Tri-service Disability Evaluation System Database Review Annual Report 2010

2011 ◽  
Author(s):  
David W. Niebuhr ◽  
Marlene E. Gubata ◽  
David N. Cowan ◽  
Elizabeth R. Packnett ◽  
Caitlin D. Blandford ◽  
...  
2012 ◽  
Author(s):  
Marlene E. Gubata ◽  
David W. Niebuhr ◽  
David N. Cowan ◽  
Elizabeth R. Packnett ◽  
Caitlin D. Blandford ◽  
...  

2017 ◽  
Vol 45 (14) ◽  
pp. 3298-3304 ◽  
Author(s):  
Darren D. Thomas ◽  
Andrew S. Bernhardson ◽  
Ethan Bernstein ◽  
Christopher B. Dewing

Background: Femoroacetabular impingement (FAI) can lead to hip pain and early joint degeneration. There have been few reports to date on the outcomes of hip arthroscopy for the treatment of FAI in the military population. Purpose/Hypothesis: The purpose of this study was to compare patient demographics with postoperative outcomes after hip arthroscopy for symptomatic FAI and to identify preoperative risk factors for poor outcomes. The hypothesis was that certain preoperative patient characteristics will be predictive of poorer outcomes and that lower outcomes scores will be associated with a higher likelihood of medical separation from the military. Study Design: Case series; Level of evidence, 4. Methods: Retrospective chart review of active-duty and dependent patients older than 18 years who underwent hip arthroscopy for symptomatic FAI from 2009 to 2014 at a single institution. Results: A total of 469 (309 males and 160 females) surgeries were performed on 456 active-duty personnel and 13 dependent civilians, with a mean 2.5-year follow-up. Overall, 39% (n = 179) were able to return to duty (RTD), 18% (n = 82) were medically cleared to return to normal daily activities but did not remain on active duty, and 43% (n = 195) required referral to the Disability Evaluation System (DES). Increasing rank and male sex were positive predictors and Axis 1 psychiatric diagnosis, revision surgery, concomitant psoas tenotomy, multiple medical comorbidities, and complaints of generalized pelvic pain were negative predictors for returning to duty. US Marine Infantry and Special Forces showed improved RTD rates (50%-86%) compared with administrative, more sedentary, occupations (22%). On average, Single Alpha Numeric Evaluation (SANE) and visual analog scale (VAS) scores improved after surgery, with SANE scores improving 37 ± 28 points and VAS scores improving 2.6 ± 2.5 points. The mean postoperative SANE and VAS scores differed significantly between the RTD group and those not returning to duty; 87 and 1.2 points compared with 69 and 3.6 points, respectively ( P < .0001). Conclusion: Hip arthroscopy for the treatment of symptomatic FAI effectively improves pain symptoms and self-reported overall function but shows a much lower than expected return to full, unrestricted active duty in the general active-duty military population. Underlying psychiatric diagnoses, female sex, and more sedentary occupations are associated with lower RTD rates. Furthermore, lower postoperative SANE and VAS scores are associated with lower RTD rates. Only the more active and elite components of the military study population showed RTD rates consistent with previously reported outcomes of return to competitive sports after hip arthroscopy for FAI.


2015 ◽  
Vol 114 (12) ◽  
pp. 1170-1180 ◽  
Author(s):  
Ai-Wen Hwang ◽  
Chia-Feng Yen ◽  
Tsan-Hon Liou ◽  
Gary Bedell ◽  
Mats Granlund ◽  
...  

2021 ◽  
Vol 186 (Supplement_1) ◽  
pp. 190-197
Author(s):  
Tim Hoyt ◽  
Brianna E Staley Shumaker

ABSTRACT Introduction The utilization of intensive outpatient programs for the treatment of military-related post-traumatic stress disorder (PTSD) has increased through initiatives both inside and outside the military health care system. However, research in veteran populations suggest that patients concurrently undergoing disability evaluation may not respond well to such interventions. This study evaluates the relationship between disability separation and endorsement of PTSD symptoms during treatment at an intensive outpatient program. Methods Patients in this retrospective study were 81 service members enrolled in a half-day, 6-week intensive outpatient program for PTSD. Sixty-seven percent (n = 54) were concurrently enrolled in the integrated disability evaluation system and were pending medical separation. Fifty-two percent (n = 42) also received a 4-week skills training intervention before beginning PTSD treatment. Patients completed the PTSD Checklist before, during, and after the treatment program as an index of PTSD symptoms. Results A significant interaction effect was observed in which PTSD symptoms throughout program enrollment differed as a function of enrollment in the integrated disability evaluation system. Patients undergoing disability evaluations did not show significant changes in endorsed PTSD symptoms during program enrollment, whereas significant decreases in PTSD symptoms were observed in patients not undergoing disability evaluations. These effects controlled for lost treatment days as a result of training or other appointments. Conclusions These results provide preliminary data indicating that participation in disability separation may attenuate the effect of PTSD treatment and endorsement of PTSD symptoms in an intensive outpatient setting.


2019 ◽  
Vol 65 (3) ◽  
Author(s):  
Iwona Radlińska ◽  
Beata Karakiewicz ◽  
Marcin Kolwitz ◽  
Ewa Kemicer-Chmielewska ◽  
Kinga Flaga-Gieruszyńska1

Introduction: The aim of this work was to assess the situationof people with moderate intellectual disability (MID), considering the legal, political, economic, social and technological determinants (PEST factors).Materials and methods: This work consisted of an in-depth legal analysis based on the Community Action Board (CAB) model, which is a part of the Rapid Policy Assessment and Response (RPAR) methodology. Having analyzed the PEST factors, as part of the analysis of strengths, weaknesses, opportunities and threats (SWOT), the CAB identified the strengths and weaknesses of the situations of persons with MID.Results: The following deficiencies were identified in the provisioning of legal and political assistance to persons with MID: disability definitions were incompatible with international law, lack of legal provisions comprehensively regulating the situation of persons with intellectual disability (ID), two-instance disability evaluation system, lack of sufficient coordination of state bodies, lack of supervision over decisions on the need for special education, poor employment opportunities after completing education. Optimal conditions for education in a special school have a positive impact on the situation of persons with MID, but their lack in a public school setting proves to have adverse effects. The most important forms of support include: places of daily stay, sheltered employment, supported employment on the open labor market, protected flats, support from an assistant.Conclusions: 1. The deficiencies in legal and political regulations in Poland make it difficult or impossible for persons with MID to receive adequate assistance. 2. Investing in special schools and ensuring their formal cooperation with public schools offers adequate education to persons with MID. 3. Poor access to special forms of support for people with MID causes their social exclusion.


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