Military medicine
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The rapid advancement and adoption of large language models (LLMs) in various academic domains necessitate an examination of their role in scholarly works by medical learners.This paper seeks to discern the implications of LLM use by medical learners when preparing works for publication. While LLMs possess great potential to revolutionize the academic writing process, they can detract from the learning process when used by students and residents who are still learning how to research, formulate ideas, and write cohesive arguments. ⋯ Although LLMs offer potential efficiencies in academic writing, unchecked use can jeopardize the development of essential critical thinking and analytical skills in medical learners. Ultimately, mentors and primary investigators are responsible for ensuring learners are advancing and appropriately utilizing new and emerging technology. This study provides a foundational framework for educators in both responsible use of generative AI and best practices.
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Attention-deficit/hyperactivity disorder (ADHD) is common among Veterans but overlapping symptoms with other prevalent psychiatric disorders (e.g., posttraumatic stress disorder [PTSD]) complicate diagnosis. This study aims to (1) assess the prevalence of ADHD, (2) evaluate the correspondence between ADHD self-report measures, and (3) examine the association between ADHD and PTSD in a sample of combat-deployed post-9/11 Veterans. ⋯ Attention-deficit/hyperactivity disorder is prevalent in this sample of Veterans and is associated with an increased risk of current and lifetime PTSD. The low correspondence across self-report ADHD measures illustrates the complexity of assessing ADHD in this highly comorbid population. When evaluating ADHD in Veterans, clinicians should carefully consider alternative and contributory symptom etiologies, such as PTSD, to ensure accurate diagnosis and treatment.
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Breast and cervical cancer screening is critical to identifying cases at earlier stages in order to begin treatment earlier and improve survival. Screening rates have been shown to vary within the Military Health System (MHS). The goal is to estimate drivers of variation in screening rates within the MHS. ⋯ Our finding of higher screening in catchment areas with higher rates of purchased care warrants additional study to understand what factors may drive this result. The differential findings of the association between individual characteristics and breast and cervical cancer screening suggest important differences in these 2 types of screening with potentially different policies required to encourage and enhance breast vs. cervical cancer screening. Finally, our results showing higher screening among non-Hispanic Black women suggests important features of the MHS, such as universal, low-cost sharing coverage may help to reduce racial and ethnic disparities in breast and cervical cancer screening.
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Protective ballistic body armor (BA) may be needed during certain threat postures while deployed. This requirement often adds between 35 and 45lbs of extra weight carried by the service member (SM) for multiple hours during the day. The physical toll of that extra weight and the effect it may have on deployed medical resources has not been clearly characterized in the literature. We sought to evaluate the association of a protective BA wear requirement with musculoskeletal (MSK) complaints and to better characterize how these effects are manifested within the deployed military health care system. ⋯ Required wear of BA was associated with an increase in MSK visits across all types of US SMs. Shoulder and back injuries were the most common with a significant increase in visits to physical therapy in the BA group. Anti-inflammatory and muscle-relaxing medications were prescribed more frequently in the BA group. A dedicated prospective study would help better elucidate the causality of these associations. Risk-benefit analysis of threat posture, with the knowledge of these health care associations, deserves serious consideration.