Military medicine
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Randomized Controlled Trial
Infant Feeding Practices, Workplace Breastfeeding/Lactation Practices, and Perception of Unit/Service Support Among Primiparous Active Duty Servicewomen.
Successful breastfeeding provides multiple health benefits to Servicewomen and their infants and has positive indirect benefits to the military. Workplace lactation support influences breastfeeding continuation after a Servicewoman's return to work. ⋯ 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.
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Sleep loss is ubiquitous in military settings, and it can be deleterious to cognitive, physiological, and operational functioning. This is especially true in the military operational context (e.g., training, garrison, combat) where continuous operations prevent adequate time for rest and recuperation. Furthermore, even when servicemembers do have opportunities for sleep, environmental disruptors in the military operational context make it difficult to obtain restorative sleep. Such environmental disruptors are potentially preventable or reversible, yet there is little public awareness of how to minimize or eliminate these sleep disruptors. Therefore, the goal of this review was to outline prominent environmental sleep disruptors, describe how they occur in the military operational context, and also discuss feasible strategies to mitigate these disruptors. ⋯ Environmental disruptors, such as light, noise, temperature, and air pollution, can negatively impact sleep in the military operational context. Simple, feasible steps can be taken to reduce sleep disruptions that are caused by light and noise. Yet there is a need for research and development on tools to mitigate air pollution, extreme temperatures, and inhospitable sleeping surfaces. Leadership at the discussed military bases and training facilities should focus on improving the sleep environment for individuals under their command. Such interventions could ultimately improve warfighter health, wellness, and operational performance, leading to greater warfighter readiness and lethality.
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Headaches are a typical presentation to a military medical department or emergency room. Having a broad differential diagnosis and utilizing a thorough physical exam can assist providers in honing down the list of pathology and in identifying potentially life-threatening causes of cephalgia such as intracranial tumors. In this case, a 27-year-old man presented with progressive headaches along with vision changes for the preceding 2-3 months. ⋯ Direct ophthalmoscopy was vital in this case to encourage referral for further management. In selected studies, emergency medicine providers performed ophthalmoscopy in 14% of patients, with roughly 10% of those patients having erroneous findings. Another study showed that 13% of all cases presenting to a large academic center had fundoscopic findings that were important to the final diagnosis.
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One challenge clinicians face is determining when a military Service Member (SM) can return to duty after an injury that affects the postural control. The gold standard to measure postural control is the Sensory Organization Test (SOT). This test measures the amount of sway present in an individual's static stance that may be used to examine range of function and monitor recovery from injury. Normative values currently available were developed using a sample of clinically normal adults from the general population (i.e., civilian non-aviator). Previous research suggests that these values should not be used as a comparative cohort for high-performing populations in the military. However, normative values, specific to military SMs, do not exist. The aim of this study was to develop a normative clinical database for functional balance (i.e., the SOT) for military-trained aviators, an occupational specialty that may consist of high performers. ⋯ Army-trained aviators are high-functioning performers whose SOT scores differ from that of the general civilian population, particularly for the more challenging test conditions. New normative values were developed from this study population. Use of the developed normative values could be used as a comparative cohort in screening aviators who are recovering from injuries that affect postural stability.