Characterization of SARS-CoV-2 Variants in Military and Civilian Personnel of an Air Force Airport during Three Pandemic Waves in Italy
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ABSTRACT:
SUBMITTER: Equestre M
PROVIDER: S-EPMC10672769 | biostudies-literature | 2023 Nov
REPOSITORIES: biostudies-literature
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Project description:Background Most SARS-CoV-2 rapid antigen detection tests (RADTs) validation studies have been performed on specimens from COVID-19 patients and negative controls or from mostly symptomatic individuals. Herein we evaluated the diagnostic accuracy of AFIAS COVID-19 Ag, hereinafter denominated as AFIAS, during a COVID-19 screening program surveillance testing conducted among personnel of an Italian military airport. Methods Nasopharyngeal swabs (NPSs) were collected from study participants and were analysed by both AFIAS and RT-PCR assay. A questionnaire collecting demographic and exposure data were administered to all participants. AFIAS accuracy parameters including Cohen’s kappa (K) were determined. Results Overall, from November 2020 to April 2021, 1294 (NPSs) were collected from 1183 participants (88.6% males, 11.4% females; mean age were 41.3, median age 42). Forty-nine NPSs (3.78%) were positive by RT-PCR, while 54 NPSs were positive by AFIAS. Overall baseline sensitivity, specificity, positive and negative predictive values were 0.633, 0.981, 0.574, 0.985, respectively and K was 0.585 (moderate). AFIAS sensitivity tended to be higher for NPSs with higher viral load. A higher sensitivity (0.944) compared to the overall baseline sensitivity (0.633) was also found for NPSs from participants with COVID-19 compatible symptoms, for which K was 0.891 (almost perfect). Instead, AFIAS sensitivity was quite poor for NPSs from asymptomatic participants. Most false negative NPSs in this group had moderate viral load. Conclusion Overall, AFIAS showed high specificity but only moderate sensitivity, mainly because of the high proportion of asymptomatic participants. However, AFIAS showed good sensitivity for NPSs with high viral load and nearly optimal accuracy parameters for NPSs from participants with COVID-19 compatible symptoms. Thus, taking into consideration its performance features, this test can be useful for COVID-19 case identification and management as well as for infection control.
| S-EPMC9704652 | biostudies-literature
Project description:Due to the wars in Iraq and Afghanistan, the unmet medical and psychological needs of military personnel are creating major challenges. Increasingly, active duty military personnel are seeking physical and mental health services from civilian professionals. The Civilian Medical Resources Network attempts to address these unmet needs. Participants in the Network include primary care and mental health practitioners in all regions of the country. Network professionals provide independent assessments, clinical interventions in acute situations, and documentation that assists GIs in obtaining reassignment or discharge. Most clients who use Network services come from low-income backgrounds and manifest psychological rather than physical disorders. Qualitative themes in professional-client encounters have focused on ethical conflicts, the impact of violence without meaning (especially violence against civilians), and perceived problems in military health and mental health policies. Unmet needs of active duty military personnel deserve more concerted attention from medical professionals and policy makers.
| S-EPMC3041942 | biostudies-literature
Project description:Military organizations often demonstrate contrasting features compared to civilian ones, including indoctrination of military identity and mind-set. Therefore, on returning after retirement, military personnel undergo acculturation to reconnect to the civilian world. Many military retirees face difficulty readjusting in multiple professional and personal life domains, and report decreased life satisfaction due to this transition. The present review conducted a thematic meta-synthesis of 28 studies that had qualitatively assessed military to civilian transition experiences. The aim was to understand the military-civilian culture gap and identify the challenges faced during this transition. The analysis led to six themes - "Military Institutionalization, Military-Civilian Cultural Contrast, The Three S's of Transition Challenges - Stereotypes, Skills, and Support, The Losses of Identity, Reconnecting with Family, Friends, and Civilian Counterparts, and Facilitators in Transition - Covering the Military-Civilian Gap." Based on these findings, the review further presents possible intervention suggestions for retirement adjustment and future research direction.
