Survey of Occupational and Environmental Exposure Monitoring Solutions.
CONCLUSIONS: Evolving technologies and data management strategies may advance personal exposure monitoring in the future. These new devices and methods will likely supplant current technologies, while still using the programmatic and data framework established with early implementation of current commercial off the shelf devices. PMID: 31498403 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - September 10, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Interaction Between Psychiatric Symptoms and History of Mild TBI When Evaluating Postconcussion Syndrome in Veterans.
CONCLUSIONS: The NSI score was primarily explained by symptoms of PTSD and depression, suggesting that the NSI is not specific to the experience of a brain injury. We recommend cautious interpretation when this measure is used in the chronic phase after mTBI, especially among patients with comorbid depression or PTSD. PMID: 31498405 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - September 10, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Noncontact Speckle Contrast Diffuse Correlation Tomography of Blood Flow Distributions in Burn Wounds: A Preliminary Study.
CONCLUSIONS: The unique noncontact 3D imaging capability makes the scDCT applicable for intraoperative assessment of burns/wounds, without risk of infection and without interfering with sterility of the surgical field. The portable scDCT device holds the potential to be used by surgeons in combat surgical hospitals to improve the acute management of battlefield burn injuries. PMID: 31498406 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - September 10, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Efficacy of Medical Operations and Layout Planning Onboard Nontraditional US Navy Vessels at High Seas.
CONCLUSION: This shows that the working conditions aboard the US Naval Ship Brunswick were satisfactory for the assigned tasks, indicating that these medical operations may be feasible aboard nontraditional US Navy vessels. PMID: 31498411 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - September 10, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

A Case Report of Slug Ingestion Causing Eosinophilic Meningitis, Papilledema, and Pronounced Motor Weakness in a US Marine.
We describe the unique clinical features of this disease in our patient. PMID: 31436288 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - August 24, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Case Study of a Breacher: Investigation of Neurotrauma Biomarker Levels, Self-reported Symptoms, and Functional MRI Analysis Before and After Exposure to Measured Low-Level Blast.
We report a case study on a single military member who received moderate blast overpressure (OP) exposure during routine breacher training. We extend previous research on blast exposure during training, which lacked sufficient data to assess symptom profiles and OP exposure. The present work was conducted because a subjective symptom profile similar to that seen in sports concussion has been reported by military personnel exposed to blast. Data collection for this study was carried out under a research protocol approved by the relevant Human Subjects Review Committees on one subject, who received the highest OP exposure du...
Source: Military Medicine - August 21, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Evidence for Residual Immunity to Smallpox After Vaccination and Implications for Re-emergence.
CONCLUSIONS: Most studies suggest a longer duration of residual immunity (at least 20 years) than assumed in smallpox guidelines. Estimates from modeling studies were less but still greater than the 3-10 years suggested by the WHO Committee on International Quarantine or US CDC guidelines. These recommendations were probably based on observations and studies conducted while smallpox was endemic. The cut-off values for pre-existing antibody levels of>1:20 and>1:32 reported during the period of endemic smallpox circulation may not be relevant to the contemporary population, but have been used as a threshold for identif...
Source: Military Medicine - August 3, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Letter From AMSUS Executive Director Dr. John Cho.
Authors: Silver M PMID: 31348826 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - July 28, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Preparing Future Medical Educators: Development and Pilot Evaluation of a Student-Led Medical Education Elective.
CONCLUSIONS: Medical education courses not only offer an opportunity for senior students to cultivate educational theoretical knowledge and teaching skills in preparation for residency but also contribute positively to the learning experiences of underclass students. Now that the elective has been piloted with initial data suggesting feasibility and benefit to both MS4 and MS1 students, the next steps are to focus on ensuring longevity of the course offering at USU and to consider working with senior students at other institutions that lack formal training in education to start similar student run medical education initiat...
Source: Military Medicine - July 25, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

High Resiliency Linked to Short-Term Patient Reported Outcomes and Return to Duty Following Arthroscopic Knee Surgery.
Authors: Drayer NJ, Wallace CS, Yu HH, Mansfield TD, Cummings DL, Hood DK, Arrington ED, Kang DG Abstract INTRODUCTION: Resilience is a psychometric construct of a patient's ability to recover from adversity and has been used to predict outcomes but its use in orthopedics has been limited. The purpose of this study was to examine the association between resilience and outcomes. MATERIALS AND METHODS: We performed a retrospective analysis of prospectively collected data of patient who underwent sports knee surgery at a single institution performed by 6 orthopedic surgeons from January 2017 to December 2017. We i...
