Military medicine
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Leishmaniasis is a protozoal infection with an increased risk of transmission to those serving in the U. S. Military due to theaters of operation in endemic regions. ⋯ The second case involved a 30-year-old active duty male with a history of travel to French Guiana who had a cutaneous lesion on his left hand that was identified as L. guyanensis, a causative species for mucosal leishmaniasis. Neither had evidence of any further mucosal involvement on otolaryngologic evaluation, and both subsequently received systemic therapy with a good clinical response. Although only 2 cases were identified over an 11-year period, this disease remains an important medical consideration when conducting military operations within Central and South America, as both cases had recent military-specific travel to areas endemic for leishmaniasis.
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Unhealthy eating behaviors are adversely impacting the health and performance of the U.S. armed forces. Vegetable intake, in particular, has been shown to be far below recommended levels in active duty military populations. Previous research in other populations has shown that the addition of spices and herbs can help overcome numerous barriers to vegetable intake. The goal of this study was to determine modifiable barriers to vegetable intake among a sample of active duty military service members at Naval Support Activity Bethesda and evaluate whether the addition of spices and herbs can help surmount these barriers. ⋯ The addition of spices and herbs appears to help overcome key sensory-related barriers to military dining facility vegetable intake. Future comparison of vegetable intake with and without spices and herbs when included in a full meal in a military dining setting is warranted in order to better evaluate the effectiveness in increasing vegetable intake under typical dining conditions.
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Posttraumatic nightmares (PTNs) are common among service members with a history of combat or mission-related trauma and are associated with decreased well-being. Unfortunately, beyond establishing an association between mental health symptoms and PTNs, the existing literature fails to provide a more comprehensive understanding of factors associated with PTNs. The effectiveness of current recommended treatments is frequently debated, with the literature varying in levels of support. Treatment of PTN is complicated, given their association with a number of mental health difficulties including posttraumatic stress disorder (PTSD), anxiety, and depression. The present study sought to better delineate the association of these difficulties with PTNs, in an effort to inform and improve treatments for the nation's service members. ⋯ Findings support the association of PTSS, anxiety, and depression to PTNs, and, importantly, suggest that other factors may be equally or more important in understanding PTNs. Notably, increased odds of PTNs were observed among patients with pain that disrupts their sleep. The cross-sectional nature of the study allows examination of these co-occurring symptoms as they would present in the clinic, potentially informing assessment and treatment strategies; however, it precludes consideration of temporal relationships. Results highlight the importance of considering comorbid symptoms and relevant military characteristics to gain a more complete understanding of PTNs. Future research utilizing longitudinal methods are needed to inform the temporal/causal aspects of these relationships.
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The 5th Army Medical Corps Caribbean campaigns provided valuable lessons on the noncombat hazards to troops and the challenges to the provision of care in a tropical theater of operations. The Army quickly adapted the lessons learnt for the invasion in Puerto Rico and future overseas expeditions.
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Physicians must be leaders more than ever with innumerable challenges. Despite this need, there is a paucity of consistent leadership development (LD) from medical student to staff physician. Military medicine has additional challenges-working within a large health care organization, constant turnover, working in a variety of contexts-that make the need for LD even more pressing. ⋯ Based on these UME and GME approaches to LD, there have been multiple lessons learned formed on the authors experience and published literature: learners do not typically see themselves as leaders; learners want applicable curriculum with less lecturing and more application and discussion; programs are often siloed from one another and sharing curriculum content does not typically occur; no one-size-fits-all model. On the basis of the lessons learned and the current state of UME and GME leadership education, there are 5 recommendations to enhance UME and GME leadership programs: (1) develop a Health Professions Scholarship Program Leadership Curriculum; (2) develop a MHS GME Leadership Curriculum; (3) integrate UME and GME Leadership Curricula; (4) develop faculty to teach leadership; and (5) conduct research on UME and GME in military and share lessons learned. We suggest a roadmap for strengthening LD within military medicine and civilian institutions.