Military medicine
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Randomized Controlled Trial
Impact of Hydrocolloid Dressing and Moisturizing Cream as Facial Skin Protectants Among Health Care Workers.
During the novel coronavirus disease 2019 pandemic, health care workers experienced facial problems from prolonged use of N95 masks, including skin irritation, pigmentation changes, and contact dermatitis. We assessed the use of hydrocolloid dressing versus dimethicone cream to prevent skin breakdown among military health care workers while wearing an N95. ⋯ Using a skin protectant with an N95 may prevent adverse skin reactions while preserving health care workers' ability to safely and competently care for patients in routine and pandemic conditions.
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The leading cause for medical evacuation from the U.S. Central Command area of responsibility is because of mental health conditions. The In-Theater Mental Health Assessment (ITMHA) is a DoD-required screening of deployed personnel. It is vital to examine the efficacy of ITMHA's potential to significantly impact the mental health outcomes of service members. ⋯ The number of deployed personnel identified through the ITMHA as requiring mental health care was modest. The ITMHA has multiple limitations that, if addressed, will improve its utility to mitigate mental health decline in the expeditionary environment.
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Tobacco use is synonymous with the military. Despite that military personnel are trained to follow commands, opportunities exist to implement various tobacco control strategies. We conducted a systematic review to evaluate the impact of tobacco control policy employed in military settings. ⋯ There is reasonable evidence to support that the tobacco control policy employed in the military population has multiple positive impacts in reducing the prevalence of TNCP use, increasing the cessation rates, reducing the intake, and lowering dependency. Other evidence-based strategies need to be fully utilized to materialize the tobacco endgame.
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Comparative Study
Comparison of Vestibular/Ocular Motor Screening (VOMS) and Computerized Eye-tracking to Identify Exposure to Repetitive Head Impacts.
Military service members (SMs) are exposed to repetitive head impacts (RHIs) in combat and training that are purported to adversely affect brain health, including cognition, behavior, and function. Researchers have reported that RHI from blast-related exposure may affect both vestibular and ocular function, which in turn may be related to symptomology. As such, an examination of the effects of RHI on exposed military SMs should incorporate these domains. To date, researchers have not compared groups of exposed special operations forces (SOF) operators on combined clinical vestibular/ocular and eye-tracker-based outcomes. Therefore, the primary purpose of this study was to compare participant-reported symptoms and performance on the Vestibular/Ocular Motor Screening (VOMS) tool with performance on the computerized RightEye tracking system between SOF operators exposed to blast-related RHI and healthy controls without blast-related exposure. In addition, the study aimed to compare subgroups of snipers and breachers exposed to RHI to controls on the preceding metrics, as well as identify a subset of individual (demographic) factors, participant-reported symptoms, and performance metrics on VOMS and RightEye that best identify SOF operators exposed to RHI from unexposed controls. ⋯ Participant-reported concussion symptoms, VOMS scores, and age were useful in identifying SOF operators exposed to RHI from controls. RightEye metrics were not useful in differentiating RHI groups from controls. Differences between snipers and breachers warrant further research. Overall, the findings suggest that VOMS may be a useful tool for screening for the effects of exposure to RHI in SOF operators. Future investigations should be conducted on a larger sample of military SMs, consider additional factors (e.g., RHI exposure levels, medical history, and sex), and include additional assessment domains (e.g., balance, cognitive, and psychological).
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Ventral hernia repair cost the U.S. healthcare system nearly 3 billion dollars annually. Surgical repair is a critical competency for residents yet hernia recurrence rates following mesh-based repair range from 0.8% to 24%. Improving surgical techniques using cadavers is often cost-prohibited for many education programs and limited research exists using simulation models with a corresponding hernia repair curriculum in the graduate medical education setting. This pilot project aimed to develop a low cost, easily reproducible novel abdominal wall reconstruction model and pilot-test the ventral hernia repair curriculum to inform further refinement prior to formal evaluation. ⋯ The novel abdominal wall surgical skills operative model fills an important proof of concept gap in simulation training. It is low cost with the potential to improve cognitive and psychomotor skills, as well as confidence to competently complete ventral hernia repair with mesh in the graduate medical education setting. Prior to formal effectiveness testing, our lessons learned should be addressed in both the model and curriculum. Future studies must include an adequately powered statistical evaluation with a larger sample across all levels of training.