Military medicine
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Randomized Controlled Trial
Mindfulness-based Therapeutic Sailing for Veterans With Psychiatric and Substance Use Disorders.
Complementary interventions have the potential to enhance treatment engagement and/or response among veterans with psychiatric disorders and/or substance use disorders (SUDs). Mindfulness-based therapeutic sailing (MBTS) is a novel three-session, complementary intervention, which combines nature exposure via recreational sailing and mindfulness training. It was developed specifically to augment both treatment response and engagement among veterans with psychiatric disorders or SUDs. The study reports a follow-up investigation of a version of MBTS modified based upon a previous initial pilot study. ⋯ The MBTS is associated with increases in psychological flexibility (AAQII) and state mindfulness (TMS). The intervention was perceived as pleasurable by participants (PACES) and is potentially associated with decreased utilization of substance use treatment services. These results must be considered as preliminary; however, these finding corroborate results from a previous pilot study and indicate that MBTS holds promise as a complementary intervention that could result in enhanced treatment engagement and/or outcomes for the population studied. A randomized controlled trial of MBTS is warranted. Further, the model of a three-session intervention combining mindfulness training with nature exposure could be adapted for other types of nature exposure, such as hiking or snowshoeing or other complementary interventions including equine-assisted activities and therapies.
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Prior studies have identified associations between specific health conditions and occupational impairments in the U.S. military, but little is known about the relative magnitude of impairments associated with different mental and physical health conditions among military service members. The goal of this study is to comparatively assess occupational impairment associated with mental and physical conditions among active duty military service members. ⋯ Common mental health conditions such as anxiety, depression, and PTSD showed robust associations with absenteeism and presenteeism among active duty U.S. military service members. Efforts to rigorously evaluate and improve existing military screening programs and reduce barriers to accessing and engaging in mental healthcare may help to reduce work absenteeism and presenteeism among active duty service members.
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Randomized Controlled Trial
Effects of Left Ventricular Versus Traditional Chest Compressions in a Traumatic Pulseless Electrical Activity Model.
Prehospital cardiopulmonary resuscitation has commonly been considered ineffective in traumatic cardiopulmonary arrest because traditional chest compressions do not produce substantial cardiac output. However, recent evidence suggests that chest compressions located over the left ventricle (LV) produce greater hemodynamics when compared to traditional compressions. We hypothesized that chest compressions located directly over the LV would result in an increase in return of spontaneous circulation (ROSC) and hemodynamic variables, when compared to traditional chest compressions, in a swine model of traumatic pulseless electrical activity (PEA). ⋯ In our swine model of traumatic PEA, chest compressions performed directly over the LV improved blood pressures during BLS but not ROSC.