Military medicine
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The benefits of exercise for older adults are well known; however, most older adults do not meet recommendations for regular physical activity. Alternative methods of improving physical activity are important and can be effective at improving mobility. This analysis evaluated if participation in a Whole Health companion dog adoption program supported changes in balance and gait performance for veterans. The role of time veteran and dog spent being physically active together (i.e., walking) on observed balance and gait changes was also explored. ⋯ A Whole Health companion dog adoption intervention can improve gait, balance, physical functioning, and physical activity.
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The aims of this study were to compare concentration maximum (Cmax), time to Cmax, area under the curve, mean concentration over 4 minutes, and frequency and time to return of spontaneous circulation (ROSC) by group. ⋯ The Cmax and area under the curve were significantly higher in the IV Group compared to the 0.1 mg/kg ET Group (P < .05). The time to Cmax was significantly longer in the 0.1 mg/kg Group than the 1 mg IV Group (P = .03). The mean concentration of the 1 mg IV Group was higher than the 0.1 mg/kg ET Group until 180 and 240 seconds. There was no significant difference between the groups relative to time to ROSC (P > .05). Return of spontaneous circulation frequencies were: 0.1 mg/kg ET Group (7 of 8); 1 mg IV Group (5 of 8); and 2 mg ET Group (1 of 8), and both CPR + defib and CPR-Only (0 out of 8). This study challenges the current guidelines relative to ET epinephrine administration. Based on our ROSC data, the 0.1 mg/kg dose of epinephrine by ET should be used as a first-line intervention.
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Deployments are stressful for both service members and their families. To promote the overall health and welfare of those impacted by military deployment, it is important to identify individual resilience-building resources that service members can employ to strengthen their own well-being, the well-being of their families, and the readiness of the force. This pilot study examines different resilience-building skills that may impact individual well-being, relationship quality, and family satisfaction post-deployment. ⋯ The strengths and resources reported as contributing the most to family effectiveness and well-being were personal character traits, external relationship skills, emotional maturity, and the ability to work. The results identified unique individual resilience-building resources for service members, which contribute to their well-being and the well-being of their families. Findings suggest that training on individual resilience-building resources for service members can offer support to the entire family system following military deployment.
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In recent conflicts, injuries to urogenital organs ranged from 5 to 7.2% of all combat-related injuries. Open surgery remains the main approach in combat settings, and in the French military, urgent surgical procedures are mostly performed by general surgeons with no specialization in urological care. To explore the specific needs in advanced surgery courses, we aimed to describe the epidemiology and management of genito-urinary traumas in recent conflicts in French Medical Treatment Facilities (MTFs). ⋯ This study is the first to examine genito-urinary traumas in overseas operations during French army deployments. The results highlight the relatively low incidence of urological trauma, with most injuries involving the bladder and testis. Our findings highlight the importance of equipping military surgeons with the skills necessary to manage complex cases.
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Historically, military anatomic pathology (AP) services have been significantly compartmentalized, with each branch independently executing its laboratory support mission. The result is redundant and costly duplication of nearly identical services in close geographic proximity. The duplication of AP services disperses the overall caseload, resulting in pathologist diagnostic acumen atrophy, excessive support personnel requirements, inadequate utilization of subspecialty expertise, and overall lower-quality patient care. ⋯ Clinical pathology services would also benefit from additional triservice cooperation including standardization of quality management processes, increased resource sharing, exchange, and cooperative contingency planning. Laboratory directorships also benefit from consolidating expertise, where pathologists could be physically located at a central site with remote oversight of laboratory services. Here, we propose a holistic triservice consolidation plan for military pathology to optimize resource utilization and ultimately realize the overarching strategic plan for military medicine set forth by the Defense Health Agency.