are a group of disorders of heart and blood vessels which are the leading cause of death globally. They are also a very important cause of military unsuitability especially among military pilots. Some of the risk factors cannot be modified, but a large group of them can be modified by introducing healthy habits or behaviors, such as regular physical activity, quitting of tobacco smoking, cessation of harmful alcohol consumption, or stress avoidance. Specific occupational and environmental factors, such as acceleration, pressure changes, hypoxia, thermal stress, noise, vibration, prolonged sedentary posture, difficulties in moving the limbs, shifts, work shift irregularities, circadian dysrhythmia, variations in the microclimate, motion sickness, radiation, toxicological threats, occupational stress, emotional tension, highly demanding tasks especially during take-off and landing, predominance of intellectual over physical activity, and forced operation speed against time shortage are considered as characteristic for military personnel, especially military aircrews. They are of special concern as some of them are considered as potential CVD risk factors. The aim of this study was to discuss the influence of selected occupational and environmental factors (noise, altitude, hypoxia, acceleration forces, tobacco smoking, oral health, and stress) regarding their importance for CVD risk in military professionals and military aviators. The performed revision confirmed that they are exposed to certain characteristic conditions, which may influence the CVD risk but the number of solid scientific data regarding this subject are limited. There is a great need to perform complex studies on environmental and occupational risk factors for CVDs in military personnel and military aviators as well as how to minimize their influence to prolong the state of health and military suitability of this professional groups.