Quantitative Procedure for Position Identity Definition.

DTIC Science & Technology

1979-12-01

integrated into an effi- cient and cohesive team, are necessary for the sucessful performance of the mission of the 2-17 Department of the Army. Military...Headquarters (Ft Monroe) ROTC Group (TRADOC-Ft Knox) Large Post Headquarters (Ft Bragg) Recruiting Support Center (Cameron Service School (Engineer) Station...College (Ft Belvoir) (Ft Belvoir) Defense Mapping School (Ft Belvoir) The apparent distinction in Army directives between combat, combat support, and

Abstracts of Master of Military Art and Science (MMAS) Theses and Special Studies 1964-1976

DTIC Science & Technology

1976-01-01

Missions. They are listed below in a probable chronological order of appli- cation. 1. Undertake self-preparation to become familiar with the concept of...analyst. Familiarity with these tools has the tendency to reduce the reluc- tance sometimes evidenced by the military decision-maker to include such...the fundamentals of combat service support, initiating a branch immaterial logistics familiarization course, teaching a Senior Officer Combat Service

The Armys Armored Multi Purpose Vehicle (AMPV): Background and Issues for Congress

DTIC Science & Technology

2017-01-11

M-113 personnel carriers, which are still in service in a variety of support capacities in Armored Brigade Combat Teams (ABCTs). While M-113s no...reliability, and interoperability by mission role variant within the Heavy Brigade Combat Team (HBCT) [now known as the Armored Brigade Combat Team – ABCT... teams within complex operational environments. For example, “commanders will not allow them to leave Forward Operating Bases (FOBs) or enter

Predeployment training for forward medicalisation in a combat zone: the specific policy of the French Military Health Service.

PubMed

Pasquier, Pierre; Dubost, Clément; Boutonnet, Mathieu; Chrisment, Anne; Villevieille, Thierry; Batjom, Emmanuel; Bordier, Emmanuel; Ausset, Sylvain; Puidupin, Marc; Martinez, Jean-Yves; Bay, Christian; Escarment, Jacques; Pons, François; Lenoir, Bernard; Mérat, Stéphane

2014-09-01

To improve the mortality rate on the battlefield, and especially the potentially survivable pre-Medical Treatment Facility deaths, Tactical Combat Casualty Care (TCCC) is now considered as a reference for management of combat casualty from the point of injury to the first medical treatment facility. TCCC comprises of a set of trauma management guidelines designed for use on the battlefield. The French Military Health Service also standardised a dedicated training programme, entitled "Sauvetage au Combat" (SC) ("forward combat casualty care"), with the characteristic of forward medicalisation on the battlefield, the medical team being projected as close as possible to the casualty at the point of injury. The aim of our article is to describe the process and the result of the SC training. Records from the French Military Health Service Academy - École du Val-de-Grâce administration, head of the SC teaching programme, defining its guidelines, and supporting its structure and its execution, were examined and analyzed, since the standardisation of the SC training programme in 2008. The total number of trainees was listed following the different courses (SC1, SC2, SC3). At the end of 2013, every deployed combatant underwent SC1 courses (confidential data), 785 health-qualified combatants were graduated for SC2 courses and 672 Role 1 physician-nurse pairs for SC3 courses. The SC concept and programmes were defined in France in 2007 and are now completely integrated into the predeployment training of all combatants but also of French Military Health Service providers. Finally, SC teaching programmes enhance the importance of teamwork in forward combat medicalisation settings. Copyright © 2014 Elsevier Ltd. All rights reserved.

US Army Armor Reference Data in Three Volumes. Volume I. The Army Division.

DTIC Science & Technology

1981-01-01

dental treatment ASSIGNMENT Organic Armored Division, TOE 17 (d) Optometrc services CAPABILITIES a Provides the following combat service support to a...Support Command. Infantry Division (Mechaniied TOE 29-ft 1 Provides expedient dental treatment CAPABILITIES a Provides medical staff services, including g...administration, and supervision of and f Provides expedient dental treatment plan, mrt division level ol4 uii novel medicaf support rendered by

Partners’ Attributions for Service Members’ Symptoms of Combat-Related Posttraumatic Stress Disorder

PubMed Central

Renshaw, Keith D.; Allen, Elizabeth S.; Carter, Sarah P.; Markman, Howard J.; Stanley, Scott M.

2014-01-01

The association of service members’ combat-related PTSD with partners’ distress is weaker when spouses/partners believe that service members experienced more traumatic events during deployment. Also, when simultaneously examining partners’ perceptions of all PTSD symptoms, perceptions of re-experiencing symptoms (the symptoms most obviously connected to traumatic events) are significantly, negatively related to distress in partners. These findings are consistent with the notion that partners may be less distressed if they make external, rather than internal, attributions for service members’ symptoms. The present study explicitly tests this possibility. Civilian wives of active duty service members completed measures regarding their own marital satisfaction, their perceptions of service members’ combat exposure during deployments, their perceptions of service members’ symptoms of PTSD, and their attributions for those symptoms. External attributions were significantly, positively associated with perceptions of combat exposure (rp = .31) and re-experiencing symptoms (β = .33) and significantly, negatively associated with perceptions of numbing/withdrawal symptoms (rp = −.22). In contrast, internal attributions were significantly, negatively associated with perceptions of re-experiencing symptoms (β = −.18) and significantly, positively associated with perceptions of numbing/withdrawal symptoms (β = .46). Internal attributions significantly moderated the negative association of PTSD symptoms with marital satisfaction, such that the association strengthened as internal attributions increased. These findings are the first explicit support for an attributional understanding of distress in partners of combat veterans. Interventions that alter partners’ attributions may improve marital functioning. PMID:24491194

Supporting Young Children in Combat-Injured Families: Call to Action

ERIC Educational Resources Information Center

Arata-Maiers, Teresa L.; Stafford, Elisabeth M.

2010-01-01

Military families are currently facing the longest period of combat in the history of the nation, along with the attendant challenges of prolonged or repeated deployment. With the return of 36,000-plus service members wounded in action, including nearly 11,000 requiring medical evacuation and those with additional "invisible injuries," there are…

Gender Issues. Trends in the Occupational Distribution of Military Women. Report to the Ranking Minority Member, Subcommittee on Readiness and Management Support, Committee on Armed Services, U.S. Senate.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC. National Security and International Affairs Div.

Since 1993 and 1994, significant changes in legislation and policy allow women to fly combat aircraft, serve on combat ships, and serve in combat-related occupations. As was the case in the early 1990s, a large percentage of military women continue to work in the areas of health care, administration, personnel, and supply occupations. However,…

Exploring the Reduction of Fuel Consumption for Ship-to-Shore Connectors of the Marine Expeditionary Brigade

DTIC Science & Technology

2013-12-01

include the Command Element (CE), the Aviation Combat Element (ACE), the Ground Combat Element ( GCE ), and the Combat Service Support Element (CSSE) (from...35 Figure 9. The upper level functional architecture for EW12 shows the three primary functions of F1-Assemble the Seabase, F2...Function F2-Perform Assault is decomposed to obtain the lower level specific functions. From this decomposition, the sub-function of F2.2- Gain Entry

The US framework for understanding, preventing, and caring for the mental health needs of service members who served in combat in Afghanistan and Iraq: a brief review of the issues and the research

PubMed Central

Castro, Carl Andrew

2014-01-01

This paper reviews the psychological health research conducted in the United States in support of combat veterans from Iraq and Afghanistan, using the Military Psychological Health Research Continuum, which includes foundational science, epidemiology, etiology, prevention and screening, treatment, follow-up care, and services research. The review is limited to those studies involving combat veterans and military families. This review discusses perplexing issues regarding the impact of combat on the mental health of service members such as risk and resilience factors of mental health, biomarkers of posttraumatic stress syndrome (PTSD), mental health training, psychological screening, psychological debriefing, third location decompression, combat and suicide, the usefulness of psychotherapy and drug therapy for treating PTSD, role of advanced technology, telemedicine and virtual reality, methods to reduce stigma and barriers to care, and best approaches to the dissemination of evidence-based interventions. The mental health research of special populations such as women, National Guardsmen and reservists, and military families is also presented. The review concludes by identifying future areas of research. PMID:25206943

Utilizing Telehealth to Support Treatment of Acute Stress Disorder in a Theater of War: Prolonged Exposure via Clinical Videoconferencing.

PubMed

Pelton, Dan; Wangelin, Bethany; Tuerk, Peter

2015-05-01

Posttraumatic stress disorder (PTSD) and acute stress disorder are prevalent mental health diagnoses associated with the military operations in Iraq and Afghanistan and are especially significant in service members returning from combat. Prolonged exposure (PE) therapy is a highly effective behavioral treatment for these symptoms, and providing this treatment as soon as possible, even in the midst of a soldier's combat deployment, has strong potential benefits. In the current case study, telehealth technology was used to support the delivery of PE therapy to treat a service member diagnosed with acute stress disorder in a war zone. PE was conducted face-to-face on the relatively secure Forward Operating Base for the first half of therapy and via clinical videoconferencing (CV) to the service member's remote combat outpost during the later stages of therapy. The service member exhibited marked improvements in symptoms over 10 sessions. Results are consistent with previous empirical findings and highlight the potential benefits of using telehealth to deliver evidenced-based treatment for traumatic stress disorders in a war zone. This case study provides a preliminary working model for delivering PE in a combat environment using multiple delivery systems. Benefits and clinical utility of CV-delivered exposure therapy are discussed, particularly for providers pending future operational deployments (e.g., including members of the military, independent government agencies, and first responders) and for those treating patients in remote locations.

Combat Service Support Model Development: BRASS - TRANSLOG - Army 21

DTIC Science & Technology

1984-07-01

throughout’the system. Transitional problems may address specific hardware and related software , such as the Standard Army Ammunition System ( SAAS ...FILE. 00 Cabat Service Support Model Development .,PASS TRANSLOG -- ARMY 21 0 Contract Number DAAK11-84-D-0004 Task Order #1 DRAFT REPOkT July 1984 D...Armament Systems, Inc. 211 West Bel Air Avenue P.O. Box 158 Aberdeen, MD 21001 8 8 8 2 1 S CORMIT SERVICE SUPPORT MODEL DEVELOPMENT BRASS -- TRANSLOG

78 FR 54242 - 36(b)(1) Arms Sales Notification

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-03

... elements of logistical and program support. The estimated cost is $1.2 billion. This proposed sale will... support services, and other related elements of logistical and program support. (iv) Military Department... logistical support to sustain the combat and operational readiness of its existing aircraft fleet. The...

Back to the Future: Does History Support the Expeditionary Air Force Concept?

DTIC Science & Technology

2000-04-01

Operations Forces 550, “Agile Combat Support,” Mr. Ron Orr, USAF/IL, 2 Feb 00. 4 Davis, pg. 11. 5 Toulmin , H.A., Jr., Air Service, American...John A., “The Expeditionary Air Force Takes Shape,” Air Force Magazine, Vol. 80, No. 6, June 1997. Toulmin , H.A., Jr., Air Service, American

Air Force Handbook. 109th Congress

DTIC Science & Technology

2009-01-01

FY06 Combat Survivor Evader Locator (CSEL) Acquisition Status Capabilities/Profile Functions /Performance Parameters 38 • Air Force’s primary source for...Broadcast Service (GBS) Capabilities/Profile Acquisition Status Functions /Performance Parameters • Purchase Requirements (Phase 2): • 3 primary ...Operations (AF CONOPS) that support the CSAF and joint vision of combat operations. • AF CONOPS describe key Air Force mission and/or functional areas

Perceived demands during modern military operations.

PubMed

Boermans, Sylvie M; Kamphuis, Wim; Kamhuis, Wim; Delahaij, Roos; Korteling, J E Hans; Euwema, Martin C

2013-07-01

Using a cross-sectional design, this study explored operational demands during the International Security Assistance Force for Afghanistan (2009-2010) across distinct military units. A total of 1,413 Dutch soldiers, nested within four types of units (i.e., combat, combat support, service support, and command support units) filled out a 23-item self-survey in which they were asked to evaluate the extent to which they experienced operational characteristics as demanding. Exploratory factor analysis identified six underlying dimensions of demands. Multivariate analysis of variance revealed that distinct units are characterized by their own unique constellation of perceived demands, even after controlling for previous deployment experience. Most notable findings were found when comparing combat units to other types of units. These insights can be used to better prepare different types of military units for deployment, and support them in the specific demands they face during deployment. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

Navy Expeditionary Support

DTIC Science & Technology

2010-04-27

Officer, Explosive Ordnance Disposal Mobil Unit TWO, conversation with author, March 2010. 12 Marc Carmichael , Lieutenant Commander, U.S. Navy, Deputy...Combat Service Support Reorganization Conference, 17-27 Jan 1977. Washington, D. C.: Headquarters U.S. Marine Corps, January 17, 1977. "Armed

Logistics Force Planner Assistant (Log Planner)

DTIC Science & Technology

1989-09-01

elements. The system is implemented on a MS-DOS based microcomputer, using the "Knowledge Pro’ software tool., 20 DISTRIBUTION/AVAILABILITY OF... service support structure. 3. A microcomputer-based knowledge system was developed and successfully demonstrated. Four modules of information are...combat service support (CSS) units planning process to Army Staff logistics planners. Personnel newly assigned to logistics planning need an

Test Area B-75 Final Range Environmental Assessment (REA), Revision 1

DTIC Science & Technology

2010-08-01

Committee on Hearing, Bioacoustics, and Biomechanics CO Carbon Monoxide CS/CSS Combat Support/Combat Service Support CWA Clean Water Act CZMA Coastal...Explosives 88 0 0 0 MK-82, AFX-644-3 HE FILL 12 0 0 0 Lasers LASER GUIDED TRAINING RD 0 4 0 16 LASER OPS, 1 HR 0 14 0 56 Mines MINE AT HEAVY M15 0 462 0...Primary) 40,000 µg/m³ = Micrograms per Cubic Meter; Avg = Average; CO = Carbon Monoxide ; hr = Hour; NOx = Nitrogen Oxides; PM = Particulate

Gender Differences Among Military Combatants: Does Social Support, Ostracism, and Pain Perception Influence Psychological Health?

PubMed

McGraw, Kate

2016-01-01

The literature on gender differences related to psychological health among in-theater service members who are deployed in a combatant role is limited. Much focuses on retrospective reports of service members who have returned from deployment. Potential key factors that contribute to gender differences in psychological health among combatants are found in literature across several topic areas, but integration of findings across disciplines is lacking. A growing body of literature on gender differences related to psychological health of postdeployment military populations suggests males and females respond differently to perceived levels of social support pre-and postdeployment. One study on service members who were deployed suggested no significant gender differences related to reported psychological health symptoms, but did appear to find significant gender differences related to reported perception of unit morale. In another related area, research explores how ostracism impacts physical and psychological health of individuals and organizations, and can result in perceptions of physical pain, although research on gender differences related to the impact of ostracism is scarce. Research has also begun to focus on sex differences in pain responses, and has identified multiple biopsychosocial, genetic, and hormonal factors that may contribute as potential underlying mechanisms. In this brief review, we focus on and begin to integrate relevant findings related to the psychological health of females in combat roles, gender differences in the impact of perception of social support on psychological health, the psychological and physical impact of ostracism on individuals and organizations, and the current literature on sex differences in pain perception. We conclude with a synthesis and discussion of research gaps identified through this review, implications for clinical practice, and potential future research directions. In conclusion, there appear to be gender differences related to the presence or absence of social support, the impact of ostracism, and the perception of pain. These differences may play a critical role in the psychological health of female combatants. More research on this topic is needed. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Customer Service Analysis of Air Combat Command Vehicle Maintenance Support

DTIC Science & Technology

1993-09-01

the survey, the researchers categorized the services or variables into marketing mix components: product, price, promotion, and customer service...comparing and analyzing the variables identified in the previous three phases to determine a strategic marketing mix (46:9). After analyzing the data...service/physical distribution. Additionally, they found that customer service/physical distribution was an integral component of the marketing mix , and

Assessment of the Combat Developer’s Role in Post-Deployment Software Support (PDSS) 30 June 1980 - 28 February 1981. Volume II.

DTIC Science & Technology

1980-09-30

systems is provided by the Intelligence School, Fort Devens , Massachusetts. 3. TRADOC System Manager for specified Corps Tactical EW/Intelligence...UNITED STATES ARMY COMBINED ARMS COMBAT DEVELOPMENT ACTIVITY E, FORT LEAVENWORTH, KANSAS 66027 BOM SERVICES COMPANY LEAVENWORTH, KANSAS 66048 SION...ATZLCA-CI-M, Mr. R. K. Schwabe UNCLASSIFIED Fort eavenorth Kanss 6607I15. DECLASSI FICATION/ DOWNGRADINGFortLeaenwothKanss 6027SCHEDULE 16

Public support for safe consumption sites and syringe services programs to combat the opioid epidemic.

PubMed

McGinty, Emma E; Barry, Colleen L; Stone, Elizabeth M; Niederdeppe, Jeff; Kennedy-Hendricks, Alene; Linden, Sarah; Sherman, Susan G

2018-06-01

We examine Americans' support for two evidence-based harm reduction strategies - safe consumption sites and syringe exchange programs - and their attitudes about individuals who use opioids. We conducted a web-based survey of a nationally representative sample of U.S. adults in July-August 2017 (N = 1004). We measured respondents' support for legalizing safe consumption sites and syringe services programs in their communities and their attitudes toward people who use opioids. We used ordered logistic regression to assess how stigmatizing attitudes toward people who use opioids, political party identification, and demographic characteristics correlated with support for the two harm reduction strategies. Twenty-nine percent of Americans supported legalizing safe consumption sites and 39% supported legalizing syringe services programs. Respondents reported high levels of stigmatizing attitudes toward people who use opioids: 16% of respondents were willing to have a person using opioids marry into their family and 28% were willing to have a person using opioids start working closely with them on a job, and 27% and 10% of respondents rated persons who use opioids as deserving (versus worthless) and strong (versus weak). Stigmatizing attitudes were associated with lower support for legalizing safe consumption sites and syringe services programs. Democrats and Independents were more likely than Republicans to support both strategies. Stigmatizing attitudes toward people who use opioids are a key modifiable barrier to garnering the public support needed to fully implement evidence-based harm reduction strategies to combat the opioid epidemic. Dissemination and evaluation of stigma reduction campaigns are a public health priority. Copyright © 2018 Elsevier Inc. All rights reserved.

76 FR 21802 - Advisory Committee on the Readjustment of Veterans Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-18

... VA mental health program activities with special attention to mental health services for retuning war Veterans and on VA's caregiver programs developed to assure support services for severely wounded combat... evaluate the availability and effectiveness of VA programs to meet these needs. On April 28, the Committee...

Design Study for Project on Standard Operating Procedures for Technical Library Services.

ERIC Educational Resources Information Center

Libbey, Miles A.; And Others

The overall objective of the Technical Information Support Activities (TISA) Project is the production of a "Post Commander's Handbook." The handbook will be instrumental in achieving greater utilization of available technical information resources to assist army scientists and engineers engaged in the support of army combat and other…

Measuring the Effectiveness of a Mathematics Support Service: An Email Survey

ERIC Educational Resources Information Center

Gillard, Jonathan; Robathan, Kirsty; Wilson, Robert

2011-01-01

Over the last decade the "mathematics problem" (students lacking basic mathematical skills on entry into higher education), and proposed solutions of this problem have been widely debated. One method to help combat this issue has been the introduction of mathematics support centres across higher education institutions. This article describes the…

Cultural differences in the impact of social support on psychological and biological stress responses.

PubMed

Taylor, Shelley E; Welch, William T; Kim, Heejung S; Sherman, David K

2007-09-01

Social support is believed to be a universally valuable resource for combating stress, yet Asians and Asian Americans report that social support is not helpful to them, resist seeking it, and are underrepresented among recipients of supportive services. We distinguish between explicit social support (seeking and using advice and emotional solace) and implicit social support (focusing on valued social groups) and show that Asians and Asian Americans are psychologically and biologically benefited more by implicit social support than by explicit social support; the reverse is true for European Americans. Our discussion focuses on cultural differences in the construal of relationships and their implications for social support and delivery of support services.

Combat Service Support (CSS) Enabler Functional Assessment (CEFA)

DTIC Science & Technology

1998-07-01

CDR), Combined Arms Support Command (CASCOM) with a tool to aid decision making related to mitigating E/I peacetime (programmatic) and wartime risks...not be fielded by Fiscal Year (FY) 10. Based on their estimates, any decisions , especially reductions in manpower, which rely on the existence of the E...Support (CSS) enablers/initiatives (E/I), thereby providing the Commander (CDR), Combined Arms Support Command (CASCOM) with a tool to aid decision

Expeditionary Logistics: How the Marine Corps Supports Its Expeditionary Operations

DTIC Science & Technology

2015-06-01

little additional information of value with regard to the U.S. Marine Corps and expeditionary logistics methodology. Since the expeditionary methodology...size and scope, necessitating differing levels of material support. Additionally , the same variables define the level of Combat Service Support that is...lie outside of doctrine and few manuals have been written discussing how the Marine Corps performs expeditionary logistics. Additionally , few sources

Defense Energy Support Center Fact Book, Fiscal Year 2008, Thirty-First Edition

DTIC Science & Technology

2009-01-01

deregulate electricity in Continental United States (CONUS) added still another mission to DESC. As states deregulate , DESC pursues and awards contracts...Panama, Republic of Korea, the Middle East and Germany . His combat service includes Company Commander in the 528th Support Battalion (Airborne) during...4650 DESC Germany ...........................................................011-49-631-3406-4280 DESC Kuwait

Update: Exertional rhabdomyolysis, active component, U.S. Army, Navy, Air Force, and Marine Corps, 2011-2015.

PubMed

Armed Forces Health Surveillance Branch

2016-03-01

Among active component members of the U.S. Army, Navy, Air Force, and Marine Corps in 2015, there were 456 incident episodes of rhabdomyolysis likely due to physical exertion or heat stress ("exertional rhabdomyolysis"). Annual rates of incident diagnoses of exertional rhabdomyolysis increased 17% between 2014 and 2015. In 2015, the highest incidence rates occurred in service members who were male; younger than 20 years of age; black, non-Hispanic; members of the Marine Corps and Army; recruit trainees; and in combat-specific occupations. Most cases of exertional rhabdomyolysis were diagnosed at installations that support basic combat/recruit training or major ground combat units of the Army or Marine Corps. Medical care providers should consider exertional rhabdomyolysis in the differential diagnosis when service members (particularly recruits) present with muscular pain and swelling, limited range of motion, or the excretion of dark urine (e.g., myoglobinuria) after strenuous physical activity, particularly in hot, humid weather.

Preventing Genocide: How the Early Use of Force Might Have Succeeded in Rwanda.

DTIC Science & Technology

1998-04-01

the Commission have been endorsed by all Commissioners. Reports to the Commission are published as a service to scholars, practitioners, and the...its normal complement of combat and service support would provide a foundation for an effective intervention force. For example, the Division Ready...recognize that their services will be in demand. This is not to say that only Western democracies can, should, or will perform the bulk of preventive

How Well do the Military Services Perform Jointly in Combat? DoD’s Joint Test-and-Evaluation Program Provides Few Credible Answers.

DTIC Science & Technology

1984-02-22

of the test conditions were unrealistic. For example, four better-than-average pilots flew all the test missions in mostly excellent weather, in one...that aircraft pilots need to respond to a request for close air support is likely to influence combat effectiveness. Earl- ier joint testing had made...in the JTF reports. For example, the IIR Maverick report contains the conclusion that, in general, the pilots detected targets easily, but the test

[A comparison of self assessment of dental status regarding dental anxiety among combat and non-combat soldiers].

PubMed

Levin, A; Zini, A

2014-01-01

The objective of the study was to evaluate the difference in the level of self dental assessment between different groups of soldiers: 115 combats and 115 non-combats. All the solders in this study where male, Jewish, with a service record of 12-48 months, ages 18-22 and born in Israel. The data was summarized, evaluated and tested by x2 - chi square and logistic regressions analysis. In the following parameters no significant differences were found regarding time past from last visit to the dentist, self assessment of dental condition, self assessment of need of dental treatment and the frequency of tooth brushing and sugar consumption. Significant differences were found in the percentage of smokers (59.1% among non-combat vs. 31.9% among combat), and in the dental anxiety level (55.3% among non-combat vs. 38% among combat). The main difference between these two groups is the nature of the social support and society surrounding them, a society that strengthens them and gives the feeling they can deal with fears and difficulties. An additional study should be done in which the soldiers self assessment should be compared to clinical examination. The importance of this study is that the non-combat group should be defined as a high risk population regarding dental anxiety.

Cybersecurity Activities Support to DoD Information Network Operations

DTIC Science & Technology

2016-03-07

8530.01, March 7, 2016 ENCLOSURE 2 24 c. Provide cybersecurity services to Combatant Commands and other organizations in accordance with support...Department of Defense INSTRUCTION NUMBER 8530.01 March 7, 2016 DoD CIO SUBJECT: Cybersecurity Activities Support to DoD Information...organizational entities within the DoD (referred to collectively in this instruction as the “DoD Components”). DoDI 8530.01, March 7, 2016 2 b

The stratification of military service and combat exposure, 1934–1994*

PubMed Central

MacLean, Alair

2010-01-01

Previous research has suggested that men who were exposed to combat during wartime differed from those who were not. Yet little is known about how selection into combat has changed over time. This paper estimates sequential logistic models using data from the Panel Study of Income Dynamics to examine the stratification of military service and combat exposure in the US during the last six decades of the twentieth century. It tests potentially overlapping hypotheses drawn from two competing theories, class bias and dual selection. It also tests a hypothesis, drawn from the life course perspective, that the processes by which people came to see combat have changed historically. The findings show that human capital, institutional screening, and class bias all determined who saw combat. They also show that, net of historical change in the odds of service and combat, the impact of only one background characteristic, race, changed over time. PMID:21113325

Combat Experience and Mental Health in the Israel National Health Survey.

PubMed

Lubin, Gadi; Barash, Igor; Levinson, Daphna

2016-01-01

To compare the mental health status of those who participated in combat related activities during their service with that of soldiers whose army service did not include combat related activities Method: A representative sample extracted from the National Population Register of non-institutionalized residents aged 21 or older of Israel was used in this crosssectional survey. Data on mental health disorders, sociodemographic background and army service were collected using face-to-face computer-assisted interviews. Combat experience per se was not associated with lifetime diagnosis of PTSD. Former combat soldiers had significantly lower lifetime prevalence and 12 months prevalence of any mood or anxiety disorders including PTSD. This work is in line with previous literature showing that combat exposure, as such, has limited contribution to lifetime PTSD in some groups of veterans. The inverse relationship between combat exposure and PTSD might be explained by the selection of potential combatants among all recruits and by the heightened preparedness to military life stressors.

The CPAT 2.0.2 Domain Model - How CPAT 2.0.2 "Thinks" From an Analyst Perspective.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Waddell, Lucas; Muldoon, Frank; Melander, Darryl J.

To help effectively plan the management and modernization of their large and diverse fleets of vehicles, the Program Executive Office Ground Combat Systems (PEO GCS) and the Program Executive Office Combat Support and Combat Service Support (PEO CS &CSS) commissioned the development of a large - scale portfolio planning optimization tool. This software, the Capability Portfolio Analysis Tool (CPAT), creates a detailed schedule that optimally prioritizes the modernization or replacement of vehicles within the fleet - respecting numerous business rules associated with fleet structure, budgets, industrial base, research and testing, etc., while maximizing overall fleet performance through time. This reportmore » contains a description of the organizational fleet structure and a thorough explanation of the business rules that the CPAT formulation follows involving performance, scheduling, production, and budgets. This report, which is an update to the original CPAT domain model published in 2015 (SAND2015 - 4009), covers important new CPAT features. This page intentionally left blank« less

The Capability Portfolio Analysis Tool (CPAT): A Mixed Integer Linear Programming Formulation for Fleet Modernization Analysis (Version 2.0.2).

DOE Office of Scientific and Technical Information (OSTI.GOV)

Waddell, Lucas; Muldoon, Frank; Henry, Stephen Michael

In order to effectively plan the management and modernization of their large and diverse fleets of vehicles, Program Executive Office Ground Combat Systems (PEO GCS) and Program Executive Office Combat Support and Combat Service Support (PEO CS&CSS) commis- sioned the development of a large-scale portfolio planning optimization tool. This software, the Capability Portfolio Analysis Tool (CPAT), creates a detailed schedule that optimally prioritizes the modernization or replacement of vehicles within the fleet - respecting numerous business rules associated with fleet structure, budgets, industrial base, research and testing, etc., while maximizing overall fleet performance through time. This paper contains a thor-more » ough documentation of the terminology, parameters, variables, and constraints that comprise the fleet management mixed integer linear programming (MILP) mathematical formulation. This paper, which is an update to the original CPAT formulation document published in 2015 (SAND2015-3487), covers the formulation of important new CPAT features.« less

Use of inpatient psychiatric services on a U.S. Army combat support post during Operations Desert Shield and Desert Storm: the stress of non-deployment.

PubMed

Koshes, R J; Rothberg, J M

1994-06-01

We studied the utilization of inpatient psychiatric services during Operations Desert Shield and Desert Storm (the Persian Gulf War of 1990-1991) on a U.S. Army combat support post. Inpatient psychiatric admissions and dispositions for the post's catchment area were tallied before, during, and after Operations Desert Shield and Desert Storm. Subjects included active duty soldiers (deployed soldiers were not studied while they were away from the post), their families, and retirees. Overall, there was no increase in psychiatric hospitalizations for active duty soldiers, their family members, or retirees. However, coincident with the return of soldiers from Operations Desert Shield and Desert Storm, the psychiatric proportion of all hospitalizations increased in the subpopulation of soldiers not deployed who had served less than 1 year. These soldiers in training may be more susceptible to increased stress levels associated with the return of soldiers from war because of their inadequate group bonding.

Women at war: implications for mental health.

PubMed

Dutra, Lissa; Grubbs, Kathleen; Greene, Carolyn; Trego, Lori L; McCartin, Tamarin L; Kloezeman, Karen; Morland, Leslie

2011-01-01

Few studies have investigated the impact of deployment stressors on the mental health outcomes of women deployed to Iraq in support of Operation Iraqi Freedom. This pilot study examined exposure to combat experiences and military sexual harassment in a sample of 54 active duty women and assessed the impact of these stressors on post-deployment posttraumatic stress disorder (PTSD) symptoms and depressive symptoms. Within 3 months of returning from deployment to Iraq, participants completed (a) the Combat Experiences Scale and the Sexual Harassment Scale of the Deployment Risk and Resilience Inventory, (b) the Primary Care PTSD Screen, and (c) an abbreviated version of the Center for Epidemiological Studies-Depression scale. Approximately three quarters of the sample endorsed exposure to combat experiences, and more than half of the sample reported experiencing deployment-related sexual harassment, with nearly half of the sample endorsing both stressors. Approximately one third of the sample endorsed clinical or subclinical levels of PTSD symptoms, with 11% screening positive for PTSD and 9% to 14% of the sample endorsing depressive symptoms. Regression analyses revealed that combat experiences and sexual harassment jointly accounted for significant variance in post-deployment PTSD symptoms, whereas military sexual harassment was identified as the only unique significant predictor of these symptoms. Findings from the present study lend support to research demonstrating that military sexual trauma may be more highly associated with post-deployment PTSD symptoms than combat exposure among female service members and veterans.

26 CFR 301.7508-1 - Time for performing certain acts postponed by reason of service in a combat zone.

Code of Federal Regulations, 2010 CFR

2010-04-01

... postponed by reason of service in a combat zone. (a) General rule. The period of time that may be... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Time for performing certain acts postponed by reason of service in a combat zone. 301.7508-1 Section 301.7508-1 Internal Revenue INTERNAL REVENUE...

Defense Headquarters: Geographic Combatant Commands Rely on Subordinate Commands for Mission Management and Execution

DTIC Science & Technology

2016-06-30

These figures do not include personnel performing contract services. The service component commands , subordinate unified commands , and joint task forces...GAO has previously found that the combatant commands do not have oversight or visibility over authorized manpower or assigned personnel at the...Jack Reed Ranking Member Committee on Armed Services United States Senate Defense Headquarters: Geographic Combatant Commands Rely on Subordinate

Leadership and Management of Medical Treatment Facilities: Case Study of Charleston Naval Hospital, 1988-1993

DTIC Science & Technology

1993-06-01

Additional preparations included conducting nurse training in trauma/combat casualty care , streamlining the patient admissions and tracking procedures...departments (i.e. surgery, ambulatory care , operating rooms, maternity ward, etc.) cooperation between the Director of Nursing and the directors of clinical...provide the 107 At quality care , staff support from nursing , administration, and ancillary services was required. s Director for Surgical Services The

The association of predeployment and deployment-related factors on dimensions of postdeployment wellness in U.S. military service members.

PubMed

Bagnell, Melissa E; LeardMann, Cynthia A; McMaster, Hope S; Boyko, Edward J; Smith, Besa; Granado, Nisara S; Smith, Tyler C

2013-01-01

To assess the effects of predeployment and deployment-related factors on dimensions of wellness following deployment. Prospective longitudinal study. The dependent variable was dimensions of wellness. Independent variables were measured in terms of modifiable, nonmodifiable, and military factors, such as sex, race/ethnicity, service branch, smoking status, and combat experience. A large military cohort participating in the Millennium Cohort Study. Included 10,228 participants who deployed in support of the operations in Iraq and Afghanistan. Dimensions of wellness were measured by using standardized instruments assessing self-reported physical health, mental health, and stress. Covariates were measured by using self-reported and electronic data. Factors of postdeployment wellness were assessed by using ordinal logistic regression. Most participants (78.7%) were categorized as "moderately well" post deployment. Significant modifiable predeployment predictors of postdeployment wellness included normal/underweight body mass index (odds ratio [OR] = 1.72, p < .05). Military factors significantly associated with wellness included not experiencing combat (OR = .56, p < .05), member of Air Force (OR = 2.02, p < .05) or Navy/Coast Guard (OR = 1.47, p < .05), and combat specialist occupation (OR = 1.22, p < .05). Multiple modifiable factors associated with postdeployment wellness were identified, which may help inform medical and military leadership on potential strategies to ensure a well force. Those trained in combat roles were more likely to be well post deployment though this apparent benefit was not conferred onto those reporting combat experiences.

The Army Study Program Fiscal Year 1992 Report

DTIC Science & Technology

1991-11-25

Investigation Command (ATTN: CIRM-M-S) 2 US Army Military District of Washington (ATTN: ANRM-RE) 2 US Army Health Services Command (ATTN: HSCM-R) 2 US Army...0 QA AM40 SURVEILLANCE TASK COST ANALYSIS (TCA) 1 9003 9004 AMC MEA AMQEI01C 0 SUPPLY AND SERVICES TASK COST ANALYSIS (TCA) ( 1 9003 9004 AMC MEA 4...CONFLICT MODEL DEVELOPMENT 1 9110 9210 TRADOC T/OAC ATRCLMOC1 P COMBAT SERVICE SUPPORT FORCE DESIGN ANALYSIS 2 9110 9212 TRADOC T/LEE ATRCLMOC2 P

Rural Women Veterans' Use and Perception of Mental Health Services.

