Women in Combat: Framing the Issues of Health and Health Research for America's Servicewomen

McGraw, Kate; Koehlmoos, Tracey Pérez; Ritchie, Elspeth Cam

doi:10.7205/milmed-d-15-00223

Cited by 30 publications

(21 citation statements)

References 9 publications

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“…With the increasing participation and higher levels of performance of women in endurance athletics (30) and with higher expectations of women serving in active military service (41), there have been concerns regarding the susceptibility of women to exertional heat illness (EHI) and exertional heat stroke (EHS) (19,29,31). In military medicine, heat stroke is a subset of heat illness and in most cases it involves exertion in the heat.…”

Section: Introductionmentioning

confidence: 99%

Sex-dependent responses to exertional heat stroke in mice

Garcia

Mattingly

Robinson

et al. 2018

Journal of Applied Physiology

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With increasing participation of females in endurance athletics and active military service, it is important to determine if there are inherent sex-dependent susceptibilities to exertional heat injury or heat stroke. In this study we compared responses of male and female adult mice to exertional heat stroke (EHS). All mice were instrumented for telemetry core temperature measurements and were exercise-trained for 3 wk before EHS. During EHS, environmental temperature was 37.5°C (35% RH) while the mice ran on a forced running wheel, using incremental increases in speed. The symptom-limited endpoint was loss of consciousness, occurring at ~42.2°C core temperature. Females ran greater distances (623 vs. 346 m, P < 0.0001), reached faster running speeds (7.2 vs. 5.1 m/min, P < 0.0001), exercised for longer times (177 vs. 124 min, P < 0.0001), and were exposed to greater internal heat loads (240 vs.160°C·min; P < 0.0001). Minimum Tc during hypothermic recovery was ~32.0°C in both sexes. Females lost 9.2% body weight vs. 7.5% in males ( P < 0.001). Females demonstrated higher circulating corticosterone (286 vs 183 ng/ml, P = 0.001, at 3 h), but most plasma cytokines were not different. A component of performance in females could be attributed to greater body surface area/mass and greater external power performance. However, there were significant and independent effects of sex alone and a crossed effect of "sex × power" on performance. These results demonstrate that female mice have greater resistance to EHS during exercise in hyperthermia and that these effects cannot be attributed solely to body size. NEW & NOTEWORTHY Female mice are surprisingly more resistant to exertional heat stroke than male mice. They run faster and longer and can withstand greater internal heat loads. These changes cannot be fully accounted for by increased body surface/mass ratio in females or on differences in aerobic performance. Although the stress-immune response in males and females was similar, females exhibited markedly higher plasma corticosteroid levels, which were sustained over 14 days of recovery.

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Section: Introductionmentioning

confidence: 99%

Sex-dependent responses to exertional heat stroke in mice

Garcia

Mattingly

Robinson

et al. 2018

Journal of Applied Physiology

View full text Add to dashboard Cite

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“…15 Shaw and colleagues' study of Veteran births in California reconfirmed this growth, and notably found that by 2012 the fraction of pregnant Veterans relying on VA for maternity benefits had grown markedly to 14%, nearly equaling those relying on Medicaid (15%) for maternity benefits. 13 A smaller analysis, by Katon et al, which relied on 2008-2009 National Survey of Women Veterans, found a slightly higher self-reported fraction of use of VA maternity benefits: 29% of 334 VA-eligible Although women have historically been excluded from serving in direct combat positions, even before recent changes in policy, 23,24 they have frequently worked in supportive roles that put them in the line of direct fire which may cause considerable stress. 25 Women, like their male colleagues, may return from conflicts with mental health problems.…”

Section: Who Takes Care Of Pregnant Veteransmentioning

confidence: 99%

Obstetric Outcomes in U.S. Veterans: Emerging Knowledge, Considerations, and Gaps

Hugin

Shaw

2019

Semin Reprod Med

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In the post-9/11 era, the number of young women serving, and deploying, in the military grew rapidly; as they exit service, there is tremendous increase in reproductive-aged women Veterans. Here, we review the limited but growing research regarding Veterans' pregnancy and obstetric outcomes. U.S. women Veterans returning from deployment carry a high burden of physical and mental health conditions, and often trauma. As poor mental health is known to predict poorer maternal and infant sequelae, there are unique concerns around perinatal outcomes in Veterans. Accordingly, there is new attention to their reproductive risks and needs—evidenced by recent research and programmatic efforts within the VA. Emerging research suggests that the unique health profiles of pregnant Veterans, including prevalent posttraumatic stress disorder, predict increased risk of preterm birth, preeclampsia, and gestational diabetes. In the most contemporary large study, relying on California birth data, Veterans who relied on VA for their health care coverage were high risk, with increased rates of preeclampsia and Cesarean delivery. Additionally, Veterans' infants (compared with non-Veterans') were more likely to require NICU care. Additional research is needed to explore upstream factors leading to these poorer outcomes. Current effort to coordinate VA and non-VA care for Veteran mothers is warranted.

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“…Previous trends in military culture suggested shifts toward a more inclusive and accepting culture (Dunivin, ). Evidence of this change includes reduced restrictions placed on women in combat (fully implemented by 2016; McGraw, Koehlmoos, & Ritchie, ) and the repeal of “don't ask, don't tell” (the military's policy of removing personnel who reveal their sexual orientation to be gay or lesbian, repealed in 2010; Hoover, Tao, & Peters, ). The Trump administration, however, is trying to repeal policies that have advanced the equality of service members, although no legislation has been passed toward those efforts at the time of writing.…”

Section: Creation Of Military Family Leisure Experiencesmentioning

confidence: 99%

The Creation of Military Family Leisure Experiences

Melton

Townsend

Hodge

2018

J of Family Theo & Revie

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This article provides a theoretical model that positions family leisure experiences as a mechanism for positive family outcomes and resilience in military families. The article integrates the Creation of Family Experiences (CFE) framework with literature on military families, family leisure, and structured experiences. The CFE framework is a conceptual model that provides a lens for examining the context of family activities in order to better identify benefits for human development and family relations. When contextualized within military settings, the CFE can be used to understand and systematically optimize military family leisure experiences. It is critical to consider the experiences of military families (e.g., relocation, deployment, reunion) and how those experiences interact with family leisure experiences to produce resilient families. Future research and practice should consider this application of the CFE framework when seeking to explain, support, and program recreation‐based activities for military families.

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Women in Combat: Framing the Issues of Health and Health Research for America's Servicewomen

Abstract: The Department of Defense should continue to explore and address policy, research, and practice related to the complex ongoing needs of military females in combat roles, and ensures sufficient staffing, resources and support from senior military leaders.

Cited by 30 publications

References 9 publications

Sex-dependent responses to exertional heat stroke in mice

Sex-dependent responses to exertional heat stroke in mice

Obstetric Outcomes in U.S. Veterans: Emerging Knowledge, Considerations, and Gaps

The Creation of Military Family Leisure Experiences

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