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American Journal of Preventive Medicine: Injuries in the U.S. Armed Forces Surveillance, Research, and Prevention.
... 9,10,33 Perhaps taller height might be important in CE and CA job tasks such as lifting and carrying large and heavy equipment, where maneuvering and maintaining a center of gravity are important in preventing excessive stresses on the shoulder, low back, and other parts of the musculoskeletal system. 15,34 Other military studies have reported Caucasian ethnicity as an injury risk factor. A higher incidence of blisters and stress fractures were reported in Caucasian soldiers when compared with African American soldiers. ...
We compared injuries/risk factors in infantry soldiers (I), construction engineers (CE), combat artillery (CA), and Special Forces (SF) during their operational and fitness activities.
Anthropometrics, ethnicity, and fitness data were collected before review of medical records.
Injury rates for I, CE, and CA were 4.0, 7.2, and 5.5 injuries/100 soldier-months, respectively; over 70% of them resulted from overuse. SF soldiers had an injury rate of 3.5 injuries/100 soldier-months, 50% of them reported as traumatic. Average limited-duty days (LDDs) were threefold higher in SF. Smoking, BMI > or =25, and APFT run time for 3.2 km >14 minutes were risk factors in I. Caucasian ethnicity, height <170.2 cm, weight > or =90 kg, and BMI > or =25 were risk factors in CE and CA. Age >27 years old was a risk factor in SF.
Greater emphasis should be placed on risk factor identification and testing strategies to reduce injuries among SF and other troops.
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This study was undertaken to examine the relationship(s) between health, nutrition, body composition, and physical performance in female soldiers during the B weeks of basic combat training (BCT). The study investigated female soldiers assigned to three platoons within a single all-female basic training company over the period of 22 March 1993 to 20 May 1993 at Fort Jackson, South Carolina. Volunteer soldiers participated in pre-training (pre-BCT; 174 original volunteers with a mean age of 21.4 yrs) and post-training (post-BCT; 158 successful BCT graduates) performance and body composition testing, as well as three separate blood draws (pre-BCT, midpoint of BCT, and.post-BCT). Additionally, a 7-day dining facility dietary assessment survey was performed on a subset of 49 randomly selected - soldiers during the second week of training. Questionnaires were utilized to acquire demographic information, as well as to assess nutrition knowledge and beliefs and food attitudes.
Objective : To determine if high-risk behavior is associated with increased injury severity and cost and if public agencies bear a disproportionate burden of that cost. Design : Case comparison study utilizing patient data collected over a 10-year period. Setting : Five level 1 and 2 trauma centers in an urban-suburban community with a population of 2.4 million. Participants : Trauma registry data from 37 304 consecutive hospitalized adult patients with trauma. Financial data were reported and analyzed on 28 842 of these. Main Oumome Measures : Incidence of alcohol intoxication, other drug use, use of vehicular protective devices, and firearm violence injuries in patients with private vs public health care sponsorship. Length of hospital stay, injury severity, and hospital unit charges were assessed for high-risk behavior. Results : High-risk behavior was more prevalent among trauma patients relying on public funding to cover the costs of their injuries (P<.001). Total hospital unit charges were 28% and 35% higher for motorists not wearing seat belts and motorcyclists not wearing helmets, respectively. Injury severity and length of stay were also higher (P<.001). Conclusions : High-risk behavior is associated with increased injury severity and cost. Trauma victims exhibiting high-risk behavior more often depend on public agencies to cover the cost of acute injury. Failure to establish and enforce laws and policies designed to reduce or prevent injury may generate enormous trauma care costs, borne to a large extent by public agencies. Further restriction of certain types of high-risk behavior and the institution of users' fees, taxes, or penalties may be necessary to reduce the disproportionate public agency cost generated by this activity.
Analytic procedures suitable for the study of human disease are scattered throughout the statistical and epidemiologic literature. Explanations of their properties are frequently presented in mathematical and theoretical language. This text provides a clear understanding of the statistical methods that are widely used in epidemiologic research without depending on advanced mathematical or statistical theory. By applying these methods to actual data, this book reveals the strengths and weaknesses of each analytic approach. The book combines techniques from the fields of statistics, biostatistics, demography, and epidemiology to present an overview that does not require computational details of the statistical techniques described. Throughout, the text contains illuminating discussions with new elements for this edition, including the analysis of multi-level categorical data and simple, intuitive arguments that exponential survival times cause the hazard function to be constant. There are also new applied examples to illustrate such topics as the pitfalls of proportional mortality data, the analysis of matched pair categorical data, and the age-adjustment of mortality rates based on statistical models. The most important new feature is a chapter on Poisson regression analysis. This essential statistical tool permits the multivariable analysis of rates, probabilities, and counts.
The analysis of censored failure times is considered. It is assumed that on each individual are available values of one or more explanatory variables. The hazard function (age-specific failure rate) is taken to be a function of the explanatory variables and unknown regression coefficients multiplied by an arbitrary and unknown function of time. A conditional likelihood is obtained, leading to inferences about the unknown regression coefficients. Some generalizations are outlined. LIFEtables are one of the oldest statistical techniques and are extensively used by medical statisticians and by actuaries. Yet relatively little has been written about their more formal statistical theory. Kaplan and Meier (1958) gave a comprehensive review of earlier work and many new results. Chiang in a series of papers has, in particular, explored the connection with birth-death processes; see, for example, Chiang (1968). The present paper is largely concerned with the extension of the results of Kaplan and Meier to the comparison of life tables and more generally to the incorporation of regression-like arguments into life-table analysis. The arguments are asymptotic but are relevant to situations where the sampling fluctuations are large enough to be of practical importance. In other words, the applications are more likely to be in industrial reliability studies and in medical statistics than in actuarial science. The procedures proposed are, especially for the two-sample problem, closely related to procedures for combining contingency tables; see Mantel and Haenzel (1959), Mantel (1963) and, especially for the application to life tables, Mantel (1966). There is also a strong connection with a paper read recently to the Society by R. and J. Peto (1972). We consider a population of individuals; for each individual we observe either the time to "failure" or the time to ccloss" or censoring. That is, for the censored individuals we know only that the time to failure is greater than the censoring time. Denote by T a random variable representing failure time; it may be discrete or continuous. Let F(t) be the survivor function, %(t) = pr (T2 t)