Military medicine
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Electronic Cigarette Use and Related Factors among Active Duty Service Members in the U.S. Military.
Electronic cigarettes (e-cigarettes) are increasingly used in the U.S.A. by young people. As young adults serve as the primary recruiting pool for military, active duty service members in military may be susceptible to using e-cigarettes. However, factors related to e-cigarette use in military population have rarely been studied. We aimed to identify factors associated with e-cigarette use and factors related to duration of use among active duty service members. ⋯ Young age, lower military ranks, other tobacco use, and low perception of harm were associated with increased odds of using e-cigarettes, while serving in combat unit was associated with decreased odds of use in active duty service members. Low harm perception and using nicotine-containing e-cigarettes were associated with long duration of use. The reasons for using e-cigarettes differed by cigarette smoking status. Our study provides clues for future hypothesis-driven studies.
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Infections with multidrug resistant organisms that spread through nosocomial transmission complicate the care of combat casualties. Missions conducted to review infection prevention and control (IPC) practices at deployed medical treatment facilities (MTFs) previously showed gaps in best practices and saw success with targeted interventions. An IPC review has not been conducted since 2012. Recently, an IPC review was requested in response to an outbreak of multidrug resistant organisms at a deployed facility. ⋯ Despite successes, ongoing challenges with optimal deployed IPC were noted. Recommendations for improvement include strengthening IPC culture, accountability, predeployment training, and stateside support for deployed IPC assets. Variability in IPC practices may occur from rotation to rotation, and regular reassessment is required to ensure that successes are sustained through times of turnover.
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Compared to their civilian counterparts, military personnel can have more exposure to sunlight and, as recent studies have shown, do have an increased incidence of melanoma. Given the inherent challenges service members may face in getting appropriate care whether because of operational tempo, deployments, and/or austere locations, many are initially diagnosed by specialties other than dermatology. In this study, we sought to determine if patients within the military health system were receiving appropriate follow-up management after biopsies by non-dermatologists led to the diagnosis of melanoma by pathology. ⋯ Our study demonstrated that a number of different specialties outside of dermatology are involved in performing biopsies on patients in which melanoma is a concern. Although the results show that the majority of patients biopsied by non-dermatologists received appropriate follow-up care, there is still room to improve to ensure that all melanoma patients receive referrals to and are seen by dermatologists after a diagnosis of melanoma.
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Breast cancer is the most common cancer diagnosed among women and the second most common cause of cancer death among women. There are ways to reduce a woman's risk of breast cancer; however, most eligible women in the United States are neither offered personalized screening nor chemoprevention. Surveys have found that primary care providers are largely unaware of breast cancer risk assessment models or chemoprevention. This survey aims to investigate Veterans Health Administration primary care providers' comfort level, practice patterns, and knowledge of breast cancer risk assessment and chemoprevention. ⋯ VHA providers and women Veterans would benefit from a system to ensure that women at increased risk of breast cancer are identified with risk modeling and that risk reduction options, such as chemoprevention, are offered when appropriate. VHA providers requested risk reduction education, which could improve primary care provider comfort level with chemoprevention.
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The USNS COMFORT (T-AH-20) deployed in support of Enduring Promise 2018 (EP-18) for an 11-week humanitarian mission providing care to the residents of four host nations in Central and South America. The COMFORT provides the capability of providing medical, dental, and surgical care in humanitarian aid missions.