PubMed

Ingelse, Kathy; Messecar, Deborah

2016-04-01

While the total number of veterans in the U.S. is decreasing overall, the number of women veterans is significantly increasing. There are numerous barriers which keep women veterans from accessing mental health care. One barrier which can impact receiving care is living in a rural area. Veterans in rural areas have access to fewer mental health services than do urban residing veterans, and women veterans in general have less access to mental health care than do their male colleagues. Little is known about rural women veterans and their mental health service needs. Women, who have served in the military, have unique problems related to their service compared to their male colleagues including higher rates of post-traumatic stress disorder (PTSD) and military sexual trauma (MST). This qualitative study investigated use of and barriers to receiving mental health care for rural women veterans. In-depth interviews were conducted with ten women veterans who have reported experiencing problems with either MST, PTSD, or combat trauma. All ten women had utilized mental health services during active-duty military service, and post service, in Veterans Administration (VA) community based-outpatient clinics. Several recurring themes in the women's experience were identified. For all of the women interviewed, a sentinel precipitating event led to seeking mental health services. These precipitating events included episodes of chronic sexual harassment and ridicule, traumatic sexual assaults, and difficult combat experiences. Efforts to report mistreatment were unsuccessful or met with punishment. All the women interviewed reported that they would not have sought services without the help of a supportive peer who encouraged seeking care. Barriers to seeking care included feeling like they were not really a combat veteran (in spite of serving in a combat unit in Iraq); feeling stigmatized by providers and other military personnel, being treated as crazy; and a lack of interest from those providing care in hearing their stories. This study may generate positive social change by helping providers approach women veterans in a way that is sympathetic to their experiences. Copyright © 2015 Elsevier Inc. All rights reserved.

Moving from Survival to Fulfillment: A Planning Framework for Community Schools

ERIC Educational Resources Information Center

Shaia, Wendy E.; Finigan-Carr, Nadine

2018-01-01

Community schooling is an effective tool for combating the effects of poverty by integrating academic, social service, health, and economic supports for students, families, and community members. But this is complex work, requiring extraordinarily careful planning and assessment. This article suggests a planning framework that can help community…

A systems approach to restoring degraded drylands

Treesearch

Jeremy J. James; Roger L. Sheley; Todd Erickson; Kimberly S. Rollins; Michael H. Taylor; Kingsley W. Dixon

2013-01-01

Drylands support over 2 billion people and are major providers of critical ecosystem goods and services across the globe. Drylands, however, are one of the most susceptible biomes to degradation. International programmes widely recognize dryland restoration as key to combating global dryland degradation and ensuring future global sustainability. While the need to...

Enhancement of the Acquisition Process for a Combat System-A Case Study to Model the Workflow Processes for an Air Defense System Acquisition

DTIC Science & Technology

2009-12-01

Business Process Modeling BPMN Business Process Modeling Notation SoA Service-oriented Architecture UML Unified Modeling Language CSP...system developers. Supporting technologies include Business Process Modeling Notation ( BPMN ), Unified Modeling Language (UML), model-driven architecture

The South Eastern Europe Brigade: An Option for NATO-Led Peace Support Operations?

DTIC Science & Technology

2011-06-10

Exercise CSSB Combat Service Support Battalion DOS Day of Supply DRO Disaster Relief Operations EOD Explosive Ordnance Disposal ETF Engineer Task...the adoption of the second Additional Protocol, the SEEBRIG member nations established an Engineer Task Force ( ETF ). The concept embeds purpose...capabilities, like the ETF structure, could be used as niche military capabilities by outside organizations that may need them. SEEBRIG engineer capabilities

The Special Forces Organization for Foreign Internal Defense in 2010.

DTIC Science & Technology

1997-06-07

synchronization of all elements of national power and interagency efforts. 7 This publication also describes three " tools " in executing the FID program...logistical, intelligence, or other combat support and service support means. This third tool also reiterates that U.S. forces may be required to engage hostile...ventilated ideas in his patient, sometimes didactic style and Magsaysay listened reverently. A Filipino nationalist once charged Lansdale with keeping

Combat experiences, pre-deployment training, and outcome of exposure therapy for post-traumatic stress disorder in Operation Enduring Freedom/Operation Iraqi Freedom veterans.

PubMed

Price, Matthew; Gros, Daniel F; Strachan, Martha; Ruggiero, Kenneth J; Acierno, Ron

2013-01-01

The association between exposure to multiple potentially traumatic events (PTEs) and subsequent increased risk of post-traumatic stress disorder (PTSD) is well established. However, less is known about the relation between exposure to numerous PTEs, as is typical with military service, and treatment outcome. Furthermore, there has been little research examining military specific protective factors, such as pre-deployment preparedness, on PTSD treatment response. The current study investigated combat exposure and potential moderators of treatment outcome for exposure therapy in Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans with PTSD. One hundred and eleven OEF/OIF veterans diagnosed with PTSD participated in 8 weeks of exposure therapy. Results indicated that increased combat exposure was associated with a reduced rate of change in PTSD symptoms but not depression symptoms. These findings were consistent across two measures of combat exposure. There was preliminary support for the moderating effect of pre-deployment preparedness on the association between combat exposure and treatment response. Together, these findings suggest that increased combat exposure is associated with poor treatment response in veterans with PTSD; however, this can be reduced by elevated pre-deployment preparedness. Copyright © 2012 John Wiley & Sons, Ltd.

A Decade of War: Prospective Trajectories of Posttraumatic Stress Disorder Symptoms Among Deployed US Military Personnel and the Influence of Combat Exposure.

PubMed

Donoho, Carrie J; Bonanno, George A; Porter, Ben; Kearney, Lauren; Powell, Teresa M

2017-12-15

Posttraumatic stress disorder (PTSD) is a common psychiatric disorder among service members and veterans. The clinical course of PTSD varies between individuals, and patterns of symptom development have yet to be clearly delineated. Previous studies have been limited by convenience sampling, short follow-up periods, and the inability to account for combat-related trauma. To determine the trajectories of PTSD symptoms among deployed military personnel with and without combat exposure, we used data from a population-based representative sample of 8,178 US service members who participated in the Millennium Cohort Study from 2001 to 2011. Using latent growth mixture modeling, trajectories of PTSD symptoms were determined in the total sample, as well as in individuals with and without combat exposure, respectively. Overall, 4 trajectories of PTSD were characterized: resilient, pre-existing, new-onset, and moderate stable. Across all trajectories, combat-deployed service members diverged from non-combat-deployed service members, even after a single deployment. The former also generally had higher PTSD symptoms. Based on the models, nearly 90% of those without combat exposure remained resilient over the 10-year period, compared with 80% of those with combat exposure. Findings demonstrate that although the clinical course of PTSD symptoms shows heterogeneous patterns of development, combat exposure is uniformly associated with poor mental health. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Gap analysis: transition of health care from Department of Defense to Department of Veterans Affairs.

PubMed

Randall, Marjorie J

2012-01-01

This study examined the effectiveness of Public Law 110-181, "National Defense Authorization Act of Fiscal Year 2008, Title XVI-Wounded Warriors Matter," as it relates to health care for returning Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) combat veterans. Specifically, it examined the gap between the time an OEF/OIF combat service member left active service and subsequently obtained health care within the Veteran Affairs (VA) Healthcare System, and which factors influenced or impeded the veteran from obtaining health care sooner. Data were collected from 376 OEF/OIF combat veterans who sought health care at the Nashville or Murfreesboro VA Medical Centers. A questionnaire was designed exclusively for this study. The average time gap for an OEF/OIF combat veteran to transition from Department of Defense to VA health care was 3.83 months (SD 7.17). Twenty-six percent of respondents reported there were factors that impeded them from coming to the VA sooner. Factors included lack of knowledge about VA benefits, transportation/distance, perceptions of losing military career, seeking help as sign of weakness, and VA reputation. The study provided some evidence to support that Department of Defense and VA are meeting mandates for providing seamless transition of health care set forth by "Public Law 110-181, National Defense Authorization Act of Fiscal Year 2008."

Combat amputees' health-related quality of life and psychological outcomes: A brief report from the wounded warrior recovery project.

PubMed

Woodruff, Susan I; Galarneau, Michael R; Sack, Daniel I; McCabe, Cameron T; Dye, Judy L

2017-03-01

This study extends what is known about long-term health-related quality of life (HrQoL) and other psychosocial outcomes (i.e., depression, posttraumatic stress disorder [PTSD]) among US military combat amputees serving in Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn. A total of 63 combat amputees were identified from the Wounded Warrior Recovery Project, a study assessing long-term self-reported HrQoL and psychological outcomes among those wounded during military service. Another 477 service members from the Wounded Warrior Recovery Project were identified as a comparison group (i.e., nonamputees with moderate to severe extremity injuries). After adjusting for age, time since injury, overall injury severity, and traumatic brain injury, amputees had poorer functional HrQoL than those in the nonamputee comparison group overall and in the specific area related to performance of usual activities, and, to some degree, chronic and acute symptoms, and mobility/self-care. On the other hand, depression and PTSD symptoms were not different for the two groups. Results suggest that when assessed over 5 years postinjury, on average, amputees have unique physical and functional limitations, yet do not report greater depression or PTSD symptoms than others seriously injured in combat. It may be that state-of-the-art integrated amputee care that includes support networks and emphasis on adjustment and psychological health may increase successful coping and adjustment, at least to a level that is on par with other types of serious combat injury. Epidemiologic/prognostic study, level III.

Women in the Military. More Military Jobs Can Be Opened under Current Statutes. Report to Congressional Requesters.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC. Div. of National Security and International Affairs.

A study determined how service policies implementing the combat exclusion provisions affect the number and assignment of military women and whether service procedures unrelated to the combat exclusion limit job opportunities for women. Based on the combat exclusion and related program needs, about 1.1 million of 2.2 million military jobs were…

Defense Logistical Support Contracts in Iraq and Afghanistan: Issues for Congress

DTIC Science & Technology

2010-09-20

Services Committee on April 14, 2010. The bill was amended by the HASC on April 21, 2010, discharged by the House Oversight and Government Reform Committee...Afghanistan; • Section 852 calls for the Army Audit Agency, the Navy Audit Services, and the Air Force Audit Agency to each conduct a comprehensive audit of...security functions in areas of combat operations and are involved in the discharge of a weapon or other active, non-lethal countermeasures; and

Trauma, social support, family conflict, and chronic pain in recent service veterans: does gender matter?

PubMed

Driscoll, Mary A; Higgins, Diana M; Seng, Elizabeth K; Buta, Eugenia; Goulet, Joseph L; Heapy, Alicia A; Kerns, Robert D; Brandt, Cynthia A; Haskell, Sally G

2015-06-01

Women veterans have a higher prevalence of chronic pain relative to men. One hypothesis is that differential combat and traumatic sexual experiences and attenuated levels of social support between men and women may differentially contribute to the development and perpetuation of pain. This investigation examined [1] gender differences in trauma, social support, and family conflict among veterans with chronic pain, and [2] whether trauma, social support, and family conflict were differentially associated with pain severity, pain interference, and depressive symptom severity as a function of gender. Participants included 460 veterans (56% female) who served in support of recent conflicts, and who endorsed pain lasting 3 months or longer. Participants completed a baseline survey during participation in a longitudinal investigation. Self-report measures included pain severity, pain interference, depressive symptom severity, exposure to traumatic life events, emotional and tangible support, and family conflict. Relative to men, women veterans reporting chronic pain evidenced higher rates of childhood interpersonal trauma (51% vs 34%; P < 0.001) and military sexual trauma (54% vs 3%; P < 0.001), along with lower levels of combat exposure (10.00 vs 16.85, P < 0.001). Gender was found to be a moderator of the association of marital status, combat exposure, childhood interpersonal trauma, and family conflict with pain interference. It also moderated family conflict in the prediction of depressive symptoms. Results underscore the potential importance of developing and testing gender specific models of chronic pain that consider the relative roles of trauma, social support, and family conflict. Wiley Periodicals, Inc.

Effectiveness and Efficiencies of Private Military Corporations

DTIC Science & Technology

2008-06-01

generalize. While some private military corporations provide direct combat services , others provide ancillary services —such as laundry and food...collection of information, including suggestions for reducing this burden, to Washington headquarters Services , Directorate for Information...for traditional military forces. The PMC consists of a for profit firm that provides military services that range from combat operations to training

Improving Support for America's Hidden Heroes

PubMed Central

Terri, Tanielian; Kathryn E., Bouskill; Rajeev, Ramchand; Esther M., Friedman; Thomas E., Trail; Angela, Clague

2018-01-01

Abstract The United States is home to more than 21 million veterans, many of whom deployed to support combat operations around the globe during their military service and sustained service-related conditions or disabilities. Supporting these wounded, ill, and injured warriors once home are millions of informal caregivers—individuals who provide unpaid support with activities that enable the service member or veteran to live in a noninstitutionalized setting. In this study, researchers describe elements of a research blueprint to inform future efforts to improve support for military and veteran caregivers. To construct this blueprint, researchers inventoried currently available research on caregiving for disabled adults and children and gathered stakeholder input by conducting a survey and facilitating an online panel. The study highlights the need for more studies that examine how military and veteran caregiver needs evolve over time, how programs are working, and how caregiving affects specific subgroups. The resulting blueprint should serve as a guide for the caregiver support community to use in prioritizing and facilitating future research. PMID:29416949

Improving Support for America's Hidden Heroes: A Research Blueprint.

PubMed

Terri, Tanielian; Kathryn E, Bouskill; Rajeev, Ramchand; Esther M, Friedman; Thomas E, Trail; Angela, Clague

2018-01-01

The United States is home to more than 21 million veterans, many of whom deployed to support combat operations around the globe during their military service and sustained service-related conditions or disabilities. Supporting these wounded, ill, and injured warriors once home are millions of informal caregivers-individuals who provide unpaid support with activities that enable the service member or veteran to live in a noninstitutionalized setting. In this study, researchers describe elements of a research blueprint to inform future efforts to improve support for military and veteran caregivers. To construct this blueprint, researchers inventoried currently available research on caregiving for disabled adults and children and gathered stakeholder input by conducting a survey and facilitating an online panel. The study highlights the need for more studies that examine how military and veteran caregiver needs evolve over time, how programs are working, and how caregiving affects specific subgroups. The resulting blueprint should serve as a guide for the caregiver support community to use in prioritizing and facilitating future research.

Child Care and Other Support Programs

ERIC Educational Resources Information Center

Floyd, Latosha; Phillips, Deborah A.

2013-01-01

The U.S. military has come to realize that providing reliable, high-quality child care for service members' children is a key component of combat readiness. As a result, the Department of Defense (DoD) has invested heavily in child care. The DoD now runs what is by far the nation's largest employer-sponsored child-care system, a sprawling network…

Effectiveness Of The Individual Riflemen In An Infantry Squad

DTIC Science & Technology

2017-12-01

adversaries. 14. SUBJECT TERMS individual carbine, interim combat service rifle, squad designated marksman rifle, commercial- off-the-shelf...7 5th–95th Percentile. Source: El Creative Advertising and Design (2007...but does not have overwhelming firepower compared to enemy infantry supported by an armored or 4 motorized assets (DA, 2006b). In order to achieve

Suitability of Agent Technology for Military Command and Control in the Future Combat System Environment

DTIC Science & Technology

2003-06-01

and Multi-Agent Systems 1 no. 1 (1998): 7-38. [23] K. Sycara, A. Pannu , M. Williamson, and D. Zeng, “Distributed Intelligent Agents,” IEEE Expert 11...services that include support for mobility, security, management, persistence, and naming of agents. [i] K. Sycara, A. Pannu , M. Williamson, and D

Supporting Air and Space Expeditionary Forces: Analysis of Combat Support Basing Options

DTIC Science & Technology

2004-01-01

Brooke et al., 2003. 13 For more information on Set Covering models, see Daskin , 1995. Analysis Methodology 43 Transportation Model. A detailed...This PDF document was made available from www.rand.org as a public service of the RAND Corporation. 6Jump down to document Visit RAND at...www.rand.org Explore RAND Project AIR FORCE View document details This document and trademark(s) contained herein are protected by law as indicated in a

A Study of Military-Civil Service Differences in Quality of Life

DTIC Science & Technology

1976-12-01

specialists -- men and women whose knowledge and skills are essential to the increasingly complex activities that support AF mission$ (Ai-- Force... essential support functions. They let military personne] concentrate fully on their primary ina lon of training to keep combat ready or reacting immediately...unification of military and civilian personnel nited in the study were: 1. The custom of dressing military in uniform when they are in GoR/sm/76D-11 essentially

The health hazard assessment process in support of joint weapon system acquisitions.

PubMed

Kluchinsky, Timothy A; Jokel, Charles R; Cambre, John V; Goddard, Donald E; Batts, Robert W

2013-01-01

Since 1981, the Army's HHA Program has provided an invaluable service to combat developers and materiel program managers by providing recommendations designed to eliminate or control health hazards associated with materiel and weapon systems. The program has consistently strived to improve its services by providing more meaningful and efficient assistance to the acquisition community. In the uncertain fiscal times ahead, the Army's HHA Program will continue to provide valuable and cost-effective solutions to mitigate the health risks of weapons systems.

Objective Versus Subjective Measurement of Stress and Social Support: Combat-Related Reactions.

ERIC Educational Resources Information Center

Solomon, Zahava; And Others

1987-01-01

Studied combat intensity, social support, and related stress reactions among soldiers who fought in the 1982 Israeli-Lebanon War, comparing those who experienced combat stress reaction (N=382) and those who did not (N=344). Subjective indicators were found to be stronger predictors than were objective indicators. Combat stress reaction was clearly…

Health-related quality of life among US military personnel injured in combat: findings from the Wounded Warrior Recovery Project.

PubMed

Woodruff, Susan I; Galarneau, Michael R; McCabe, Cameron T; Sack, Daniel I; Clouser, Mary C

2018-05-01

Little is known about the long-term, health-related quality of life (HRQOL) of those wounded in combat during Operations Enduring Freedom, Iraqi Freedom, and New Dawn. The present study described the overall HRQOL for a large group of US service members experiencing mild-to-severe combat-related injuries, and assessed the unique contribution of demographics, service- and injury-related characteristics, and mental health factors on long-term HRQOL. The Wounded Warrior Recovery Project examines patient-reported outcomes in a cohort of US military personnel wounded in combat. Participants were identified from the Expeditionary Medical Encounter Database, a US Navy-maintained deployment health database, and invited to complete a web-based survey. At the time of this study, 3245 service members consented and completed the survey. Hierarchical linear regression analyses were conducted to assess the unique contribution of each set of antecedents on HRQOL scores. HRQOL was uniquely associated with a number of demographics, and service- and injury-related characteristics. Nevertheless, screening positive for posttraumatic stress disorder (B = - .09; P < .001), depression (B = - .10; P < .001), or both as a set (B = - .19; P < .001) were the strongest predictors of lower long-term HRQOL. Postinjury HRQOL among service members wounded in combat was associated with service and injury experience, and demographic factors, but was most strongly linked with current mental health status. These findings underscore the significance of mental health issues long after injury. Further, findings reinforce that long-term mental health screening, services, and treatment are needed for those injured in combat.

The mental health of UK ex-servicemen with a combat-related or a non-combat-related visual impairment: does the cause of visual impairment matter?

PubMed

Stevelink, Sharon A M; Malcolm, Estelle M; Gill, Pashyca C; Fear, Nicola T

2015-08-01

Since the start of the conflicts in Iraq and Afghanistan, the numbers of young service personnel who have sustained a combat-related visual impairment have increased. This cross-sectional study examined the mental well-being of ex-servicemen (aged 22-55 years) with a visual impairment and determined if the mental health of those with a combat-related visual impairment differed from those whose visual impairment is not combat-related. Male ex-service personnel with a visual impairment completed a telephone interview assessing the presence of depressive symptomatology, probable anxiety disorder, post-traumatic stress disorder (PTSD) symptomatology and alcohol misuse. Data were analysed using descriptive statistics. 77 participants were included in the study, reflecting a response rate of 76.2%. Of those with complete data (n=74), 20 ex-servicemen had a combat-related visual impairment. Among ex-service personnel with a combat-related visual impairment, 10.0% (95% CI 0 to 23.2) screened positive for a probable depression, 25.0% (95% CI 6.0 to 44.0) for probable anxiety and 10.0% (95% CI 0 to 23.2) for probable PTSD. The prevalence of probable depression and probable PTSD differed among those with a non-combat-related visual impairment, namely 18.5% (95% CI 8.1 to 28.9) and 16.7% (95% CI 6.8 to 26.7), respectively. Probable anxiety was 18.5% (95% CI 8.1 to 28.9) among non-combat-related visually impaired ex-service personnel. 45.0% (95% CI 23.2 to 66.8) of combat-related visually impaired personnel reported hazardous drinking, compared with 20.4% (95% CI 9.7 to 31.2) of those with a non-combat-related visual impairment. Mental health problems were prevalent among visually impaired younger ex-servicemen. No statistically significant differences were found in the prevalence of mental health problems among ex-servicemen with a combat-related visual impairment compared with those with a non-combat-related visual impairment. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Update: Exertional rhabdomyolysis, active component, U.S. Armed Forces, 2012-2016.

PubMed

2017-03-01

Among active component service members in 2016, there were 525 incident diagnoses of rhabdomyolysis likely due to physical exertion and/or heat stress ("exertional rhabdomyolysis"). The crude incidence rate in 2016 was 40.7 cases per 100,000 person-years. Annual rates of incident diagnoses of exertional rhabdomyolysis increased 46.2% between 2013 and 2016, with the greatest percentage change occurring between 2014 and 2015. In 2016, relative to their respective counterparts, the highest incidence rates of exertional rhabdomyolysis affected service members who were male; younger than 20 years of age; and black, non-Hispanic. During the surveillance period, annual incidence rates were highest among service members of the Marine Corps, intermediate among those in the Army, and lowest among those in the Air Force and Navy. Most cases of exertional rhabdomyolysis were diagnosed at installations that support basic combat/recruit training or major ground combat units of the Army or the Marine Corps. Medical care providers should consider exertional rhabdomyolysis in the differential diagnosis when service members (particularly recruits) present with muscular pain or swelling, limited range of motion, or the excretion of dark urine (possibly due to myoglobinuria) after strenuous physical activity, particularly in hot, humid weather.

A study protocol for tracking quality of life among U.S. service members wounded in Iraq and Afghanistan: the Wounded Warrior Recovery Project.

PubMed

Woodruff, Susan I; Galarneau, Michael R; Luu, Bethi N; Sack, Daniel; Han, Peggy

2014-03-01

There is a need for more work to understand the quality of life (QOL) outcomes of survivors of Operations Enduring Freedom and Iraqi Freedom combat injury to improve care and treatment, and prevent poor physical, psychological, and social outcomes. We describe the study design and methods of the Wounded Warrior Recovery Project, a study supported by the Department of Defense that will track close to 10,000 military personnel wounded in Operations Enduring Freedom and Iraqi Freedom. The overall objective of the 6-year longitudinal study is to track changes in QOL and describe variations in those changes as they relate to sociodemographic factors, injury characteristics, service-related factors, clinical/diagnostic measures including traumatic brain injury and posttraumatic stress disorder, and medical procedures and services. The Wounded Warrior Recovery Project study will be among the first longitudinal population-based investigations of QOL outcomes after combat injury and will provide a basis upon which large-scale epidemiological studies can be conducted. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Supporting Student Veterans: Utilizing Game-Based Role-Plays with Virtual Humans to Build Military Cultural Competency and Helping Behaviors in Faculty and Staff

ERIC Educational Resources Information Center

Cate, Chris A.; Albright, Glenn

2015-01-01

Veterans and military service members enter the classroom with valuable life and leadership experience; however, transitioning to student life represents unique challenges. Like the larger veteran population, student veterans may bring to campus the negative aftereffects of their combat experiences in the form of post-traumatic stress, substance…

Health Impact of U.S. Military Service in a Large Population-based Military Cohort: Findings of the Millennium Cohort Study, 2001-2008

DTIC Science & Technology

2011-01-01

Special emphasis was placed on obtaining information on vac- cines , environmental exposures, and combat-related experiences. Electronic deployment...aPercentages rounded up and may not sum to 100. bDeployed in support of the Global War on Terrorism between September 1, 2001, and August 31, 2007

Diet, physical activity, and bone density in soldiers before and after deployment.

PubMed

Carlson, Ashley R; Smith, Martha A; McCarthy, Mary S

2013-01-01

To investigate diet, physical activity, and bone mineral density (BMD) in combat service support Soldiers before and after deployment, and to determine if any components of diet or physical activity impacted BMD. Fifty-three Soldiers participated in the study. The BMD of the femoral neck and lumbar spine were measured using dual-energy x-ray absorptiometry. Diet was assessed using the Block Food Frequency Questionnaire. Physical activity was assessed using the Baecke Habitual Physical Activity Questionnaire. The BMD of the spine (0.79%; P=.03) increased significantly during deployment. Reported physical activity at work (-10.76%; P=.01) decreased and vitamin K intake increased (37.21%; P=.01). Soldiers did not meet the dietary reference intake for vitamin D and exceeded the dietary reference intakes for all other nutrients. No significant relationships were observed between change in diet or physical activity and change in BMD. Due to the small sample size, we could not determine if deployment impacted BMD, diet, or physical activity in combat service support Soldiers. Future research should focus on investigating the association between lower levels of physical activity, inadequate diet, and decreased BMD in larger military populations.

Combination of Extracorporeal Life Support and Mesenchymal Stem Cell Therapy for Treatment of ARDS in Combat Casualties and Evacuation of Service Members with ARDS

DTIC Science & Technology

2016-10-01

devastating injuries. Aeromedical evacuation of patients with Acute Respiratory Distress Syndrome (ARDS) is sometimes beyond the possibilities because of...sheep induces lung injury equivalent to a moderated ARDS. In a second group of studies sheep in which respiratory support was providing by a low flow...low pressure ECMO (ALung) partially rescued the animals returned the parameters of respiratory function to normal values. It is our goal to now use

Combat and Operational Stress: Minimizing Its Adverse Effects on Service Members

DTIC Science & Technology

2008-04-18

munitions. Combat stress has received many labels since the First World War. These labels include “shell shock, war neurosis , psychoneurosis, combat...war neurosis and psychoneurosis carried an inherently negative connotation because they implied by their name that a mental illness or disorder...who became combat stress casualties. In 1916, the term war neurosis replaced shell shocked as the number of combat stress casualties continued due

Posttraumatic Stress in U.S. Marines: The Role of Unit Cohesion and Combat Exposure

ERIC Educational Resources Information Center

Armistead-Jehle, Patrick; Johnston, Scott L.; Wade, Nathaniel G.; Ecklund, Christofer J.

2011-01-01

Combat exposure is a consistent predictor of posttraumatic stress (PTS). Understanding factors that might buffer the effects of combat exposure is crucial for helping service members weather the stress of war. In a study of U.S. Marines returning from Iraq, hierarchical multiple regression analyses revealed that unit cohesion and combat exposure…

Refractive surgery in Israel Defense Forces recruits.

PubMed

Horowitz, Josepha; Mezer, Eedy; Shochat, Tzippora; Mandel, Yossi; Buckman, Gila; Sasson, Adi; Geyer, Orna

2008-02-01

To determine the prevalence of refractive surgery history in recruits for military service in the Israel Defense Forces (IDF) between 1998 to 2005 and to evaluate the effect of surgery on the recruits' fitness to serve in combat units. Surgeon General's HQ, Medical Corps, Israel Defense Forces. The computerized medical records of all ametropic Israeli army inductees were reviewed. They included spectacle-wearing, contact lens-wearing, and post refractive-surgery individuals who were examined in the recruitment office before their compulsory military service. The extracted data from the personal files consisted of the assignment to combat units of those who had refractive surgery and those who wore corrective eyewear and the first and last military position of all ametropic recruits who were assigned to combat units. Five hundred ninety-seven inductees (513 men, 84 women) had refractive surgery before their military service during the study period. The prevalence of recruits who had refractive surgery increased from 0.8/1000 ametropes in 1998 to 4.9/1000 ametropes in 2005. Significantly more recruits who had surgery (73.5%) than recruits who wore corrective eyewear were assigned to combat units (P<.001). The dropout rate from combat units of the former was significantly lower than that of the latter (13.1% versus 29.2%) (P<.001). More corrective eyewear users had refractive surgery before their IDF military service, and relatively more of them applied for combat duty. The high percentage of recruits who had refractive surgery who serve uninterruptedly in combat units indicates that the procedure has no deleterious effect on the recruits' fitness.

Combat stressors and post-traumatic stress in deployed military healthcare professionals: an integrative review.

PubMed

Gibbons, Susanne W; Hickling, Edward J; Watts, Dorraine D

2012-01-01

  While there has been a growing body of literature on the impact of combat stressors and post-traumatic stress on military service members involved in current conflicts, there has been little available information that directly examines the impact of these on healthcare providers. Aims for this integrative review included: (1) identifying exposures, experiences and other factors influencing stress responses in military healthcare providers previously engaged in a war effort and (2) describing the incidence of post-traumatic stress and related mental health problems in this population. Using Cooper's integrative review method, relevant documents were collected and analysed using content categories and a coding scheme to assist with identifying and recording data for units of analysis. Literature searches (including all years to present) were conducted using keywords for stress reaction, for healthcare provider and for military war effort involvement. Literature was obtained using the Cumulative Index to Nursing and Allied Health Literature, the National Library of Medicine and the American Psychological Association databases. Evidence suggests that similar to military combatants, military healthcare provider exposure to life-threatening situations will increase the probability of adverse psychological disorders following these traumatic experiences. The presence of a strong sense of meaning and purpose, within a supportive environment appear to help mediate the impact of these dangerous and stressful events. Results of this review and other supporting literature indicate the need for a systematic approach to studying combat stress and post-traumatic stress in deployed healthcare providers. © 2011 Blackwell Publishing Ltd.

Predicting Resource Needs for Multiple and Mass Casualty Events in Combat: Lessons Learned From Combat Support Hospital Experience in Operation Iraqi Freedom

DTIC Science & Technology

2009-04-01

from rocket attack near a forward operating base (Photo courtesy of Tommy A. Brown). Predicting Resource Needs for Mass Casualty in Combat Volume 66...combat support hospital. J Trauma 2008; 64(2 suppl):S79–S85. 19. Wedmore I, McManus JG, Pusateri AE, et al. A special report on the chitosan -based

Exploring positive pathways to care for members of the UK Armed Forces receiving treatment for PTSD: a qualitative study

PubMed Central

Murphy, Dominic; Hunt, Elizabeth; Luzon, Olga; Greenberg, Neil

2014-01-01

Objective To examine the factors which facilitate UK military personnel with post-traumatic stress disorder (PTSD) to engage in help-seeking behaviours. Methods The study recruited active service personnel who were attending mental health services, employed a qualitative design, used semi-structured interview schedules to collect data, and explored these data using interpretative phenomenological analysis (IPA). Results Five themes emerged about how participants were able to access help; having to reach a crisis point before accepting the need for help, overcoming feelings of shame, the importance of having an internal locus of control, finding a psychological explanation for their symptoms and having strong social support. Conclusions This study reported that for military personnel who accessed mental health services, there were a number of factors that supported them to do so. In particular, factors that combated internal stigma, such as being supported to develop an internal locus of control, appeared to be critical in supporting military personnel to engage in help-seeking behaviour. PMID:24624262

A Randomized, Head-to-Head Study of Virtual Reality Exposure Therapy for Posttraumatic Stress Disorder.

PubMed

McLay, Robert N; Baird, Alicia; Webb-Murphy, Jennifer; Deal, William; Tran, Lily; Anson, Heather; Klam, Warren; Johnston, Scott

2017-04-01

Virtual reality exposure therapy (VRET) is one of the few interventions supported by randomized controlled trials for the treatment of combat-related posttraumatic stress disorder (PTSD) in active duty service members. A comparative effectiveness study was conducted to determine if virtual reality technology itself improved outcomes, or if similar results could be achieved with a control exposure therapy (CET) condition. Service members with combat-related PTSD were randomly selected to receive nine weeks of VRET or CET. Assessors, but not therapists, were blinded. PTSD symptom improvement was assessed one week and 3 months after the conclusion of treatment using the clinician-administered PTSD scale (CAPS). A small crossover component was included. Results demonstrated that PTSD symptoms improved with both treatments, but there were no statistically significant differences between groups. Dropout rates were higher in VRET. Of those who received VRET, 13/42 (31%) showed >30% improvement on the CAPS, versus 16/43 (37%) who received CET. Three months after treatment, >30% improvement was seen in 10/33 (30%) of VRET participants and 12/33 (36%) in CET. Participants who crossed over (n = 11) showed no statistically significant improvements in a second round of treatment, regardless of condition. This study supported the utility of exposure therapy for PTSD, but did not support additional benefit by the inclusion of virtual reality.

Investigation of Current State of Crytpography and Theoretical Implementation of a Cryptographic System for the Combat Service Support Control System.

DTIC Science & Technology

1987-05-01

34 Advances in Crypt g: Proceedings of CRYPTO 84,r o ... .. .. _ __...o ... .. ... ....... ed. by G.R. Blakely and D. Chaum . [Wagn84b] Wagner, Neal R...in Distributed Computer Systems," IEEE Trans. on Computers, Vol. C-35, No. 7, Jul. 86, pp. 583-590. Gifford, David K., "Cryptographic Sealing for

An Engineering Report in Civil Engineering and Management.

DTIC Science & Technology

1987-12-01

programs as the Apollo program and the Canaveral program. Progress in the late 70s and the 80s has seen advancements in the application of sophisticated...other forces in military operations; subsequent combat service support ashore and defense against overt or clandestine enemy attacks directed toward...construction execution plans; assigns construction projects to NCF units; monitors progress and assures adherence to quality standards: directs

Combat Service Support Enabler Functional Assessment (CEFA). Volume 2: Individual (65) Mini-CEFA Assessments

DTIC Science & Technology

1997-12-01

SLOT) 356 57. Sensor Artificial Intelligence Communications Interactive Maintenance System (SACIMS) 361 58. Soldier’s Portable On- System Repair...increased mobility ; NBC overpressure, environmental control; and situational awareness.] 19. Related changes in CSS effectiveness. Increase The AMEV...to paragraph 17 above.] 19. Related changes in CSS effectiveness. Increase. Driver Minder alerts the maintainer about equipment and operator faults

[Loyalty to professional and military duty].

PubMed

Chizh, I M

1995-01-01

The author of this article--Chief of the Russian Armed Forces Medical Service--analyses the trends of optimization of medical support of the Army and Navy, taking into account the experience of combat casualty care during Chechen crisis. In order to enhance the efficiency of medical support during combat activities all the personnel is supplied with first-aid kits. Each company is reinforced with a medical assistant or army physician; battalion medical posts--with physicians, medical assistants, aidmen, mobile dressing room and ambulances; regiment medical posts--with two surgeons, an anaesthesiologist, an instrument nurse and nurse-anaesthetist. The primary medical care is provided at the battalion medical post; qualified (secondary) surgical care--at regiment medical posts, and specialized (tertiary) medical care--at special medical detachments (SMD) and military hospitals. The wounded are evacuated from the zone of combat actions by APC or MICV, and then by helicopters. The further evacuation of wounded is realized by transport or medical aircraft, including "Skalpel" flight surgery plane. The experience of army physicians has proved the necessity of multilateral development of Mobile Forces Medical Service and the formation of aeromobile hospitals. An airborne infantry battalion must have a medical company in its organic structure, and respectively a separate medical battalion must have an aeromobile medical company. The SMD which are assigned to act in the emergency situations of peaceful time also can be effective in providing medical care (including specialized care) during local military conflicts. Thinking over the further development of medical support in the Armed Forces the author assigns a number of tasks throughout all the chain of medical command, including medical establishments, medical examination boards, the Corps of Senior medical specialists (in surgery, internal medicine, pathologicoanatomy, sanitary supervision, etc). A special attention is paid to the formation of an efficient system of sanitary-epidemiological supervision in the Armed Forces; the improvement of medical assistance for servicewomen, retired officers and their dependents; the enforcement of military and labour discipline in the units and establishments of medical service; training and education of medical personnel; the strict adherence to the principles of medical ethics, deontology, and oath of physician.

Implications of Posttraumatic Stress Among Military-Affiliated and Civilian Students

PubMed Central

Barry, Adam E.; Whiteman, Shawn D.; MacDermid Wadsworth, Shelley M.

