Military medicine
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Leading medical teams as a new attending physician can be a challenging task. This case highlights the important role of leaders in fostering a positive learning environment, developing interpersonal relationships, and establishing clear expectations with regular feedback to improve team function to deliver effective health care.
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In order to better treat obstructive sleep apnea (OSA) in a more efficient and cost-effective way, a joint program between dental clinics and the sleep medicine clinic was piloted at Fort Hood, Texas. Obstructive sleep apnea negatively affects soldier readiness and deployability, leading to the need to establish a successful and proven workflow to treat these patients with oral appliance therapy (OAT). ⋯ Oral appliance therapy has the potential to increase both readiness and deployability for active duty soldiers. Using baseline O2 nadir can help predict success with OAT patients, determining which patients will benefit from this joint program between the dental and medical sleep clinics. Future studies can aim to establish an evidence-based pathway for clinic testing and follow-up. If this patient workflow is implemented properly, there can be significant cost savings army-wide. This all helps The United States Medical Command (MEDCOM) align with the DHA's Quadruple Aim of increased readiness, better health, better care, and lower cost.
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The newly implemented Army Combat Fitness Test (ACFT) of the U.S. Army seeks to revolutionize the Army's fitness culture and reduce the rate of preventable injuries among soldiers. The initial rollout of the ACFT has been met with several challenges, including a gender-neutral scoring system. The ACFT has undergone several revisions to adapt to the present state of U.S. Army physical fitness; however, the test faces several more obstacles as more data become available. The ACFT was designed to measure combat readiness, a useful tool for units facing deployment or a change in duty station to a high-altitude environment. Reduced oxygen availability (hypoxia) at high altitude influences many physiological functions associated with physical fitness, such that there is an increased demand for oxygen in exercising muscle. Therefore, the purpose was to investigate the effects of normoxic and two levels of hypoxia exposure (moderate and severe; fraction of inspired oxygen [FiO2]: 16.0% and 14.3%) during the 3-repetition deadlift (MDL), hand-release push-up (HRP), and leg tuck (LTK) events of the ACFT. ⋯ Performance and scores of the modified ACFT were not influenced by acute normobaric MH and SH exposure compared to normoxia. Further investigations should examine the full testing battery of the ACFT to provide a comprehensive analysis and potential evidence for such differences.
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Editorial Comment
Building Trust Between Military Pilots and Flight Surgeons.