RESUMO
Self-reported physical fitness has advantages in cost and time over objective methods, but previous studies demonstrate equivocal conclusions regarding validity. Methods for self-reporting are usually based on subjective judgements, while another approach includes performing field tests at home. The Norwegian military relies on the latter method for conscript selection, but its validity is unknown and should be investigated. In total 14,166 young men and women were included in the study. During conscript selection step one, the subjects were requested to perform 3,000â m run, push-up, pull-up and standing long jump tests at home, and report the results online ("self-reported measurements"). Step two took place at a conscript selection centre 1-18 months later. Here, the subjects completed a maximal treadmill test, seated medicine ball throw, pull-up and standing long jump tests ("objective measurements"). The results demonstrated correlation coefficients from 0.29 to 0.82 (P < 0.05) for self-reported vs. objective measurements, with the highest association found for self-reported and objectively measured pull-ups. Kappa values ranged from 0.05 to 0.34 (P < 0.05), with pull-ups demonstrating the highest agreement. More women than men over-reported their physical fitness. Among men and women indicating similar self-reported fitness, men's objective fitness was higher for all objective tests (effect sizes from 0.5 to 3.0). In conclusion, large variations in correlation coefficients were observed between self-reported and objectively measured physical fitness, while the kappa values indicated poor to fair agreement. The finding that more women than men over-reported their fitness level contradicts most previous studies.Highlights Low, moderate, and high correlations, and poor to fair agreements (kappa values), were observed between self-reported and objectively measured endurance and muscle strength variables.More women than men overreported their actual fitness level.Self-reported fitness based on performing field tests at home may be a feasible alternative to traditional methods which rely on self-perceived fitness.
Assuntos
Teste de Esforço , Saúde Militar , Seleção de Pessoal , Aptidão Física , Autorrelato , Feminino , Humanos , Masculino , Exercício Físico , Teste de Esforço/métodos , Teste de Esforço/estatística & dados numéricos , Força Muscular/fisiologia , Aptidão Física/fisiologia , Autorrelato/estatística & dados numéricos , Noruega/epidemiologia , Militares/estatística & dados numéricos , Saúde Militar/estatística & dados numéricos , Seleção de Pessoal/estatística & dados numéricosRESUMO
BACKGROUND: The use of temporary intravascular shunts (TIVS) in the setting of military and civilian trauma has grown in recent years, predominantly because of the mounting evidence of improved limb outcomes. We sought to characterize the use and outcomes of TIVS in trauma through a systematic review of military and civilian literature. METHODS: The MEDLINE, EBSCO, EMBASE, and Cochrane databases were searched for studies on TIVS use in military and civilian trauma settings published between January 2000 and March 2021. Reports lacking systematic data collection along with those with insufficient TIVS descriptive and outcome data were excluded. Data regarding the characteristics and outcomes of TIVS were assessed and collective syntheses of military and civilian data performed. RESULTS: Twenty-one reports were included, 14 from civilian trauma centers or databases and 7 from military field data or databases (total of 1,380 shunts in 1,280 patients). Sixteen were retrospective cohort studies, and four were prospective. Five studies had an unshunted comparison group. Shunts were predominantly used in the lower extremity and most commonly for damage control indications. Dwell times were infrequently reported and were not consistently linked to shunt thrombosis or other complications. Anticoagulation during shunting was sparsely reported and inconsistently applied. Shunted limbs had higher injury severity than unshunted limbs but similar salvage rates. CONCLUSION: Temporary intravascular shunts are effective for expeditious restoration of perfusion in severely injured limbs and likely contribute to limb salvage. There is a paucity of comparative TIVS data in the literature and no consistently applied reporting standards, so controversies regarding TIVS use remain. LEVEL OF EVIDENCE: Systematic Review, level IV.
