Military medicine
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The current model for treating behavioral health patients requires that providers and patients be in the same location for appointments. However, deploying warfighters present a challenge to this current model. Recent advances in technology make telehealth or virtual visits a viable option to replace the current model. This project leveraged mobile technology to see if performing tele-behavioral health visits presented a viable option to the current in-person model for future deployed warfighters. At the time of this publication, the authors note the current pandemic lends all the more urgency to the need for enhancing our video communication platforms for remote monitoring with the Military Health System. ⋯ It is technically feasible to provide desktop Video Tele-Conference capabilities from a .mil computer to a personal mobile device without compromising DoD security and information assurance requirements using future WebRTC systems. Approved ports, protocols, and system settings must be configured to accept both inbound and outbound, encrypted traffic to/from personal mobile devices to maintain consistent quality of service with all DoD networks. Of the current DoD WebRTC options, working with the DISA GVS Program Manager to expand services to support commercial mobile devices has the highest probability of future success.
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Point of care ultrasound (POCUS) is increasingly used in primary care in the USA and has been shown to provide significant benefit to care in deployed military settings and during disaster relief efforts. It is less studied as a tool during humanitarian assistance missions. We sought to determine the utility of POCUS in a humanitarian assistance setting during the February 2019 joint U.S.-Brazilian hospital assistance mission aboard the Hospitalar Assistance Ship Carlos Chagas along the Madeira River in the Brazilian Amazon. ⋯ In this austere setting, POCUS proved to be an inexpensive, effective tool at preventing unnecessary referrals. Future medical humanitarian assistance missions may likewise find POCUS to be a primary care force-multiplier.
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A new training and rehabilitation methodology called Sanomechanics® is presented based on a recent discovery of the anatomical system called Floating Skeleton System (FSS) responsible for redistributing contact pressures in the joint capsules and thus minimizing the loads on joint cartilages. ⋯ The FSS provides for a guidance for development of scientific approaches to the training and rehabilitation techniques. The SMM is balanced mind-body training system, which can help U.S. Servicemen and Servicewomen be better prepared for extreme load during their service.
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Military operations often involve intense exposure to stressors combined with acute sleep deprivation, while military personnel also experience high prevalence of chronic sleep deficiency from insomnia and other sleep disorders. However, the impact of acute and chronic sleep deficiency on physiologic stressor responses is poorly understood. In a controlled laboratory study with normal sleepers and individuals with chronic sleep-onset insomnia, we measured responses to an acute stressor administered in a sleep deprivation condition or a control condition. ⋯ Blunted stressor reactivity as a result of sleep deficiency, whether acute or chronic, may reflect reduced resiliency attributable to allostatic load and may put warfighters at increased risk in high-stakes, rapid response scenarios.
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This research has resulted in a system of sensors and software for effectively adjusting prosthetic alignment with digital numeric control. We called this suite of technologies the Prosthesis Smart Alignment Tool (ProSAT) system. ⋯ The accuracy of a prototype ProSAT system has been validated for controlled alignment changes by a prosthetist. Refinement of the ergonomic form and technical function of the hardware and clinical usability of the mobile software application are currently being completed with benchtop experiments in advance of further human subject testing of alignment efficiency, accuracy, and user experience.