Barriers and facilitators to mental healthcare for women veterans: a scoping review.

Background: Traditionally, veteran research and support have centred on the requirements of a predominantly male population. However, as female participation in the Armed Forces increases and their roles diversify, consideration of women's unique mental health needs is imperative. Women veterans are at greater risk of post-service mental health challenges than their male counterparts, and female mental health outcomes have deteriorated in recent years.

The impact of caring for family members with mental illnesses on the caregiver: a scoping review.

A large number of multidisciplinary, qualitative and quantitative research suggests that providing care for family members with mental health illnesses can have both positive and negative effects on the carers' wellbeing. However, to date a comprehensive overview and synthesis of literature that compares and contrasts positive and negative effects of family-caregiving on the carer is missing. To address this gap, this scoping review examines the effects of family-caregiving on carers' wellbeing.

Gluteal Muscle Atrophy and Increased Intramuscular Lipid Concentration Are Not Mitigated by Daily Artificial Gravity Following 60-Day Head-Down Tilt Bed Rest.

Exposure to spaceflight and head-down tilt (HDT) bed rest leads to decreases in the mass of the gluteal muscle. Preliminary results have suggested that interventions, such as artificial gravity (AG), can partially mitigate some of the physiological adaptations induced by HDT bed rest. However, its effect on the gluteal muscles is currently unknown.

Gender differences in barriers to mental healthcare for UK military veterans: a preliminary investigation.

Introduction: Limited UK research focuses on female military veterans' gender-related experiences and issues when accessing civilian mental healthcare support. This study sought to illuminate a preliminary understanding of any gender differences in barriers that may discourage them accessing mental healthcare support.

Methods: A total of 100 participants completed an open online survey of UK triservice veterans who identified as having experienced postmilitary mental health problems.

A simulation study on implementing marginal structural models in an observational study with switching medication based on a biomarker.

Assessing treatment effectiveness in longitudinal data can be complex when treatments are not randomly assigned and patients are allowed to switch treatment to other or no treatment, often in a manner that is driven by changes in one or more variables associated with patient or clinical characteristics. There can be confounding of the treatment effect from a time-varying variable, i.e.

Subdural Hemorrhage in a Military Aviator.

Background: The occurrence of any intracranial bleeding is highly significant from an aeromedical risk perspective and potentially career-ending for a military aviator. Where it arises from head trauma, there is always concern regarding ongoing risk of post-traumatic epilepsy.

Case Report: A 26-yr-old male military aviator with persistent headache was found to have small right frontal and parietal subacute subdural hematomas, most likely precipitated by minor head trauma and possibly exacerbated by other concurrent physiological stressors.

Reducing bloodstream infections in pediatric rehabilitation patients receiving parenteral nutrition.

Objective: To report our quality improvement efforts to reduce total parenteral nutrition (TPN)-associated bloodstream infections, and the results of those efforts, during the period including the first quarter of 2004 through the third quarter of 2010.

Methods: A variant on failure modes and effect analysis and existing guidelines were used to develop and modify interventions. Effectiveness of the interventions was assessed by using a graphical depiction of interrupted time-series data on TPN-associated infections per 1000 TPN-days, aggregated across quarters within intervention periods.

Hypoxia awareness training for aircrew: a comparison of two techniques.

Introduction: Major hazards associated with hypoxia awareness training are the risks of decompression sickness, barotrauma, and loss of consciousness. An alternate method has been developed which combines exposure to a simulated altitude of 10,000 ft (3048 m) with breathing of a gas mixture containing 10% oxygen and 90% nitrogen. The paradigm, called Combined Altitude and Depleted Oxygen (CADO), places the subjects at a physiological altitude of 25,000 ft (7620 m) and provides demonstration of symptoms of hypoxia and the effects of pressure change.

Current use of aspirin and antithrombotic agents in the United States among outpatients with atherothrombotic disease (from the REduction of Atherothrombosis for Continued Health [REACH] Registry).

Despite its proven efficacy, low cost, and wide availability, aspirin remains underused. We examined current aspirin use and determined factors that influence its use among outpatients in the United States (US). The REduction of Atherothrombosis for Continued Health (REACH) Registry is an international, prospective, longitudinal study of >68,000 outpatients with established atherothrombosis or >or=3 atherothrombotic risk factors.

PROCLAIM: pilot study to examine the effects of clopidogrel on inflammatory markers in patients with metabolic syndrome receiving low-dose aspirin.

Metabolic syndrome is associated with intravascular inflammation, as determined by increased levels of inflammatory biomarkers and an increased risk of ischemic atherothrombotic events. Evidence suggests that atherothrombosis and intravascular inflammation share predictive biomarkers, including high-sensitivity C-reactive protein, CD40 ligand, P-selectin, and N-terminal pro-brain natriuretic peptide. Patients who had metabolic syndrome were randomized to receive clopidogrel 75 mg/day plus aspirin 81 mg/day (n = 89) or placebo plus aspirin 81 mg/day (n = 92) for 9 weeks to assess the efficacy of each treatment in suppression of inflammatory markers.

Efficacy and safety of fixed combinations of irbesartan/hydrochlorothiazide in hypertensive women: the inclusive trial.

Objective: This post hoc analysis of the Irbesartan/Hydrochlorothiazide Blood Pressure Reductions in Diverse Patient Populations (INCLUSIVE) trial evaluated the efficacy and safety of irbesartan/hydrochlorothiazide (HCTZ) in a diverse population of hypertensive women.

