Articles: health.
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Observational Study
Standing Tall: Do Height-Based Accountability Incentives Predict Artificial Increases in Measured Height Among Sailors in the U.S. Military?
The objective of this study was to investigate the changes in men's and women's measured height in response to weight gain above standards for the U.S. Navy and to quantify associated distortions in body mass index (BMI). We expected that some servicemembers would manipulate their measured height to comply with service standards. ⋯ Among U.S. sailors, taller height was correlated with surpassing height-based weight limits, where taller individuals were allowed to weigh more and still meet professional weight standards. Results underscore that current height-weight accountability standards may distort behavior, leading servicemembers to manipulate measurements rather than improve job-relevant fitness. Instead, greater reliance on fitness-based measures of health, such as fitness tests, may hold promise for upholding servicemember readiness. Our results highlight that when stakes are attached to a measure, individuals may work to raise their performance using strategies that are misaligned with the policy intent.
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The Advanced Medical Technology Initiative (AMTI) program solicits research proposals for technology demonstrations and performance improvement projects in the domain of military medicine. Advanced Medical Technology Initiative is managed by the U.S. Army Telemedicine and Advanced Technology Research Center (TATRC). Advanced Medical Technology Initiative proposals span a wide range of topics, for example, treatment of musculoskeletal injury, application of virtual health technology, and demonstration of medical robots. The variety and distribution of central topics in these proposals (problems to be solved and technological solutions proposed) are not well characterized. Characterizing this content over time could highlight over- and under-served problem domains, inspire new technological applications, and inform future research solicitation efforts. ⋯ A semi-supervised document clustering approach was applied to a repository of proposals to partially automate the process of document annotation. By applying this process, we successfully extracted thematic content from the proposals related to problems to be addressed and proposed technological solutions. This analysis provides a snapshot of the research supply in the domain of military medicine over the last 12 years. Future work should seek to replicate and improve the document clustering process used. Future efforts should also be made to compare these results to actual published work in the domain of military medicine, revealing differences in demand for research as determined by funding and publishing decision-makers and supply by researchers.
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The battle along Antietam Creek in September 1862 was pivotal in shaping future combat medical readiness practices. With the full confidence of his commander, Major (Dr) Jonathan Letterman implemented an innovative ambulance corps system, which contributed immensely to modern-day battlefield medicine. Each year, the Uniformed Services University (USU) holds the Antietam Staff Walk, during which military medical students are engaged by faculty at various "stops" along the 6-mile walk. The four learning objectives for the Antietam Staff Walk are to (1) introduce the role of the "staff ride," (2) orient learners to reading terrain, (3) reinforce the six principles of health service support, and (4) recall the heritage of the military medical officer. The Department of Military and Emergency Medicine at USU commissioned a program evaluation to determine if these course objectives were being met, evaluate the effectiveness of the Antietam Staff Walk as a teaching tool, and make recommendations for improving its educational impact. ⋯ Our review of the Antietam Staff Ride resulted in several curricular recommendations for enhancing its learning impact. Our program evaluation serves as a model for line units and other military organizations to optimize the impact of the historical staff ride as a teaching tool.
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Review Case Reports
Early Repolarization Syndrome Leading to Recurrent Cardiac Arrest in a Young Active Duty Patient.
A previously healthy, active duty 37-year-old male experienced recurrent cardiac arrests because of ventricular fibrillation and polymorphic ventricular tachycardia. Initial evaluation did not reveal a clear ischemic, structural, toxic, or metabolic cause. ⋯ In this case, we review the diagnosis, epidemiology, and prognostic significance of early repolarization pattern as it relates to ERS. We also discuss acute and long-term treatment strategies for patients with ERS.
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Randomized Controlled Trial
Improving Resiliency in U.S. Air Force Healthcare Personnel: A Randomized Preventive Trial.
The effectiveness of the Stress Management and Resilience Training (SMART) with U.S. military personnel has not been reported in the literature. The purpose of this study was to examine the effectiveness of SMART in increasing resilience in Air Force healthcare personnel. ⋯ In this pilot study, SMART demonstrated significant and meaningful improvements in self-reported CD-10 and PSS-14 scores at 12, 18, and 24 weeks post-training completion. A future replication of the study is necessary to evaluate the effectiveness of SMART on a larger scale.