Assuntos
Extremidades , Salvamento de Membro/métodos , Enxerto Vascular , Lesões do Sistema Vascular , Ferimentos e Lesões , Extremidades/irrigação sanguínea , Extremidades/lesões , Humanos , Saúde Militar/estatística & dados numéricos , Avaliação de Resultados em Cuidados de Saúde , Centros de Traumatologia/estatística & dados numéricos , Enxerto Vascular/efeitos adversos , Enxerto Vascular/métodos , Enxerto Vascular/estatística & dados numéricos , Lesões do Sistema Vascular/etiologia , Lesões do Sistema Vascular/cirurgia , Ferimentos e Lesões/complicações , Ferimentos e Lesões/cirurgiaRESUMO
This study described the whole blood fatty acid profile and Omega-3 Index (O3I) of Australian Army recruits at the commencement and completion of basic military training (BMT). Eighty males (17-34 y, 77.4 ± 13.0 kg, 43.5 ± 4.3 mL/kg/min) and 37 females (17-45 y, 64.3 ± 8.8 kg, 39.3 ± 2.7 mL/kg/min) volunteered to participate (N = 117). Whole blood samples of each recruit were collected using a finger prick in weeks 1 and 11 (n = 82) and analysed via gas chromatography for the relative proportions of each fatty acid (mean [95% confidence interval]). The macronutrient characteristics of the diet offerings was also determined. At commencement there was a low omega-3 status (sum of omega-3; 4.95% [4.82-5.07]) and O3I (5.03% [4.90-5.16]) and no recruit recorded an O3I >8% (desirable). The omega-6/omega-3 (7.04 [6.85-7.23]) and arachidonic acid/eicosapentaenoic acid (AA/EPA) (18.70 [17.86-19.53]) ratios for the cohort were also undesirable. The BMT mess menu provided a maximum of 190 mg/day of EPA and 260 mg/day of docosahexaenoic acid (DHA). The O3I of the recruits was lower by week 11 (4.62% [4.51-4.78], p < 0.05), the omega-6/omega-3 increased (7.27 [7.07-7.47], p < 0.05) and the AA/EPA remained elevated (17.85 [16.89-18.81]). In conclusion, Australian Army recruits' omega-3 status remained undesirable during BMT and deserves nutritional attention. Novelty: Australian Army recruits' Omega-3 Index, at the commencement of BMT, was reflective of the Western-style diet. The BMT diet offered minimum opportunity for daily EPA and DHA consumption. Every recruit experienced a further reduction of their Omega-3 Index during BMT.
Assuntos
Dieta/métodos , Ácidos Graxos Ômega-3/sangue , Ácidos Graxos/sangue , Saúde Militar/estatística & dados numéricos , Militares/estatística & dados numéricos , Adolescente , Adulto , Austrália , Estudos de Coortes , Ácidos Docosa-Hexaenoicos/sangue , Ácido Eicosapentaenoico/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
PURPOSE/BACKGROUND: Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) commonly co-occur among US military veterans. Oxytocin may have therapeutic value in treating both conditions. The potential for oxytocin to augment affective features common to PTSD and AUD, such as anger, is relevant to inform emerging treatments. METHODS/PROCEDURES: We examined the influence of intranasally administered oxytocin on connections between alcohol craving and stress-induced anger in a sample of 73 veterans (91.3% men) with co-occurring PTSD and AUD. Participants self-administered oxytocin (40 IU) or placebo (saline) 45 minutes before completing the Trier Social Stress Task (TSST). Self-reports of alcohol craving and anger were assessed pre- and post-TSST using a modified visual analog scale. Multiple regression analysis, including main effects for group, baseline craving, and their interaction, was used to predict post-TSST anger. FINDINGS/RESULTS: A marginally significant interaction was observed, suggesting a positive association between baseline craving and anger for those in the oxytocin group (B = 0.65, P = 0.01). Among those reporting low craving, participants in the oxytocin group reported significantly lower post-TSST anger than those in the placebo group. IMPLICATIONS/CONCLUSIONS: The current study is among the first to examine relevant psychosocial moderators that may influence the effects of oxytocin among veterans with comorbid PTSD and AUD. Although oxytocin attenuated ratings of anger after a stress task among those with low baseline craving, findings suggest that oxytocin may not be as effective at reducing anger, a highly salient factor in PTSD, for individuals experiencing high levels of craving. Findings are consistent with the social salience hypothesis and suggest that individual differences in alcohol craving should be considered when evaluating oxytocin as a potential treatment for individuals with comorbid PTSD and AUD.
