scholarly journals The impact of the reserve military neurosurgeon: practice, community, and service

2018 ◽  
Vol 45 (6) ◽  
pp. E14 ◽  
Author(s):  
Richard Menger ◽  
Benjamin F. Mundell ◽  
J. Will Robbins ◽  
Peter Letarte ◽  
Randy Bell ◽  
...  
Keyword(s):  
Military Service ◽  
Local Community ◽  
Active Duty ◽  
Economic Modeling ◽  
Fiscal Year ◽  
Challenges And Opportunities ◽  
Military Reservists ◽  
Council Of State ◽  
The Military ◽  
The Impact

OBJECTIVEPapers from 2002 to 2017 have highlighted consistent unique socioeconomic challenges and opportunities facing military neurosurgeons. Here, the authors focus on the reserve military neurosurgeon who carries the dual mission of both civilian and military responsibilities.METHODSSurvey solicitation of current active duty and reserve military neurosurgeons was performed in conjunction with the AANS/CNS Joint Committee of Military Neurosurgeons and the Council of State Neurosurgical Societies. Demographic, qualitative, and quantitative data points were compared between reserve and active duty military neurosurgeons. Civilian neurosurgical provider data were taken from the 2016 NERVES (Neurosurgery Executives Resource Value and Education Society) Socio-Economic Survey. Economic modeling was done to forecast the impact of deployment or mobilization on the reserve neurosurgeon, neurosurgery practice, and the community.RESULTSSeventy-five percent (12/16) of current reserve neurosurgeons reported that they are satisfied with their military service. Reserve neurosurgeons make significant contributions to the military’s neurosurgical capabilities, with 75% (12/16) having been deployed during their career. No statistically significant demographic differences were found between those serving on active duty and those in the reserve service. However, those who served in the reserves were more likely to desire opportunities for improvement in the military workflow requirements compared with their active duty counterparts (p = 0.04); 92.9% (13/14) of current reserve neurosurgeons desired more flexible military drill programs specific to the needs of practicing physicians. The risk of reserve deployment is also borne by the practices, hospitals, and communities in which the neurosurgeon serves in civilian practice. This can result in fewer new patient encounters, decreased collections, decreased work relative value unit generation, increased operating costs per neurosurgeon, and intangible limitations on practice development. However, through modeling, the authors have illustrated that reserve physicians joining a larger group practice can significantly mitigate this risk. What remains astonishing is that 91.7% of those reserve neurosurgeons who were deployed noted the experience to be rewarding despite seeing a 20% reduction in income, on average, during the fiscal year of a 6-month deployment.CONCLUSIONSReserve neurosurgeons are satisfied with their military service while making substantial contributions to the military’s neurosurgical capabilities, with the overwhelming majority of current military reservists having been deployed or mobilized during their reserve commitments. Through the authors’ modeling, the impact of deployment on the military neurosurgeon, neurosurgeon’s practice, and the local community can be significantly mitigated by a larger practice environment.

Health and Service-related Impact of Sexual and Stalking Victimization During United States Military Service on LGBT Service Members

2020 ◽  
pp. 088626052097031
Author(s):  
Cary Leonard Klemmer ◽  
Ashley C. Schuyler ◽  
Mary Rose Mamey ◽  
Sheree M. Schrager ◽  
Carl Andrew Castro ◽  
...  
Keyword(s):  
United States ◽  
Military Service ◽  
The United States ◽  
Active Duty ◽  
Service Members ◽  
United States Military ◽  
Service Outcomes ◽  
Study Participants ◽  
The Military ◽  
Stalking Victimization

Prior research among military personnel has indicated that sexual harassment, stalking, and sexual assault during military service are related to negative health sequelae. However, research specific to LGBT U.S. service members is limited. The current study aimed to explore the health, service utilization, and service-related impact of stalking and sexual victimization experiences in a sample of active-duty LGBT U.S. service members ( N = 248). Respondent-driven sampling was used to recruit study participants. U.S. service members were eligible to participate if they were 18 years or older and active-duty members of the U.S. Army, U.S. Navy, U.S. Marine Corps, or U.S. Air Force. This study included a sizeable portion of transgender service members ( N = 58, 23.4%). Sociodemographic characteristics, characteristics of military service, health, and sexual and stalking victimization in the military were assessed. Regression was used to examine relationships between health and service outcomes and sexual and stalking victimization during military service. Final adjusted models showed that experiencing multiple forms of victimization in the military increased the odds of visiting a mental health clinician and having elevated somatic symptoms, posttraumatic stress disorder symptomatology, anxiety, and suicidality. Sexual and stalking victimization during U.S. military service was statistically significantly related to the mental and physical health of LGBT U.S. service members. Interventions to reduce victimization experiences and support LGBT U.S. service members who experience these types of violence are indicated. Research that examines the role of LGBT individuals’ experiences and organizational and peer factors, including social support, leadership characteristics, and institutional policies in the United States military is needed.

