Job requirements and physical demands (JRPD) questionnaire: cross-cultural adaptation and psychometric evaluation in Iranian Army personnel with chronic low back pain

Background Biomechanical risk factors have been identified as the main predisposing factor of chronic low back pain (CLBP), especially in Army personnel. The Job Requirements and Physical Demands (JRPD) questionnaire has been developed to assess the biomechanical exposures related to CLBP. Examining the biomechanical risk factors could prevent CLBP. This study aimed to translate and cross-culturally adapt the JRPD into Persian and assess its psychometric properties among Iranian male Army personnel with CLBP. Methods In this cross-sectional study, the content validation of the JRPD was assessed after translating to Persian. The Persian JRPD was administered to 198 male Army personnel with CLBP, with an interval of 7 days, to assess test-retest reliability, including Cronbach’s α, intraclass correlation coefficients (ICC), standard error of measurement (SEM), and minimal detectable change at 95% confidence interval (MDC95%). Scores of the Persian JRPD were correlated with the scores of visual analog scale (VAS), Borg’s category-ratio (CR10) scale, general health questionnaire-28 (GHQ-28), and physical functioning (PF1 and PF2) subscale of the 12-item short-form health survey (SF-12) to assess convergent validity using Spearman correlation for a priori hypotheses. Results The Persian JRPD had good content validity evidenced by the higher content validity index (> 0.70). The questionnaire had a significant positive negligible to weak correlation with the VAS (rho = 0.27; p < 0.001), Borg’s CR10 scale (rho = 0.19; p = 0.009), and the total score of GHQ-28 and its domains (rho ≤0.34; p < 0.05); and significant negative weak correlation with PF2 (rho = − 0.27; p < 0.001) and significant negative moderate correlation with PF1 (rho = − 0.35; p < 0.001), thus confirming the priori hypotheses (89%, 8/9). The internal consistency and ICC (α = 0.91; ICC = 0.80) were highly adequate, with SEM and MDC95% of 7.91 and 21.3 respectively. Conclusions The JRPD was successfully adapted into Persian and had adequate psychometric properties in terms of content and convergent validity, internal consistency, and test-retest reliability. The questionnaire is found useable to assess the CLBP-related biomechanical exposures in Iranian male Army personnel.

Awareness on Heart Diseases among Bangladesh Army Personnel

Introduction: Heart diseases are global public health problem. In 2015, 14.31% of total death in Bangladesh was due to coronary heart disease. Moreover in 2016, 2(two) recruits and 1(one) officer of Bangladesh army encountered sudden death due to cardiac arrest. Objective: To ascertain the level of knowledge, awareness and health practice regarding the threat of cardiovascular diseases among Bangladesh Army personnel. Materials and Methods: This cross-sectional observational study was conducted among 242 members of Bangladesh Army in different training centers and school under Army training and doctrine command (ARTDOC), units of 19 infantry division, Battle group of ARTDOC and Head quarter (HQ) ARTDOC, from February to July 2017. Results: Among the respondents, 56.2%, 45% and 44.6% respectively mentioned tobacco smoking, obesity and sedentary life style are the causes of heart disease and 62%, 42%, 31%, 10% and 2% mentioned that chest pain, shortness of breathing, sweating, radiating pain in jaw and extremity and snoring-sleep apnea are the symptoms and signs of heart disease. Conclusion: From the study it was revealed that, majority of the respondents had poor level of knowledge on awareness of heart disease. Adequate effort may be taken to increase the awareness by expert professionals and social media. JAFMC Bangladesh. Vol 16, No 2 (December) 2020: 47-50

Mental Disorders, Gun Ownership, and Gun Carrying Among Soldiers After Leaving the Army, 2016–2019

Objectives. To examine associations of current mental and substance use disorders with self-reported gun ownership and carrying among recently separated US Army soldiers. Veterans have high rates of both gun ownership and mental disorders, the conjunction of which might contribute to the high suicide rate in this group. Methods. Cross-sectional survey data were collected in 2018–2019 from 5682 recently separated personnel who took part in the Army Study to Assess Risk and Resilience in Servicemembers. Validated measures assessed recent mood, anxiety, substance use, and externalizing disorders. Logistic regression models examined associations of sociodemographic characteristics, service characteristics, and mental disorders with gun ownership and carrying. Results. Of the participants, 50% reported gun ownership. About half of owners reported carrying some or most of the time. Mental disorders were not associated significantly with gun ownership. However, among gun owners, major depressive disorder, panic disorder, posttraumatic stress disorder, and intermittent explosive disorder were associated with significantly elevated odds of carrying at least some of the time. Conclusions. Mental disorders are not associated with gun ownership among recently separated Army personnel, but some mental disorders are associated with carrying among gun owners. (Am J Public Health. 2021;111(10):1855–1864. https://doi.org/10.2105/AJPH.2021.306420 )