| S-EPMC11622583 | biostudies-literature
Project description:Background: Prior studies comparing the mental healthcare utilisation (MHU) of Danish formerly deployed military personnel (FDP) with the general population have not included data on psychotherapy through the Defence or talking therapy with the general practitioner. This study included these and several other data sources in a comprehensive comparison of MHU between Danish FDP and civilians.Methods: First-time deployed military personnel (N = 10,971) who had returned from a mission to Kosovo, Afghanistan, Iraq or Lebanon between January 2005 and July 2017 were included. A sex and birth-year-matched civilian reference group was randomly drawn from the entire Danish non-deployed population (N = 253,714). Furthermore, a sub-cohort, including male FDP and civilians deemed eligible for military service, was defined. These cohorts were followed up in military medical records and registers covering the primary and secondary civilian health sectors from 2005 to 2018, and the rates of MHU were compared.Results: Approximately half of the initial help-seeking for FDP took place through the Defence (49.4%), and the remainder through the civilian healthcare system. When help-seeking through the Defence was not included, MHU was significantly lower among FDP in the main cohort during the first two years (IRR = 0.84, 95% CI: [0.77, 0.92]) compared to civilians. When help-seeking through the Defence was included, MHU was significantly higher among FDP compared to civilians both in the first two years of follow-up (IRR = 2.01, 95% CI: [1.89, 2.13]) and thereafter (IRR = 1.18, 95% CI: [1.13, 1.23]). In the sub-cohort, these differences were even more pronounced both in the first two years of follow-up and thereafter.Conclusions: MHU was higher among Danish FDP compared to civilians only when data from the Defence was included. The inclusion of data on both civilian and military healthcare services is necessary to evaluate the full impact of deployment on MHU among Danish FDP.
| S-EPMC10795587 | biostudies-literature
Project description:The aviation industry needs to work on the resilience of air travel against health threats and regain passenger trust. This paper proposes a pandemic-free travel concept based on creating an infectious diseases free zone in the airport terminal building through screening of passengers, crews and airport workers. This research shows that infectious disease detection methods applicable at the airport could be available in a short timeframe, at affordable cost and in scale. The potential location of passenger health screening, facilitation requirements, health responsibilities delegation and appropriate usage of industry standards for regulations are key elements to a potential implementation that would be phased and long term. Highlights • Air travel industry needs to work on resilience and regain passenger trust.• Proposed pandemic-free travel based on airport sterile zone.• Methods for infectious diseases detection at airports available in short term.• Strategy based on a multilayer risk-management approach.• Guidelines, industry standards and health responsibility delegation needed.
| S-EPMC7544451 | biostudies-literature
Project description:BackgroundThe impact of the COVID-19 pandemic period continues to be felt, including a resulting increase in prevalence and rates of individuals with obesity within the Unites States, which had already been trending upward prior to the pandemic. This study aims to identify changes in body mass index (BMI) among the active-duty U.S. Air Force (USAF) personnel prior to and during the pandemic.Materials and methodsWe conducted a retrospective cohort study of USAF active-duty personnel. BMI data points were sourced from the Military Health System Data Repository and included a measure from each period: pre- (September 1, 2018 - February 28, 2020), early (March 1, 2020 - September 30, 2020), and late pandemic (October 1, 2020 - September 30, 2022). Pregnant women delivering during or one year prior to the study periods were excluded. Statistical analysis included percent change, the Stuart-Maxwell test for marginal homogeneity, and ANOVA comparing mean BMI with post-hoc mean comparisons. Additionally, the percentage change toward obese BMI was stratified by rank and occupation.ResultsWe identified a cohort of 111,392 active-duty USAF personnel. The overall increase in prevalence of USAF personnel with obesity over the entire study period was 44.1%. The prevalence of USAF personnel with obesity among our cohort increased by 11.6% from the pre-pandemic period to the early pandemic period (18% pre-pandemic; 20.8% early pandemic) with a 29.1% increase in prevalence from the early to late pandemic periods (20.8% early pandemic; 26.9% late pandemic). USAF aircrew members progressed to having a BMI of obese at lower rates over the same periods increasing by 7.8%, 21.3%, and 30.7%, respectively. The most prominent changes were observed among females, personnel between the ages 20 and 24, of American Indian or Alaska Native race, and in junior enlisted ranks.ConclusionsOur analysis indicates that like the other service branches of the U.S. military, the Air Force experienced an increase in active-duty personnel with obesity during the COVID-19 pandemic period. This indicates increases in rates of service members with obesity across the U.S. armed forces, which is likely to result in decreased force readiness.
