The Veterans With Diabetes Transition Study. Veterans Experience of the Process of Transition Following Active Duty Diagnosis.
Conclusions: Study participants reported consistent compliance in diabetes self-management. Skills and attitudes obtained during military service led to participant's desire to manage their healthcare with determination to cope with challenges accompanying diabetes. The healthcare transition process would benefit from additional exploration of veteran's needs. Improved processes may facilitate the healthcare management transition of personnel with diabetes from active duty to veteran status. PMID: 30690514 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - January 30, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Infant Feeding Practices, Workplace Breastfeeding/Lactation Practices, and Perception of Unit/Service Support Among Primiparous Active Duty Servicewomen.
Conclusion: While almost half of the respondents were still breastfeeding and planned to continue 5-6 months postpartum and the majority of respondents felt "mostly" or "very" supported in their breastfeeding by their unit and the Army, comprehensive physical support for lactation in the workplace was inconsistent. This study provides feedback to inform ongoing implementation of the existing Army breastfeeding support directive. PMID: 30690531 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - January 30, 2019 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.
Authors: PMID: 30690562 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - January 30, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Management of Chronic Migraine and Occipital Neuralgia in Post 9/11 Combat Veterans.
Conclusion: This study evaluated the effectiveness of using occipital blocks and Botox as dual therapy for reducing headache frequency for post 9/11 combat veterans with CM, occipital neuralgia, and a history of TBI or neck trauma. Results revealed a statistically significant reduction in the number of headache days per month after the dual therapy. There were multiple limitations to the study to include a small sample size, lack of a control group, self-reported headaches for only 1 month pre-and post-treatment, and no control for other interventions or events which may have influenced the outcome. There is a strong need ...
Source: Military Medicine - January 30, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Self-Managed Strength Training for Active Duty Military With a Knee Injury: A Randomized Controlled Pilot Trial.
Conclusions: Knee extensor strength improvements in the COMBO group were significantly higher compared to usual PT. Pain, functional measures, and ADLS all improved during the study with no group differences. Further research is required to confirm these findings. PMID: 30690578 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - January 30, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Lessons from Leading US Public Health Service Physicians.
Authors: Iskander J, Ahluwalia J, Luckhaupt S, Lewis B PMID: 30690585 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - January 30, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Spinal Fusions in Active Military Personnel: Who Gets a Lumbar Spinal Fusion in the Military and What Impact Does It Have on Service Member Retention?
Discussion: This investigation reports on the largest cohort of active military personnel undergoing spinal fusion. A variety of demographic information are reviewed to clarify the picture of soldiers at risk for needing a spinal fusion. While younger age was an independent risk factors for worsened VAS scores, no independent variable portended a worse ODI score at last follow-up. Despite improvements in objective measures such as VAS, ODI, and increases in rank, soldiers going on to retirement collected a dramatic service-connected disability percentage. Level of Evidence: Level IV, Therapeutic. PMID: 30690620 [Pu...
Source: Military Medicine - January 30, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Current Practices in Anterior Cruciate Ligament Reconstruction in the U.S. Military: A Survey of the Society of Military Orthopaedic Surgeons.
This study was exempt from IRB approval. Results: Of the identified 131 surgeons, 56 were excluded, leaving 75 providers for study inclusion, with a 100% response rate. Surgeons preferred autograft for younger patients (80.5%) (patients ≤25 yr), whereas they relied on patient choice more commonly for older patients (51.9%). Surgeons preferred bone-patellar tendon-bone autograft for males ≤25 yr of age (51.3%) compared with 34.2% for females in the same age range. Independent femoral drilling was performed by 96.0% of surgeons for primary soft tissue ACL reconstructions. Suspensory fixation was the preferred fixat...
Source: Military Medicine - January 30, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Civil War Drummer Boys: Musicians, Messengers, and Medical Assistants.
Authors: Schuette W, Armstrong ML PMID: 30551149 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - December 15, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

A Tale of Two Compulsions - Two Case Studies Using Accelerated Resolution Therapy (ART) for Obsessive Compulsive Disorder (OCD): Corrigendum.
Authors: PMID: 30551197 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - December 15, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Non-battle Emergency Department Utilization of the First Modular Army Field Hospital Prototype in Support of Operation INHERENT RESOLVE.
Conclusions: Non-battle injuries and illnesses were the predominant reason for ED utilization. Most subjects were discharged back to duty with relatively low-resource utilization. Few visits required procedural interventions. PMID: 30534976 [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

En Route Resuscitation - Utilization of CCATT to Transport and Stabilize Critically Injured and Unstable Casualties.
Conclusion: This brief report demonstrates the need of CCATT in the transport of unstable patients from forward deployed locations. The Air Force has adapted and is continuing to adapt CCATT training, equipment, onboard diagnostics and therapies, and team members' clinical skills to meet en route care combat casualty needs. PMID: 30535030 [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