scholarly journals PERIACETABULAR OSTEOTOMY IN ACTIVE DUTY U.S. MILITARY PERSONNEL: A SINGLE CENTER’S EXPERIENCE WITH A MINIMUM OF TWO YEARS FOLLOW-UP

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0014
Author(s):  
Andrew S. Murtha ◽  
Matthew R. Schmitz
Keyword(s):  
United States ◽  
Military Service ◽  
Periacetabular Osteotomy ◽  
The United States ◽  
Active Duty ◽  
Service Members ◽  
Military Service Members ◽  
Active Service ◽  
The Impact

Background: The primary focus of periacetabular osteotomy (PAO) literature has been survivorship until hip arthroplasty. This endpoint overlooks its impact on young, active patients. Hypothesis/Purpose: This study sought to assess the impact of the PAO on the careers of active duty members of the United States Armed Forces. Methods: A retrospective review identified 38 patients who underwent PAO performed by a single surgeon at an academic, military medical center from January 2014 through April 2017. Twenty-one of the patients were active duty United States military service members (16 female, 5 male) and had a minimum 28 months of post-operative follow-up at the time of review. Preoperative and postoperative duty restrictions were noted and referrals to the U.S Army and U.S. Air Force Medical Evaluation Boards (MEB) were queried. Results: The average age at surgery was 25.6 years (range, 19-40y). Preoperatively, sixteen patients (94.1%) were on duty restrictions, one had been referred to the MEB, and records were not available on three patients who separated from the military prior to review. Average follow-up was 3.4 years (range, 2.3 – 5.4y). Among the patients without a preoperative MEB referral, 85.0% remained on active duty (n = 12) or completed their military service commitment (n=5). Of the fourteen patients with temporary duty restrictions preoperatively, 35.7% (n=5) were relieved of their restrictions and returned to full duty and 50% (n=7) were retained on active service with permanent duty restrictions. Such permanent duty restrictions typically consisted of modifications to the aerobic component of the semiannual military fitness testing. Six patients (28.6%) were referred to the MEB including one who was referred prior to PAO. Of these patients, two were deemed fit to retain on active service with permanent duty restrictions, two were medically separated for non-hip conditions, and two were medically separated for a hip condition. The average Veteran Affairs (VA) disability score related to hip pathology in patients referred to MEB was 16% (range 0-40%). Conclusion: This is the first study to look at the PAO in active duty military service members. In patients with symptomatic acetabular dysplasia, PAO may provide an opportunity to relieve preoperative duty restrictions and allow for continued military service. Further study with the inclusion of patient reported outcomes are necessary assess the impact of the procedure in this active patient population.

scholarly journals The Health and Readiness of Service Members: ACEs to PACEs

2020 ◽  
Vol 185 (Supplement_1) ◽  
pp. 348-354 ◽  
Author(s):  
Angela Lamson ◽  
Natalie Richardson ◽  
Erin Cobb
Keyword(s):  
Adverse Childhood Experiences ◽  
Military Service ◽  
Active Duty ◽  
Early Career ◽  
Service Members ◽  
Childhood Experiences ◽  
Adverse Childhood ◽  
Active Duty Personnel ◽  
The Military

ABSTRACT Introduction Over the past three decades, a growing research base has emerged around the role of adverse childhood experiences (ACEs) in the biological, psychological, social, and relational health and development of children and adults. More recently, the role of ACEs has been researched with military service members. The purpose of this article was to provide a brief description of ACEs and an overview of the key tenets of the theory of toxic stress as well as a snapshot of ACEs and protective and compensatory experiences (PACEs) research with active duty personnel. Methods Ninety-seven active duty personnel completed the study including questions pertaining to demographics, adverse childhood experiences, adult adverse experiences, and PACEs survey. Results Significant findings pertaining to ACEs and PACEs were found by service member’s sex and rank, with higher ACE scores for men and enlisted service members. Conclusions The contrast by rank and sex in relation to ACEs punctuates the need for attention to ACEs and protective factors among early career service members in order to promote sustainable careers in the military.

