How to stop fighting ourselves: removing the stigma of mental health treatment for soldiers.

Soldiers' fear of stigmatization by peers and superiors is the primary barrier that the US Army must overcome as a prerequisite to providing successful mental health treatment to Soldiers who have been exposed to the combat environment. Untreated mental health conditions can lead to increased severity of symptoms and adversely affect mission readiness. Command leadership must become aware of the effects of combat exposure upon their Soldiers, and refer Soldiers to behavioral health facilities when necessary, so that their Soldiers are peak performers and mission ready.

The effect of group aerobic exercise and t'ai chi on functional outcomes and quality of life for persons living with acquired immunodeficiency syndrome.

OBJECTIVE: This study aimed to assess the usefulness of two interventions in a group rehabilitation medicine setting to determine strategies and exercise guidelines for long-term care of the HIV/AIDS population with human immunodeficiency virus (HIV) and/or acquired immunodeficiency syndrome (AIDS). DESIGN: This was a randomized clinical trial investigating the effects of tai chi (TC) and aerobic exercise (EX) on functional outcomes and quality of life (QOL) in patients with AIDS. SETTING: Two outpatient infectious disease clinics in a mid-atlantic state were the setting. SUBJECTS AND INTERVENTION: Thirty-eight (38) subjects with advanced HIV (AIDS) were randomized to one of three groups: TC, EX, or control. Experimental groups exercised twice weekly for 8 weeks. OUTCOME MEASURES: The primary outcomes included QOL as measured by the Medical Outcomes Short Form (MOS-HIV) and Spirituality Well-Being Scale (SWB). Functional measures included the functional reach (FR) for balance, sit and reach (SR) for flexibility, and sit-up (SU) test for endurance. The physical performance test (PPT) was used to determine overall function, and the Profile of Mood States (POMS) was used to evaluate psychologic changes. To consider the patients' explanations for these measurements, qualitative data were collected from subjects' journals, focus groups, and nonparticipant observation. RESULTS: Thirty-eight (38) subjects were included in data analysis: 13 in the TC group, 13 in the EX group, and 12 in the control group. Results of analysis of covariance showed significant changes in the exercise groups in overall functional measures (p < 0.001). The MOS-HIV showed a significant difference on the subscale of overall health (p = 0.04). The POMS showed significant main effect for time in confusion-bewilderment (p = 0.000) and tension-anxiety (p = 0.005). Three dominant themes emerged from the qualitative data, including: positive physical changes, enhanced psychologic coping, and improved social interactions. CONCLUSIONS: This study shows that TC and EX improve physiologic parameters, functional outcomes, and QOL. Group intervention provides a socialization context for management of chronic HIV disease. This study supports the need for more research investigating the effect of other types of group exercise for this population. This study sets the stage for a larger randomized controlled trial to examine the potential short- and long-term effects of group exercise that may prove beneficial in the management of advanced HIV disease. Further research is warranted to evaluate additional exercise interventions that are accessible, safe, and cost-effective for the HIV population.