Military medicine
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Resilience is the ability to maintain or quickly return to a stable physical and psychological equilibrium despite experiencing stressful events. Flexibility of the autonomic nervous system is particularly important for adaptive stress responses and may contribute to individual differences in resilience. Power spectrum analysis of heart rate variability (HRV) allows measurement of sympathovagal balance, which helps to evaluate autonomic flexibility. The present study investigated HRV as a broad index of resilience. ⋯ Greater resilience to stress was associated with HRV during nonstress periods. Higher levels of resilience to traumatic events were associated with HRV during circumstances that were more stressful and emotionally distressing. Post hoc analysis revealed that specific factors including flexibility, emotional control, and spirituality were driving the relationship between general resilience and HRV following emotionally laden stressors. Less stress vulnerability was associated with HRV following intermittent brief stressors. In sum, HRV appears to represent some aspects of an individual's overall resilience profile. Although resilience remains a complex, multidimensional construct, HRV shows promise as a global psychophysiological index of resilience. This study also offers important perspectives concerning ways to optimize both physical and psychological health.
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Musculoskeletal injuries (MSIs) have direct impact on occupational readiness and task performance in military populations. Until this date, no epidemiologic data have been published concerning MSI incidence in the Netherlands Armed Forces (NAF). The aim of this study was to assess the MSI incidence and related costs in the NAF. ⋯ Our study provided evidence that MSIs result in substantial financial burden. Injuries of the back, knee, and foot account for the majority of demands on curative care for MSIs.
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Cohesion within military teams is not only vital to their performance but also modulates the adverse impact of work stressors on mental health, including depression, distress, and morale. This study stems from previous findings concerning cohesion during recruit training in the Australian Army. In that study, ratings of cohesion clustered on three dimensions, namely horizontal bonding among team members, vertical bonding with leaders, and organizational bonding with the wider army. Ratings on all three dimensions increased during recruit training, similar to what has been during U.S. Army basic training. The present study takes the next step, which is to determine the relationship between team cohesion and external measures of group performance during training in three types of military occupational specialty, specifically, infantry, quartermaster, and administrative clerk. ⋯ The present results during military occupational specialty training paralleled previous findings that Australian Army recruits quickly developed solid team cohesion early in their training, which generally continued to rise in all three courses. Furthermore, as seen previously with recruits, vertical bonding between section members in all three courses and their instructor leaders tended to be higher than horizontal bonding among team members, which in turn was higher than vertical bonding of the trainees with the wider Army. These findings have useful implications for health professionals. When discussing feelings of depression, distress, and low morale, health professionals might explore a military member's sense of bonding with their team members, their leaders, and their wider organization as possible contributors to their concerns. By the same token, advice aimed at promoting cohesion may help evoke their protective effects.
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We report an unusual case of extensive subcutaneous emphysema, pneumomediastinum, and pneumopericardium identified in an otherwise healthy U. S. Marine who was enrolled in the Marine Corps School of Infantry. ⋯ Although he lacked a history of trauma, he was found to have pneumopericardium, pneumomediastinum, and subcutaneous emphysema without pneumothorax. He was admitted to the general surgery service for observation and was ultimately released back to his unit after 24 hours. To our knowledge, pneumopericardium has never been attributed to persistent yelling in the setting of a lower respiratory tract infection and should be considered in the differential of atraumatic chest symptomatology in otherwise healthy military service members.