Military medicine
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Clinical Trial Controlled Clinical Trial
The COPE program: treatment efficacy and medical utilization outcome of a chronic pain management program at a major military hospital.
This study presents a treatment efficacy and medical utilization evaluation of a cognitive-behavioral, outpatient, chronic pain management program in a military hospital setting. A total of 61 nonmalignant chronic pain patients with heterogeneous pain syndromes who participated in sequential group programs were included in the study. Comprehensive and multi-dimensional outcome criteria were used, including pain ratings, relaxation skills, quality of life, satisfaction ratings, and medical utilization. ⋯ This reduction amounts to a projected net annual saving of $78,960 in the first year after behavioral medicine intervention. In light of the increasing cost of health care for chronic pain patients, psychological approaches as an adjunct to traditional medical care seem to present a sound solution for cost savings. This study also supports the notion that a strategic biopsychosocial pain program, which targets the multiple dimensions of persistent pain, provides effective treatment and increases patient satisfaction.
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Forward-deployed medical units do not have the capability to warm intravenous (i.v.) fluids before their administration. We intend to demonstrate a field-expedient means of warming i.v. fluids and preventing hypothermia using the flameless heater available in the Meal, Ready to Eat (MRE). ⋯ Average temperature increases ranged from 15.8 to 31.2 degrees C in times ranging from 8 to 20 minutes. Therefore, we conclude that the flameless MRE heater provides a simple, field-expedient means of warming i.v. fluids before their administration.
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This study evaluates patient reasons and preferences for gender selection of their obstetrician-gynecologist. ⋯ Although a majority of our study population preferred female obstetrician-gynecologist providers, experience and reputation were more frequently cited than gender as the most important factors in selecting a provider. Patients felt that female physicians understand their problems better.
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This study determined the incidence of and risk factors for injuries among 356 Marines during a winter mountain training exercise. ⋯ Military winter training is associated with injuries and lost training time. Risk factors were identified, suggesting that these injuries may be preventable.
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The objective of this study was to characterize injuries occurring to crew members aboard a U.S. Navy ship. ⋯ Overuse musculoskeletal injuries occurred with the greatest incidence, but acute musculoskeletal injuries were responsible for the greatest morbidity. Soft tissue injuries occurred with an intermediate incidence but had the lowest overall morbidity. The safest place for crew members assigned to this Navy ship was aboard that ship at sea. Further studies of this nature could help guide medical efforts at injury treatment and prevention for shipboard personnel.