U.S. Army Medical Department journal
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Randomized Controlled Trial
Incremental Effects of Telephone Call Center and Healthcare Utilization Database Use to Improve Follow-up Rate in the Prevention of Low Back Pain in the Military Trial.
Studies that have relied exclusively on web-based surveys to secure follow-up have yielded inadequate follow-up rates, resulting in the need to explore whether supplementing with other methods results in incremental improvements. The primary purpose of this study was to determine the effectiveness of each follow up strategy that was used to collect the follow up data in our ongoing Prevention of Low Back Pain in the Military (POLM) trial. ⋯ The results of this study can inform the design of future clinical trials by establishing the benefit of supplementing a web-based survey with a telephone call center to secure additional follow-up.
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Lower extremity and low back injuries represent a significant financial burden on the military healthcare system. Subsequent injuries often occur during the recuperation period or in the period directly after physical therapy ends when the patient returns to full duty. Medical providers have relatively few objective tools with which to determine if someone is ready for return to duty (RTD). The purpose of this study is to assess interrater and test-retest reliability of a novel gender-neutral RTD screening tool that requires minimal training, equipment, and time. ⋯ This study has demonstrated that a novel RTD screening tool can reliably be administered to an active duty population to assist clinicians in making RTD decisions. However, at this time, it cannot be determined if a certain composite or individual event score will indicate increased risk for injury.
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Noise exposure is a known occupational health hazard to those serving in the military. Previous military epidemiology studies have identified military occupations at risk of noise induced hearing loss (NIHL); however, musicians have not been specifically mentioned. The focus of military NIHL studies is usually on those service members of the combat arms occupations. ⋯ During 2013, the data showed that the Navy had the highest percentage of musicians with annual hearing tests at 70.9%, and the Air Force had the lowest at 11.4%. The Air Force had the highest percentage of hearing injuries of those musicians with annual hearing tests for all 5 years analyzed. Although noise surveillance and annual hearing tests are being conducted, they occur at a much lower rate than required for a population that is known to be overexposed to noise.
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The civilian trauma literature suggests that the sexes differ in physical and mental health outcomes following traumatic injury. In order to determine if the reaction to combat injury is different between the sexes in a specific war wounded population, service members with amputations, we examined the disability profiles of male and female amputees. ⋯ Outside of variable occupational descriptions, both male and female amputees were exposed to explosions resulting in their injuries. Consistent with many civilian trauma and veterans' population studies, female amputees have higher frequencies of disability from PTSD. These results support the need for additional effort and attention directed towards optimizing physical and mental fitness following deployment in order to reduce disability and promote return to duty. Because certain conditions, such as PTSD, may be more or less common in men versus women veterans, postdeployment fitness may need to be tailored in a gender specific way.
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Comparative Study
Comparison of female and male casualty cohorts from conflicts in Iraq and Afghanistan.
Although there has been interest in the literature regarding the casualties within the recent US military conflicts in Iraq and Afghanistan, very little to date has looked specifically at a difference between the sexes. As the role of the female Soldier has changed over the years, so have the risk and the nature of the female casualty. Combat injuries in women are an important medical consideration that has yet to be studied. ⋯ Women comprised 2.75% of the DoDTR casualties during the studied time frame and were less likely to be involved in explosions or during battle. The ISS were significantly different when comparing battle and nonbattle injuries for both of the sexes. However, since men were more likely to be injured in battle, their total ISS mean was higher.