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Study
Abstract
BACKGROUND: Recent reports reinforce the widespread interest in complementary and alternative medicine (CAM), not only among military personnel with combat-related disorders, but also among providers who are pressed to respond to patient demand for these therapies. However, an understanding of utilization of CAM therapies in this population is lacking.
OBJECTIVE: The goals of this study are to synthesize the content of self-report population surveys with information on use of CAM in military and veteran populations, assess gaps in knowledge, and suggest ways to address current limitations.
RESEARCH DESIGN: The research team conducted a literature review of population surveys to identify CAM definitions, whether military status was queried, the medical and psychological conditions queried, and each specific CAM question. Utilization estimates specific to military/veterans were summarized and limitations to knowledge was classified.
RESULTS: Seven surveys of CAM utilization were conducted with military/veteran groups. In addition, 7 household surveys queried military status, although there was no military/veteran subgroup analysis. Definition of CAM varied widely limiting cross-survey analysis. Among active duty and Reserve military, CAM use ranged between 37% and 46%. Survey estimates do not specify CAM use that is associated with a medical or behavioral health condition.
CONCLUSIONS: Comparisons between surveys are hampered due to variation in methodologies. Too little is known about reasons for using CAM and conditions for which it is used. Additional information could be drawn from current surveys with additional subgroup analysis, and future surveys of CAM should include military status variable.
PMID: 25397828 [PubMed - in process]
- Publication Status: Published
- Sponsoring Organization: DoD agency, office, or organization other than the Army, Navy, Air Force, or Defense Health Agency
- Sponsoring Office:
- Congressionally Mandated: No
- Funding Source: Agency, office or organization under authority of the Sec Def (not affiliated to Army, Navy, or Air Force)
- Release Date/Publication: December 01, 2014
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Citation: Davis MT, Mulvaney-Day N, Larson MJ, Hoover R, Mauch D. Complementary and alternative medicine among veterans and military personnel: a synthesis of population surveys. Med Care. 2014 Dec;52 Suppl 5:S83-90.
Study
Abstract
OBJECTIVE:
Limited data suggest that the children of U.S. service members may be at increased risk for disordered-eating. To date, no study has directly compared adolescent military-dependents to their civilian peers along measures of eating pathology and associated correlates. We, therefore, compared overweight and obese adolescent female military-dependents to their civilian counterparts along measures of eating-related pathology and psychosocial functioning.
METHOD:
Adolescent females with a BMI between the 85th and 97th percentiles and who reported loss-of-control eating completed interview and questionnaire assessments of eating-related and general psychopathology.
RESULTS:
Twenty-three military-dependents and 105 civilians participated. Controlling for age, race, and BMI-z, military-dependents reported significantly more binge episodes per month (p < 0.01), as well as greater eating-concern, shape-concern, and weight-concern (p's < 0.01) than civilians. Military-dependents also reported more severe depression (p < 0.05).
DISCUSSION:
Adolescent female military-dependents may be particularly vulnerable to disordered-eating compared with civilian peers. This potential vulnerability should be considered when assessing military-dependents.
- Publication Status: Published
- Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
- Sponsoring Office: Uniformed Services University of Health Sciences
- Congressionally Mandated: No
- Funding Source: Undetermined
- Release Date/Publication: September 01, 2015
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Citation: Schvey NA, et al., Comparison of overweight and obese military-dependent and civilian adolescent girls with loss-of-control eating. Int J Eat Disord. 2015 Sep;48(6):790-4.
Study
Abstract
A clearer understanding of risk factors for suicidal behavior among soldiers is of principal importance to military suicide prevention. It is unclear whether soldiers who attempt suicide and those who die by suicide have different patterns of risk factors. As such, preventive efforts aimed toward reducing suicide attempts and suicides, respectively, may require different strategies. We conducted a latent class analysis (LCA) to examine classes of risk factors among suicide attempters (n = 1,433) and decedents (n = 424). Both groups were represented by three classes: (1) External/Antisocial Risk Factors, (2) Mental Health Risk Factors, and (3) No Pattern. These findings support the conceptualization that military suicide attempters and decedents represent a single population.
