Military medicine
-
The increase in women in the military is reshaping the veteran population and Veterans Affairs (VA) health care delivery imperatives. To determine women veterans' perspectives and decision-making about VA health care use, we conducted six focus groups (four VA users and two nonusers) and identified key themes. Barriers to VA use for both VA users and nonusers included lack of information about eligibility and available services. ⋯ VA environment and quality concerns led many women to limit their VA use to women's clinics. These qualitative findings provide a context to highlight where interventions and policies suggested by quantitative findings should focus. Dissemination of accurate information about VA eligibility and services, and continued responsiveness to women's perceptions of care are indicated.
-
The aim of this study was to examine the Mangled Extremity Severity Score (MESS) in a combat setting. ⋯ A MESS of >7 correlated with amputation, thus validating the MESS in a combat setting. A young average patient age and high-energy injury mechanism on the battlefield leave ischemic time and shock as the most important factors in dictating whether a MESS is >7 or <7.
-
The purpose of this study was to assess the possible association between scores of >200 on U.S. Medical Licensure Examination (USMLE) step 1 and the Council on Resident Education in Obstetrics and Gynecology (CREOG) in-training examinations and the pass rate on the American Board of Obstetrics and Gynecology (ABOG) written examination. ⋯ Program directors have used USMLE step 1 to identify trainees who are likely to perform well on the CREOG in-training examination. The CREOG in-training examination has been used to identify residents who are likely to pass the ABOG written examination. The results of this study document the strength of these associations.
-
Review Case Reports
Meralgia paresthetica due to body armor wear in U.S. soldiers serving in Iraq: a case report and review of the literature.
Meralgia paresthetica is a disorder of the lateral femoral cutaneous nerve that results in symptoms of anterolateral thigh paresthesias and dysesthesias without associated loss of reflexes or motor weakness. Chronic meralgia paresthetica, not related to traumatic or lesion-producing compression of the nerve, is associated with obesity, pregnancy, tight-fitting garments, as well as specific duty uniform belts used by police officers and carpenters. ⋯ S. soldiers in Iraq experienced symptoms of meralgia paresthetica, most likely due to repetitive wear of protective body armor. Although use of protective body armor is proven to be lifesaving, modifications to improve current equipment may help to decrease morbidities such as meralgia paresthetica.
-
The objective of the study was to examine veterans' perceptions of problems and benefits of outsourcing inpatient care from Veterans Affairs (VA) hospitals to private sector hospitals. Primary data were collected from a cross-section of 42 veterans who were VA users and nonusers using focus groups. Focus group discussion examined reasons patients use VA care, differences between VA and civilian care, positive and negative impacts of outsourcing, and special needs of veterans. ⋯ Participants identified a variety of potential positive and negative impacts. In general, veterans perceived more advantages than disadvantages to outsourcing VA care but still expressed significant concerns related to outsourcing. These issues should be considered in the development of future policy toward outsourcing VA care to the private sector.