Military medicine
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Physical fitness is an integral part of military readiness, and failure to meet military Physical Fitness Assessment (PFA) standards can severely damage or end careers. Postpartum active duty service members experience a drop in PFA scores and passing rates compared to their pre-pregnancy assessments. Each branch recently extended recovery time to 12 months, but more research is required to see if this change alone is enough to return both active duty and reserve component postpartum personnel to their own preconception PFA outcomes (scores, passing rates, and injury rates) and those of a control group of nullpartum female airmen. ⋯ Even with a 12-month recovery period, postpartum airmen fare worse on all PFA outcome dimensions studied compared to nulliparous airmen and with preconception selves. Perinatal airmen with more experience, education, and access to resources have better PFA outcomes. The U.S. Air Force should consider a comprehensive maternal wellness program including physical fitness programming and medical preventative health accessible to total force perinatal airmen. This would increase operational readiness, retainability, and well-being while decreasing musculoskeletal injuries and associated medical costs.
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Future military conflicts are likely to involve peer or near-peer adversaries in large-scale combat operations, leading to casualty rates not seen since World War II. Casualty volume, combined with anticipated disruptions in medical evacuation, will create resource-limited environments that challenge medical responders to make complex, repetitive triage decisions. Similarly, pandemics, mass casualty incidents, and natural disasters strain civilian health care providers, increasing their risk for exhaustion, burnout, and moral injury. ⋯ These systems may help address both the anticipated scale of casualties in large-scale combat operations and the critical expertise gaps during future pandemics, mass casualty events, and natural disasters. This study advocates for urgent research at the intersection of high-stress, resource-limited care contexts that may cause moral injury in health care providers and the potential for AIDeSS to reduce that risk. Understanding these dynamics may yield strategies to mitigate psychological distress in medical responders, increase patient survival, and improve the health of our medical systems.
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Department of Veterans Affairs disability benefits for post-traumatic stress disorder (PTSD), also known as "service connection," have been shown to reduce homelessness and poverty, increase mental health engagement, and improve clinical outcomes. However, gender and race disparities in PTSD service connection have been described in Vietnam and post-Vietnam era Veterans. ⋯ Women were less likely to receive PTSD service connection compared to men; this difference was nearly completely mediated by gender differences in combat exposure. Black women were less likely than non-Black women to receive PTSD service connection, but we could not identify a plausible mechanism to explain this finding. On net, the base compensation package was lower for Veterans denied PTSD service connection than for those receiving PTSD service connection.
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In current and anticipated future conflicts, including large-scale combat operations, medical teams are tasked to provide prolonged casualty care (PCC) or extended patient care that occurs when delays in evacuation exceed the team's capabilities. Although the principles of PCC are often taught to military medical providers using simulation, educators rarely dedicate the time to training required to simulate the prolonged nature of these encounters. Therefore, a lack of knowledge exists regarding which aspects of extended care may be lost in an accelerated training scenario. ⋯ Wars and disasters require medical providers trained in PCC. Future educational activities aimed at teaching PCC should continue to incorporate temporal fidelity to help teach these valuable lessons.