Rising hepatitis A immunity in U.S. military recruits

BACKGROUND: The U.S. military immunizes new recruits against hepatitis A. Since 2001, immunization with the hepatitis A vaccine has been recommended for civilian adolescents in higher risk areas. Recently, the Armed Forces Epidemiological Board recommended serologic screening where feasible to reduce redundant recruit immunizations. OBJECTIVES: The purpose of this study was to determine hepatitis A seroprevalence in recruit populations to inform screening policy. METHODS: Banked serum from a sample of military recruits (n = 2,592) in 2004 was tested for total antibody to hepatitis A (anti-hepatitis A virus (HAV)). RESULTS: The overall anti-HAV seroprevalence was 12.0% (95% confidence interval, 10.8%-13.3%). Adjusted to the age distribution of the 18- to 34-year-old population, the seroprevalence was 11.9% (10.5%-13.4%). The lowest seroprevalence was noted in the 1984 birth cohort, with significantly higher seroprevalence among younger recruits. CONCLUSIONS: Rising hepatitis A immunity among successive birth cohorts suggests increasing compliance with immunization recommendations. In anticipation of rising population immunity, universal screening of military recruits for anti-HAV is recommended.     

Physical training injuries and interventions for military recruits

Low physical fitness levels are associated with increased musculoskeletal injury risk and attrition among military recruits. The authors review physical fitness trends, injury risk factors, and Department of the Army initiatives to address recruit fitness, injuries, and attrition. Initiatives include the Fitness Assessment Program, which reduced injury risk and attrition among low-fit trainees, and the Assessment of Recruit Motivation and Strength, which enabled the Army to enlist individuals exceeding body composition accession standards without increasing attrition. Physical Readiness Training (PRT) is the Army's primary initiative to address training-related injuries and attrition. PRT's inherent injury control and exercise progression components are designed to address low fitness levels across entry-level training. PRT has been shown to decrease injury rates, but low-fit recruits remain at increased risk regardless of program design. The authors recommend resuming pre-enlistment fitness screening and fitness programming before low-fit recruits begin entry-level training. The decision whether to screen for fitness before beginning entry-level training could be based upon the existing recruiting environment in terms of applicant supply and the demand for recruits. However, the Army should anticipate increased injury and attrition rates when discontinuing screening and/or fitness programming for low-fit recruits.     

Methods for improving thermal tolerance in military personnel prior to deployment

Acute exposure to heat,such as that experienced by people arriving into a hotter or more humid environment,can compromise physical and cognitive performance as well as health.In military contexts heat stress is exacerbated by the combination of protective clothing,carried loads,and unique activity profiles,making them susceptible to heat illnesses.As the operational environment is dynamic and unpredictable,strategies to minimize the effects of heat should be planned and conducted prior to deployment.This review explores how heat acclimation (HA) prior to deployment may attenuate the effects of heat by initiating physiological and behavioural adaptations to more efficiently and effectively protect thermal homeostasis,thereby improving performance and reducing heat illness risk.HA usually requires access to heat chamber facilities and takes weeks to conduct,which can often make it impractical and infeasible,especially if there are other training requirements and expectations.Recent research in athletic populations has produced protocols that are more feasible and accessible by reducing the time taken to induce adaptations,as well as exploring new methods such as passive HA.These protocols use shorter HA periods or minimise additional training requirements respectively,while still invoking key physiological adaptations,such as lowered core temperature,reduced heart rate and increased sweat rate at a given intensity.For deployments of special units at short notice (＜ 1 day) it might be optimal to use heat re-acclimation to maintain an elevated baseline of heat tolerance for long periods in anticipation of such an event.Methods practical for military groups are yet to be fully understood,therefore further investigation into the effectiveness of HA methods is required to establish the most effective and feasible approach to implement them within military groups.     

