Military medicine
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A deeper understanding of personality specifics in military personnel may increase the efficacy of health care professionals in this field. Changes in modern warfare require army officers to make decisions in complicated situations with increasing levels of autonomy. Character is traditionally regarded as a key quality in these dynamics. However, it remains unclear which character strengths are conducive to effective leadership in the military. The present study aims at mapping Czech Army cadets' and professional soldiers' perceptions of the character strengths of those officers, who they consider the best they served under. The study also examined how these perceptions vary across soldiers at different stages of their careers and how much they overlap with the same soldiers' ratings of their own strengths. In addition, a regression analysis, to outline combinations of strengths for various aspects of character-based leadership, was performed. ⋯ The present study achieved its aims. First, it suggests the officers' character strengths that tend to be most valued by their subordinates among Czech Army cadets and soldiers serving in reconnaissance units. Second, the strong overlap of best officers' character profiles in all groups suggests that this perception may remain stable throughout a soldier's career. Third, the relationship between chosen officers' and respondents' self-reported strengths was negligible, suggesting that the perception of officer's strengths may not be an individual's projection. Fourth, regression models of character-based leadership proposed a combination of character strengths that may contribute to the officer's perceived efficacy. Compared to other studies, the sample included both cadets and military professionals with a proportional number of females being included. These results imply that health care practitioners working with military clients may benefit from the acknowledgment of their specific character strengths, most notably honesty and fairness, while providing care to this population.
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Aneurysms and pseudoaneurysms of the visceral arteries are a rare pathology with a prevalence of 0.1-2% in the general population, most common in men. Despite low prevalence, visceral aneurysms pose a significant threat to the patient's health and life; a ruptured superior mesenteric branch aneurysm carries mortality rates of 10-25% and up to 30-90%. This article presents a case of a 50-year-old former active duty soldier and veteran of a military combat mission in Afghanistan, during which he sustained a traumatic injury resulting from a mine explosion under a vehicle. ⋯ An angiotomography performed at 1 year of endovascular treatment confirmed good effects of the embolization procedure and coagulation of the aneurysm. Visceral aneurysms are a rare vascular pathology but are associated with significant morbidity and mortality rates. The incidence of ruptured aneurysms is probably underestimated as some patients may be operated on for acute abdominal symptoms, e.g., bowel obstruction.
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Combat penetrating brain injury (PBI) differs significantly from PBI in civilian environments. Differences include technical factors such as the weapons involved, strained resource environments, and limited medical materials and human resources available. Ethical issues regarding the management of PBI in military settings may occur. ⋯ Nowadays, we possess the medical and surgical resources as well as the aeromedical evacuation capability to save the life of a soldier with a penetrating craniocerebral wound. Nonetheless, the functional outcome of this type of wound places military doctors in an ethical dilemma. The line of conduct and clinical protocol established by the French Medical Health Service is to manage all PBIs when the patient's life can be saved and to provide all available financial and social support for the rehabilitation of patients and their family.
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Risk factors for gastric cancer in the United States are not well understood, especially in populations with a low proportion of immigrants. We conducted a matched case-control study in a Veteran Affairs Medical Center to identify risk factors for gastric cancer. ⋯ The high proportion of late-stage gastric cancer diagnoses highlights the need for improved risk stratification as well as screening and surveillance protocols in the U.S. population. Racial disparities among veterans in an equal-access system necessitate further investigation into the etiology of these disparities.
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Appendectomy is the treatment of choice for acute appendicitis. The procedure can be performed open or laparoscopically. However, laparoscopy is not available on military missions abroad. It is unclear whether treatment outcomes differ between the two surgical approaches. ⋯ Open appendectomy can be considered equivalent in outcome to the laparoscopic procedure and thus can be performed on military missions abroad without compromising outcome. Military surgeons must continue to be trained and confident in open appendectomy.