Search

Norovirus is the leading cause of acute gastroenteritis (AGE) worldwide. Norovirus outbreaks at military facilities can cause loss of training and working days and increased healthcare utilization, affecting force readiness. During 2013-2023, we enrolled 2,304 US military recruits from 4 basic training facilities to investigate AGE outbreaks among this population. Among enrollees, we detected norovirus in 433 (18.8%) AGE cases, and norovirus caused 49 AGE outbreaks during our longitudinal study. On average, each norovirus case-patient missed 1.2 training days due to illness, and 6.2% required infusion care. Whole-genome sequencing of selected samples from each outbreak produced full-length genomes (6,989-7,787 bp) for 39 samples. Norovirus GII.4 Sydney was the most (12/39, 30.8%) identified genotype over the study period. Phylogenetic and comparative genomic analyses revealed that several outbreak strains were responsible for causing >1 outbreak, even across different training sites. Our findings can inform infection control practices at military installations and overall norovirus vaccine development.

Service Members, particularly members of the Reserve Component, seek medical and mental health care in their civilian communities. To the extent that providers communicate respect and value for military culture, they can better engage and enhance outcomes., Competing Interests: Acknowledgments: The authors have no conflicts of interest to disclose. The views expressed are those of the authors and do not necessarily reflect the opinions of the Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., the Uniformed Services University of the Health Sciences, the Department of Defense, the Department of Health and Human Services, or the US Government. The identification of specific products, scientific instrumentation, or organizations is considered an integral part of the scientific endeavor and does not constitute endorse­ment or implied endorsement on the part of the authors, DoD, DHHS, or any component agency., (Copyright ©2023 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.)

Risk behaviors associated with sexually transmitted infections (STIs) among people living with HIV (PLWH) have not been well characterized in the US military. We identified risk behaviors associated with a new STI in this population after the repeal of "Don't Ask, Don't Tell." US Military HIV Natural History Study participants who completed the risk behavior questionnaire (RBQ) between 2014 and 2017 and had at least 1 year of follow-up were included ( n  = 1589). Logistic regression identified behaviors associated with incident STI in the year following RBQ completion. Overall, 18.9% acquired an STI and 52.7% reported condom use at last sexual encounter. Compared with those with no new sex partners, participants with between one and four or five or more new partners were 1.71 [1.25-2.35] and 6.12 [3.47-10.79] times more likely to get an STI, respectively. Individuals reporting low or medium/high perceived risk of STI were 1.83 [1.23-2.72] and 2.65 [1.70-4.15] times more likely to acquire a new STI than those reporting no perceived risk, respectively. Participants who preferred not to answer about sexual preference, number of new partners, or perceived STI risk were also more likely to acquire a new STI. Our study illustrates that despite regular access to health care and accurate perceptions of risk, rates of STI among PLWH remain high in the US military setting, as in others. Given the potential individual and public health consequences of STI coinfection after HIV, more work is needed to assess interventions aimed at sexual behavior change for PLWH.

Background: In conducting population-based surveys, it is important to thoroughly examine and adjust for potential non-response bias to improve the representativeness of the sample prior to conducting analyses of the data and reporting findings. This paper examines factors contributing to second stage survey non-response during the baseline data collection for the Millennium Cohort Family Study, a large longitudinal study of US service members and their spouses from all branches of the military., Methods: Multivariate logistic regression analysis was used to develop a comprehensive response propensity model., Results: Results showed the majority of service member sociodemographic, military, and administrative variables were significantly associated with non-response, along with various health behaviours, mental health indices, and financial and social issues. However, effects were quite small for many factors, with a few demographic and survey administrative variables accounting for the most substantial variance., Conclusions: The Millennium Cohort Family Study was impacted by a number of non-response factors that commonly affect survey research. In particular, recruitment of young, male, and minority populations, as well as junior ranking personnel, was challenging. Despite this, our results suggest the success of representative population sampling can be effectively augmented through targeted oversampling and recruitment, as well as a comprehensive survey weighting strategy.