Changes in smoking patterns in young military recruits in relationship to psychosocial characteristics

We followed 295 young infantry recruits during their first 14 weeks of basic training. The prevalence of smoking increased by 50%. About half of this increase was accounted for by ex-smokers, 57% of whom had resumed the habit. Average education and military psychometric measures of both the baseline smokers and the new smokers were significantly lower than those of the abstaining never-smokers. Asian and North African origin and a lower peer group evaluation score were also risk factors. These relationships were not demonstrated among resuming ex-smokers. The rise in the smoking rate accounts for most of the known rise during full military service. We suggest early preventive measures, especially for the two groups at risk.     

The asthma accession standard: a survival analysis of military recruits, 1995 to 1997

Asthma has a significant impact on U.S. military expenditures and readiness. Every year approximately 1,000 recruits are discharged for asthma during their first 6 months of service. This study was done to evaluate the practice of allowing some individuals with a history of asthma to enter military service (waiving). A survival analysis was performed to compare length of time until discharge and asthma-related failure for individuals waived for asthma (cases) and individuals not disqualified for asthma (controls). Cases were 587 recruit applicants initially disqualified who received waivers for asthma and accessed in the years 1995 to 1997. Controls were 1,761 matched enlisted recruits starting basic training in those years. No significant differences were found with respect to general attrition. The statistical differences for asthma-related hospitalization or discharge did not translate into practical differences. Waiving for asthma was not a significant occupational liability in terms of asthma-related hospitalization or early military attrition.     

Effect of static stretching on prevention of injuries for military recruits

This prospective study was designed to evaluate whether static stretching can prevent training-related injuries in Japan Ground Self-Defense Force military recruits. A total of 901 recruits between 1996 and 1998 were divided into two groups. Of which, 518 recruits were assigned to the stretching group and practiced static stretching before and after each physical training session. The control subjects (383 recruits in the nonstretching group) did not stretch statically prior to exercise. The static stretching consisted of 18 exercises. We collected injury data from medical records and assessed the incidence and the location of injury. The total injury rate was almost the same between two groups; however, the incidences of muscle/tendon injury and low back pain were significantly lower in the stretching group (p < 0.05). Static stretching decreased the incidence of muscle-related injuries but did not prevent bone or joint injuries.     

新兵自我效能与军事作业绩效的相关研究

 目的 研究自我效能与军事作业绩效的相关性;提出以自我效能理论为依托的心理干预方向,从而改善新兵在集训应激状态下的适应不良,提高作业绩效.方法 选用一般自我效能感量表(GSES)、简易应对方式量表、社会支持量表对2005年底入伍的570名新兵集中训练2个月后进行测评.结果 军事作业考核中成绩优秀新兵自我效能得分明显高于非优秀新兵自我效能得分;成绩优秀新兵的消极应对分值明显低于非优秀新兵.结论 新兵自我效能与军事作业绩效密切相关.应进一步探讨建立针对军人自我效能的心理干预体系,从而有效提高部队整体军事作业绩效.     

高原低氧环境下军事训练对武警新兵微循环功能的影响

 目的 观察高原低氧环境下军事训练对武警新兵微循环功能的影响,为指导高原地区军事、体能训练提供科学依据。方法 试验在青海( 海拔约3000 m,大气压力60.49 kPa ) 和天津( 海拔约4 m,大气压力101.08 kPa ) 完成。受试者为武警某部新兵连战士,将受试者分为3组,分别为平原籍平原训练组(对照组,60人)、平原籍高原训练组(A组,62人)和高原籍高原训练组(B组,38人)。所有受试者进行12周训练,训练强度相同。训练前和训练后第4、8、12周用XXG-E3 型自动心血管功能诊断仪记录微循环功能指标,并对受试者甲襞微循环进行检测。结果 在高原低氧环境下军事训练新兵血容量明显减少,以A组减少最为显著(P<0.05);B组半更新率低于其他两组(P<0.05),平均滞留时间和半更新时间高于其他两组(P< 0.05);B组形态积分和流态积分高于对照组(P<0.05);A组襻周积分[(2.78±0.85)vs(0.93±0.34)]和流态积分[(1.33±0.34)vs(0.59±0.31)]显著高于对照组(P<0.05)。结论 高原籍战士的微循环功能对高原训练适应性较强,平原籍战士高原低氧军事训练应当逐步增加训练量,以减少高原反应和微循环障功能碍的发生。     