2012-01-01

Objectives Determine whether posttraumatic stress symptoms (PTS) are associated with problem drinking and alcohol-related consequences, as well as academic correlates among military-affiliated and civilian students. Participants Final sample (n = 248) included 78 combat exposed student service members/veterans, 53 non-combat exposed student service members/veterans, 38 ROTC students, and 79 civilian students. Method Self-report data was collected spring 2011 via a web-based survey measuring PTS, problem drinking, alcohol-related consequences, GPA, educational self-efficacy, academic amotivation and persistence. Results Military students exposed to combat-related trauma reported significantly greater PTS symptoms than other military and civilian groups. PTS symptoms were associated with problem drinking and alcohol-related consequences for all groups, yet unrelated to academic correlates among those exposed to combat-related trauma. Conclusions This study adds to the scant literature base exploring the unique characteristics of student service members/veterans in higher education. PMID:23157198

Implications of posttraumatic stress among military-affiliated and civilian students.

PubMed

Barry, Adam E; Whiteman, Shawn D; MacDermid Wadsworth, Shelley M

2012-01-01

To determine whether posttraumatic stress (PTS) symptoms are associated with problem drinking and alcohol-related consequences, as well as academic correlates among military-affiliated and civilian students. The final sample (n = 248) included 78 combat-exposed student service members/veterans, 53 non-combat-exposed student service members/ veterans, 38 ROTC (Reserve Officers' Training Corps) students, and 79 civilian students. Self-report data were collected spring 2011 via a Web-based survey measuring PTS, problem drinking, alcohol-related consequences, grade point average, educational self-efficacy, academic amotivation, and persistence. Military students exposed to combat-related trauma reported significantly greater PTS symptoms than other military and civilian groups. PTS symptoms were associated with problem drinking and alcohol-related consequences for all groups, yet unrelated to academic correlates among those exposed to combat-related trauma. This study adds to the scant literature base exploring the unique characteristics of student service members/veterans in higher education.

Why Does Military Combat Experience Adversely Affect Marital Relations?

ERIC Educational Resources Information Center

Gimbel, Cynthia; Booth, Alan

1994-01-01

Describes investigation of ways in which combat decreases marital quality and stability. Results support three models: (1) factors propelling men into combat also make them poor marriage material; (2) combat causes problems that increase marital adversity; and (3) combat intensifies premilitary stress and antisocial behavior which then negatively…

Injuries associated with combat sports, active component, U.S. Armed Forces, 2010-2013.

PubMed

2014-05-01

The practice of combat sports creates a potential for training- and sports-related injuries among military members. During the 4-year surveillance period, there were 12,108 cases of injuries associated with combat sports among active component service members; the overall incidence rate was 21.0 per 10,000 person-years (p-yrs). The rates were higher among service members who were male, Hispanic, in the youngest age groups, in the Army, junior enlisted, and in combat-specific occupations. The rate among recruit/ trainees (779.4 per 10,000 p-yrs) was more than 165 times the rate among all other active component service members (non-recruits) (4.7 per 10,000 p-yrs). Sprains, strains, and contusions accounted for more than one-half of the primary (first-listed) diagnoses associated with combat sports cases. More serious conditions such as concussions/head injuries and skull/face fractures/intracranial injuries were reported among 3.9% and 2.1% of all cases and were more common among boxing-related cases. Hand/wrist fractures were also common among boxing cases. Wrestling had comparatively greater proportions of dislocations and open wounds. Although the combat sport training provides many physical and mental benefits to the individual, safety practices should be enforced to reduce the most frequent and serious injuries.

Modeling and Reinforcement to Combat HIV: The MARCH Approach to Behavior Change

PubMed Central

Galavotti, Christine; Pappas-DeLuca, Katina A.; Lansky, Amy

2001-01-01

Theory and research suggest that behavioral interventions to prevent HIV/AIDS may be most effective when they are personalized and affectively compelling, when they provide models of desired behaviors, and when they are linked to social and cultural narratives. Effective strategies must also take into account the opportunities and obstacles present in the local environment. The Modeling and Reinforcement to Combat HIV (MARCH) projects combine key aspects of individual behavior change with efforts to change social norms. There are 2 main components to the program: entertainment as a vehicle for education (longrunning serialized dramas on radio or television portray role models evolving toward the adoption of positive behaviors) and interpersonal reinforcement at the community level (support from friends, family members, and others can help people initiate behavior changes; support through changes in social norms is necessary for behavioral effects to be sustained over time). Both media and interpersonal intervention activities should be linked to existing resources in the community and, wherever possible, provide increased access to preventive services, supplies, and other supporting elements. PMID:11574317

Eye injury in the Israeli Defense Force: "an ounce of prevention is worth a pound of cure".

PubMed

Gendler, Sami; Nadler, Roy; Erlich, Tomer; Fogel, Ofir; Shushan, Guy; Glassberg, Elon

2015-07-01

The eye occupies 0.1% of the total body surface yet it accounts for 8-13% of battle injuries in modern warfare worldwide. Protective eyewear can prevent over 90% of these eye injuries in both military and civilian settings. This study presents an analysis of a military casualty database and describes the proportion and distribution of eye injuries among Israel Defense Force (IDF) Soldiers. All trauma patients recorded in the IDF Trauma Registry (ITR) in whom ocular injury related to combat or to training was documented were reviewed. There were 129 patients with documented eye injury sustained during combat or training between 1997 and 2013: 75% of injuries were related to combat and the remainder occurred during training. Penetrating fragmental injuries accounted for 74% of combat related injuries and 28% of training related injuries. Sixty-six percent (66%) of these casualties were subsequently re-classified as no longer fit for combat duties. Combat related injuries resulted in a higher incidence of severe injuries compared to training related injuries (P<0.05). Despite optimal medical care, the majority of soldiers who sustain eye injuries during military service suffer from substantial disability and most are no longer fit for combat service. A majority are discharged from military service. Protective eyewear could potentially prevent penetrating fragmental wounds which are the most common cause of injury. Further research on optimal orbital protection is critical for both the military and the civilian sectors. Copyright © 2015 Elsevier Ltd. All rights reserved.

Service-Oriented Architecture (SOA) Instantiation within a Hard Real-Time, Deterministic Combat System Environment

ERIC Educational Resources Information Center

Moreland, James D., Jr

2013-01-01

This research investigates the instantiation of a Service-Oriented Architecture (SOA) within a hard real-time (stringent time constraints), deterministic (maximum predictability) combat system (CS) environment. There are numerous stakeholders across the U.S. Department of the Navy who are affected by this development, and therefore the system…

Tradeoff Analysis for Combat Service Support Wireless Communications Alternatives

DOE Office of Scientific and Technical Information (OSTI.GOV)

Burnette, John R.; Thibodeau, Christopher C.; Greitzer, Frank L.

2002-02-28

As the Army moves toward more mobile and agile forces and continued sustainment of numerous high-cost legacy logistics management systems, the requirement for wireless connectivity and a wireless network to supporting organizations has become ever more critical. There are currently several Army communications initiatives underway to resolve this wireless connectivity issue. However, to fully appreciate and understand the value of these initiatives, a Tradeoff Analysis is needed. The present study seeks to identify and assess solutions. The analysis identified issues that impede Interim Brigade Combat Team (IBCT) communication system integration and outlined core requirements for sharing of logistics data betweenmore » the field and Army battle command systems. Then, the analysis examined wireless communication alternatives as possible solutions for IBCT logistics communications problems. The current baseline system was compared with possible alternatives involving tactical radio systems, wireless/near term digital radio, cellular satellite, and third-generation (3G) wireless technologies. Cellular satellite and 3G wireless technologies offer clear advantages and should be considered for later IBCTs.« less

Intelligence, Surveillance, and Reconnaissance (ISR) Acquisition: Issues for Congress

DTIC Science & Technology

2013-04-16

scientists and engineers that launched the satellite program.7 5 Ibid., p. 21. 6 Ibid., p. 22. It is...major role in supporting combat operations in Iraq and Afghanistan, although the E-8s are scheduled to have new engines to extend their service life...that the Army is even considering the development of intelligence- gathering airships .43 In comparison to the complex acquisition history of UAS, the

Designing Assessments of Microworld Training for Combat Service Support Staff

DTIC Science & Technology

2003-01-01

training for distribution management skills as a part of a larger project that entailed making changes to the current structure, content, and methods...of CSS training. Microworld models are small-scale simulations of organizations and operations. They are useful for training distribution management processes...pilot studies using a microworld model for U.S. Army Reserve (USAR) soldiers in Distribution Management Centers. The degree to which trainees learned

Translations on USSR Military Affairs No. 1252

DTIC Science & Technology

1976-11-05

as given by source. The contents of this publication in no way represent the poli- cies, views or attitudes of the U.S. Government. PROCUREMENT OF...pertaining to matters other than procurement may be addressed to Joint Publications Research Service, 1000 North Glebe Road, Arlington, Virginia 22201...conditions for its successful conduct of combat operations. It is well known that in the solution of all problems of rear area support, the dominant

2006 Munitions Executive Summit

DTIC Science & Technology

2006-02-09

focused on issues related to the global defense-industrial enterprise. Second, we maintain resident experts on all of the world’s major geographical...Train Maintain Inventory Surveillance Demil All Services 393K STONS = 20% of Storage Manufacture Procure Operate the Industrial Base We: Maintenance...Performed on 12.4K tons Demilitarized 41.4K tons Shipped 162K tons Received 208K tons FY2004 Examples: Direct Support to All Combatant Commanders 702K

Combat Service Support MOD II Design (CSS MOD II). Volume 2. Appendixes

DTIC Science & Technology

1986-10-01

through contractual aoreement with Michael Jackson , Ltd. London. The spelling, syntax, and word usage adopted throughout the document have been made...to conform to army standards. The design teas members wish to thank the followin, individuals for their assistances Mr. John Cameron, Michael Jackson , Ltd...JSP) methodology is a product of Michael Jackson Systems, Ltd., London, England. In 1984, Dr. Wilbur Payne, Director, TRADOC Operations Research

Microworld Simulations: A New Dimension in Training Army Logistics Management Skills

DTIC Science & Technology

2004-01-01

Providing effective training to Army personnelis always challenging, but the Army facessome new challenges in training its logisticsstaff managers in...soldiers are stationed and where materiel and services are readily available. The design and management of the Army’s Combat Ser- vice Support (CSS) large...scale logistics systems are increasingly important. The skills that are required to manage these systems are difficult to train. Large deployments

Longitudinal Assessment of Self-Reported Recent Back Pain and Combat Deployment in the Millennium Cohort Study.

PubMed

Granado, Nisara S; Pietrucha, Amanda; Ryan, Margaret; Boyko, Edward J; Hooper, Tomoko I; Smith, Besa; Smith, Tyler C

2016-11-15

A prospective cohort study. Activities performed during military operations vary in complexity and physical demand. The risk for mental illness following military combat deployment has been well documented. However, information regarding the possible contribution of back pain to decreased mental and functional health is scarce. To our knowledge, this is the first study to prospectively assess deployment and self-reported recent back pain in a population-based U.S. military cohort. The study consisted of Millennium Cohort participants who were followed for the development of back pain for an average of 3.9 years. Descriptive statistics and longitudinal analyses were used to assess the temporal relationship of deployment with self-reported recent back pain at follow-up (N = 53,933). Recent back pain was self-reported by 8379 (15.5%) participants at follow-up. After adjusting for covariates, deployers with combat experiences had higher odds [odds ratio (OR) = 1.38, 95% confidence interval (95% CI): 1.28-1.50] of recent back pain than noncombat deployers. There was no association between recent back pain and nondeployers compared with noncombat deployers. Service support/supply handlers were at an increased odds of reporting recent back pain (OR = 1.11, 95% CI: 1.02-1.21) than functional support/administration occupations. Occupations associated with a physically demanding work environment had a higher risk of back pain. Deployers with combat experiences were more likely to report back pain postdeployment. This well-defined group of military personnel may potentially benefit from integrated prevention efforts. 3.

Sex Trafficking: Policies, Programs, and Services.

PubMed

Orme, Julie; Ross-Sheriff, Fariyal

2015-10-01

Sex trafficking (ST), a contemporary form of female slavery, is a human rights issue of critical concern to social work. The global response to ST has been substantial, and 166 countries have adopted anti-ST legislation. Despite considerable efforts to combat ST, the magnitude is increasing. To date, the majority of anti-ST efforts have focused on criminalization policies that target traffickers or purchasers of sexual services, who are predominantly male; prevention programming and services for predominantly female victims have received less support. Therapeutic services to assist pornography addicts and purchasers of sexual services are also necessary. In this article, authors examine current anti-ST policies, programs, and services, both domestically and globally, and present an innovative paradigm that addresses social inequities and emphasizes prevention programming. They conclude with a discussion of the paradigm's implications for social work policies, practices, and services.

Study on combat effectiveness of air defense missile weapon system based on queuing theory

NASA Astrophysics Data System (ADS)

Zhao, Z. Q.; Hao, J. X.; Li, L. J.

2017-01-01

Queuing Theory is a method to analyze the combat effectiveness of air defense missile weapon system. The model of service probability based on the queuing theory was constructed, and applied to analyzing the combat effectiveness of "Sidewinder" and "Tor-M1" air defense missile weapon system. Finally aimed at different targets densities, the combat effectiveness of different combat units of two types' defense missile weapon system is calculated. This method can be used to analyze the usefulness of air defense missile weapon system.

76 FR 14402 - Draft Action Plan-A Public Health Action Plan To Combat Antimicrobial Resistance

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-16

...-2011-0002] Draft Action Plan--A Public Health Action Plan To Combat Antimicrobial Resistance AGENCY: Centers for Disease Control and Prevention (CDC), Department of Health and Human Services (DHHS). ACTION... requesting public comment on the draft A Public Health Action Plan to Combat Antimicrobial Resistance. HHS...

76 FR 21907 - Draft Action Plan-A Public Health Action Plan To Combat Antimicrobial Resistance

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-19

...-2011-0002] Draft Action Plan--A Public Health Action Plan To Combat Antimicrobial Resistance AGENCY: Centers for Disease Control and Prevention (CDC), Department of Health and Human Services (DHHS). ACTION... Federal Register requesting public comment on the draft, A Public Health Action Plan to Combat...

Gender differences in the effects of deployment-related stressors and pre-deployment risk factors on the development of PTSD symptoms in National Guard Soldiers deployed to Iraq and Afghanistan.

PubMed

Polusny, Melissa A; Kumpula, Mandy J; Meis, Laura A; Erbes, Christopher R; Arbisi, Paul A; Murdoch, Maureen; Thuras, Paul; Kehle-Forbes, Shannon M; Johnson, Alexandria K

2014-02-01

Although women in the military are exposed to combat and its aftermath, little is known about whether combat as well as pre-deployment risk/protective factors differentially predict post-deployment PTSD symptoms among women compared to men. The current study assesses the influence of combat-related stressors and pre-deployment risk/protective factors on women's risk of developing PTSD symptoms following deployment relative to men's risk. Participants were 801 US National Guard Soldiers (712 men, 89 women) deployed to Iraq or Afghanistan who completed measures of potential risk/protective factors and PTSD symptoms one month before deployment (Time 1) and measures of deployment-related stressors and PTSD symptoms about 2-3 months after returning from deployment (Time 2). Men reported greater exposure to combat situations than women, while women reported greater sexual stressors during deployment than men. Exposure to the aftermath of combat (e.g., witnessing injured/dying people) did not differ by gender. At Time 2, women reported more severe PTSD symptoms and higher rates of probable PTSD than did men. Gender remained a predictor of higher PTSD symptoms after accounting for pre-deployment symptoms, prior interpersonal victimization, and combat related stressors. Gender moderated the association between several risk factors (combat-related stressors, prior interpersonal victimization, lack of unit support and pre-deployment concerns about life/family disruptions) and post-deployment PTSD symptoms. Elevated PTSD symptoms among female service members were not explained simply by gender differences in pre-deployment or deployment-related risk factors. Combat related stressors, prior interpersonal victimization, and pre-deployment concerns about life and family disruptions during deployment were differentially associated with greater post-deployment PTSD symptoms for women than men. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Musculoskeletal Injuries in Iraq and Afghanistan: Epidemiology and Outcomes Following a Decade of War.

PubMed

Belmont, Philip J; Owens, Brett D; Schoenfeld, Andrew J

2016-06-01

The combined wars in Afghanistan and Iraq represent the longest ongoing conflicts in American military history, with a combined casualty estimate of >59,000 service members. The nature of combat over the last decade has led to precipitous increases in severe orthopaedic injuries, including traumatic amputations and injuries to the spine. Nearly 75% of all injuries sustained in combat now are caused by explosive mechanisms, and fractures comprise 40% of all musculoskeletal injuries. Injuries to the axial skeleton are more frequent among personnel exposed to combat, and spinal trauma is identified in nearly 40% of those killed. Musculoskeletal injuries are expensive and generate some of the highest rates of long-term disability. Noncombat musculoskeletal injuries are endemic within deployed military service members and occur at a greater than threefold rate compared with combat musculoskeletal injuries. Service members with musculoskeletal injuries or behavioral health conditions, such as posttraumatic stress disorder, depression, and psychosis, and those occupying a low socioeconomic status, have an increased risk of inferior outcomes.

[Livestock producer participation in the control of epizootics in developed countries: the experience of France].

PubMed

Cassagne, M H

2004-04-01

Based on the French experience of animal health defence groups (groupements de défense sanitaire), the author highlights the importance, for both Veterinary Services and livestock producers, of livestock producer health organisations acting as partners of the Veterinary Services to complement the actions of private veterinarians. Charged with the task of providing livestock producers with information and raising awareness of the health regulations, these organisations offer key support to Veterinary Services in carrying out regulatory prophylactic measures, monitoring their execution, supplementing public compensation measures, and even being delegated to manage all or part of such prophylactic measures. By designing and implementing plans, with the support of private veterinarians, to combat or control epizootics which have an economic or trade impact, and by participating in or carrying out animal identification and offering health and environmental services, these organisations help to improve herd health and support the livestock producing industry. Growing demand, from both European Union applicant members and countries to the south, shows that although the French experience is not transposable, it can serve as a useful example.

Enhancing Resilience in Active Duty Military Personnel.

PubMed

Crabtree-Nelson, Sonya; DeYoung, Lcdr Peter

2017-02-01

A systematic, evidence-based training program to support active duty military personnel through building unit-level resiliency in preparation for anticipated individual times of crisis is needed. Mental health nurses and social workers in the military possess critical training and expertise in identifying and supporting individual and community resilience factors. Their knowledge of the protective aspects of resilience can and should be used to educate all active duty military personnel, ensure military leaders are knowledgeable in how best to support their units, and provide research on the effectiveness of pre-combat resilience training. [Journal of Psychosocial Nursing and Mental Health Services, 55(2), 44-48.]. Copyright 2017, SLACK Incorporated.

Alternative Futures: United States Air Force Security Police in the Twenty-First Century

DTIC Science & Technology

1988-04-01

34What policies should today’s Air Force leadership be pursuing to prepare for tomorrow’s combat support and security police roles?’ The monograph...Further, it addresses the capability of the Air Force to respond to its future combat support and security police missions and their integration into the...security police organizations. His most recent assignments were as the deputy commander of a combat support group and the commander of a security police

Automated Information System (AIS) Support for FMF Units When Deployed or in Combat (1985-1995).

DTIC Science & Technology

1982-04-13

1995 ) MAJOR T. J. DUNN DEPUTY CHIEF OF STAFF FOR DEVELOPMENTAL COORDINATION DEVELOPMENT CENTER MARINE CORPS DEVELOPMENT AND EDUCATION COMMAND...Support for FMF Units When Deployed or in Combat (1985- 1995 ) (Deployed AIS-88) Study (SCN: 60-81-02) 1. The objectives of the study were: a. To...S. TYPE OF REPORT 6 PERIOD COVERED Automated Information System (AIS) Support for Final Report FMF Units When Deployed or in Combat (1985- 1995 ) 6

Combat Leadership

DTIC Science & Technology

1990-05-01

concern that the Army and other services will breed managers instead of leaders, and they will lack the leadership skills necessary for combat. Colonel...AD-A 2 4 1 101 AiL WAR COLLEGE COMBAT LEADERSHIP LIEUTENANT COLONEL J.kyMES M. FISHER, USA 1990 i 91-12129 -. ROVED F R PUBLIC AIR UNIVERSPL" A...tELEASE; 01IRBUIBiMA UN. D STATES AIR FORCE MAXWELL AIR FORCE BASE, ALABAA UF7 AIR WAR COLLEGE AIR UNIVERSITY COMBAT LEADERSHIP by James M. Fisher

An Exploration of Cohesion in the Land of Combat Service Support

DTIC Science & Technology

1991-12-18

the group AAR the soldier finds that the companions he could not see were doing the same things that he was. Leaders discover actions of subordinates...seventy-eight years, and many wars ago. 39 ENDOUES. £ William Shakespeare , Tie Complete Works of William Shakespeare . (London: Octopus Books, 1986), 478...Beverly Hill, CA: Sage Publications, 1980. Shakespeare , William. The ComDlete Works of William Shakespeare . London: Octopus Books, 1985. Simpkin

System Engineering and Evolution Decision Support

DTIC Science & Technology

2001-09-30

collection of Tuple Space model was first conceived in the mid- 1980 at objects that isolates the requestor of services from the Yale University by...Academic Press, NY, 1980 , pp. 325-347. [2] V. Berzins, M. Shing, Luqi, M. Saluto and J. Williams, Re-engineering the Janus(A) Combat Simulation System...Naval Postgraduate School Monterey, CA 93943-5100 3. Research Office, Code 09 Naval Postgraduate School Monterey, CA 93943-5000 4. Dr. David Hislop U.S

Combat and peacekeeping operations in relation to prevalence of mental disorders and perceived need for mental health care: findings from a large representative sample of military personnel.

PubMed

Sareen, Jitender; Cox, Brian J; Afifi, Tracie O; Stein, Murray B; Belik, Shay-Lee; Meadows, Graham; Asmundson, Gordon J G

2007-07-01

Although military personnel are trained for combat and peacekeeping operations, accumulating evidence indicates that deployment-related exposure to traumatic events is associated with mental health problems and mental health service use. To examine the relationships between combat and peacekeeping operations and the prevalence of mental disorders, self-perceived need for mental health care, mental health service use, and suicidality. Cross-sectional, population-based survey. Canadian military. A total of 8441 currently active military personnel (aged 16-54 years). The DSM-IV mental disorders (major depressive disorder, posttraumatic stress disorder, generalized anxiety disorder, panic disorder, social phobia, and alcohol dependence) were assessed using the World Mental Health version of the World Health Organization Composite International Diagnostic Interview, a fully structured lay-administered psychiatric interview. The survey included validated measures of self-perceived need for mental health treatment, mental health service use, and suicidal ideation. Lifetime exposure to peacekeeping and combat operations and witnessing atrocities or massacres (ie, mutilated bodies or mass killings) were assessed. The prevalences of any past-year mental disorder assessed in the survey and self-perceived need for care were 14.9% and 23.2%, respectively. Most individuals meeting the criteria for a mental disorder diagnosis did not use any mental health services. Deployment to combat operations and witnessing atrocities were associated with increased prevalence of mental disorders and perceived need for care. After adjusting for the effects of exposure to combat and witnessing atrocities, deployment to peacekeeping operations was not associated with increased prevalence of mental disorders. This is the first study to use a representative sample of active military personnel to examine the relationship between deployment-related experiences and mental health problems. It provides evidence of a positive association between combat exposure and witnessing atrocities and mental disorders and self-perceived need for treatment.

Enabling Theater Security Cooperation Through Regionally Aligned Forces

DTIC Science & Technology

2013-03-01

combatant commanders in successfully implementing this initiative, the Service and the Department of Defense will have to overcome several significant...commanders in successfully implementing this initiative, the Service and the Department of Defense will have to overcome several significant challenges...combatant commands, but several significant challenges must be overcome for the RAF to become a viable force employment concept. Analyzing the Army’s

Fresh whole blood transfusions in coalition military, foreign national, and enemy combatant patients during Operation Iraqi Freedom at a U.S. combat support hospital.

PubMed

Spinella, Philip C; Perkins, Jeremy G; Grathwohl, Kurt W; Repine, Thomas; Beekley, Alec C; Sebesta, James; Jenkins, Donald; Azarow, Kenneth; Holcomb, John B

2008-01-01

United States military doctrine permits the use of fresh whole blood (FWB), donated by U.S. military personnel on site, for casualties with life-threatening injuries at combat support hospitals. U.S. Military Medical Department policy dictates that all patients treated at military facilities during combat (coalition military personnel, foreign nationals, and enemy combatants) are to be treated equally. The objectives of this study were to describe admission vital signs and laboratory values and injury location for patients transfused with FWB, and to determine if FWB was employed equally among all patient personnel categories at a combat support hospital. This retrospective cohort study evaluated admission vital signs and laboratory values, injury location, and personnel category for all patients receiving FWB at a U.S. Army combat support hospital in Baghdad, Iraq, between January and December 2004. Eighty-seven patients received 545 units of FWB. Upon admission, the average (+/-S.D.) heart rate was 144 bpm (+/-25); systolic blood pressure, 106 mmHg (+/-33); base deficit, 9 (+/-6.5); hemoglobin, 9.0 g/dl (+/-2.6); platelet concentration, 81.9 x 10(3)/mm(3) (+/-81); international normalized ratio (INR), 2.0 (+/-1.1); and temperature 95.7 degrees F (+/-2.6). The percentages of intensive care patients who received FWB by personnel category were as follows: coalition soldiers, 51/592 (8.6%); foreign nationals, 25/347 (7.2%); and enemy combatants, 11/128 (8.5% (p = 0.38). The amount of FWB transfused by personnel category was as follows: coalition soldier, 4 units (1-35); foreign national, 4 units (1-36); and enemy combatant, 4 units (1-11) (p = 0.9). Fresh whole blood was used for anemic, acidemic, hypothermic, coagulopathic patients with life-threatening traumatic injuries in hemorrhagic shock, and it was transfused in equal percentages and amounts for coalition soldiers, foreign nationals, and enemy combatants.

Perceptions of the community on the pricing of community mental health services.

PubMed

Ogden, J R; Ogden, D T

1992-01-01

In the past few years there has been a decrease in governmental support of Community Mental Health centers. Because of this, there has been some concern, on the part of Community Mental Health professionals, as to the overall impact of this decreased governmental support. Research has been conducted that speculates on how best to handle this mini-crisis. One article suggests moving to an overall marketing approach to help combat this dollar support decline (Day and Ford 1988). Others provide methods for surveying Community Mental Health users (Ludke, Curry & Saywell 1983). William Winston (1988) suggests an overall psychographic segmentation approach to developing market targets. There has also been research detailing promotional methods for expanded marketing coverage (Moldenhauer 1988), however little has been written defining the pricing impact on Community Mental Health services. This study addresses the perceptions of Community Mental Health Center users toward the price variable of the marketing mix.

Medical capability team: the clinical microsystem for combat healthcare delivery in counterinsurgency operations.

PubMed

Clark, Susz; Van Steenvort, Jon K

2008-01-01

Today's operational environment in the support of counterinsurgency operations requires greater tactical and operational flexibility and diverse medical capabilities. The skills and organizations required for full spectrum medical operations are different from those of the past. Combat healthcare demands agility and the capacity for rapid change in clinical systems and processes to better support the counterinsurgency environment. This article proposes the Army Medical Department (AMEDD) develop and implement the medical capability team (MCT) for combat healthcare delivery. It discusses using the concept of the brigade combat team to develop medical capability teams as the unit of effectiveness to transform frontline care; provides a theoretical overview of the MCT as a "clinical microsystem"; discusses MCT leadership, training, and organizational support, and the deployment and employment of the MCT in a counterinsurgency environment. Additionally, this article proposes that the AMEDD initiate the development of an AMEDD Combat Training Center of Excellence to train and validate the MCTs. The complexity of combat healthcare demands an agile and campaign quality AMEDD with joint expeditionary capability in order to promote the best patient outcomes in a counterinsurgency environment.

Caffeine and energy drink use by combat arms soldiers in Afghanistan as a countermeasure for sleep loss and high operational demands.

PubMed

McLellan, Tom M; Riviere, Lyndon A; Williams, Kelly W; McGurk, Dennis; Lieberman, Harris R

2018-03-11

Combat deployments are characterized by high operational demands with limited opportunities for sleep leading to fatigue and degraded cognitive and operational performance. Caffeine in moderate doses is recognized as an effective intervention for physical and cognitive decrements associated with sleep loss. This report is based on data collected by two separate, independently conducted surveys administered in Afghanistan in 2011-2012. It assessed caffeine use and sleep disruption among U.S. Army combat soldiers (J-MHAT 8; n = 518) and among deployed soldiers with different military assignments (USARIEM Deployment Survey; n = 260). Daily caffeine intake assessed in the J-MHAT 8 survey averaged 404 ± 18 mg. In the USARIEM Deployment Survey, intake was 303 ± 29 mg and was significantly higher among combat arms soldiers (483 ± 100 mg) compared to combat service support personnel (235 ± 23 mg). In both surveys, over 55% of total caffeine intake was from energy drinks. Additional sources of caffeine included coffee, tea, sodas, gum, candy, and over-the-counter medications. Higher caffeine intake was not associated with ability to fall asleep at night or wake-up in the morning (J-MHAT 8 survey). Higher caffeine consumption was associated with disrupted sleep from high operational tempo and nighttime duties of combat operations. Overall caffeine consumption and energy drink use in Afghanistan was greater than among non-deployed soldiers and civilians. Caffeine was frequently used as a countermeasure during night operations to offset adverse effects of sleep loss on physical and cognitive function, consistent with current Department of the Army recommendations.

A Meta-Analysis of Risk Factors for Combat-Related PTSD among Military Personnel and Veterans

PubMed Central

Liu, Yuan; Kang, Peng; Wang, Meng; Zhang, Lulu

2015-01-01

Post-traumatic stress disorder (PTSD), a complex and chronic disorder caused by exposure to a traumatic event, is a common psychological result of current military operations. It causes substantial distress and interferes with personal and social functioning. Consequently, identifying the risk factors that make military personnel and veterans more likely to experience PTSD is of academic, clinical, and social importance. Four electronic databases (PubMed, Embase, Web of Science, and PsycINFO) were used to search for observational studies (cross-sectional, retrospective, and cohort studies) about PTSD after deployment to combat areas. The literature search, study selection, and data extraction were conducted by two of the authors independently. Thirty-two articles were included in this study. Summary estimates were obtained using random-effects models. Subgroup analyses, sensitivity analyses, and publication bias tests were performed. The prevalence of combat-related PTSD ranged from 1.09% to 34.84%. A total of 18 significant predictors of PTSD among military personnel and veterans were found. Risk factors stemming from before the trauma include female gender, ethnic minority status, low education, non-officer ranks, army service, combat specialization, high numbers of deployments, longer cumulative length of deployments, more adverse life events, prior trauma exposure, and prior psychological problems. Various aspects of the trauma period also constituted risk factors. These include increased combat exposure, discharging a weapon, witnessing someone being wounded or killed, severe trauma, and deployment-related stressors. Lastly, lack of post-deployment support during the post-trauma period also increased the risk of PTSD. The current analysis provides evidence of risk factors for combat-related PTSD in military personnel and veterans. More research is needed to determine how these variables interact and how to best protect against susceptibility to PTSD. PMID:25793582

A meta-analysis of risk factors for combat-related PTSD among military personnel and veterans.

PubMed

Xue, Chen; Ge, Yang; Tang, Bihan; Liu, Yuan; Kang, Peng; Wang, Meng; Zhang, Lulu

2015-01-01

Post-traumatic stress disorder (PTSD), a complex and chronic disorder caused by exposure to a traumatic event, is a common psychological result of current military operations. It causes substantial distress and interferes with personal and social functioning. Consequently, identifying the risk factors that make military personnel and veterans more likely to experience PTSD is of academic, clinical, and social importance. Four electronic databases (PubMed, Embase, Web of Science, and PsycINFO) were used to search for observational studies (cross-sectional, retrospective, and cohort studies) about PTSD after deployment to combat areas. The literature search, study selection, and data extraction were conducted by two of the authors independently. Thirty-two articles were included in this study. Summary estimates were obtained using random-effects models. Subgroup analyses, sensitivity analyses, and publication bias tests were performed. The prevalence of combat-related PTSD ranged from 1.09% to 34.84%. A total of 18 significant predictors of PTSD among military personnel and veterans were found. Risk factors stemming from before the trauma include female gender, ethnic minority status, low education, non-officer ranks, army service, combat specialization, high numbers of deployments, longer cumulative length of deployments, more adverse life events, prior trauma exposure, and prior psychological problems. Various aspects of the trauma period also constituted risk factors. These include increased combat exposure, discharging a weapon, witnessing someone being wounded or killed, severe trauma, and deployment-related stressors. Lastly, lack of post-deployment support during the post-trauma period also increased the risk of PTSD. The current analysis provides evidence of risk factors for combat-related PTSD in military personnel and veterans. More research is needed to determine how these variables interact and how to best protect against susceptibility to PTSD.

Influence of Combat Blast-Related Mild Traumatic Brain Injury Acute Symptoms on Mental Health and Service Discharge Outcomes

DTIC Science & Technology

2013-08-15

McCrea, M., Harding, H.P., Jr., Matthews, A., and Cantu, R.C. (2007). Recurrent concussion and risk of depression in retired professional football ... concussion , is often unrecog nized due to the severity of the other injuries occurring in a combat setting, particularly life threatening injuries and...foreign body; light sensitivity Previous blast Documented in SOAP note or EMED Previous combat concussion Combat related, documented in SOAP note or EMED

The combat experience of military surgical assets in Iraq and Afghanistan: a historical review.

PubMed

Schoenfeld, Andrew J

2012-09-01

The Forward Surgical Team and Combat Support Hospital have been used extensively only during the past decade in Iraq and Afghanistan. The scope of their operational experience and historical development remain to be described. The literature was searched to obtain publications regarding the historical development of Forward Surgical Teams and Combat Support Hospitals, as well as their surgical experiences in Iraq and Afghanistan. Relevant publications were reviewed in full and their results summarized. The doctrine behind the use of modern military surgical assets was not well developed at the start of the Iraq and Afghanistan conflicts. The Forward Surgical Team and Combat Support Hospital were used in practice only over the past decade. Because of the nature of these conflicts, both types of modern military surgical assets have not been used as intended and such units have operated in various roles, including combat support elements and civilian medical treatment facilities. As more research comes to light, a better appreciation for the future of American military medicine and surgery will develop. Published by Elsevier Inc.

Longitudinal assessment of gender differences in the development of PTSD among US military personnel deployed in support of the operations in Iraq and Afghanistan.

PubMed

Jacobson, Isabel G; Donoho, Carrie J; Crum-Cianflone, Nancy F; Maguen, Shira

2015-09-01

Divergent findings from previous research examining gender differences in the development of posttraumatic stress disorder (PTSD) among US military members deployed to the operations in Iraq or Afghanistan (recent operations) prompted this study utilizing a matching approach to examine whether risk for new-onset PTSD and PTSD severity scores differed by gender. US military members from the Millennium Cohort Study deployed in support of the recent operations were followed for approximately 7 years from baseline through 2 follow-up periods between 2001 and 2008. Propensity score matching was used to match 1 male to each female using demographic, military, and behavioral factors including baseline sexual assault. Analyses were stratified by combat experience defined as reporting at least one of five exposures during follow-up. Outcome measures included a positive screen for PTSD and severity scores measured by the PTSD Patient Checklist-Civilian Version. Discrete-time survival analysis quantified the association between gender and incident PTSD. Among 4684 matched subjects (2342 women and men), 6.7% of women and 6.1% of men developed PTSD during follow-up. Results showed no significant gender differences for the likelihood of developing PTSD or for PTSD severity scores among women and men who reported combat experience and among those who did not. This study is the first of its kind to match a large population of male and female service members on important baseline characteristics including sexual assault. Findings suggest that while combat deployed personnel develop PTSD, women do not have a significantly different risk for developing PTSD than men after experiencing combat. Published by Elsevier Ltd.

