The Department of Defense has implemented a mandate that all military personnel be vaccinated against COVID-19. This article reviews the historical precedent of vaccine mandates for United States military personnel dating back to the formation of the continental army, as well as previous controversies about vaccine mandates such as the first influenza vaccine mandate and the Anthrax Vaccine Immunization Program. The historical review discusses precedent for the current COVID-19 vaccine mandate and the reception of these vaccine mandates by military personnel. The review then discusses how these historical lessons can inform the present COVID-19 vaccine mandate. 相似文献
BackgroundComputerized dynamic posturography is commonly used to assess balance in service members, but normative values for the military population have not been established.Research questionWhat are the normative values for the Motor Control Test (MCT), Sensory Organization Test (SOT) and the enhanced SOT (eSOT) within the military population and at which point do they differ?MethodsCross-sectional study. 237 active duty service members (78 % male) completed the MCT, SOT and the eSOT with the sway manipulated at a gain of 1.2, 1.4, 1.6, 1.8, or 2.0. A Mann-Whitney U test was used to compare the means of men and women for the SOT and MCT composite scores. A Kruskal-Wallis H test was used to compare the means of age groups for the SOT composite score. An independent t-test was used to compare the SOT composite scores from our military population to the manufacturer’s normative (civilian) data. The means and standard deviations for the eSOT scores were reported for each gain. Paired-samples t-tests were performed to compare the SOT composite score with the eSOT composite score for each level of gain.ResultsThere was no difference between SOT composite scores for men and women (Mann-Whitney U = 4363.50, p = 0.19) or among age groups (Kruskal-Wallis = 2.77, p = 0.25). The mean SOT composite scores were not different from the manufacturer’s normative values (p = 0.155). SOT composite scores were significantly higher than eSOT composite scores for gains of 1.4 (t = 3.16, p = 0.003), 1.6 (t = 5.73, p < 0.001), 1.8 (t = 5.26, p < 0.001) and 2.0 (t = 5.89, p < 0.001). MCT composite scores were lower in the 18−26 year old than the 36−45 year old age group (p = 0.013).SignificanceThis study establishes normative values for the MCT, SOT and eSOT in active duty military service members. The results suggest that the manufacturer’s normal values are appropriate for making judgments about the postural stability of service members. 相似文献
AbstractThis was a retrospective cohort study linking provincial administrative databases to compare rates of non-fatal self-harm between CAF and RCMP veterans living in Ontario and age-matched civilians. This study included male veterans who registered for provincial health insurance between 2002 and 2013. A civilian comparator group was matched 4:1 on age and sex. Self-harm emergency department (ED) visits were identified from provincial ED admission records until death or December 31, 2015. Multivariable Poisson regression compared the risk of self-harm. Analyses adjusted for age, geography, income, rurality, and major physical and mental comorbidities. In total, 9514 male veterans and 38,042 age- and sex-matched civilians were included. Overall, 0.55% of veterans had at least one non-fatal self-harm ED visit, compared with 0.81% of civilians. The rate of ED self-harm visits was 40% lower in the veteran population, compared to the civilian population (RR?=?0.60; 95% CI?=?0.41–0.87). In both groups, psychosocial and physical comorbidities, and death by suicide were more common in those who self-harmed than those who did not. A better understanding of why veterans have a lower rate of self-harm emergency department visits and how it is related to the number of completed suicides is an important area for future consideration. 相似文献
Objectives: Late-onset stress symptomatology (LOSS) is a phenomenon observed in older combat veterans who experience increased combat-related thoughts, feelings, and reminiscences corresponding with the changes and challenges of aging. Previously, we developed the LOSS Scale to assess LOSS. This paper describes the development and validation of a LOSS Scale short form (LOSS-SF) to screen veterans in various settings who may be actively re-examining their past wartime experiences.
Method: Three studies examined the reliability and validity of the LOSS-SF in separate samples of male combat veterans age 55 and older (total N = 346). Veterans were administered measures via telephone and mail survey. Correlation and regression analyses examined the reliability and validity of the LOSS-SF.
Results: The LOSS-SF exhibited strong internal consistency (alpha = .93), test-retest reliability (2 week interval on average; r = .88), and good concurrent validity with the LOSS Scale (r = .81). Convergent and divergent validity were supported by the pattern of correlations between the LOSS-SF and other construct measures.
Conclusion: The LOSS-SF is a reliable and valid measure to quickly assess thoughts, feelings, and reminiscences about past combat experiences in older veterans and identify those veterans in distress who may benefit from psychological interventions.. 相似文献
BackgroundPrevious studies have suggested that statins decrease influenza vaccine effectiveness and increase risk of medically attended acute respiratory illness (MAARI).ObjectivesTo examine the association of incident statin use and MAARI in a cohort of influenza vaccine recipients.MethodsThis retrospective cohort study evaluated influenza vaccine recipients within the Tricare population. The primary outcome compared MAARI incidence during the follow-up period in a propensity score-matched cohort of incident statin users and statin non-users. Secondary analysis included propensity score-adjusted comparisons between incident statin users and statin non-users in the entire cohort and prespecified sub-cohorts with and without comorbidities. The propensity score was derived from 72 variables encompassing demographics, medical history, comorbidities, medication use, and healthcare utilization.ResultsMAARI incidence in statin users was similar to non-users in the propensity score-matched cohort (odds ratio [OR] 0.92; 95% confidence interval [CI] 0.84–1.01). In contrast, statin users with lower comorbidity had lower OR for MAARI compared to non-users (Charlson Score zero cohort: 0.85 [CI 0.74–0.98]; No Diabetes cohort: 0.88 [CI 0.80–0.96]).ConclusionIncident statin use was not associated with increased MAARI incidence and may be associated with lower incidence of MAARI in those with less comorbidity. This study thus offers reassurance regarding the effectiveness of the influenza vaccine in statin users. 相似文献
BackgroundNew army recruits undertake initial training to develop their skillset and physical and mental preparedness for military service. Recruits experience a range of stressors both physical and psychological, often at extremes, and in combination. These stressors place recruits at risk of suboptimal energy and macronutrient intakes, which may negatively influence their performance.ObjectiveThe objectives of this systematic literature review are to examine, against the Military Recommended Dietary Intakes (MRDIs), the energy, carbohydrate, protein, and fat intakes of army recruits and trainees undertaking initial training internationally, and identify any associated influence on their performance.DesignA systematic literature review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses guidelines. Information sources were searched from their inception until May 2019.Main outcome measuresOutcome data included dietary intakes of energy, carbohydrate, protein, and fat before, during, and/or after army initial training, as well as measures of physical fitness and performance. A custom tool was used to assess the quality of included studies.ResultsThe results of 14 studies were synthesized. Six were conducted in the United States and four in each of Australia and Israel. Average energy intake represented 69% to 120% of the MRDIs before training commencement, 69% to 106% of the MRDIs in the early weeks of training and 56% to 77% of the MRDIs in the later weeks of training. Average carbohydrate and protein intakes represented 49% to 121% and 64% to 143% of the MRDIs, respectively, across the various time points. Three studies measured physical fitness and/or performance outcomes, with one showing a significant improvement in push-up performance when extra protein was provided.ConclusionsThe novel findings of this systematic literature review are that army recruits, internationally, are likely to be underconsuming energy for extended periods of their initial training, with greater deficits in carbohydrate intake compared with other macronutrients. Only a handful of studies investigated the subsequent influents on performance, with no definitive conclusions drawn in most instances. Further research is needed to understand the influence of suboptimal dietary intake on military relevant performance indicators to help better inform key stakeholders when devising nutrition guidance and strategies for army recruits in the future. 相似文献