某部2008-2010年入伍新兵急性呼吸道疾病发病情况调查

目的 调查某部入伍新兵急性呼吸道疾病(ARD)的发病率及常见的感染病因.方法 收集某部2008-2010年入伍新兵的咽拭子及外周静脉血标本,采用荧光定量PCR法检测15种呼吸道疾病常见病原体;采用间接免疫荧光法检测抗嗜肺军团菌抗体;采用ELISA法检测血清抗肺炎支原体-IgM和IgG及抗流感病毒抗体.结果 182名20...     

High prevalence of iron deficiency and anemia in female military recruits

Iron deficiency anemia has long been known to impair physical and mental performance. Iron deficiency itself, even without anemia, may also cause such an effect. Similar to female athletes, women in active military units may have increased risks for iron deficiency and its detrimental effects. Female recruits were screened for anemia and iron store status, and a questionnaire on lifestyle habits and menstruation was completed. Iron depletion (serum ferritin level of <20 microg/L) was found for 77% of study participants. Iron deficiency (ferritin level of <12 microg/L and transferrin saturation of <15%) was found for 15% of study participants. Anemia was found for 24% of subjects, and iron deficiency anemia was found for 10% of subjects. High prevalence of iron depletion, iron deficiency, anemia, and iron deficiency anemia was found among female recruits intended for active military duty. Therefore, a recommendation can be made to screen such female recruits for anemia and iron stores.     

常规军训对新兵血清细胞因子变化的影响研究

目的研究常规军训对新兵血清细胞因子浓度的影响,判断机体损伤及适应程度。方法选择2010年底新入伍新兵共80人,在常规军训前及军训1个月后分别采静脉血,进行血清IL-2、IL-6、IL-18、TNF-α、IFN-γ等细胞因子检测,并进行前后对比。结果血清IL-6、TNF-α、IFN-γ浓度在军训前后显示良好相关性,证明其变化在所有研究对象中呈现一致性;IL-2、IL-6、IFN-γ浓度值在军训前后显著降低。结论常规军训能够促进新入伍新兵免疫功能,提升机体对训练引起细胞损伤的抵抗力。     

The cost-effectiveness of varicella screening and vaccination in U.S. Army recruits

Varicella outbreaks in the U.S. Army disrupt training, reduce readiness, and represent substantial costs. Vaccination of susceptible individuals may be cost-effective. We conducted a cost-effectiveness analysis comparing screening of all incoming recruits and vaccination of susceptible individuals at either initial entry training (IET) or medical entrance processing station (MEPS), universal vaccination at IET, and no intervention. Primary health outcomes included the number of varicella cases prevented during the 8-week initial training period. The varicella hospitalization rate was 21.6 per 10,000 per year. In 100,000 recruits, 36 cases of varicella are expected at a cost of $181,000 in the absence of an intervention. Screening at IET would prevent 4 cases but would cost an additional $3,255,000 more than no intervention. Screening at MEPS would prevent 3 cases and save $521,000 per case prevented during the IET but would cost $2,734,000 more than no intervention. Universal vaccination would prevent 2 cases but would cost $15,858,000 more than MEPS screening and $18,592,000 more than no intervention. These results are robust. Cost per case of varicella prevented ranged from $390,000 to $7.9 million. Scarce prevention resources could be more cost-effectively allocated to other prevention programs.     

某军医大学2007～2009年新学员体检结果分析

严格按照《军队院校招收学员体格检查标准》（2006年）对新学员开展入学身体复查是切实把好新学员入门关,保证合格学员进入部队的关键环节,同时也可为全面了解新入校学员身体健康状况,