Assuntos
Sintomas Afetivos , Alcoolismo , Ira/efeitos dos fármacos , Fissura , Ocitocina/administração & dosagem , Transtornos de Estresse Pós-Traumáticos , Veteranos/psicologia , Administração Intranasal , Sintomas Afetivos/tratamento farmacológico , Sintomas Afetivos/etiologia , Alcoolismo/complicações , Alcoolismo/diagnóstico , Alcoolismo/tratamento farmacológico , Alcoolismo/psicologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Saúde Militar/estatística & dados numéricos , Técnicas Psicológicas , Transtornos de Estresse Pós-Traumáticos/complicações , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/tratamento farmacológico , Transtornos de Estresse Pós-Traumáticos/psicologia , Tranquilizantes/administração & dosagem , Resultado do TratamentoRESUMO
The metabolically healthy obese (MHO) characterized by the absence of metabolic syndrome have shown superior cardiorespiratory fitness (CRF) and similar muscular strength as compared with the metabolically unhealthy obese (MUO). However, this finding might be biased by the baseline sedentary behavior in the general population. This study utilized 3669 physically active military males aged 18-50 years in Taiwan. Obesity and metabolically unhealthy were respectively defined as body mass index ≥ 27.5 kg/m2 and presence of at least two major components of the metabolic syndrome, according to the International Diabetes Federation criteria for Asian male adults. Four groups were accordingly classified as the metabolically healthy lean (MHL, n = 2510), metabolically unhealthy lean (MUL, n = 331), MHO (n = 181) and MUO (n = 647). CRF was evaluated by time for a 3-km run, and muscular strengths were separately assessed by numbers of push-up and sit-up within 2 min. Analysis of covariance was utilized to compare the difference in each exercise performance between groups adjusting for age, service specialty, smoking, alcohol intake and physical activity. The metabolic syndrome prevalence in MUL and MUO was 49.8% and 47.6%, respectively. The performance of CRF did not differ between MHO and MUO (892.3 ± 5.4 s and 892.6 ± 3.0 s, p = 0.97) which were both inferior to MUL and MHL (875.2 ± 4.0 s and 848.6 ± 1.3 s, all p values < 0.05). The performance of muscular strengths evaluated by 2-min push-ups did not differ between MUL and MUO (45.3 ± 0.6 and 45.2 ± 0.4, p = 0.78) which were both less than MHO and MHL (48.4 ± 0.8 and 50.6 ± 0.2, all p values < 0.05). However, the performance of 2-min sit-ups were only superior in MHL (48.1 ± 0.1) as compared with MUL, MHO and MUO (45.9 ± 0.4, 46.7 ± 0.5 and 46.1 ± 0.3, respectively, all p values < 0.05). Our findings suggested that in a physically active male cohort, the MHO might have greater muscle strengths, but have similar CRF level compared with the MUO.
Assuntos
Obesidade Metabolicamente Benigna , Aptidão Física , Adolescente , Adulto , Índice de Massa Corporal , Aptidão Cardiorrespiratória , Estudos Transversais , Humanos , Modelos Logísticos , Masculino , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Saúde Militar/estatística & dados numéricos , Força Muscular/fisiologia , Obesidade Metabolicamente Benigna/epidemiologia , Taiwan/epidemiologia , Adulto JovemRESUMO
Laboratory-based influenza surveillance was conducted in the 2019-2020 influenza season among Department of Defense (DoD) beneficiaries through the DoD Global Respiratory Pathogen Surveillance Program (DoDGRS). Sentinel and participating sites submitted 28,176 specimens for clinical diagnostic testing. A total of 5,529 influenza-positive cases were identified. Starting at surveillance week 45 (3-9 November 2019), influenza B was the predominant influenza type, followed by high activity of influenza A(H1N1)pdm09 three weeks thereafter. Both influenza B and influenza A(H1N1)pdm09 were then highly co-circulated through surveillance week 13 (22-28 March 2020). End-of-season influenza vaccine effectiveness (VE) was estimated using a test-negative case-control study design. The adjusted end-of-season VE for all beneficiaries, regardless of influenza type or subtype, was 46% (95% confidence interval: 40%-52%). The influenza vaccine was moderately effective against influenza viruses during the 2019-2020 influenza season.
