2021 ENRS Grantee

Eastern Nursing Research Society (ENRS) – CANS Dissertation Award 

The Impact of Military Blast Exposures on Metabolic Abnormalities in Post 9/11 Veterans

Dora Lendvai Wischik, MSN, RN, PhD Candidate, Yale School of Nursing

Background: according to Veterans Health Administration (VHA) data, over 44% of post 9/11 veterans (served since 2001) are obese, which exceeds what is observed in the general public of equivalent age groups. Obesity is an independent risk factor for developing more serious metabolic abnormalities such as glucose dysregulation and insulin resistance (IR). While the risk for obesity in post 9/11 veterans is complex, military service injuries (such as traumatic brain injuries [TBIs]), post-military psychological disorders (e.g., post-traumatic stress disorder [PTSD], depressive, anxiety and substance use disorders [SUD]) and somatic sequalae (sleep disturbance and pain) have been suggested as unique predictors of obesity in this veteran cohort. Recent evidence also suggests that damages sustained from exposure to repeated low impact (between 10 – 100 m), or close-range blast explosions (< 10m) during deployment to post 9/11 military conflicts may also impact metabolic health.

Specific Aims
: (1) to identify associations between military blast exposures and metabolic abnormalities; and (2) to examine the mediating effect of psychological and somatic factors on metabolic abnormalities in a sample of post 9/11 veterans.

Methods: cross-sectional, secondary data analysis of the Translational Research Center for TBI and Stress Disorders (TRACTS) ongoing longitudinal cohort’s baseline sample (n=573), following a conceptual framework derived from a systematic review of the literature. Using a secure VHA data sharing platform, and the SAS analytical software, I will compute a series of logistic regression and mediation analyses according to the counterfactual approach.

Significance: the expected outcomes of this project include better understanding the impact of military blast exposure on key metabolic abnormalities in post 9/11 veterans and the post-military psycho-somatic factors that affect the strength of these relationships. Results of this study will provide important clinical implications for the prevention and treatment of metabolic abnormalities in post 9/11 veterans.

Awardee Statement:

Dora_Lendvai_WIschik_-_Wischik_Dora.jpgI am grateful for the Council for the Advancement of Nursing Science (CANS) for granting me the 2021-2022 Pre-doctoral Dissertation Award, for multiple reasons. First, winning this was a highlight of my training in nursing science (at least so far), which further fueled my motivation to help people improve their lives through the findings of science, delivered from a nursing perspective. Giving such jolt to early career professionals certainly aligns with one of CANS’s goals – facilitating and recognizing nursing science development.

Second, winning this award also provided me with a substantial financial support that in turn will allow me to reach my professional goals. These include helping to cover open-access publishing costs, as well as creating a website that will further help to disseminate my research findings to the special population of people I serve: Post-9/11 Veterans. Military service – especially Post 9/11 conflicts – put those serving in the military at higher risk for developing certain health conditions and pathologies earlier than the general population. Through Veterans Health Administration data, we see an increasing trend for the development of metabolic health abnormalities (such as obesity or insulin resistance) in these still young men and women, which I hope to address through my career in nursing science and leadership. I believe these also align with the goals and mission of CANS (sharing, translating and dissemination scientific information). Future publications of my dissertation findings will be shared with CANS and the community around Spring of 2022.