- Publication Status: Published
- Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
- Sponsoring Office: Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury
- Congressionally Mandated: No
- Funding Source: Undetermined
- Release Date/Publication: January 01, 2016
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Citation: Skopp NA, Smolenski DJ, Sheppard SC, Bush NE, Luxton DD. Comparison of Suicide Attempters and Decedents in the U.S. Army: A Latent Class Analysis. Suicide Life Threat Behav. 2016 Jan 8.
Study
Abstract
Conflicting data exist regarding the effects of statin therapy on the prevalence of inflammatory bowel diseases. We aimed to examine the association of statin therapy with diagnoses of inflammatory bowel diseases and noninfectious gastroenteritis. This is a retrospective study using data of a military health care system from October 1, 2003, to March 1, 2012. Based on medication fills during fiscal year 2005, patients were divided into: (1) statin users (received at least 90-day supply of statin) and (2) nonusers (never received a statin). A propensity score-matched cohort of statin users and nonusers was created using 80 variables. Primary analysis examined the risks of being diagnosed with inflammatory bowel diseases and noninfectious gastroenteritis between statin users and nonusers in the propensity score-matched cohort. Secondary analyses examined the risk of outcomes in the whole cohort and in patients with no comorbidities according to Charlson Comorbidity Index. Of 43,438 patients meeting study criteria (13,626 statin users and 29,812 nonusers), we propensity score matched 6,342 statin users with 6,342 nonusers. For our primary analysis, 93 statin users and 92 nonusers were diagnosed with inflammatory bowel diseases (odds ratio = 1.01, 95% confidence interval = 0.76 to 1.35), and 632 statin users and 619 nonusers were diagnosed of noninfectious gastroenteritis (odds ratio = 1.02, 95% confidence interval = 0.91 to 1.15). In conclusion, the risks of inflammatory bowel diseases and noninfectious gastroenteritis among statin users and nonusers are similar after adjusting for other potential confounding factors.
- Publication Status: Published
- Sponsoring Organization: Undetermined
- Sponsoring Office:
- Congressionally Mandated: No
- Funding Source: Undetermined
- Release Date/Publication: May 01, 2015
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Citation: Khalil D, Boktor M, Mortensen EM, Frei CR, Mansi I. Comparison of frequency of inflammatory bowel disease and noninfectious gastroenteritis among statin users versus nonusers. Am J Cardiol. 2015 May 15;115(10):1396-401.
Study
Abstract
The emergence of invasive fungal wound infections (IFIs) in combat casualties led to development of a combat trauma-specific IFI case definition and classification. Prospective data were collected from 1133 US military personnel injured in Afghanistan (June 2009-August 2011). The IFI rates ranged from 0·2% to 11·7% among ward and intensive care unit admissions, respectively (6·8% overall). Seventy-seven IFI cases were classified as proven/probable (n = 54) and possible/unclassifiable (n = 23) and compared in a case-case analysis. There was no difference in clinical characteristics between the proven/probable and possible/unclassifiable cases. Possible IFI cases had shorter time to diagnosis (P = 0·02) and initiation of antifungal therapy (P = 0·05) and fewer operative visits (P = 0·002) compared to proven/probable cases, but clinical outcomes were similar between the groups. Although the trauma-related IFI classification scheme did not provide prognostic information, it is an effective tool for clinical and epidemiological surveillance and research.
- Publication Status: Published
- Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
- Sponsoring Office: Walter Reed National Military Medical Center
- Congressionally Mandated: No
- Funding Source: Agency, office or organization under authority of the Sec Def (not affiliated to Army, Navy, or Air Force)
- Release Date/Publication: January 01, 2015
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Citation: Weintrob AC, et. al., Combat trauma-associated invasive fungal wound infections: epidemiology and clinical classification. Epidemiol Infect. 2015 Jan;143(1):214-24.
Study
Abstract
OBJECTIVE:
To examine whether experiencing a traumatic brain injury (TBI) on a recent combat deployment was associated with postdeployment binge drinking, independent of posttraumatic stress disorder (PTSD).
METHODS:
Using the 2008 Department of Defense Survey of Health Related Behaviors among Active Duty Military Personnel, an anonymous survey completed by 28 546 personnel, the study sample included 6824 personnel who had a combat deployment in the past year. Path analysis was used to examine whether PTSD accounted for the total association between TBI and binge drinking.
