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Military trauma

Joan K Monin, Natalie Mota, Becca Levy, John Pachankis, Robert H Pietrzak
OBJECTIVES: Objectives were to: (a) identify the mental health needs of older and younger sexual minority and heterosexual U.S. veterans and (b) examine whether sexual minority status confers vulnerability or resiliency in older adulthood. Support and trauma exposure were examined as potential mechanisms for age by sexual orientation differences. METHODS: Participants were a nationally representative sample of 3,095 U.S. veterans (ages 21 to 96 years). Measures included demographics, military characteristics, sexual orientation (lesbian, gay, or bisexual; LGB), social support, trauma, and mental health indicators (lifetime and present depression and post-traumatic stress disorder (PTSD); lifetime anxiety and suicidal ideation)...
September 23, 2016: American Journal of Geriatric Psychiatry
Pauline K Park, Jeremy W Cannon, Wen Ye, Lorne H Blackbourne, John B Holcomb, William Beninati, Lena M Napolitano
BACKGROUND: The overall incidence and mortality of acute respiratory distress syndrome (ARDS) in civilian trauma settings have decreased over the past four decades; however, the epidemiology and impact of ARDS on modern combat casualty care are unknown. We sought to determine the incidence, risk factors, resource utilization, and mortality associated with ARDS in current combat casualty care. METHODS: This was a retrospective review of mechanically ventilated US combat casualties within the Department of Defense Trauma Registry (formerly the Joint Theater Trauma Registry) during Operation Iraqi Freedom/Enduring Freedom (October 2001 to August 2008) for ARDS development, resource utilization, and mortality...
November 2016: Journal of Trauma and Acute Care Surgery
Joseph K Maddry, Alejandra G Mora, Shelia Savell, Lauren K Reeves, Crystal A Perez, Vikhyat S Bebarta
BACKGROUND: Medical evacuation (MEDEVAC) is the movement and en route care of injured and medically compromised patients by medical care providers via helicopter. Military MEDEVAC platforms provide lifesaving interventions that improve survival in combat. There is limited evidence to support decision making related to en route care and allocation of resources. The association between provider type and en route care is not well understood. Our objective was to describe MEDEVAC providers and identify associations between provider type, procedures performed, and outcomes...
November 2016: Journal of Trauma and Acute Care Surgery
Jessica C Rivera, Renee M Greer, Mary Ann Spott, Anthony E Johnson
BACKGROUND: The Military Orthopaedic Trauma Registry (MOTR) was designed to replicate the Department of Defense Trauma Registry's (DoDTR's) role as pillar for data-driven management of extremity war wounds. The MOTR continuously undergoes quality assurance checks to optimize the registry data for future quality improvement efforts. We conducted a quality assurance survey of MOTR entrants to determine if a simple MOTR data pull could provide robust orthopedic-specific information toward the question of causes for late amputation...
November 2016: Journal of Trauma and Acute Care Surgery
Nina S Nnamani, Judson C Janak, Steven J Hudak, Jessica C Rivera, Eluned A Lewis, Douglas W Soderdahl, Jean A Orman
BACKGROUND: In Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF), genitourinary (GU) wounds have occurred in unprecedented numbers. Severe concomitant injuries, including extremity amputations, are common. The epidemiology of GU injury and extremity amputation in OEF/OIF has not been described. MATERIALS AND METHODS: The Department of Defense Trauma Registry was queried from October 2001 through August 2013 to identify all surviving US male service members with GU injuries sustained in OEF/OIF...
November 2016: Journal of Trauma and Acute Care Surgery
Christine Anne Ganzer
: A review of recent research and its relevance for nurses in all settings. ABSTRACT: The last two decades have seen increasing numbers of women entering all branches of the U.S. armed forces. Now that women in the military are no longer prohibited from holding direct combat positions, they are often exposed to traumatic events that place them at higher risk for mental health conditions. Nurses working within the Veterans Affairs (VA) system and those working in non-VA settings are likely to encounter female veterans...
October 13, 2016: American Journal of Nursing
Nicholas S Szuflita, Chris J Neal, Michael K Rosner, Ralph F Frankowski, Robert G Grossman
Spine injuries are more prevalent among Iraq and Afghanistan veterans than among veterans of previous conflicts. The purpose of this investigation was to characterize the context, mode, and clinical outcomes of spine injuries sustained by U.S. military personnel in theater. Injury and clinical data from patients who sustained a spine injury in Iraq or Afghanistan between 2003 and 2008 were extracted from the Joint Theater Trauma Registry. Fischer's exact test was used to compare demographic variables between battle and nonbattle spine injuries...
