scholarly journals Understanding the Impact and Treatment of Moral Injury Among Military Service Members

2017 ◽  
Vol 15 (4) ◽  
pp. 399-405 ◽  
Author(s):  
Philip Held ◽  
Brian J. Klassen ◽  
Alyson K. Zalta ◽  
Mark H. Pollack
Keyword(s):  
Military Service ◽  
Moral Injury ◽  
Service Members ◽  
Military Service Members ◽  
The Impact

scholarly journals PERIACETABULAR OSTEOTOMY IN ACTIVE DUTY U.S. MILITARY PERSONNEL: A SINGLE CENTER’S EXPERIENCE WITH A MINIMUM OF TWO YEARS FOLLOW-UP

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0014
Author(s):  
Andrew S. Murtha ◽  
Matthew R. Schmitz
Keyword(s):  
United States ◽  
Military Service ◽  
Periacetabular Osteotomy ◽  
The United States ◽  
Active Duty ◽  
Service Members ◽  
Military Service Members ◽  
Active Service ◽  
The Impact

Background: The primary focus of periacetabular osteotomy (PAO) literature has been survivorship until hip arthroplasty. This endpoint overlooks its impact on young, active patients. Hypothesis/Purpose: This study sought to assess the impact of the PAO on the careers of active duty members of the United States Armed Forces. Methods: A retrospective review identified 38 patients who underwent PAO performed by a single surgeon at an academic, military medical center from January 2014 through April 2017. Twenty-one of the patients were active duty United States military service members (16 female, 5 male) and had a minimum 28 months of post-operative follow-up at the time of review. Preoperative and postoperative duty restrictions were noted and referrals to the U.S Army and U.S. Air Force Medical Evaluation Boards (MEB) were queried. Results: The average age at surgery was 25.6 years (range, 19-40y). Preoperatively, sixteen patients (94.1%) were on duty restrictions, one had been referred to the MEB, and records were not available on three patients who separated from the military prior to review. Average follow-up was 3.4 years (range, 2.3 – 5.4y). Among the patients without a preoperative MEB referral, 85.0% remained on active duty (n = 12) or completed their military service commitment (n=5). Of the fourteen patients with temporary duty restrictions preoperatively, 35.7% (n=5) were relieved of their restrictions and returned to full duty and 50% (n=7) were retained on active service with permanent duty restrictions. Such permanent duty restrictions typically consisted of modifications to the aerobic component of the semiannual military fitness testing. Six patients (28.6%) were referred to the MEB including one who was referred prior to PAO. Of these patients, two were deemed fit to retain on active service with permanent duty restrictions, two were medically separated for non-hip conditions, and two were medically separated for a hip condition. The average Veteran Affairs (VA) disability score related to hip pathology in patients referred to MEB was 16% (range 0-40%). Conclusion: This is the first study to look at the PAO in active duty military service members. In patients with symptomatic acetabular dysplasia, PAO may provide an opportunity to relieve preoperative duty restrictions and allow for continued military service. Further study with the inclusion of patient reported outcomes are necessary assess the impact of the procedure in this active patient population.

scholarly journals Longitudinal Associations of PROMIS-29 Anxiety and Depression Symptoms With Low Back Pain Impact in a Sample of U.S. Military Service Members

2021 ◽  
Author(s):  
Michael S Dunbar ◽  
Anthony Rodriguez ◽  
Maria O Edelen ◽  
Ron D Hays ◽  
Ian D Coulter ◽  
...  
Keyword(s):  
Military Service ◽  
Treatment Time ◽  
Psychological Symptoms ◽  
Service Members ◽  
Anxiety And Depression ◽  
Low Back ◽  
Military Service Members ◽  
Longitudinal Associations ◽  
The Impact ◽  
Time Point