Health impact of US military service in a large population-based military cohort: findings of the Millennium Cohort Study, 2001-2008

PubMed Central

2011-01-01

Background Combat-intense, lengthy, and multiple deployments in Iraq and Afghanistan have characterized the new millennium. The US military's all-volunteer force has never been better trained and technologically equipped to engage enemy combatants in multiple theaters of operations. Nonetheless, concerns over potential lasting effects of deployment on long-term health continue to mount and are yet to be elucidated. This report outlines how findings from the first 7 years of the Millennium Cohort Study have helped to address health concerns related to military service including deployments. Methods The Millennium Cohort Study was designed in the late 1990s to address veteran and public concerns for the first time using prospectively collected health and behavioral data. Results Over 150 000 active-duty, reserve, and National Guard personnel from all service branches have enrolled, and more than 70% of the first 2 enrollment panels submitted at least 1 follow-up survey. Approximately half of the Cohort has deployed in support of operations in Iraq and Afghanistan. Conclusion The Millennium Cohort Study is providing prospective data that will guide public health policymakers for years to come by exploring associations between military exposures and important health outcomes. Strategic studies aim to identify, reduce, and prevent adverse health outcomes that may be associated with military service, including those related to deployment. PMID:21281496

Automated and Autonomous Systems for Combat Service Support: Scoping Study and Technology Prioritisation

DTIC Science & Technology

2016-10-01

workshop, and use case development for automated and autonomous systems for CSS. The scoping study covers key concepts and trends, a technology scan, and...requirements and delimiters for the selected technologies. The report goes on to present detailed use cases for two technologies of interest: semi...selected use cases . As a result of the workshop, the large list of technologies and applications from the scoping study was narrowed down to the top

A Critical Analysis of the U.S. Marine Corps 04XX Logistics Community

DTIC Science & Technology

2013-04-15

logistics community. Study .!Manuscript c. PAGE COUNT d . SUBJECT AREA 221 An examination of the training and readiness of a specific military...occupational field. 2. AUTHOR/SPEAKER e. NA M E (LasT. First. M iddle lnhia/J b . RANK c . T ITLE Lathers, Jolm, D. GS-12 Instructional Systems/ Training ...Specialist d. OFFICE e. AGENCY Marine Corps Combat Service Support Schools DoD, DoN, USMC, TECOM, Ground Training Branch 3 . PRESENTATION/ PUBLICA

Defense Logistical Support Contracts in Iraq and Afghanistan: Issues for Congress

DTIC Science & Technology

2009-06-24

on Wartime Contracting in Iraq and Afghanistan; • Section 852 calls for the Army Audit Agency, the Navy Audit Services, and the Air Force Audit...reporting requirements for contractors that perform security functions in areas of combat operations and are involved in the discharge of a weapon or other...hand in dealing with industry. As an example, Secretary of the Navy Donald C. Winter and Chief of Naval Operations Adm. Michael G. Mullen have reported

Helping military families through the deployment process: Strategies to support parenting

PubMed Central

Gewirtz, Abigail H.; Erbes, Christopher R.; Polusny, Melissa A.; Forgatch, Marion S.; DeGarmo, David S.

2011-01-01

Recent studies have highlighted the impact of deployment on military families and children and the corresponding need for interventions to support them. Historically, however, little emphasis has been placed on family-based interventions in general, and parenting interventions in particular, with returning service members. This paper provides an overview of research on the associations between combat deployment, parental adjustment of service members and spouses, parenting impairments, and children’s adjustment problems, and provides a social interaction learning framework for research and practice to support parenting among military families affected by a parent’s deployment. We then describe the Parent Management Training-Oregon model (PMTO™), a family of interventions that improves parenting practices and child adjustment in highly stressed families, and briefly present work on an adaptation of PMTO for use in military families (After Deployment: Adaptive Parenting Tools, or ADAPT). The article concludes with PMTO-based recommendations for clinicians providing parenting support to military families. PMID:21841889

Vaginal yeast infections while deployed in Southwest/Central Asia, active component females, U.S. Armed Forces, 2008-2013.

PubMed

2014-08-01

In field settings, female service members may not have adequate access to bathrooms, showers, laundry, or sanitary products necessary to maintain adequate feminine hygiene; therefore, service women may be at risk for vaginal yeast infections while deployed. During the 6-year surveillance period, nearly 3,000 U.S. military service women were diagnosed with at least one clinically significant yeast infection while supporting combat operations in Southwest/Central Asia. The crude overall incidence rate was 35.1 per 1,000 person-years (p-yrs). Overall incidence rates were higher among black, non-Hispanic service women, and among those in the Army and Air Force, in enlisted grades, and in communications/intelligence and motor transport occupations. The yearly rate of yeast infections was relatively stable from 2008 through 2010, then decreased in 2011 through 2013. Prior to deploying to austere operational settings, female service members should be provided practical and useful information, realistic training, and material support to decrease the risk of acquiring and increase the effectiveness of treating clinically and military operationally significant yeast infections.

The Marine Engineers in Today’s MAGTF: Historical Perspective, Consequences and Alternatives

DTIC Science & Technology

2013-04-15

Inhibited Flexibility for Resource Leveling ...........................................................................17 Mission and Capability...21 Inhibited Flexibility for Resource Leveling ...ground combat element ( GCE ); an engineer support battalion (ESB) supports the logistics combat element (LCE); and engineer operations divisions

Olecranon Bursitis in a Military Population: Epidemiology and Evidence for Prolonged Morbidity in Combat Recruits.

PubMed

Schermann, Haggai; Karakis, Isabella; Dolkart, Oleg; Maman, Eran; Kadar, Assaf; Chechik, Ofir

2017-09-01

Olecranon bursitis (OB) is a benign but disturbing condition that may adversely affect a military recruit's combat preparedness. This study was designed to assess incidence, risk factors, and associated medical burden of OB in the Israel Defense Forces. This is a retrospective study drawing on medical records of all Israel Defense Forces soldiers diagnosed as having OB between 2005 and 2015. OB was classified as septic and noninfectious. Crude incidence rates and duty-specific incidence rates were calculated. Medical burden was defined by the number of physician visits, referrals to orthopedic specialist consultations, duration of symptoms, and duration of pharmaceutical treatment. Demographic and occupational information (age, sex, height, weight, socioeconomic status, country of origin, type of military service, time of presentation to medical services) was used to identify risk factors for septic bursitis and longer duration of symptoms. Statistical analysis was performed in R statistical software. Risk factors were evaluated using the Chi-square test for categorical variables and Pearson correlation coefficients were used for continuous variables. The study was approved by the Israeli Defense Force IRB. A total of 2,692 soldiers were diagnosed with OB during the study period. The crude annual incidence rate of OB was 29/100,000 person-years (PY). Combat duty had an incidence of 97/100,000 PY, and noncombat duties had an incidence of 12/10,000 PY (p < 0.001). Female incidence (8.4/100,000 PY) was similar to male incidence (11/100,000 PY) in administrative duties (p = 0.54). More cases were diagnosed during summer and autumn than in other seasons (p = 0.016). Septic bursitis constituted 24% of all cases, was more frequent in combat soldiers (32%), and on average presented earlier in service than noninfectious OB (13 vs. 17 weeks since recruitment). The mean duration of symptoms was estimated at 17.58 weeks, with a mean of 1.75 physician visits per soldier. About 19% received a specialist referral. Origin from the former USSR was associated with a higher duration of symptoms (p = 0.012). Type of military service was the principal risk factor for OB, as indicated by a higher incidence of the disorder among combat compared to noncombat units, possibly the result of field training without protective gear and repetitive trauma to elbows. The greater number of diagnoses of OB during summer and autumn, when training is more intensive, support that explanation. Sex did not affect incidence of OB in administrative units. The medical burden appears to be relatively low, since most of the soldiers had only one physician visit. OB is highly prevalent in military compared to civilian populations. Outdoor training involving crawling is a probable explanation for the much higher rates among combat units and increased number of diagnoses during warm summer and autumn months. Prevention by use of protective gear seems to be the most promising intervention. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

MEG Working Memory N-Back Task Reveals Functional Deficits in Combat-Related Mild Traumatic Brain Injury.

PubMed

Huang, Ming-Xiong; Nichols, Sharon; Robb-Swan, Ashley; Angeles-Quinto, Annemarie; Harrington, Deborah L; Drake, Angela; Huang, Charles W; Song, Tao; Diwakar, Mithun; Risbrough, Victoria B; Matthews, Scott; Clifford, Royce; Cheng, Chung-Kuan; Huang, Jeffrey W; Sinha, Anusha; Yurgil, Kate A; Ji, Zhengwei; Lerman, Imanuel; Lee, Roland R; Baker, Dewleen G

2018-04-13

Combat-related mild traumatic brain injury (mTBI) is a leading cause of sustained cognitive impairment in military service members and Veterans. However, the mechanism of persistent cognitive deficits including working memory (WM) dysfunction is not fully understood in mTBI. Few studies of WM deficits in mTBI have taken advantage of the temporal and frequency resolution afforded by electromagnetic measurements. Using magnetoencephalography (MEG) and an N-back WM task, we investigated functional abnormalities in combat-related mTBI. Study participants included 25 symptomatic active-duty service members or Veterans with combat-related mTBI and 20 healthy controls with similar combat experiences. MEG source-magnitude images were obtained for alpha (8-12 Hz), beta (15-30 Hz), gamma (30-90 Hz), and low-frequency (1-7 Hz) bands. Compared with healthy combat controls, mTBI participants showed increased MEG signals across frequency bands in frontal pole (FP), ventromedial prefrontal cortex, orbitofrontal cortex (OFC), and anterior dorsolateral prefrontal cortex (dlPFC), but decreased MEG signals in anterior cingulate cortex. Hyperactivations in FP, OFC, and anterior dlPFC were associated with slower reaction times. MEG activations in lateral FP also negatively correlated with performance on tests of letter sequencing, verbal fluency, and digit symbol coding. The profound hyperactivations from FP suggest that FP is particularly vulnerable to combat-related mTBI.

Use of computerized neuropsychological testing to help determine fitness to return to combat operations when taking medication that can influence cognitive function.

PubMed

McLay, Robert; Spira, James; Reeves, Dennis

2010-12-01

Nowhere is it more important to maintain peek mental functioning than in a combat zone. Conditions ranging from pain to head injury to post-traumatic stress disorder can cause impairments in neuropsychological function and place service members at risk. Medications can sometimes help alleviate these problems, but also have the risk of further slowing cognitive function or impairing reaction time. Standard methods of neuropsychological testing are often not available in a combat environment. New technologies are being advanced that can allow portable, computerized neuropsychological testing to be performed at almost any location. We present a case that demonstrates how the use of such handheld technology can assist a military physician in assessing the influence of medication on reaction time and in determining if and when a service member is ready to return to combat.

The 274th Forward Surgical Team experience during Operation Enduring Freedom.

PubMed

Peoples, George E; Gerlinger, Tad; Craig, Robert; Burlingame, Brian

2005-06-01

The 274th Forward Surgical Team (FST) was deployed in support of Operation Enduring Freedom from October 14, 2001 to May 8, 2002. During this period, the FST was asked to perform many nondoctrinal missions. The FST was tasked with functioning as a mini-combat support hospital during the earlier phases of Operation Enduring Freedom, performing in-flight surgical procedures and resuscitation of combat wounded, conducting split operations with surgical coverage of both Karshi and Khanabad, Uzbekistan, and Bagram, Afghanistan, and leading the multinational medical coalition assembled for Operation Anaconda and other combat operations staged from Bagram. Overall, the 274th FST took care of approximately 90% of U.S. combat casualties during this period and treated a total of 221 combat casualties. The FST treated 103 total surgical cases, including 73 with combat wounds. At the time, this experience with combat casualties and the surgical care of combat wounds was the largest since the Persian Gulf War. More importantly, this account describes the flow, frequency, and type of combat casualties seen in a low-intensity conflict like that being waged currently in Afghanistan. It is hoped that this depiction will aid in the preparation, equipping, and overall utilization of surgical assets in similar future conflicts.

U.S. Service Member Deployment in Response to the Ebola Crisis: The Psychological Perspective.

PubMed

Sipos, Maurice L; Kim, Paul Y; Thomas, Stephen J; Adler, Amy B

2018-03-01

In the fall of 2014, the United States and other nations responded to the worst outbreak of the Ebola virus disease in history. As part of this effort, U.S. service members deployed to West Africa to support a spectrum of activities that did not involve direct patient care. Although previous studies identified the psychological impact of responding to an outbreak, these studies were limited to retrospective data, small sample sizes, and medical personnel. The goals of the present study were to (a) document the mental health and well-being of troops deploying in response to an infectious disease outbreak; (b) identify their stressors, attitudes toward deployment, and health risk concerns; and (c) understand the role of combat experience in adjusting to these types of missions. Study participants at both pre- and during deployment were active duty U.S. soldiers in a combat aviation battalion from a large U.S. military installation. U.S. soldiers were surveyed (n = 251) 3 wk before deploying to Liberia (October 2014) and surveyed again during their deployment (February 2015; n = 173). Participants were primarily male (86.1%), junior ranking (56.0%), and just over half had previous combat deployment experience (51.2%). Surveys were anonymous and not linked to one another over time. Overall rates of mental health problems were low (2.4% at pre-deployment and 5.8% during deployment), whereas sleep problems were reported by 4.9% at pre-deployment and 12% during deployment. At pre-deployment, top stressors focused on health threats; fewer stressors were reported during deployment. Soldiers were relatively less concerned about contracting Ebola than other more prevalent diseases. Soldiers with combat experience reported more somatic and sleep problems at pre-deployment than those without previous combat experience. There were no significant differences during deployment between those with and without previous combat experience. Overall, a small proportion of respondents reported significant rates of mental health problems. In contrast, sleep problems were reported by 12% during deployment. In terms of attitudes toward the mission, the vast majority reported that they knew what to do to protect themselves from disease and that they understood the potential risk involved. The study also confirmed previous findings that soldiers with previous combat experience had more somatic symptoms at pre-deployment than those without, although this distinction appeared limited to the pre-deployment phase. Results can be used to address anxiety by personnel during pre-deployment and to inform leadership preparing personnel to deploy in response to future infectious disease outbreaks.

Combat injury coding: a review and reconfiguration.

PubMed

Lawnick, Mary M; Champion, Howard R; Gennarelli, Thomas; Galarneau, Michael R; D'Souza, Edwin; Vickers, Ross R; Wing, Vern; Eastridge, Brian J; Young, Lee Ann; Dye, Judy; Spott, Mary Ann; Jenkins, Donald H; Holcomb, John; Blackbourne, Lorne H; Ficke, James R; Kalin, Ellen J; Flaherty, Stephen

2013-10-01

The current civilian Abbreviated Injury Scale (AIS), designed for automobile crash injuries, yields important information about civilian injuries. It has been recognized for some time, however, that both the AIS and AIS-based scores such as the Injury Severity Score (ISS) are inadequate for describing penetrating injuries, especially those sustained in combat. Existing injury coding systems do not adequately describe (they actually exclude) combat injuries such as the devastating multi-mechanistic injuries resulting from attacks with improvised explosive devices (IEDs). After quantifying the inapplicability of current coding systems, the Military Combat Injury Scale (MCIS), which includes injury descriptors that accurately characterize combat anatomic injury, and the Military Functional Incapacity Scale (MFIS), which indicates immediate tactical functional impairment, were developed by a large tri-service military and civilian group of combat trauma subject-matter experts. Assignment of MCIS severity levels was based on urgency, level of care needed, and risk of death from each individual injury. The MFIS was developed based on the casualty's ability to shoot, move, and communicate, and comprises four levels ranging from "Able to continue mission" to "Lost to military." Separate functional impairments were identified for injuries aboard ship. Preliminary evaluation of MCIS discrimination, calibration, and casualty disposition was performed on 992 combat-injured patients using two modeling processes. Based on combat casualty data, the MCIS is a new, simpler, comprehensive severity scale with 269 codes (vs. 1999 in AIS) that specifically characterize and distinguish the many unique injuries encountered in combat. The MCIS integrates with the MFIS, which associates immediate combat functional impairment with minor and moderate-severity injuries. Predictive validation on combat datasets shows improved performance over AIS-based tools in addition to improved face, construct, and content validity and coding inter-rater reliability. Thus, the MCIS has greater relevance, accuracy, and precision for many military-specific applications. Over a period of several years, the Military Combat Injury Scale and Military Functional Incapacity Scale were developed, tested and validated by teams of civilian and tri-service military expertise. MCIS shows significant promise in documenting the nature, severity and complexity of modern combat injury.

The music of war: Seven World War 1 composers and their experience of combat.

PubMed

Davidson, Jonathan Rt

2016-09-28

The effect of World War 1 military service on composers has been neglected in comparison with poets and artists. This article describes the wartime service of Arthur Bliss, Ralph Vaughan Williams, Ivor Gurney, EJ Moeran, Gordon Jacob, Patrick Hadley, and Maurice Ravel. The relationship between experiences of combat and the psychological health of these men is examined, with consideration being given to predisposition and possible causative influences of military service on their later careers, examined from individual and societal perspectives. © The Author(s) 2016.

[Violence in the family: Ecuadorian experience in the formulation of policies for health services].

PubMed

Maira, G

1999-01-01

Since 1995, PAHO has been carrying out in Bolivia, Ecuador, and Peru a project known as "Violence against Women and Girls: Proposal to Establish Community-coordinated Interventions in Three Countries of the Andean Subregion." Its purpose is to support initiatives being conducted by various nongovernmental organizations (NGOs), government agencies, and social institutions in an attempt to improve the status of women. One of its objectives is to formulate public policies and local services aimed at preventing and combating violence against women and girls through local action networks, data-gathering systems, and legal proposals. This article examines what the initiative has achieved so far in Ecuador, in efforts conducted in Quito, Guayaquil, and Sigsig with the support of three national NGOs and in conjunction with the Ministry of Health and the National Women's Council.

Amputation: Not a failure for severe lower extremity combat injury.

PubMed

van Dongen, Thijs T C F; Huizinga, Eelco P; de Kruijff, Loes G M; van der Krans, Arie C; Hoogendoorn, Jochem M; Leenen, Luke P H; Hoencamp, Rigo

2017-02-01

The use of improvised explosive devices is a frequent method of insurgents to inflict harm on deployed military personnel. Consequently, lower extremity injuries make up the majority of combat related trauma. The wounding pattern of an explosion is not often encountered in a civilian population and can lead to substantial disability. It is therefore important to study the impact of these lower extremity injuries and their treatment (limb salvage versus amputation) on functional outcome and quality of life. All Dutch repatriated service members receiving treatment for wounds on the lower extremity sustained in the Afghan theater between august 2005 and August 2014, were invited to participate in this observational cohort study. We conducted a survey regarding their physical and mental health using the Short Form health survey 36, EuroQoL 6 dimensions and Lower Extremity Functional Scale questionnaires. Results were collated in a specifically designed electronic database combined with epidemiology and hospital statistics gathered from the archive of the Central Military Hospital. Statistical analyses were performed to identify differences between combat and non-combat related injuries and between limb salvage treatment and amputation. In comparison with non-battle injury patients, battle casualties were significantly younger of age, sustained more severe injuries, needed more frequent operations and clinical rehabilitation. Their long-term outcome scores in areas concerning well-being, social and cognitive functioning, were significantly lower. Regarding treatment, amputees experienced higher physical well-being and less pain compared to those treated with limb salvage surgery. Sustaining a combat injury to the lower extremity can lead to partial or permanent dysfunction. However, wounded service members, amputees included, are able to achieve high levels of activity and participation in society, proving a remarkable resilience. These long-term results demonstrate that amputation is not a failure for casualty and surgeon, and strengthen a life before limb (damage control surgery) mindset in the initial phase. For future research, we recommend the use of adequate coding and injury scoring systems to predict outcome and give insight in the attributes that are supportive for the resilience that is needed to cope with a serious battle injury. Copyright © 2016 Elsevier Ltd. All rights reserved.

Real options valuation in the design of Future surface combatants

DTIC Science & Technology

2017-06-01

VALUATION IN THE DESIGN OF FUTURE SURFACE COMBATANTS by Lauren B. Majchrzak June 2017 Thesis Advisor: Johnathan Mun Second Reader: Tom...thesis 4. TITLE AND SUBTITLE REAL OPTIONS VALUATION IN THE DESIGN OF FUTURE SURFACE COMBATANTS 5. FUNDING NUMBERS 6. AUTHOR(S) Lauren B. Majchrzak...meeting their service-life expectancy of 40 years. Modular Adaptable Ship (MAS) designs that include flexibility, decoupled payloads from the platform

Army Airspace Command and Control (A2C2): Action Plan for Issue Resolution

DTIC Science & Technology

1993-09-01

INFO Information INTEL Intelligence IPR In-Process Review IVIS Inter-Vehicular Information System JACC Joint Airspace Control Center JAOC Joint Air...base, centralized such as intelligence at Fort Huachuca and combat service support at Fort Lee , or a combination of both. It is no longer efficient to...Regiment (ATS) Ft. Bragg, NC 28307 ATTN: AFZF-ATS-C (LTC Ledbetter ) (919) 396-8899/7649 Bldg 87009, 16th Street Ft. Hood, TX 76544 Commander, 1st

Military and Veteran Support: DOD and VA Programs That Address the Effects of Combat and Transition to Civilian Life

DTIC Science & Technology

2014-11-01

servicemembers to civilian life. For its part, VA’s agency priority goals are to (1) ensure access to VA benefits and services, (2) eliminate the disability...transfer their benefits to dependents. VA – Veterans Benefit Administration ( VBA ) Spinal Cord Injury and Disorders Centers Disability; Physical...who are temporarily residing in a home owned by a family member to help adapt the home to meet his or her special needs. VA - VBA Yellow Ribbon

Journal of Special Operations Medicine. Training Supplement: Tactics, Techniques, and Procedures, Volume 8 Edition 4, Fall 2008

DTIC Science & Technology

2008-01-01

alimentary tract anaerobes (AI). Initial antibacterial activity should not be directed at multidrug-resistant pathogens such as Acinetobacter baumannii...plus 4 isolation beds Ancillary Lab, x-ray 5. LPH, AKA, APA, LST class ships are no longer in active service. 6. Hospital ships (T-AH) may provide...responsibilities and as the supported combatant commander for the Global War on Terrorism (GWOT). USSOCOM is actively engaged in the JLLP, where the goal

A Prospective Study of Depression Following Combat Deployment in Support of the Wars in Iraq and Afghanistan

DTIC Science & Technology

2010-01-01

disor- der.21 Another cross-sectional study utilizing National Comorbidity Survey data found an in- creased risk for major depressive disorders among...Health Questionnaire (PHQ)38 and the Medical Outcomes Study Short Form 36-Item Health Survey for Veterans.39 We used Millennium Cohort Study data to in...was launched in 2001 to collect and evaluate population- based data on behavioral and occupational risks related to military service that may be

Building (Family) Muscle: How Prolonged Conflicts Can Strengthen Military Families

DTIC Science & Technology

2011-03-12

deployments in combat zones. Approximately 1.5 million American troops have been deployed in support of the war effort; one-third of them have served at...officers killed in battle.”9 Globally recognized today as the world ‟s premier war fighting force, the United States Armed Forces owes a debt of gratitude...the back seat to the needs of the military services. As the military continued to evolve and transform through the First World War , there was no

Self Reported Behavioral Health Habits and Other Health Issues Influencing Capabilities and Mission Readiness of Combat Search and Rescue Personnel

DTIC Science & Technology

2017-02-23

percentages for increased poor health habits, healthcare utilization, and medication usage were computed using the group n as the denominator instead of the n... survey to assess for general areas of health-related behaviors (i.e., sleep and exercise; alcohol, tobacco, and caffeine use; common reasons for seeking...medical care and mental health support services; and reasons for increased prescription and over-the-counter medication usage ) relevant to

Naval Expeditionary Logistics. Enabling Operational Maneuver From the Sea

DTIC Science & Technology

1999-01-01

of the core objectives of the President’s national security strategy is to "enhance our [the nation’s] security with effective diplomacy and with... effect on logistics requirements, and some interpretations of OMFTS assume that the concept applies to a future force much lighter than today’s. Others...addition to, or in lieu of, today’s capabilities? The answer has a profound effect on the future combat service support structure of both the Marine

Horizon Scan of Emerging Technologies and Trends for ADF Combat Service Support 2016

DTIC Science & Technology

2016-12-01

Autonomous Robot (SMART) for stitching [315], Flex Robotic System and Flex arm for operating through non-linear winding paths (like the throat) [314...knows-about-customers-habits.html?referer=&_r=0. 15. Singer, P. W. (2009) Wired for War. The Robotics Revolution and Conflict in the 21st Century...spotlight/spotid=40493.php. 61. Chandler, D. L. (2015) Tiny wires could provide a big energy boost. MIT via Nanowerk News, 7 July 2015 [Last accessed 16

Combination of Extracorporeal Life Support and Mesenchymal Stem Cell Therapy for Treatment of ARDS in Combat Casualties and Evacuation of Service Members with ARDS

DTIC Science & Technology

2017-10-01

invasiveness of mechanical ventilation and inflammatory mediators as well as improvement in oxygenation and functional outcome. 4 Keywords Acute...The Clark system is allowing us to measure the mitochondrial activity by the oxygen consumption during activation. Because the LPS-induced injury we... Ventilation • Tidal Volume • Respiratory Rate • Peak inspiratory Pressure • Positive End Expiratory Pressure (PEEP) • Fraction of inspired oxygen

Air Land Sea Bulletin, Issue No. 2013-2, Joint Close Air Support

DTIC Science & Technology

2013-05-01

game plan between his aircraft or element and the coor- dinated attack aircraft or element (s) for a specific JTAC/FAC(A) designated target. However...5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME...Service Department of Defense field agency sponsored by the US Army Train - ing and Doctrine Command (TRADOC), Marine Corps Combat Development Command

Culture Circles in adolescent empowerment for the prevention of violence

PubMed Central

Monteiro, Estela Maria Leite Meirelles; Neto, Waldemar Brandão; de Lima, Luciane Soares; de Aquino, Jael Maria; Gontijo, Daniela Tavares; Pereira, Beatriz Oliveira

2015-01-01

An action research based on Paulo Freire's Culture Circles was developed to implement a health education intervention involving adolescents, in collective knowledge construction about strategies for the prevention of violence. The data collection in the Culture Circles involved 11 adolescents and included observation and field diary, photographic records and recording. The educational action aroused a critical socio-political and cultural position in the adolescents towards the situations of vulnerability to violence, including the guarantee of human rights, justice and the combat of inequities; changes in the social relations, combat against discrimination and intolerance; expansion of access and reorientation of health services through intersectoral public policies. The intervention empowered the group of adolescents for the prevention of violence and permitted the inclusion of health professionals in the school context, from an interdisciplinary perspective, contributing to the establishment of social support and protection networks. PMID:25931647

Alcohol Misuse in Reserve Soldiers and their Partners: Cross-Spouse Effects of Deployment and Combat Exposure.

PubMed

Vest, Bonnie M; Heavey, Sarah Cercone; Homish, D Lynn; Homish, Gregory G

2018-04-16

Military deployment and combat are associated with worse outcomes, including alcohol misuse. Less is known about how these experiences affect soldiers' spouses. The study objective was to explore relationships between deployment, combat exposure, and alcohol misuse; especially cross-spouse effects (effect of one partner's experiences/behavior on the other partner), which has been under-examined in military samples. U.S. Army Reserve/National Guard soldiers and their partners completed a questionnaire covering physical and mental health, military service and substance use. Negative binomial regression models examined number of deployments and combat exposure individually for alcohol misuse and frequent heavy drinking (FHD). In additional models, we examined combat exposure's role on alcohol outcomes, controlling for the soldiers' number of deployments, PTSD symptoms, age, and in cross-spouse models, alcohol use and FHD. We considered individuals' deployment experiences related to their alcohol outcomes and to their spouses' alcohol outcomes. The study sample included male soldiers with current/lifetime military service (n = 248) and their female partners. Combat exposure was related to FHD (RR: 1.01, p < .05, 95% CI: 1.01, 1.01) among male soldiers while controlling for PTSD symptoms, number of deployments, and age. Female partners of male soldiers were more likely to engage in FHD (RR: 1.01, p < .05, 95% CI: 1.01, 1.01) if their spouse experienced combat. Our results demonstrate that male soldiers and their spouses are at increased risk of FHD if the soldier experienced combat. This points to the need for better screening, particularly of spouses of soldiers, whose alcohol misuse may be overlooked.

Army Logistician. Volume 37, Issue 4, July-August 2005

DTIC Science & Technology

2005-08-01

Galaxy , and the C–17 Globe- master can only lift one M1 tank at a time. The C–17 can lift up to four UH–60 Black Hawk helicopters, two AH–64 Apache...SOLDIERS MAY ATTEND RANGER SCHOOL Soldiers in combat support (CS) and combat ser- vice support (CSS) branches of the Army may now attend Ranger School...In the past, attendance at Ranger School was limited to combat arms soldiers and those who were assigned to the 75th Ranger Regiment or the Ranger

Improving Air Force Command and Control Through Enhanced Agile Combat Support Planning, Execution, Monitoring, and Control Processes

DTIC Science & Technology

2012-01-01

Tripp, Lionel A. Galway , Timothy L. Ramey, Mahyar A. Amouzegar, and Eric Peltz (MR-1179-AF), 2000. This report describes a vision for the combat...Postures, Lionel  A. Galway , Robert S. Tripp, Timothy  L. Ramey, and John G. Drew (MR-1075-AF), 2000. This report describes how alternative resourcing of...Aerospace Forces: An Integrated Strate- gic Agile Combat Support Planning Framework, Robert S. Tripp, Lionel  A. Galway , Paul Killingsworth, Eric Peltz

Worldwide actions to combat abuse.

PubMed

1998-01-01

This paper reports several developments on the global efforts to combat abuse and violence against women and children. It is noted that in South Africa, Belem, Brazil, and Lesotho, protest actions were conducted against women and child abuse. Although the protests were made separately, the protests generally called for implementation of initiatives from the government to address the issue of child and women abuse. In the context of preventing abusive behaviors, a study by the University of Cape Town in South Africa on the appropriateness and feasibility of short-term community-based group therapy concluded that such an approach might be effective in treating delinquent behavior. In Indonesia, the Rifka Annisa Women's Crisis Centre is working to combat violence against women by providing services to victims; while in Israel, a media campaign is aiming to increase awareness and support for women's help centers. In addition, the government of Bangladesh has established a Cell Against Violence Against Women that provides legal counseling and assistance for civil and criminal cases related to violence against women. Furthermore, the WHO and the International Federation of Obstetricians and Gynecologists have collaborated to conduct a joint workshop to explore how violence against women can be eliminated.

New Equipping Strategies for Combat Support Hospitals

DTIC Science & Technology

2010-01-01

Combat and Doctrine Development and COL Timothy Lamb , supported by MAJ Gary Cooper, included members of our team in visits to Sierra Army Depot and...aspect of improving materiel stew - ardship is improving the quality of data related to the procurement, maintenance, and upgrading of equipment

Cross (Unit)-Level Effects of Cohesion on Relationships of Suicide Thoughts to Combat Exposure, Postdeployment Stressors, and Postdeployment Social Support.

PubMed

Griffith, James

2015-01-01

A behavioral health concern for the US military has been suicide, largely due to its increased prevalence in the last several years during US involvement in the Iraq and Afghanistan wars. Using hierarchical linear modeling (HLM), the present study examined relationships among combat exposure, postdeployment stressors, social support, and unit cohesion. Survey data were obtained from 4,567 soldiers who were members of 50 company-sized units. At the individual level, combat exposure and postdeployment stressors were associated with suicidal thoughts. Postdeployment social support was associated with fewer suicidal thoughts. There was no evidence of the stress-buffering effect of social support. At the group level, reduced risk for suicidal thoughts was associated with units having higher than average cohesion. Reduced risk for suicidal thoughts in conjunction with combat experiences was observed in units having higher than average cohesion, though not reaching a traditional level of statistical significance.

Instinctive analytics for coalition operations (Conference Presentation)

NASA Astrophysics Data System (ADS)

de Mel, Geeth R.; La Porta, Thomas; Pham, Tien; Pearson, Gavin

2017-05-01

The success of future military coalition operations—be they combat or humanitarian—will increasingly depend on a system's ability to share data and processing services (e.g. aggregation, summarization, fusion), and automatically compose services in support of complex tasks at the network edge. We call such an infrastructure instinctive—i.e., an infrastructure that reacts instinctively to address the analytics task at hand. However, developing such an infrastructure is made complex for the coalition environment due to its dynamism both in terms of user requirements and service availability. In order to address the above challenge, in this paper, we highlight our research vision and sketch some initial solutions into the problem domain. Specifically, we propose means to (1) automatically infer formal task requirements from mission specifications; (2) discover data, services, and their features automatically to satisfy the identified requirements; (3) create and augment shared domain models automatically; (4) efficiently offload services to the network edge and across coalition boundaries adhering to their computational properties and costs; and (5) optimally allocate and adjust services while respecting the constraints of operating environment and service fit. We envision that the research will result in a framework which enables self-description, discover, and assemble capabilities to both data and services in support of coalition mission goals.

The New Jersey Comprehensive Plan to Combat Mental Retardation.

ERIC Educational Resources Information Center

New Jersey State Interdepartmental Committee on Lifetime Disability, Trenton.

Recommendations to combat mental retardation in New Jersey are made in the following areas: coordination; research; prevention, detection, and treatment; clinical, social, recreation, and religious services; residential care; education; vocational rehabilitation; law; manpower and training; and public awareness. Additional information is given…

Women in Combat: Issues for Congress

DTIC Science & Technology

2016-12-13

also consider issues such as equal opportunity, equal responsibility (such as selective service registration), and the overall manpower needs of the...have become increasingly blurred and as a result DOD’s combat exclusion policies have been called into question. On January 24, 2013, then

Talking in the Ranks: Gender and Military Discourse

DTIC Science & Technology

2005-04-29

argue that women’s performance and the military’s reliance upon women in the current conflict are reasons to reconsider some of the restrictions placed...masculinity. The proximity to combat can be key to analysis of language and gender in a military environment due to restrictions placed upon women in the...combat positions. Some restrictions , however, are not driven by proximity to combat, notably women’s restriction from service aboard submarines. Women

A Comparison of the US Air Force Fitness Test and Sister Services’ Combat-Oriented Fitness Tests

DTIC Science & Technology

2009-03-01

could lead to injuries such as twisted ankles, sprains, bruises, lower back pain, abdominal cramps and pain, muscle fatigue , strains, exhaustion, nausea...twisted ankles, sprains, bruises, lower back pain, abdominal cramps and pain, muscle fatigue , strains, exhaustion, nausea, headaches, or other...combat skills, anaerobic exercises, and burst speed exercises. They have, or are in the process of, creating their own versions of combat fitness tests

Precipice of Parity: Future of the USAF Fighter Force Structure

DTIC Science & Technology

2014-04-01

573 to 487 aircraft to conduct combat operations . The total force that one can never expect to get off the ground on a given day is thus 86 of the...AD area denial ADOC Air Defense Operations Center AGM air-to- ground missile ASCM anti-ship cruise missile CAF Combat Air Force CAPES Combat...suggestions for reducing this burden, to Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis

Teaching tactical combat casualty care using the TC3 sim game-based simulation: a study to measure training effectiveness.

PubMed

Sotomayor, Teresita M

2010-01-01

The effectiveness of games as instructional tools has been debated over the past several decades. This is due to the lack of empirical data to support such claims. The US ARMY developed a game-based simulation to support Tactical Combat Casualty Care (TCCC) Training. The TC3 Game based Simulation is a first person game that allows a Soldier to play the role of a combat medic during an infantry squad mission in an urban environment. This research documents results from a training effectiveness evaluation conducted at the Department of Combat Medic Training (Ft Sam Houston) in an effort to explore the capability of the game based simulation as a potential tool to support the TCCC program of instruction. Reaction to training, as well as, acquisition of knowledge and transfer of skills were explored using Kirkpatrick's Model of Training Effectiveness Evaluation. Results from the evaluation are discussed.