October 2016: Military Medicine
David R Tribble, Ping Li, Tyler E Warkentien, Bradley A Lloyd, Elizabeth R Schnaubelt, Anuradha Ganesan, William Bradley, Deepak Aggarwal, M Leigh Carson, Amy C Weintrob, Clinton K Murray
The Trauma Infectious Disease Outcomes Study began in June 2009 as combat operations were decreasing in Iraq and increasing in Afghanistan. Our analysis examines the rate of infections of wounded U.S. military personnel from operational theaters in Iraq and Afghanistan admitted to Landstuhl Regional Medical Center between June 2009 and December 2013 and transferred to a participating U.S. hospital. Infection risk factors were examined in a multivariate logistic regression analysis (expressed as odds ratios [OR]; 95% confidence intervals [CI])...
October 2016: Military Medicine
Adrienne J Heinz, Nicole L Cohen, Lori Holleran, Jennifer A Alvarez, Marcel O Bonn-Miller
Post-traumatic stress disorder (PTSD), a condition that disproportionately affects military veterans, is associated with heightened rates of aggression and suicide. Although experience with firearms is common among this population, virtually nothing is known regarding who is more likely to own a firearm and whether firearm ownership is differentially associated with psychological and behavioral risk factors among veterans with PTSD. Of 465 veterans (79% male) entering PTSD treatment, 28% owned a firearm (median number of firearms among owners = 3, range = 1-40)...
October 2016: Military Medicine
James Snyder, Abigail Gewirtz, Lynn Schrepferman, Suzanne R Gird, Jamie Quattlebaum, Michael R Pauldine, Katie Elish, Osnat Zamir, Charles Hayes
Transactional cascades among child internalizing and externalizing symptoms, and fathers' and mothers' posttraumatic stress disorder (PTSD) symptoms were examined in a sample of families with a male parent who had been deployed to recent military conflicts in the Middle East. The role of parents' positive engagement and coercive interaction with their child, and family members' emotion regulation were tested as processes linking cascades of parent and child symptoms. A subsample of 183 families with deployed fathers and nondeployed mothers and their 4- to 13-year-old children who participated in a randomized control trial intervention (After Deployment: Adaptive Parenting Tools) were assessed at baseline prior to intervention, and at 12 and 24 months after baseline, using parent reports of their own and their child's symptoms...
November 2016: Development and Psychopathology
William R Saltzman
This article describes the core principles and components of the FOCUS Program, a brief intervention for families contending with single or multiple trauma or loss events. It has been administered nationally to thousands of military family members since 2008 and has been implemented in a wide range of civilian community, medical, clinical, and school settings. Developed by a team from the UCLA and Harvard Medical Schools, the FOCUS Program provides a structured approach for joining with traditional and nontraditional families, crafting shared goals, and then working with parents, children, and the entire family to build communication, make meaning out of traumatic experiences, and practice specific skills that support family resilience...
October 13, 2016: Family Process
Kerri A Van Arnem, David P Supinski, Jonathan E Tucker, Shawn Varney
BACKGROUND: Trauma patients sustaining blunt injuries are exposed to multiple radiologic studies. Evidence indicates that the risk of cancer from exposure to ionizing radiation rises in direct proportion to the cumulative effective dose (CED) received. The purpose of this study is to quantify the amount of ionizing radiation accumulated when arriving directly from point of injury to San Antonio Military Medical Center (SAMMC), a level I trauma center, compared with those transferred from other facilities...
September 13, 2016: American Journal of Emergency Medicine
(no author information available yet)
It has been known for some time that common principles should be applied to the management of civilian and military trauma, even though the differences in presentation can be significant. Civilian trauma predominantly presents as blunt trauma, for example from road collisions, whereas military trauma generally comprises blast and gunshot wounds.
