Military medicine
-
Skin cancer rates have been steadily increasing among the American public for decades, but multiple studies have demonstrated that the U. S. military suffers from higher rates of skin cancer than the general public. As with so many aspects of health, simple preventive measures made early on can dramatically improve long-term health outcomes. ⋯ Options to do so include issuing soldiers small portable packets or bottles of sunscreen to carry on their person, incorporating small packets of sunscreen in MREs, and issuing sunscreen to commands to distribute before field exercises. Unit and medical leadership should encourage the use of sunscreen and sun-protective strategies when possible; leadership engagement is critical to overcoming current behavioral barriers to change. Finally, we recommend that units attempt to reduce sun exposure during training by encouraging soldiers to seek shade and avoiding outdoor training in the middle of the day.
-
Anterior cruciate ligament (ACL) rupture in military personnel and civilians can be a devastating injury. A service member is 10 times more likely to suffer an ACL injury than their civilian counterparts, and despite successful surgical stabilization, 4%-35% will develop arthrofibrosis, over 50% will not return to full active duty, and up to 50% will develop post-traumatic osteoarthritis (PTOA) within 15 years. Equally concerning, woman are 2 to 8 times more likely to experience ACL injuries than men, which represents a major knowledge gap. ⋯ ACL injuries continue to be a major concern among military personnel and civilians and represent a significant loss in command readiness and quality of life. The lack of predictability in outcomes after ACL repair or reconstruction underscores the need for new joint protection therapies. The male-female disparity requires urgent investigation.
-
The Office of Naval Research sponsored the Blast Load Assessment Sense and Test (BLAST) program to develop a rapid, in-field solution that could be used by team leaders, commanders, and medical personnel to provide a standardized approach to operationally relevant monitoring and analysis of service members exposed to single or repeated low-level blast. A critical piece of the BLAST team's solution was the development of the Brain Gauge technology which includes a cognitive assessment device that measures neurofunctional changes by testing sensory perceptions and a suite of mathematical algorithms that analyze the results of the test. The most recent versions of the technology are easily portable; the device is in the size and shape of a computer mouse. Tests can be administered in a matter of minutes and do not require oversight by a clinician, making Brain Gauge an excellent choice for field use. This paper describes the theoretical underpinnings and performance of a fieldable Brain Gauge technology for use with military populations. ⋯ The overall objective of the work was to provide an efficient tool, or tools, that can be effectively used for (1) determining stand-down criteria when critical levels of blast exposure have been reached and (2) tracking the brain health history until return-to-duty status is achieved. Neurofunctional outcome measures will provide the scientific link between blast sensors and the impact of blast on biological health. This calibration process is strengthened with outcome measures that have a biological basis that are paralleled in animal models. The integrative approach that utilizes the Brain Gauge technology will provide a significant advance for assessing the impact of blast exposure and support rapid, science-based decision-making that will ensure mission success and promote the protection of brain health in service members.
-
The lack of an integrated approach to data capture, information management, and analysis limits the contribution of occupational and environmental medicine to protecting 2.3 million uniformed and civilian DoD workers. Despite an abundance of military information systems that include the terms "Safety" and "Occupational Health" in their names, none of these systems provide capabilities needed to aggregate and analyze the results of occupational medicine exams, use medical surveillance to mitigate exposure incidents, provide enterprise-level management of occupational medicine services, or comply with privacy and recordkeeping law and regulation. ⋯ Bridging these capability gaps will improve the occupational health care of the DoD workforce, improve the quality of occupational medicine services, increase public trust in the DoD management of exposure incidents, and potentially generate hundreds of millions of dollars through cost-avoidance on workers' compensation claims and through identification and elimination of non-value-added medical certification exams. The ongoing Military Health System transformation represents a unique opportunity to bridge these long-recognized but persistent capability gaps.
-
Decreases in routine healthcare practices have been shown to occur during disasters. However, research regarding the impacts of natural disasters, pandemics, or military conflicts on emergency medical services (EMS) is scarce. ⋯ This study shows decreasing trends in routine daily calls for EMS during both Operation Protective Edge and COVID-19. However, different patterns of needs for EMS were evidenced for medical illnesses, MVC, or calls concerning other injuries. These results are instrumental for managing the operational demands of EMS during military conflicts and pandemics.