Facilitators and Barriers to Contraceptive Use Among U.S. Servicewomen Who Had an Abortion.
Conclusions: Active duty servicewomen who had an abortion experienced many barriers to accessing contraception while in the military. These findings highlight the need to improve contraceptive counseling and access in the U.S. military. Results support the need to implement mandatory yearly and pre-deployment contraceptive counseling as required by the 2016 National Defense Authorization Act, offer contraceptive counseling in multiple settings, ensure military providers receive training to avoid contraceptive coercion, expand military clinic and pharmacy hours, increase the number of female military health care providers a...
Source: Military Medicine - December 12, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Pulsed Dose Oxygen Delivery During Mechanical Ventilation: Impact on Oxygenation.
Authors: Blakeman T, Rodriquez D, Johannigman J, Branson R Abstract Introduction: Adequate oxygenation is one of the primary goals of mechanical ventilation. Maintenance of adequate oxygenation and prevention of hypoxemia are the primary goals for the battlefield casualty, but military operations have unique concerns. In military operations, oxygen is a limited resource. A portable oxygen concentrator has the advantage of operating solely from electrical power and theoretically is a never-exhausting supply of oxygen. Our previous bench work demonstrated that the pulsed dose setting of the concentrator can be used i...
Source: Military Medicine - December 12, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

The Overtraining Syndrome in Soldiers: Insights from the Sports Domain.
Conclusions: Much research on NFOR/OTS has been conducted in the sports domain and the military could make use of these insights to promote a more efficient balance between training load and recovery. It is suggested to regularly test soldiers on physical performance, psychomotor speed and mood using ideally a military-specific test or the 1.5-mile run, psychomotor vigilance test and Profile of Mood States. The two-bout exercise test can be used as a specific test if previous testing indicates the development of NFOR/OTS and can be combined with metabolic and immunological testing to exclude pathological causes. PMID: ...
Source: Military Medicine - December 12, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

A Cross-Sectional Survey on Cigarette Smoking in the Chinese Navy.
Conclusions: Smoking prevalence in the Chinese navy is higher than that among Chinese civilians and the US and UK military personnel. Although many sailors are aware of the dangers of smoking to their health, they seldom get advice or help regarding smoking cessation. Most smokers believed that smoking cessation could improve their health. Therefore, the navy should formulate policies encouraging and facilitating military personnel's smoking cessation. PMID: 30535298 [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

The Downside Risk of Failing to Transcend Extraordinarily Negative Experiences: A Narrative Analysis.
Conclusion: Transcendence as an experiential meaning-making process may utilize existential resources that enable one to make sense of personally relevant, extraordinarily positive, and negative events. If identity-relevant experiences are more powerful predictors of distress and well-being than those not relevant to one's sense of identity, then there should be greater focus on those kinds of experiences when working with service members struggling to bounce back from trauma. There are many contexts in which this can be done. Military chaplains, for example, are potentially very well suited to help service members reconne...
Source: Military Medicine - December 12, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Contemporary Comparison of Open to Robotic Prostatectomy at a Veteran's Affairs Hospital.
Authors: Desai A, Hudnall M, Weiner AB, Patel M, Cohen J, Gogana P, Sharifi R, Meeks JJ Abstract Introduction: Among veterans, prostate cancer is the most common malignancy and has a higher incidence compared to the rest of the nation. No study has compared the effectiveness of Robotic-assisted-laparoscopic radical prostatectomy (RALP) vs. open radical prostatectomy (ORP) in the Veteran's Affairs (VA) hospital setting during the adoption of RALP. Methods: Institutional Review Board approval was obtained. Retrospective review was completed on Veterans with prostate cancer who underwent ORP or RALP from March 201...
Source: Military Medicine - December 12, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Input of a Multi-Disciplinary Meeting in the Treatment of Osteoarticular Infections in French War Casualties.
Conclusion: The MDM seems to have had a beneficial impact on orthopedic surgeon practices. A significant increase of the number of samples taken was the most obvious sign that the French recommended practices for osteoarticular infections were followed since the creation of MDM. PMID: 30535350 [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

The Effects of Group Prenatal Care on Infant Birthweight and Maternal Well-Being: A Randomized Controlled Trial.
Conclusions: Military parturients receiving group prenatal care in the CenteringPregnancy model were less likely to deliver an small for gestational age or large for gestational age newborn and were more likely to be satisfied with their access to care. Group prenatal care is well received by patients and may positively influence neonatal metabolic status. PMID: 30535396 [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

The Incidence of Dental Needs During Isolated Missions Compared to Non-isolated Missions: A Systematic Review and Implications for Future Prevention Strategies.
Conclusion: This systematic review shows that the incidence of dental pathology in long-term isolation conditions may seem relatively infrequent but it exists and is relevant. Dental events are unpredictable, unrelated to trauma, and caused mainly by poor dental status. Preventive measures considerably reduce dental prevalence. PMID: 30535397 [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

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