Study of attrition documentation at the U.S. Navy recruit training command

This thesis examines the administrative separation process and attrition documentation as well as the characteristics of recruits who attrite from the U.S. Navy's Recruit Training Command (RTC). A random sample of 754 "retained files" from Customer Service Desk RTC was examined for attrition documentation and the information obtained was compared with attrition documentation contained in the Corporate Enterprise Training Activity Resource System (CETARS). The comparison is used to determine the accuracy of CETARS in documenting the reasons for medical and psychiatric attrition and its relationship to Separation Program Codes (SPD) listed on the DD 214 discharge form. The results indicate that CETARS is 95.2 percent accurate in documenting medical reasons for attrition and 94.2 percent accurate for psychiatric reasons. It was unclear whether a relationship existed between SPD codes and CETARS in documenting attrition. The specific reasons for psychiatric attrition include the following: Personality Disorder, Adjustment Disorder, Borderline Personality Disorder, and Attention Deficit Hyperactivity Disorder. In addition to the analysis of attrition documentation, we analyzed data on 216,028 recruits entering RTC between fiscal year 2000 and 2004 to determine the predictors of non-psychiatric attrites versus psychiatric attrites. Logit regression found that the predictors of both types of attrition were similar.http://archive.org/details/studyofttritiond109452362Approved for public release; distribution is unlimited

Digestive Manifestations in Patients Hospitalized With Coronavirus Disease 2019

This article is made available for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.BACKGROUND & AIMS: The prevalence and significance of digestive manifestations in coronavirus disease 2019 (COVID-19) remain uncertain. We aimed to assess the prevalence, spectrum, severity, and significance of digestive manifestations in patients hospitalized with COVID-19. METHODS: Consecutive patients hospitalized with COVID-19 were identified across a geographically diverse alliance of medical centers in North America. Data pertaining to baseline characteristics, symptomatology, laboratory assessment, imaging, and endoscopic findings from the time of symptom onset until discharge or death were abstracted manually from electronic health records to characterize the prevalence, spectrum, and severity of digestive manifestations. Regression analyses were performed to evaluate the association between digestive manifestations and severe outcomes related to COVID-19. RESULTS: A total of 1992 patients across 36 centers met eligibility criteria and were included. Overall, 53% of patients experienced at least 1 gastrointestinal symptom at any time during their illness, most commonly diarrhea (34%), nausea (27%), vomiting (16%), and abdominal pain (11%). In 74% of cases, gastrointestinal symptoms were judged to be mild. In total, 35% of patients developed an abnormal alanine aminotransferase or total bilirubin level; these were increased to less than 5 times the upper limit of normal in 77% of cases. After adjusting for potential confounders, the presence of gastrointestinal symptoms at any time (odds ratio, 0.93; 95% CI, 0.76-1.15) or liver test abnormalities on admission (odds ratio, 1.31; 95% CI, 0.80-2.12) were not associated independently with mechanical ventilation or death. CONCLUSIONS: Among patients hospitalized with COVID-19, gastrointestinal symptoms and liver test abnormalities were common, but the majority were mild and their presence was not associated with a more severe clinical course