Military medicine
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The subject of this study was the creation of a new type of laboratory walking stress test for the Special Forces of the Army of the Czech Republic. This study developed a test model that has been validated in practice and that reflects the fact that the performance of endurance without and with a load varies considerably. Especially, if we focus on operators, as their activities are always performed with loads/full gear (equipment, weapons, equipment, etc.). ⋯ The designed weighted walking test proved to be fully functional and effective in measurement. The further established protocol corresponds to the requirements of the current needs of the Special Forces of the Army of the Czech Republic. Last but not least, the walking stress test is applied for the external and internal selection and screening of operators. Data obtained from testing were used to develop deployment requirements for patrol/nuclear combat missions.
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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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The prevalence of tobacco use in the Veteran population and among Veterans Health Administration patients remains high, resulting in significant health and economic consequences. This problem has generated many tobacco research studies and clinical interventions, which often rely upon tobacco use status data previously recorded in electronic health records (EHR). Therefore, the consistency and reliability of these data are critical. The Veterans Health Administration uses an extensive EHR system where tobacco use status can be documented either as free text (FT) or as health factors (HF). The current literature assessing the reliability of HF and FT data is limited. This analysis evaluated the agreement between HF and FT tobacco use status data. ⋯ Agreement between HF and FT data that document the tobacco use statuses of Veterans varied because of implausible data. HF data had fewer implausible tobacco use statuses, but FT data were recorded more frequently. Although HF and FT data can be reasonably relied upon to determine the tobacco use statuses of Veterans, researchers and clinicians must be aware of implausible data and consider methods to overcome this limitation. Future studies should investigate the ways of improving the consistency of EHR documentation by health care providers and benchmark HF and FT data against a gold standard like biochemical verification to determine accuracy.
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Fitness is a vital component in military success. The Army is in the process of implementing a new assessment for soldier fitness, the Army Combat Fitness Test (ACFT). Success on the assessment is a major factor in job assignments and promotional opportunities. This generates questions related to modifiable (i.e., fitness and body composition) and non-modifiable (i.e., limb length and testing equipment) factors impacting performance. Currently, anthropometrics differences in ACFT performance have not been investigated. Thus, this study aimed to assess the impact of anthropometrics on ACFT performance in Reserve Officer Training Corps Cadets. ⋯ Hand and lower leg length significantly impact ACFT performance. These results present practical information to individuals responsible for developing protocols and scoring for the ACFT. Reassessment of events and the equipment utilized are warranted to assure that event performance is not hindered by a non-modifiable factor that is not representative of fitness or occupational demands. Future work should investigate how different trap-bar and kettlebell handle sizes, as well as medicine ball sizes, impact performance on the ACFT.
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Operations in the Middle East have slowed, and near-peer tensions escalate. The U. S. ⋯ Furthermore, use of ACNPs in theater could advance deployed medical capabilities and help conserve the fighting force of the U. S. Military and its partners.