Source: Military Medicine - July 25, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Influence of Time to Transport to a Higher Level Facility on the Clinical Outcomes of US Combat Casualties with TBI: A Multicenter 7-Year Study.
CONCLUSIONS: In patients with moderate to severe TBI, a delay in aeromedical evacuation out of the combat theater was associated with improved mortality rates and a higher likelihood of discharge to home and return to duty dispositions. This study is correlational in nature and focused on CCATT transports from Role III to Role IV facilities; as such, care must be taken in interpreting our findings and future studies are needed to establish a causal link between delayed evacuation and improved discharge disposition. Our study suggests that delaying aeromedical evacuation of TBI patients when feasible may confer benefit. ...
Source: Military Medicine - July 25, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Single-Item Versus Multiple-Item Headache Ratings in Service Members Seeking Treatment for Brain Injury.
The objective of this proposed study was to validate the single headache item from the Neurobehavioral Symptom Inventory (NSI) compared to the 6-item Headache Impact Test (HIT-6). MATERIALS AND METHODS: Participants included consecutive treatment-seeking outpatients at the Brain Injury Rehabilitation Service at the Brooke Army Medical Center from August 2007 to January 2010 who were administered a battery of assessment measures at initial intake, as part of usual care. Archival record review was conducted using procedures approved by the local Institutional Review Board. Inclusionary criteria included completion of bot...
Source: Military Medicine - July 25, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Preliminary Evidence for a Hormetic Effect on DNA Nucleotide Excision Repair in Veterans with Gulf War Illness.
CONCLUSION: We suggest that the observed elevations in DNA repair capacity and NER gene expression are indicative of a "hormetic," i.e., induced or adaptive protective response to battlefield exposures. Normally such effects are short-term, but in these individuals this response has resulted in a long-term metabolic shift that may also be responsible for the persistent symptoms of GWI. PMID: 31334811 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - July 25, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

A 5-Year Continued Follow-up of Cancer Risk and All-Cause Mortality Among Norwegian Military Peacekeepers Deployed to Kosovo During 1999-2016.
Authors: Strand LA, Martinsen JI, Borud EK Abstract INTRODUCTION: In 2012, Norwegian news media reported on cases of brain cancer among Norwegian peacekeeping troops who served in Kosovo, allegedly caused by exposure to depleted uranium fired during airstrikes before the peacekeepers arrived in 1999. A first study followed 6076 military men and women with peacekeeping service in Kosovo during 1999-2011 for cancers and deaths throughout 2011. The study did not support to the idea that peacekeeping service in Kosovo could lead to increased risk of brain cancer or other cancers. However, the average time of follow-up ...
Source: Military Medicine - July 21, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Safety Events and Privilege Utilization Rates in Advanced Practice Physical Therapy Compared to Traditional Primary Care: An Observational Study.
Authors: Mabry LM, Notestine JP, Moore JH, Bleakley CM, Taylor JB Abstract INTRODUCTION: The general practitioner shortage in the United States coupled with a growing number of Americans living with disability has fueled speculation of non-physician providers assuming a greater role in musculoskeletal healthcare. Previous physician shortages have been similarly addressed, and expanding physical therapy (PT) scope of practice may best serve to fill this need. Resistance to expanding PT practice focuses on patient safety as PTs assume the roles traditionally performed by primary care providers. While studies have sho...
Source: Military Medicine - July 21, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Extended Ketogenic Diet and Physical Training Intervention in Military Personnel.
Authors: Volek JS, LaFountain RA, Dituro P PMID: 31318410 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - July 20, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Letter to the Editor.
Authors: Scott JM, Deuster PA, McClung JP PMID: 31318418 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - July 20, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

The Management of Newly-Diagnosed Non-muscle Invasive Bladder Cancer in Veterans Integrated Services Network 02 of the Veterans Health Administration.
CONCLUSIONS: We observed high rates of sampling of detrusor in the first TURBT specimen, utilization of repeat TURBT, and administration of induction and maintenance intravesical BCG for high-risk patients among a regional cohort of US Veterans with NMIBC. While not a comparative study, our findings suggest high quality NMIBC care in VA VISN 02. PMID: 31294791 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - July 12, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Virologic Suppression in U.S. Navy Personnel Living with HIV Infection and Serving in Operational Assignments.
