Myocardial Bridging, the Hidden Risk Factor for Ischemia

ABSTRACT Myocardial bridging is an uncommon cause of a quite common emergency department complaint for chest pain and is often associated with left ventricular hypertrophy. We present a case of an otherwise healthy middle-aged U.S. military service member who presented with acute coronary syndrome which was ultimately determined to be the result of myocardial bridging.

Dissents and Sensibility

The architecture of objective control has informed a great deal of the development of civil-military norms and the professional education of military officer corps, particularly in the democratic West. But while this idealized vision of civil-military relations has been influential, it is incomplete in its accounting of the moral, ethical, legal, and political structures surrounding the military service member. In practical terms, it is not a simple task to divide problems into purely military and purely political aspects, nor is it easy to determine how to reconcile conflicting imperatives. This chapter attempts to provide a comprehensive typology of the various loyalty structures within which military personnel are located and the various ways in which these structures can conflict. It discusses how democratic theory and classical principal-agent models may prescribe different outcomes for such conflicts and provide a granular understanding of the sources of civil-military friction.

Daily Life, Communication and Affections of Siblings and Parents of Military Service Members in Mission

The Portuguese military in mission state that parents and siblings are a fundamental support; however, research is very scarce in this area. This study aimed to investigate the impact of a mission on the daily life, communication and emotional responses of 227 relatives of 92 military personnel, 114 siblings (M age = 29.14, SD = 9.81) e 113 parents (M age = 55.06, SD = 9.12). A questionnaire related to the mission was applied, focusing on changes in the daily life, social support, communication and advice to other family members; and the Positive and Negative Affect Schedule since receiving notification. The results revealed that the parents suffered more with the notification and that there were changes in family functioning and in the functional support. Communication with the deployed military service member strengthens family relationships, morale, and well-being. Participants reported emotions of concern and pride, and gave advice based on a positive attitude toward the military and the mission.

The ‘Social Warfare State’

The Serviceman’s Readjustment Act of 1944, also called the GI Bill or the ‘New Deal for Veterans’, constituted one of the most expansive social policies in US history. In one deft move, a bi-partisan coalition passed a surprisingly and under-appreciatedly progressive social agenda providing training vouchers, family allowances, up to a year’s worth of transitional unemployment payments, and low-interest, federally guaranteed loans for homes, farms, and businesses to nearly 8 million citizens. Every Second World War military service member was made eligible, regardless of race or ethnicity. The bill extended access to higher education, social support, and homeownership to 75 per cent of the young male cohort in post-Second World War America. As a consequence, higher educational attainment grew by 20 per cent. More generally, the bill boosted social mobility, creating the ‘civic generation’. The policy was so successful and popular that it has been routinely expanded and renewed for veterans in the seventy years since. It endures as a core component of compensation for service members today.

Defining Normal Balance for Army Aviators

Introduction One challenge clinicians face is determining when a military Service Member (SM) can return to duty after an injury that affects the postural control. The gold standard to measure postural control is the Sensory Organization Test (SOT). This test measures the amount of sway present in an individual’s static stance that may be used to examine range of function and monitor recovery from injury. Normative values currently available were developed using a sample of clinically normal adults from the general population (i.e., civilian non-aviator). Previous research suggests that these values should not be used as a comparative cohort for high-performing populations in the military. However, normative values, specific to military SMs, do not exist. The aim of this study was to develop a normative clinical database for functional balance (i.e., the SOT) for military-trained aviators, an occupational specialty that may consist of high performers. Materials and Methods Forty-three U.S. Army trained aviators, between 23 and 40 years old with medical clearance for flight operations from the Fort Rucker, Alabama area community consented and participated in this study. The SOT was delivered using the NeuroCom SMART EquiTest Clinical Research System with the Data Acquisition Toolkit (version 9.3). Results A statistically significant (p < 0.01) difference between the study cohort of Army-trained aviators and the publically available general civilian normative values was found for the more challenging conditions, in which the force plate was not fixed (i.e., conditions four through six). The study cohort of Army-trained aviators were found to have a higher equilibrium score in each of these three conditions. Similarly, a significant difference (p < 0.01) between the two cohorts was found on the visual and vestibular sensory analysis ratios, and the visual preference scores (i.e., greater reliance upon visual information in the maintenance of balance). The study cohort were found to have a higher ratios (i.e., greater dependence upon these sensory cues) in each of these conditions. Conclusion Army-trained aviators are high-functioning performers whose SOT scores differ from that of the general civilian population, particularly for the more challenging test conditions. New normative values were developed from this study population. Use of the developed normative values could be used as a comparative cohort in screening aviators who are recovering from injuries that affect postural stability.

Military Service Member Perspectives About Occupational Therapy Treatment in a Military Concussion Clinic

The purpose of this study is to describe important features of occupational therapy practice for treatment of military service members with chronic symptoms and a history of mild traumatic brain injury (mTBI) in a military concussion care clinic from service members’ perspectives with support from occupational therapy practitioners. Two series of focus groups were conducted with service members with chronic mTBI-related symptoms ( n = 6) and practitioners ( n = 5). Data were analyzed concurrently with collection. We identified five main themes: therapeutic relationship, consistent inclusion of family members, combat versus noncombat injuries, loss of military identity, and assessment against population norms. The findings of this study suggest that service members’ evaluations of occupational therapy are based on the overall experience of the encounter, centered by the therapeutic relationship, rather than specific intervention strategies or technology.