[Medical support of the Armed Forces of the Russian Federation: the results of the activities and the main tasks for 2015].

PubMed

Fisun, A Ia

2015-01-01

Presented the directions of activity of the medical service in the past year, including improving the legal framework, the optimization of medical management software, improving combat and mobilization readiness of units of the army, the optimization of therapeutic and preventive activities, implementation of innovative technologies, increasing mobility of units and subunits, their level of equipping with modern samples of property, training of qualified personnel, intensify research and etc. Analyzed and formulated directions of development of military medicine in 2015, including improvement of combat and mobilization readiness of the management body, military and medical organizations and departments, improving the legal framework of the military health care, holding among the troops interventions for the prevention morbidity of personnel by pneumonia and meningitis, work with commanders at all levels to ensure the preservation and strengthening of health of servicemen, improving of the system of early and active detection of diseases in the military, providing a guaranteed level of care to all contingent Ministry of Defense, improving the quality and accessibility of sanatorium treatment, maintaining constant readiness of medical special forces to carry out tasks for the purpose, improvement of professional training of personnel of the medical service, providing qualitative preparation of government medical service to participate in the training of troops, implementation of unexpected problems, equipping of army medical service with modern medical equipment finishing of the construction and renovation of military medical organizations facilities, improvement of social protection of personnel and many others.

Mental Health and Comorbidities in U.S. Military Members.

PubMed

Crum-Cianflone, Nancy F; Powell, Teresa M; LeardMann, Cynthia A; Russell, Dale W; Boyko, Edward J

2016-06-01

Using data from a prospective cohort study of U.S. service members who joined after September 11, 2001 to determine incidence rates and comorbidities of mental and behavioral disorders. Calculated age and sex adjusted incidence rates of mental and behavioral conditions determined by validated instruments and electronic medical records. Of 10,671 service members, 3,379 (32%) deployed between baseline and follow-up, of whom 49% reported combat experience. Combat deployers had highest incidence rates of post-traumatic stress disorder (PTSD) (25 cases/1,000 person-years [PY]), panic/anxiety (21/1,000 PY), and any mental disorder (34/1,000 PY). Nondeployers had substantial rates of mental conditions (11, 13, and 18 cases/1,000 PY). Among combat deployers, 12% screened positive for mental disorder, 59% binge drinking, 16% alcohol problem, 19% cigarette smoking, and 20% smokeless tobacco at follow-up. Of those with recent PTSD, 73% concurrently developed >1 incident mental or behavioral conditions. Of those screening positive for PTSD, 11% had electronic medical record diagnosis. U.S. service members joining during recent conflicts experienced high rates of mental and behavioral disorders. Highest rates were among combat deployers. Most cases were not represented in medical codes, suggesting targeted interventions are needed to address the burden of mental disorders among service members and Veterans. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

A composite CBRN surveillance and testing service

NASA Astrophysics Data System (ADS)

Niemeyer, Debra M.

2004-08-01

The terrorist threat coupled with a global military mission necessitates quick and accurate identification of environmental hazards, and CBRN early warning. The Air Force Institute for Operational Health (AFIOH) provides fundamental support to protect personnel from and mitigate the effects of untoward hazards exposures. Sustaining healthy communities since 1955, the organizational charter is to enhance warfighter mission effectiveness, protect health, improve readiness and reduce costs, assess and manage risks to human heath and safety, operational performance and the environment. The AFIOH Surveillance Directorate provides forward deployed and reach-back surveillance, agent identification, and environ-mental regulatory compliance testing. Three unique laboratories process and analyze over two million environmental samples and clinical specimens per year, providing analytical chemistry, radiological assessment, and infectious disease testing, in addition to supporting Air Force and Department of Defense (DoD) clinical reference laboratory and force health protection testing. Each laboratory has an applied or investigational testing section where new technologies and techniques are evaluated, and expert consultative support to assist in technology assessments and test analyses. The Epidemiology Surveillance Laboratory and Analytical Chemistry Laboratory are critical assets of the Centers for Disease Control and Prevention (CDC) National Laboratory Response Network. Deployable assets provide direct support to the Combatant Commander and include the Air Force Radiological Assessment Team, and the Biological Augmentation Team. A diverse directorate, the synergistic CBRN response capabilities are a commander"s force protection tool, critical to maintaining combat power.

Homecoming of Citizen Soldiers: Postdeployment Problems and Service Use Among Army National Guard Soldiers.

PubMed

Griffith, James

2017-10-01

The present study described the types and amount of problems and services sought among returned deployed Army National Guard soldiers (4568 soldiers in 50 units). The study responds to gaps in the research literature to better understand community intervention needs of reservists. About half (48%) of the soldiers reported one or two problems, mostly those of psychological well-being, such as feelings of anger and frustration, upsetting memories, and troubled sleep (34% of the study sample), followed by problems of social support (18%), alcohol use (17%), feelings of isolation including suicidal thoughts (13%), and financial difficulties (11%). Having engaged in direct combat and having wounded or killed someone showed positive relationships with reported problems. One-third (35%) of soldiers who reported having used services went to one service and, generally, soldiers went to services related to their expressed problems. Variance in self-reported problems explained by service use was low, suggesting unsought postdeployment services.

A Review of Combat Support Training.

ERIC Educational Resources Information Center

Montague, Ernest K.; Showel, Morris

This report presents a review of current training practices and problems as they relate to the broad spread of individual ability among soldiers, and to the increasing need for functionalization of training. Combat support training was observed at four army training centers, with particular reference to training objectives, methods, and student…

Combat veterans, mental health issues, and the death penalty: addressing the impact of post-traumatic stress disorder and traumatic brain injury.

PubMed

Giardino, Anthony E

2009-05-01

More than 1.5 million Americans have participated in combat operations in Iraq and Afghanistan over the past seven years. Some of these veterans have subsequently committed capital crimes and found themselves in our nation's criminal justice system. This Essay argues that combat veterans suffering from post-traumatic stress disorder or traumatic brain injury at the time of their offenses should not be subject to the death penalty.Offering mitigating evidence regarding military training, post-traumatic stress disorder, and traumatic brain injury presents one means that combat veterans may use to argue for their lives during the sentencing phase of their trials. Alternatively, Atkins v. Virginia and Roper v. Simmons offer a framework for establishing a legislatively or judicially created categorical exclusion for these offenders, exempting them from the death penalty as a matter of law. By understanding how combat service and service-related injuries affect the personal culpability of these offenders, the legal system can avoid the consequences of sentencing to death America's mentally wounded warriors, ensuring that only the worst offenders are subject to the ultimate punishment.

32 CFR 47.4 - Policy.

Code of Federal Regulations, 2010 CFR

2010-07-01

... the military organizational structure. (4) Emoluments associated with military personnel; i.e., the... alter the organization's prewar character. (B) If the application is based on service in a combat zone... similar groups not in a combat zone. (ii) Organizational authority over the group. The concept of military...

Neural indicators of interpersonal anger as cause and consequence of combat training stress symptoms.

PubMed

Gilam, G; Lin, T; Fruchter, E; Hendler, T

2017-07-01

Angry outbursts are an important feature of various stress-related disorders, and commonly lead to aggression towards other people. Findings regarding interpersonal anger have linked the ventromedial prefrontal cortex (vmPFC) to anger regulation and the locus coeruleus (LC) to aggression. Both regions were previously associated with traumatic and chronic stress symptoms, yet it is unclear if their functionality represents a consequence of, or possibly also a cause for, stress symptoms. Here we investigated the relationship between the neural trajectory of these indicators of anger and the development and manifestation of stress symptoms. A total of 46 males (29 soldiers, 17 civilians) participated in a prospective functional magnetic resonance imaging experiment in which they played a modified interpersonal anger-provoking Ultimatum Game (UG) at two-points. Soldiers were tested at the beginning and end of combat training, while civilians were tested at the beginning and end of civil service. We assumed that combat training would induce chronic stress and result in increased stress symptoms. Soldiers showed an increase in stress symptoms following combat training while civilians showed no such change following civil service. All participants were angered by the modified UG irrespective of time point. Higher post-combat training stress symptoms were associated with lower pre-combat training vmPFC activation and with higher activation increase in the LC between pre- and post-combat training. Results suggest that during anger-provoking social interactions, flawed vmPFC functionality may serve as a causal risk factor for the development of stress symptoms, and heightened reactivity of the LC possibly reflects a consequence of stress-inducing combat training. These findings provide potential neural targets for therapeutic intervention and inoculation for stress-related psychopathological manifestations of anger.

Support Air and Space Expeditionary Forces. Analysis of Combat Support Basing Options

DTIC Science & Technology

2004-01-01

Mahyar A . Amouzegar, Robert S. Tripp, Ronald G. McGarve Edward W Chan C. Robert Roll, Jr. _77 Ap L_ L; Reý PROJECT AIR FORCE - Supporting Air and Space...Expeditionary Forces Analysis of Combat Support Basing Options Mahyar A . Amouzegar Robert S. Tripp Ronald G. McGarvey Edward W. Chan C. Robert Roll...support basing options / Mahyar A . Amouzegar ... [et al. p. cm. "’MG-261." Indudes bibliographical references. ISBN 0-8330-3675-0 (pbk.) 1. Air bases

A twin study of the effects of the Vietnam conflict on alcohol drinking patterns.

PubMed Central

Goldberg, J; Eisen, S A; True, W R; Henderson, W G

1990-01-01

This study examines the association between military service in Southeast Asia and alcohol drinking patterns in 2,169 male-male monozygotic twin pairs who both served on active military duty during the Vietnam era (1965-75). Data on alcohol drinking were collected in 1987 by mail and telephone interview. The alcohol drinking measures include three indicators of abstention (lifetime abstainer, lifetime non-regular drinker, and current abstainer) and two indicators of consumption (average daily ethanol consumption and high consumption). In unadjusted and co-twin adjusted analyses, neither service in Southeast Asia nor combat exposure was significantly associated with any measure of abstention. In the co-twin adjusted analysis, there was no association of Southeast Asia service and combat exposure with average daily ethanol consumption. After adjustment for co-twin effects, 4.0 percent of non-Southeast Asia veterans were high consumers compared to 6.7 percent of Southeast Asia veterans who served in high combat. We conclude that prior military service in a war zone has a relatively modest long-term effect on the alcohol drinking patterns of male veterans. PMID:2327534

Development of a lightweight portable ventilator for far-forward battlefield combat casualty support

NASA Astrophysics Data System (ADS)

Cutchis, Protagoras N.; Smith, Dexter G.; Ko, Harvey W.; Wiesmann, William P.; Pranger, L. Alex

1999-07-01

Immediate medical provision substantially reduces the number of fatalities sustained during military operations. However, the shift from large-scale regional conflicts to smaller peacekeeping and humanitarian missions has reduced the military medical support infrastructure. Civilian emergency medical services have long emphasized the 'golden hour' during which a patient must receive definitive medical attention. Without on-scene medical support, injured soldiers must be transported significant distances before receiving advanced medical care, and rapid transport to a medical facility is not always a viable option. Technological solutions enable military medics to deliver advanced medical care on the battlefield. We report here on the development of a small lightweight portable respirator for the treatment of far- forward battlefield casualties. The Far Forward Life Support System (FFLSS) utilizes a combination of COTS (commercial off the shelf) components and custom designed systems to provide ventilatory support to injured combatants. It also incorporates a small IV fluid pump and IV fluids for resuscitation. A microcompressor control system monitors both system performance and patient parameters for system control. Telemetry to a pager-like device worn by the front line medic alerts of any anomalies in ventilator or patient parameters, which will add greatly to triage decisions and resource management. Novel elements of the FLSS design include oxygen generation, low-pressure air generation, available patient suction, and the absence of any high pressure air cylinders. A prototype developed for animal testing will be described in detail as well as further design requirements for the human rated prototype.

Male combat veterans' narratives of PTSD, masculinity, and health.

PubMed

Caddick, Nick; Smith, Brett; Phoenix, Cassandra

2015-01-01

This article uniquely examines the ways a group of male combat veterans talk about masculinity and how, following post-traumatic stress disorder (PTSD), they performed masculinities in the context of a surfing group, and what effects this had upon their health and wellbeing. Participant observations and life history interviews were conducted with a group of combat veterans who belonged to a surfing charity for veterans experiencing PTSD. Data were rigorously explored via narrative analysis. Our findings revealed the ways in which veterans enacted masculinities in accordance with the values that were cultivated during military service. These masculine performances in the surfing group had important effects both on and for the veterans' wellbeing. Significantly, the study highlights how masculine performances can be seen alternately as a danger and as a resource for health and wellbeing in relation to PTSD. The article advances knowledge on combat veterans and mental health with critical implications for the promotion of male veterans' mental health. These include the original suggestion that health-promoting masculine performances might be recognised and supported in PTSD treatment settings. Rather than automatically viewing masculinity as problematic, this article moves the field forward by highlighting how hegemonic masculinities can be reconstructed in positive ways which might improve veterans' health and wellbeing. A video abstract of this article can be found at: https://www.youtube.com/watch?v=BaYzaOP1kAY. © 2015 The Authors. Sociology of Health & Illness © 2015 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

Association Between Combat Stress and Post-Concussive Symptom Reporting in OEF/OIF Service Members with Mild Traumatic Brain Injuries

DTIC Science & Technology

2010-01-01

and treatment of traumatic brain injury ( TBI ) in service members returning from combat- deployment [1]. Several recent studies provide incidence...DVBlC) at Walter Reed Army between January 2003 and met criteria for mild TBI [3]. prevalence study of of the sample of over 22qCJltrjeSI)0...improvements in body armour, increased screening and diagnosis and greater knowledge and awareness of mild TBI arising from civilian sports-related

Navy DDG-1000 and DDG-51 Destroyer Programs: Background, Oversight Issues, and Options for Congress

DTIC Science & Technology

2008-09-11

July 31, 2008, hearing before the Seapower and Expeditionary Forces subcommittee of the House Armed Services Committee, Navy officials announced a major...Aegis combat system and the arming of the ship with the SM-3, a version of the Navy’s Standard Missile that is designed for BMD operations.7 The Navy has...the Navy (Ship Programs), before the Subcommittee on Seapower and Expeditionary Forces of the House Armed Services Committee, on Surface Combatant

Navy DDG-1000 and DDG-51 Destroyer Programs: Background, Oversight Issues, and Options for Congress

DTIC Science & Technology

2008-10-09

of the House Armed Services Committee, Navy officials announced a major change in the service’s position on what kind of destroyers it wants to...among other things, the addition of a new software program for the Aegis combat system and the arming of the ship with the SM-3, a version of the...Expeditionary Forces of the House Armed Services Committee, on Surface Combatant Requirements and Acquisition Strategies, July 31, 2008, 11 pp., and the spoken

Associations of coping processes with posttraumatic stress disorder symptoms in national guard/reserve service members deployed during the OEF-OIF era.

PubMed

Rodrigues, Camila S; Renshaw, Keith D

2010-10-01

Studies have identified coping processes as one potential factor influencing PTSD in veterans. This study examined the associations between coping, combat exposure, and PTSD among 218 National Guard veterans deployed overseas since 2001. Problem-focused coping was unrelated to combat exposure and PTSD symptoms. In contrast, increased levels of emotion focused coping (EFC) were found in veterans who reported higher levels of combat exposure. Moreover, the severity of combat was a curvilinear moderator of the relation between coping process and PTSD, such that EFC was unrelated to PTSD symptom severity at low levels of combat, associated with higher symptom severity at moderate levels of combat, and associated with lower symptom severity at high levels of combat. These findings indicate that the type and severity of trauma may moderate the association of coping and psychological outcomes, and that these associations might not be linear. Published by Elsevier Ltd.

Unit Support Protects Against Sexual Harassment and Assault among National Guard Soldiers

PubMed Central

Walsh, Kate; Galea, Sandro; Cerda, Magdalena; Richards, Catherine; Liberzon, Israel; Tamburrino, Marijo B.; Calabrese, Joseph; Koenen, Karestan C.

2014-01-01

Objective Despite concerns about increased sexual harassment and assault following 2013 legislation repealing the ban on women in combat, little research has examined military factors that could prevent sexual harassment and assault during deployment. This study examined whether unit support, which reflects the quality of service members’ relationships within their unit, protects against sexual harassment and assault during deployment. Methods Participants were 1674 Ohio Army National Guard service members who reported at least one deployment during a telephone survey conducted in 2008-2009. Participants completed measures of sexual harassment/assault, unit support, and psychosocial support. Logistic regression was used to model odds of sexual harassment/assault. Results Approximately 13.2% (n=198) of men and 43.5% (n=74) of women reported sexual harassment, and 1.1% (n=17) of men and 18.8% (n=32) of women reported sexual assault during their most recent deployment. Higher unit support was associated with decreased odds of sexual harassment and assault. Conclusions A substantial proportion of men and women reported sexual harassment/assault. Higher unit support was associated with diminished odds of sexual harassment/assault during deployment. Programming designed to improve unit cohesion has potential to reduce sexual harassment and assault. PMID:25442705

UNEQUAL RISK: COMBAT OCCUPATIONS IN THE VOLUNTEER MILITARY

PubMed Central

MacLEAN, ALAIR; PARSONS, NICHOLAS L.

2011-01-01

This study evaluates the characteristics of the men who served in the volunteer military in combat occupations. It examines whether these characteristics stem from supply-side or demand-side decisions, or reflect class bias. The findings suggest that, on the supply side, men who had greater academic abilities were more likely to go to college, thereby avoiding military service and the possibility of serving in a combat occupation. On the demand side, the armed forces were more likely to exclude men with lower academic abilities but were more likely to assign such men in the military to combat occupations. Net of the impacts of these supply-side and demand-side decisions, men who served in combat occupations still differed from those who did not in terms of their family background. The impact of family background was stronger on entering the military than on being assigned to combat occupations once in the military. PMID:21691446

The Costs and Benefits of High Speed Vessels Relative to Traditional C-17 Military Airlift

DTIC Science & Technology

2003-12-01

37 APPENDIX D SWOT Analysis...Port Action Officers Group IBCT Interim Brigade Combat Team LCS Littoral Combat Ship LST Landing ship tank LSV Logistics Support Vessel... SWOT Strength Weakness Opportunity Threat TACOM Tank and Automotive Command TSV Theater Support Vessel USS United States Ship USTRANSCOM

Child maltreatment among U.S. Air Force parents deployed in support of Operation Iraqi Freedom/Operation Enduring Freedom.

PubMed

Rabenhorst, Mandy M; McCarthy, Randy J; Thomsen, Cynthia J; Milner, Joel S; Travis, Wendy J; Colasanti, Marie P

2015-02-01

This study examined child maltreatment perpetration among 99,697 active-duty U.S. Air Force parents who completed a combat deployment. Using the deploying parent as the unit of analysis, we analyzed whether child maltreatment rates increased postdeployement relative to predeployment. These analyses extend previous research that used aggregate data and extend our previous work that used data from the same period but used the victim as the unit of analysis and included only deploying parents who engaged in child maltreatment. In this study, 2% (n = 1,746) of deploying parents perpetrated child maltreatment during the study period. Although no overall differences were found in child maltreatment rates postdeployment compared to predeployment, several maltreatment-related characteristics qualified this finding. Rates for emotional abuse and mild maltreatment were lower following deployment, whereas child maltreatment rates for severe maltreatment were higher following deployment. The finding that rates of severe child maltreatment, including incidents involving alcohol use, were higher postdeployment suggests a need for additional support services for parents following their return from combat deployment, with a focus on returning parents who have an alcohol use problem. © The Author(s) 2014.

Implications of Posttraumatic Stress among Military-Affiliated and Civilian Students

ERIC Educational Resources Information Center

Barry, Adam E.; Whiteman, Shawn D.; MacDermid Wadsworth, Shelley M.

2012-01-01

Objectives: To determine whether posttraumatic stress (PTS) symptoms are associated with problem drinking and alcohol-related consequences, as well as academic correlates among military-affiliated and civilian students. Participants: The final sample (n = 248) included 78 combat-exposed student service members/veterans, 53 non-combat-exposed…

THE ROLE OF GUIDANCE SERVICES IN COMMUNITY ACTION PROGRAMS COMBATING POVERTY.

ERIC Educational Resources Information Center

GUIDANCE OBJECTIVES TO BE INCLUDED IN A COMMUNITY ACTION PROGRAM COMBATING PROVERTY ARE PRESENTED. THE OBJECTIVES INCLUDE EARLY ADJUSTMENT OF STUDENTS, EARLY IDENTIFICATION AND INTERPRETATION OF ABILITIES, EDUCATIONAL AND CAREER PLANS BASED ON ABILITIES AND SKILLS, PARENT UNDERSTANDING OF OPPORTUNITIES, ENCOURAGEMENT OF REALISTIC GOALS IN LINE…

2007 Joint Services Small Arms Systems Annual Symposium, Exhibition and Firing Demonstration

DTIC Science & Technology

2007-05-10

CAN Chairman Combat Clothing Individual Equipment & Protection Henk Reulink – NLD Chairman Dan Fitzgerald – USA Deputy C4I & Systems Architecture Rune ...Chairman Combat Clothing Individual Equipment & Protection Henk Reulink – NLD Chairman Dan Fitzgerald – USA Deputy C4I & Systems Architecture Rune

Epidemiology and prevention of substance use disorders in the military.

PubMed

Sirratt, Deborah; Ozanian, Alfred; Traenkner, Barbara

2012-08-01

U.S. military service members have been in active combat for more than 10 years. Research reveals that combat exposure increases the risk of substance use disorders, post-traumatic stress disorder, major depression, and tobacco use. The Services and the field of addiction medicine are working hard to find a common definition for prescription drug misuse, which is a growing concern in both the general U.S. population and the force. Meanwhile, leaders at all levels of Department of Defense are diligently working to address barriers to care, particularly stigma related to substance abuse care, by seeking a balance between improving service member privacy in order to encourage self-referral for medical care and a commander's need to know the status of the unit and its combat readiness. The treatment and management of substance abuse disorders are a complex force health issue that requires the use of evidence-based medical interventions and policies that are consistent with them.

Prehospital Care of Canine Gastric Dilatation and Volvulus.

PubMed

Palmer, Lee E

The intent of the Operational K9 (OpK9) ongoing series is to provide the Special Operations Medical Association community with clinical concepts and scientific information on preventive and prehospital emergency care relevant to the OpK9. Often the only medical support immediately available for an injured or ill OpK9 in the field is their handler or the human Special Operations Combat Medic or civilian tactical medic attached to the team (e.g., Pararescueman, 18D, SWAT medic). The information is applicable to personnel operating within the US Special Operations Command as well as civilian Tactical Emergency Medical Services communities that may have the responsibility of supporting an OpK9. 2018.

Boomer Matters: Responding to Emotional Health Needs in an Aging Society.

PubMed

O'Connor, Deborah; Kelson, Elizabeth

2018-01-01

This study explores baby boomer-aged adults' experiences accessing an emotional health program (EHP) in a community-based seniors' center, examining differences between it and an older cohort of users. Data generation includes client-based surveys (n=118), in-depth qualitative interviews (n=20) with client users and professionally-trained counselors (n=2), and a focus group with peer support service worker (n=14). Key findings suggest EHPs as a preventative strategy to address familial abuse, the need for education and support on sexual health and dating, and the need to combat ageism to improve access. Community-based seniors' centers as a cost-effective approach to health promotion is also highlighted.

Cyber Security: Assessing Our Vulnerabilities and Developing an Effective Defense

NASA Astrophysics Data System (ADS)

Spafford, Eugene H.

The number and sophistication of cyberattacks continues to increase, but no national policy is in place to confront them. Critical systems need to be built on secure foundations, rather than the cheapest general-purpose platform. A program that combines education in cyber security, increasing resources for law enforcement, development of reliable systems for critical applications, and expanding research support in multiple areas of security and reliability is essential to combat risks that are far beyond the nuisances of spam email and viruses, and involve widespread espionage, theft, and attacks on essential services.

American Military Barrier War Paint, Camp Buehring, Kuwait: A Discovery of Troop Identity, Values, and Warfighting Attributes as They Deployed into Combat for Operation Iraqi Freedom

DTIC Science & Technology

2014-05-21

6. AUTHOR(S) Hutsell, Loren B., Chaplain Major, USA 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING...source of information, humor, and motivation to see the project through. Special recognition is given to my lovely wife, Heather, for her daily support...spouse is a cornerstone for their military member’s service, my wife is the force that enabled me to complete this project . Together we share in its

Field Feeding Transformation: Is There a Requirement for Food Service Personnel in Support of the Stryker Brigade Combat Team?

DTIC Science & Technology

2002-01-01

fiber for a 3,600-calorie diet , the MREs 20.75 grams of fiber pale in comparison. Thirdly, recent studies indicate conclusively that the quantities...calories. This tendency was mainly due to the lower levels of protein in the entrees, especially the vegetarian entrees in the later versions of the ration...include two vegetarian meals in each module. Included in each MRE are heating elements. Remote Unit Self-Heating Meal (RUSH-M). This is not a cook

Approval of System MANPRINT Management Plan (SMMP) for the Modernized Demolitions Initiators (MDI) Set

DTIC Science & Technology

1990-07-01

at the different skill levels are: C-1 a. MOSC 12B10. Assists combat engineers by performing combat construction, combat demolitions, and related...duties. b. MOSC 12B20. Performs as team leader and assistant squad leader in combat construction, demolition, and duties. c. MOSC 12B30. Serves as squad...instructor. d. MOSC 12B40. Serves as platoon sergeant; as operations sergeant; as construction inspector; as advisor to supported units, allied forces

News

Science.gov Websites

attendees read about one of the four mission area working group chairmen who led a team to think combat rescue support for Inherent Resolve, and was one of the seven Airmen killed in an HH-60G Pave Hawk innovatively in tackling one of the Air Force's toughest agile combat support challenges during the San Antonio

Wartime Requirements for Ammunition Materiel and Personnel (WARRAMP). Volume I. Materiel Postprocessor User’s Manual.

DTIC Science & Technology

1981-08-01

ZONE IV ZONE V FEBA DIVISION DIVISION CORPS COMZ COMBAT SUPPORT SUPPORT 0.1 Km i4lKm 6-30Km 30-50’(m 50 +Km Figure 1.4.3 WARF Matrix MDA .) Z. -3 Z 7...publication date, the Combat Support Units (i.e., AG Company, TMT Company, Combat Engineer Company, etc.) will not be arrayed in the COSAGE stylized units...TmE "Y)(" POWTIPTVd OF TmT 3:4n𔃿 ELE’Er4T %AmE MUST bF ChE~ifE 0 TO ’AfFLICT THE1 APPD,PFIAT.. 33:. PT POSTuRE I!L. AT. D_, [t JP ’LI. 34 :.ASC ,T p

Medical civil-military operations: the deployed medical brigade's role in counterinsurgency operations.

PubMed

Bryan, Jeffrey; Miyamoto, Danelle; Holman, Vincent

2008-01-01

Medical civil-military operations are a critical combat multiplier directly supporting the counterinsurgency fight. Army Medical Department Soldiers support medical civil affairs activities at all levels from platoon to the United States Mission-Iraq (Department of State) initiatives enhancing the legitimacy of medical services in the Iraq Ministry of Health, Ministry of Defense, Ministry of the Interior, and Ministry of Justice. The civil-military operations mission of the deployed Task Force 62 Medical Brigade has also evolved into a broad mission encompassing over 120 contractors including Iraqi-American, Bilingual Bicultural Advisors-Subject Matter Experts serving as case management liaison officers and medical trainers, as well as Iraqi Advisor Task Force members providing medical atmospherics, assessments, training, and the overall management of Iraqi linguists supporting all level III medical facilities.

Life satisfaction and quality in Korean War veterans five decades after the war.

PubMed

Ikin, J F; Sim, M R; McKenzie, D P; Horsley, K W A; Wilson, E J; Harrex, W K; Moore, M R; Jelfs, P L; Henderson, S

2009-05-01

Military service is considered to be a hidden variable underlying current knowledge about well-being in the elderly. This study aimed to examine life satisfaction and quality of life in Australia's surviving male Korean War veterans and a community comparison group, and to investigate any association with war deployment-related factors. Participants completed a postal questionnaire which included the Life Satisfaction Scale, the brief World Health Organization Quality of Life (WHOQOL-Bref) questionnaire and the Combat Exposure Scale. Korean War veterans reported significantly lower Percentage Life Satisfaction (PLS) and quality of life scores on four WHOQOL-Bref domains, compared with similarly aged Australian men (each p value <0.001). These outcomes were most strongly associated with severity of combat exposure and low rank. Mean PLS was approximately 15% lower in veterans who reported heavy combat compared with those reporting no combat, and approximately 12% lower in enlisted ranked veterans compared with officers. Fifty years after the Korean War, life satisfaction and quality in Australian veterans is poor relative to other Australian men, and is associated with deployment-related factors including combat severity and low rank. In order to respond effectively to current and projected population health needs, nations with large veteran populations may need to consider the impact of military service on well-being in later life.

CSS/EMW/SOF (Combat Service Support/Engineering and Mine Warfare/Special Operations Forces) Mission Area Materiel Plan (MAMP) Software.

DTIC Science & Technology

1986-09-01

receive much benefit . [] 2. The MAMP program prioritization algorithm is the responsibility of TRADOC. This study analyzed the perceived deficiencies...C o I 0 w m a 0 0 - 0.. -W >. m a -a ZZ II w u3 c w Ir 0 ccD I j cnC 0 o w a w W a- Im 3 El0 1>1- - < OUU4 0 .0.. 3.0 I * T- ui l. IT w3 >0 . I- *, wWE ...34Related" else if deftpe - 3 then print "Non-Materiel" else if def tqjpe - 4 then print " Health Service’ alse print skip I line printcolum-81

A Method for Increasing the Training Effectiveness of Marine Corps Tactical Exercises: A Pilot Study.

ERIC Educational Resources Information Center

Rocklyn, Eugene H.; And Others

Methods for better utilizing simulated combat systems for training officers are required by the Marine Corps to ensure efficient acquisition of combat decision-making skills. In support of this requirement, a review and analysis of several combat training systems helped to identify a set of major training problems. These included the small number…

Historical Group Debriefing Following Combat

DTIC Science & Technology

1991-12-01

support, appraisal of combat event, and ensuing psychological rumination of stressful events were administered to all the participants before and after... psychological rumination of stressful events were administered to all the participants before and after each debriefing session. The sessions were recorded...combat. C. To identify individual traits (such as coping style, denial and social desirability) which might modulate the psychological effects of

Women in Combat: Framing the Issues of Health and Health Research for America's Servicewomen.

PubMed

McGraw, Kate; Koehlmoos, Tracey Perez; Ritchie, Elspeth Cam

2016-01-01

Although women have served in the U.S. military officially since 1901, the medical needs of women in combat have historically been poorly understood. Recent expansion of the opportunities females may now play in combat roles has created an urgent need for a review of how Department of Defense supports females as they transition into these new roles, as well as current science related to key aspects of the health of female warriors. There is currently no systematic institutional structure in place to regularly and methodically examine gaps in policy, research, and treatment for issues related to women in combat. This article serves as a brief overview and introduction to some of the critical topics related to the health of women in combat roles, to include women's health issues research and treatment efforts, physiological differences between sexes, and leadership and unit factors. The Department of Defense should continue to explore and address policy, research, and practice related to the complex ongoing needs of military females in combat roles, and ensures sufficient staffing, resources and support from senior military leaders. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Strategic Plan for Autism Spectrum Disorder Research: 2013 Update

ERIC Educational Resources Information Center

Interagency Autism Coordinating Committee, 2014

2014-01-01

The Combating Autism Act (CAA; Public Law 109-416) and the subsequent Combating Autism Reauthorization Act (CARA; Public Law 112-32) established an Interagency Autism Coordinating Committee (IACC) to advise the Secretary of Health and Human Services on issues related to Autism Spectrum Disorder (ASD). One responsibility of the IACC is the…

Role of Occupational Therapy in Combating Human Trafficking.

PubMed

Gorman, Kathleen W; Hatkevich, Beth Ann

Human trafficking is a modern-day form of slavery that includes sex trafficking, labor trafficking, and trafficking of children. It is estimated that 35.8 million people are enslaved around the world. Because of the traumatic experiences that victims of human trafficking encounter, the needs of victims are extensive and require the services of several providers, including health care providers, for victims to transform into survivors and thrivers. Currently, the role of occupational therapy is minimal and unexplored. The profession of occupational therapy has the capacity of having a profound role in both providing client-centered care services to victims and survivors of human trafficking and partaking in preventive advocacy efforts to combat human trafficking. Further advocacy efforts are required to promote the profession of occupational therapy in combating human trafficking. Copyright © 2016 by the American Occupational Therapy Association, Inc.

Active-duty military service members’ visual representations of PTSD and TBI in masks

PubMed Central

Walker, Melissa S.; Kaimal, Girija; Gonzaga, Adele M. L.; Myers-Coffman, Katherine A.; DeGraba, Thomas J.

2017-01-01

ABSTRACT Active-duty military service members have a significant risk of sustaining physical and psychological trauma resulting in traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD). Within an interdisciplinary treatment approach at the National Intrepid Center of Excellence, service members participated in mask making during art therapy sessions. This study presents an analysis of the mask-making experiences of service members (n = 370) with persistent symptoms from combat- and mission-related TBI, PTSD, and other concurrent mood issues. Data sources included mask images and therapist notes collected over a five-year period. The data were coded and analyzed using grounded theory methods. Findings indicated that mask making offered visual representations of the self related to individual personhood, relationships, community, and society. Imagery themes referenced the injury, relational supports/losses, identity transitions/questions, cultural metaphors, existential reflections, and conflicted sense of self. These visual insights provided an increased understanding of the experiences of service members, facilitating their recovery. PMID:28452610

Ethnic and racial differences in clinically relevant symptoms in active duty military personnel with posttraumatic stress disorder.

PubMed

Kaczkurkin, Antonia N; Asnaani, Anu; Hall-Clark, Brittany; Peterson, Alan L; Yarvis, Jeffrey S; Foa, Edna B

2016-10-01

Previous research has shown racial/ethnic differences in Vietnam veterans on symptoms related to posttraumatic stress disorder (PTSD). The current study explored racial/ethnic differences in PTSD symptoms and clinically relevant symptoms. Resilience and social support were tested as potential moderators of racial/ethnic differences in symptoms. The sample included 303 active duty male service members seeking treatment for PTSD. After controlling for age, education, military grade, and combat exposure, Hispanic/Latino and African American service members reported greater PTSD symptoms compared to non-Hispanic White service members. Higher alcohol consumption was endorsed by Hispanic/Latino service members compared to non-Hispanic White or African American service members, even after controlling for PTSD symptom severity. No racial/ethnic differences were found with regard to other variables. These results suggest that care should be made to thoroughly assess PTSD patients, especially those belonging to minority groups, for concurrent substance use problems that may impede treatment utilization or adherence. Copyright © 2016 Elsevier Ltd. All rights reserved.

Active-duty military service members' visual representations of PTSD and TBI in masks.

PubMed

Walker, Melissa S; Kaimal, Girija; Gonzaga, Adele M L; Myers-Coffman, Katherine A; DeGraba, Thomas J

2017-12-01

Active-duty military service members have a significant risk of sustaining physical and psychological trauma resulting in traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD). Within an interdisciplinary treatment approach at the National Intrepid Center of Excellence, service members participated in mask making during art therapy sessions. This study presents an analysis of the mask-making experiences of service members (n = 370) with persistent symptoms from combat- and mission-related TBI, PTSD, and other concurrent mood issues. Data sources included mask images and therapist notes collected over a five-year period. The data were coded and analyzed using grounded theory methods. Findings indicated that mask making offered visual representations of the self related to individual personhood, relationships, community, and society. Imagery themes referenced the injury, relational supports/losses, identity transitions/questions, cultural metaphors, existential reflections, and conflicted sense of self. These visual insights provided an increased understanding of the experiences of service members, facilitating their recovery.

Deployment-Related Insomnia in Military Personnel and Veterans

PubMed Central

Bramoweth, Adam D.

