Military/Veterans

Preliminary findings of the relationship of lower heart rate variability with military sexual trauma and presumed posttraumatic stress disorder
The SDNN and RMSSD of a 25-year-old female veteran with MST were comparable to that of female veterans aged 69 to 81 years without MST. Further research is needed to evaluate relationships between MST and HRV measures. Lee EA, Bissett JK, Carter MA, Cowan PA, Pyne JM, Speck PM, Theus SA, Tolley EA. J Trauma Stress. 2013 Apr;26(2):249-56. PMID: 23568414

Salivary cortisol lower in posttraumatic stress disorder
Post hoc analyses revealed that the PTSD group had lower area-under-the-curve ground and waking, 30 min, and bedtime values; the cortisol awakening response and area-under-the-curve increase were not different between groups. The 4-factor avoidance PTSD symptom cluster was associated with cortisol, but not the other symptom clusters. This study supports the finding that cortisol is lower in people with PTSD. Wahbeh H, Oken BS. J Trauma Stress. 2013 Apr;26(2):241-8. Epub 2013 Mar 25. PMID: 23529862

The military health system: a community of solutions for medical education, health care delivery, and public health
Multiple strategies have been proposed to improve health care in the United States. These include the development of communities of solution (COSs), implementation of patient-centered medical homes (PCMHs), and lengthening family medicine residency training. There is scant literature on how to build and integrate these ideal models of care, and no literature about how to build a model of care integrating all 3 strategies is available. The Military Health System has adopted the PCMH model and will offer some 4-year family medicine residency positions starting in 2013. Lengthening residency training to 4 years represents an unprecedented opportunity to weave experiential COS instruction throughout a family physician's graduate medical education, providing future family physicians the skills needed to foster a COS in their future practice. Lennon RP, Saguil A, Seehusen DA, Reamy BV, Stephens MB. J Am Board Fam Med. 2013 May-Jun;26(3):264-70. PMID: 23657694