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Injuries are the leading cause of healthcare encounters and lost work days among military service members in the U.S. Armed Forces. Fractures often entail a lengthy recovery time and can affect the operational ability of both the individual and the unit. From 1 January 2003 through 31 December 2012, active component service members were diagnosed with 244,248 incident fractures (19.4 per 1,000 person-years[p-yrs]). Hand and foot/ankle fractures were the most common types. During the same surveillance period, recruit trainees were diagnosed with 18,773 incident fractures (66.0 per 1,000 p-yrs). Annual incidence rates among trainees declined 38% from 2003 to 2012. Stress fractures were the most common type in this population. From 1 January 2008 through 31 December 2012, deployed service members were diagnosed with 12,328 incident fractures (16.5 per 1,000 p-yrs). The most common sites of fracture among the deployed population were the hand, foot/ankle, and arm. Comments address preventive interventions, stress fractures in trainees, gender differences in incidence, and limitations of the study.

Partial contents:Sunburn among active component service members, U.S. Armed Forces, 2002 2013, Brief report: sunburn diagnoses while deployed in Southwest/Central Asia, active component, U.S. Armed Forces, 2008 2013, Surveillance of cataract in active component service members, U.S. Armed Forces, 2000 2013, Oseizame V. Emasealu, MD, MPH; Kerri A. Dorsey, MPH; Sumitha Nagarajan,MPH, Relationships between diagnoses of sexually transmitted infections and urinary tract infections among male service members diagnosed with urethritis, active component, U.S. Armed Forces, 2000 2013, Surveillance snapshot: cases of service member meningococcal disease reported to the Naval Health Research Center Laboratory based Meningococcal Disease Surveillance Program, 2006 2014 Michael P. Broderick, PhD, Deployment-related conditions of special surveillance interest., MSMR Vol. 21 No. 7 July 2014. The original document contains color images.

June 2014 Vol. 21 No. 6 MSMR. The original document contains color images.

The original document contains color images.

Partial contents: Absolute and relative morbidity burdens attributable to various illnesses and injuries, U.S. Armed Forces, 2013, Hospitalizations among members of the active component, U.S. Armed Forces, 2013, Surveillance snapshot: illness and injury burdens among reserve component service members, U.S. Armed Forces, 2013. Ambulatory visits among members of the active component, U.S. Armed Forces, 2013, Deployment-related conditions of special surveillance interest Annual Summary Issue. Surveillance snapshot: illness and injury burdens among U.S. military recruit trainees, 2013. Absolute and relative morbidity burdens attributable to various illnesses and injuries, non-service member beneficiaries of the Military Health System, 2013, Deployment-related conditions of special surveillance interest Annual Summary Issue, Pub. in Medical Surveillance Monthly Report, v21 n4, p1-31, Apr 2014.

The original document contains color images.

Anxiety is a normal reaction to stress; however, in individuals with anxiety disorder, the anxiety becomes chronic and exaggerated, and affects the physical and psychological health of the individual. Th e main types of anxiety disorders are generalized anxiety disorder, panic disorder, post-traumatic stress disorder (PTSD), phobias, and obsessive-compulsive disorder (OCD). Incident diagnoses of anxiety disorders among active component service members steadily increased from 2000 to 2012. A majority of incident anxiety disorder diagnoses were non-specific anxiety disorders (ICD-9-CM codes: 300.0, 300.00, or 300.09) and over 75 percent of service members diagnosed with non-specific anxiety disorders did not have a more specific anxiety disorder diagnosis during subsequent medical encounters. Incidence rates of anxiety disorders were highest among females, white, non-Hispanics, in the youngest age groups, and among recruits and junior enlisted service members. About one-third of anxiety disorder cases also had a co-occurring diagnosis of either adjustment or depressive disorder within one year before or aft er the incident anxiety disorder encounter., MSMR(Medical Surveillance Monthly rept. v20 n19, 2013e 20,Number 10. The original document contains color images.

Despite suicide being a leading cause of death among new mothers during the postpartum period, there has been limited research on self-harm in the postpartum period and associated risk factors. One potential risk factor for suicidality (completed suicides, suicide attempts, and suicide ideation including thoughts of self harm) during the postpartum period is postpartum depression (PPD). Between 1 January 2007 and 31 December 2012, 5,267 (9.9%) active component service women and 10,301 (8.2%) dependent spouses were received with an incident PPD diagnosis during the postpartum period; 213 (0.4%) service women and 221 (0.2%) dependent spouses were diagnosed with incident suicidality. Aft er adjusting for the eff ects of other covariates, service women with PPD had 42.2 times the odds of being diagnosed with suicidality in the postpartum period than service women without PPD; dependent spouses with PPD had 14.5 times the odds compared to those without PPD. Th e fi ndings of this report suggest that history of mental disorders was common among service women and dependent spouses with PPD in the postpartum period, and, in turn, PPD was a strong predictor for suicidality in the postpartum period. Th ese results emphasize the importance of PPD screening during the postpartum period. Th is also suggests that additional focused screening for suicidal behavior among those already diagnosed with PPD may be warranted., The original document contains color images.

