Military medicine
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It is estimated that sailors who are assigned to surface ships and submarines are deployed for more than 1 year across their careers and they spend 15% to 23% of their time away from home. Research suggests that shipboard sailors experience rates of behavioral health issues similar to those with ground combat experiences. Despite the rigorous operational tempo and the unique shipboard environment experienced by these service members, little military health research has examined the health outcomes of sailors serving aboard ships. The objectives of this study were to develop an evidence map of the peer-reviewed literature to (1) identify potential threats to the health and readiness of shipboard sailors, (2) identify health and performance issues experienced by this population, and (3) identify gaps in the current peer-reviewed published literature on shipboard health and performance. ⋯ The evidence map identified various gaps in the research pertaining to the health and performance of shipboard sailors. These gaps included a lack of research on the risk factors for common health and performance issues experienced by sailors and on the relationship between stressors of shipboard life and sailors' health, performance, and readiness. The results of this evidence map should be used to inform the development, implementation, and evaluation of interventions to improve the shipboard environment and/or the preventive health behaviors used by sailors while underway or deployed.
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Military personnel are at increased risk of asymmetric hearing loss secondary to noise exposure. This report illustrates the importance of expeditiously evaluating for retrocochlear pathology even in young active duty service members with asymmetric or sudden hearing loss. A 36-year-old male presented with right-sided sudden hearing loss and dizziness. ⋯ Despite preservation of the facial nerve, progression of post-operative facial weakness required gold weight placement to prevent exposure keratopathy. The patient had recovered partial function in all facial nerve branches at last follow-up. In light of the rising global incidence of VS, any asymmetric or sudden hearing loss in military service members should be evaluated with audiometry and referral to otolaryngology for workup of retrocochlear pathology.
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Breastfeeding is a human biological norm that is widely acknowledged as the ideal form of nutrition for all infants. Human milk saves lives, improves long-term health for the both mother and infant, and significantly reduces health care-related costs. The American Academy of Pediatrics recommends exclusive breastfeeding for at least 6 months and thereafter to continue with breastfeeding, in addition to complimentary foods for at least 1 year or longer. The World Health Organization extends this recommendation to at least 2 years or beyond this age. ⋯ The well-documented evidence of long-term breastfeeding health benefits in addition to the economic benefits justifies such global military policy and would be a foundation to a national maternity leave policy, given that the USA is the only developed country without nationally mandated statutory entitlement to paid maternity leave.
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Whole blood (WB) is the optimal resuscitation fluid in hemorrhagic shock. Military research focuses on mortality benefits of WB acquired through walking blood banks (WBBs). Few military-based studies on donation effects exist, almost exclusively performed on small special operation forces. No Department of Defense regulations for postdonation precautions in nonaviation crew members exist. Further study is warranted regarding safety and limitations in postdonation populations. ⋯ This feasibility study demonstrates the first safety test of regular military populations performing exertion immediately following the standardized WB donation. VS changes may translate into a small but significant increase in perceived postdonation exertion. Future studies should expand duration and intensity of exertion to match combat conditions.
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Ethical issues can arise when planning for direct patient care surgical missions. Based on the lessons learned from the USNS COMFORT Deployment 2019, the authors present concise considerations and recommendations for future hospital ship surgical mission planning.