MAIN MEASURES:
The dependent variable, binge drinking days, was an ordinal measure capturing the number of times personnel drank 5+ drinks on one occasion (4+ for women) in the past month. Traumatic brain injury level captured the severity of TBI after a combat injury event exposure: TBI-AC (altered consciousness only), TBI-LOC of 20 or less (loss of consciousness up to 20 minutes), and TBI-LOC of more than 20 (loss of consciousness >20 minutes). A PTSD-positive screen relied on the standard diagnostic cutoff of 50+ on the PTSD Checklist-Civilian.
RESULTS:
The final path model found that while the direct effect of TBI (0.097) on binge drinking was smaller than that of PTSD (0.156), both were significant. Almost 70% of the total effect of TBI on binge drinking was from the direct effect; only 30% represented the indirect effect through PTSD.
CONCLUSION:
Further research is needed to replicate these findings and to understand the underlying mechanisms that explain the relationship between TBI and increased postdeployment drinking.
- Publication Status: Published
- Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
- Sponsoring Office: Defense Health Agency (formerly TRICARE Management Activity)
- Congressionally Mandated: No
- Funding Source: Federal government department, agency, or organization, other than the Department of Defense
- Release Date/Publication: January 01, 2016
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Citation: Adams RS, Larson MJ, Corrigan JD, Ritter GA, Horgan CM, et.al., Combat-Acquired Traumatic Brain Injury, Posttraumatic Stress Disorder, and Their Relative Associations With Postdeployment Binge Drinking. J Head Trauma Rehabil. 2016 Jan-Feb;31(1):13-22.
Study
Abstract
BACKGROUND:
The number of lymph nodes examined during colon cancer surgery falls below nationally recommended guidelines in the general population, with Blacks and Hispanics less likely to have adequate nodal evaluation in comparison to Whites. The Department of Defense's (DoD) Military Health System (MHS) provides equal access to medical care for its beneficiaries, regardless of racial/ethnic background. This study aimed to investigate whether racial/ethnic treatment differences exist in the MHS, an equal-access medical care system.
METHODS:
Linked data from the DoD cancer registry and administrative claims databases were used and included 2,155 colon cancer cases. Multivariate logistic regression assessed the association between race/ethnicity and the number of lymph nodes examined (<12 and ≥12) overall and for stratified analyses.
RESULTS:
No overall racial/ethnic differences in the number of lymph nodes examined was identified. Further stratified analyses yielded similar results, except potential racial/ethnic differences were found among persons with poorly differentiated tumors, where non-Hispanic Blacks tended to be less likely to have ≥12 lymph nodes dissected (odds ratio 0.34; 95 % confidence interval 0.14-0.80; p = 0.01) compared with non-Hispanic Whites.
CONCLUSION:
Racial/ethnic disparities in the number of lymph nodes evaluated among patients with colon cancer were not apparent in an equal-access healthcare system. However, among poorly differentiated tumors there might be racial/ethnic differences in nodal yield, suggesting the possible effects of factors other than access to healthcare.
- Publication Status: Published
- Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
- Sponsoring Office: Walter Reed National Military Medical Center
- Congressionally Mandated: No
- Funding Source: Defense Health Agency (formerly TRICARE Management Activity)
- Release Date/Publication: January 01, 2015
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Citation: Gill AA, Zahm SH, Shriver CD, Stojadinovic A, McGlynn KA, Zhu K. Colon cancer lymph node evaluation among military health system beneficiaries: an analysis by race/ethnicity. Ann Surg Oncol. 2015 Jan;22(1):195-202
Study
Abstract
Symptoms and illnesses reported by veterans of the 1991 Gulf War era are a cause of potential concern for those military members who have deployed to the Gulf region in support of more recent contingency operations in Iraq and Afghanistan. In the present study, we quantified self-reported symptoms from participants in the Millennium Cohort Study, a prospective study representing all US service branches, including both active duty and Reserve/National Guard components (2001-2008). Self-reported symptoms were uniquely compared with those in a cohort of subjects from the 1991 Gulf War to gain context for the present report. Symptoms were then aggregated to identify cases of chronic multisymptom illness (CMI) based on the case definition from the Centers for Disease Control and Prevention. The prevalence of self-reported CMI symptoms was compared with that collected in 1997-1999 from a study population of US Seabees from the 1991 Gulf War, as well as from deployed and nondeployed subgroups. Although overall symptom reporting was much less in the Millennium Cohort than in the 1991 Gulf War cohort, a higher prevalence of reported CMI was noted among deployed compared with nondeployed contemporary cohort members. An increased understanding of coping skills and resilience and development of well-designed screening instruments, along with appropriate clinical and psychological follow-up for returning veterans, might help to focus resources on early identification of potential long-term chronic disease manifestations.
