Adopting M. Segal's framework, we focused on examining four military lifestyle demands-(1) risk of service member injury or death, (2) frequent relocations, (3) periodic separations, and (4) foreign residence-and their relationships to psychological and physical well-being, satisfaction with the Army, and marital satisfaction. Questionnaire results from 346 spouses living overseas indicated that the impact of separations was negatively related to all four outcomes, while foreign residence was negatively related to physical and psychological well-being, fear for soldier safety was negatively related to physical well-being, and the impact of moving was negatively related to satisfaction with the Army. The results further indicated that perceptions of moving and separations were more important in determining outcomes than were the actual number of moves or separations.

In a group randomized trial of critical incident stress debriefing (CISD) with platoons of 952 peacekeepers, CISD was compared with a stress management class (SMC) and survey-only (SO) condition. Multilevel growth curve modeling found that CISD did not differentially hasten recovery compared to the other two conditions. For those soldiers reporting the highest degree of exposure to mission stressors, CISD was minimally associated with lower reports of posttraumatic stress and aggression (vs. SMC), higher perceived organizational support (vs. SO), and more alcohol problems than SMC and SO. Soldiers reported that they liked CISD more than the SMC, and CISD did not cause undue distress.

Nine months deployment to Afghanistan negatively affected aerobic capacity, upper body power, and body composition. The predeployment to postdeployment changes were not large and unlikely to present a major health or fitness concern. If deployments continue to be extended and time between deployments decreased, the effects may be magnified and further study warranted.

This investigation evaluated the effects of a 13-month deployment to Iraq on body composition and selected fitness measures. Seventy-three combat arms soldiers were measured pre- and postdeployment. Body composition was assessed by dual X-ray absorptiometry (DXA). Strength was measured by single repetition maximum (1-RM) lifts on bench press and squat. Power was assessed by a bench throw and squat jump. Aerobic endurance was evaluated with a timed 2-mile run. Exercise and injury history were assessed by questionnaire. Upper and lower body strength improved by 7% and 8%, respectively (p < 0.001). Upper body power increased 9% (p < 0.001) and lean mass increased 3% (p < 0.05). In contrast, aerobic performance declined 13% (p < 0.001) and fat mass increased 9% (p < 0.05). Fewer soldiers participated in aerobic exercise or sports during deployment (p < 0.001). Unit commanders should be aware of potential fitness and body composition changes during deployment and develop physical training programs to enhance fitness following deployment.

This study examined psychosocial issues within Army families and the contribution of support networks to spouses' well-being and to their desire that their soldiers remain in the Army. Data from a self-administered questionnaire were analyzed for 137 spouses from the active duty component, 410 from the National Guard, and 174 from the reserve. Differences among the three groups were found with regard to both the composition of their social support networks as well as their use of such networks. Use of support was associated with well-being, but not with retention.

Carpal tunnel syndrome (CTS) is a disorder frequently encountered by occupational health care specialists. The health care management of this disorder has involved a diverse set of clinical procedures. The present article is a review of the literature related to CTS with an emphasis on occupational‐related CTS. MEDLINE, Cumulative Index to Nursing and Allied Health Literature, PsycLIT, and NIOSHTIC databases from 1985–1997 were searched for treatment outcome studies related to CTS. Treatments of interest included surgery, physical therapy, drug therapy, chiropractic treatment, biobehavioral interventions, and occupational rehabilitation. A systematic review of the effects of these interventions on symptoms, medical status, function, return to work, psychological well‐being, and patient satisfaction was completed. Compared to other treatments, the majority of studies assessed the effects of surgical interventions. Endoscopic release was associated with higher levels of physical functioning and fewer days to return to work when compared to open release. Limited evidence indicated: 1) steroid injections and oral use of B6 were associated with pain reduction; 2) in comparison to splinting, range of motion exercises appeared to be associated with less pain and fewer days to return to work; 3) cognitive behavior therapy yielded reductions in pain, anxiety, and depression; and, 4) multidisciplinary occupational rehabilitation was associated with a higher percentage of chronic cases returning to work than usual care. Workers' compensation status was associated with increased time to return to work following surgery. Conclusions are preliminary due to the small number of well‐controlled studies, variability in duration of symptoms and disability, and the broad range of reported outcome measures. While there are several opinions regarding effective treatment, there is very little scientific support for the range of options currently used in practice. Despite the emerging evidence of the multivariate nature of CTS, the majority of outcome studies have focused on single interventions directed at individual etiological factors or symptoms and functional limitations secondary to CTS. Am. J. Ind. Med. 35:232–245, 1999. © 1999 Wiley‐Liss, Inc.

No abstract

Upper extremity disorders (UEDs) account for a significant number of work-related illnesses in the US workforce. Little information exists on the distribution of UEDs, their associated health care and indemnity costs, or patterns of work disability. The study presented is an analysis of upper extremity claims within the federal workforce. In this study, the universe consisted of all claims accepted by the US Department of Labor, Office of Workers' Compensation Programs (OWCP), from October 1, 1993, through September 30, 1994. A total of 185,927 claims of notices of injury were processed during the study period, and of these, 8,147 or 4.4% had an UED diagnosis coded according to the International Classification of Diseases, Clinical Modification (ICD-9-CM). 5,844 claims involved a single UED diagnosis and were the only claims field by these employees between October 1, 1990, and September 30, 1994. These single claims with single diagnoses comprised the sample for further analysis. Mononeuritis and enthesopathies of the upper limb were the most common diagnoses, accounting for 43% and 31% of the claims, respectively. Women had a higher proportion of carpal tunnel syndrome, "unspecified" mononeuritis, and "unspecified" enthesopathies. The majority of claimants for both the mononeuritis- and enthesopathy-related diagnoses were between 31 and 50 years of age, received only health care benefits, and did not incur wage loss. Health care costs for mononeuritis and enthesopathy claims were $12,228,755 (M = $2,849). Carpal tunnel syndrome (CTS) and enthesopathy of the elbow were the most costly diagnoses, accounting for 57% and 16% of the total, respectively. Surgical services represented the highest expenditures in CTS claims. Physical therapy accounted for the majority of health care costs for enthesopathy cases. The mean number of workdays lost for CTS and enthesopathy claims were 84 and 79, and the average indemnity costs were $4,941 and $4,477, respectively. These findings indicate that while UEDs represent a relatively small percentage of all workers' compensation cases, the health care and indemnity costs are considerable. Also mean duration and pattern of work disability revealed that these disorders can result in chronic work disability similar to that observed in low back pain. The results highlight the need to determine whether interventions that account for the majority of costs significantly impact long-term outcomes. There is also a need to identify risk factors for prolonged disability in those who experience problems with delayed recovery.