Assuntos
Vacinas contra Influenza/uso terapêutico , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Saúde Militar/estatística & dados numéricos , Vigilância da População , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Influenza Humana/virologia , Alphainfluenzavirus , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , United States Department of Defense , Cobertura Vacinal/tendências , Adulto JovemRESUMO
In a study of US Marine recruits, seroprevalence of severe acute respiratory syndrome coronavirus 2 IgG was 9.0%. Hispanic and non-Hispanic Black participants and participants from states affected earlier in the pandemic had higher seropositivity rates. These results suggest the need for targeted public health strategies among young adults at increased risk for infection.
Assuntos
COVID-19 , Saúde Militar , Militares/estatística & dados numéricos , Seleção de Pessoal , SARS-CoV-2 , Fatores Etários , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/imunologia , COVID-19/prevenção & controle , Teste Sorológico para COVID-19/métodos , Teste Sorológico para COVID-19/estatística & dados numéricos , Estudos Transversais , Demografia , Feminino , Humanos , Masculino , Saúde Militar/etnologia , Saúde Militar/estatística & dados numéricos , Serviços de Saúde Militar , Seleção de Pessoal/métodos , Seleção de Pessoal/estatística & dados numéricos , Quarentena , SARS-CoV-2/imunologia , SARS-CoV-2/isolamento & purificação , Estudos Soroepidemiológicos , Estados Unidos/epidemiologia , Adulto JovemRESUMO
The prevalence of gambling harm among active duty military personnel is a largely unexplored topic. With different forms of social gambling often found within (or in close proximity to) military bases around the world, understanding the extent of gambling activities and consequent harms occurring within military contexts warrants further attention. This review aims to identify, describe and thematically synthesise published literature on gambling harm and related issues among active duty military personnel. Scoping review methods were applied in order to understand this relatively under-researched population and understand appropriate avenues for future research. A systematic multi-database text word search, incorporating search results from Scopus, Pubmed, Web of Science, PsychInfo, and the Journal Military Medicine, was conducted. A total of 11 sources met inclusion criteria, all originating from the United States of America. The results suggest a distinct gap in the current international literature on this topic. Despite gambling's long and colourful association with defence downtime, research into gambling harm prevalence rates in relation to what could be considered a high-risk group is limited. Findings reveal that strategies to identify and address gambling harm within this population are severely lacking from the published literature and non-existent outside North America. Implications for understanding and addressing gambling harm among active duty personnel and directions for future research are discussed.
Assuntos
Comportamento Aditivo/psicologia , Jogo de Azar/psicologia , Saúde Militar/estatística & dados numéricos , Militares/psicologia , Comportamento Aditivo/epidemiologia , Jogo de Azar/epidemiologia , Humanos , Militares/estatística & dados numéricos , Prevalência , Estados UnidosRESUMO
BACKGROUND: The Joint Trauma System database estimates that about 1,200 individuals have sustained a combat-related amputation during the Global War on Terror. Previous retrospective studies have demonstrated that combat-related amputees develop obesity and cardiovascular disease, but the incidence of obesity and associated comorbidities in this population is unknown. The objectives of this study are to determine the prevalence of obesity in the military amputee population and to compare this with the general population. METHODS: This is a retrospective review of 978 patients who sustained a combat-related amputation from 2003 to 2014. Prevalence of obesity and comorbid conditions were determined. A multivariate logistic regression model was performed to identify risk factors for postamputation obesity. Kaplan-Meier curves were constructed using obesity as the event of interest. RESULTS: A total of 1,233 charts were reviewed with 978 patients included for analysis. The median age of injury was 24 years. Median follow-up time was 8.7 years, ranging from 0.5 years to 16.9 years. The average Injury Severity Score was 23.3. The average body mass index preinjury was 25.6 kg/m2, and the average most recent corrected body mass index was found to be 31.4 kg/m2. Prevalence of comorbidities was higher in the amputee population. Fifty percent of patients who progressed to obesity did so within 1.3 years. CONCLUSION: There is a notable prevalence of obesity that develops in the amputee population that is much higher than the general population. We determined that the amputee population is at risk, and these patients should be closely monitored for 1 to 2.5 years following injury. This study provides a targeted period for which monitoring and intervention can be implemented. LEVEL OF EVIDENCE: Retrospective, basic science, outcomes analysis, level III/IV.
