Military medicine
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Hearing loss among military personnel is a well-known challenge, reported as the second most common VA service-connected disability. Although most hearing loss occurs gradually, a subset occurs suddenly and significantly impacts quality of life and military readiness and is considered as a medical emergency. This study aims to evaluate the incidence of sudden hearing loss among different subpopulations within the military system to better identify at-risk groups. ⋯ Sudden hearing loss appears to occur more frequently in military personnel than in the civilian population. The increased incidence in senior officers is likely driven by increased age, though further evaluation into the discrepancies between reported incidence of hearing loss among enlisted service members and officers is warranted. Although military occupational specialty did not demonstrate any significant difference in incidence, for thus far unknown reasons those in the Air Force demonstrated increased rates of sudden hearing loss. Although other potentially at-risk groups were identified, focused efforts to better understand contributing factors to elevated incidence in senior officers and Air Force personnel will help to better mitigate the incidence and effects of sudden hearing loss.
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Difficulty controlling anger is a common postdeployment problem in military personnel. Chronic and unregulated anger can lead to inappropriate aggression and is associated with behavioral health, legal, employment, and relationship problems for military service members. Military-related betrayal (e.g., military sexual assault, insider attacks) is experienced by over a quarter of combat service members and is associated with chronic anger and aggression. The high level of physical risk involved in military deployments make interconnectedness and trust in the military organization of utmost importance for survival during missions. While this has many protective functions, it also creates a vulnerability to experiencing military-related betrayal. Betrayal is related to chronic anger and aggression. Individuals with betrayal-related injuries express overgeneralized anger, irritability, blaming others, expectations of injustice, inability to forgive others, and ruminations of revenge. Current approaches to treating anger and aggression in military populations are inadequate. Standard anger treatment is not trauma-informed and does not consider the unique cultural context of anger and aggression in military populations, therefore is not well suited for anger stemming from military-related betrayal. While trauma-informed interventions targeting anger for military personnel exist, anger outcomes are mixed, and aggression and interpersonal functioning outcomes are poor. Also, these anger interventions are designed for patients with posttraumatic stress disorder. However, not all military-related betrayal meets the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition-5 definition of trauma, though it may still lead to chronic anger and aggression. As a result, these patients lack access to treatment that appropriately targets the function of their anger and aggression. ⋯ If outcomes show feasibility, acceptability, and initial effectiveness, CART will demonstrate a culturally relevant treatment for chronic anger, the most frequent postdeployment problem, in a sample of active duty service members who have suffered a military betrayal. The DoD will also have an evidence-based treatment option focusing on interpersonal functioning, including relationships within the military and within families.
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Simulation-based medical training has been shown to be effective and is widely used in civilian hospitals; however, it is unclear how widely and how effectively simulation is utilized in the U.S. Military Health System (MHS). The current operational state of medical simulation in the MHS is unknown, and there remains a need for a system-wide assessment of whether and how the advances in simulation-based medical training are employed to meet the evolving needs of the present-day warfighter. Understanding the types of skills and methods used within simulation programs across the enterprise is important data for leaders as they plan for the future in terms of curriculum development and the investment of resources. The aim of the present study is to survey MHS simulation programs in order to determine the prevalence of skills taught, the types of learners served, and the most common methodologies employed in this worldwide health care system. ⋯ The survey demonstrated that the most common skills taught were all related to point of injury combat casualty care and addressed the most common causes of death on the battlefield. The availability of training in medic skills, nursing skills, and advanced provider skills were similar in small, medium, and large programs. However, medium and small programs were less likely to deliver training for advanced providers and GMOs compared to larger programs. Overall, this study found that simulation-based medical training in the MHS is focused on medic and nursing skills, and that large programs are more likely to offer training for advanced providers and GMOs. Potential gaps in the availability of existing training are identified as over 50% of skills included in the nursing, advanced provider, and GMO skill categories are not covered by at least 80% of sites serving those learners.
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Reserve Officers' Training Corps (ROTC) trainees are college students who complete military courses and participate in physical and tactical training under the direction of military Service Members assigned to ROTC programs to serve as faculty and staff at US colleges. ROTC trainees report musculoskeletal injuries (MSKIs) attributable to ROTC training in line with MSKI incidence in other training environments. However, concealment is prevalent, as 66% of MSKIs in ROTC go unreported. The current study investigated if a brief, online educational video could increase ROTC trainees' reporting intentions. In addition, we investigated if the message's source (i.e., peer or authority figure) affected reporting intentions. ⋯ Findings did not support the use of a single educational intervention video to influence MSKI help-seeking intentions of ROTC trainees. Intentions may already be ingrained such that a single intervention could not influence change. Previous research on concussion reporting indicates that concealment cultures may be systematic and indoctrination of concealment can influence one's reporting intentions. Our sample had already participated in ROTC for 2 years. Future research should evaluate if MSKI help-seeking intentions change over the course of ROTC participation, or even over a military career.
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This study investigated the influence of stimulus color wavelength on cognitive performance in a virtual reality (VR) Go/No-Go task by assessing participant's reaction time and accuracy. Previous research has indicated that color has a variety of cognitive, physiological, and behavioral effects on individuals, differentiating their performance. However, there is a gap in understanding the influence of color on performance on VR cognitive tasks. An understanding of how stimulus color wavelength influences human performance could enhance the control over the design and interpretation of assessment and training outcomes in VR. ⋯ Shorter color wavelengths were associated with higher accuracy in a VR Go/No-Go task. These findings support the importance of color selection in VR tasks and trainings, especially in scenarios that include decision-making and require accuracy. Realistic colors encountered in real-life military operations into VR training environments may better prepare individuals for real-world challenges. Future research in this area could explore color effects in additional tasks and incorporate realistic color-based cues in VR training scenarios.