Development of Longitudinal Data Analysis in Mental Health Research For Military Service Members.
Conclusions: Failure to use correct, appropriate models and methods in longitudinal data analysis can have unfortunate repercussions on a military health system that needs accurate findings to support valid policy decisions. By applying adequate models and methods, military health researchers will be able to better understand the complex interactions of biological, psychological, and social factors on mental health trends and transitions among military Service members. PMID: 30535418 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - December 12, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Intravenous Hydroxocobalamin Versus Hextend Versus Control for Class III Hemorrhage Resuscitation in a Prehospital Swine Model.
Authors: Bebarta VS, Garrett N, Boudreau S, Castaneda M Abstract Background: Hydroxyethyl starch (Hextend) has been used for hemorrhagic shock resuscitation, however, hydroxyethyl starch may be associated with adverse outcomes. Objective: To compare systolic blood pressure (sBP) in animals that had 30% of their blood volume removed and treated with intravenous hydroxocobalamin, hydroxyethyl starch, or no fluid. Methods: Twenty-eight swine (45-55 kg) were anesthetized and instrumented with continuous femoral and pulmonary artery pressure monitoring. Animals were hemorrhaged 20 mL/kg over 20 minutes and then ...
Source: Military Medicine - December 7, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Inertial Sensor-Based Assessment of Central Sensory Integration for Balance After Mild Traumatic Brain Injury: Corrigendum.
Authors: PMID: 30517673 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - December 7, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Return to Duty Following Open Reduction and Internal Fixation of Unstable Ankle Fractures in the Active Duty Population.
Conclusion: This study sought to determine predictors for return to duty within an active duty military population after ORIF of unstable ankle fractures. Given the paucity of military literature on this subject, the end goal was to provide realistic recovery expectations for both injured service members and their command teams. Overall, 81% of patients were able to return to active duty following operative treatment of unstable ankle fractures. There were no associations found between age, gender, military rank, or fracture patterns and return to duty. PMID: 30517675 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - December 7, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Response to the Letter by Weisman et al on: Twenty Thousand Needles Under the Sea: Trigger Point Dry Needling Aboard an Israeli Navy Submarine. A Case Report.
Authors: Ronel D, Gabbay O, Esterson A, Brand R, Vulfsons S PMID: 30517683 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - December 7, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Simulation Training for Operational Medicine Providers (STOMP): Impact of a Comprehensive Skills-Based Curriculum for Military General Medical Officers.
This study aimed to determine the impact this novel curriculum had on GMOs'confidence levels in 21 core privileges covering eight different subspecialties while stationed at Naval Medical Center Portsmouth (NMCP). Materials and Methods: A cohort study from 2015 to 2017 was designed to address our specific aim to examine if the implementation of the STOMP curriculum increased GMOs' confidence levels. Fifty-seven participants enrolled in the study. The GMO case group completed the STOMP curriculum (n = 22), while the control or GMO self-study group (n = 35) did not complete the curriculum. Six months after starting clini...
Source: Military Medicine - December 7, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

A Cluster of Exertional Rhabdomyolysis Cases in an ROTC Program Engaged in an Extreme Exercise Program: Corrigendum.
Authors: PMID: 30517717 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - December 7, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Incidence of Traumatic Brain Injury in the U.S. Military, 2010-2014.
Conclusions: Across all years, Marines and Army Soldiers experience the highest rates of injury with deployed SMs having elevated IRs of TBI. The TBI IR among deployed SMs was 91% higher than among those in the non-deployed setting, due to continued exposures to combat. Deployed Reserve/Guard component SMs seem to have an above average rate, a finding with implications for training and prevention. PMID: 30517721 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - December 7, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Telemedical Support for Military Medicine.
Conclusions: Broad implementation of telemedicine in the operational setting is challenged by network limitations and cyber security concerns. Reliable, high bandwidth, low latency, secure communications that is necessary for advanced telemedicine capabilities (i.e., procedural telementoring) will not likely be available at all times during future engagements. The military must develop and train a full spectrum of telemedical support options that include low-to-high bandwidth solutions. Telemedicine is not a substitute for deploying anticipated medical resources or optimizing training: telemedicine is plan B where plan A i...