In the face of an unprecedented epidemic of Ebola Virus Disease, in September 2014, the US military began sending thousands of personnel to Liberia and supporting areas in Senegal in its largest deployment to the African continent in over two decades. In this review, media reports, published photographs and official statements are evaluated and summarized to identify and describe key time points in the US military response. Specific events include the initial establishment of the Monrovia Medical Unit and the buildup of forces for the expanded mission, which involved enhancement of laboratory testing capacity, construction of Ebola Treatment Units, and training of health care workers. The review concludes with a discussion and critical evaluation of the timeliness of this US military response in the context of the original expectations of the humanitarian community and government officials.

The US military presence in South Korea [hereby Korea] in the aftermath of the Korean War has been a politically sensitive and contentious issue for Korea. While the relationship between the US military and Korea has often been characterized in Korean popular and scholarly discourse as neocolonial, I argue that in recent years, Korean yeneung (television entertainment programs) have been reversing such power dynamics in how they depict US soldiers. They contest the image of Korea as a neocolonial nation-state and portray it as a powerful and aspirational one. Such nationalistic portrayals of the relationship between the two countries coincide with the nation's rise in economic and cultural status. I build on theories derived from Media Studies and scholarship on national identity formation. I use the theoretical framework of "illusions of reality" to analyze the Korean popular media depictions of US soldiers stationed in Korea. I contend that yeneung mobilize illusions of reality to depict an aspirational future reality where the neocolonial power dynamics between the US military and Korea are reversed and where stereotypes that the US held of Korea are mirrored and projected back onto the US. [ABSTRACT FROM AUTHOR]

Public and clinical interest in a condition called moral injury – psychological distress resembling posttraumatic stress disorder (PTSD) but said to originate from shame, guilt, or transgression in war experience – explicitly links moral, psychological, and political dimensions of war-making in the context of the US's post-9/11 wars. This article critically analyzes moral injury's politics of psychological suffering, which tends to treat morality as a universal and apolitical terrain, by reading it against soldier narratives of combat experience. American soldiers' accounts of US military violence in Iraq and Afghanistan suggest that embodied, affective, and technical dimensions of military experience constitute their own moral worlds that do not necessarily conform to moral injury's narratives of individual transgression. These accounts show that the US's counterinsurgency techniques produce Orientalist framings of threat and violence but also volatile and ambivalent battlefield moralities that critically comment on the ostensibly liberal and humane techniques of US war-making. [ABSTRACT FROM AUTHOR]

The United States often applies its laws to conduct or persons in foreign countries. How do these countries respond to US extraterritorial pressure? This study examines a central case of extraterritoriality: the protection of US troops from criminal justice in troop-hosting countries. I argue that greater security dependence on the United States brings hosts to comply with US pressure—when such compliance receives limited public attention. This argument is tested through a microlevel analysis of host countries' treatment of US personnel who committed criminal offenses during the Cold War (1954–70). The results suggest that in countries dependent on US-provided security, American troops were less likely to face trial. Yet if troops indeed stood trial, the host's dependence on the United States did not bias verdicts or sentences, since those were public. The data also show that the involvement of US troops in crime was far greater than previously known. [ABSTRACT FROM AUTHOR]

The basic structure of contemporary military biopolitics, in which military bodies and minds are kept alive and allowed to die, entails both an institutional problem of how to shore up life that is exposed to harm and a cultural problem of how to reckon with a routinized trade in life and death that happens not incidentally, but on purpose. Amidst this tension, the military psyche becomes both an inhabited, embodied site and an imaginative point of reference for the question of how to feel about war. This article takes stock of the contemporary landscape of war-related mental affliction via three relatively novel interventions: military suicide prevention, the framing post-traumatic stress as "moral injury," and resiliency training meant to inoculate soldiers against the stress of the battlefield. Drawing on a range of clinical and media sources and ethnographic research with post-9/11 military personnel, I show how each of these efforts constructs specific forms of war-related psychic destruction as objects of public and institutional concern, normalizes the institutional arrangements that produce it, and informs public perceptions of what war is by constructing figures of what it does to those who fight it. [ABSTRACT FROM AUTHOR]

