Military medicine
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The purpose of this project was to create a teaching module and evaluation tool for the prehospital assessment of patients with head injuries using the Full Outline of UnResponsiveness (FOUR) Score scale. The teaching module consisted of an overview of brain injury scales, general characteristics of the Glasgow Coma Scale (GCS) and the FOUR Score, demonstrations of the FOUR Score, and evaluation of the teaching module by participants. Participants determined that the FOUR Score is a viable alternative to the GCS, but took longer time to assess patients. Development of a more rapidly obtained FOUR Score, called the EMBR, is one option that may make this a viable alternative to the GCS.
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We used an anonymous self-reported questionnaire to assess posttraumatic stress disorder symptoms, relationship concerns, and treatment preferences including interest in family-focused interventions among 100 National Guard Soldiers who were recently redeployed from Iraq or Afghanistan. We found that the majority of married or partnered soldiers were concerned about getting along with their partners, while the majority of parents were concerned about their child-rearing practices. Posttraumatic stress disorder symptoms were significantly associated with the degree of relationship concerns. Soldiers showed a striking preference for family-based interventions over individual treatment, highlighting the importance of developing family-based interventions tailored to address post-deployment mental health and co-occurring family problems.
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This report describes the development and initial validation of the Response to Stressful Experiences Scale (RSES), a measure of individual differences in cognitive, emotional, and behavioral responses to stressful life events. We validated this instrument with active-duty and reserve components of military and veterans samples (N = 1,014). The resulting 22-item scale demonstrated sound internal consistency (alpha = 0.91-0.93) and good test-retest reliability (r = 0.87). ⋯ Associations with other measures supported convergent, discriminant, and concurrent validity. In separate military samples, the RSES accounted for unique variance in posttraumatic stress disorder symptoms above and beyond existing scales measuring resilience-related constructs, thereby demonstrating incremental validity. The RSES provides a brief, reliable, and valid measure of individual differences in cognitive, emotional, and behavioral responses to life's most stressful events.
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Pneumonia is a major cause of hospital admissions and deaths worldwide. Our aim was to examine the trends in admissions for pneumonia in the Department of Veterans Affairs (VA). We examined data for the fiscal years 2002 through 2007 on patients aged 65 years and older hospitalized with pneumonia by using VA administrative databases. ⋯ However, length of hospital stay and 30- and 90-day mortality decreased during this period. The proportion of patients admitted to the intensive care unit remained relatively constant, but fewer received mechanical ventilation; there was substantial increase in noninvasive ventilation. In the VA, pneumonia-related admissions are being managed more effectively even as the overall number of admissions remains stable.