Source: Military Medicine - December 1, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Response to Letter to the Editor From Mr. Russell Greene of CrossFit Inc.
Authors: Raleigh MF, Barrett JP, Jones BD, Beutler AI, Deuster PA, O'Connor FG PMID: 30496582 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - December 1, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Virtual Reality Training System for Anytime/Anywhere Acquisition of Surgical Skills: A Pilot Study: Corrigendum.
Authors: Wilhelmsen T PMID: 30496583 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - December 1, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Urological Manifestation of Cryptic Severe Psychiatric Illness.
In this report, we review the published literature on penile cellulitis and genital dermatitis artefacta. This case shows that military providers should always have psychiatric causes in their differential and not hesitate to ask about genital abnormalities. Recognition of underlying psychiatric etiology may play a key role in helping the patient get the care he or she needs. PMID: 30462252 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - November 22, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Split-Night Polysomnography Overestimates Apnea-Hypopnea Index in High-Risk Professions.
Conclusions: In the relatively young, non-obese ADSM population, the majority did not qualify for a SN-PSG. The 3-hour SN-PSG accurately determined OSA severity in those with moderate-severe OSA; however, some patients with mild OSA would have been misclassified which can result in unnecessary duty limitations. A SN-PSG may not be ideal for this population. PMID: 30462265 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - November 22, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Exploring Chiropractic Services in the Canadian Forces Health Services - Perceptions of Facilitators and Barriers Among Key Informants.
Conclusion: This study illuminated many opportunities and barriers, in complex and diverse domains, related to introducing collaborative chiropractic services in the CFHS. The findings are relevant to increasing understanding and strengthening interprofessional collaborative care within the unique CAF health care delivery system. PMID: 30462275 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - November 22, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Public Health Accreditation of Army Preventive Medicine Departments: Improving Military Medical Treatment Facility Practice to Impact Force Readiness.
Authors: Melton JJ, Shirey LA, Barraza EM, Bullock SH PMID: 30462286 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - November 22, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Analysis of a Military Parachutist Injury - A Retrospective Review of Over 37,000 Landings ‡.
Conclusions: The material has revealed a significant relationship among physical fitness, number of parachute jumps, soldier's age, and traumatism. Ankle sprain is the most frequent parachute injury. Compared to the soldiers of other types of military forces, soldiers - parachutists run a higher risk for military disqualification in the aftermath of sustained injury. PMID: 30462319 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - November 22, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Letter from the Executive Director November/December 2018.
Authors: Cho JM PMID: 30462323 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - November 22, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

The Physician Shortage: A Red Herring in American Health Care Reform.
This article contends that increasing the physician supply will not improve the health of Americans. Rather, solutions which lower health care costs while concomitantly improving health status will. Aside from community-level actions, health can improve at lower costs by increasing the prevalence of and proficiency in team-based care models, that address individual patient determinants of health, and poorly coordinated care. Future directions for this research and policy development are discussed. PMID: 30462337 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - November 22, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Person-Centricity: Promoting Self-Determination and Responsibility in Health and Health Care.
Authors: Robbins DA, Mattison JE, Dorrance KA Abstract The transition from a system focused on the delivery of sickness and illness services to one with a heavy focus of helping people become and remain healthier requires a major shift in how we view the patient and person. The health care system attempts to magically transform us from persons to patients in a context of sickness and disease, in need of medical procedures and interventions. Those few hours we spend a year in formal medical and health care contexts do not define us in the broader life space. We contend that "person-centricity" is more refl...
Source: Military Medicine - November 22, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Developing the Next Generation of Physicians.
Authors: LaRochelle J, Durning SJ, Gilliland W, Henry J, Ottolini M, Reamy B, Ritter J, Dorrance KA Abstract To improve health care, the USA needs to create a longitudinal medical education system that will develop physicians able to lead the transformation of health care toward a focus on the promotion of healthy behaviors aimed at preventing disease. The development of patient-centered care has been an important step in promoting healthy behaviors. However, to truly develop a meaningful relationship with a patient, a physician must first see them as a person, not as a list of diseases. Medical education should de...