Methods: INCLUSIVE was a multicenter, prospective, open-label, single-arm trial. Adult subjects had uncontrolled systolic blood pressure (SBP 140-159 mm Hg; 130-159 mm Hg for those with type 2 diabetes mellitus [T2DM]) after > or =4 weeks of antihypertensive monotherapy.

Predictors of blood pressure response to angiotensin receptor blocker/diuretic combination therapy: a secondary analysis of the irbesartan/hydrochlorothiazide blood pressure reductions in diverse patient populations (INCLUSIVE) study.

The secondary analysis of the Irbesartan/Hydrochlorothiazide Blood Pressure Reductions in Diverse Patient Populations (INCLUSIVE) clinical trial investigated whether baseline demographic and clinical variables are predictive of different degrees of blood pressure reduction following an angiotensin II receptor blocker/diuretic treatment regimen. Irbesartan/hydrochlorothiazide and other angiotensin receptor blocker combinations with a diuretic have been shown to be effective in reducing systolic blood pressure in a diverse patient population previously uncontrolled on monotherapy. Ordinary least squares regression analysis was performed on the intent-to-treat population of the INCLUSIVE study to identify variables predictive of variations in blood pressure changes in response to irbesartan/hydrochlorothiazide combination therapy.

Anxiety-related visits to New Jersey emergency departments after September 11, 2001.

The purpose of this study was to examine the effect of September 11, 2001 on anxiety-related visits to selected Emergency Departments (EDs). We performed a retrospective analysis of consecutive patients seen by emergency physicians in 15 New Jersey EDs located within a 50-mile radius of the World Trade Center from July 11 through December 11 in each of 6 years, 1996--2001. We chose by consensus all ICD-9 (International Classification of Diseases, 9th revision) codes related to anxiety.

The effect of acute simulated moderate altitude on power, performance and pacing strategies in well-trained cyclists.

Athletes regularly compete at 2,000-3,000 m altitude where peak oxygen consumption (VO2peak) declines approximately 10-20%. Factors other than VO2peak including gross efficiency (GE), power output, and pacing are all important for cycling performance. It is therefore imperative to understand how all these factors and not just VO2peak are affected by acute hypobaric hypoxia to select athletes who can compete successfully at these altitudes.

Wealth from Health: an incentive program for disease and population management: a 12-year project.

The future of healthcare is linked with its ability to face the challenges of consumerism. Disease and population management will represent the dominant style of healthcare delivery in the future. This article describes the Wealth from Health programs which utilize current and future technologies to help the healthcare system become a leader in healthcare delivery and to assist many communities at an affordable cost.

Community pharmacists and Colleges of Pharmacy: the Ohio partnership.

Objective: To develop pharmacist practice standards, pharmacy preceptor standards, and objectives for students completing advanced practice community pharmacy rotations.

Setting: Ohio.

Practice Description: Pharmacy schools and community pharmacies that serve as advanced practice rotation sites.

The Frontlines of Medicine Project progress report: standardized communication of emergency department triage data for syndromic surveillance.

This article reports progress since the original publication of the Frontlines of Medicine Project. This project is a collaborative effort of emergency medicine (including emergency medical services and clinical toxicology), public health, other government agencies involved in health care and preparedness, law enforcement, and informatics to develop nonproprietary, standardized methods for reporting emergency department patient data. These data may be used for a variety of public health or clinical care initiatives, including syndromic surveillance for chemical and biological terrorism.

Agreement between pediatric medication orders and medication cardex.

This study examined the individual and temporal factors that explain whether the medication cardex agrees with a physician's pediatric medication order. After controlling for several potentially confounding factors, it was found that, among other things, pediatric intensive care unit cardexes were 62% less likely to agree with the physician order than cardexes from other units. Cardexes for "stat" orders were twice as likely to agree with the physician order.

Effect of lunar cycle on temporal variation in cardiopulmonary arrest in seven emergency departments during 11 years.

Objective: To determine the effect of the phase of the full and new moon on the variation in the number of daily cardiopulmonary resuscitations.

Design: A retrospective analysis of a computerized billing database of emergency department visits in a cohort of seven northern New Jersey (USA) emergency departments.

Participants: Consecutive patients seen by emergency department physicians over an 11-year period (1 January 1988 to 31 December 1998).

Meta-analysis of prostate-specific antigen and digital rectal examination as screening tests for prostate carcinoma.

Background: Physicians commonly screen for prostate cancer by using prostate-specific antigen (PSA) and digital rectal examination (DRE). The usefulness of these screening mechanisms is not well established, however. A meta-analysis of PSA and DRE to detect prostate carcinoma was conducted with a focus on sensitivity, specificity, and positive predictive value.

In-flight hypoxia incidents in military aircraft: causes and implications for training.

Background: Hypoxia has long been recognized as a significant physiological threat at altitude. Aircrew have traditionally been trained to recognize the symptoms of hypoxia using hypobaric chamber training at simulated altitudes of 25,000 ft or more. The aim of this study was to analyze incidents of hypoxia reported to the Directorate of Flying Safety of the Australian Defence Force (DFS-ADF) for the period 1990-2001, as no previous analysis of these incidents has been undertaken.

Delineation of prevalence and risk factors for early coronary artery disease by electron beam computed tomography in young adults with type 1 diabetes.

Objective: Type 1 diabetes increases the risk for coronary artery disease (CAD), but limited information is available regarding the early natural history of this process. Electron beam tomography (EBT) can measure coronary artery calcification (CAC), an early marker for CAD. This study was designed to assess the prevalence and risk factors for CAC in young adults with established type 1 diabetes.