MSMR Vol. 20 No. 4 April 2013. The original document contains color images.

Partial contents: Editorial: the mental health of our deploying generation, Summary of mental disorder hospitalizations, active and reserve components, U.S. Armed Forces, 2000-2012 Surveillance Snapshot: anxiety disorders, active component, U.S. Armed Forces, 2000-2012. Mental disorders and mental health problems among recruit trainees, U.S. Armed Forces, 2000-2012. Surveillance Snapshot: mental disorder hospitalizations among recruit trainees, U.S. Armed Forces, 2000-2012. Malingering and factitious disorders and illnesses, active component, U.S. Armed Forces, 1998-2012. Surveillance Snapshot: conditions diagnosed concurrently with insomnia, active component, U.S. Armed Forces, 2003-2012., Pub. in Medical Surveillance Monthly Report, v20 n7, p1-27, July 2013. The original document contains color images.

The original document contains color images.

The original document contains color images.

The original document contains color images.

July 2012 Vol. 19 No. 7, 28 pgs.. The original document contains color images.

Viruses are the most common causes of meningitis, a condition characterized by inflammation of the protective membranes that surround the brain and spinal cord. During the 10-year surveillance period, there were 3,205 confirmed cases, 724 probable cases, and 2,495 suspected cases of viral meningitis among active and reserve component members. In all three categories of cases, the most common diagnoses were meningitis due to enteroviruses; however a majority of these were unspecified enteroviruses. Nearly two-thirds (64.2%) of all cases due to enteroviral infection were hospitalized; on average, cases were hospitalized for 3.2 days. Numbers of cases peaked in late summer/early fall; and higher than average numbers of cases in 2003 reflected several outbreaks that occurred in civilian populations that year. Six states (Texas, California, Virginia, North Carolina, Florida, Georgia) reported the most cases in 2003 and overall during the period. Prevention of viral meningitis relies upon the interruption of viral transmission, e.g., thorough hand washing and disinfection of contaminated surfaces., Pub. in Medical Surveillance Monthly Report, v19 n8, p2-23, Aug 2012.

The original document contains color images.

The original document contains color images.

Suicide is a leading cause of deaths of U.S. service members. Medical care providers may play a role in suicide prevention. We summarized the outpatient experiences of service members prior to suicide or self-infl icted injury and compared them with service members without suicidal behavior. During 2001-2010, 45 percent of individuals who completed suicide and 75 percent of those who injured themselves had outpatient encounters within 30 days prior to suicide/self-harm. Primary care was the most frequently visited clinical service prior to suicide/self-harm. As compared to their counterparts, service members with suicidal behavior had especially excessive outpatient visit rates within, but not prior to, 60 days of their deaths/injuries. Th e fi nding suggests that there may be one or more triggering events that lead to care-seeking. Th ese results may help identify individuals that should be screened for suicide risk., Medical Surveillance Monthly Report, v19 n2, p1-27, February 2012. The original document contains color images.

In July 2011, the U.S. Air Force School of Aerospace Medicine (USAFSAM) Epidemiology Consult Service investigated an ongoing outbreak of acute gastrointestinal (GI) illness characterized by vomiting, nausea, diarrhea, and stomach cramps that affected cadets and support personnel at a field training location at the U.S. Air Force Academy. Six outbreak-related stool specimens were confirmed by RT-PCR to be infected with norovirus, genogroup I. Overall, 290 cases (suspected and confirmed) of norovirus-related GI illness were recorded; the estimated attack rate among 1,359 cadets was 18%. The investigation suggested that norovirus was introduced into the field dining facility by one or more food service workers, possibly transmitted via common use serving utensils, and then further spread among cadets by person-to person contact. Numbers of new cases sharply declined after ill cadets were segregated in separate tents for convalescence, and after all cadets moved from fi eld billets (i.e., tents) to dormitories after completing the field training., Pub. in Medical Surveillance Monthly rept., Vol. 18 No. 11, p2-19, November 2011. The original document contains color images.

The fundamental aim of this study is to trace the development of elementary teacher certification in the State of New York from 1795 up to 1934. Before any work was attempted on the problem a search was made by the writer to determine whether or not any similar study had been completed or was in the process of being written. No work was found which would indicate duplication. As an added precaution, J. Cayce Morison, Assistant Commissioner for Elementary Education of New York State, was kind enough to check the records of the Teacher Education Division for work of a similar nature, but nothing was to be found in the records. Thus the writer feels that it is reasonable to assume that this is the only study of its kind attempted in connection with New York State.