Assuntos
Amputação Cirúrgica , Saúde Militar/estatística & dados numéricos , Obesidade , Complicações Pós-Operatórias , Ferimentos e Lesões , Adulto , Amputação Cirúrgica/efeitos adversos , Amputação Cirúrgica/métodos , Amputação Cirúrgica/estatística & dados numéricos , Conflitos Armados , Índice de Massa Corporal , Comorbidade , Feminino , Humanos , Escala de Gravidade do Ferimento , Masculino , Militares , Avaliação das Necessidades , Obesidade/diagnóstico , Obesidade/epidemiologia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Prevalência , Medição de Risco/métodos , Medição de Risco/estatística & dados numéricos , Estados Unidos/epidemiologia , Guerra , Ferimentos e Lesões/diagnóstico , Ferimentos e Lesões/epidemiologia , Ferimentos e Lesões/etiologia , Ferimentos e Lesões/cirurgiaRESUMO
Morbidity and mortality from carbon monoxide (CO) poisoning are important public health problems, but their full impact is difficult to estimate. The current analysis used the 2018 Council of State and Territorial Epidemiologist criteria and International Classification of Diseases (ICD) codebased data to classify CO poisoning cases by intent, source of exposure, and degree of certainty that poisoning was CO related. During July 2009-June 2019, there were 1,288 CO poisoning cases classified as confirmed/probable among active component service members, 366 among reserve component members, and 4,754 among non-service member beneficiaries. Service members working in repair/engineering occupations accounted for the greatest proportion of confirmed CO poisoning cases among active component members and the second greatest proportion among reserve component members. Compared to suspected cases, confirmed/probable cases were more often associated with intentional self-harm and undetermined causes of injury, whereas suspected cases were more often coded as unintentional. Confirmed/probable active component and non-service member beneficiary cases were more likely than their respective suspected case counterparts to receive care in inpatient settings. The need for improvements in ICD coding to reduce the percentage of CO poisoning cases coded with unknown injury intent and/or unknown CO poisoning source is discussed.
Assuntos
Intoxicação por Monóxido de Carbono/epidemiologia , Saúde Militar/estatística & dados numéricos , Adulto , Intoxicação por Monóxido de Carbono/diagnóstico , Feminino , Humanos , Classificação Internacional de Doenças , Masculino , Pessoa de Meia-Idade , Vigilância da População , Estados Unidos/epidemiologia , Adulto JovemRESUMO
This report primarily focuses on the data collected and analyzed from the worldwide network of sentinel military treatment facilities chosen to participate in the Department of Defense Global Respiratory Pathogen Surveillance (DoDGRS) program. Sites that participated in the 2018-2019 DoDGRS program submitted 24,320 respiratory specimens for diagnostic testing. Clinical results showed a total of 5,968 positive influenza cases. In the beginning of the season, starting in surveillance week 48, influenza A(H1N1)pdm09 was the predominant subtype. The predominant subtype switched to influenza A(H3N2) beginning in week 6 and continued through the end of the season. Influenza B virus detection was less common during the surveillance period (i.e., 1% of total submitted specimens and 5% of total influenza detected). In addition to routine surveillance, the DoDGRS program also conducts vaccine effectiveness (VE) studies twice per year to determine interim and end of season estimates. Overall, the adjusted end of season VE for all dependents regardless of influenza type was 30% (95% CI: 22%-38%).