ABSTRACT Introduction The Impact Stratification Score (ISS) is a measure of the impact of chronic low back pain (LBP) consisting of nine Patient-Reported Outcomes Measurement Information System (PROMIS-29) items, but no studies have examined the ISS or its association with psychological symptoms in military samples. This study examines longitudinal associations between psychological symptoms and the ISS among military service members. Material and Methods The study involved secondary data analysis of a sample of active duty U.S. military service members aged 18-50 years with LBP (n = 733). Participants completed the PROMIS-29 at three time points during treatment: baseline (time 1, T1), week 6 of treatment (time 2, T2), and week 12 of treatment (time 3, T3). The impact of LBP was quantified using the ISS (ranging from 8 = least impact to 50 = greatest impact). Psychological symptoms were assessed as PROMIS-29 anxiety and depression scores. Separate autoregressive cross-lagged models examined reciprocal associations of ISSs with anxiety, depression, and emotional distress scores from T1 to T3. Results Within each time point, the ISS was significantly and positively correlated with anxiety and depression. In autoregressive cross-lagged models, anxiety and depression predicted the ISS at the next time point and associations were similar in magnitude (e.g., anxiety T2 to ISS T3: β = 0.12, P < .001; depression T2 to ISS T3: β = 0.12, P <.001). The ISS did not predict future depression or emotional distress scores at any time point, but the ISS at T2 was significantly, positively associated with anxiety scores at T3 (β = 0.07, P = .04). Conclusion Psychological symptoms consistently and prospectively predict the impact of LBP as measured by the ISS among service members undergoing pain treatment. The ISS may also be associated with future anxiety but not depression. PROMIS-29 anxiety and depression items may be useful adjunctive measures to consider when using the ISS to support LBP treatment planning and monitoring with service members.

The Children of Military Service Members

2011 ◽  
Vol 81 (4) ◽  
pp. 566-618 ◽  
Author(s):  
Kris M. Tunac De Pedro ◽  
Ron Avi Astor ◽  
Rami Benbenishty ◽  
Jose Estrada ◽  
Gabrielle R. Dejoie Smith ◽  
...  
Keyword(s):  
Public Schools ◽  
Educational Research ◽  
Military Service ◽  
Military Families ◽  
Primary Objective ◽  
Service Members ◽  
Military Children ◽  
Military Service Members ◽  
Outcomes For Children ◽  
The Impact

The wars in Afghanistan and Iraq have led to concerning psychological, behavioral, and academic outcomes for children in military families. Of the 1.2 million school-aged children of military service members, only 86,000 actually attend schools administered by the Department of Defense on military installations throughout the world. The remaining military children attend schools administered by civilian public schools, private schools, and other civilian-run educational agencies. At present, there is a knowledge gap in educational research regarding military-connected schools and students. Given the lack of educational research on military children, the primary objective of this review is to outline findings from noneducational disciplinary empirical literatures that are of direct relevance to schooling for educational researchers who want to conduct studies on military-connected schools and students. The authors reviewed studies on military children and their families that examined links between special circumstances and stressors as well as outcomes that are known to impact students’ school experiences. A synthesis of literature generated six themes: mental health in military families, child maltreatment, the impact of deployment on military children and families, the reintegration experience, war-related trauma of the returning veteran parent, and the experience of Reservist and Guard families in civilian contexts. The article concludes with a heuristic model for future educational research, including linkages to school reform.

Prospective study of anxiety, post-traumatic stress and depression on postural control, gait, otolith and visuospatial function in military service members with persistent post-concussive symptoms

2019 ◽  
pp. 271-287
Author(s):  
◽  
Andrew Lewandowski ◽  
Lindell K. Weaver ◽  
◽  
◽  
...  
Keyword(s):  
Brain Injury ◽  
Postural Control ◽  
Traumatic Stress ◽  
Military Service ◽  
Service Members ◽  
Post Traumatic Stress ◽  
High Anxiety ◽  
Affective Symptoms ◽  
Military Service Members ◽  
Post Traumatic

Purpose: Military service members often report both affective and vestibular complaints after mild traumatic brain injury (mTBI), but associations between symptoms and vestibular deficits can be subtle and inconsistent. Methods: From two complementary studies, one of military service members with persistent post-concussive symptoms after mTBI (NCT01611194) and the other of adult volunteers with no history of brain injury (NCT01925963), affective symptoms were compared to postural control, gait, otolith and visuospatial function. Results: The studies enrolled 71 participants with mTBI and 75 normative controls. Participants with mTBI had significantly reduced postural equilibrium on the sensory organization test (SOT), and more so in those with high anxiety or post-traumatic stress. Cervical and ocular vestibular evoked myogenic potentials (cVEMP; oVEMP) showed prolonged latencies in mTBI participants compared to controls; oVEMPs were significantly delayed in mTBI participants with high anxiety, post-traumatic stress or depression. A subset of the mTBI group had abnormal tandem gait and high anxiety. Anxiety, posttraumatic stress, and depression did not correlate with performance on the 6-Minute Walk Test, visuospatial neuropsychological measures, and the Satisfaction with Life Scale in the mTBI group. Conclusions: In this study military service members with mTBI reported affective symptoms, concurrently with vestibular-balance concerns. Worse scores on affective measures were associated with abnormal findings on measures of postural control, gait and otolith function.

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