- Publication Status: Published
- Sponsoring Organization: Undetermined
- Sponsoring Office:
- Congressionally Mandated: No
- Funding Source: Undetermined
- Release Date/Publication: December 01, 2014
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Citation: Smith TC, Powell TM, Jacobson IG, Smith B, Hooper TI, Boyko EJ, Gackstetter GD. Chronic multisymptom illness: a comparison of iraq and afghanistan deployers with veterans of the 1991 gulf war. Am J Epidemiol. 2014 Dec 15;180(12):1176-87.
Study
Abstract
OBJECTIVE:
To examine the clinical utility and psychometric properties of the Traumatic Brain Injury Quality of Life (TBI-QOL) scale in a US military population.
PARTICIPANTS:
One hundred fifty-two US military service members (age: M = 34.3, SD = 9.4; 89.5% men) prospectively enrolled from the Walter Reed National Military Medical Center and other nationwide community outreach initiatives. Participants included 99 service members who had sustained a mild traumatic brain injury (TBI) and 53 injured or noninjured controls without TBI (n = 29 and n = 24, respectively).
PROCEDURE:
Participants completed the TBI-QOL scale and 5 other behavioral measures, on average, 33.8 months postinjury (SD = 37.9).
MAIN OUTCOME MEASURES:
Fourteen TBI-QOL subscales; Neurobehavioral Symptom Inventory; Posttraumatic Stress Disorder Checklist-Civilian version; Alcohol Use Disorders Identification Test; Combat Exposure Scale.
RESULTS:
The internal consistency reliability of the TBI-QOL scales ranged from α = .91 to α = .98. The convergent and discriminant validity of the 14 TBI-QOL subscales was high. The mild TBI group had significantly worse scores on 10 of the 14 TBI-QOL subscales than the control group (range, P < .001 to P = .043). Effect sizes ranged from medium to very large (d = 0.35 to d = 1.13). The largest differences were found on the Cognition-General Concerns (d = 1.13), Executive Function (d = 0.94), Grief-Loss (d = 0.88), Pain Interference (d = 0.83), and Headache Pain (d = 0.83) subscales.
CONCLUSION:
These results support the use of the TBI-QOL scale as a measure of health-related quality of life in a mild TBI military sample. Additional research is recommended to further evaluate the clinical utility of the TBI-QOL scale in both military and civilian settings.
- Publication Status: Published
- Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
- Sponsoring Office: Defense and Veterans Brain Injury Center
- Congressionally Mandated: No
- Funding Source: Undetermined
- Release Date/Publication: January 01, 2016
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Citation: Lange RT, Brickell TA, Bailie JM, Tulsky DS, French LM. Clinical Utility and Psychometric Properties of the Traumatic Brain Injury Quality of Life Scale (TBI-QOL) in US Military Service Members. J Head Trauma Rehabil. 2016 Jan-Feb;31(1):62-78.
Study
Abstract
Estimates of the risk of tuberculosis (TB) infection resulting from overseas deployment among U.S. military service members have varied widely, and have been plagued by methodological problems. The purpose of this study was to estimate the incidence of TB infection in the U.S. military resulting from deployment. Three populations were examined: 1) a unit of 2,228 soldiers redeploying from Iraq in 2008, 2) a cohort of 1,978 soldiers followed up over 5 years after basic training at Fort Jackson in 2009, and 3) 6,062 participants in the 2011-2012 National Health and Nutrition Examination Survey (NHANES). The risk of TB infection in the deployed population was low-0.6% (95% confidence interval [CI]: 0.1-2.3%)-and was similar to the non-deployed population. The prevalence of latent TB infection (LTBI) in the U.S. population was not significantly different among deployed and non-deployed veterans and those with no military service. The limitations of these retrospective studies highlight the challenge in obtaining valid estimates of risk using retrospective data and the need for a more definitive study. Similar to civilian long-term travelers, risks for TB infection during deployment are focal in nature, and testing should be targeted to only those at increased risk.