CONCLUSION: All service members within this review were able to maintain viral suppression despite the location of their assignments. This limited study suggests that care is accessible and the standard HIV care continuum is maintained while deployed or stationed overseas. PMID: 31294798 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - July 12, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Postpartum Fitness and Body Mass Index Changes in Active Duty Navy Women.
CONCLUSIONS: Our findings show that additional interventions may be needed to assist women in returning to prepregnancy fitness up to 1 year postpartum. Future studies should examine additional factors that may improve postpartum fitness in addition to enhancing maternity leave policies. PMID: 31295347 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - July 12, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Comparison of Electric Resistive Heating Pads and Forced-Air Warming for Pre-hospital Warming of Non-shivering Hypothermic Subjects.
This study compared the rewarming effectiveness of an electric resistive heating pad system (requiring 80 W) to forced-air rewarming on cold subjects in whom shivering was pharmacologically inhibited. MATERIALS AND METHODS: Shivering was inhibited by intravenous meperidine (1.5 mg/kg), administered during the last 10 min of cold-water immersion. Subjects then exited from the cold water, were dried and lay on a rescue bag for 120 min in one of the following conditions: spontaneous rewarming only (rescue bag closed); electric resistive heating pads (EHP) wrapped from the anterior to posterior torso (rescue bag closed); o...
Source: Military Medicine - July 12, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Reconstructing the Face of War.
CONCLUSION: While the epidemiology and characteristics of military CMF injuries have been well described, their management remains poorly defined and creates an opportunity for reconstructive principles proven in the civilian sector to be applied in the care of severely wounded service members. The War on Terror marks the first time that microsurgery has been used extensively to reconstruct combat sustained wounds of the CMF region. Our manuscript reviews various options to reconstruct these devastating CMF injuries and emphasizes the need for steady communication between the civilian and military surgical communities to e...
Source: Military Medicine - July 11, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Definitive Management of a Traumatic Airway: Case Report.
Authors: Fabich RA, Franklin BT, Langan N Abstract Maxillofacial and neck trauma from penetrating injuries present unique challenges for anesthesia providers and surgeons. In the austere conditions of a combat setting these challenges may be amplified due to limited resources and injury severity. Currently there is a lack of evidence and consensus on how to best manage a traumatized airway in this situation. The authors of this paper present the successful emergency management of a traumatized airway from a severe maxillofacial and neck-penetrating wound. A stepwise team approach using strong communication and a gl...
Source: Military Medicine - July 11, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Hospitalization Costs and Length of Stay in Chinese Naval Hospitals Between 2008 and 2016 Based on Influencing Factors: A Longitudinal Comparison.
Authors: Xu Z, Xue C, Zhao F, Hu C, Wu Y, Zhang L Abstract INTRODUCTION: A retrospective review conducted in three hospitals of Guangdong and Hainan, China. To analyze the variation tendency of mean hospitalization costs and length of stay (LOS) in naval hospitals over nine years, paying special attention to the factors affecting hospitalization costs and LOS to provide a reference base for health resource allocation in naval hospitals. MATERIALS AND METHODS: A total of 21,375 cases of military patients who were hospitalized and treated in three naval hospitals between January 2008 to December 2016 were extract...
Source: Military Medicine - July 11, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Suicidal Ideation in Pregnant and Postpartum Women Veterans: An Initial Clinical Needs Assessment.
CONCLUSIONS: It is important to understand the mental health needs of perinatal veterans given their vulnerability to develop mental health concerns, including suicidal ideation. The unpredicted pattern of correlations determined in this study implies the need for multifaceted measures for safety-related mental health assessment of perinatal veterans, including assessment for PTSS. Strengths of this study include its longitudinal assessment and a sampling from a general population of veterans. Limitations include small sample size, a single gestational time point, and loss of participants who did not return for their postp...
Source: Military Medicine - July 11, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Factors Associated with Cigarette Use During Airmen's First Year of Service in the United States Air Force.
CONCLUSIONS: Multiple risk factors are associated with tobacco use. Given that Airmen are tobacco-free for the first 12 weeks of training, tobacco interventions during this period might be more effective. Our findings can be used to tailor interventions to prevent tobacco use in the U.S. military. PMID: 31287888 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - July 11, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Development and Trial Implementation of a 30-Day Outpatient Program for Subthreshold PTSD.