Triggering Mechanisms of Gayari Avalanche, Pakistan

A massive snow avalanche occurred on April, 2012 at Gayari, located in NE part of Pakistan, close to India and China Border. The catastrophic avalanche killed nearly 148 people, majority of which were Pakistan army personnel destroying army base camp. To mitigate its future hazard, different triggering mechanisms have been investigated in this study. We contemplate that the avalanche was triggered due to snow pack existence on favorable slope in combination with different meteorological conditions and anomalous ground vibration. The avalanche occurrence clock was advanced by two earthquakes: M4.1 at a distance ∼ 125 km that occurred about 21 hours before and another comparatively larger (M5.6) earthquake that occurred comparatively at larger distance (∼ 370 km) and longer time (∼ 25 days) before which have significantly changed the loading conditions. The latter event (M 5.6) has imparted maximum peak dynamic stress and cumulative seismic moment a month before the avalanche. Interestingly the avalanche occurred within the seismic coda of M2.8 earthquake from Hindu Kush region, located at 560 km distance. Although the size and its expected impact on avalanche might be minor but its role in instantaneous triggering cannot be ruled out. Even smaller events at larger distance have been reported to cause snow avalanches in same environments. The presence of cracks within the avalanche, were further weaken by persistence of extremely low temperature (lowest in the past decade), causing high precipitation rate along with altering the mechanical properties of the weak layer within the snow pack. Robust wind pressure pattern highest and lowest in March and April, 2012 respectively might be responsible for abrupt changes in loading conditions.

Prevalence and Predictors of Overweight and Obesity among Military Personnel with Low Socio-Economic Status in Kuala Lumpur

Background: It is a major public health concern when 52% of adults worldwide were overweight and obese. Military institutions worldwide were included, which led to negative impacts on the overall combat readiness due to the obesity-associated-diseases. This study determined the prevalence and predictors of overweight and obesity among the low socioeconomic status (SES) army personnel in Kuala Lumpur. Methods: A cross-sectional study involving 772 low SES army personnel in Kuala Lumpur was conducted. Online questionnaires were distributed while anthropometric measurements’ data were obtained from Military Lifetime Health Record (MLHR) system with BMI of > 25kg/m2 as the outcome. Data analysed using SPSS version 23.0 (descriptive and inferential statistics). Results: The median age of the respondents was 30 (IQR=7) years. The prevalence of overweight and obese army personnel was 41.1% (95%CI:37.6-44.6). The predictors found were being married (AOR:2.026,95%CI:1.318-3.113), secondary education (AOR:2.545,95%CI:1.245-5.203), Lance Corporal (AOR:1.994,95%CI:1.061-3.748), Corporal (AOR:2.814,95%CI:1.578-5.020), Sergeant (AOR:4.174,95%CI:2.076-8.390), past injury (AOR:1.879,95%CI: 1.191-2.965), history of obese sibling (AOR:1.737,95%CI:1.013-2.973), history of obese parent (AOR:3.344,95%CI:1.965-5.688), history of obese grandparent (AOR:11.321,95%CI:2.207-58.072), poor knowledge on dietary intake (AOR:1.524,95%CI:1.077-2.157), less than 2 litres daily plain water intake (AOR:1.606,95%CI:1.166-2.210). Conclusions: Knowledge on dietary intake and plain water intake are the two modifiable predictors for overweight and obesity found in this study, while the other nine predictors are non-modifiable. Understanding on issues surrounding the low SES group will help the strategic level in planning for future comprehensive interventions on overweight and obesity, specifically targeting on those predictors.

