Military medicine
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Musculoskeletal injuries (MSKI) are the most common clinical condition in the military that affect medical readiness. Evaluation of MSKI burden and the effects of these injuries on readiness in large deck Navy ships is warranted. ⋯ The findings in the current study demonstrate the substantial burden of MSKI aboard large deck ships, both in homeport and while deployed. Inclusion of a physical therapist aboard LHA/LHDs, like the CVN, may help to prevent and mitigate the effects of MSKI through early access to specialized care and integral injury prevention and performance optimization methods.
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Lyme disease (LD) is an underrated threat to the military that negatively impacts mission readiness. Lyme disease has traditionally been thought to only be a risk in an operational context, where training or deployments are frequently conducted in heavily wooded environments. However, this view diminishes risks posed by many off-duty outdoor recreational activities. Furthermore, although the Army introduced a permethrin factory-treated Army Combat Uniform in 2012, permethrin retention and subsequent protection have been shown to decrease significantly after 3 months of wear. Thus, although LD is a known health risk that threatens unit readiness, beyond using treated uniforms there has been little progress at the unit level to address this threat. ⋯ Lyme disease poses a genuine threat to the health and careers of service members and is an often-overlooked disruptor to military operations. Simple, feasible prevention strategies that are tailored to high-risk geographic regions can be emphasized by military units to reduce the incidence of on-duty and off-duty cases. Additionally, there remains a critical need for new preventative and diagnostic measures for LD.
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Casualty evacuation has been identified as a typical and essential single military task which every soldier should be able to perform rapidly during combat. Previous studies suggest that casualty evacuation is typically conducted by dragging and demands e.g., lean body mass and anaerobic performance. Association of physical fitness with casualty evacuation by dragging has been studied widely but previous studies lack comprehensive assessment of all physical fitness determinants. The purpose of the present study was to examine comprehensively how casualty emergency evacuation (CEE) performance associates with physical fitness and body composition. ⋯ This study examined thoroughly how different physical fitness dimensions and body composition relate to a CEE test performed by a combination of dragging while crawling and in upright position. Casualty emergency evacuation was discovered as a high-intensity military task, which demands most importantly high anaerobic performance, lean body mass, and maximal strength capabilities. Improving these dimensions of physical fitness should be considered highly important as CEE is essential and possibly one of the most demanding military tasks which every soldier should be able to conduct in combat. From operational perspective, it is relevant that soldiers are able to perform CEE during operations; therefore, further research is needed on how acute operational stress changes the nature of CEE and its physical determinants.
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Military aviators may have increased risk of cervical spine injuries because of exposure to supraphysiologic forces and vibration during dynamic flight. Aviator medical attrition impairs mission readiness, decreases operational capabilities, increases overall DoDcosts, and decreases retention of seasoned aviators. This study evaluated incidence and risk factors for cervical spine conditions in U.S. military aviators from 1997 to 2015. ⋯ Military aviators had a statistically significant increase in risk of neck pain and medically disqualifying degenerative cervical spine conditions compared to non-aviator controls. Rates of neck pain increased in all aviators over the study epoch. Possible explanations could be related to the operational demands and the increased use of forward helmet-mounted display systems during the study period, a supposition that requires further investigation. There was no significant difference in rates of neck pain or degenerative cervical conditions between aircraft platforms (fighter/bomber, other fixed wing, and rotary wing). Female sex, age over 40 years, and Army/Marine Corps service were the greatest risk factors for neck pain and degenerative cervical spine conditions. Targeted prevention programs and expanded treatment modalities are necessary to reduce aviator attrition and Department of Defense cost burden.
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The Defense Health Agency aims to ensure that military surgical residents have the expeditionary general surgical skills necessary to deploy to a combat environment and maintains the Clinical Investigation Programs (CIPs) that foster research during graduate medical education. This project evaluates the potential to achieve both aims simultaneously through a large animal Combat Casualty Care Research Program (CCCRP). ⋯ This large animal CCCRP represents a unique training model that not only achieves its primary goal of fostering graduate medical education research but also bolsters Emergency General Surgery readiness for military surgical residents.