CONCLUSION: Although more research is needed, there exists preliminary empirical evidence of efficacy for an accelerated protocol of biweekly evidence-based therapy for service members with subthreshold PTSD. DISCLAIMER: The opinions expressed in this abstract are those of the authors and do not necessarily represent the opinions of the Uniformed Services University of the Health Sciences, the Department of Defense, or the United States Government. Additionally, the authors have no conflicts of interests to report. PMID: 31287892 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - July 11, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

A Randomized Feasibility Trial of a Novel, Integrative, and Intensive Virtual Rehabilitation Program for Service Members Post-Acquired Brain Injury.
CONCLUSION: This research provides evidence for the feasibility of implementing the BBVR system into an outpatient military setting for treatment of ABI symptoms. It is believed these data justify conducting a larger, randomized trial of the clinical effectiveness of the BBVR system. PMID: 31268524 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - July 5, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

United States Air Force Academy Cadets' Perceived Costs of Concussion Disclosure.
CONCLUSIONS: Cadet interviews described a complex environment where concussions were often viewed as costly to future career ambitions and provided potential reasons for non-disclosure largely including disruption in daily life. Reduction in perceived and actual harms due to concussion disclosure will require not only improving clinical care, but also addressing barriers to self-disclosure. Additionally, research suggests the sooner one reports a concussion, the sooner they return to physical or military activity. Educational interventions should be designed to address the perceived costs identified from our study and educ...
Source: Military Medicine - July 5, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Sexual Dysfunction in Male Canadian Armed Forces Members and Veterans Seeking Mental Health Treatment.
Authors: Richardson JD, Ketcheson F, King L, Forchuk CA, Hunt R, St Cyr K, Nazarov A, Shnaider P, McIntyre-Smith A, Elhai JD Abstract INTRODUCTION: There is mixed evidence regarding how posttraumatic stress disorder (PTSD) symptom clusters are associated with sexual dysfunction (SD), and most studies to date have failed to account for potentially confounding variables. Our study sought to explore the unique contribution of PTSD symptom clusters on (a) lack of sexual desire or pleasure, and (b) pain or problems during sexual intercourse, after adjusting for comorbidities and medication usage. MATERIALS AND METHO...
Source: Military Medicine - July 5, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Improving Clinician Decisions and Communication in Critical Care Using Novel Information Technology.
CONCLUSIONS: The primary findings of these assessments are that clinicians found the NHIT easy to use despite minimal training and experience and that it did not degrade clinician efficiency or decision-making accuracy. These findings are in contrast to common user experiences when introduced to new EMRs in clinical practice. PMID: 31271437 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - July 5, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

An Evaluation of a Novel Medical Device Versus Standard Interventions in the Treatment of Tension Pneumothorax in a Swine Model (Sus scrofa).
Authors: Sheldon RR, Do WS, Forte DM, Weiss JB, Derickson MJ, Eckert MJ, Martin MJ Abstract INTRODUCTION: Tension pneumothorax is a common cause of preventable death in trauma. Needle decompression is the traditional first-line intervention but has high failure rates. We sought to evaluate the effectiveness and expedience of needle thoracostomy, surgical tube thoracostomy, and Reactor™ thoracostomy - a novel spring-loaded trocar insertion device. MATERIALS AND METHODS: Yorkshire swine underwent controlled thoracic insufflation to create tension pneumothorax physiology for device comparison. Additional exp...
Source: Military Medicine - July 1, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Commentary to Military Medicine and the Academic Surgery Gender Gap.
Authors: Holt D, Copeland A, Knudson MM, Elster E PMID: 31241139 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - June 28, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Military Medicine and the Academic Surgery Gender Gap.
This study was granted exemption from the Walter Reed National Military Medical Center (WRNMMC) Internal Review Board (IRB). The Uniformed Services University (USU) Department of Surgery academic appointment list was reviewed to assess female representation in the categories of Instructor, Assistant Professor, Associate Professor, Professor, and Other. Defense Manpower Data Center (DMDC) and the US Navy Bureau of Medicine and Surgery (BUMED) were assessed for total numbers of female surgeons on active duty, and numbers were compared with nationally published Association of American Medical Colleges (AAMC) data using a logi...
Source: Military Medicine - June 28, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Combining Ab Interno Kahook Trabeculectomy with Gonioscopy-Assisted Transluminal Trabeculotomy Reduces IntraoCular Pressure.
