Articles: trauma.
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Few service members with posttraumatic stress disorder (PTSD) receive evidence-based psychotherapy (EBP) in the military health system (MHS). Efforts to increase EBP implementation have focused on provider training but have not adequately addressed organizational barriers. Thus, although behavioral health providers are trained in EBPs, clinic-, facility-, and system-level barriers preclude widespread EBP implementation. ⋯ Additional recommendations include providing ongoing support for EBP implementation (e.g., protected time to participate in EBP consultation) and matching patients to providers based on patient's clinical needs and treatment preferences. The barriers to EBP implementation that these recommendations target are interrelated. Therefore, adopting multiple policy recommendations is likely necessary to yield a meaningful and sustained increase in the implementation of EBPs for PTSD in the MHS.
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Military service members disproportionately experience sexual violence (SV) and its related health concerns. Although recent work has shown physical activity to be an effective strategy for improving physical and mental health among trauma-exposed military populations, little of this work has focused specifically on military service members with a history of SV. To address these gaps in knowledge and practice, this study identified the most salient perceived benefits/barriers of exercise among men and women survivors of SV with military affiliations. Additionally, these analyses explore willingness to engage in exercise programs, and preferences for the structure/content of these programs, among men and women survivors of SV with military affiliations. ⋯ This study identified perceived benefits and barriers to exercise, along with willingness to engage in exercise programs, and exercise preferences among men and women survivors of SV with military involvement. Targeting these factors in intervention planning will be important for physical activity promotion and program engagement among veterans to reduce the disproportionate impact of SV and disease burden among U.S. service members and veterans.
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Recent research on traumatic brain injury (TBI) has suggested that the mechanism of injury (i.e., whether the TBI was caused by high-level blast [HLB] vs. direct physical impact to the head) may be an important factor in injury severity, symptomology, and recovery because of differences in physiological effects of each type of injury on the brain. However, differences in self-reported symptomology resulting from HLB- vs. impact-related TBIs have not been thoroughly examined. This study tested the hypothesis that HLB- and impact-related concussions result in different self-reported symptoms in an enlisted Marine Corps population. ⋯ These findings support recent research suggesting that the mechanism of injury may play an important role in symptom reporting and/or physiological changes to the brain after concussion. The results of this epidemiological investigation should be used to guide further research on the physiological effects of concussion, diagnostic criteria for neurological injuries, and treatment modalities for various concussion-related symptoms.
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A growing number of veterans are having children, and pregnancy is an opportunity to engage with health care. Within the Veterans Health Administration (VA), the VA maternity care coordination program supports veterans before, during, and after pregnancy, which are periods that inherently involve transitions between clinicians and risk care fragmentation. Postpartum transitions in care are known to be especially tenuous, with low rates of primary care reengagement. The objective of this study is to better understand this transition from the perspectives of the VA care teams. ⋯ The Department of Veterans Affairs Healthcare System care team perspectives may inform practice changes to support the transition from maternity to primary care for veterans. To move toward health equity, a system-level approach to policy and programming is necessary to reduce barriers to primary care reengagement. This study was limited in terms of sample size, and future research should explore veteran perspectives on VA postpartum care transitions.
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Fractures of the acetabulum are one of the most challenging injuries treated by orthopedic surgeons. However, a bibliometric analysis has not been performed in the literature on acetabular fractures, which seriously affect the quality of life of patients. The aim of this study was to summarize the bibliometric and intellectual structure, and determine and map the most recent trends on the topic of acetabular fractures by analyzing the social and structural relationships between the different research components of articles published on the acetabular fractures. 1599 articles on acetabular fractures published between 1980 and 2022 were extracted from the Web of Science (WoS) database and analyzed. ⋯ A high-level statistically significant correlation was found between the number of articles on the topic of acetabular fractures published by nations and the gross domestic product (GDP) and GDP per capita values of those countries (R = 0.719, P < .001; R = 0.701, P < .001, respectively). The trending topics researched in recent years were 3D printing, 3-dimensional printing, outcomes, Open Reduction and Internal Fixation (ORIF), mortality, Kocher-Langenbeck, Pararectus approach, tranexamic acid, transfusion, epidemiology, fracture mapping, modified Stoppa approach, post-traumatic osteoarthritis, pelvis fracture, pelvic trauma, fracture reduction, and pelvic ring injury. The leading countries in research on the subject of acetabular fractures were seen to be western countries with large economies (especially the USA, European countries, and Canada) and China, India and Turkey.