- Publication Status: Published
- Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
- Sponsoring Office: Uniformed Services University of Health Sciences
- Congressionally Mandated: No
- Funding Source: Undetermined
- Release Date/Publication: December 01, 2015
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Citation: Mancuso JD, Geurts M. Challenges in Obtaining Estimates of the Risk of Tuberculosis Infection During Overseas Deployment. Am J Trop Med Hyg. 2015 Dec 9;93(6):1172-8.
Study
Abstract
The introduction and rapid spread of chikungunya virus (CHIKV) into the Western Hemisphere after December 2013 pose a potentially significant risk to Department of Defense (DoD) personnel, operations, and the military healthcare system. This report describes the DoD experience with CHIKV between January 2014 and February 2015 using case reports in the Defense Medical Surveillance System's (DMSS) Reportable Medical Events database and the Navy and Marine Corps Public Health Center's laboratory test results database. Case finding identified 157 confirmed cases; of these, 118 (75.2%) were either active or reserve component service members and 39 (24.8%) were other beneficiaries. Exposure locations were known for 117 (74.5%) of all cases, and of these, 113 (96.6%) reported likely exposures in the Western Hemisphere; 85 (75.2%) of those cases occurred in Puerto Rico. Although historical data on CHIKV in DoD populations are scant, introduction of CHIKV into the Western Hemisphere with ongoing transmission appears to have resulted in a significant increase in the number of cases among DoD healthcare beneficiary populations.
- Publication Status: Published
- Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
- Sponsoring Office: Armed Forces Health Surveillance Center
- Congressionally Mandated: No
- Funding Source: Defense Health Agency (formerly TRICARE Management Activity)
- Release Date/Publication: October 01, 2015
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Citation: Chikungunya infection in DoD healthcare beneficiaries following the 2013 introduction of the virus into the Western Hemisphere, 1 January 2014 to 28 February 2015. MSMR. 2015 Oct;22(10):2-6.
Study
Abstract
BACKGROUND: Understanding physical activity (PA) after discharge from the military can inform theory on the role of habit and reinforcement in behavior maintenance and has implications for this population's future health.
METHODS: Using data from 28,866 Millennium Cohort Study participants (n=3782 of whom were discharged during the years between assessments), we: 1) investigated changes in meeting federal PA Guidelines for moderate-to-vigorous activity (MVPA) following military discharge, and 2) determined predictors of meeting these Guidelines after discharge.
RESULTS: MVPA declined more in those who were discharged than those who were not (-17.8 percentage points vs. -2.7 percentage points), with greater declines in former active-duty personnel, those who had deployed with combat exposures, had 14-25 years of service, and had been discharged more recently (>2 years prior). In those who were discharged, being normal or overweight (vs. obese), and a nonsmoker or former smoker (vs. current smoker) were positively associated with meeting MVPA Guidelines at follow-up, while meeting MVPA Guidelines at baseline and depression were inversely associated.
CONCLUSIONS: Reductions in MVPA were substantial and unexpected. Increased understanding of transitional periods that may benefit from interventions to mitigate declines in PA will help prevent excess weight gain and physical inactivity-associated health consequences.
- Publication Status: Published
- Sponsoring Organization: Undetermined
- Sponsoring Office:
- Congressionally Mandated: No
- Funding Source: Undetermined
- Release Date/Publication: May 01, 2014
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Citation: Littman A, Jacobson IG, Boyko EJ, Smith TC. Changes in Meeting Vigorous Physical Activity Guidelines After Discharge From the Military. J Phys Act Health. 2014 May 9.
Study
Abstract
BACKGROUND:
The incidence of eye injuries in military service members is high in the combat setting. This is the first study that identifies the primary reason for poor visual acuity (worse than 20/200).
METHODS:
This is a retrospective, noncomparative, interventional case series analyzing US Operation Iraqi and Enduring Freedom members who were evacuated from the theater of operations to Walter Reed Army Medical Center from 2001 through 2011. Primary outcome measures were the length of follow-up, globe survival, and anatomic causes of blindness. Secondary outcome measures included surgical procedures performed, use of eye protection, nonocular injuries, incidence of traumatic brain injury, source of injury, visual outcomes, and predictability of Ocular Trauma Score (OTS) on visual outcome. Univariate analysis was performed using χ and Fisher's exact test. A p < 0.01 was considered significant because of the multiple hypotheses tested.
