Military medicine
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In early March 2020, Johns Hopkins University Applied Physics Lab hosted an Association of Military Surgeons of the United States regional conference to address medical demands of the future battlefield for which prolonged field care is expected. Arising from this conference, we propose here an approach to prolonged field care research-and also summarize the major concepts discussed at the conference. ⋯ The exceedingly daunting medical challenges of the future battlefield, on land and at sea, must be addressed to maintain an effective force able to compete with modern highly capable adversaries. Since the human element, and its health, will allow future mission success, we propose here an approach to making soldier health-related research most impactful.
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Mild traumatic brain injury (mTBI) is associated with significant financial cost and reduced military readiness and impacts quality of life for active duty service members (SMs). Post-concussive symptoms can include vestibular impairments, such as chronic dizziness and postural instability, which can be compounded by psychological comorbidities like PTSD. Comprehensive vestibular evaluations are required to assess symptoms and guide clinical decision-making. At the National Intrepid Center of Excellence (NICoE), in addition to traditional vestibular assessments, clinicians can also leverage virtual environments (VEs) in the Computer-Assisted Rehabilitation Environment (CAREN) to further evaluate balance. The objective of this study was to examine the relationship between conventional outcomes and VE performance on immersive balance tasks in the CAREN, determine whether VE performance could predict conventional outcomes, and explore the impact of PTSD. ⋯ Objective balance and gait, SOT and FGA, demonstrated the strongest relationships to immersive VE performance in the CAREN. Our findings suggest that these immersive balance tasks may be effective as an adjunct assessment to examine balance. Future work will focus on moving these VEs from the CAREN to a portable system, which could be more readily utilized in a variety of clinical settings, increasing accessibility.
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The maintenance of military surgeons' operative skills is challenging. Different and specific training strategies have been implemented in this context; however, little has been evaluated with regard to their effectiveness. Cancer surgery is a part of military surgeons' activities in their home hospitals. This study aimed to assess the role of oncological surgery in the improvement of military surgeons' operative skills. ⋯ This study demonstrates the usefulness of cancer surgery in improving the operative skills of military surgeons.
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The aims of the study are to identify health-related behaviors associated with sexual orientation among active duty military personnel and to compare those behaviors when lesbian, gay, and bisexual (LGB) groups are aggregated and disaggregated. ⋯ The findings are consistent with those of previous research showing highest risk for suicidal behaviors and substance abuse among bisexual individuals. We recommend that future studies and clinical care consider LGB sexual identities as heterogeneous groups; otherwise, risks for adverse health behaviors may be overlooked.
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The purpose of this study was to report on the career accomplishments of Public Health Service (PHS) alumni from the Uniformed Services University (USU) School of Medicine (SOM) in several professional areas such as specialty choice, board certification rates, leadership roles, academic achievements, deployments, and length of service. ⋯ Our findings suggest that PHS alumni are likely to enter primary care specialties, engage in medical volunteering and humanitarian missions, frequently remain in uniform longer than their initial active duty commitment, and are affiliated with numerous universities and medical schools throughout their career. PHS alumni appear to be successfully meeting the mission set forth by the U.S. PHS.