October 6, 2016: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
Sharon Edwards, Jason Smith
Trauma is a leading cause of death and disability worldwide, in civilian environments and on the battlefield. Trauma-induced haemorrhage is the principal cause of potentially preventable death, which is generally attributable to a combination of vascular injury and coagulopathy. Survival rates following severe traumatic injury have increased due to advanced trauma management initiatives and treatment protocols, influenced by lessons learned from recent conflicts in Iraq and Afghanistan. The use of tourniquets and intraosseous needles, early blood and blood product transfusion, administration of tranexamic acid in pre-hospital settings, and consultant-led damage control resuscitation incorporating damage control surgery have all played their part...
October 6, 2016: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
James G Smith, Ruvanee P Vilhauer, Vanessa Chafos
OBJECTIVE: We sought to assess military veterans' functioning in college by comparing their experience to that of civilian students. PARTICIPANTS: The study, conducted from April, 2012 to February, 2013, included 445 civilian and 61 student service member/veteran (SSM/V) undergraduates, drawn from a community college and two four-year Catholic colleges, in Pennsylvania, New Jersey and New York. METHODS: Participants completed anonymous online surveys...
October 10, 2016: Journal of American College Health: J of ACH
Darryl Wade, Louise Mewton, Tracey Varker, Andrea Phelps, David Forbes
OBJECTIVE: The study investigated the impact of potentially traumatic events on mental health outcomes among males who had ever served in the Australian Defence Force. METHOD: Data from a nationally representative household survey of Australian residents, the 2007 National Survey of Mental Health and Wellbeing, were used for this study. RESULTS: Compared with community members, Australian Defence Force males were significantly more likely to have experienced not only deployment and other war-like events but also accidents or other unexpected events, and trauma to someone close...
September 30, 2016: Australian and New Zealand Journal of Psychiatry
Guy Divita, Marjorie E Carter, Le-Thuy Tran, Doug Redd, Qing T Zeng, Scott Duvall, Matthew H Samore, Adi V Gundlapalli
INTRODUCTION: Substantial amounts of clinically significant information are contained only within the narrative of the clinical notes in electronic medical records. The v3NLP Framework is a set of "best-of-breed" functionalities developed to transform this information into structured data for use in quality improvement, research, population health surveillance, and decision support. BACKGROUND: MetaMap, cTAKES and similar well-known natural language processing (NLP) tools do not have sufficient scalability out of the box...
2016: EGEMS
Sanjay Maurya, Prem Singh Bhandari
Significance: Wounds sustained in a combat trauma often result in a composite tissue loss. Combat injuries, due to high energy transfer to tissues, lead to trauma at multiple anatomical sites. An early wound cover is associated with lower rate of infections and a faster wound healing. The concept of negative pressure wound therapy (NPWT) in the management of combat-related wounds has evolved from the civilian trauma and the wounds from nontraumatic etiologies. Recent Advances: Encouraged by the results of NPWT in noncombat-related wounds, the military surgeons during Operation Iraqi Freedom and Operation Enduring Freedom used this novel method in a large percentage of combat wounds, with gratifying results...
September 1, 2016: Advances in Wound Care
Koffi Benjamin Manou, Ndoula Espérance Kounkou, Romaric Toe, Awo Dorcas Akadje, Cisse Ali, Amonso Daniel Alloh, Manse Béatrice Nandjui
OBJECTIVE: The quality of the residual limb of the amputations in the consequences of a ballistic trauma often was compromised and limits the success of a good equipment for a satisfactory locomotive function. The objective of the study is to describe the various anomalies of the residual limb and their difficulty of equipment of the traumatic amputations by bal PATIENTS AND METHODS: A descriptive retrospective study concerned patients amputated of lower limbs in the consequences of a ballistic trauma during the military crisis in Ivory Coast from 2010 to 2012 and dealt in the center of equipment "Vivre Debout" in the Teacher Hospital of Yopougon...
September 2016: Annals of Physical and Rehabilitation Medicine
William B Elder, Jessica L Domino, Timothy O Rentz, Emma L Mata-Galán
Objective: Male sexual trauma is understudied, leaving much to be known about the unique mental health needs of male survivors. This study examined veteran men's perceptions of the effects of military sexual trauma. Method: Military sexual trauma was defined as physically forced, verbally coerced, or substance-incapacitated acts experienced during military service. Interviews were conducted with 21 male veterans who reported experiencing military sexual trauma. Data were drawn together using a grounded theory methodology...
September 26, 2016: Psychological Trauma: Theory, Research, Practice and Policy
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