Military medicine
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Airway compromise is the third leading cause of preventable death on the battlefield. Most combat medics carry supraglottic airway (SGA) devices for airway management. However, exchanging an SGA device for a definitive airway can be challenging, especially in austere environments. This study aims to compare the Aintree intubation catheter (AIC) to the gum elastic bougie (GEB) as adjuncts for performing airway device exchange with the i-gel SGA device in place. ⋯ This study demonstrates no significant difference in success rate and time to completion of successful iterations of airway exchanges between the two devices. Although the AIC performed slightly better overall, these results are not statistically significant. Additionally, blind exchange intubations appear to be of high risk with minimal success, so we recommend against this technique in routine practice.
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Nationally representative studies have shown that lesbian, gay, and bisexual adults have higher levels of substance use than heterosexual adults. In the military, substance use is often associated with adverse mental health outcomes and is often comorbid with other mental health conditions and adverse or harmful behaviors. Few military studies to date have comprehensively examined the relationship between sexual orientation, mental health, and substance use. ⋯ Substance use in the military was more likely among sexual minority individuals compared to heterosexual individuals. These findings reflect the patterns of substance use seen in the general population. Increased levels of psychological distress were associated with both the lesbian, gay, and bisexual population in this study and self-reported substance use behaviors. Further investigation of health disparities by sexual orientation may inform more efficacious treatment and prevention programs.
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Although a leading cause of developmental disability in the United States, many individuals with fetal alcohol spectrum disorders (FASDs) do not receive a timely diagnosis, are misdiagnosed, or are never diagnosed. Prevention, diagnosis, and clinical management of FASD have not been previously studied in the U.S. Military Health System (MHS), where nearly 1 million of the nation's children receive health care. To address this gap, we undertook an environmental scan of the clinical guidelines, services, programs, educational resources, and policies within the MHS pertaining to alcohol use (AU), AU disorder (AUD), prenatal alcohol exposure, and FASD. ⋯ Findings suggest opportunities to raise awareness, educate providers, and improve guidelines, policies, and practices in the MHS.