In this report, we describe a surgical technique using both the Kahook Dual Blade and Gonioscopy-assisted transluminal trabeculotomy (GATT), to treat a 23-year-old active duty female with idiopathic uveitis and subsequent corticosteroid-induced glaucoma who presented with consistently elevated intraocular pressure (IOP) measurements despite maximal pharmacologic interventions. This combination was effective in consistently lowering intraocular pressure for at least 12 months in a young, phakic, active duty patient with uveitis and steroid-responsive open-angle glaucoma. PMID: 31247075 [PubMed - as supplied by publisher...
Source: Military Medicine - June 28, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Comparison of Carbapenem-Resistant Microbial Pathogens in Combat and Non-combat Wounds of Military and Civilian Patients Seen at a Tertiary Military Hospital, Philippines (2013-2017).
CONCLUSION: We describe in this study the wound bacterial and antibiotic resistance profile in the military (combat vs non-combat associated) and civilian population. We observed that, with the exception of Acinetobacter sp., resistance of prevalent Gram-negative bacterial species to imipenem or meropenem were not significantly different between the military and civilian populations. We also presented data on the prevalent bacterial species isolated from both combat and non-combat wounds in a military tertiary care hospital setting as well as the carbapenemase-encoding gene primarily responsible for carbapenem resistance a...
Source: Military Medicine - June 28, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

The Risk of Pregnancy Related Hypertension Disorder Associated with Sickle Cell Trait in U.S. Service Women.
CONCLUSIONS: The results of this study indicate that being SCT positive is a risk factor for PRHD and provides evidence that SCT status may have an adverse effect on reproductive health. Future research needs to include other known risk factors for PRHD to include gravity and parity history, BMI, past history of PRHD prior to enlistment as well as to examine the association with maternal/child pregnancy outcomes. PMID: 31247087 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - June 28, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Implementation of a Generalized Vestibular Rehabilitation Approach.
CONCLUSION: Generalized Vestibular Rehabilitation Treatment (GVRT) was successfully implemented at the Warrior Recovery Center at Fort Carson, Colorado. The individual exercises used during the interventions were challenging to patients yet well tolerated. Resource allocation was appropriate in terms of personnel, time, and equipment. Both the clinical staff and the patients felt comfortable with the therapy and subjectively found it to be effective. The project provided valuable information to clinical staff, administrators, and the organization. PMID: 31247088 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - June 28, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Ultrasonography for Dorsal-Sided Wrist Pain in a Combat Environment: Technique, Pearls, and a Case Report of Dynamic Evaluation of the Scapholunate Ligament.
Authors: Rodriguez RM, Ernat JJ Abstract Ultrasonography is a commonly utilized tool in orthopedic surgery for the diagnosis and treatment of a variety of musculoskeletal conditions, including pathology about the wrist. Its value should not be underestimated when other diagnostic resources are unavailable - such as in a combat setting where ultrasounds, but not X-ray, are a standard equipment item. An active duty soldier presented to an orthopedic provider in an austere environment with chronic dorsal wrist pain due to a previous fall. Physical examination and dynamic ultrasound examination allowed the deployed pro...
Source: Military Medicine - June 28, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Dental Patient Safety in the Military Health System: Joining Medicine in the Journey to High Reliability.
CONCLUSION: Safety initiatives in the dental profession remain immature in comparison to the medical field and the use of an HRO framework is just beginning to emerge in dentistry. The MHS benefits from a robust dental patient safety reporting system when compared to civilian practice in the United States. Review of these data demonstrates that a high priority focus should be the elimination of WSS. Initiatives based on high reliability strategies to address this issue will be discussed. A commitment to reporting and analyzing its performance and adopting the principles and behaviors of HROs will accelerate the MHS goal of...
Source: Military Medicine - June 28, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Metabolic Syndrome Prevalence among Armed Forces Personnel (Military Personnel and Police Officers): A Systematic Review and Meta-Analysis.
CONCLUSION: The findings from the present meta-analyses displayed a low prevalence of metabolic syndrome in armed forces in general. These findings will allow healthcare providers and policy-makers to find solutions in order to take action to reduce MetS risks on a wider scale, especially among police officers. PMID: 31247092 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - June 28, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Exercise Testing of Muscle Strength in Military.
CONCLUSIONS: Although strength training has been included in military training, it was concluded that the existed physical fitness test batteries focused mostly on muscle endurance rather than on muscle strength. Therefore, it would be suggested that muscle strength tests be included in future physical fitness test batteries in order to evaluate effectively the content of military training. PMID: 31247093 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - June 28, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Heterogeneity in Military Trauma Casualty Care.
