Military medicine
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Observational Study
Preoperative Psychological Assessment and Weight Loss Outcomes in Bariatric Surgery Patients at a Military Treatment Facility: A Retrospective Profile Analysis.
Research on effectiveness of preoperative psychological measures as predictors of weight loss success and weight regain following bariatric surgery has been inconsistent. Despite mixed findings, preoperative psychological assessment instruments are used routinely, including in military medical facilities. Health concerns associated with obesity potentially impact military family readiness, with accompanying utilization of medical resources. Examining psychological factors associated with successful bariatric surgery outcomes may help to optimize care. ⋯ The average elevations of scales were not above clinical cutoff, but still indicate characteristic trends in patients undergoing surgery at an MTF. These scales may be important to attend to with bariatric surgery candidates, especially scales which are related to psychopathology, treatment prognosis, and treatment management. Study results about scale elevations on preoperative psychological assessment instruments may help patients better manage bariatric surgery and can lead to enhanced warfighter readiness and decreased utilization of healthcare resources. Future work should examine postoperative behavioral and psychological factors, as the adjustment to lifestyle limitations of bariatric surgery is substantial.
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United States Air Force Academy (USAFA) cadets are at risk for sustaining concussions; however, several factors inhibit disclosure. We aimed to better understand the role of social support in concussion disclosure. ⋯ Our results suggested that cadets felt comfortable reporting a suspected concussion or bell-ringer/ding to various peers and that those peers would be supportive of that choice, indicating social support. Future interventions should include educating cadets that peers may come to them, especially if they are AOCs/AMTs or squadmates.
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Case Reports
Shallow Water Diving-Associated Alveolar Hemorrhage in an Active Duty Sailor: A Case Report.
Breath-hold diving is a common practice as a part of military dive training. An association between prior lung injury and a propensity for lung barotrauma may have the potential to impact mission readiness for combat divers, Pararescue, Combat Controllers, Army Engineer divers, and various units in Naval Special Warfare and Special Operations. ⋯ We describe the case of a 25-year-old male, with a remote history of polytrauma and resultant pulmonary pleural adhesions, whose dive training was complicated by lung barotrauma at shallow depths. In missions or training utilizing breath-hold diving, the association with secondary alterations in lung or thoracic anatomy and function may limit which service members can safely participate.
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The purpose of this study was to determine if short-term, high-quantity opioid use following adult tonsillectomy in active duty military members results in opioid misuse, using a proxy measure of referrals to substance abuse rehabilitation programs. ⋯ Short-term, high-quantity opioid treatment of post-tonsillectomy pain in active duty adults does not result in long-term opioid misuse, as measured by substance abuse treatment program referrals within a year after surgery. This finding supports the appropriateness of adequate short-term narcotic medication treatment. The long-term readiness of these patients appears unaffected by long-term opioid misuse or abuse. Even with this finding, there is an institutional shift to multi-modality pain management and appropriate opioid reduction to further mitigate the risk of opioid misuse. Extrapolation of these findings to all adult tonsillectomy patients should be done with caution, as there are several protective factors in the active duty population such as stable full-time employment with mandatory random drug screening.
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The U.S. Army's Soldier 2020 program, which started in January 2016, was designed to achieve full integration of women in all military occupational specialties. This study was undertaken to determine differences in risk of musculoskeletal injury and behavioral health (BH) disorders among U.S. Army Active Duty Servicewomen (ADSW) in ground combat military occupational specialties (MOS) versus those in non-ground combat MOS since the start of the program until January 2019. ⋯ With the increasing focus on soldier medical readiness in today's U.S. Army, the health of all soldiers is of paramount concern to command groups, unit leaders, and individual soldiers. The integration of women into ground combat military occupational specialties is a relatively new program; further longitudinal research of these groups should follow, focusing on their progression and improvement in soldier readiness, overall health, and the well-being of all servicewomen.