Military Service and Lifetime Arrests: Examining the Effects of the Total Military Experience on Arrests in a Sample of Prison Inmates

2015 ◽  
Vol 29 (1) ◽  
pp. 24-44 ◽  
Author(s):  
Erika J. Brooke ◽  
Jacinta M. Gau
Keyword(s):  
Criminal Justice ◽  
Military Service ◽  
Prison Inmates ◽  
Civilian Life ◽  
Military Experience ◽  
Entry Length ◽  
Life Trajectories ◽  
Increased Risk ◽  
The Military ◽  
The Impact

Service in the military is an important event that may shape veterans’ life trajectories. Research has shown that military service is associated with increased risk of alcohol and substance abuse, mental illness, and antisocial behaviors, yet it remains unclear whether service places veterans at elevated risk of criminal justice involvement. In addition, most prior research treats military service as a dichotomous variable and does not consider the specific components of the military experience that might affect the impact that service has upon veterans. In the present study, a large sample of state prison inmates is utilized to test for the potential impact of military service, by itself, as well as age of entry, length of service, combat exposure, discharge type, and branch status on lifetime arrests. Results have implications for both military and criminal justice policies in ensuring that veterans have the assistance they need as they re-enter civilian life.

Handbook of Military and Veteran Suicide

2017 ◽  
Keyword(s):  
Mental Health Professionals ◽  
Military Service ◽  
Suicide Risk ◽  
National Guard ◽  
Psychological Trauma ◽  
The United States ◽  
Active Duty ◽  
Service Members ◽  
Care Providers ◽  
The Impact

There are approximately 30,000 suicides in the United States each year. Over 20% of these suicides are completed by active duty service members and military veterans. Experts in the field of military suicide collaboratively contributed to this textbook to summarize the current state of research on this important topic. The text encompasses various themes; it defines the scope of the problem, outlines current methods for screening and assessing suicide risk, summarizes both evidence-based treatments and risk management techniques, and describes current suicide prevention efforts. Specific topics among such themes explore the effect of psychological trauma, traumatic brain injury, and the impact of military culture on suicide risk. In addition, the text provides an overview of suicide efforts targeted for special population veteran and active duty service members, such as the Army National Guard and Special Operations Forces. Ethical considerations, challenges of research, as well as future directions are highlighted to provide the reader with a critical analysis of military and veteran suicide research. The information provided herein is ideal for care providers such as physicians, psychologists, and mental health professionals—as well as academics whose work involves military service members and veterans.

scholarly journals Relationship Between Body Mass Index and Diagnosis of Obesity in the Military Health System Active Duty Population

2021 ◽  
Author(s):  
Daren Yang ◽  
Alexis Beauvais ◽  
Whitney L Forbes ◽  
Darrick Beckman ◽  
Jason Estes ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Health System ◽  
Body Mass ◽  
Military Service ◽  
Active Duty ◽  
Service Members ◽  
Data Repository ◽  
Military Health System ◽  
Military Health ◽  
The Military

ABSTRACT Objective The overall rate of obesity is rising in the USA; this is also reflected in the military population. It is important that providers appropriately diagnose obesity and discuss treatment options with their patients. The purpose of this study was to investigate diagnosis of obesity compared to documented body mass index (BMI) in the military health system. Methods Institutional review board approval was obtained by the 59th Medical Wing (Lackland Air Force Base, Texas) as an exempt study. This study included active duty military service members aged 18-65 years who sought outpatient care at a military treatment facility from September 2013 to August 2018 with a weight within the range of 31.8-226.8 kg and height between 121.9 and 215.9 cm. Data were collected from the Clinical Data Repository vitals and M2 encounter data to determine the percentage of each sub-population with a diagnosis of obesity according to BMI (≥30 kg/m2) and International Classification of Diseases diagnosis codes. Results Using BMI, 19.2% of female and 26.8% of male service members can be diagnosed with obesity; however, only 42.2% and 35.1%, respectively, with a BMI ≥30 was diagnosed as such. This discrepancy was consistent among all service branches and BMI ranges. Conclusion This study demonstrates that obesity is underdiagnosed compared to BMI. This may result in insufficient resources being provided to patients to reduce weight. Further investigation is warranted to identify causes of underdiagnosis and potential barriers to diagnosis.

scholarly journals The Impact of Having a Child With Special Healthcare Needs on Length of Military Service

2021 ◽  
Author(s):  
Elizabeth M Perkins ◽  
Ian Sorensen ◽  
Apryl Susi ◽  
Elizabeth Hisle-Gorman
Keyword(s):  
Military Service ◽  
Chronic Conditions ◽  
Linear Regression Analysis ◽  
Service Member ◽  
Military Health ◽  
Healthcare Needs ◽  
Healthcare Coverage ◽  
Military Healthcare ◽  
The Military ◽  
The Impact