Assuntos
Vacinas contra Influenza/uso terapêutico , Influenza Humana/epidemiologia , Benefícios do Seguro/estatística & dados numéricos , Saúde Militar/estatística & dados numéricos , Vigilância da População , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Vírus da Influenza A Subtipo H1N1/imunologia , Vírus da Influenza A Subtipo H3N2/imunologia , Vacinas contra Influenza/imunologia , Influenza Humana/prevenção & controle , Influenza Humana/virologia , Masculino , Pessoa de Meia-Idade , Estações do Ano , Estados Unidos/epidemiologia , United States Department of Defense , Adulto JovemRESUMO
BACKGROUND: Recently, the UK Armed Forces have revised the ground close combat role to include women. AIMS: To assess the potential mental health impact of this initiative we examined gender differences in deployment patterns, work strain, occupational factors, mental health, alcohol use and help-seeking following operational deployment. METHODS: The study was a secondary analysis of self-report survey data; 8799 men (88%) and 1185 women (12%) provided data. A sub-sample (47%, n = 4659) provided data concerning post-deployment help-seeking. The latter consisted of 408 women (8.8%) and 4251 men (91%). RESULTS: With the exception of alcohol misuse, which was significantly lower for women, women reported significantly more common mental disorder symptoms, subjective depression and self-harm. Women were significantly more likely to seek help from healthcare providers. Men were significantly more likely to have deployed operationally and for longer cumulative periods. Subjective work strain, but not job control, was significantly lower for women whose military careers were significantly shorter. Post-traumatic stress disorder (PTSD) symptom intensity was similar to men. CONCLUSIONS: With the exception of PTSD and alcohol misuse, UK military women experience more mental health-related problems than military men. This finding was not related to the more arduous aspects of military service as women served for shorter times, deployed less and for shorter cumulative periods and were less likely to report work-related stress.
Assuntos
Transtornos Mentais/epidemiologia , Saúde Militar/estatística & dados numéricos , Militares/estatística & dados numéricos , Doenças Profissionais/epidemiologia , Fatores Sexuais , Adulto , Alcoolismo/epidemiologia , Alcoolismo/psicologia , Distúrbios de Guerra/epidemiologia , Distúrbios de Guerra/psicologia , Feminino , Comportamento de Busca de Ajuda , Humanos , Masculino , Transtornos Mentais/psicologia , Saúde Mental , Militares/psicologia , Doenças Profissionais/psicologia , Fatores de Risco , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Reino Unido/epidemiologiaRESUMO
BACKGROUND: Management of suspected serious bacterial infections (SBIs) in infants less than 3 months old is challenging. Understanding the epidemiology of SBI is necessary to inform management decisions. Recent publications have challenged the previously accepted distribution of infections by specimen source and pathogen. We sought to describe the burden of SBIs in previously healthy infants less than 90 days old. METHODS: We conducted a retrospective analysis of the Military Health System database to identify SBI cases among term infants less than 90 days of age from 2005 to 2015. We defined an SBI case as any previously healthy infant with positive cultures for a likely pathogen from blood, urine or cerebrospinal fluid. RESULTS: Of 467,462 live births between January 2005 and September 2015, 3421 infants had positive cultures. After excluding 1781 episodes with isolates considered nonpathogenic or ICD-9 codes for chronic conditions, the overall incidence of SBI was 3.1 cases/1000 live births. The SBI rate dropped from 5.0 cases/1000 live births in 2005 to 2.0 cases/1000 live births in 2015 (P < 0.001 for trend). The most common pathogen was Escherichia coli (51.3%). CONCLUSIONS: In this retrospective review of 467,462 live births, the incidence of SBI decreased from 5.0/1000 to 2.0/1000 live births over time. We identified no cases of Listeria monocytogenes. These data can help inform decisions related to treatment and management of infants with suspected bacterial infections.
Assuntos
Infecções Bacterianas/epidemiologia , Infecções Bacterianas/microbiologia , Saúde Militar , Infecções Bacterianas/diagnóstico , Biomarcadores , Estudos de Coortes , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Saúde Militar/estatística & dados numéricos , Vigilância em Saúde Pública , Estudos RetrospectivosRESUMO
The natural human sex ratio at birth (male:female) slightly favors males, and altered sex ratios might be indicative of exposure to reproductive hazards. In the U.S. Navy submarine community, there is a widespread belief that submariners are more likely to father females, but corroborating scientific evidence is limited. To assess this, Department of Defense Birth and Infant Health Research program data were used to identify 7,087 singleton infants whose fathers were considered submariners. Chi-square tests and unconditional logistic regression models were used to compare the offspring sex ratio of male submariners with 2 other active duty populations and the U.S. population. The offspring sex ratio of male submariners was 1.048, which did not substantially differ from the sex ratio of each comparison population. Furthermore, this study found no meaningful variation in offspring sex ratio by length of submarine or military service or by rating.
