Military medicine
-
Retrospective review (level of evidence III). ⋯ The 1-year rate of surgery for LDH was modestly higher in beneficiaries who were diagnosed in purchased care versus direct care. Among patients who were diagnosed in direct care, several patient-level and facility-level characteristics were associated with receiving surgery in purchased care, suggesting potentially unexpected variation in care utilization across components of the MHS.
-
Throughout history, armies of the world have codified grooming standards for their members. In the USA, the Department of Defense (DoD) provides overall guidance for grooming standards and each uniformed military service develops, promulgates, and enforces its own grooming standards. The specific details of each service's grooming standards are revised regularly to conform to contemporaneous notions of professionalism and operational necessity. In light of growing recognition of and respect for the diversity of people serving in the military, specific language used to describe certain hairstyles and hair textures as well as associated grooming policies have gained attention. Efforts have been made to modify the policy and language to be more inclusive, especially of minority groups with physiologic and cultural differences that influence grooming practices. Initial efforts in the DoD toward this endeavor were made possible with advocacy from members of the Congressional Black Caucus. ⋯ The DoD has recognized that former grooming standards, specifically regarding hair and hairstyles, may have introduced inequities in the treatment of military personnel. The DoD and its component military services have long been engaged in programs to ensure equal protections among its workforces. The re-examination and clarification of grooming standards related to hair and hairstyles is another effort to ensure equity and inclusion. The military services are working with great sincerity to implement policies that promote inclusiveness broadly. Steps to remove discrimination on the basis of hair and hairstyle can make the overall work environment more inclusive for people of color. Passage of a federal CROWN Act will promote similar or parallel changes for federal employees outside the military services.
-
The recent article by Knisely et al. provides a comprehensive review and summary of recent literature describing simulation techniques, training strategies, and technologies to teach medics combat casualty care skills. Some of the results reported by Knisely et al. align with the findings of our team's work, and these findings may be helpful to military leadership with their ongoing efforts to maintain medical readiness. ⋯ Our team recently published two papers describing the results of a large survey that examined Army medic pre-deployment training. Combining the findings of Knisely et al. along with some of the contextual information from our work, we provide some recommendations for improving and optimizing the pre-deployment training paradigm for medics.
-
Before the COVID-19 pandemic, a 1-week in-person Clinical Ultrasound Course was taught in African nations as part of a U.S. Department of State-funded program that supports and trains African peacekeepers serving with the United Nations and African Union. In order to maintain active engagement with host nations despite the travel restrictions due to the COVID-19 pandemic, portions of the course were taught virtually in 2021 to providers in Ghana, Senegal, and Rwanda. An abbreviated course was delivered covering the Focused Assessment with Sonography in Trauma (FAST) trauma exam and vascular access. The goal of this study is to assess the effectiveness of the Clinical Ultrasound Course while taught in a virtual classroom. ⋯ Virtual delivery of the Clinical Ultrasound Course was successful. Participants felt more comfortable in all aspects of ultrasound taught during the course and indicated that they were more likely to use ultrasound in clinical practice. This demonstrates that virtual ultrasound teaching is a viable option for international educational programs in the future.