This study aims to evaluate a subsequent team to determine if heterogeneity of teams exists and to determine if this level of efficiency persists or can be improved. MATERIALS AND METHODS: Military trauma teams at the Role 3 hospital in Bagram, Afghanistan, were evaluated over the course of a single deployment between April and October 2018. Trauma teams were directly observed and performance of the ATLS primary trauma survey timed. These results were compared to previously published times from Kandahar and Bagram Role 3 sites from Oct 2016 to Apr 2017. RESULTS: Time to completion of the primary survey in 2018 was ...
Source: Military Medicine - June 28, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Clinic Use at the Departments of Defense and Veterans Affairs Following Combat Related Amputations.
CONCLUSIONS: The present study indicated a gradual transition from DoD to VA only healthcare which extended across 5 years following combat related amputations. Patients with lower levels of amputation or early amputation generally transitioned earlier to VA only healthcare. These results can inform medical planning to support a timely and clinically effective transition from DoD to VA healthcare. PMID: 31247095 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - June 28, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

A Novel Use of the Erector Spinae Block in the Austere Environment.
Authors: Fabich RA, Greene S, Tighe C, Devasahayam R, Becker T Abstract A 25 year-old male presented with penetrating chest trauma to a split forward surgical team located in an austere setting. Due to limited resources and a minimal monitoring in-transit a regional anesthetic was placed for pain control. This is the first description of an Erector Spinae Block utilized in a far forward combat setting. PMID: 31247096 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - June 28, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Promotion of Cadaver-Based Military Trauma Education: Integration of Civilian and Military Trauma Systems.
This report has been reviewed and approved by the Institutional Review Board (IRB) at Rutgers University. RESULTS: Most attendees (12 of 13) agreed that the 6-hour total time length and division of classroom versus lab time was appropriate. Most attendees (12 of 13) agreed that this type of supplemental hands-on cadaver training should be a mandatory part of their medical training. The attendees' rated confidence in covered techniques was significantly increased from 3.77 ± 0.73 to 4.85 ± 0.38 (p
Source: Military Medicine - June 28, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Hope, Religiosity, and Mental Health in U.S. Veterans and Active Duty Military with PTSD Symptoms.
Authors: Koenig HG, Youssef NA, Smothers Z, Oliver JP, Boucher NA, Ames D, Volk F, Teng EJ, Haynes K Abstract INTRODUCTION: Many studies have linked hope with better mental health and lower risk of suicide. This is especially true in those who have experienced severe physical or emotional trauma. Religious involvement is associated with greater hope. We examine here the relationship between hope, religiosity, and mental health in a sample of Veterans and Active Duty Military (ADM) with PTSD symptoms. MATERIALS AND METHODS: A cross-sectional multi-site study was conducted involving 591 Veterans and ADM from acro...
Source: Military Medicine - June 28, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Soldier Attitudes Toward Behavioral Health Profiles in the US Army.
CONCLUSIONS: Results suggest soldiers who would be less likely to seek or more likely to drop out of BH care due to a BH profile may be those that are less likely to access conventional BH services in the first place. This may provide some preliminary reassurance to conventional providers that increased BH profiling practices may not be inversely proportional to the amount of BH care delivered and may encourage treatment-seeking behaviors among the population they serve. Soldiers seeking BH care from sources incapable of issuing a profile may be sensitive to a potential BH profile-related stigma effect (possibly more globa...
Source: Military Medicine - June 28, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Implementation of Tele-Critical Care at General Leonard Wood Army Community Hospital.
CONCLUSIONS: These findings support the implementation of tele-ICU in the MHS as a cost-effective method to sustain readiness amongst critical care clinicians and improve safety culture in MHS hospitals. PMID: 31247104 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - June 28, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Prevalence of Lyme Disease Attributable to Military Service at the USMA, West Point NY: FY2016-2018.
CONCLUSIONS: While this study was unable to capture the military specific occupational exposure to I. scapularis, it does show a difference in period prevalence between service members and family members with the family members being at higher risk to contract Lyme instead of service members as is commonly suggested in the literature. Additional studies may be conducted to see if this holds true across service member Military Occupational Specialties as a proxy for occupational exposure. Similar studies should be conducted at military installations situated in Lyme endemic areas to determine if these results are comparable...
Source: Military Medicine - June 28, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research