RESULTS:
There were 265 eyes of 239 patients who had final best-corrected visual acuity of worse than 20/200. The average age was 27.4 years (range, 19-53 years). Of the patients, 97.5% were male, and 28.9% had documented use of eye protection. The average follow-up was 350.19 days (range, 3-2,421 days). There were 128 right-eye and 133 left-eye injuries, with a total of 26 bilateral injuries. There were 206 open-globe and 56 closed-globe injuries, which were further subdivided into zones. Open-globe Zone III injuries (81.6%) were the number one cause of blindness, and most injuries were caused by improvised explosive devices (64.2%). Enucleation was the most common surgery performed (40.6%) and therefore the leading cause of blindness, followed by a multifactorial cause and direct traumatic optic neuropathy.
CONCLUSION:
Ocular trauma is common among combat injuries. Close to a third of service members that experience an ocular trauma become legally blind. Further research is needed to focus on strategies to prevent injury and improve visual outcomes.
- Publication Status: Published
- Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
- Sponsoring Office: Walter Reed National Military Medical Center
- Congressionally Mandated: No
- Funding Source: Undetermined
- Release Date/Publication: October 01, 2015
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Citation: Vlasov A, Ryan DS, Ludlow S, Weichel ED, Colyer MH. Causes of combat ocular trauma-related blindness from Operation Iraqi Freedom and Enduring Freedom. J Trauma Acute Care Surg. 2015 Oct;79(4 Suppl 2):S210-5.
Study
Abstract
Can social resilience be trained? We report results of a double-dissociative randomized controlled study in which 48 Army platoons were randomly assigned to social resilience training (intervention condition) or cultural awareness training (active control group). The same surveys were administered to all platoons at baseline and after the completion of training to determine the short-term training effects, generalization effects beyond training, and possible adverse effects. Multilevel modeling analyses indicated that social resilience, compared with cultural awareness, training produced small but significant improvements in social cognition (e.g., increased empathy, perspective taking, & military hardiness) and decreased loneliness, but no evidence was found for social resilience training to generalize beyond these training foci nor to have adverse effects. Moreover, as predicted, cultural awareness, compared with social resilience, training produced increases in knowledge about and decreases in prejudice toward Afghans. Additional research is warranted to determine the long-term durability, safety, and generalizability of social resilience training.
- Publication Status: Published
- Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
- Sponsoring Office: Walter Reed National Military Medical Center
- Congressionally Mandated: No
- Funding Source: Undetermined
- Release Date/Publication: July 01, 2015
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Citation: Cacioppo JT, Adler AB, Lester PB, McGurk D, Thomas JL, Chen HY, Cacioppo S. Building social resilience in soldiers: A double dissociative randomized controlled study. J Pers Soc Psychol. 2015 Jul;109(1):90-105.
Study
Abstract
Recent armed conflicts and the expanded reach of international terror groups has resulted in an increased incidence of blast-related injuries in both military and civilian populations. Mass-casualty incidents may require both on-scene and in-hospital triage to maximize survival rates and conserve limited resources. Initial evaluation should focus on the identification and control of potentially life-threatening conditions, especially life-threatening hemorrhage. Early operative priorities for musculoskeletal injuries focus on the principles of damage-control orthopaedics, with early and aggressive debridement of soft-tissue wounds, vascular shunting or grafting to restore limb perfusion, and long-bone fracture stabilization via external fixation. Special considerations such as patient transport, infection control and prevention, and amputation management are also discussed. All orthopedic surgeons, regardless of practice setting, should be familiar with the basic principles of evaluation, resuscitation, and initial management of explosive blast injuries.
- Publication Status: Published
- Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
- Sponsoring Office: Walter Reed National Military Medical Center
- Congressionally Mandated: No
- Funding Source: Defense Health Agency (formerly TRICARE Management Activity)
- Release Date/Publication: September 01, 2015
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Citation: Balazs GC, Blais MB, Bluman EM, Andersen RC, Potter BK. Blurred front lines: triage and initial management of blast injuries. Curr Rev Musculoskelet Med. 2015 Sep;8(3):304-11.
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