Military medicine
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Emergency departments (EDs) continue to struggle with overcrowding, increasing wait times, and a surge in patients with non-urgent conditions. Patients frequently choose the ED for non-emergent medical issues or injuries that could readily be handled in a primary care setting. We analyzed encounters in the ED at the Brooke Army Medical Center-the largest hospital in the Department of Defense-to determine the percentage of visits that could potentially be managed in a lower cost, appointment-based setting. ⋯ Over half of all ED visits in our dataset could be primary care eligible. Our findings suggest that our patient population may benefit from other on-demand and appointment-based healthcare delivery to decompress the ED.
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To compare the clinical outcomes of bilateral labia minora hypertrophy reduction using ultrasonic shears versus traditional methods. ⋯ Ultrasonic shears significantly reduce the time needed for the reduction of bilateral labia minora hypertrophy and therefore should be considered by surgeons as a useful tool in increasing the efficiency of this procedure.
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Femtosecond-assisted thin flap, laser-assisted in situ keratomileusis (LASIK) and photorefractive keratectomy with mitomycin-C (PRK-MMC) are the two most common refractive surgical procedures used to enhance visual capability in the U.S military. The purposes of the study were to examine effects on quality of vision following LASIK and PRK-MMC using a novel computer-based quick contrast sensitivity function (qCSF) test. ⋯ Quality of vision recovers at postoperative 1 week after LASIK and at postoperative 1 month after PRK-MMC. The standard black-on-white high-contrast, chart-based visual acuity test is weak in predicting quality of vision. The qCSF detects mild-to-moderate visual changes and is suitable for quality of vision assessment following refractive eye surgery.
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In June of 2020, the U.S. DVA and DoD approved a new joint clinical practice guideline for assessing and managing patients with headache. This guideline provides a framework to evaluate, treat, and longitudinally manage the individual needs and preferences of patients with headache. ⋯ This synopsis summarizes the key features of the guideline in three areas: prevention, assessing and treating medication overuse headache, and nonpharmacologic and pharmacologic management of headache.
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In Antarctica, human access and presence are complex and require detailed planning and preparation in advance. The personnel of National Antarctic Programs (NAPs, i.e., scientists and support personnel, including military, civilians, and mountaineers) stay in different isolation, confinement, and extreme (ICE) environments such as ships, research stations, and scientific summer camps. Antarctica imposes harsh conditions that influence physiological and psychological responses impacting health, mood, and physical and cognitive performances. ⋯ We evaluated and compared the individual's mood at the beginning and the end of the PAT week and observed group-specific mood changes depending on the sex, functions, and the facilities that participants accessed. Finally, we proposed that conducting training before staying in Antarctica, besides promoting conditions to better plan the voyage and knowledge of the region, can contribute to dealing with the possible mood swings during expeditions and even promote positive affect. Therefore, the psychophysiological effects of PAT are topics for further investigations.