Military medicine
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Veteran populations are frequently diagnosed with mental health conditions such as substance use disorder and PTSD. These conditions are associated with adverse outcomes including a higher risk of suicide. The Veterans Health Administration (VHA) has designed a robust mental health system to address these concerns. Veterans can access mental health treatment in acute inpatient, residential, and outpatient settings. Residential programs play an important role in meeting the needs of veterans who need more structure and support. Residential specialty types in the VHA include general mental health, substance use disorder, PTSD, and homeless/work programs. These programs are affiliated with a DVA facility (i.e., medical center). Although residential care can improve outcomes, there is evidence that some patients are discharged from these settings before achieving the program endpoint. These unplanned discharges are referred to using language such as against medical advice, self-discharge, or irregular discharge. Concerningly, unplanned discharges are associated with patient harm including death by suicide. Although there is some initial evidence to locate factors that predict irregular discharge in VHA residential programs, no work has been done to examine features associated with irregular discharge in each residential specialty. ⋯ Irregular discharge is a key concern in VHA residential care. Patient characteristics do not account for all of the observed variation in rates across residential specialty types. There is a need to develop specialty-specific measures of irregular discharge to learn about system-level factors that contribute to irregular discharge. These data can inform strategies to avoid harms associated with irregular discharge.
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Cancer is a prominent cause of mortality in today's active duty service members (ADSMs), killing over 700 ADSMs between 2004 and 2015. Hence, more research is needed to better understand the survival of U.S. service members with cancer. Lymphoma is the most common hematologic malignancy diagnosed in ADSMs, serving as a good cancer type to study. ⋯ Service members with lymphoma have superior survival than their matched civilian counterparts, without evident racial or sex disparities. Results of this study are favorable in terms of readiness. Further research on cancer mortality in ADSMs is needed to improve long-term outcomes.
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Use rates of cannabis, a substance associated with a host of comorbid physical and mental health concerns, continue to rise for military veterans. Despite this prevalence, descriptive patterns of use among veterans and research on treatment factors that predict cannabis outcomes are lacking. This study aimed to conduct a descriptive profile of veterans who endorse cannabis use, compare veterans endorsing cannabis use to those who do not endorse use, and investigate what factors (other substance use, psychiatric symptoms, and treatment outcomes) predicted return to cannabis use following residential treatment. ⋯ Identification of relevant risk factors and treatment processes, such as impulse control, confidence in treatment, and length of stay in treatment, provides practical recommendations for future intervention efforts. This study calls for further examination of cannabis use outcomes among veterans, particularly those participating in substance use treatment.
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Physiological adaptations in military jungle survival training have not yet been studied. Knowledge about the relationship between the insulin-like growth factor type I (IGF-I)/insulin-like growth factor binding protein type 3 (IGFBP-3) system and survival activities in a jungle environment can improve readiness and prepare Brazilian Air Force cadets for this kind of battlefield. Our goal was to assess changes in body composition and serum concentrations of the IGF-I/IGFBP-3 system in Brazilian Air Force cadets during five-day Amazon rainforest survival training and whether differences in sex influence these variations. ⋯ These findings all suggest that changes in body mass and body fat, as well as variations in the IGF-I/IGFBP-3 system, corroborate the need for military readiness preparation. Equivalent changes in both sexes indicate probable equal recovery intervals after survival training.
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Research has linked high occupational demands to multiple adverse health outcomes, both physical and mental. As far as we know, researchers have not identified the profile characteristics of military police personnel based on occupational demands. The current study aims to identify profiles based on self-perceived occupational demands and work-related factors. This study is a starting point for characterizing performance and health in a military police population. ⋯ We established two distinct profiles that describe the characteristics reported by the Royal Netherlands Marechaussee personnel based on workload and work characteristics. High scores on autonomy, work support, and task clarity predict favorable perceived occupational demands, whereas fatigue and boredom predict unfavorable occupational demands. Remarkably, the physical workload did not predict high perceived occupational demands.