Assuntos
Saúde Militar/estatística & dados numéricos , Militares/estatística & dados numéricos , Razão de Masculinidade , Adulto , Serviços de Saúde da Criança/estatística & dados numéricos , Feminino , Humanos , Lactente , Masculino , Saúde Reprodutiva , Estados Unidos/epidemiologiaRESUMO
This report presents the incidence and prevalence of diagnosed female infertility among active component service women. During 2013-2018, 8,744 active component women of childbearing potential were diagnosed with infertility for the first time, resulting in an overall incidence of 79.3 cases per 10,000 person-years (p-yrs). Compared to their respective counterparts, women in their 30s, non-Hispanic blacks, those in healthcare and pilot/air crew occupations, Army personnel, and those who were married had the highest incidence rates. The incidence of diagnosed female infertility decreased from 85.1 per 10,000 p-yrs in 2013 to 63.6 per 10,000 p-yrs in 2018 despite a concurrent increase in the rate of fertility testing. During the surveillance period, the average annual prevalence of diagnosed female infertility was 1.6%. Of the service women who were diagnosed with infertility for the first time during the surveillance period, 1,808 (20.7%) delivered a live birth within 2 years after the incident infertility diagnosis. Current findings indicate that the prevalence of diagnosed female infertility among active component service women is lower than estimates of self-reported infertility from surveys of U.S. civilians and service women.
Assuntos
Infertilidade Feminina , Saúde Militar/estatística & dados numéricos , Saúde Reprodutiva/estatística & dados numéricos , Saúde da Mulher/estatística & dados numéricos , Adulto , Feminino , Humanos , Incidência , Infertilidade Feminina/diagnóstico , Infertilidade Feminina/epidemiologia , Militares/estatística & dados numéricos , Vigilância da População , Estados Unidos/epidemiologiaAssuntos
Serviços de Saúde da Criança/estatística & dados numéricos , Família , Serviços de Saúde para Idosos/estatística & dados numéricos , Benefícios do Seguro/estatística & dados numéricos , Serviços de Saúde Militar/estatística & dados numéricos , Saúde Militar/estatística & dados numéricos , Militares , Serviços de Saúde da Mulher/estatística & dados numéricos , Adulto , Fatores Etários , Idoso , Criança , Saúde da Família , Feminino , Humanos , Lactente , Masculino , Vigilância da População , Fatores Sexuais , Estados Unidos/epidemiologiaAssuntos
Efeitos Psicossociais da Doença , Transtornos Mentais/epidemiologia , Serviços de Saúde Militar/estatística & dados numéricos , Saúde Militar/estatística & dados numéricos , Militares/estatística & dados numéricos , Doenças Musculoesqueléticas/epidemiologia , Ferimentos e Lesões/epidemiologia , Adulto , Feminino , Humanos , Incidência , Masculino , Vigilância da População , Estados Unidos/epidemiologiaRESUMO
The prenatal genetic counseling process may be influenced by the patient's insurance coverage for both prenatal testing and termination. Major commercial insurance providers have different policies. TRICARE is the United States Department of Defense health program for uniformed service members. TRICARE provides coverage to approximately 9.4 million beneficiaries, including health plans, special programs, prescriptions, and dental plans. TRICARE's covered medical expenses are outlined in their policies, including those pertaining to genetic testing and termination. This qualitative study aimed to explore the extent to which insurance coverage of prenatal genetic testing and termination of pregnancy affect the genetic counseling process by exploring genetic counselors' experience with TRICARE. The majority of counselors stated that they did not change their overall counseling process for TRICARE patients. However, several counselors expressed that they changed the way they discussed cost with TRICARE patients, specifically in regard to genetic testing. Additionally, counselors provided their perceptions of their patients' emotional experiences. With the recent consolidation of the three TRICARE regions into two TRICARE Regional Office (TRO) regions and the renewal of the Laboratory Developed Tests Demonstration Project, the findings of this study are valuable in the evaluation of TRICARE's coverage of prenatal genetic services.