Source: Military Medicine - November 22, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Toward a Contemporary Definition of Health.
Authors: Bradley KL, Goetz T, Viswanathan S Abstract Aristotle saw that the striving of humanity was toward being well - a physical, mental and spiritual state where life flourished. A contemporary definition of health recognizes that disease and disability can and often do co-exist with wellness. In this new conception, health is transformed from a state that requires the absence of disease to a state where the central theme is the fullness of life. Health becomes not a static state of being, but a dynamic quality of living where body, mind, and spirit are fully employed to make the most of each day. PMID: 304...
Source: Military Medicine - November 22, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

A Systems Approach to Person-Centric Health Economics.
Authors: Kimsey L, Hoburg A, Olaiya S, Jones KD, Richard P Abstract The economics of health and the economics of health care are not the same, and in fact can be competitors for resources in some cases. Using a traditional supply/demand framework can clarify the forces at work in person-centric health economics. Use of cost-effectiveness analysis, employing a broader systems perspective that incorporates sectors other than health care, and nudging individuals to better health habits are three strategies that can help to drive a shift from health care to health. PMID: 30462341 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - November 22, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

The Role of Incentives in Health - Closing the Gap.
Authors: Bradley KL, Shachmut K, Viswanathan S, Griffin B, Vielehr D Abstract Incentives motivate individuals to act in a certain way. Incentives are everywhere and in everything; they are woven into the very fabric of our lives. To address the issue of spiraling health care costs, incentive programs must be put into place to discourage the behaviors driving the growth of these costs. With nearly 75% of all health care costs associated with chronic diseases, most of which are preventable, the value of incentives must be recognized in policy and practice. Incentives can drive behavior, help realign the system, and i...
Source: Military Medicine - November 22, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Toward a National Conversation on Health: The Transformative Power of Deregulated Markets and Market-Driven Innovation.
Authors: Dorrance KA, Phillips AA Abstract The U.S. health care system is broken. Unhealthy behaviors, misaligned incentives, excessive regulations, and a reactive care delivery system have created an unsustainable situation for the American people. Health care reform efforts to date have focused primarily on costs, insurance coverage, and policies and regulations in an attempt to increase access, improve quality and control costs. In addition, the Affordable Care Act has created so much complexity that it is nearly impossible to determine how elements in the health care system interact or impact health outcomes. H...
Source: Military Medicine - November 22, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Promoting and Sustaining Positive Personal Health Behaviors - Putting the Person First.
Authors: Teyhen DS, Robbins D, Ryan BA Abstract Amidst the national debate on the future of health care, there must be a focus on how individuals, communities, and the system need to change to promote and sustain health rather than reactively treat sickness and disability. To transition from a health care system to a "System for Health", we need to move from a patient-focused to a person-focused position. A system that focuses on improving personal decisions related to activity, nutrition, sleep, and tobacco-free living could have a profound impact on health and well-being. The delivery of health, instead...
Source: Military Medicine - November 22, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Toward a National Conversation on Health: Disruptive Intervention and the Transformation from Health Care to Health.
Authors: Dorrance KA, Robbins DA, Kimsey L, LaRochelle JS, Durning S Abstract Over a century ago, Abraham Flexner's landmark report on medical education resulted in the most extensive reforms of medical training in history. They led to major advances in the diagnosis and treatment of disease and the relief of suffering. His prediction that "the physician's function is fast becoming social and preventive, rather than individual and curative," however, was never realized.Instead, with the rise of biomedical science, the scientific method and the American Medical Association, the health care system became in...
Source: Military Medicine - November 22, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Incidence and Risk Factors of Foot and Ankle Disorders in Male Finnish Conscripts.
Conclusions: The study shows that foot and ankle disorders are common in this population. Most of them occur in the first 2 months of the military service. Further analysis of different conditions was not possible, as many of the diagnostic codes were missing. PMID: 30423135 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - November 15, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Suicide in the Military: Understanding Rates and Risk Factors Across the United States' Armed Forces.