Introduction: Traumatic brain injury (TBI) is a significant health issue that affects U.S. military service members (SM) at home and in combat deployments. We estimated the TBI incidence rate in the deployed and non-deployed setting between 2010 and 2014 and identified subgroups with elevated rates for prevention efforts.Methods: Retrospective population-based study of all active duty U.S. military SM that sustained a first active duty TBI diagnosis between January 2010 and December 2014 collected and analyzed in 2017. Using Armed Forces Health Surveillance Branch data we calculated the Mantel-Haenszel (MH) standardized TBI incidence rate in the deployed and non-deployed setting, adjusting for service and demographic factors.Results: From 2010 to 2014, the MH standardized incidence rate for deployed SMs was 3,265 TBIs per 100 thousand p-yrs (95% CI: 3,222-3,307) and 1,705.2 (95% CI: 1,694.0-1,716.5) for non-deployed SMs. The youngest deployed male Army soldiers, those ages 17-24, especially White and Hispanic soldiers, had the highest TBI incidence rate (IR) of 5,748.7 (95% CI: 5,585.8-5,916.4) and 5,010.3 (95% CI: 4,647.5-5,401.4), respectively. The IR for all branches was 1,972.6 (95% CI: 1,959.5-1,985.7) and 724.0 (95% CI: 714.9-733.0) for Reserve/Guard Service members.Conclusions: Across all years, Marines and Army Soldiers experience the highest rates of injury with deployed SMs having elevated IRs of TBI. The TBI IR among deployed SMs was 91% higher than among those in the non-deployed setting, due to continued exposures to combat. Deployed Reserve/Guard component SMs seem to have an above average rate, a finding with implications for training and prevention. [ABSTRACT FROM AUTHOR]

Over the past decade, the US Department of Defense has become increasingly concerned with how the financial insecurity of military families compromises the overall security of the nation. Through an analysis of the policy reports focusing on predatory lending and military personnel and the initiatives designed to improve the financial capabilities of servicemembers and their families, this article situates the everyday domestic lives of indebted military personnel with respect to the racialized, gendered and militarized logics of global finance capital. Specifically, I argue that the perceived crisis in ‘financial readiness’ is endemic to the US security state and its efforts to protect and produce financialized markets at home and abroad. Inspired by the growing body of Cultural Studies and American Studies scholarship on the relationship between race, empire and the financialization of capitalism, this article unpacks the ways in which state practices of war-making fuel and are fueled by the chronic indebtedness of communities of colour and working-class communities. I open with a discussion of how the Pentagon's coercive enlistment practices burden economically insecure bodies with the work of securing the nation and, in doing so, create concentrated populations of young people who, with a regular pay cheque yet no credit history, are particularly vulnerable to the financial structures they ‘volunteered’ to defend. I then conclude with an examination of the Pentagon's family-focused financial readiness programmes that school servicemembers in how to invest for their futures and that call specifically upon military wives to do the labour of mobilizing household financial plans in the service of US imperial interests. By focusing on how military families are imagined to manage and mismanage their debt, this article offers insight into how the militarization of citizenship coincides with the financialization of family life in the United States today. [ABSTRACT FROM AUTHOR]

After a decade of successful recruiting, the US military began experiencing recruiting difficulties in the 1990s. Cyclical factors as well as trend factors may have played a role. This paper uses monthly data by state over the period 1989-1997 to estimate models of enlistment and evaluate the various explanations for the recruiting slowdown. Estimates of the impact of economic variables - relative military pay and unemployment - and recruiting resource variables - recruiters and advertising - are similar to those in previous studies. Two trend factors, rising college attendance and declining adult veteran population (influencers), are found to be important factors explaining the decline in enlistment. [ABSTRACT FROM AUTHOR]