| S-EPMC11817703 | biostudies-literature
Project description:IntroductionEmergency Medicine (EM) personnel in both military and civilian prehospital settings are often exposed to stressful and extreme events. Therefore, a cross-pollination between both contexts in terms of coping strategies may generate new information for purposes of training, prevention, and support programs. In the current study, we aimed at comparing both contexts to understand the type of stress events personnel experience; whether experience differs between civilian and military personnel; and how they cope with it.MethodsWe used a mixed method approach, combining the results of a quantitative questionnaire and a thematic analysis of 23 in-depth semi-structured interviews to gain additional qualitative information.ResultsWhereas the questionnaire pointed to a significant preference for task-oriented coping over avoidant and emotion-oriented coping, the interviews offered a more nuanced insight, showing a constant aim to position themselves on a continuum between emotional disconnection from the patient to preserve operationality on the one hand; and remaining enough empathic to preserve humanity on the other hand. We further identified an ambivalent awareness regarding emotions and stress, a vulnerable disbalance between an excessive passion for the job with the sacrifice of own's personal life (for a growing volatile and dangerous working environment) and a lack of recognition from both the patient and organizational environment. The combination of these factors may carry the risk for moral injury and compassion fatigue. Therefore, mutual trust between the organizational level and EM personnel as well as among team members is crucial.DiscussionThe results are discussed from a systemic SHELL perspective, indicating how the specific profile of EM personnel relates to the software, hardware, environmental and liveware components of their professional and private life. Trainings on stress- and risk awareness should be approached both on an individual and systemic level, knowing that there is clearly no "one-size-fits-all" manner.
| S-EPMC10335750 | biostudies-literature
Project description:IntroductionPrevention of musculoskeletal injury is vital to the readiness, performance, and health of military personnel with the use of specialized systems (e.g., force plates) to assess risk and/or physical performance of interest. This study aimed to identify the reliability of one specialized system during standard assessments in military personnel.MethodsSixty-two male and ten female Australian Army soldiers performed a two-leg countermovement jump (CMJ), one-leg CMJ, one-leg balance, and one-arm plank assessments using a Sparta Science force plate system across three testing sessions. Sparta Science (e.g., total Sparta, balance and plank scores, jump height, and injury risk) and biomechanical (e.g., average eccentric rate of contraction, average concentric force, and sway velocity) variables were recorded for all sessions. Mean ± SD, intraclass correlation coefficients (ICCs), coefficient of variation, and bias and limits of agreement were calculated for all variables.ResultsMean results were similar between sessions 2 and 3 (P > .05). The relative reliability for the Sparta Science (ICC = 0.28-0.91) and biomechanical variables (ICC = 0.03-0.85) was poor to excellent. The mean absolute reliability (coefficient of variation) for Sparta Science variables was similar to or lower than that of the biomechanical variables during the CMJ (1-10% vs. 3-7%), one-leg balance (4-6% vs. 9-14%), and one-arm plank (5-7% vs. 12-17%) assessments. The mean bias for most variables was small (<5% of the mean), while the limits of agreement varied with most unacceptable (±6-87% of the mean).ConclusionsThe reliability of most Sparta Science and biomechanical variables during standard assessments was moderate to good. The typical variability in metrics documented will assist practitioners with the use of emerging technology to monitor and assess injury risk and/or training interventions in military personnel.
| S-EPMC10363007 | biostudies-literature
Project description:180 Airforce personnel selected by stratified random sampling technique were studied for coronary risk factors. Nearly 27% individuals had one, 21% had two and 15% had multiple risks. Tobacco smoking was found to be the commonest risk factor (54%) followed by physical inactivity (45%), hyper-cholesterolaemia (22.2%), obesity (20%), hypertension (15%) and positive family history (12.2%). The prevalence of smoking, physical inactivity, excessive intake of dietary cholesterol and serum cholesterol values were seen significantly rising with age. The mean cholesterol values in the age group of 30-39, 40 years and above were higher than the WHO recommended values. The findings of the study suggest a greater emphasis on health education of airmen on coronary heart disease and its positive association with certain risk factors.
| S-EPMC5533113 | biostudies-other
Project description:Exposure to stressful and potentially traumatic experiences is a risk for military personnel and for some this may increase susceptibility to reduced well-being. The aim of this systematic review was to examine the effectiveness of interventions to promote the well-being of military personnel adjusting to civilian life. Electronic databases were searched including MEDLINE, Embase, HMIC, PsycINFO, Pilots and CINAHL. Twelve articles, all conducted in the USA, were included in the review. Articles were synthesised narratively and assessed for bias against established criteria. The studies evaluated the effectiveness of interventions for current and former military personnel. The interventions included expressive writing, anger management, cognitive training, psycho-education, and techniques to promote relaxation, connection in relationships and resilience. Interventions had some significant positive effects mostly for veterans adjusting to civilian life and other family members. There was much heterogeneity in the design and the outcome measures used in the studies reviewed. The review highlights the need for future robust trials examining the effectiveness of well-being interventions in military groups with diverse characteristics; in addition qualitative research to explore a conceptualisation of well-being for this group and the acceptability of interventions which may be perceived as treatment. The results of the review will be of interest to a number of stakeholders in military, public health and mental health settings. PROSPERO Registration number: CRD42015026341.
| S-EPMC5931793 | biostudies-literature