Authors: Pruitt LD, Smolenski DJ, Bush NE, Tucker J, Issa F, Hoyt TV, Reger MA Abstract This paper presents data from the United States Department of Defense Suicide Event Report System for years 2012-2015 to detail descriptive, longitudinal rate data and risk factor profiles associated with military suicide. The annual findings were aggregated from all U.S. military suicide deaths and suicide attempts. Data elements included the most common method of suicide (firearms), most common behavioral health diagnoses (substance abuse/dependence), common life stressors (failed intimate-partner relationships), and an indivi...
Source: Military Medicine - November 15, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

The Effectiveness of an Upper Extremity Neuromuscular Training Program on the Shoulder Function of Military Members With a Rotator Cuff Tendinopathy: A Pilot Randomized Controlled Trial.
Authors: Ager AL, Roy JS, Gamache F, Hébert LJ Abstract Introduction: Shoulder pain, a leading reason to consult a physician or physiotherapist, continues to be a challenge to rehabilitate, particularly with a military population. A rotator cuff (RC) tendinopathy, the most important source of shoulder pain, is one of the leading reasons for sick leave or a discharge from active military service. Research encourages the use of exercise prescription for the management of a RC tendinopathy, however the ideal method of delivery (group setting versus one-on-one) remains uncertain. The purpose of this single-blind...
Source: Military Medicine - November 15, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Hemoglobin San Diego: An Uncommon Cause of Hereditary Erythrocytosis Discovered Incidentally in a Military Trainee.
We report such a case involving an 18-year-old active duty military trainee who presented to the hematology clinic after an isolated erythrocytosis was incidentally discovered during a flight physical. The patient was asymptomatic but did report a family history of erythrocytosis in his mother and maternal grandmother which intermittently required venesection. Initial history and physical exam were unremarkable. P50 RBC Oxygen Dissociation showed a left-shifted oxygen dissociation curve, although hemoglobin electrophoresis did not reveal an abnormal hemoglobin variant. A β-globin variant was identified via mass spectr...
Source: Military Medicine - November 15, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

A Comparison of Mentorship Attitudes and Attributes Between Civilian and Army Healthcare Leaders.
Conclusion: The differences between the Army and civilian samples appear to arise from differences in their respective cultures. The utilization by the Army of formal training programs such as the Army's Basic Officer Leadership Course (BOLC), fill a need provided by mentors in civilian organizations. The common experience of professional training like BOLC is part of what creates and sustains the "thick" culture of the Army. Former Army members making the transition to a civilian career should bear in mind that they are leaving behind a thick culture, and that individual relationships may have greater impact on ...
Source: Military Medicine - November 15, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

The Rising Physicians Program: A Novel Approach for Mentoring Medical Students.
Conclusions: The Rising Physician Program provides a near-peer mentoring model for new medical students. Students preferred to communicate with their mentors in person, but the flexibility of communication appears to be important. New students have a variety of academic and professional development concerns that could partially be addressed through mentoring by residents. PMID: 30423166 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - November 15, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Predictors of Postdeployment Prescription Opioid Receipt and Long-term Prescription Opioid Utilization Among Army Active Duty Soldiers: Corrigendum.
Authors: PMID: 30423173 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - November 15, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Safety of Repeated Imported Fire Ant Ultra-Rush Protocols.
Authors: Adams KE, Johnson KS Abstract Treatment of imported fire ant (IFA) hypersensitivity includes avoidance and venom immunotherapy (VIT) that reduces the risk of reactions to less than 5%. Previous studies have shown that rush immunotherapy (RIT) is safe and efficacious. It is unknown if multiple RIT procedures on individuals with breaks in VIT are safe and effective. This is a retrospective chart review of three patients who have undergone six IFA VIT rush protocols at our institution. Patients were all female with a median age of 27 years. All are active duty service members without medical problems who resi...
Source: Military Medicine - November 7, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Instructor and Trainee Judgments of Cohesion in Mixed-Gender Military Teams.
Conclusions: Our findings agree with a previously published analysis of recruit performance over a 5-year period (2011-2015). Composite instructor ratings of recruit performance, including their teamwork, were similar for males and females regardless of the gender composition of platoons, which ranged from all male to 45% female. The next step in this research is to determine the pattern and dynamics of bonding between team members and their leaders as soldiers progress through their advanced training and ultimately operational deployment. Such research should reveal whether any differences in cohesion appear in relation t...