ABSTRACT Introduction In 2010, the National Survey of Children with Special Healthcare Needs revealed that parents of children with special healthcare needs (CSHCN) report employment decisions are influenced by healthcare coverage needs. The U.S. military healthcare system arguably offers service member parents of CSHCN with the most comprehensive, inexpensive, long-term healthcare in the country—potentially increasing their incentive to remain in the military. This study explored the effect of having a CSHCN on the length of parental military service. Materials and Methods A retrospective cohort was formed using the Military Health System database from 2008 to 2018. Included children were <10 years in 2010 and received ≥1 year of military healthcare between 2008 and 2010. The Pediatric Medical Complexity Algorithm categorized children as having special healthcare needs via ICD 9/10 codes as having complex chronic (C-CD), non-complex chronic (NC-CD), or no chronic disease (CD). Families were classified by the child with the most complex healthcare need. Duration of military healthcare eligibility measured parental length of service (LOS). ANOVA and linear regression analysis compared LOS by category. Logistic regression determined odds of parental LOS lasting the full 8-year study length. Adjusted analyses controlled for child age and sex, and military parent sex, rank, and marital status. Results Over 1.45 million children in 915,584 families were categorized as per the algorithm. Of individual children included, 292,050 (20.1%) were CSHCN including those with complex chronic and non-complex chronic conditions. After grouping by family, 80,909 (8.8%) families had a child/children with C-CD (mean LOS 6.39 years), 170,787 (18.7%) families had a child/children with NC-CD (mean LOS 6.41 years), and 663,888 (72.5%) families had children with no CD (mean LOS 5.7 years). In adjusted analysis, parents of children with C-CD and NC-CD served 0.4 [0.37-0.42] and 0.33 [0.31-0.34] years longer than parents of children with no CD; odds of parents serving for the full study period were increased 33% (1.33 [1.31-1.36]) in families of children with C-CD and 27% (1.27 [1.26-1.29]) in families of children with NC-CD. Conclusions Findings indicate that military parents of CSHCN serve longer military careers than parents of children with no chronic conditions. Continued provision of free, high-quality healthcare coverage for dependent children may be important for service member retention. Retaining trained and experienced service members is key to ensuring a ready and lethal U.S. military.

Military Experience and Elite Decision-Making: Self-Selection, Socialization, and the Vietnam Draft Lottery

2021 ◽  
Author(s):  
Danielle L Lupton
Keyword(s):  
Decision Making ◽  
Military Service ◽  
Voting Behavior ◽  
Roll Call ◽  
Military Experience ◽  
Self Selection ◽  
Draft Lottery ◽  
Vietnam Draft ◽  
The Military ◽  
The Impact

Abstract Scholars across international relations (IR) debate the role military experience plays in elite decision-making. I argue there are two critical problems with this debate. First, it fails to adequately consider the underlying mechanisms linking military service to elite policy preferences. Second, it narrowly focuses on the use of force and largely ignores other ways in which military experience may shape elite behavior. I employ vulnerability to the Vietnam draft lottery to disentangle the impact of two key mechanisms linking military service to elite preferences: self-selection and socialization. I compare the foreign and defense policy roll call votes of Members of Congress (MCs) in the House of Representatives across the 94th–113th Congresses who were eligible for the draft and served in the military to those who were eligible for the draft but did not serve. I find significant differences in the roll call voting behavior between these groups, particularly on issues associated with arming and defense budget restrictions, as well as broader oversight of the military. These effects are heightened for MCs who served on active duty, in the military longer, and in combat, providing strong support for socialization effects. My study carries implications for civil–military relations, elite decision-making, and the study of leaders in IR.

scholarly journals Fertility Preservation Before Deployment: Oocyte and Sperm Freezing in Members of the Active Duty Military

2019 ◽  
Vol 37 (05/06) ◽  
pp. 232-238
Author(s):  
Anne E. Martini ◽  
Joseph O. Doyle
Keyword(s):  
Fertility Preservation ◽  
Military Service ◽  
Safety Data ◽  
Active Duty ◽  
Military Family ◽  
For Profit ◽  
Active Duty Military ◽  
Military Community ◽  
Government Initiative ◽  
The Military

AbstractActive duty military service and deployment has the potential to compromise fertility through combat-related genitourinary injury, gonadotoxic exposures, and physical separation from a partner. Despite a growing interest among the military community as well as promising efficacy and safety data, fertility preservation remains an uncovered benefit for active duty soldiers. In 2016, the Pentagon proposed a program that would cover oocyte and sperm cryopreservation for any member of the active duty military desiring its use. Regrettably, that funding was not secured and predeployment fertility preservation remains an out-of-pocket expense. Today, advocacy groups, non-for-profit organizations, and physicians remain vigilant in their attempts to drive another government initiative through Congress. While activism continues, it is important to stress the value of fertility preservation counseling in soldiers' predeployment preparation and military family planning.

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