Military medicine
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Feeding and eating disorders can be difficult to treat and frequently co-occur with other mental health conditions. The last systematic review of eating disorders in a military and veteran population was published in 2015. An updated review is warranted to re-examine the current literature on eating disorders in the active duty and veteran populations. ⋯ Research on eating disorders in the military and veteran populations has expanded in recent years. Limitations of the evidence included in this review stem from the use of self-reported questionnaires, changes to medical record systems, and limited generalizability to the overall population of patients with eating disorders. Further research should investigate the impact of demographic factors and trauma exposure on the development of an eating disorder within the military and veteran populations.
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Metabolic Demands and Kinematics During Level Walking in Darkness With No Vision or With Visual Aid.
Uniformed services commonly perform foot-borne operations at night, while using visual aid in terms of night vision goggles (NVG). During slow-level walking, complete lack of visual input alters kinematics and markedly increases the metabolic demand, whereas the effect on kinematics and energy expenditure of restricting the peripheral visual field by wearing NVG is still unknown. The purpose was to evaluate whether metabolic demands and kinematics during level walking are affected by complete darkness with and without visual aid. ⋯ The study confirms that complete lack of visual cues markedly reduces the mechanical efficiency during level walking, even under obstacle-free and highly predictable conditions. That $\dot{\text{V}}$O2 and step length values for the NVG conditions fell in between those of the Light and Dark conditions suggest that both foveal and peripheral vision may play important roles in optimizing the mechanical efficiency during level walking.
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Female warfighters are at risk for sex-specific and frequently unrecognized urogenital health challenges that may impede their ability to serve. The constraints on water, sanitation, and hygiene (WASH) resources by austere environments, whether at home or abroad, require women to practice unhealthy hygiene behaviors that jeopardize their urogenital health. In this manuscript, we examine the use of WASH resources by U.S. Army active duty servicewomen (ADSW) across three settings-home duty, field training, and deployment-to determine how the changing availability of WASH resources alters hygiene and sanitation practices in austere environments. Additionally, we report findings from a previously developed theoretical framework for determining the impacts of austere environments on ADSW's hygiene knowledge, behaviors, and outcomes. ⋯ This is the first study to characterize sex-specific challenges by a large sample of operational ADSW and to explore the use of WASH resources in home duty, field training, and deployment settings. The results show that field training is more austere than deployed settings, indicating that austerity, not deployment, increases the urogenital infection risk for ADSW. With women more integrated into the military strategy than at any time in U.S. history, military leaders can use our results to develop interventions that ameliorate the unique challenges that influence the military readiness and overall health of female warfighters.
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Opioids are often a mainstay of managing postsurgical pain. Persistent use of opioids for more than 90 days after surgery is problematic, and the incidence of this adverse outcome has been reported in the civilian population ranging from 0.4% to 7%. Veterans compose a special population exposed to trauma and stressful situations and consequently face increased risk for habit-forming behavior and drug overdose. This evaluation determined the prevalence of opioid persistence after surgery and its relationship to patient characteristics in a military veteran population. ⋯ Among a cohort of over 1,200 opioid-naïve veterans undergoing surgery at a VA Medical Center, just over 3% went on to develop persistent opioid use beyond 3 months following their procedure. Persistent use was not found to be related to the type of procedure (major or minor) or patient age. Significant patient-level risk factors for opioid persistence were cancer and a history of mental health and substance use disorders.
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Several previous studies have reported that hypoxia accidents of fighter pilots are rarer than gravity-induced loss of consciousness and spatial disorientation; however, the risk is greater. Therefore, this study aimed to investigate the relationship between physical fitness and body composition on time of useful consciousness (TUC) in hypobaric hypoxia. ⋯ Our results revealed that increased cardiorespiratory fitness and decreased body fat mass could significantly impact the TUC. Therefore, for Air Force pilots who are frequently at high altitudes and at risk for exposure to hypoxia, aerobic exercise is significant to hypoxia tolerance.