Source: Military Medicine - November 7, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

The Modular Adaptive Electrotherapy Delivery System (MAEDS): An Electroceutical Approach for Effective Treatment of Wound Infection and Promotion of Healing.
Authors: Bogie KM Abstract Background: Infected wounds are painful and cannot heal, with antibiotics showing reduced efficacy. Appropriate wound electrotherapy may limit incident planktonic and polymicrobial colonization, inhibit biofilm formation and accelerate healing. Methods: The Modular Adaptive Electrotherapy Delivery System (MAEDS) is a lightweight, flexible, battery-powered disposable bandage which delivers controlled reliable electrotherapy to the wound for up to 7 days. Large full-thickness excisional wounds (6 cm diameter) were created in a porcine model and freshly cultured 0.5 McFarland green fluor...
Source: Military Medicine - November 7, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

The First 30 Months Experience in the Non-Doctrinal Operation Inherent Resolve Medical Theater.
Conclusions: Host nation military males injured by explosion comprised the majority of casualties. Open fracture was the most common major injury. Hence, future research should focus upon the unique challenges of delivering care to members of partner forces with particular focus upon interventions to optimize outcomes among patients sustaining open fractures. PMID: 30395276 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - November 7, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Demographics, Risk Factors, and Incidence of Melanoma in Patients in the New England VA Healthcare system.
Authors: Bae E, Leone D, Konnikov N, Mahalingam M Abstract Introduction: A recent study found that the incidence of melanoma and melanoma-related mortality was decreasing in residents of the New England region. However, it is unknown whether this trend is conserved in Veterans of New England who constitute more than 14% of the national Veteran population. Given this, our goal was to analyze the incidence of melanoma in patients of Veteran Integrated Service Network-1 (VISN-1) (geographically consisting of VA health care facilities in Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont) and t...
Source: Military Medicine - November 7, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

The Importance of Understanding the Medical Education System in Partner Nations.
Authors: Shinwari SA, Zuerlein S, Singer L, Kumpf J PMID: 30395281 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - November 7, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Negative Life Events (NLEs) Contributing to Psychological Distress, Pain, and Disability in a U.S. Military Sample.
Conclusions: Findings revealed that NLEs may impart a significant burden on military pain sufferers. Greater numbers of endorsed NLEs are associated with increased psychosocial distress and poor pain coping. Future longitudinal studies examining long-term psychosocial distress/poor pain coping as related to NLEs would help to elaborate the long-term consequences of NLEs on pain coping and psychosocial distress. PMID: 30395305 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - November 7, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Jaundice in a Service member Returning From Taiwan; Diagnostic Challenges in a Case of Acute Hepatitis E.
Authors: Bush A, Sadowski B, Torres D Abstract When the evaluation of newly elevated liver enzymes is unrevealing, a common diagnosis of exclusion is drug-induced liver injury. A 39-year-old active duty service member who presented with jaundice after returning from a mission in Thailand was found to have an acute hepatitis and developing acute liver failure. He was ultimately diagnosed with acute hepatitis E, but his diagnosis was initially confounded by multiple exposures to supplements known to cause drug-induced liver injury. This case illustrates the importance of broadened serologic testing in patients with a...
Source: Military Medicine - November 7, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Dietary Supplement Use in Australian Army Personnel.
This study investigated the prevalence and types of DS used by Australian Army personnel and examined the underpinning reasons and demographic factors influencing this use. Materials and Methods: A Convenience sample of Australian Army personnel from both Headquarter (desk-based) and Brigade (field-based) environments completed a researcher-designed DS questionnaire. The questionnaire examined 19 types of DS (including sports foods) and reasons for use. Logistic regression, adjusting for age, sex, education, physical activity, BMI, and occupational group were performed. Results: A total of 667 personnel completed t...
Source: Military Medicine - October 30, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Longitudinal Analysis of CAD/CAM Restoration Incorporation Rates into Navy Dentistry.