2013-01-01

Insomnia is a prevalent disorder that greatly impacts military personnel, especially those deployed in support of combat efforts. Deployment-related stressors like combat exposure, mild traumatic brain injury (mTBI) irregular sleep-wake schedules, and adjustment to the return home all contribute to insomnia. However, insomnia can also exacerbate the deployment experience and is a risk factor for traumatic stress reactions such as PTSD, depression, and suicide. Military personnel with mTBI are significantly impacted by insomnia; the majority experience sleep disruption and this can impede recovery and rehabilitation. As more service members return home from deployment, treatment is vital to reduce the impact of insomnia. Preliminary outcome data, showing positive results for reduction of sleep disruption, has been found with treatments such as combined cognitive behavioral treatment of insomnia (CBTI) and imagery rehearsal therapy (IRT), preference-based interventions, as well as efforts to broadly disseminate CBTI. The recent literature on the impact and treatment of deployment-related insomnia is reviewed. PMID:24005883

Trauma Risk Management (TRiM): Promoting Help Seeking for Mental Health Problems Among Combat-Exposed U.K. Military Personnel.

PubMed

Jones, Norman; Burdett, Howard; Green, Kevin; Greenberg, Neil

2017-01-01

Trauma Risk Management (TRiM) is a peer-led, occupational mental health support process that aims to identify and assist U.K. military personnel with persistent mental ill health related to potentially traumatic events (PTEs). This study compared help seeking, mental disorder symptoms, and alcohol use between TRiM recipients and personnel experiencing similar combat events who did not receive TRiM; an unexposed group provided context. Records of TRiM activity during a U.K. military deployment in Afghanistan were linked to contemporaneous survey data assessing mental health and combat experiences. The resulting deployment data set was amalgamated with mental health, alcohol use, and help-seeking data collected within 12 weeks of homecoming and again one to two years later. Mental health and help-seeking outcomes were compared between a nonexposed, non-TRiM sample (n = 161), an exposed, non-TRiM sample (n = 149), and an exposed, TRiM-recipient sample (n = 328) using logistic regression analyses. At follow-up, TRiM recipients were significantly more likely to seek help from mental health services than exposed, non-TRiM personnel. At baseline, TRiM recipients had significantly greater adjusted odds of reporting possible posttraumatic stress disorder (PTSD) symptoms than exposed non-TRiM personnel; the difference was not significant at follow-up. TRiM recipients were significantly more likely to report persistent mental disorder and alcohol misuse caseness over the follow-up period. TRiM recipients were significantly more likely to seek help from mental health services than a similar PTE-exposed group that did not receive TRiM; however, TRiM recipients experienced more persistent mental ill-health symptoms and hazardous alcohol use over the period of follow-up despite seeking help.

Women's stress in compulsory army service in Israel: A gendered perspective.

PubMed

Huss, Ephrat; Cwikel, Julie

2015-01-01

A growing number of women are serving in the military in a variety of roles, yet information on their experience of stressors not associated with either combat or sexual harassment is not commonly reported. To present phenomenological data on stressors experienced in military service, together with the use of coping strategies as a way to focus on women's mental needs following deployment from service. Twenty women who had recently completed their compulsory army service in Israel drew a picture expressing stressors they experienced in the army. They analyzed their own pictures on three levels: the content, context, and the composition as expressing stress and the resources they used in coping with stress. Six themes were raised: proximity to war situations, coping with accidents in training soldiers under their command, a conflict between political values and military orders, witnessing the injury of another female soldier, responsibility for accidental injury of a civilian, and distress over the army placement. Coping resources were relational, primarily family and friend support, rather than from the army framework. This reliance on relational sources of support was both a resource and a source of vulnerability and is viewed as distinct from men's style of coping.

A Big Bang versus a Small Bang Approach: A Case Study of the Expeditionary Combat Support System (ECSS) and the Maintenance, Repair, and Overhaul Initiative (MROi)

DTIC Science & Technology

resource planning (ERP) solution called the Expeditionary Combat Support System (ECSS), a big - bang approach. In early 2012, the ECSS program was cancelled...Repair, and Overhaul initiative (MROi), a small- bang approach, to increase enterprise visibility and efficiency across all three Air Logistics

5 CFR 831.301 - Military service.

Code of Federal Regulations, 2010 CFR

2010-01-01

... is not receiving military retired pay awarded for reasons other than (i) service-connected disability incurred in combat with an enemy of the United States, (ii) service-connected disability caused by an... receiving military retired pay awarded for reasons other than (i) service-connected disability incurred in...

Evaluation of the King-Devick Test to Assess Eye Movements and the Performance of Rapid Number Naming in Concussed and Non-Concussed Service Members

DTIC Science & Technology

2017-07-01

pre -Combatives baseline and their post - Combatives assessment, to determine to what extent individuals diagnosed as having an mTBI event differ from...their King- Devick Test pre -Combatives baseline, and to determine to what extent individuals who report a history of concussion during their pre ...Award Number: W81XWH-14-1-0173 TITLE: Evaluation of the King-Devick Test to Assess Eye Movements and the Performance of Rapid Number Naming in

Past and present role of extracorporeal membrane oxygenation in combat casualty care: How far will we go?

PubMed

Cannon, Jeremy W; Mason, Phillip E; Batchinsky, Andriy I

2018-06-01

Advanced extracorporeal therapies have been successfully applied in the austere environment of combat casualty care over the previous decade. In this review, we describe the historic underpinnings of extracorporeal membrane oxygenation, review the recent experience with both partial and full lung support during combat operations, and critically assess both the current status of the Department of Defense extracorporeal membrane oxygenation program and the way forward to establish long-range lung rescue therapy as a routine capability for combat casualty care.

Illness Behavior and Transitional States: A Study of Outpatient Rates and Symptom Presentation in Relation to Troop Deployment during Peacetime. The Health Consequences of Deployment. Types and Rates of Outpatient Sickcall Visits. June 1980 - May 1981. Combat Arms and Support Troops

DTIC Science & Technology

1982-12-06

study I are listed In Appendix A. The combat and support groups are different in several ways. They were picked for the vast differences in their I...a week. These differences allow us to Nighlight the Medical problems related to highly stressed soldiers. The clinirs providing first line care to...these two groups were ;lj, different,. The combat arms unit had Battalion Aid "Stations (DAS) to provide medical care to each battalion f (approximately

Cost effectiveness of virtual reality graded exposure therapy with physiological monitoring for the treatment of combat related post traumatic stress disorder.

PubMed

Wood, Dennis Patrick; Murphy, Jennifer; McLay, Robert; Koffman, Robert; Spira, James; Obrecht, Robert E; Pyne, Jeff; Wiederhold, Brenda K

2009-01-01

Virtual Reality Graded Exposure Therapy (VRGET) is an effective treatment for combat-related PTSD. We summarize the outcomes of a VRGET pilot study with 12 participants who completed one to multiple combat tours in support of the War on Terrorism and who were subsequently diagnosed with combat-related PTSD. Details of the collaborative program amongst the Virtual Reality Medical Center (VRMC), Office of Naval Research, the Naval Medical Center San Diego (NMCSD) and the Navy Hospital Camp Pendleton are discussed as is the VRGET outcomes of significant reductions in PTSD symptoms severity. We also described the estimated cost-effectiveness of VRGET for the treatment of combat-related PTSD, as contrasted to Treatment as Usual (TAU) for combat-related PTSD.

Draft Environmental Impact Statement (DEIS)

DTIC Science & Technology

2000-07-01

MCB Marine Corps Base MCCDC Marine Corps Combat Development Center MCHC Marine Corps Heritage Center MCHMD Marine Corps History and Museum...other federal agencies. In addition to the MCU, the base is the site of the Marine Corps Officer Candidate School (OCS), the Marine Corps Combat ...at the Air-Ground Museum to support instruction and research on combat doctrine, tactics, and technology. The Air-Ground Museum also loans items to

National Center for Combating Terrorism Strategic Plan, September 2003

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bechtel Nevada

2003-09-01

National Center for Combating Terrorism Strategic Plan is to document the mission, vision, and goals for success; define the build plan; and describe initiatives that support the U.S. Department of Homeland Security, U.S. Department of Defense, U.S. Department of Energy, U.S. Department of Justice, intelligence community, National Governors Association, and other organizations or departments with combating terrorism training, testing, and technology responsibilities.

The Long War and Parental Combat Deployment: Effects on Military Children and At-Home Spouses

ERIC Educational Resources Information Center

Lester, Patricia; Peterson, Kris; Reeves, James; Knauss, Larry; Glover, Dorie; Mogil, Catherine; Duan, Naihua; Saltzman, William; Pynoos, Robert; Wilt, Katherine; Beardslee, William

2010-01-01

Objective: Given the growing number of military service members with families and the multiple combat deployments characterizing current war time duties, the impact of deployments on military children requires clarification. Behavioral and emotional adjustment problems were examined in children (aged 6 through 12) of an active duty Army or Marine…

Can the Marine Corps Overcome the Obstacles of Effectively Supplying the Small Infantry Unit in the 21st Century Urban Conflict?

DTIC Science & Technology

2001-04-01

opposed to combat engineering, and services are items such as laundry and consumable personal-use items (e.g. soap, shampoo , exchange items, etc...like insults and verbal abuse from non- combatants. In Grozny, about seventy-eight percent of soldiers surveyed had some type

Anticipating the traumatic brain injury-related health care needs of women veterans after the Department of Defense change in combat assignment policy.

PubMed

Amara, Jomana; Iverson, Katherine M; Krengel, Maxine; Pogoda, Terri K; Hendricks, Ann

2014-01-01

Female service members' presence in combat zones during Operation Enduring Freedom and Operation Iraqi Freedom is unprecedented both in terms of the number of women deployed and the nature of their involvement. In light of changing Department of Defense policy governing the deployment of women in combat zones, this article intends to set the groundwork for estimating future combat-related injuries and subsequent Veterans Health Administration (VHA) utilization while focusing on traumatic brain injury (TBI). The article summarizes and presents the results of a study that examines veterans who present to VHA for TBI evaluation. For a national sample of veterans, a dataset including information on post-screening utilization, diagnoses, and location of care was constructed. The dataset included self-reported health symptoms and other information obtained from a standardized national VHA post-screening clinical evaluation, the comprehensive TBI evaluation (CTBIE). Both women and men utilize high levels of VHA health care after a CTBIE. However, there are gender differences in the volume and types of services used, with women utilizing different services than their male counterparts and incurring higher costs, including higher overall and outpatient costs. As women veterans seek more of their health care from the VHA, there will be a need for more coordinated care to identify and manage deployment-related TBI and common comorbidities such as posttraumatic stress disorder, depression, and chronic pain. Deployment-connected injuries are likely to rise because of the rescinding of the ban on women in combat. This in turn has critical implications for VHA strategic planning and budgeting. Published by Elsevier Inc.

Unethical battlefield conduct reported by soldiers serving in the Iraq war.

PubMed

Wilk, Joshua E; Bliese, Paul D; Thomas, Jeffrey L; Wood, Michael D; McGurk, Dennis; Castro, Carl A; Hoge, Charles W

2013-04-01

Research involving military service members has shown a strong relationship between combat experiences and increased risk for posttraumatic stress disorder (PTSD) and other mental health problems. Comparatively little research has examined the relationship between combat experiences, PTSD, aggression, and unethical conduct on the battlefield, although news stories sometimes suggest links between unethical conduct and disorders such as PTSD. This study systematically examined whether unethical conduct is a proxy for aggression and whether specific combat experiences and PTSD are independently associated with unethical behavior. The results of this study indicate that aggression (β = 0.30) and specific combat experiences (particularly, witnessing war atrocities [β = 0.14] and fighting [β = 0.13]) are much more strongly associated with unethical conduct than is PTSD (β = 0.04).

CSAR (Combat, Search and Rescue) Aide: Design Requirements for a Combat Search and Rescue Decision Support System for Joint Rescue Coordination Centers

DTIC Science & Technology

1989-06-01

with acetate depicting intelligence estimates of the order of battle (updated manually by intelligence specialists), in regulations, manuals , and a...mundane tasks (e.g. typing messages, filling out forms, and chasing down data) must be performed manually . The possibility of an important fact...formulate the requirements for CSAR AIDE. 2-1 D?cisiion Support Systems A Decision Support System (DSS) is a "systea ( manual or automated) that

Unit support protects against sexual harassment and assault among national guard soldiers.

PubMed

Walsh, Kate; Galea, Sandro; Cerda, Magdalena; Richards, Catherine; Liberzon, Israel; Tamburrino, Marijo B; Calabrese, Joseph; Koenen, Karestan C

2014-01-01

Despite concerns about increased sexual harassment and assault after the 2013 legislation repealing the ban on women in combat, little research has examined military factors that could prevent sexual harassment and assault during deployment. This study examined whether unit support, which reflects the quality of service members' relationships within their unit, protects against sexual harassment and assault during deployment. Participants were 1,674 Ohio Army National Guard service members who reported at least one deployment during a telephone survey conducted in 2008 and 2009. Participants completed measures of sexual harassment/assault, unit support, and psychosocial support. Logistic regression was used to model odds of sexual harassment/assault. Approximately 13.2% of men (n = 198) and 43.5% of women (n = 74) reported sexual harassment, and 1.1% of men (n = 17) and 18.8% of women (n = 32) reported sexual assault during their most recent deployment. Greater unit support was associated with decreased odds of sexual harassment and assault. A substantial proportion of men and women reported sexual harassment/assault. Greater unit support was associated with diminished odds of sexual harassment/assault during deployment. Programming designed to improve unit cohesion has the potential to reduce sexual harassment and assault. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

[Management of war orthopaedic injuries in recent armed conflicts].

PubMed

Frank, M; Mathieu, L

2013-01-01

The extremities continue to be the most frequent sites of wounding during armed conflicts despite the change of combat tactics, soldier armour and battlefield medical support. Due to the advances in prehospital care and timely transport to the hospital, orthopaedic surgeons deal with severe and challenging injuries of the limbs. In contrast to civilian extremity trauma, the most combat-related injuries are open wounds that often have infection-related complications. Data from two recent large armed conflicts (Iraq, Afghanistan) show that extremity injuries are associated with a high complication rate, morbidity and healthcare utilization. A systematic approach that consists of sequential surgical care and good transport capabilities can reduce the complication rate of these injuries. New medical technologies have been implemented in the treatment strategy during the last decade. This article reviews the published scientific data and current opinions on combat-related extremity injuries. Key words: extremity, combat, trauma, medical support system.

The Life-Long Mortality Risks Of World War II Experiences

PubMed Central

Elder, Glen H.; Brown, James Scott; Martin, Leslie R.; Friedman, Howard W.

2009-01-01

Objective This longitudinal study of American veterans investigated the mortality risks of five World War II military experiences (i.e., combat exposure) and their variation among veterans in the post-war years. Methods The male subjects (N=854) are members of the Stanford-Terman study, and 38 percent served in World War II. Cox models (proportional hazards regressions) compared the relative mortality risk associated with each military experience. Results Overseas duty, service in the Pacific and exposure to combat significantly increased the mortality risks of veterans in the study. Individual differences in education, mental health in 1950, and age at entry into the military, as well as personality factors made no difference in these results. Conclusions A gradient is observable such that active duty on the home front, followed by overseas duty, service in the Pacific, and combat exposure markedly increased the risk of relatively early mortality. Potential linking mechanisms include heavy drinking. PMID:20161074

Prevention of Infections Associated With Combat-Related Eye, Maxillofacial, and Neck Injuries

DTIC Science & Technology

2011-08-01

REVIEW ARTICLE Prevention of Infections Associated With Combat-Related Eye, Maxillofacial, and Neck Injuries Kyle Petersen, DO, FACP, FIDSA...Marcus H Colyer, MD, David K. Hayes, MD, FACS, Robert G. Hale, DDS, R. B1yan Bell, DDS, MD, FACS, and the Prevention of Combat-Related Infections ...article reviews recent data from military and civilian studies to support evidence-based recommendations for the prevention of infections associated

Social Sciences Support to Military Personnel Engaged in Counter-Insurgency and Counter-Terrorism Operations (Soutien en sciences sociales apporte au personnel militaire engage dans des operations de contre-insurrection et de contre-terrorisme)

DTIC Science & Technology

2011-11-01

much more negative about Muslims, became jumpy, felt the world is less safe, found it hard to sleep, found it hard to detach, becoming emotionally ...the impact of military posture and ways to minimize the negative impact of military operations, disengagement and deradicalization efforts, as well as...combat is difficult. After armed conflict, 70% of participants have a negative outlook toward military service and choose to resign. A key factor in this

Fathering after military deployment: parenting challenges and goals of fathers of young children.

PubMed

Walsh, Tova B; Dayton, Carolyn J; Erwin, Michael S; Muzik, Maria; Busuito, Alexandra; Rosenblum, Katherine L

2014-02-01

Although often eagerly anticipated, reunification after deployment poses challenges for families, including adjusting to the parent-soldier's return, re-establishing roles and routines, and the potentially necessary accommodation to combat-related injuries or psychological effects. Fourteen male service members, previously deployed to a combat zone, parent to at least one child under seven years of age, were interviewed about their relationships with their young children. Principles of grounded theory guided data analysis to identify key themes related to parenting young children after deployment. Participants reported significant levels of parenting stress and identified specific challenges, including difficulty reconnecting with children, adapting expectations from military to family life, and coparenting. Fathers acknowledged regret about missing an important period in their child's development and indicated a strong desire to improve their parenting skills. They described a need for support in expressing emotions, nurturing, and managing their tempers. Results affirm the need for support to military families during reintegration and demonstrate that military fathers are receptive to opportunities to engage in parenting interventions. Helping fathers understand their children's behavior in the context of age-typical responses to separation and reunion may help them to renew parent-child relationships and reengage in optimal parenting of their young children.

Lessons of War: Combat-related Injury Infections during the Vietnam War and Operation Iraqi and Enduring Freedom

PubMed Central

Blyth, Dana M.; Yun, Heather C.; Tribble, David R.; Murray, Clinton K.

2015-01-01

Summary In over a decade of war, numerous advancements have been made to improve overall combat-related mortality, but infectious complications remain a leading cause of both morbidity and mortality in combat-related injured personnel. Here we will attempt to compare the challenges and lessons of combat-related injuries and infections from the Vietnam War with those of OIF/OEF. Throughout the Vietnam War and OIF/OEF, there have been similar infection-related challenges faced in caring for combat-related trauma patients. Both conflicts reinforced the importance of rapid medical evacuation and definitive surgical management of war wounds. They revealed the constant evolution of infecting organisms and the challenge of increasing antimicrobial resistance. We have also seen that with decreased mortality of severely injured personnel new morbidities must be addressed. Using the foundation of fragmented research from the Vietnam War, previously successful models were assembled into joint service research institutions which have allowed these questions to be addressed. However, many questions regarding measures to reduce infectious complications in our combat-injured personnel remain unanswered. Continued research building on established knowledge is critical for continued improvements in the care of combat-related trauma patients. PMID:26406435

Complex contribution of combat-related post-traumatic stress disorder to veteran suicide: facing an increasing challenge.

PubMed

Lee, Elizabeth A D

2012-04-01

The purpose of this case study is to present the complex contribution of combat-related post-traumatic stress disorder (PTSD) to suicide and international standards of treatment among veterans deployed to the Middle East. PTSD carries increased physical and psychological health risk in combat soldiers. Internationally, guidelines for PTSD promote cognitive behavior therapies, specifically exposure therapy, as first line treatment; however, implementation varies among countries. Evidence supports the benefit of exposure-based psychotherapy for combat-related PTSD. Commonly prescribed antidepressants and other psychotherapy treatments may not be as beneficial. © 2011 Wiley Periodicals, Inc.

[The demand for blood transfusion agents and blood substitutes in the treatment of wounded patients].

PubMed

Zhiburt, E B; Danil'chenko, V V; Popova, N N; Vil'ianinov, V N

1999-09-01

Modern arms in combat tend to increase sanitary losses, change their structure and make combat traumas more severe. Blood transfusion therapy became a necessity in the wounds treatment. The recent armed conflicts made military medics move the blood transfusion service to the front lines. The authors present some data obtained in Afghanistan and Chechnya.

Sleep and the use of energy products in a combat environment.

PubMed

Waits, Wendi M; Ganz, Michael B; Schillreff, Theresa; Dell, Peter J

2014-01-01

The use of energy products appears to be widespread among deployed personnel, presumably to combat fatigue and sleep deprivation. However, these products have been associated with unpleasant side effects and adverse events, including insomnia, mood swings, fatigue, cardiac arrest, and even death. To quantify the sleep habits and energy products used among deployed service members in Afghanistan from 2010-2011. Participants completed an anonymous survey querying their demographic information, sleep habits, combat exposure, and energy product use. Respondent data: 83% experienced some degree of insomnia; 28% were using a prescription or over-the-counter sleep aid; 81% reported using at least one energy product daily. The most frequently consumed energy products were caffeinated coffee and soda. Only 4 energy products were used more frequently during deployment than prior to deployment: Rip-It, Tiger, Hydroxycut, and energy drink powders. On average, respondents who increased their use consumed only 2 more servings per week during deployment than they had prior to deployment. Only degree of combat exposure, not quantity of energy products consumed, predicted degree of insomnia. Energy product consumption by service members during deployment was not dramatically different than predeployment and was not associated with insomnia.

Some problems associated with war experience in men of the Vietnam generation.

PubMed

Yager, T; Laufer, R; Gallops, M

1984-04-01

A national sample of men who were of military age during the Vietnam War (n = 1,342) was interviewed six to 15 years after veterans in the sample had left the service. Our findings showed that violent experiences in war were associated with a variety of behavioral and emotional problems. When preservice background factors were statistically controlled, combat exposure showed an association with arrests and convictions (generally for nonviolent offenses), with drinking, and with symptoms of traumatic stress. Participants in atrocities reported more stress symptoms and greater use of heroin and marijuana than did other veterans. Veterans who experienced no combat and did not take part in atrocities, however, did not differ appreciably from nonveterans. Not all men who experienced combat or took part in atrocities reported personal difficulties; almost three fourths of heavy-combat veterans were not arrested after the service. Tape recorded responses of the ten blacks and 18 whites who took part in atrocities suggested that soldiers' emotional responses may have been determined by their ability or inability to dehumanize the victims. Future research would benefit from a closer coordination of clinical and epidemiologic approaches.

Improving Operational Readiness through Total Quality Management

DTIC Science & Technology

1991-06-21

DTIC AD-A236 611 EL CT F NAVAL WAR COLL GE C Newport, R. I. IMPROVING OPERATIONAL READINESS THROUGH TOTAL QUALITY MANAGEMENT by Herb Westphal Defense...IMPROVING OPERATIONAL READINESS THROUGH TOTAL QUALITY MANAGEMENT (TQM) A Case Study: The Defense Mapping Agency Combat Support Center (DMACSC) initiated a...of the Defense Mapping Agency Combat Support Center’s (DMACSC) Total Quality Management (TQM) improvement methodology. This allows the reader to

Combat Power Analysis is Combat Power Density

DTIC Science & Technology

2012-05-17

Fires battalion of 16x - Partisan employment of lEOs determine the outcome of any engagement 155mm - 81mm and 60mm Mortars where collateral damage...Cutting the enemy LOC to support their - 4x Forward support - Relatively light sustainment conventional forces will be relatively ineffective so...Neutralization of the partisan company as well Weakness: Weakness: as attacking the LOCs will isolate the enemy. Logistical assets require roads - LOCs

"To care for him who shall have borne the battle and for his widow and his orphan" (Abraham Lincoln): the Department of Veterans Affairs polytrauma system of care.

PubMed

Sigford, Barbara J

2008-01-01

The initiation of combat in Iraq and Afghanistan has resulted in a new cohort of active-duty service members and veterans seeking rehabilitation care through the U.S. Department of Veterans Affairs (VA). Service members injured in combat most often sustain multiple injuries (polytrauma) and require a unique service delivery model to meet their needs. The VA recognized this need and responded with the development of the Polytrauma System of Care (PSC). This national system of care balances access and expertise to provide specialized life-long care to the combat injured. The PSC is comprised of: 4 specialized regional rehabilitation centers that are accredited in brain injury by the Commission on Accreditation of Rehabilitation Facilities; 21 specialized outpatient and subacute rehabilitation programs; designated polytrauma teams at smaller, more remote VA facilities; and a point of contact at all other VA facilities. In addition, the PSC has developed a proactive case-management model, a specialized telehealth network, guidelines for long-term follow-up, and services for those individuals who are unable to return home. The following commentary and articles provide additional detail on this new and unique system of care.

To Determine the Impact of OPMS on the Development of Commanders.

DTIC Science & Technology

1982-04-19

and training policies are designed to promote the development of leadership , managerial, and technical skills.5 In spite of the foregoing, there is...corps into commanders and staff, with the in- evitable consequence of each group convinced the other does not under- stand its problems . Further, the...developing leadership skills needed to effec- tively command troops* Caterory Label Combat Arms Combat Support Combat Svc Spt Strongly agree/agree 65% 58

The influence of combat and interpersonal trauma on PTSD, depression, and alcohol misuse in U.S. Gulf War and OEF/OIF women veterans.

PubMed

Hassija, Christina M; Jakupcak, Matthew; Maguen, Shira; Shipherd, Jillian C

2012-04-01

The present study evaluated the impact of combat and interpersonal trauma exposure in a sample of 115 U.S. women veterans from Gulf War I and the Iraq and Afghanistan wars on 3 postdeployment trauma-related mental health outcomes: posttraumatic stress disorder symptoms (PSS), depressive symptom severity (DSS), and alcohol misuse. Patients presenting for healthcare services at a Veterans Affairs postdeployment health specialty clinic completed screening questionnaires that assessed combat exposure, lifetime interpersonal trauma history of childhood neglect, physical, or sexual abuse, and adult sexual and physical assault. In a regression model, combat exposure was the only significant independent variable associated with PSS, DSS, and alcohol misuse (β = .42, .27 and B = 1.58, respectively) even after adding lifetime interpersonal assault exposure to the model. Results highlight the negative effects of combat exposure on treatment-seeking women veterans' postdeployment mental health. Incorporating combat exposure into routine screening procedures for Gulf War and Iraq and Afghanistan war women veterans can aid in mental health treatment planning. Copyright © 2012 International Society for Traumatic Stress Studies.

Are there atheists in foxholes? Combat intensity and religious behavior.

PubMed

Wansink, Brian; Wansink, Craig S

2013-09-01

After battle, the moral and mortality stresses influence different soldiers in different ways. Using two large-scale surveys of World War II veterans, this research investigates the impact of combat on religiosity. Study 1 shows that as combat became more frightening, the percentage of soldiers who reported praying rose from 42 to 72%. Study 2 shows that 50 years later, many soldiers still exhibited religious behavior, but it varied by their war experience. Soldiers who faced heavy combat (vs. no combat) attended church 21% more often if they claimed their war experience was negative, but those who claimed their experience was positive attended 26% less often. The more a combat veteran disliked the war, the more religious they were 50 years later. While implications for counselors, clergy, support groups, and health practitioners are outlined, saying there are no atheists in foxholes may be less of an argument against atheism than it is against foxholes.

Forging Medical Public-Private Relationships in Support of Combatant Commander Objectives-Getting Past the Vision Statement

DTIC Science & Technology

2009-04-01

non-governmental levels . The military planner faces a daunting question—in what missions are NGO partnerships appropriate? AU/ACSC/LaGrou/AY09 8...for a wide range of operations. As the illustration shows, partnerships at the cooperative level are more likely to exist (and succeed) in...Support of Combatant Commander Objectives—Getting Past the Vision Statement by Edward J. LaGrou, Major, USAF A Research Report

What drives the relationship between combat and alcohol problems in soldiers? The roles of perception and marriage.

PubMed

Vest, Bonnie M; Homish, D Lynn; Hoopsick, Rachel A; Homish, Gregory G

2018-04-01

While the relationship between combat exposure and alcohol problems is well-established, the role of perceptions of trauma is less understood. The goal of this study was to explore associations between National Guard (NG) and reserve soldiers' perceptions of combat experiences as traumatic and alcohol problems, and to examine marital satisfaction as a possible protective factor. The Operation: SAFETY study recruited US Army Reserve and NG soldiers and their partners to complete a questionnaire covering many physical and mental health, military service, and substance use topics. Negative binomial regression models examined the impact of perceived trauma of combat experiences on alcohol problems (N = 198). The potential role of marital satisfaction as a resiliency factor was also examined. The perception of combat experiences as traumatic was associated with increased risk of alcohol problems (risk ratio [RR] = 1.06, 95% confidence interval [CI] 1.01, 1.12; p = 0.024). Combat exposure itself showed no relationship. Marital satisfaction had a significant interaction with perceived combat trauma on alcohol problems (RR = 0.90, 95% CI 0.81, 0.99, p = 0.046), such that soldiers who perceived combat exposure as moderately-highly traumatic were less likely to have alcohol problems when they rated their marital satisfaction highly. Our results demonstrate that the perception of combat experiences as traumatic may be a greater contributor to adverse outcomes, such as alcohol problems, than mere combat exposure. They also demonstrate the importance of marital satisfaction as a resiliency factor, particularly at the highest levels of trauma.

Mental health care use by soldiers conducting counterinsurgency operations.

PubMed

Applewhite, Larry; Keller, Nathan; Borah, Adam

2012-05-01

Counterinsurgency (COIN) has become the cornerstone of the military's strategy to combat terrorist threats. COIN operations are complex and often expose soldiers to unfamiliar stressors as they fight the enemy while developing and maintaining rapport with the local populace. Utilizing a retrospective record review protocol, we examined 282 mental health files of soldiers assigned to a brigade combat team that operated from a large forward operating base in Iraq during the counterinsurgency campaign. Most reported sleep disturbance, depression, anxiety, irritability, and conflict with supervisors related to either operational stress, exposure to direct combat, or home front concerns. Most received brief individual supportive therapy or attended solution-focused group counseling emphasizing life skills training, post-traumatic stress treatment, women's support, or relationship skills. Psychopharmacologic treatment was an essential adjunct to the counseling program. Results indicate that supporting a COIN deployment requires a comprehensive mental health program that can respond to a wide range of mental health problems.

Effectiveness Testing and Evaluation of Non-Lethal Weapons for Crowd Management

DTIC Science & Technology

2014-06-01

and Combat Service Support• Program Executive Office Ground Combat Systems • Program Executive Office Soldier TACOM LCMC MG Michael J. Terry Assigned...technologies and explosive ordnance disposal Fire Control: Battlefield digitization; embedded system software; aero ballistics and telemetry ARDEC...influence predictive variables Introduction Crowd Behavior Research at TBRL UNCLASSIFIED 7 Data Measurement • Vicon V8i system • 24 cameras • 120 fps

Post-combat syndromes from the Boer war to the Gulf war: a cluster analysis of their nature and attribution

PubMed Central

Jones, Edgar; Hodgins-Vermaas, Robert; McCartney, Helen; Everitt, Brian; Beech, Charlotte; Poynter, Denise; Palmer, Ian; Hyams, Kenneth; Wessely, Simon

2002-01-01

Objectives To discover whether post-combat syndromes have existed after modern wars and what relation they bear to each other. Design Review of medical and military records of servicemen and cluster analysis of symptoms. Data sources Records for 1856 veterans randomly selected from war pension files awarded from 1872 and from the Medical Assessment Programme for Gulf war veterans. Main outcome measures Characteristic patterns of symptom clusters and their relation to dependent variables including war, diagnosis, predisposing physical illness, and exposure to combat; and servicemen's changing attributions for post-combat disorders. Results Three varieties of post-combat disorder were identified—a debility syndrome (associated with the 19th and early 20th centuries), somatic syndrome (related primarily to the first world war), and a neuropsychiatric syndrome (associated with the second world war and the Gulf conflict). The era in which the war occurred was overwhelmingly the best predictor of cluster membership. Conclusions All modern wars have been associated with a syndrome characterised by unexplained medical symptoms. The form that these assume, the terms used to describe them, and the explanations offered by servicemen and doctors seem to be influenced by advances in medical science, changes in the nature of warfare, and underlying cultural forces. What is already known on this topicService in the Gulf war is associated with an increased rate of reported symptoms and worsening subjective healthPost-combat syndromes have been described after most modern conflicts from the US civil war onwardsWhat this study addsThere seems to be no single post-combat syndrome but a number of variations on a themeThe ever changing form of post-combat syndromes seems to be related to advances in medical understanding, the developing nature of warfare, and cultural undercurrentsBecause reported symptoms are subject to bias and changing emphasis related to advances in medical science or the discovery of new diseases, the characterisation of individual syndromes has to be treated with cautionAttributions by servicemen are generally consistent with symptom characteristics, though there seems to be a growing reluctance to consider the stress of military service as a cause PMID:11834557

High Frontier, The Journal for Space & Missile Professionals. Volume 3, Number 4, August 2007

DTIC Science & Technology

2007-08-01

effective . Space power theories based on satellites and historical space activ - ity may be reasonably successful at adding structure to current...provider of combat effects for all mediums and levels of warfare should be proud of their accom- plishments. As we engage in global combat operations...we see everyday how our space and missile forces play a significant role in support of land, sea, and air combat operations. Space effects are

FY2012 Annual Report for Director Operational Test & Evaluation (DOT&E)

DTIC Science & Technology

2012-01-01

The JLTV FoV consists of two vehicle categories: the JLTV Combat Tactical Vehicle (CTV), designed to seat four passengers ; and the JLTV Combat...Support Vehicle (CSV), designed to seat two passengers . • The JLTV CTV has a 3,500-pound payload and three mission package configurations: - Close...For example, a previous ground combat vehicle had KPPs that only required it seat nine passengers , be transportable by a C-130, and have a

A Serious Game for Massive Training and Assessment of French Soldiers Involved in Forward Combat Casualty Care (3D-SC1): Development and Deployment.

PubMed

Pasquier, Pierre; Mérat, Stéphane; Malgras, Brice; Petit, Ludovic; Queran, Xavier; Bay, Christian; Boutonnet, Mathieu; Jault, Patrick; Ausset, Sylvain; Auroy, Yves; Perez, Jean Paul; Tesnière, Antoine; Pons, François; Mignon, Alexandre

2016-05-18

The French Military Health Service has standardized its military prehospital care policy in a ''Sauvetage au Combat'' (SC) program (Forward Combat Casualty Care). A major part of the SC training program relies on simulations, which are challenging and costly when dealing with more than 80,000 soldiers. In 2014, the French Military Health Service decided to develop and deploy 3D-SC1, a serious game (SG) intended to train and assess soldiers managing the early steps of SC. The purpose of this paper is to describe the creation and production of 3D-SC1 and to present its deployment. A group of 10 experts and the Paris Descartes University Medical Simulation Department spin-off, Medusims, coproduced 3D-SC1. Medusims are virtual medical experiences using 3D real-time videogame technology (creation of an environment and avatars in different scenarios) designed for educational purposes (training and assessment) to simulate medical situations. These virtual situations have been created based on real cases and tested on mannequins by experts. Trainees are asked to manage specific situations according to best practices recommended by SC, and receive a score and a personalized feedback regarding their performance. The scenario simulated in the SG is an attack on a patrol of 3 soldiers with an improvised explosive device explosion as a result of which one soldier dies, one soldier is slightly stunned, and the third soldier experiences a leg amputation and other injuries. This scenario was first tested with mannequins in military simulation centers, before being transformed into a virtual 3D real-time scenario using a multi-support, multi-operating system platform, Unity. Processes of gamification and scoring were applied, with 2 levels of difficulty. A personalized debriefing was integrated at the end of the simulations. The design and production of the SG took 9 months. The deployment, performed in 3 months, has reached 84 of 96 (88%) French Army units, with a total of 818 hours of connection in the first 3 months. The development of 3D-SC1 involved a collaborative platform with interdisciplinary actors from the French Health Service, a university, and videogame industry. Training each French soldier with simulation exercises and mannequins is challenging and costly. Implementation of SGs into the training program could offer a unique opportunity at a lower cost to improve training and subsequently the real-time performance of soldiers when managing combat casualties; ideally, these should be combined with physical simulations.

