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Essays On The Patient-Centered Medical Home In The United States Military Health System, Glen N. Gilson

Theses & Dissertations

The Patient-Centered Medical Home has been endorsed by the primary care community as the model of the future, with hopes that it will increase quality of care and the patient and provider experience while decreasing costs. Many aspects of the implementation of the Patient-Centered Medical Home model remain unexplored. This dissertation comprises three independent studies examining Patient-Centered Medical Home implementation in the Military Health System, including (1) the effects of environmental correlates on the time to implement the model, (2) the impact of differences in implementation on preventive care quality outcomes, and (3) the effect of differences in implementation on …

Hormonal Contraceptive Use Among Active Duty Army Servicewomen. Trends And Implications For Risk Of Musculoskeletal Injury., Melanie K. Hosker

Doctoral Dissertations

Almost 40% of servicewomen use hormonal contraception every year, and 60% will use a contraceptive method in their military career. Rates of contraceptive use and musculoskeletal injury are higher among servicewomen as compared to civilians. Gender differences in rates of musculoskeletal injury have led investigators to question the role of sex hormones, including contraception. Recent studies suggest that hormonal contraceptives may decreased risk of anterior cruciate ligament (ACL) injury, potentially decreasing early onset osteoarthritis (OA). We utilized the Total Army Injury and Health Outcome Database, which prospectively captured demographics, clinical and pharmacy records on over 5.6 million Army soldiers since …

Brazilian Jiu Jitsu: A Tool For Veteran Reassimilation, Gino L. Collura

USF Tampa Graduate Theses and Dissertations

This dissertation evaluates veteran participation in the martial art of Brazilian Jiu Jitsu (BJJ) as a tool of reassimilation for veterans suffering from anxiety, stress and/or combat PTSD associated with military deployment. From the onset of Operation Iraqi Freedom, Operation Enduring Freedom and Operation New Dawn, challenges associated with U.S. Veteran assimilation and reintegration have been increasing. Coping with long term displacement, trauma, loss, and making sense of identity shifts between being an active duty service member and civilian can often present challenges when navigating back into civilian life.

By utilizing a neuroanthropological lens, ethnographic inquiry, surveys, semi-structured interviews, and …

The Impact Of Non-Mandated Physical Training On Physiological Measures And Performance In Army Officers, Emily Garrett

Theses and Dissertations

The purpose of this study was to observe the physiological changes in body composition and fitness assessments in US Army Officers after 5 months of non-mandated exercise. Twenty two captains stationed at Fort Benning, Georgia volunteered to participate (age; 26.9£1.2 years, height; 1.76+0.6m, and weight; 83.1+11.1kg). Eleven participants remained in active units with mandated training (MT) while 11 participants were in positions where training was not mandated (NMT). Anthropometrics, body composition, cardiorespiratory fitness, anaerobic power, and muscular strength were measured in both groups before and after the intervention period (1812 weeks). At pre-intervention, MT and NMT were not different in …

In Honor Of Self: A Weight Loss Project For A Military Population With Mental Disorders, Tanya Denise Stevenson-Gaines

Doctor of Nursing Practice Final Manuscripts

Background: Obesity in people diagnosed with mental disorders is at an epidemic level. Individuals with a mental illness who are prescribed medication for stability are at risk for obesity and metabolic syndrome. People with mental disorders have a 10 to 30-year decrease in life expectancy associated with chronic illnesses. Military personnel are separated from service when they are measured outside of body composition assessment standards.

Aims: To address the problem of obesity in military members by providing a weight loss program with structured and collaborative weight management education and telephonic coaching.

Methods: Stakeholders were informed about the purpose and goals …

Exploration Of Rape Myths Among Former Military Professionals, Gabrielle Caldara

Electronic Theses and Dissertations

Sexual violence is sometimes considered a taboo topic for discussion, but it gained widespread attention in the media in late 2017 due to the social movements addressing the sexual assault of women. However, sexual violence perpetrated against men lacks publicity in America, and highlights a similar situation in the Armed Forces. A discussion of sexually violent acts committed against men is sometimes impeded by cultural norms. This discrepancy associated with civilian and military communities inspired this exploratory study.

A convenience sample of 520 former American military professionals completed an anonymous online survey to describe their attitudes and beliefs regarding rape …

Physiological Tremor In Handgun Aiming And Shooting Tasks, Kyle J. Kellran

Human Movement Sciences & Special Education Theses & Dissertations

When holding an outstretched limb or aiming at a target, humans produce small involuntary fluctuations that may hamper performance. Current strategies for minimizing the impact of tremulous oscillations predominantly include both extrinsic and intrinsic support. The aim of the current dissertation is to better understand the parameters of physiological tremor associated with handgun aiming with the end goal of improving shooting accuracy. Experiment 1 focused on handgun aiming and the influence of different arm posture adopted during aiming. Experiment 2 expanded upon the findings of experiment 1 by comparing tremor during finger pointing, handgun aiming, and handgun shooting. Experiment 3 …

Risk Factors Associated With Opioid Misuse Among Military Personnel, Brittany Sullivan, Mark Bonica, Chris Armijo, Anne Jamieson, Semra Aytur

Honors Theses and Capstones

Risk Factors Associated with Opioid Misuse Among Military Personnel

Opioid overdoses are increasing among military personnel. Opioids are a class of drugs that include heroin, synthetic opioids, and pain relievers. Almost half of all Veterans returning from deployment in Afghanistan and Iraq have chronic pain; one in six veterans turn to opioids for pain relief.

Veterans between the ages of eighteen and fifty-three are five times as likely to have a Substance Use Disorder and two times as likely to have Post-Traumatic Stress Disorder in contrast to the general public.

Risk factors that have been shown to increase the probability …

Gender, Social Support, And Resiliency In Suicidal Ideation Among U.S. Army Soldiers, John Franklin Ambrose

Walden Dissertations and Doctoral Studies

Suicidal behaviors have continued to increase in the United States (U.S.) Army population since the beginning of the wars in Iraq and Afghanistan. Suicide rates are higher in men compared to women; yet, the rate of suicidal ideation is higher in women than men. The purpose of this study was to determine if there is a correlation between suicidal ideation and protective factors, if social support and resiliency are different for men and women within the U.S. Army population, and if gender acts as a moderating variable between suicidal ideation and protective factors. The interpersonal-psychological theory of suicidal behavior was …