Articles: health.
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Hospital medicine, a specialty encompassing physicians and advanced practice providers in internal medicine, pediatrics, and family medicine, has been a core and rapidly growing component of civilian health care for the past two decades. More recently, hospitalists have been taking on key roles during surge and contingency planning and operations, most notably during the COVID-19 pandemic which necessitated marked changes in inpatient care across the United States. The military health system has been slower to incorporate hospitalists into clinical care and planning than civilian organizations due to its unique features. ⋯ To demonstrate this capability, we present here the experience of two operational units employing hospitalists for high acuity patient management and two civilian hospitals implementing surge operations during the 2022-2023 "tripledemic" of viral respiratory infections in the United States. Their innovations facilitated the care of higher acuity and higher volume during times when medical care requirements were limited by traditional staffing models. We end by reviewing opportunities and challenges related to expanding hospitalist use within the military health system and describing efforts that are underway to address the challenges.
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Combat-related traumatic injury (CRTI) adversely affects heart rate variability (HRV). The mediating effect of mental and physical health factors on the relationship between CRTI, its severity and HRV has not been previously studied and investigated. ⋯ The findings suggest that greater physical function may improve HRV following CRTI. Longitudinal studies are warranted to further validate these findings.
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U.S. Navy Medicine's temporary limited duty (LIMDU) program is the primary vehicle for managing the medical care and subsequent career outcomes of the ill and injured active component (AC) Sailors and Marines to ensure a medically ready force. Before the LIMDU Sailor and Marine Readiness Tracker System (SMART) came online, it was very difficult to examine LIMDU program administration metrics, patients' experiences during LIMDU, and their subsequent health and career outcomes. This study examined the LIMDU patient population's demographic, military career, and LIMDU-specific characteristics; identified characteristics that differed significantly by military service; and evaluated potentially modifiable factors associated with patient outcomes. ⋯ Navy Medicine's SMART data is an important new resource for LIMDU program evaluation and population-level patient research, despite the data limitations and concerns identified and addressed by this study. The study results provide a baseline empirical understanding about the LIMDU patient population. Further research is necessary to interrogate the validity of these results over a longer period and to initiate other lines of inquiry. While the construction of the larger project's LIMDU patient population longitudinal dataset required a significant initial investment, future dividends from ongoing work are anticipated. Results derived from verified SMART data will benefit Navy Medicine, operational commands, and LIMDU patients alike by informing continuing efforts to improve patient health and career outcomes, identify and implement best clinical and administrative practices, and optimize force readiness.
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The present study's central aim was to examine two questions: (1) Will there be differences in mental health outcomes between medics and non-medics who sought help at the Israeli Combat Reaction Unit (CRU)? (2) Will there be differences in mental health outcomes between combatants and non-combatants? ⋯ The elapsed time to seek help for non-MCs was explained by their reluctance to seek help, not being combatants, and being medics who are portrayed as resilient. Recommendations for encouraging this subgroup to seek help were given.
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A deeper understanding of personality specifics in military personnel may increase the efficacy of health care professionals in this field. Changes in modern warfare require army officers to make decisions in complicated situations with increasing levels of autonomy. Character is traditionally regarded as a key quality in these dynamics. However, it remains unclear which character strengths are conducive to effective leadership in the military. The present study aims at mapping Czech Army cadets' and professional soldiers' perceptions of the character strengths of those officers, who they consider the best they served under. The study also examined how these perceptions vary across soldiers at different stages of their careers and how much they overlap with the same soldiers' ratings of their own strengths. In addition, a regression analysis, to outline combinations of strengths for various aspects of character-based leadership, was performed. ⋯ The present study achieved its aims. First, it suggests the officers' character strengths that tend to be most valued by their subordinates among Czech Army cadets and soldiers serving in reconnaissance units. Second, the strong overlap of best officers' character profiles in all groups suggests that this perception may remain stable throughout a soldier's career. Third, the relationship between chosen officers' and respondents' self-reported strengths was negligible, suggesting that the perception of officer's strengths may not be an individual's projection. Fourth, regression models of character-based leadership proposed a combination of character strengths that may contribute to the officer's perceived efficacy. Compared to other studies, the sample included both cadets and military professionals with a proportional number of females being included. These results imply that health care practitioners working with military clients may benefit from the acknowledgment of their specific character strengths, most notably honesty and fairness, while providing care to this population.