RESUMO
There is a growing need for clear and definitive guidelines to prevent firearm violence in communities across the United States. Recommendations explore the utility and feasibility of universal screenings and recommend utilizing universal screening due to a lack of a clear risk to it. Providers should also work to create risk reduction plans with patients as well. Furthermore, recommendations for mental health care, counseling, and bystander training are made for institutions and their providers.
RESUMO
As the United States military engage with different countries and cultures throughout the world, personnel become exposed to new biospheres as well. There are many infectious pathogens that are not endemic to the US, but two of particular importance are Plasmodium and Leishmania, which respectively cause malaria and leishmaniasis. These parasites are both known to cause significant disease burden in their endemic locales, and thus pose a threat to military travelers. This review introduces readers to basic life cycle and disease mechanisms for each. Local and military epidemiology are described, as are the specific actions taken by the US military for prevention and treatment purposes. Complications of such measures with regard to human health are also discussed, including possible chemical toxicities. Additionally, poor recognition of these diseases upon an individual's return leading to complications and treatment delays in the United States are examined. Information about canine leishmaniasis, poorly studied relative to its human manifestation, but of importance due to the utilization of dogs in military endeavors is presented. Future implications for the American healthcare system regarding malaria and leishmaniasis are also presented.