Military medicine
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In order to evaluate the outcomes of a USU School of Medicine (SOM) education, a program director (PD) evaluation survey was developed in 2005 and is completed annually by PDs regarding trainees who graduated from USU and are in their first post-graduate training year (PGY-1) and their third post-graduate training year (PGY-3). The survey was last reviewed and revised in 2010 to better align with the competencies established by the Accreditation Council for Graduate Medical Education but has not been further evaluated or revised. The objective of the study was to utilize 12 years of aggregated data to improve the psychometric properties of the survey, with an emphasis on shortening the survey. A secondary objective was to refine the verbiage of the existing questions and add new items to assess health systems science competencies. ⋯ The USU SOM has benefited from over 15 years of results from the PD surveys. We identified those questions that performed well, and these were refined and augmented in order to optimize the performance of the survey and fill gaps in our knowledge of graduates' performance. To determine how well the revised set of questions performs, efforts will be made to increase the response rate and completion of 100% of items on the survey, and the EFA should be repeated after about 2-4 years. Furthermore, the USU graduates should continue to be tracked longitudinally past residency to determine if PGY-1 and PGY-3 survey measures predict long-term performance and patient outcomes.
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Despite a wide literature describing the impact of PTSD on military personnel, there is limited information concerning the results of PTSD treatment within military clinics mental health. Having such information is essential for making predictions about service members' chances of recovery, choosing best treatments, and for understanding if new interventions improve upon the standard of care. ⋯ Recovery from PTSD is possible during military service, but it is less likely in individuals with certain negative prognostic factors, most notably severe depression.
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Meta Analysis
Acute Fatigue Responses to Occupational Training in Military Personnel: A Systematic Review and Meta-Analysis.
Military personnel are required to undertake rigorous physical training to meet the unique demands of combat, often leading to high levels of physiological stress. Inappropriate recovery periods with these high levels of physical stress may result in sub-optimal training and increased risk of injury in military personnel. However, no reviews have attempted to examine the magnitude of training-induced stress following military training activities. The aim of this systematic review was to assess the magnitude of physiological stress (physical, hormonal, and immunological) following task-specific training activities in military personnel. ⋯ These findings indicate that assessments of muscle damage, anabolic hormones like testosterone, strength, and power are effective for determining the level of acute stress following military-specific activities. With regular monitoring of these measures, appropriate recovery periods may be implemented to optimize training adaptations and occupational performance, with minimal adverse training responses in military personnel.
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Randomized Controlled Trial
A Randomized Controlled Trial of the Prevent Alcohol and Risk-Related Trauma in Youth Program in Reducing Alcohol-Related Harms in Young Naval Trainees.
The aim of this study was to test whether participation in an alcohol risk reduction program known as Prevent Alcohol and Risk-Related Trauma in Youth (P.A.R.T.Y.) is effective in reducing the prevalence of risky drinking at 12 months' post-intervention in a sample of Royal Australian Navy (RAN) trainees. ⋯ Participation in either an on-base or an in-hospital P.A.R.T.Y. program did not affect the proportion of naval trainee participants screening positive for risky drinking on the AUDIT.
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More than 40,000 soldiers cannot deploy every year, which undermines readiness. The medical readiness of soldiers is a critical component of the overall operational readiness of the U.S. Army. Acute musculoskeletal injuries (MSIs) are the greatest threat to medical readiness. Medical providers place soldiers on temporary profiles to facilitate treatment and recovery of acute MSIs. Poorly managed temporary profiles negatively impact a soldier's work attendance, resulting in the loss or limitation of over 25 million workdays annually. Upgrading the electronic profile system and implementing the Army Medical Home has led to improvements in managing temporary profiles over the last decade. The Army Medical Home encompasses care delivery platforms, including the Patient-Centered Medical Home (PCMH) and Soldier-Centered Medical Home (SCMH). The structure of U.S. Army PCMHs and SCMHs differ in ways that may affect care processes and patient outcomes. Temporary profile management is an important soldier health outcome that has not been studied in relation to the U.S. Army's PCMH and SCMH structures or care processes. Access to care, continuity, and communication are three care processes that have been described as essential factors in reducing lost workdays and functional limitations in workers after an acute injury. Understanding the impact of the medical home on temporary profile days is vital to medical readiness. This study aimed to (1) compare temporary profile days between the U.S. Army PCMHs and SCMHs and (2) determine the influence of medical home structures and care processes on temporary profile days among active duty U.S. Army soldiers receiving care for MSIs. ⋯ Excessive temporary profile days threaten medical readiness and overall soldier health. Aspects of the medical home structure and care processes were predictors of temporary profile days for musculoskeletal conditions. This work supports continued efforts to improve MSI-related outcomes among soldiers. Knowledge gained from this study can guide future research questions and help the U.S. Army better meet soldier needs.