Soldier and family wellness across the life course: a developmental model of successful aging, spirituality, and health promotion, Part II.

As an alternative to the current Department of Defense approach to health promotion and related research, which is critiqued in Part I of this article, the authors present a new, integrative health promotion and wellness model. This age-graded model incorporates successful aging, targeted health promotion, and spirituality in the context of the developmental perspective provided by life course constructs. By using an age-graded, multidisciplinary system of assessment, intervention, and follow-up in the context of preparing military personnel and families for the next season of life, this model advocates the prevention of disease and disability, active engagement with life, the maximization of high cognitive and physical functioning, and positive spirituality. Preliminary, selected illustrations from a variation of this model at the U.S. Army War College are provided. Progressive extrapolation of the model to other military leadership schools is proposed as a more efficacious health promotion strategy for the Department of Defense.

Soldier and family wellness across the life course: a developmental model of successful aging, spirituality, and health promotion. Part I.

The primary purposes of this article are to (1) highlight current challenges facing health promotion advocates within the military and civilian culture; (2) present the strengths and weaknesses of the current Army approach to health promotion and preventive medicine; and (3) present several unifying themes that contribute to enhanced progress within the field of health promotion. A conceptual model that links common goals across the fields of successful aging, health promotion, spirituality and health, and life course is advocated to maximize efficacious interventions and to transform the current Army approach to health promotion. A companion article will describe an integrative model of health promotion and wellness that responds to the challenges and incorporates the unifying themes described in this article.

Falls in the elderly.

Falls are the leading cause of injury-related visits to emergency departments in the United States and the primary etiology of accidental deaths in persons over the age of 65 years. The mortality rate for falls increases dramatically with age in both sexes and in all racial and ethnic groups, with falls accounting for 70 percent of accidental deaths in persons 75 years of age and older. Falls can be markers of poor health and declining function, and they are often associated with significant morbidity. More than 90 percent of hip fractures occur as a result of falls, with most of these fractures occurring in persons over 70 years of age. One third of community-dwelling elderly persons and 60 percent of nursing home residents fall each year. Risk factors for falls in the elderly include increasing age, medication use, cognitive impairment and sensory deficits. Outpatient evaluation of a patient who has fallen includes a focused history with an emphasis on medications, a directed physical examination and simple tests of postural control and overall physical function. Treatment is directed at the underlying cause of the fall and can return the patient to baseline function.

Influenza A among hospital personnel and patients. Implications for recognition, prevention, and control.

An outbreak of influenza A/Philippines H3N2 at a 1156-bed Veterans Administration Hospital involved 118 hospital personnel and 49 patients. Prospective surveillance methods that had been established within the hospital were not useful in identifying the number of involved individuals. Community indicators of influenza, which were reviewed retrospectively, would not have identified circulating influenza in this population. Control of the outbreak was accomplished using a creative approach that immunized over a third of the physician and nursing staff. This immunization program was successfully used in subsequent years to increase personnel compliance with the Immunization Practices Advisory Committee recommendations to annually immunize hospital personnel.

Hemoglobins A and A2 in New World primates: comparative variation and its evolutionary implications.

Hemoglobin A(2) (alpha(2)delta(2)) in New World primates represents about 1/160 to 1/16 of total hemoglobin and, by virtue of this low proportion, is presumed to be functionally unimportant. Nonetheless, A(2) exhibits genetic polymorphism by electrophoresis in three out of five genera, whereas the major component, hemoglobin A (alpha(2)beta(2)), is electrophoretically invariant. Moreover, in four genera, including man, the evolutionary accumulation of mutations has been greater in delta than in beta Such findings suggest that both polymorphism and evolutionary changes can accrue to an effectively functionless and thus selectively nearly netutral gene.