Job Requirements and Physical Demands (JRPD) Questionnaire: Cross-Cultural Adaptation and Psychometric Evaluation in Iranian Army Personnel with Chronic Low Back Pain

Background: Biomechanical risk factors have been identified as the main predisposing factor of Chronic Low Back Pain (CLBP), especially in Army personnel. The Job Requirements and Physical Demands (JRPD) questionnaire has been developed to assess the biomechanical exposures related to CLBP. Examining the biomechanical risk factors could prevent CLBP. This research was designed to cross-cultural adaptation and the psychometric properties of the Persian version of the Job Requirements and Physical Demands (JRPD) questionnaire among Iranian Army personnel with Chronic Low Back Pain (CLBP).Methods: In this non-experimental and methodological designed study, the content validation of the JRPD was performed after translating to Persian. The Persian JRPD was administered to 198 Army personnel with CLBP, with an interval of seven days, to assess test-retest reliability. Scores of the Visual Analog Scale (VAS), Borg's Category-Ratio (CR10) scale, General Health Questionnaire-28 (GHQ-28), and two Physical Functioning (PF1 and PF2) items of the 12-item Short Form survey (SF-12) were recorded to estimate the correlation with the Persian JRPD.Results: After content validation, the number of items in the Persian JRPD remained unchanged. Persian JRPD was correlated with VAS (r = .27; p < .001), Borg's scale (r = .19; p < .009), GHQ-28 (r = .31; p < .001), PF1 (r = -.35; p < .001), and PF2 (r = -.27; p < .001). Also, test-retest reliability and internal consistency values were found to be .80 and .91, respectively.Conclusion: The Persian version of the JRPD is a valid questionnaire with good reliability when applied to Iranian Army personnel with CLBP.

Prevalence and Risk Factors for Musculoskeletal Back Injury Among U.S. Army Personnel

ABSTRACT Introduction Physical and medical readiness have emerged as a top priority in the army over the last decade. With this emphasis on deployment readiness, it is important to understand key risk factors attributed to common medical problems that arise in our soldiers, including low back pain. The purpose of this study is to elucidate demographic and lifestyle risk factors which would result in seeking medical care for musculoskeletal low back pain among active duty army personnel. Materials and Methods A cross-sectional retrospective study investigating all active duty soldiers between October 1, 2016 and September 30, 2018 was performed using the existing Military Health System Data Repository to retrospectively review administrative claims data. Our study queried 39 unique International Classification of Disease codes, 10th Revision codes for low back pain to determine a positive case. We compared those with and without back pain across all variables using a chi-square analysis in SAS. Multivariate logistic analysis was performed to adjust for confounding within any single proposed risk factor and the six other proposed risk factors. Results Six hundred fifty seven thousand and six thirty soldiers met inclusion criteria; 228,184 of whom had a medical encounter for low back pain (34.7%). All of the proposed risk factors included statistically significant unadjusted and adjusted odds ratios (ORs) with age conferring the greatest risk in soldiers aged 50–59 with an OR of 2.89 (2.73–3.05) compared to those aged 20–29. Obesity-adjusted OR was 1.77 (1.74–1.80) compared to those who were normal weight. Senior Enlisted status–adjusted OR was 1.34 (1.32–1.36). Females were 66% more likely to have low back pain compared to males with an OR of 1.66 (1.63–1.68). Conclusion Disease burden for low back pain tends to be high in the U.S. Army with 34.7% of service members experiencing low back pain. Older age, obesity, and being an enlisted, female service member are risk factors for these musculoskeletal injuries, which is in agreement with previously reported literature on the topic. To mitigate the burden of low back pain, policies and incentives to encourage healthy body mass index and lifestyle are needed. The results of this work inform future studies aimed at further delineating the risk factors found in this study.

Rapid Acclimatisation to High Altitude by Intermittent Hypoxia Training at Sea Level Role of Biochemical Markers

Rapid induction of soldiers to high altitude under emergency situation may lead to higher incidence of acute mountain sickness (AMS) and other high altitude illness. Intermittent Hypoxia Training (IHT) at sea level before going to high altitude is an approach for rapid acclimatisation. This approach may be helpful to reduce the occurrence of AMS and leads to better acclimatisation at high altitude in shorter duration. The present study evaluates the role of biochemical markers of acclimatisation after IHT before induction to actual high altitude. The study participants were Indian Army Personnel (n=30) and they were divided into two groups of control (n=16) and IHT exposed (n=14). The intermittent hypoxia training was administered at 12 per cent Oxygen for 4h/day for 4 days at sea level using normobaric hypoxia chamber and within 24 hrs - 48 hrs the subjects were airlifted to Leh, Ladakh, India at 11,700 ft. Preconditioning with IHT may be beneficial in maintaining antioxidant levels and ameliorate oxidative stress at high altitude. The hypoxia responsive proteins like Hemeoxygenase -1 (HO-1) and Vascular endothelial growth factor (VEGF) and the cytoprotective stress proteins, which facilitate the acclimatisation, may also get benefited by IHT exposure.