Military medicine
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A military exists in a unique position. It is an organization in which active duty members knowingly join or are conscripted into service with the understanding that there is an increased risk of mental and/or bodily harm as compared to many other occupations. However, while the nature of the profession can inherently be dangerous, it does not follow that its members be placed at undue excess risk if that risk can be reasonably avoided or reduced. ⋯ The ethical obligation is fortified by the extent of control a military exercises over its personnel. Taken together, these factors necessitate a concerted effort by militaries to remain cognizant of the ethical impacts of their policies and practices and to ensure focus remains on the well-being and readiness of its personnel. As such, militaries have ethical responsibilities to promote healthy social determinants of health among their service members via policies and public health measures.
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Myocardial bridging is an uncommon cause of a quite common emergency department complaint for chest pain and is often associated with left ventricular hypertrophy. We present a case of an otherwise healthy middle-aged U. S. military service member who presented with acute coronary syndrome which was ultimately determined to be the result of myocardial bridging.
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Review
Overall Safety and Risks Associated with Blood Flow Restriction Therapy: A Literature Review.
Blood flow restriction therapy (BFRT) is used in scenarios ranging from muscle building in athletic performance to decreasing recovery time in postoperative orthopedic rehabilitation. The efficacy of BFRT for treating diseases has been increasingly researched; however, there has been less literature focused on establishing the safety of this therapy. ⋯ Blood flow restriction provides tremendous opportunity with a potential for accelerated exercise rehabilitation and injury prevention. This modality could be used in the military setting to help injured active duty personnel expeditiously return to deployable status. Further prospective randomized controlled trials are warranted to further support BFRT safety; however, from this literature review, it can be concluded that BFRT can be utilized safely in the proper patient population when administered by qualified professionals who have undergone the appropriate training.
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Racial disparities in health care are a well-documented phenomenon in the USA. Universal insurance has been suggested as a solution to mitigate these disparities. We examined race-based disparities in the Military Health System (MHS) by constructing and analyzing a framework of existing studies that measured disparities between direct care (care provided by military treatment facilities) and private sector care (care provided by civilian health care facilities). ⋯ Universal coverage mitigates many, but not all, racial disparities in health care. An examination of a broader range of interventions, a closer look at variation in care provided by civilian facilities, and a look at the quality of care by race provide further opportunities for research.
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Medical school leaders are seeking strategies to increase the diversity of their student populations. Post-baccalaureate premedical (PBPM) programs are one such pipeline that has supported diversity in medicine. The purpose of this study was to evaluate the Uniformed Services University's (USU's) PBPM program (the Enlisted to Medical Degree Preparatory Program, EMDP2) to determine how well it prepares its learners for the School of Medicine (SOM). ⋯ The EMDP2 appears to prepare medical students on a par with their non-EMDP2 peers. The EMDP2 contributes to USU's commitment to train physicians who represent the nation and its citizens by making medical education available to enlisted service members, a population that closely mirrors the diversity of the nation.