Psychophysiological response to virtual reality and subthreshold posttraumatic stress disorder symptoms in recently deployed military.

PubMed

Costanzo, Michelle E; Leaman, Suzanne; Jovanovic, Tanja; Norrholm, Seth D; Rizzo, Albert A; Taylor, Patricia; Roy, Michael J

2014-01-01

Subthreshold posttraumatic stress disorder (PTSD) has garnered recent attention because of the significant distress and functional impairment associated with the symptoms as well as the increased risk of progression to full PTSD. However, the clinical presentation of subthreshold PTSD can vary widely and therefore is not clearly defined, nor is there an evidence-based treatment approach. Thus, we aim to further the understanding of subthreshold PTSD symptoms by reporting the use of a virtual combat environment in eliciting distinctive psychophysiological responses associated with PTSD symptoms in a sample of subthreshold recently deployed US service members. Heart rate, skin conductance, electromyography (startle), respiratory rate, and blood pressure were monitored during three unique combat-related virtual reality scenarios as a novel procedure to assess subthreshold symptoms in a sample of 78 service members. The Clinician-Administered PTSD Scale was administered, and linear regression analyses were used to investigate the relationship between symptom clusters and physiological variables. Among the range of psychophysiological measures that were studied, regression analysis revealed heart rate as most strongly associated with Clinician-Administered PTSD Scale-based measures hyperarousal (R = 0.11, p = .035,) reexperiencing (R = 0.24, p = .001), and global PTSD symptoms (R = 0.17, p = .003). Our findings support the use of a virtual reality environment in eliciting physiological responses associated with subthreshold PTSD symptoms.

Longitudinal Changes in Combat-Related Posttraumatic Stress Disorder Among Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn Veterans With Hazardous Alcohol Use: The Role of Avoidance Coping.

PubMed

Lee, Joohyun; Possemato, Kyle; Ouimette, Paige C

2017-10-01

Military personnel who have experienced combat trauma are at risk for developing posttraumatic stress disorder (PTSD). A greater recognition of the complex array of vulnerability factors that contribute to PTSD severity has led researchers to examine other non-combat-related factors. This longitudinal study examined a number of pre-, peri-, and postdeployment factors hypothesized to contribute to PTSD symptomatology among returning Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn veterans presenting with at least subthreshold PTSD symptoms and hazardous alcohol use in a primary care setting. Purported risk factors included childhood family environment, severity of combat exposure, postdeployment social support, alcohol dependence severity, and an avoidant coping style. At baseline, postdeployment social support and avoidant coping contributed to PTSD severity. Only avoidant coping was associated with changes in PTSD symptom at 1-year follow-up. Reducing avoidant coping may deter the maintenance of PTSD among veterans with PTSD symptoms and hazardous alcohol use.

Returning home: resettlement of formerly abducted children in Northern Uganda.

PubMed

Corbin, Joanne N

2008-06-01

This exploratory qualitative study considers the subjective resettlement experiences of children forced into armed conflict in Northern Uganda from the perspectives of 11 former child combatants and 11 adult community members. A thematic analysis was performed on the narrative data. The bioecological model was used to provide a conceptual framework for key themes. Major findings included the overarching impact of ongoing armed conflict on returnees' lives, the important role of the family in supporting children's resettlement, the harassment of former child soldiers by community members, and the community's inability to support systematically the returning children in tangible ways. This study recommends that humanitarian services at all levels strengthen the capacity of families to care for the material and psychoemotional needs of former child soldiers within their communities.

Installation Tobacco Control Programs in the U.S. Military

PubMed Central

Smith, Elizabeth A.; Poston, Walker S. C.; Haddock, Christopher K.; Malone, Ruth E.

2016-01-01

Tobacco use prevalence is unacceptably high in the U.S. military, and the Department of Defense and service branches have implemented tobacco control policies and cessation programs. To explore aspects of programs regarded as exemplary by their services, we visited four installations, nominated by their service's health promotion leaders, and conducted interviews, observations, and focus groups. Installations included Naval Hospital Guam, Tripler Army Medical Center, MacDill Air Force Base, and the Naval Hospital at Marine Corps Air Ground Combat Center Twentynine Palms. The tobacco control managers (TCMs) at the programs studied were all civilian employees, highly motivated and enthusiastic, and had remained in their positions for approximately a decade. Other commonalities included support from command, a “culture” of health, and location in warm climates. Programs varied in their involvement in establishing designated tobacco use areas, and length and requirement of attending cessation classes; however, no evaluation of cessation programs is currently underway. TCMs should be more engaged in policy discussions for the larger installations they serve. A strong policy framework and command support for TCMs will be necessary to achieve the goal of a tobacco-free military. PMID:27244072

Injury during U.S. Army basic combat training: a systematic review of risk factor studies.

PubMed

Bulzacchelli, Maria T; Sulsky, Sandra I; Rodriguez-Monguio, Rosa; Karlsson, Lee H; Hill, Maj Owen T

2014-12-01

Approximately one quarter of men and half of women in U.S. Army basic combat training experience an injury. Preventing basic combat training-related injuries would reduce associated human and economic costs and discharges from the Army. Identification of risk factors for such injuries is a crucial step toward their prevention. Although some research has begun to address this need, prior studies of risk factors for training-related injury have not been reviewed systematically. This study systematically reviews the literature on risk factors for injury during U.S. Army basic combat training. Original studies of risk factors for injury during U.S. Army basic combat training published since 1990 in peer-reviewed journals were identified using PubMed and manual searches of reference lists. This search was last performed in May 2013. Nineteen studies met the inclusion criteria. Methodologic quality and potential for bias were assessed. The findings of 11 studies deemed to be of high or medium quality were synthesized to determine the level of evidence supporting the association between each risk factor studied and risk of injury during basic combat training. Quality assessment and evidence synthesis were performed from June to September 2013. There is strong or moderate evidence supporting association of older age, history of smoking, and self-rated low physical activity level prior to basic combat training with increased risk of training-related injury among male trainees. There is limited, mixed, or insufficient evidence to identify risk factors for injury among female trainees. Copyright © 2014 American Journal of Preventive Medicine. All rights reserved.

Race/ethnicity, psychological resilience, and social support among OEF/OIF combat veterans.

PubMed

Herbert, Matthew S; Leung, Desmond W; Pittman, James O E; Floto, Elizabeth; Afari, Niloofar

2018-07-01

This study examined the relationship between race/ethnicity and psychological resilience, and the moderating role of social support in this relationship among non-Hispanic White (n = 605), Hispanic (n = 107), African American (n = 141), and Asian American (n = 97) Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) combat veterans. Veterans were primarily male (88%) with a mean age of 31.4 years (SD = 8.35). An analysis of covariance showed that Asian American veterans reported significantly lower psychological resilience than non-Hispanic White veterans. The interaction of race/ethnicity and social support with psychological resilience was examined via linear regression. We found that the relationship between psychological resilience and social support significantly differed by race/ethnicity such that social support was positively associated with psychological resilience among non-Hispanic White veterans, but not among other racial/ethnic groups. Our findings are consistent with previous studies that show Asian American veterans report lower psychological resilience than non-Hispanic White veterans. Cultural differences in how and why individuals use social support may underlie racial/ethnic differences in the relationship between social support and psychological resilience. Future qualitative and quantitative research is encouraged to better understand how social support relates to psychological resilience among minority OEF/OIF combat veterans. Copyright © 2018. Published by Elsevier B.V.

Physiological and psychological fatigue in extreme conditions: the military example.

PubMed

Weeks, Sharon R; McAuliffe, Caitlin L; Durussel, David; Pasquina, Paul F

2010-05-01

The extreme conditions causing fatigue in military service members in combat and combat training deserve special consideration. The collective effects of severe exertion, limited caloric intake, and sleep deprivation, combined with the inherent stressors of combat, lead to both physiological and psychological fatigue that may significantly impair performance. Studies of combat training have revealed a myriad of endocrine, cognitive, and neurological changes that occur as a result of exposure to extreme conditions. Further contributory effects of multiple military deployments, post-traumatic stress disorder, and traumatic brain injury may also influence both the susceptibility to and expression of fatigue states. Further research is needed to explore these effects to enhance military readiness and performance as well as prevent injuries. Copyright (c) 2010 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Combating Terrorism Technology Support Office 2007 Review

DTIC Science & Technology

2007-01-01

George W. Bush May 23, 2007 It’s a movie cliché: the hero disarms the bomb at the last second, saving the city, averting the crisis, and embracing...Forces warrior who is hunting al Qaeda, and the law-enforcement offi cer or fi rst Preface Combating Terrorism Technology Support Office 2007 Review ...No. 0704-0188 Public reporting burden for the collection of information is estimated to average 1 hour per response, including the time for reviewing

Analysis of Operational Pace Versus Logistical Support Rate in the Ground Combat Element of a Marine Expeditionary Brigade

DTIC Science & Technology

2006-09-01

logistical resources necessary to sustain its movement toward assigned objectives while being supported by a CSSE in an expanding maneuver warfare...thesis defines a logistics process and develops a simulation where the GCE consumes logistical resources necessary to sustain its movement toward...the MAGTF is responsible for responding to the logistics needs of the MAGTF Ground Combat Element (GCE) in order to sustain its movement. Yet

38 CFR 3.357 - Civil service preference ratings.

Code of Federal Regulations, 2010 CFR

2010-07-01

... preference only, a service-connected disability may be assigned an evaluation of “less than ten percent.” Any... impairment may be held to exist at the level of less than ten percent. For disabilities incurred in combat...

Design Calculations 93’ MLW Structure East Coast Air Combat Maneuvering Range Offshore Kitty Hawk, North Carolina.

DTIC Science & Technology

1976-09-01

CALCULATIONS 93’ MLW PLATFORM EAST COAST AIR COMBAT MANEUVERING RANGE OFFSHORE KITTY HAWK, NORTH CAROLINA CONTRACT NO. N62477-76-C-0179 MODIFICATION NO. P0001...of structures comprising the U.S. Navy East Coast Air Combat Maneuvering Range. Its purpose is to provide a platform to support electronic...All portions of the platform above elevation (-) 4.0 feet will be painted. 2. All main structural members located within the splash zone will have an

[The significance of the experience in organizing medical support for the troops during the war years for the development of the modern military medical infrastructure].

PubMed

Pogodin, Iu I; Gurov, A N

1995-05-01

In the present period when combat activities are being carried out at the territory of Russia, namely in Chechnya, it is very important to solve the problem of the improvement of the infrastructure of medical service as a basis of territorial system of medical support of troops. That's why we are looking at the experience of medical support of troops in the period of the Great Patriotic war in order to determine the basic characteristic features of military medical infrastructure (MMI) of that time. Using the experience of medical support in the period of the Great Patriotic war it is necessary to draw the main attention on studying the medico-geographical aspects of the Armed Forces deployment over the whole territory of the country, state of health service system (taking into account its reformation), influence of natural, socio-economic and ecological factors of different regions upon the health of servicemen, organization of medical support of troops, proliferation of infectious and parasitic diseases, local resources and availability of medication materials, medical supplies, equipment and technique, as well as other indices which must be taken into consideration in routine situations or during disaster relief. All this information is very valuable for the process of the formation of an adequate MMF in the zone of responsibility of medical support of troops.

Long-Term Outcomes and Needs of Military Service Members After Noncombat-Related Traumatic Brain Injury.

PubMed

Miller, Kelly J; Kennedy, Jan E; Schwab, Karen A

2017-03-01

Assess the prevalence of self-identified unmet service needs in a military sample an average of 5 years following noncombat traumatic brain injury (TBI). Examine relationships between unmet needs and background, injury-related and outcome variables. The study sample consisted of 89 veterans and service members who sustained non-combat TBI between 1999 and 2003, selected from enrollees in the Defense and Veterans Brain Injury Center TBI registry. Semistructured telephone interview was used to collect information about participants' self-reported unmet service needs, symptoms, and functional status. Most participants (65%) reported having at least one unmet service need. The most prevalent needs were "getting information about available post-TBI services" (47%) and "improving memory and attention" (45%). Unmet needs were associated with cognitive difficulties, physical and emotional symptoms, mental health diagnosis/treatment, and poorer functional status. Needs for services following TBI are associated with poor symptomatic and functional outcomes and may persist for years after injury in military service members and veterans. The study suggests service members' needs post TBI for improved cognition, support for emotional issues, and resources for vocational skills. Information about available services should be made accessible to those recovering from TBI to reduce the incidence of long-term unmet needs. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

Analysis of Suicide Behaviors in the Navy Active Duty and Reserve Component Population

DTIC Science & Technology

2015-03-01

deployment are exposed to combat or have the same combat experiences that could affect other facets of their physical and mental health . 4. Transitions...specific demographics, access to firearms, experiencing a loss (relational, financial, or career), physical and mental health , substance abuse...CODE 13. ABSTRACT (maximum 200 words) We analyze the role of service-specific and mental health risk factors in active duty and reserve

Canadian military personnel's population attributable fractions of mental disorders and mental health service use associated with combat and peacekeeping operations.

PubMed

Sareen, Jitender; Belik, Shay-Lee; Afifi, Tracie O; Asmundson, Gordon J G; Cox, Brian J; Stein, Murray B

2008-12-01

We investigated mental disorders, suicidal ideation, self-perceived need for treatment, and mental health service utilization attributable to exposure to peacekeeping and combat operations among Canadian military personnel. With data from the Canadian Community Health Survey Cycle 1.2 Canadian Forces Supplement, a cross-sectional population-based survey of active Canadian military personnel (N = 8441), we estimated population attributable fractions (PAFs) of adverse mental health outcomes. Exposure to either combat or peacekeeping operations was associated with posttraumatic stress disorder (men: PAF = 46.6%; 95% confidence interval [CI] = 27.3, 62.7; women: PAF = 23.6%; 95% CI = 9.2, 40.1), 1 or more mental disorder assessed in the survey (men: PAF = 9.3%; 95% CI = 0.4, 18.1; women: PAF = 6.1%; 95% CI = 0.0, 13.4), and a perceived need for information (men: PAF = 12.3%; 95% CI = 4.1, 20.6; women: PAF = 7.9%; 95% CI = 1.3, 15.5). A substantial proportion, but not the majority, of mental health-related outcomes were attributable to combat or peacekeeping deployment. Future studies should assess traumatic events and their association with physical injury during deployment, premilitary factors, and postdeployment psychosocial factors that may influence soldiers' mental health.

Combat and herbicide exposures in Vietnam among a sample of American Legionnaires

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stellman, S.D.; Stellman, J.M.; Sommer, J.F. Jr.

A cross-sectional survey of 6,810 randomly selected members of The American Legion in six states who served in the US Armed Forces during the Vietnam Era was conducted by a mailed questionnaire. Combat stress was evaluated by a previously validated eight-item scale. Exposure to Agent Orange and other herbicides was estimated via exposure probability index previously developed by the authors which uses an algorithm based on the combined Air Force and Joint Services HERBS files of spray data. Two-fifths of the men had served in Southeast Asia, generally at the same time during which the major proportion of herbicides weremore » used; the remaining subjects served elsewhere. Both combat and Agent Orange exposure exhibited distinct, meaningful distributions among Vietnam veterans with service in Southeast Asia and were also correlated with each other. Our analysis demonstrates conclusively that mere presence in Vietnam cannot be used as a proxy for exposure to Agent Orange. Categorization of Vietnam veterans according to herbicide exposure can be successfully accomplished, based on an existing detailed herbicide application data base. This analysis, together with the consistent dose-related results obtained in this series of papers on health and behavioral effects, demonstrates the utility of questionnaire-derived herbicide and combat exposure measures for epidemiologic study of Vietnam veterans.« less

Effects of Military Service on Marital Stability Among World War II U.S. Veterans of Japanese Descent.

PubMed

Mackintosh, Margaret-Anne; Schaper, Kim M; Willis, Emy A; Edland, Steven; Liu, Catherine; White, Lon R

2018-06-23

This study had two goals. First, we investigated how World War II (WW II) military service impacted marital stability during men's young and middle adulthood in a large community sample of American men of Japanese descent. Second, within a subgroup of WW II veterans, we assessed how the level of combat exposure affected marital stability. The Honolulu Heart Program and later Honolulu-Asia Aging Project were longitudinal, community-based studies of Japanese-American men living in Hawai'i. This study is a secondary data analysis of 1,249 male WW II veterans and 3,489 men of Japanese descent who were civilians during WW II, born 1910-1919, who completed interviews at the first (1965-1968) and third (1971-1975) exams. Data from a subsample of veterans who completed a military service interview during the sixth exam (1997-1999) also were used. In the first set of analyses, we compared veterans to civilians on three marital outcomes for ages 15-59: (1) likelihood of never marrying, (2) age at first marriage, and (3) likelihood of divorce. Next, we investigated the negative consequences of increasing combat exposure on the same marital outcomes. All analyses controlled for age in 1941 and occupation. Overall, 88% of the sample remained in their first marriage with no differences between veterans and civilians. We found no effects of military service on the timing of first marriages on the likelihood of divorce during young and middle adulthood. However, among those who had not married before WW II, veterans were significantly more likely to remain unmarried compared with civilians; odds ratio = 1.52 (1.10, 2.09). The level of combat exposure did not predict any of the three marital outcomes among WW II veterans. In fact, none of the other military service characteristics assessed (i.e., age of military induction, years of service, and service-connected disability) predicted marital outcomes. We found that age at the beginning of WW II impacted the timing and stability of marriage in both veterans and civilians. Finally, we identified cultural effects on the likelihood of marriage between Nisei and Kibei groups with Nisei men being less likely to marry. Similar to other groups in this era, long-term marriage with one partner was the norm for both veterans and civilians. For a small portion of American men of Japanese descent, military service seemed to impact the transition into marriage. However, we found no differences in the timing of marriage or the likelihood of divorce based on military service or level of combat exposure. While our findings are inconsistent with previous research on the impact of military service and combat exposure, much of that research was conducted with mainland veterans, usually of European descent. There appears to be little long-term disruption of life course events. Results highlight the importance of studying diverse groups of veterans to understand how experiences in the military interact with pre-military factors in defining long-term responses to military service.

Improvised explosive device-related lower genitourinary trauma in current overseas combat operations.

PubMed

Banti, Matthew; Walter, Jack; Hudak, Steven; Soderdahl, Douglas

2016-01-01

The use of improvised explosive devices (IEDs) has had a profound effect on battlefield trauma in the 21st century. Historically, wounds to the genitourinary (GU) structures have been less common than extremity and penetrating abdominal trauma in combat operations. GU injury incidence, severity, and associated injuries secondary to the use of this weapon in Operations Iraqi and Enduring Freedom has not been described. Data from the Department of Defense Trauma Registry was reviewed for combat-related GU injuries in Operations Iraqi and Enduring Freedom from 2001 to 2011. All wounded US armed service members are included in this database. Subjects were selected by a query of current procedural terminology and DRG International Classification of Diseases-9th Rev. codes related to traumatic injury of the penis, scrotum, testicles, and urethra. A retrospective chart review was performed for each patient to identify the date of injury, the mechanism of injury, and the associated traumatic wounds. Subjects' follow-up records were reviewed until present time or separation from active duty. A total of 501 soldiers sustained lower GU trauma, with a total of 729 injuries. Of these casualties, 448 (89%) were wounded by IEDs. Dismounted injuries (87%) made up more of the cohort than did vehicular. Specific trauma sites include 149 (20%) penile, 260 (36%) testicular, 284 (39%) scrotal, and 36 (5%) urethral injuries. The 180 limb amputations (36%) and 86 fractures (17%) were the most encountered concomitant skeletal wounds among service members with GU injuries. This is the first review of all lower GU trauma sustained by all US armed service members in current overseas combat operations. Combat-related lower GU trauma is primarily caused by IEDs in the spectrum of complex dismounted blast injuries. The mechanism primarily results in multisystem injury, with isolated GU involvement being uncommon. Continued evaluation of long-term sequelae, including sexual, urinary, and reproductive dysfunction, is needed. Epidemiologic study, level V.

The Association of Combat Exposure With Postdeployment Behavioral Health Problems Among U.S. Army Enlisted Women Returning From Afghanistan or Iraq.

PubMed

Adams, Rachel Sayko; Nikitin, Ruslan V; Wooten, Nikki R; Williams, Thomas V; Larson, Mary Jo

2016-08-01

An association between combat exposure and postdeployment behavioral health problems has been demonstrated among U.S. military service members returning from Afghanistan or Iraq in predominantly male samples, yet few studies have focused on the experiences of women. Using data from the longitudinal, observational Substance Use and Psychological Injury Combat (SUPIC) Study, we explored the self-report of 4 combat exposure items and postdeployment behavioral health screening results for 42,397 Army enlisted women who had returned from Afghanistan or Iraq from fiscal years 2008 through 2011. We ran multivariate logistic regression models to examine how a constructed composite combat exposure score (0, 1, 2, 3+) was associated with screening positive postdeployment for posttraumatic stress disorder (PTSD), depression, and at-risk drinking among active duty (AD) and National Guard/Reserve (NG/R) women. AD and NG/R women commonly reported being wounded, injured, assaulted, or hurt (17.3% and 29.0%, respectively). In all 6 multivariate models, Army women with any report of combat exposure had increased odds of the behavioral health problem (i.e., PTSD, depression, or at-risk drinking). The magnitude of the association between combat exposure and PTSD was most striking, indicating increased odds of PTSD as combat exposure score increased. AD and NG/R women with a combat exposure score of 3+ had increased odds of PTSD, 20.7, 95% confidence interval (CI) [17.0, 25.1] and 27.8, 95% CI [21.0, 36.9], respectively. Women who report combat exposure may benefit from early prevention and confidential intervention to promote postdeployment health and reduce long-term behavioral health problems. Copyright © 2016 International Society for Traumatic Stress Studies.

The Association of Combat Exposure With Postdeployment Behavioral Health Problems Among U.S. Army Enlisted Women Returning From Afghanistan or Iraq

PubMed Central

Adams, Rachel Sayko; Nikitin, Ruslan V.; Wooten, Nikki R.; Williams, Thomas V.; Larson, Mary Jo

2016-01-01

An association between combat exposure and postdeployment behavioral health problems has been demonstrated among U.S. military service members returning from Afghanistan or Iraq in predominantly male samples, yet few studies have focused on the experiences of women. Using data from the longitudinal, observational Substance Use and Psychological Injury Combat (SUPIC) study, this study explored the self-report of 4 combat exposure items and postdeployment behavioral health screening results for 42,397 Army enlisted women who returned from Afghanistan or Iraq from fiscal years 2008 through 2011. We ran multivariate logistic regression models to examine how a constructed composite combat exposure score (0, 1, 2, 3+) was associated with screening positive postdeployment for posttraumatic stress disorder (PTSD), depression, or at-risk drinking among active duty (AD) and National Guard/Reserve (NG/R) women. AD and NG/R women commonly reported being wounded, injured, assaulted, or hurt (17.3% and 29.0%, respectively). In all 6 multivariate models, Army women with any report of combat exposure had increased odds of the behavioral health problem (i.e., PTSD, depression, or at-risk drinking). The magnitude of the association between combat exposure and PTSD was most striking, indicating increased odds of PTSD as combat exposure score increased. AD and NG/R women with a combat exposure score of 3+ had increased odds of PTSD, 20.7, 95% CI [17.0, 25.1] and 27.8, 95% CI [21.0, 36.9], respectively. Women who reported combat exposure may benefit from early prevention and confidential intervention to promote postdeployment health and reduce long-term behavioral health problems. PMID:27476700

Culture: what is its effect on stress in the military?

PubMed

Langston, Victoria; Gould, Matthew; Greenberg, Neil

2007-09-01

Culture provides the unwritten rules that inform and shape expected behaviors. To date, little research has been conducted into the attitudes or opinions that service personnel hold toward mental health issues. This article examines current literature and research into the recognition of mental health problems in the military and potential organizational barriers to care including stigma and the specific characteristics of a military culture such as the significant reliance on buddy support. We conclude that the barriers to care which operate in both military and civilian populations are not insignificant. Western militaries in fact currently face an uphill struggle to combat the substantial barriers to care that exist.

144th Fighter Wing

Science.gov Websites

, the wing provides agile combat support, and intelligence, surveillance and reconnaissance to combatant the U.S. Air Force AF Week in Photos Senior leaders meet with industry to discuss utilizing artificial intelligence and quantum science throughout the Air Force AF announces 2018 Blacks in Government Meritorious

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Please select at least one (1) and up to five (5) keywords that describe your site from the list below : Air Control Wing Air Expeditionary Wing Air Force Air Mobility Wing Air Refueling Group Air Refueling Wing Airlift Wing Bomb Wing Combat Communications Group Combat Support Wing Command and Control Wing

Arming Commanders to Combat PTSD: A Time for Change - Attacking the Stressors Vice the Symptoms

DTIC Science & Technology

2009-01-01

using psychiatric, developmental, psychodynamic, family support, cognitive-behavioral, and existential - humanistic approaches either individually or in...relates to coping with the fiscal, and humanistic challenges that manifest within a nation at war, and those who experience the trauma of combat. The

Combat Support and the Operational Commander

DTIC Science & Technology

1988-09-01

adversity" (31:64). During the 19th century , Heinrich von Treitschke wrote that: The state’s first duty was to maintain its power in its relations...beyond its own frontiers [9:271. the prevailing attitude towards combat support was still mired in the 19th century . As an example of the prevailing...Donald C. McNeeley, Jr., B.A. Lieutenant, USN AFIT/GLM/LSM/88S-48 a DTIC E’ 7CTEe DEC 2 2188 C H Approved for public release; distribution unlimited The

Prehospital burn management in a combat zone.

PubMed

Lairet, Kimberly F; Lairet, Julio R; King, Booker T; Renz, Evan M; Blackbourne, Lorne H

2012-01-01

The purpose of this article is to provide a descriptive study of the management of burns in the prehospital setting of a combat zone. A retrospective chart review was performed of U.S. casualties with >20% total-body-surface-area thermal burns, transported from the site of injury to Ibn Sina Combat Support Hospital (CSH) between January 1, 2006, and August 30, 2009. Ibn Sina CSH received 225 burn casualties between January 2006 and August 2009. Of these, 48 met the inclusion criteria. The mean Injury Severity Score was 31.7 (range 4 to 75). Prehospital vascular access was obtained in 24 casualties (50%), and 20 of the casualties received fluid resuscitation. Out of the 48 casualties enrolled, 28 (58.3%) did not receive prehospital fluid resuscitation. Of the casualties who received fluid resuscitation, nearly all received volumes in excess of the guidelines established by the American Burn Association and those recommended by the Committee for Tactical Combat Casualty Care. With regard to pain management in the prehospital setting, 13 casualties (27.1%) received pain medication. With regard to the prehospital fluid resuscitation of primary thermal injury in the combat zone, two extremes were noted. The first group did not receive any fluid resuscitation; the second group was resuscitated with fluid volumes higher than those expected if established guidelines were utilized. Pain management was not uniformly provided to major burn casualties, even in several with vascular access. These observations support improved education of prehospital personnel serving in a combat zone.

Non-battle injury among repatriated UK armed forces since cessation of combat operations: a prospective observational study.

PubMed

Toman, Emma; Beaven, A; Naumann, D N; Myatt, R W; Parker, P J; Kay, A R

2018-02-01

To describe the mechanisms, burden of injury, inpatient management and rehabilitation requirements of wounded military personnel at the UK Role 4 (R4) facility within the first 12 months following cessation of combat operations in Afghanistan. All aeromedical evacuations were recorded prospectively between October 2014 and October 2015. Demographic, logistical and clinical data were derived manually from referring medical unit and patient movement requests in addition to host nation and R4 medical records. Ninety-five patients were repatriated to R4 following traumatic injury: 98.9% (n=94) were male, and median age was 27 years (IQR 25-36 years). The most common mechanisms of injury (MOIs) were sports 26.3% (n=25), falls <2 m 11.6% (n=11) and road traffic collisions 9.8% (n=9). The most common anatomical regions of injury were isolated lower limb 24.1% (n=22), isolated hand 20.0% (n=19) and polytrauma 14.7% (n=14). Median Injury Severity Score was 4 (IQR 4-9), mean 8 (range 1-41). Eleven patients (11.6%) were discharged to rehabilitation units, of whom 7 (63.6%) required neurorehabilitation. Although service personnel sustain civilian-type injuries, the specific rehabilitation goals and shift in the acute rehabilitation requirements for military personnel must be considered in the absence of enduring combat operations. It is notable that permanent medical downgrading secondary to trauma still occurs outside of warfare. The colocation of civilian major trauma services and R4 has ensured a mutually beneficial partnership that contributes to institutional memory and improves the coordination of patient pathways. The importance of relevant resource allocation, training, support and logistical considerations remain, even during the current scale of military activity overseas. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Injuries from combat explosions in Iraq: injury type, location, and severity.

PubMed

Eskridge, Susan L; Macera, Caroline A; Galarneau, Michael R; Holbrook, Troy L; Woodruff, Susan I; MacGregor, Andrew J; Morton, Deborah J; Shaffer, Richard A

2012-10-01

Explosions have caused a greater percentage of injuries in Iraq and Afghanistan than in any other large-scale conflict. Improvements in body armour and field medical care have improved survival and changed the injury profile of service personnel. This study's objective was to determine the nature, body region, and severity of injuries caused by an explosion episode in male service personnel. A descriptive analysis was conducted of 4623 combat explosion episodes in Iraq between March 2004 and December 2007. The Barell matrix was used to describe the nature and body regions of injuries due to a combat explosion. A total of 17,637 International Classification of Diseases, Ninth Revision (ICD-9) codes were assigned to the 4623 explosion episodes, with an average of 3.8 ICD-9 codes per episode. The most frequent single injury type was a mild traumatic brain injury (TBI; 10.8%). Other frequent injuries were open wounds in the lower extremity (8.8%) and open wounds of the face (8.2%), which includes tympanic membrane rupture. The extremities were the body regions most often injured (41.3%), followed by head and neck (37.4%) and torso (8.8%). The results of this study support previous observations of TBI as a pre-eminent injury of the wars in Iraq and Afghanistan, with mild TBI as the most common single injury in this large cohort of explosion episodes. The extremities had the highest frequency of injuries for any one body region. The majority of the explosion episodes resulted in more than one injury, and the variety of injuries across nearly every body region and injury type suggests a complex nature of explosion injuries. Understanding the constellation of injuries commonly caused by explosions will assist in the mitigation, treatment, and rehabilitation of the effects of these injuries. Copyright © 2012 Elsevier Ltd. All rights reserved.

The reported incidence of man-machine interface issues in Army aviators using the Aviator's Night Vision System (ANVIS) in a combat theatre

NASA Astrophysics Data System (ADS)

Hiatt, Keith L.; Rash, Clarence E.

2011-06-01

Background: Army Aviators rely on the ANVIS for night operations. Human factors literature notes that the ANVIS man-machine interface results in reports of visual and spinal complaints. This is the first study that has looked at these issues in the much harsher combat environment. Last year, the authors reported on the statistically significant (p<0.01) increased complaints of visual discomfort, degraded visual cues, and incidence of static and dynamic visual illusions in the combat environment [Proc. SPIE, Vol. 7688, 76880G (2010)]. In this paper we present the findings regarding increased spinal complaints and other man-machine interface issues found in the combat environment. Methods: A survey was administered to Aircrew deployed in support of Operation Enduring Freedom (OEF). Results: 82 Aircrew (representing an aggregate of >89,000 flight hours of which >22,000 were with ANVIS) participated. Analysis demonstrated high complaints of almost all levels of back and neck pain. Additionally, the use of body armor and other Aviation Life Support Equipment (ALSE) caused significant ergonomic complaints when used with ANVIS. Conclusions: ANVIS use in a combat environment resulted in higher and different types of reports of spinal symptoms and other man-machine interface issues over what was previously reported. Data from this study may be more operationally relevant than that of the peacetime literature as it is derived from actual combat and not from training flights, and it may have important implications about making combat predictions based on performance in training scenarios. Notably, Aircrew remarked that they could not execute the mission without ANVIS and ALSE and accepted the degraded ergonomic environment.

Legal Services during War.

DTIC Science & Technology

1987-03-23

thorough education about the laws of war, suggesting that even lawyers were ill prepared to address many of the questions that arose. In addition, there...should be "more intensive education of troops prior to combat to help avoid breaches of the laws and usages of war. 147 28 Military Affairs Military...must be determined, Inter lqa , whether damage or injury was caused by US forces during combat. Interests of both the claimant and government are served

Training and Human Factors Research in Military Systems. A Final Report

DTIC Science & Technology

1989-05-01

Combat vehicle Human factors/ identification (CVI), Operational test and evaluatio (Continued) 19. ABSTRACT (Continue on reverse if necessaty and...prepared on the management of CVI for service schools (1985). * A videotape entitled "Training for Combat" was prepared as an update for the CVI and TAATS...media, and the effects of image motion on CVI training performance. Future Developments The ART -Fort Hood TAATS program was terminated in 1987, and

The Protective Value of Hardiness on Military Posttraumatic Stress Symptoms

DTIC Science & Technology

2013-01-01

such as the death of service member colleagues and combat experi- ences. Extensive military experience may play a larger role in the development of...related stres - sors, such as number of deployments, combat experience, and exposure to death or serious injury of military colleagues and nonmilitary...predictor of PTSD. Although it is impor- tant to acknowledge that extensive military ser- vice may play a role in the development of PTSD, it is

Marine Tactical Command and Control System (MTACCS) Field Development System-1 (FDS-1) assessment: Final report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Avery, L.W.; Hunt, S.T.; Savage, S.F.

1992-04-01

The United State Marine Corps (USMC) is continuing the development and fielding of the Marine Corps Tactical Command and Control System (MTACCS), a system which exists in varying states of development, fielding, or modernization. MTACCS is currently composed of the following components: Tactical Combat Operations System (TCO) for ground command and control (C2), Intelligence Analysis System (IAS) with a Genser terminal connected to a TCO workstation for intelligence C2, Marine Integrated Personnel System (MIPS) and a TCO workstation using the Marine Combat Personnel System (MCPERS) software for personnel C2, Marine Integrated Logistics System (MILOGS) which is composed of the Landingmore » Force Asset Distribution System (LFADS), the Marine Air-Ground Task Force (MAGTF) II, and a TCO terminal using the Marine Combat Logistics System (MCLOG) for logistics C2, Marine Corps Fire Support System (MCFSS) for fire support C2, and Advanced Tactical Air Command Central (ATACC) and the Improved Direct Air Support Central for aviation C2.« less

PTSD and marital satisfaction in military service members: examining the simultaneous roles of childhood sexual abuse and combat exposure.

PubMed

Miller, Adam B; Schaefer, Karen E; Renshaw, Keith D; Blais, Rebecca K

2013-11-01

Childhood sexual abuse (CSA) is relatively common and is associated with a multitude of negative outcomes in adulthood, including posttraumatic stress disorder (PTSD) and lower marital satisfaction. However, CSA has been understudied in military samples. The purpose of the present study was to examine the relative contributions of CSA and combat exposure to PTSD and marital satisfaction. Two hundred eighteen National Guard/Reserve veterans who deployed overseas between 2001 and 2008 completed self-report measures of CSA, marital satisfaction, combat exposure, and PTSD symptom severity. Data were analyzed using linear regression and path analysis to evaluate a comprehensive model including all variables. CSA accounted for unique variance in PTSD symptom severity independent of combat exposure. CSA also had a negative direct association with marital satisfaction, independent of combat exposure and PTSD symptom severity. In contrast, combat exposure had only a negative indirect association with marital satisfaction via PTSD when all variables were examined simultaneously. CSA accounted for unique variance in both PTSD symptom severity and marital satisfaction in this sample of combat veterans. Clinically, results suggest that assessment and treatment of CSA is indicated for military veterans suffering from PTSD. Further, treatment of CSA may improve marital satisfaction, which may positively affect psychological functioning in the veteran. Copyright © 2013 Elsevier Ltd. All rights reserved.

