Military medicine
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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.
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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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At the outset of the 2019 coronavirus disease (COVID-19) pandemic, New York City faced the highest burden of COVID-19 cases in the United States. In response, the U. S. ⋯ There quickly arose a need for psychiatric services for patients with COVID-19 and psychological support for medical staff. Psychiatrists were tasked with establishing a consult-liaison psychiatry service in this unique environment. The authors detail the establishment of a novel consultation-liaison psychiatry service in a large convention center and explore lessons learned from this experience with the aim to empower uniformed psychiatrists to prepare for and deliver patient-focused care in pandemic settings.
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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.