Military medicine
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Recent conflicts have led significant advancements in casualty care. Facilities serving combat wounded operate in challenging environments. Our purpose is to describe the multidisciplinary resuscitation algorithm utilized at a United Kingdom-led, Role 3 multinational treatment facility in Afghanistan focusing on injury severity and in-hospital mortality. ⋯ A systematic, multidisciplinary approach to trauma is associated with low in-hospital mortality. The outcomes in this study serve as a measure for future care in Role 3 facilities.
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Comparative Study
Effects of personal and occupational stress on injuries in a young, physically active population: a survey of military personnel.
The aim of this study was to document risk factors for any injury and sports- and exercise-related injuries, including personal and occupational stress among active duty service members (SMs) in the Air Force, Army, Marine Corps, and Navy. A total of 10,692 SMs completed the April 2008 Status of Forces Survey of Active Duty Members. The survey asked about demographics, personal stress and occupational stress, injuries from any cause, and participation in sports- and exercise- related activities in the past year. ⋯ This survey showed that higher personal and occupational stress was associated with higher risks of injury. SMs who experienced higher levels of personal or occupational stress reported higher risks of injuries. The effects of stress reduction programs on injury risks should be evaluated in military and other young physically active populations.
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Unilateral painful opthalmoplegia involving the third, fourth, or sixth cranial nerve in association with a retro-orbital mass should be evaluated for rheumatologic conditions and malignancy. The assessment may require a biopsy of the mass. ⋯ Tolosa-Hunt is a rare condition that presents as an acute unilateral eye pain with motor dysfunction and responds to prolonged treatment with corticosteroids. Presented is a case of Tolosa-Hunt syndrome.
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Combat-related concussions are significant sources of injury and morbidity among deployed military service members. Musculoskeletal injury also is one of the most prevalent battle and nonbattle-related deployed injury types. Both injuries threaten the service member's physical condition as well as unit and mission readiness due to reduced duty status or evacuation from military theater of operations. ⋯ Concussion injury was secondary to blast injury in 90% of cases. Sport/recreation, occupational, and other accidental injuries each represented 30% of the musculoskeletal injuries with only 10% reported as result of combat. The utilization patterns and outcome measures demonstrate the success and utility of a multidisciplinary clinical model of care for these two types of injuries in the far-forward deployed setting.
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Adolescents in military families contend with normative stressors that are universal and exist across social contexts (minority status, family disruptions, and social isolation) as well as stressors reflective of their military life context (e.g., parental deployment, school transitions, and living outside the United States). This study utilizes a social ecological perspective and a stress process lens to examine the relationship between multiple risk factors and relevant indicators of youth well-being, namely depressive symptoms and academic performance, as well as the mediating role of self-efficacy (N = 1,036). ⋯ Each model was predictive of depressive symptoms and academic performance through persistence; however, each model provides unique findings about the relationship between risk factors and youth outcomes. Discussion is provided pertinent to service providers and researchers on how risk is conceptualized and suggestions for identifying at-risk youth.