Conclusions: Implementation of CAD/CAM digital restorations has led to a significant decline in specific traditional analog procedures since productivity tracking of CAD/CAM was initiated in 2011. Navy dentistry has embraced CAD/CAM as an efficient means to prepare sailors and marines for deployments, improve operational dental readiness, and potentially decrease dental emergencies by reducing the need for provisional restorations. The trend toward increased utilization of digital dentistry is expected to continue for the following reasons: (1) incorporation of CAD/CAM technology into dental school curricula, (2) advanceme...
Source: Military Medicine - October 30, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Restrictive Transfusion Strategy Is More Effective in Massive Burns: Results of the TRIBE Multicenter Prospective Randomized Trial.
Authors: Palmieri TL, Holmes JH, Arnoldo B, Peck M, Cochran A, King BT, Dominic W, Cartotto R, Bhavsar D, Tredget E, Stapelberg F, Mozingo D, Friedman B, Sen S, Taylor SL, Pollock BH Abstract Objectives: Studies suggest that a restrictive transfusion strategy is safe in burns, yet the efficacy of a restrictive transfusion policy in massive burn injury is uncertain. Our objective: compare outcomes between massive burn (≥60% total body surface area (TBSA) burn) and major (20-59% TBSA) burn using a restrictive or a liberal blood transfusion strategy. Methods: Patients with burns ≥20% were block randomized by...
Source: Military Medicine - October 30, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Gender Differences in Post-deployment Adjustment of Air Force Personnel: The Role of Wartime Experiences, Unit Cohesion, and Self-efficacy.
Conclusion: There are similarities and differences in the wartime experiences of military men and women. Increased exposure to combat experiences is a risk factor for both groups. Women appear to have greater vulnerability to PTSD and depression at all levels of combat exposure, and also report lower levels of unit cohesion and self-efficacy. It is possible that interventions that boost self-efficacy and unit cohesion could promote resilience for combat-exposed military personnel. Because self-efficacy operated differently for men and women, the role of this variable in post-deployment adjustment should be examined more cl...
Source: Military Medicine - October 30, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Factors Associated With U.S. Army Physician Service After Obligation Completion.
Conclusions: The physicians most likely to continue serving after completion of their obligation and ultimately retire are those who had the most years of service accumulated when they could leave the Army. Graduates from the Uniformed Services University of the Health Sciences (USU) incur an obligation of 7 years vs. 4 years for most other programs. USU also attracts a higher proportion of applicants with prior military service and pre-medical school service obligations. The lack of significant difference in service after obligation completion or achievement of retirement eligibility between USU and non-USU graduates was ...
Source: Military Medicine - October 30, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Barriers and Enablers Influencing Dietary Practices in Australian Army Personnel.
Conclusion: Time, motivation, deployment, and ready access to take away food challenged healthy eating in this AA sample. However, participants were keen to engage with nutrition education for physique improvement, military readiness, and health reasons. PMID: 30371876 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - October 30, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Operational Readiness: Redesigning Advanced Practice Registered Nurse (APRN) Curriculum for an Evolving Battlefield.
Conclusions: This manuscript describes a novel approach to provide operational readiness education to military APRN students. Through an evaluation of the current literature, expert reports and information of the current operational requirements, the USU GSN has developed a model and curricula for APRN operational readiness that lie beyond the traditional skills in the peacetime setting. Through this plan of instruction, USU GSN APRN students will have the requisite skills to meet the evolving operational needs of the Department of Defense. PMID: 30371877 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - October 30, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Endocrine Effects of Simulated Complete and Partial Aortic Occlusion in a Swine Model of Hemorrhagic Shock.
Conclusions: Simulated EVAC was associated with higher serum angiotensin II, which may have contributed to previously reported cardiovascular benefits. Future studies should evaluate the renal effects of EVAC and the concomitant therapeutic use of angiotensin II. PMID: 30371879 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - October 30, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Modified Battlefield Acupuncture Does Not Reduce Pain or Improve Quality of Life in Patients with Lower Extremity Surgery.
Conclusion: The use of modified battlefield acupuncture protocol does not change pain opioid use or quality of life in those with lower extremity surgery. PMID: 30371882 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - October 30, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research