Military medicine
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Scant research has examined mental health treatment utilization and barriers to care in deployed U.S. soldiers. This study aims to assess mental health treatment utilization in deployed soldiers, including providers used and barriers to care. ⋯ Prevalence of common psychopathology and receipt of care in a combat environment was similar to previous reports from postdeployment settings. Nonprovider sources of care were more frequently utilized as compared to an in-Garrison report. Findings suggest important differences exist in sources of help and barriers to care in deployed vs. postdeployment environments. The hypothesized barriers to care did not preclude receiving any help, however, less than one-half of soldiers at mental health risk received help. Thus, future research should identify factors that have the greatest influence on help seeking behavior in both deployed and Garrison settings.
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Overweight and obesity are a major public health concern in the United States, including among active duty military personnel. Approximately 51% of active duty personnel are classified as overweight and 15% are classified as obese. This may impact military readiness. The current study aimed to determine if a weight loss intervention impacted fitness test scores among Air Force personnel. ⋯ Behavioral weight management interventions that achieve 5% weight loss may help improve military fitness test ratings.
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The American Society of Anesthesiologists' Physical Status (ASA-PS) Classification System was established to grade a patient's physical status prior to surgery. The literature shows inconsistencies in the application of the ASA-PS classification among providers. The many uses of the ASA-PS class require reliable ASA-PS class designations between providers. While much literature illustrates the inconsistency, there is limited research on how to improve inter-rater agreement. ⋯ While there was improvement in agreement following an education intervention, the agreement seen was not statistically significant. More research needs to be done to determine how to improve inter-rater reliability of the ASA-PS classification system with a focus on non-anesthesia providers.
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The purpose of this case report is to highlight the benefits of using teleconsultation to diagnose ophthalmologic conditions within the restraints of a combat environment. A previously healthy 49-year-old service member deployed in the Middle East presented with diplopia over the course of 2 weeks. Initial diagnosis by his primary care physician upon partial ophthalmologic exam was a pupil-sparing CN III palsy without ptosis. ⋯ Overall, his diagnosis remained a nonurgent condition that allowed the service member to remain at his duty station and prevent an unnecessary evacuation. Ultimately, teleconsultation provided many benefits for the service member and the U. S. military.
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Historical Article
Antidepressant Effect of the VA Weight Management Program (MOVE) Among Veterans With Severe Obesity.
Obesity is prevalent among users of Veteran's Health Administration services, where it is comorbid with depression, post-traumatic stress disorder, type 2 diabetes, cardiovascular disease, colon, and breast cancer. Among obese subjects, severe obesity represents a subpopulation with the highest risk of depression. We investigate the antidepressant effect of a local VA weight management program (Managing Overweight Veterans Everywhere - MOVE) among depressed veterans with severe obesity. ⋯ Depressed veterans with severe obesity improved their depressive symptoms by participating in the MOVE program. Veterans in the IMP had greater but short-term antidepressant effect as compared to educational intervention for obesity. Future studies with larger sample size may elucidate the underlying mechanisms of weight reduction to improve depression and, more importantly, sustain response among veterans with severe obesity.