PDF Version

ADF Health April 2007 - Volume 8 Number 1

CMVH in focus

Research priorities at the CMVH

• Sonya Bennett, Peter Nasveld and Ruth McLaughlin

THE CENTRE FOR Military and Veterans' Health (CMVH) is an innovative, multidisciplinary centre, focusing specifically on the health of Australian Defence Force members during and after their service. It is a consortium led by the University of Queensland, with the University of Adelaide and Charles Darwin University, and is supported by the Department of Defence (DoD) and the Department of Veterans' Affairs (DVA). The CMVH brings together military and veterans' health experts - researchers, health practitioners, serving ADF personnel and Reservists - who, through their combined talent, expertise and experience, seek to better understand and propose practical solutions to the health issues facing Australia's serving and former military men and women.

The research pillar of CMVH

The research section commenced operations in February 2004 with a single position, Research Manager, staffed by one fulltime Defence member. The inaugural appointee, Commander Sonya Bennett, held the position for 3 years to the end of 2006, when Lieutenant Colonel Peter Nasveld took up the appointment. The pillar has grown steadily and now consists of a multidisciplinary research team (10 full-time and 4 part-time staff) comprising specialist military and civilian health researchers. The CMVH draws on expertise from within the CMVH and the university consortium, and, where necessary, expert academics from outside the consortium.

The research priorities of CMVH are aligned with the key health priorities of CMVH's major stakeholders (DoD, DVA, civilian sector). The Box summarises these priorities across the three sectors:

• preventing injuries and illnesses;
• supporting a deployable capability (including treatment, rehabilitation and evacuation); and
• developing a capability edge (including enhancing physical, mental and integrated system performance).

Students enrolled in the Master of Public Health (Defence) have the option to include a research project as an elective. 1 The CMVH university consortium supports and promotes research programs through the CMVH, including the provision of academic supervision.

Deployment health surveillance program

The ADF has a continuing increased commitment in overseas locations, with operations including provision of health care and other support for disasters such as the recent tsunami in Asia. The health risks to which serving members are exposed are considerable, and vary with each location. Since 1999, the Australian Government has made a commitment to conduct formal health reviews of all overseas Defence deployments. In response, the Defence Health Service established a surveillance program to detect emerging veterans' health issues and generate data for investigation of identified health issues. The Deployment Health Surveillance Program (DHSP) is the flagship research program of CMVH.

Traditionally, post-deployment health studies have been retrospective, in that health issues were either raised from veterans' concerns or were hypotheses generated in descriptive studies of veterans' health. This approach had limitations, and it has been identified that a prospective capability would offer a range of benefits, including improved information on exposures, evaluation of current preventive practices, improved timeliness of benefits to veterans, and more quality reporting to community and government on post-deployment health. Thus, the long-term goal of the surveillance program is to analyse data that are routinely collected from ADF personnel before overseas deployment, at regular intervals during deployment, and on return to Australia. The DHSP has commenced studies on deployments in the Near North Area of Influence (Bougainville, East Timor and Solomon Islands) and the Middle East Area of Operations.

Completed research

A number of individual research projects have been completed. These include:

• The Oberon Class Submarine Occupational Hygiene Study: sponsored by the DoD, conducted by CMVH University of Queensland and University of Adelaide nodes.
• The InterFET Pilot Project, as part of the DHSP: sponsored by the DoD, conducted by CMVH.
• The Dental Risk Assessment Pilot Study: conducted by CMVH and the University of Adelaide.
• Research into Veteran Quality of Life, Health Care Utilisation and Personal Attributes: sponsored by DVA (through competitive tender), conducted by CMVH University of Queensland in collaboration with the University of Queensland School of Population Health and the Australasian Centre on Ageing.

Current programs of research

Research projects are grouped in research programs relevant to the identified CMVH research priorities.

Post-deployment health

• Deployment Health Surveillance Program.
• Clinical practice guidelines for post-deployment ill-health: Stage 1.
• Intergenerational research into health and psychosocial outcomes following military service.

Occupational health and safety

• Toxicology review of military aircraft turbine fuels.
• Scoping of clinical practice guidelines in key injury areas for workers compensation.
• Pilot study of Defence occupational health and safety management systems. The local management of health hazards is being critically examined, and recommendations with template risk assessments will be provided.
• Health risk evaluation of exposure to airborne particulates (dust) in the Middle East Area of Operations.
• Review of medical recruiting standards for Defence. CMVH is critically reviewing recruiting standards in the areas of asthma, colour vision, and body mass index for the DoD.

Prevention of chronic disease

• Dental risk management of unscheduled dental visits.
• Changes in dental caries risk in Navy recruits.

Tropical health

• A study of Chlamydia trachomatis: sexual risk behaviour, infection and prevention in the ADF.

Directors' research initiative

• Development of a new program of work on early intervention, rehabilitation and wellness, including self-managed care. This program is consistent with a change of policy direction by DVA, in which the emphasis on compensation will be lessened and the emphasis on early intervention, rehabilitation and wellness will be enhanced.

Future direction

The research pillar mission is to “undertake and facilitate high quality health and human performance research in relation to the needs of Defence and DVA to maximise the health, performance and deployability of ADF personnel and promote, improve and maintain the health, well-being and independence of the veteran community”.

CMVH has made a good start towards achieving this mission, but has some way to go to ensure the outputs of research are able to inform government policy in a meaningful way and that the research program is relevant to and balanced between the DoD and DVA.

The goals for the research pillar for the next 18 months are:

• to have a successful health and human performance research program;
• to have effective processes and tools for measuring success;
• to have a research program integrated across CMVH nodes;
• to be a major source of knowledge on military and veterans' health in Australian research and academic circles;
• to be the leading authority on military and veterans' health for the general public; and
• to be well regarded and an active contributor in the international community.

Reference

1. Duff N, Cannell G. CMVH in focus. Professional development. ADF Health 2006; 7: 92-93.

(Received 21 Feb 2007, accepted 21 Feb 2007)

Commander Sonya Bennett joined the Royal Australian Navy as an Undergraduate Medical Officer in 1991. She has had a variety of primary health care postings, including experience in submarine and underwater medicine and service at sea. Following various management postings in health centres, she was posted to the Army Malaria Institute, as first Research Officer and then OIC Clinical Studies and Surveillance, with research interests in tropical health and reproductive health.

Lieutenant Colonel Peter Nasveld has extensive experience as a Defence researcher at both the Army Malaria Institute and the Centre for Military and Veterans' Health, where he now holds the position of Research Manager. He recently completed an MPH at the University of Queensland and is currently undertaking doctoral studies at James Cook University. He has been the recipient of both the Surgeon General's Medal and the Weary Dunlop award. His deployment history includes Operation Tamar to Rwanda, as well as Operation Shaddock, Operation Bel Isi, and Operation Tanager. Ruth McLaughlin has a research background in exercise physiology and nutrition, with a special interest in weight loss and wellbeing. She was previously at the University of Strathclyde in Glasgow, before moving to Australia to take up a position at the National Heart Foundation Australia.

Centre for Military and Veterans' Health, Brisbane, QLD.

Sonya Bennett, Research Manager 2004-2006; Peter Nasveld, Research Manager; Ruth McLaughlin, Research Fellow and Head, Research Coordination Unit.

Correspondence: LTCOL Peter Nasveld, Centre for Military and Veterans' Health, Brisbane, QLD.