Military medicine
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Stress fractures (SFx) represent a significant proportion of injuries in military recruits internationally. Stress fractures disproportionately affect female recruits, a disparity that has similarly been consistently demonstrated in female athletes. Stress fractures result in medical morbidity, financial burden, and medical discharge from military service. This review presents current literature regarding SFx risk factors to identify and/or mitigate in this high-risk population. ⋯ This review, Part II of a two-part series, guides multidisciplinary management of military recruits, especially females, who are at risk for developing SFx. Unique nuances of the military recruit require specific knowledge to reduce high incidence rates of injury internationally.
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Regulations of the United States Air Force (USAF) prohibit male members from growing beards. Shaving waivers can be issued to airmen who are not able to shave due to various medical conditions such as pseudofolliculitis barbae, a condition that predominantly affects Blacks/African-Americans. Beard growth has been anecdotally associated with a negative impact on career progression. This study sought to establish if shaving waivers are associated with delays in promotion and, if present, if this association leads to racial bias. ⋯ This study found an association between shaving waivers and delayed promotions. The majority of the waiver group was Black/African-American, which may lead to a racially discriminatory effect of the male grooming standards of the USAF.
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Combat medics, or 68W Healthcare Specialists in the Army, are an early part of a combat casualty's chain of survival. Their job requires a high degree of competency in emergency medical guidelines established by the Committee of Tactical Combat Casualty Care (CoTCCC) as well as basic bleeding control skills. The American Warfighting Experience for the last two decades highlights just how important these skills are in preventing death on the battlefield. A recent Government Office of Accountability suggests sustainment for critical wartime skills is lacking. This is especially concerning for National Guard Soldiers who must juggle their military obligations with their civilian ones. It is unknown how well-prepared National Guard combat medics are in fulfilling their most critical combat care responsibilities. The current study attempts to address this gap in knowledge by assessing National Guard Soldiers due for their annual recertification. ⋯ A soldier's experience alone could not predict if the soldier will be successful in performing bleeding control tasks or if they will demonstrate higher levels of casualty care knowledge. Future research is needed in this area to better define recertification and refresher training issues.
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Excessive sweating or focal hyperhidrosis (HH) of the residual limb in persons with amputations is thought to be a significant contributor to residual limb dermatoses, prosthesis dysfunction, and decreased quality of life. Treatment algorithms used for HH in persons without amputation do not effectively translate to residual limb HH, and research in this area is sparse. ⋯ Although the reported side effects of post-procedure edema and prolonged time out of a prosthesis are challenging, MT of the residual limb appears to be a promising treatment modality for persons with amputation. Further investigations for standardized treatment guidelines are required to improve management of residual limb HH with MT.