Military medicine
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The purpose of this paper is to examine a scalable secure firearm storage intervention in the U.S. National Guard (NG) in preventing firearm injury and suicide. A study among firearm-owning members of the Mississippi NG testing Project Safe Guard (PSG), a 10 to 15 min lethal means counseling intervention, found that PSG increased self-reported secure firearm storage practices. Here, we sought to examine a "real world" rollout of a modified PSG program in the NG in which NG members were trained to understand the importance of lethal means safety and to deliver PSG to Guardsmen peers within their units. ⋯ The adapted version of PSG shows promise as a relevant and acceptable intervention among Guardsmen to enhance knowledge and attitudes regarding firearm suicide, increase secure firearm storage practices, and normalize conversations about firearm suicide prevention among peers. This intervention seeks to frame firearm suicide prevention within a culture of safety, complementary to the existing prevention methods and training within the NG.
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Staff nurse attrition negatively impacts readiness of the warfighter and the health and wellbeing of all beneficiaries of the Military Health System (MHS). To promote the retention of a robust nursing workforce, a complete understanding of nurses' perceptions regarding their intent to leave is necessary. The purpose of this study was to explore the free-text responses of 1,438 nurses working among military medical treatment facilities for factors influencing their intent to leave, as an indicator of potential turnover, or attrition. ⋯ Our findings support the evaluation of retention strategies using implementation science for nurses and nurse resource personnel (e.g., nursing assistants, technicians, medics, and corpsman) to ensure a robust nursing work force throughout the MHS. Staff nurses and resource personnel working among military treatment facilities and embedded in units supporting combat and humanitarian missions ensure access to care and health promotion of the warfighter and all MHS beneficiaries.
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The U.S. Army Telemedicine and Advanced Technology Research Center Advanced Medical Technology Initiative (AMTI) demonstrate key emerging technologies related to military medicine. AMTI invites researchers to submit proposals for short-term funding opportunities that support this goal. AMTI proposal selection is guided by a time-intensive peer review process, where proposals are rated on innovation, military relevance, metrics for success, and return on investment. Utilizing machine learning (ML) could assist in proposal evaluations by learning relationships between proposal performance and proposal features. This research explores the viability of artificial intelligence/ML for predicting proposal ratings given content-based proposal features. Although not meant to replace experts, a model-based approach to evaluating proposal quality could work alongside experts to provide a fast, minimally biased estimate of proposal performance. This article presents initial stages of a project aiming to use ML to prioritize research proposals. ⋯ This research was the first stage of a larger project to explore the use of ML to predict proposal ratings for the purpose of providing automated support to proposal reviewers and to reveal the preferences and values of AMTI proposal reviewers and other decision-makers. The result of this work will provide practical insights regarding the review process for the AMTI program. This will facilitate reduction in bias for AMTI innovators and a streamlined and subjective process for AMTI administrators, which benefits the military health system overall.
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Acute Compartment Syndrome (ACS) is a severe trauma caused by elevated intra-muscle-compartment pressure (ICP). The current standard method for diagnosis is to insert a needle into the muscle sterilely under anesthesia. However, to secure the environment is sometimes not easy and leads to delays in diagnosis. Recently, we have focused on shear wave ultrasound elastography (SWE) as an alternative, which can be done concisely in unclean environment and without anesthesia. We would like to report the usefulness of SWE for ACS diagnosis using 2-pedal walking turkey model recently developed in our lab. ⋯ SWE seems to be a substitute measure of ICP in diagnosing ACS. With regard to our in vivo ACS model using turkey, survival at 50 mmHg ICP for 6 hours and 6 weeks post ACS would be an appropriate situation.
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Apoptotic Cell-Based Therapy for the Modification of the Inflammatory Response to Hemorrhagic Shock.
Many trauma patients die from hemorrhagic shock in the military and civilian settings. Although two-thirds of hemorrhagic shock victims die of reasons other than exsanguination, such as the consequent cytokine storm, anti-inflammatory therapies failed to be utilized. Apoptotic cell-based treatments enhance innate ability to exert systemic immunomodulation as demonstrated in several clinical applications and hence might present a novel approach in hemorrhagic shock treatment. ⋯ In a pressure-control hemorrhagic shock model in rats, apoptotic cell infusion showed preliminary signs of a uniform attenuated cytokine response. Apoptotic cell-based therapies might serve as a novel immunomodulatory therapy for hemorrhagic shock.