Jeeva Kanesarajah

Stereoscopy in diagnostic radiology and procedure planning: does stereoscopic assessment of volume-rendered CT angiograms lead to more accurate characterisation of cerebral aneurysms compared with traditional monoscopic viewing?

Stereoscopic vision is a critical part of the human visual system, conveying more information than two‐dimensional, monoscopic observation alone. This study aimed to quantify the contribution of stereoscopy in assessment of radiographic data, using widely available three‐dimensional (3D)‐capable display monitors by assessing whether stereoscopic viewing improved the characterisation of cerebral aneurysms.

Unit cohesion, traumatic exposure and mental health of military personnel

BACKGROUND The benefit of military unit cohesion to morale and psychological resilience is well established. But it remains unclear whether unit cohesion modifies the association between deployment-related traumatic exposure and mental health problems. AIMS To examine the association between unit cohesion, traumatic exposure and poor mental health [symptoms of post-traumatic stress disorder (PTSD), psychological distress and alcohol dependency] and assess whether the relationship between traumatic exposure and poor mental health differs by level of unit cohesion. METHODS A self-reported cross-sectional survey of Australian military personnel deployed to Iraq or Afghanistan between 2001 and 2009. RESULTS Among 11411 participants, those with low levels of unit cohesion had higher odds of PTSD symptoms [aOR (95% CI): 2.54 (1.88, 3.42)], very high psychological distress [aOR (95% CI): 4.28 (3.04, 6.02)] and a high level of alcohol problems [aOR (95% CI): 1.71 (1.32, 2.22)] compared with those reporting high unit cohesion on deployment. Higher exposure to traumatic events on deployment was associated with greater risk of PTSD symptoms, very high levels of psychological distress and high levels of alcohol problems in this cohort. However, there was no evidence of a statistically significant interaction between unit cohesion and traumatic exposures in influencing poor mental health. CONCLUSIONS Our findings suggest that both unit cohesion and traumatic exposure are independently associated with poor mental health. Efforts to improve military unit cohesion may help to improve the mental health resilience of military personnel, regardless of their level of traumatic exposure.

Effect of Multiple Deployments on Military Families: A Cross-Sectional Study of Health and Well-Being of Partners and Children

This study explored the impact of multiple deployments on the health and well-being of the partners (married or de facto) and children of Australian military personnel who have deployed frequently. Permission to contact military partners was sought from a sample of Australian Defence Force (ADF) members. Partners provided data on deployment history, physical health, mental health, and their childrens emotions, and behaviors. Associations between multiple deployments and health and well-being of partners and children were assessed using logistic regression. Data were collected from 1,332 Australian Defence Force partners (response rate 36%) with 1,095 children aged between 4 and 17 years. Almost half (47%) of partners had experienced more than one deployment, mainly to Timor-Leste, Iraq, and Afghanistan. There was little evidence of associations between numbers of deployments and the health of the partner. In contrast, more behavioral problems were reported for children who experienced two or more deployments with odds ratios generally greater than 2 and significant trends with increasing numbers of deployment. Although military families who experience multiple deployments may, by selection, be more resilient than those who have fewer deployments, these results suggest that adverse impacts on the children may accrue with increasing parental absences because of deployment.

Childhood adversity and traumatic exposures during deployment as predictors of mental health in Australian military veterans

Objective: To examine whether the relationship between traumatic exposure on deployment and poor mental health varies by the reported level of childhood adversity experienced in Australian military veterans deployed to the Bougainville or East Timor military operations.

Multimorbidity and quality of life at mid-life: A systematic review of general population studies

There is substantial multimorbidity at mid-life but little is known about the strength of evidence on multimorbidity and health-related quality of life (HrQoL) at mid-life. This review addresses this gap, focusing on studies of the general population. PubMed, Web of Science, Embase and APA PsycNET databases were screened on 6 March 2017 for original research on multimorbidity and HrQoL in adults aged 40-65 years from the general population. Studies focused on index conditions, using single-item HrQoL measures, unlikely to represent the general population (e.g. primary care), and papers that were not in the English language were excluded. A narrative synthesis was presented due to heterogeneity in the measurement of multimorbidity. Of the 2557 articles, 83 underwent full text screening and 8 were included in the review. Included studies were of moderate to high quality and no exclusions were made on the basis of quality or bias. Multimorbidity was associated with poorer HrQoL at mid-life. Two cross-sectional studies found that adults with multimorbidity at early mid-life reported poorer HrQoL than adults with multimorbidity at late mid-life, while another found the reverse. Two distinct disease clusters were identified: mental health conditions and cardiovascular disease (CVD). Those in the mental health cluster reported poorer HrQoL than those in the CVD cluster, women more so than men. Limitations of the selected studies include lack of longitudinal evidence, use of self-reported conditions and no assessment of disease severity. Multimorbidity is associated with poor HrQoL at mid-life at the population level, with some evidence of differences in association with age and disease cluster and sparse evidence on sex differences. Longitudinal research using a weighted disease severity index and multimorbidity trajectories is needed to strengthen the evidence base.

Physical activity and body mass shape quality of life trajectories in mid-age women

Objective: To determine the combined longitudinal effect of body mass index (BMI) and physical activity (PA) on health‐related quality of life (HrQoL), using the SF‐6D (SF‐36) utility measure.

Factors associated with low unit cohesion in Australian Defence Force members who deployed to the Middle East (2001–2009)

Introduction Unit cohesion has been shown to bolster the mental health of military personnel; hence, it is important to identify the characteristics that are associated with low unit cohesion, so that interventions to improve unit cohesion can be targeted and implemented. Little is known about the factors associated with low unit cohesion. This research aims to identify demographic, military service and deployment factors associated with low unit cohesion. Methods Data from a self-reported cross-sectional study of 11 411 current or ex-serving Australian military personnel deployed to Iraq or Afghanistan between 2001 and 2009 were used. Multivariable logistic regression was used to investigate the research aims. Results Being female (adjusted OR (aOR) (95% CI) 1.35 (1.21 to 1.51)), non-commissioned officer (aOR (95% CI) 1.50 (1.39 to 1.62)), lower ranked (aOR (95% CI) 1.74 (1.51 to 2.01)) or having left military service (aOR (95% CI) 1.71 (1.46 to 2.02)) was associated with reporting low unit cohesion. Potentially modifiable factors such as performing logistic roles on deployment (aOR (95% CI) 1.13 (1.01 to 1.27)), dissatisfaction with work experience on deployment such as working with colleagues who did not do what was expected of them (aOR (95% CI) 4.09 (3.61 to 4.64)), and major problems at home while deployed (aOR (95% CI) 1.50 (1.38 to 1.63)) were also associated with reporting low unit cohesion. Conclusions This is the first study to identify demographic, military service and deployment factors associated with low unit cohesion. The modifiable nature of unit cohesion means that military leaders could use this information to identify subgroups for targeted resilience interventions that may reduce vulnerabilities to mental health problems and improve the job satisfaction, preparedness and deployment experiences of serving members.