Military medicine
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High rates of physician burnout are well documented in the USA. Identifying beneficial leadership behaviors as an organizational approach to mitigating burnout can lead to improved wellness in the physicians that they lead; however, few studies have examined which leadership behaviors are beneficial and which may be detrimental. ⋯ Organizational interventions are needed to improve burnout in physicians. Adopting favorable leadership behaviors while avoiding unfavorable leadership behaviors can improve burnout in those physicians being led. These findings could inform the conceptual basis of future physician leadership training programs as transactional leadership behaviors also have an impact on physician wellness.
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Known as the "golden hour," survival of most critically injured patients is highly dependent on providing the required treatment within the first hour of injury. Recent technological advances in additive manufacturing (also known as three-dimensional [3D] printing) allow for austere deployment and point-of-care rapid fabrication of a variety of medical supplies, including human tissues and bioactive bandages, in prolonged field care scenarios. In this pilot project, our aim was to investigate the ability to 3D print a range of potential biomedical supplies and solutions in an austere field environment. ⋯ The current and future challenges of prolonged field care need to be addressed with new techniques, training, and technology. Ruggedized, deployable 3D printers allow for the direct fabrication of medical tools, supplies, and biological solutions for austere use. Delivery of packages can vary, and attention to routes and location is key, especially for transit of time-sensitive perishable supplies such as live cells. The significance of this study provides the real possibility to 3D print "just-in-time" medical solutions tailored to the need of an individual service member in any environment. This is a potentially exciting opportunity to bring critical products to the war front.
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Over the last two decades, the conflicts in Iraq and Afghanistan have cost the United States significantly in terms of lives lost, disabling injuries, and budgetary expenditures. This manuscript calculates the differences in costs between veterans with combat injuries vs veterans without combat injuries. This work could be used to project future costs in subsequent studies. ⋯ Combat injured patients have significantly higher long-term health care costs compared to their noninjured counterparts. If this random sample is extrapolated to the 53,251 total of combat wounded service members, it implies a total excess cost of $1.6 billion to date after adjustment for covariates and a median follow-up time of 10 years. These costs are likely to increase as injured veterans age and develop additional chronic conditions.
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Military-civilian partnerships are crucial to maintaining the skills of active duty surgeons and sustaining readiness. There have been no publications to date that report the quantitative effect of these partnerships on academic research. To address this question, the Hirsch indices (H-indices) of active duty surgeons with a civilian affiliation (CA) were compared to those without. As a secondary outcome, H-indices of military surgeons with and without an appointment to the Uniformed Services University (USU) were similarly compared. We hypothesized that military surgeons with a CA would have a higher H-index as compared to those without. ⋯ This article provides objective evidence that there is a benefit to military-civilian partnerships on the academic output of military surgeons. These relationships should continue to be fostered and expanded.
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Musculoskeletal injuries (MSIs) are common among U.N. military personnel and cause a substantial toll, but little is known about the actual risks and changes of MSIs. The Chinese level II hospital (CHN L2H) was the highest-level hospital in the Western Sector of the U.N. Mission in South Sudan (UNMISS). This study reviewed and analyzed the MSIs managed by the CHN L2H in UNMISS. ⋯ MSIs are common diseases in the CHN L2H in the Western Sector of UNMISS. The universality and complexity of MSIs demonstrate the urgent need to improve prevention, treatment, and rehabilitation.