Soldier’s beliefs in abstinence before and after the implementation of a novel army nicotine-free policy

United States Army soldiers have used tobacco for decades1 despite known health risks associated with these products.2 Material connections between the tobacco industry and the military during the early part of the 20th century, coupled with pervasive advertising images of soldiers using tobacco during combat, served to promote tobacco use among young recruits entering training.3 A variety of policieshave been instituted during the training period, to varied and sometimes suboptimal effect.4 Currently, tobacco (defined as any non-therapeutic nicotine product) is banned during basic combat training (BCT), the first phase of training in a soldier’s career, which lasts 10 weeks. It is allowed in the longer subsequent advanced individual training (AIT), during which soldiers learn their military occupationspecialty. Trainee soldiers in an AIT aviation battalion on Fort Eustis in Virginia previously reported a reduction in overall tobacco use following BCT,5 prompting a decision to institute a proposed nicotine-free policy during AIT, which lasts approximately 3–6 months. This study aimed to determine if the AIT nicotine-free policy implementation process would change the tobacco user’s intentionto remain abstinent following AIT, when tobacco use would not be restricted

Pathogenesis, Clinical Course and Neuro-Radiological Signs of Proprionibacterium Acnes Cerebritis: Case Report and Literature Review.

The clinical and neuroimaging characteristics of brain infections related to Propionibacterium acnes are not well-characterized, making early diagnosis and treatment a challenge. More recently, life-threatening central nervous system infections with P. acnes are being reported with increasing frequency as complications of neurointerventional procedures. We present a rare case of P. acnes cerebritis that occurred as a sequela of bare platinum aneurysm coiling and a contaminant of percutaneous angiographic intervention. We include an extensive review of the literature describing the pathogenesis of P. acnes and neuro-radiological signs of brain infections related to this pathogen

Code ICH:A Call to Action

Intracerebral hemorrhage is the most serious type of stroke, leading to high rates of severe disability and mortality. Hematoma expansion is an independent predictor of poor functional outcome and is a compelling target for intervention. For decades, randomized trials aimed at decreasing hematoma expansion through single interventions have failed to meet their primary outcomes of statistically significant improvement in neurological outcomes. A wide range of evidence suggests that ultra-early bundled care, with multiple simultaneous interventions in the acute phase, offers the best hope of limiting hematoma expansion and improving functional recovery. Patients with intracerebral hemorrhage who fail to receive early aggressive care have worse outcomes, suggesting that an important treatment opportunity exists. This consensus statement puts forth a call to action to establish a protocol for Code ICH, similar to current strategies used for the management of acute ischemic stroke, through which early intervention, bundled care, and time-based metrics have substantially improved neurological outcomes. Based on current evidence, we advocate for the widespread adoption of an early bundle of care for patients with intracerebral hemorrhage focused on time-based metrics for blood pressure control and emergency reversal of anticoagulation, with the goal of optimizing the benefit of these already widely used interventions. We hope Code ICH will endure as a structural platform for continued innovation, standardization of best practices, and ongoing quality improvement for years to come.</p