The effect of self efficacy and meaning in life on posttraumatic stress disorder and depression severity among veterans.

PubMed

Blackburn, Laura; Owens, Gina P

2015-03-01

The current study examined the relationships among combat exposure, presence of and search for meaning in life, general and social self-efficacy, and both posttraumatic stress disorder (PTSD) and depression symptom severity for a Veteran sample (N = 93). Participants completed an online survey comprising the Combat Exposure Scale, Meaning in Life Questionnaire, Self-Efficacy Scale, Depression subscale of the Depression, Anxiety, Stress Scales-21, and PTSD Checklist-Specific Stressor version. The majority of participants were male and Caucasian. Participants served in various service eras To determine factors that predicted PTSD and depression severity, separate hierarchical linear regressions were performed. In the final PTSD model, rank, combat exposure, and general self-efficacy were significant predictors, with officer rank, lower combat exposure, and higher general self-efficacy associated with lower PTSD severity. The interaction between combat exposure and general self-efficacy was also significant, with self-efficacy moderating the relationship between combat exposure and PTSD severity. For depression, rank, presence of meaning in life, and general self-efficacy were significant predictors in the model, with officer rank, higher presence of meaning in life, and general self-efficacy associated with lower depression severity. A focus on strengthening self-efficacy may assist with lower levels of PTSD and depression symptomatology after combat trauma. © 2014 Wiley Periodicals, Inc.

The Australian Vietnam Veterans Health Study: II. self-reported health of veterans compared with the Australian population.

PubMed

O'Toole, B I; Marshall, R P; Grayson, D A; Schureck, R J; Dobson, M; Ffrench, M; Pulvertaft, B; Meldrum, L; Bolton, J; Vennard, J

1996-04-01

Self-reported physical health status of Australian Vietnam veterans was determined 20-25 years after the war and its relation to combat was investigated. An epidemiological cohort study of a simple random sample of Army veterans posted to Vietnam between 1964 and 1972 was conducted with personal interviews using the Australian Bureau of Statistics Health Interview Survey questionnaire to compare veterans with the Australian population and a 21-item combat exposure index used to measure the relationship of combat to physical health. Veterans reported greater health service usage and more recent health actions than population expectations. They also reported excess health problems in almost all recent illness disease categories except endocrine conditions and cardiovascular conditions; only 6 of 37 chronic disease groups were not elevated compared to the population. Adjustment for non-response changed estimates only slightly. Combat exposure was significantly related to reports of recent and chronic mental disorders, recent hernia and chronic ulcer, recent eczema and chronic rash, deafness, chronic infective and parasitic disease, chronic back disorders and symptoms, signs and ill-defined conditions. Combat exposure may have significantly increased reports of only some health problems. A general position to complain as a result of psychological conditions due to combat is not consistent with the lack of relationship between combat and reports of physical conditions.

Defense.gov Special Report: Unified Combatant Commands

Science.gov Websites

in support of U.S. strategic objectives. Their mission is to maintain command and control of U.S coverage and more information. Unified Combatant Command strategic map U.S. Northern Command NORTHCOM U.S U.S. Strategic Command STRATCOM . Main Menu Home Today in DOD About DOD Leaders Biographies

Evaluation and Management of Combat-Related Spinal injuries: A Review Based on Recent Experiences

DTIC Science & Technology

2012-01-01

Piedras St, El Paso, TX 79920, USA bIntegrated Department of Orthopaedic Surgery and Rehabilitation, Walter Reed National Military Medical Center...Surgery, 115th Combat Support Hospital and William Beaumont Army Medical Center, 5005 N. Piedras St, El Paso, TX 79920, USA. Tel.: (330) 329 2594. E

Optimizing the use of Limb Tourniquets in Tactical Combat Casualty Care: TCCC Guidelines Change 14-02

DTIC Science & Technology

2014-02-01

Sebesta JA, Blackbourne LH, Herbert GS, Kauvar DS, Baer DG, Walters TJ, Mullenix PS, Holcomb JB, 31 st Combat Support Hospital Research Group...K, Dixon P, Cowart J, Spencer J, Rasmussen TE. Hemorrhagic shock worsens neuromuscular recovery in a porcine model of hind limb vascular injury and

32 CFR Appendix A to Part 169a - Codes and Definitions of Functional Areas

Code of Federal Regulations, 2011 CFR

2011-07-01

...) intermediate/direct/general maintenance performed by fixed activities that are not designed for deployment to combat areas and that provide direct support of organizations performing or designed to perform combat... commercial activities that are especially designed and constructed for the low-cost and efficient storage and...

32 CFR Appendix A to Part 169a - Codes and Definitions of Functional Areas

Code of Federal Regulations, 2010 CFR

2010-07-01

...) intermediate/direct/general maintenance performed by fixed activities that are not designed for deployment to combat areas and that provide direct support of organizations performing or designed to perform combat... commercial activities that are especially designed and constructed for the low-cost and efficient storage and...

32 CFR Appendix A to Part 169a - Codes and Definitions of Functional Areas

Code of Federal Regulations, 2012 CFR

2012-07-01

...) intermediate/direct/general maintenance performed by fixed activities that are not designed for deployment to combat areas and that provide direct support of organizations performing or designed to perform combat... commercial activities that are especially designed and constructed for the low-cost and efficient storage and...

32 CFR Appendix A to Part 169a - Codes and Definitions of Functional Areas

Code of Federal Regulations, 2014 CFR

2014-07-01

...) intermediate/direct/general maintenance performed by fixed activities that are not designed for deployment to combat areas and that provide direct support of organizations performing or designed to perform combat... commercial activities that are especially designed and constructed for the low-cost and efficient storage and...

32 CFR Appendix A to Part 169a - Codes and Definitions of Functional Areas

Code of Federal Regulations, 2013 CFR

2013-07-01

...) intermediate/direct/general maintenance performed by fixed activities that are not designed for deployment to combat areas and that provide direct support of organizations performing or designed to perform combat... commercial activities that are especially designed and constructed for the low-cost and efficient storage and...

--No Title--

Science.gov Websites

, there will be a continuous presence of three fully equipped Army Brigade Combat Teams (one Armored, one Airborne, one Stryker); one prepositioned set of combat-ready equipment sufficient to support another eucom By Chris Isleib Public Affairs Officer, World War One Centennial Commission The U.S. World War I

Military Aerospace. Aerospace Education II.

ERIC Educational Resources Information Center

Smith, J. C.

This book is a revised publication in the series on Aerospace Education II. It describes the employment of aerospace forces, their methods of operation, and some of the weapons and equipment used in combat and combat support activities. The first chapter describes some of the national objectives and policies served by the Air Force in peace and…

Social Sciences Support to Military Personnel Engaged in Counter-Insurgency and Counter-Terrorism Operations (Soutien en sciences sociales apporte au personnel militaire engage dans des operations de contre-insurrection et de contre-terrorisme)

DTIC Science & Technology

2011-11-01

Aleksanin, M.D., Ph.D., Director of the Nikiforov Russian Centre of Emergency and Radiation Medicine: Dr. Aleksanin has worked as a therapist and served as a...four components of being combat ready: psychological health, physical health, combat skills and physical training. The combat potential of the...clear that participation in armed conflict affects mental and physical health adversely. Studies have shown that certain personality changes take

Ohio Army National Guard Mental Health Initiative: Risk and Resilience Factors for Combat-Related Posttraumatic Psychopathology and Post Combat Adjustment

DTIC Science & Technology

2013-10-01

never married , divorced/separated/widowed, married ), race (White, Black, other), annual income (≤ $60,000 vs . > $60,000), ed- ucation (high school...to a combat setting (Elhai, et al. 2012), while protection is associated with post-deployment support, being married and being female (Orr, et al...never deployed (53.0% vs . 39.5%, p = 0.005) and PTSD (8.3% vs . 1.9%, p = 0.005)  Women more often had a history of mood disorders as compared to

Appetitive Aggression and Adverse Childhood Experiences Shape Violent Behavior in Females Formerly Associated with Combat

PubMed Central

Augsburger, Mareike; Meyer-Parlapanis, Danie; Bambonye, Manassé; Elbert, Thomas; Crombach, Anselm

2015-01-01

This study investigated the impact of violent experiences during childhood, posttraumatic stress disorder (PTSD) and appetitive aggression on everyday violent behavior in Burundian females with varying participation in war. Moreover, group differences in trauma-related and aggression variables were expected. Appetitive aggression describes the perception of violence perpetration as fascinating and appealing and is a common phenomenon in former combatants. Semi-structured interviews were conducted with 158 females, either former combatants, supporters of armed forces or civilians during the civil war in Burundi. The PTSD Symptom Scale Interview was used to assess PTSD symptom severity, the Appetitive Aggression Scale to measure appetitive aggression and the Domestic and Community Violence Checklist to assess both childhood maltreatment and recent aggressive behavior. Former combatants had experienced more traumatic events, perpetrated more violence and reported higher levels of appetitive aggression than supporters and civilians. They also suffered more severely from PTSD symptoms than civilians but not than supporters. The groups did not differ regarding childhood maltreatment. Both appetitive aggression and childhood violence predicted ongoing aggressive behavior, whereas the latter outperformed PTSD symptom severity. These findings support current research showing that adverse childhood experiences and a positive attitude toward aggression serve as the basis for aggressive behavior and promote an ongoing cycle of violence in post-conflict regions. Female members of armed groups are in need of demobilization procedures including trauma-related care and interventions addressing appetitive aggression. PMID:26635666

Out of the Shadows: The Health and Well-Being of Private Contractors Working in Conflict Environments.

PubMed

Dunigan, Molly; Farmer, Carrie M; Burns, Rachel M; Hawks, Alison; Setodji, Claude Messan

2014-01-01

Over the past decade, private contractors have been deployed extensively around the globe. In addition to supporting U.S. and allied forces in Iraq and Afghanistan, contractors have assisted foreign governments, nongovernmental organizations, and private businesses by providing a wide range of services, including base support and maintenance, logistical support, transportation, intelligence, communications, construction, and security. At the height of the conflicts in Iraq and Afghanistan, contractors outnumbered U.S. troops deployed to both theaters. Although these contractors are not supposed to engage in offensive combat, they may nonetheless be exposed to many of the stressors that are known to have physical and mental health implications for military personnel. RAND conducted an online survey of a sample of contractors who had deployed on contract to a theater of conflict at least once between early 2011 and early 2013. The survey collected demographic and employment information, along with details about respondents' deployment experience (including level of preparation for deployment, combat exposure, and living conditions), mental health (including probable posttraumatic stress disorder, depression, and alcohol misuse), physical health, and access to and use of health care. The goal was to describe the contractors' health and well-being and to explore differences across the sample by such factors as country of citizenship, job specialty, and length and frequency of contract deployment. The findings provide a foundation for future studies of contractor populations and serve to inform policy decisions affecting contractors, including efforts to reduce barriers to mental health treatment for this population.

Accommodating Veterans with Posttraumatic Stress Disorder Symptoms in the Academic Setting

ERIC Educational Resources Information Center

Glover-Graf, Noreen M.; Miller, Eva; Freeman, Samuel

2010-01-01

Iraq veterans were asked to describe readjustment difficulties following their return from combat service. A qualitative analysis addressed four themes (professional concerns, social interactions, behavioral and emotional challenges, and changing life views) relevant to post service classroom adjustment. Recommendations for educational…

5 CFR 1604.8 - Death benefits.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 3 2012-01-01 2012-01-01 false Death benefits. 1604.8 Section 1604.8 Administrative Personnel FEDERAL RETIREMENT THRIFT INVESTMENT BOARD UNIFORMED SERVICES ACCOUNTS § 1604.8 Death... a service member account contains combat zone contributions, the death benefit payment will be made...

5 CFR 1604.8 - Death benefits.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 3 2011-01-01 2011-01-01 false Death benefits. 1604.8 Section 1604.8 Administrative Personnel FEDERAL RETIREMENT THRIFT INVESTMENT BOARD UNIFORMED SERVICES ACCOUNTS § 1604.8 Death... a service member account contains combat zone contributions, the death benefit payment will be made...

Patella Fracture in US Servicemember in an Austere Location.

PubMed

Schermerhorn, Sophia M; Auchincloss, Paul J; Kraft, Kyle; Nelson, Kenneth J; Pamplin, Jeremy C

Review the management of a patient with acute patella fracture supported by telemedical consultation. Clinical Context: Regionally Aligned Forces (RAF) supporting US Army Africa/Southern European Task Force (USARAF/ SETAF) in Africa Command area of responsibility. Care was provided by a Role I facility on the compound. Organic Expertise: Three 68W combat medics; one Special Operations Combat Medic (SOCM). Closest Medical Support: Organic battalion physician assistant (PA) located in the United States; USARAF PA located in a European country; French Role II located in nearby West African country; telemedical consults via e-mail, phone, or videoteleconsultation. Earliest Evacuation: Estimated at 12 to 24 hours with appropriate clearances. 2018.

Enhancing pharmacists' role in developing countries to overcome the challenge of antimicrobial resistance: a narrative review.

PubMed

Sakeena, M H F; Bennett, Alexandra A; McLachlan, Andrew J

2018-01-01

Antimicrobial resistance (AMR) is a global health challenge and developing countries are more vulnerable to the adverse health impacts of AMR. Health care workers including pharmacists can play a key role to support the appropriate use of antimicrobials in developing countries and reduce AMR. The aim of this review is to investigate the role of pharmacists in the appropriate use of antibiotics and to identify how the pharmacists' role can be enhanced to combat AMR in developing countries. The databases MEDLINE, EMBASE, Web of Science and Google Scholar were searched for articles published between 2000 and the end of August 2017 that involved studies on the role of pharmacists in developing countries, the expanded services of pharmacists in patient care in developed countries and pharmacists' contributions in antimicrobial use in both developed and developing nations. In developing countries pharmacists role in patient care are relatively limited. However, in developed nations, the pharmacists' role has expanded to provide multifaceted services in patient care resulting in improved health outcomes from clinical services and reduced health care costs. Success stories of pharmacist-led programs in combating AMR demonstrates that appropriately trained pharmacists can be part of the solution to overcome the global challenge of AMR. Pharmacists can provide education to patients enabling them to use antibiotics appropriately. They can also provide guidance to their healthcare colleagues on appropriate antibiotic prescribing. This review highlights that appropriately trained pharmacists integrated into the health care system can make a significant impact in minimising inappropriate antibiotic use in developing countries. Strengthening and enhancing the pharmacists' role in developing countries has the potential to positively impact the global issue of AMR.

Posttraumatic stress disorder post Iraq and Afghanistan: prevalence among military subgroups.

PubMed

Hines, Lindsey A; Sundin, Josefin; Rona, Roberto J; Wessely, Simon; Fear, Nicola T

2014-09-01

A large body of research has been produced in recent years investigating posttraumatic stress disorder (PTSD) among military personnel following deployment to Iraq and Afghanistan, resulting in apparent differences in PTSD prevalence. We compare prevalence estimates for current PTSD between military subgroups, providing insight into how groups may be differentially affected by deployment. Systematic literature searches using the terms PTSD, stress disorder, and acute stress, combined with terms relating to military personnel, identified 49 relevant papers. Studies with a sample size of less than 100 and studies based on data for treatment seeking or injured populations were excluded. Studies were categorized according to theatre of deployment (Iraq or Afghanistan), combat and noncombat deployed samples, sex, enlistment type (regular or reserve and [or] National Guard), and service branch (for example, army, navy, and air force). Meta-analysis was used to assess PTSD prevalence across subgroups. There was large variability in PTSD prevalence between studies, but, regardless of heterogeneity, prevalence rates of PTSD were higher among studies of Iraq-deployed personnel (12.9%; 95% CI 11.3% to 14.4%), compared with personnel deployed to Afghanistan (7.1%; 95% CI 4.6% to 9.6%), combat deployed personnel, and personnel serving in the Canadian, US, or UK army or the navy or marines (12.4%; 95% CI 10.9% to 13.4%), compared with the other services (4.9%; 95% CI 1.4% to 8.4%). Contrary to findings from within-study comparisons, we did not find a difference in PTSD prevalence for regular active-duty and reserve or National Guard personnel. Categorizing studies according to deployment location and branch of service identified differences among subgroups that provide further support for factors underlying the development of PTSD.

Posttraumatic Stress Disorder Post Iraq and Afghanistan: Prevalence Among Military Subgroups

PubMed Central

Hines, Lindsey A; Sundin, Josefin; Rona, Roberto J; FFPH; Wessely, Simon; FMedSci; Fear, Nicola T

2014-01-01

A large body of research has been produced in recent years investigating posttraumatic stress disorder (PTSD) among military personnel following deployment to Iraq and Afghanistan, resulting in apparent differences in PTSD prevalence. We compare prevalence estimates for current PTSD between military subgroups, providing insight into how groups may be differentially affected by deployment. Systematic literature searches using the terms PTSD, stress disorder, and acute stress, combined with terms relating to military personnel, identified 49 relevant papers. Studies with a sample size of less than 100 and studies based on data for treatment seeking or injured populations were excluded. Studies were categorized according to theatre of deployment (Iraq or Afghanistan), combat and noncombat deployed samples, sex, enlistment type (regular or reserve and [or] National Guard), and service branch (for example, army, navy, and air force). Meta-analysis was used to assess PTSD prevalence across subgroups. There was large variability in PTSD prevalence between studies, but, regardless of heterogeneity, prevalence rates of PTSD were higher among studies of Iraq-deployed personnel (12.9%; 95% CI 11.3% to 14.4%), compared with personnel deployed to Afghanistan (7.1%; 95% CI 4.6% to 9.6%), combat deployed personnel, and personnel serving in the Canadian, US, or UK army or the navy or marines (12.4%; 95% CI 10.9% to 13.4%), compared with the other services (4.9%; 95% CI 1.4% to 8.4%). Contrary to findings from within-study comparisons, we did not find a difference in PTSD prevalence for regular active-duty and reserve or National Guard personnel. Categorizing studies according to deployment location and branch of service identified differences among subgroups that provide further support for factors underlying the development of PTSD. PMID:25569079

2009 Defense Supply Center Columbus Land and Maritime Supply Chains: Business Conference and Exhibition

DTIC Science & Technology

2009-08-19

DSN: 388-7453 CSCASSIG@CSD.DISA.MIL  DFAS eCommerce web site http://www.dfas.mil/contractorpay/electroniccommerce.html  DFAS Customer Service...M-ATV is a separate category within the MRAP family of vehicles. ►Mission: Small-unit combat operations in highly restricted rural , mountainous...vehicles. ►Mission: Small-unit combat operations in highly restricted rural , mountainous and urban environments. ► Troop Transport: Carry up to five

2009 Defense Supply Center Columbus Land and Maritime Supply Chains Business Conference and Exhibition

DTIC Science & Technology

2009-08-19

DSN: 388-7453 CSCASSIG@CSD.DISA.MIL  DFAS eCommerce web site http://www.dfas.mil/contractorpay/electroniccommerce.html  DFAS Customer Service...M-ATV is a separate category within the MRAP family of vehicles. ►Mission: Small-unit combat operations in highly restricted rural , mountainous...vehicles. ►Mission: Small-unit combat operations in highly restricted rural , mountainous and urban environments. ► Troop Transport: Carry up to five

Every Citizen a Soldier: Historic Foundations for Gender Integrated Training (GIT) and Implications for Air Force Readiness

DTIC Science & Technology

1999-04-01

masculine world. Noted military experts suggest pluralism is the desired end state for successful gender integrated service, and this concept is...book in progress, Dr. Dunivin discusses two, current U.S. 5 military culture models. The first is the Traditional Model, termed the Combat Masculine ... Masculine Warrior. Charles Moskos, cited by Dunivin, describes what the 6 Combat Masculine Warrior paradigm actually means to the military: “Thus a

Injuries from Participation in Sports, Exercise, and Recreational Activities Among Active Duty Service Members - Analysis of the April 2008 Status of Forces Survey of Active Duty Members

DTIC Science & Technology

2011-09-13

included physical training (PT), combatives, Frisbee/ultimate Frisbee, rugby , dodge ball, wrestling, aerobics/cross fit, bowling, hiking/walking, and...Frisbee, rugby , dodge ball, wrestling, and bowling. Injury Prevention Report No. 12-HF-0DPT-08 42 Percent Percent Percent...responses included combatives, Frisbee, rugby , dodge ball, wrestling, and bowling. Injury Prevention Report No. 12-HF-0DPT-08 44

Optimizing fitness for duty and post-combat clinical services for military personnel and combat veterans with ADHD—a systematic review of the current literature

PubMed Central

Ivanov, Iliyan; Yehuda, Rachel

2014-01-01

Background Attention deficit hyper activity disorder (ADHD) is a developmental disorder, most often diagnosed in childhood, and characterized by hyperactivity and inattention that negatively impacts one's ability to function and fulfill social and personal obligations. Individuals with past history of ADHD may enlist in the military under certain conditions, however the full impact of military training and deployment of later in life ADHD symptoms is unclear. It is of particular interest how military experience may affect ADHD in remission and if such individuals might be at elevated risk for relapse of ADHD symptoms. Method We performed a systematic review f the available literature including the Department of Defense (DOD) guidelines for both eligibility to enlist and fitness for deployment based on reported history and current symptomatology of ADHD. Results The after care for veterans with ADHD relapse is inconsistent and presents with number of challenges. We evaluate the DOD policies regarding the implications of ADHD for fitness for military service and post-combat mental health. Conclusion The full extend of the interaction between pre-existing ADHD and post-combat PTSD are not fully understood. The development of comprehensive and clear algorithms for diagnosing and treating ADHD in the military before and after deployment will have a strong positive impact on the quality of care delivered to soldiers and veterans. PMID:25206949

Burns to the genitalia, perineum, and buttocks increase the risk of death among U.S. service members sustaining combat-related burns in Iraq and Afghanistan.

PubMed

Clemens, Michael S; Janak, Judson C; Rizzo, Julie A; Graybill, John C; Buehner, Michelle F; Hudak, Steven J; Thompson, Charles K; Chung, Kevin K

2017-08-01

Among service members injured in Iraq and Afghanistan, to determine the risk of mortality associated with combat-related burns to the genitalia, perineum, and buttocks. The prospectively maintained burn registry from the United States Army Institute of Surgical Research was retrospectively reviewed to identify all service members with combat-related burns sustained in Iraq and Afghanistan from March 2003 to October 2013. The two primary risk factors of interest were (1) any burn to the genitals, perineum, and/or buttocks (PB) and (2) burns involving the entire perineal, genital, and buttock region (complete PB). Cox proportional hazard models were used to estimate the risk of mortality for both primary risk factors, and adjusted for severe non-burn-related trauma, percent of burn over total body surface area (TBSA), inhalational injury, time to urinary tract infection, and time to bacteremia. A post-hoc analysis was performed to explore the potential effect modification of TBSA burned on the relationship between PB and mortality. Among the 902 U.S. service members with combat-related burns sustained during the study period, 226 (25.0%) had involvement of the genitalia, perineum, and/or buttocks. Complete PB was associated with a crude risk of mortality (HR: 5.3; 2.9-9.7), but not an adjusted risk (HR=1.8; 0.8-4.0). However, TBSA burned was identified as a potential negative effect modifier. Among patients with burns <60% TBSA, sustaining a complete PB conferred an adjusted risk of death (HR=2.7; 1.1-6.8). Further, patients with a perineal burn had a five-fold increased incidence of bacteremia. In adjusted models, each event of bacteremia increased the risk of mortality by 92% (HR 1.92; 1.39-2.65). Perineal burns were associated with a two-fold increased incidence of severe non-burn related trauma that also doubled mortality risk in adjusted models (HR 2.29; 1.23-4.27). Among those with relatively survivable combat-related burns (<60% TBSA), genital/perineal/buttock involvement increases the risk of death. Bacteremia may account for part of this increased risk, but does not fully explain the independent risk associated with perineal burns. Published by Elsevier Ltd.

[Epidemiological health surveillance among the troops during combat operations in armed conflicts].

PubMed

Mel'nichenko, P I

1997-08-01

With local wars and armed conflicts the sanitary-epidemiological situation for the troops and local population shows a tendency to worsen. The main objects of the military medical service at the period of deployment are the preventive measures against troops infection from local sources by virus hepatitis A, bacterial dysentery, typhoid, cholera etc. As a rule, combat actions result in communal service destruction, low quality of potable water, soil contamination and worsening sanitary norms and standards. Also, there is a danger of reactivation of the natural centres of infection due to large-scale defence earthworks in the region of operations. The experience of the military medical service in Afghanistan and Chechnya proves, that a multimedia approach to preventive antiepidemic measures is necessary together with the emphasis on the most important actions against infections that represent the biggest danger for the land troops.

Acknowledging the Risk for Traumatic Brain Injury in Women Veterans.

PubMed

Amoroso, Timothy; Iverson, Katherine M

2017-04-01

Since the Iraq and Afghanistan wars began, an unprecedented number of women have been engaging in combat operations. Likewise, the number of women using Department of Veterans Affairs (VA) services has doubled since 2001. Military service, and deployment to combat in particular, poses certain risks for traumatic brain injury (TBI)-for all service members. However, women may have additional military and nondeployment risk factors such as intimate partner violence (IPV). We briefly review the definition and classification issues related to TBI, as well as common acute and chronic health symptoms after TBI. Specific sex differences in prognosis after TBI, in particular the neurobehavioral symptoms, are also reviewed. We then focus on the emerging literature regarding TBI in women veterans including the etiologies, outcomes, and unique challenges this population faces. The article concludes with suggestions for enhanced screening by VA and non-VA providers alike, as well as directions for future research and clinical inquiry.

Prevalence of, risk factors for, and consequences of posttraumatic stress disorder and other mental health problems in military populations deployed to Iraq and Afghanistan.

PubMed

Ramchand, Rajeev; Rudavsky, Rena; Grant, Sean; Tanielian, Terri; Jaycox, Lisa

2015-05-01

This review summarizes the epidemiology of posttraumatic stress disorder (PTSD) and related mental health problems among persons who served in the armed forces during the Iraq and Afghanistan conflicts, as reflected in the literature published between 2009 and 2014. One-hundred and sixteen research studies are reviewed, most of which are among non-treatment-seeking US service members or treatment-seeking US veterans. Evidence is provided for demographic, military, and deployment-related risk factors for PTSD, though most derive from cross-sectional studies and few control for combat exposure, which is a primary risk factor for mental health problems in this cohort. Evidence is also provided linking PTSD with outcomes in the following domains: physical health, suicide, housing and homelessness, employment and economic well-being, social well-being, and aggression, violence, and criminality. Also included is evidence about the prevalence of mental health service use in this cohort. In many instances, the current suite of studies replicates findings observed in civilian samples, but new findings emerge of relevance to both military and civilian populations, such as the link between PTSD and suicide. Future research should make effort to control for combat exposure and use longitudinal study designs; promising areas for investigation are in non-treatment-seeking samples of US veterans and the role of social support in preventing or mitigating mental health problems in this group.

Longitudinal Investigation of Smoking Initiation and Relapse Among Younger and Older US Military Personnel

PubMed Central

Trone, Daniel W.; Peterson, Arthur V.; Jacobson, Isabel G.; Littman, Alyson J.; Maynard, Charles; Seelig, Amber D.; Crum-Cianflone, Nancy F.; Bricker, Jonathan B.

2015-01-01

Objectives. We examined whether military service, including deployment and combat experience, were related to smoking initiation and relapse. Methods. We included older (panel 1) and younger (panel 2) participants in the Millennium Cohort Study. Never smokers were followed for 3 to 6 years for smoking initiation, and former smokers were followed for relapse. Complementary log-log regression models estimated the relative risk (RR) of initiation and relapse by military exposure while adjusting for demographic, health, and lifestyle factors. Results. Deployment with combat experience predicted higher initiation rate (panel 1: RR = 1.44; 95% confidence interval [CI] = 1.28, 1.62; panel 2: RR = 1.26; 95% CI = 1.04, 1.54) and relapse rate (panel 1 only: RR = 1.48; 95% CI = 1.36, 1.62). Depending on the panel, previous mental health disorders, life stressors, and other military and nonmilitary characteristics independently predicted initiation and relapse. Conclusions. Deployment with combat experience and previous mental disorder may identify military service members in need of intervention to prevent smoking initiation and relapse. PMID:25880953

Complexity of the Relationships of Pain, Posttraumatic Stress, and Depression in Combat-Injured Populations: An Integrative Review to Inform Evidence-Based Practice.

PubMed

Giordano, Nicholas A; Bader, Christine; Richmond, Therese S; Polomano, Rosemary C

2018-04-01

Understanding the complex interrelationships between combat injuries, physical health, and mental health symptoms is critical to addressing the healthcare needs of wounded military personnel and veterans. The relationship between injury characteristics, pain, posttraumatic stress disorder (PTSD), and depression among combat-injured military personnel is unique to modern conflicts and understudied in the nursing literature. This integrative review synthesizes clinical presentations and relationships of combat injury, PTSD, depression, and pain in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) United States military service members and veterans. A literature search was conducted using relative key terms across databases to identify peer-reviewed publications between 2001 and 2016 that examined health outcomes of combat-injured persons in OEF and OIF. The quality of evidence was evaluated and results synthesized to examine the association of combat injury as a risk factor for PTSD, the relationship of PTSD and depression pre- and postinjury, and pain management throughout care. Twenty-two articles were included in this review. Greater injury and pain severity poses risks for developing PTSD following combat injury, while early symptom management lessens risks for PTSD. Depression appears to be both a contributing risk factor to postinjury PTSD, as well as a comorbidity. Findings demonstrate a compelling need for improvements in standardized assessment of pain and mental health symptoms across transitions in care. This integrative review informs nurse researchers and providers of the clinical characteristics of pain, PTSD, and depression following combat injury and offers implications for future research promoting optimal surveillance of symptoms. © 2018 Sigma Theta Tau International.

Experiences of hearing loss and views towards interventions to promote uptake of rehabilitation support among UK adults.

PubMed

Rolfe, Crystal; Gardner, Benjamin

2016-11-01

Effective hearing loss rehabilitation support options are available. Yet, people often experience delays in receiving rehabilitation support. This study aimed to document support-seeking experiences among a sample of UK adults with hearing loss, and views towards potential strategies to increase rehabilitation support uptake. People with hearing loss were interviewed about their experiences of seeking support, and responses to hypothetical intervention strategies, including public awareness campaigns, a training programme for health professionals, and a national hearing screening programme. Semi-structured qualitative interview design with thematic analysis. Twenty-two people with hearing loss, aged 66-88. Three themes, representing barriers to receiving rehabilitation support and potential areas for intervention, were identified: making the journey from realization to readiness, combatting social stigma, and accessing appropriate services. Barriers to receiving support mostly focused on appraisal of hearing loss symptoms. Interventions enabling symptom appraisal, such as routine screening, or demonstrating how to raise the topic effectively with a loved one, were welcomed. Interventions to facilitate realization of hearing loss should be prioritized. Raising awareness of the symptoms and prevalence of hearing loss may help people to identify hearing problems and reduce stigma, in turn increasing hearing loss acceptance.

Unlawful Combatants at the Controls: The CIA, Armed RPAS and LOAC

DTIC Science & Technology

2011-02-16

career judge advocate, beginning military service with the Judge Advocate General’s Corps, United States Navy . After a brief stint in private...of Xe Services, formerly known as Blackwater , the private security firm that has been at the forefront of other allegations concerning civilians

Transitions: Combat Veterans as College Students

ERIC Educational Resources Information Center

Ackerman, Robert; DiRamio, David; Garza Mitchell, Regina L.

2009-01-01

The experience of war makes those who fight a special group within the general population. The purpose of this study was to investigate how combat veterans who become college students make the transition to campus life, in order to identify how administrators can acknowledge and support them. A total of six women and 19 men were interviewed; 24…

The Financial War on Terrorism: Grading U.S. Strategy for Combating the Financing of Terrorism

DTIC Science & Technology

2006-04-15

15 April 2006 Signature______________________________ Thesis Advisor: CAPTAIN Dave Jerabek, US Navy Report Documentation...activities to combat terrorist financing, this thesis proposes how DoD can use threat finance exploitation to meaningfully support the overall...of Terrorism FORMAT: Thesis DATE: 14 April 2006 PAGES: 94 CLASSIFICATION: Unclassified Following the September 11, 2001, attacks

Emergency Department Patients Support the Use of Combat Medics in Their Clinical Care

DTIC Science & Technology

2015-07-01

indirect supervision is the growing complexity of modern medi- cine . If this level of supervised and controlled training is required of aviation and...readiness of brigade combat teams fighting the Global War on Terror . J Surg Res. 2007;138:25–31. 4. Mabry RL, Apodaca A, Penrod J, et al. Impact of

2006 Combat Vehicles Conference

DTIC Science & Technology

2006-10-25

stressed or worn out beyond economic repair due to combat operations by repairing, rebuilding, or procuring replacement equipment. These...lives Vehicle Hardening Logistics Solutions for the Warfighter • Unique and economical surge capability • Support in coordination with op tempo...Speed, • Diagnostics Indicators – DECU Health Check Indicator, Utility Bus Comm Failure, 1553 Bus Comm Failure; MPU Critical Failure, Cautions and

Open Science Grid (OSG) Ticket Synchronization: Keeping Your Home Field Advantage In A Distributed Environment

NASA Astrophysics Data System (ADS)

Gross, Kyle; Hayashi, Soichi; Teige, Scott; Quick, Robert

2012-12-01

Large distributed computing collaborations, such as the Worldwide LHC Computing Grid (WLCG), face many issues when it comes to providing a working grid environment for their users. One of these is exchanging tickets between various ticketing systems in use by grid collaborations. Ticket systems such as Footprints, RT, Remedy, and ServiceNow all have different schema that must be addressed in order to provide a reliable exchange of information between support entities and users in different grid environments. To combat this problem, OSG Operations has created a ticket synchronization interface called GOC-TX that relies on web services instead of error-prone email parsing methods of the past. Synchronizing tickets between different ticketing systems allows any user or support entity to work on a ticket in their home environment, thus providing a familiar and comfortable place to provide updates without having to learn another ticketing system. The interface is built in a way that it is generic enough that it can be customized for nearly any ticketing system with a web-service interface with only minor changes. This allows us to be flexible and rapidly bring new ticket synchronization online. Synchronization can be triggered by different methods including mail, web services interface, and active messaging. GOC-TX currently interfaces with Global Grid User Support (GGUS) for WLCG, Remedy at Brookhaven National Lab (BNL), and Request Tracker (RT) at the Virtual Data Toolkit (VDT). Work is progressing on the Fermi National Accelerator Laboratory (FNAL) ServiceNow synchronization. This paper will explain the problems faced by OSG and how they led OSG to create and implement this ticket synchronization system along with the technical details that allow synchronization to be preformed at a production level.

Brain-derived neurotropic factor polymorphisms, traumatic stress, mild traumatic brain injury, and combat exposure contribute to postdeployment traumatic stress.

PubMed

Dretsch, Michael N; Williams, Kathy; Emmerich, Tanja; Crynen, Gogce; Ait-Ghezala, Ghania; Chaytow, Helena; Mathura, Venkat; Crawford, Fiona C; Iverson, Grant L

2016-01-01

In addition to experiencing traumatic events while deployed in a combat environment, there are other factors that contribute to the development of posttraumatic stress disorder (PTSD) in military service members. This study explored the contribution of genetics, childhood environment, prior trauma, psychological, cognitive, and deployment factors to the development of traumatic stress following deployment. Both pre- and postdeployment data on 231 of 458 soldiers were analyzed. Postdeployment assessments occurred within 30 days from returning stateside and included a battery of psychological health, medical history, and demographic questionnaires; neurocognitive tests; and blood serum for the D2 dopamine receptor (DRD2), apolipoprotein E (APOE), and brain-derived neurotropic factor (BDNF) genes. Soldiers who screened positive for traumatic stress at postdeployment had significantly higher scores in depression (d = 1.91), anxiety (d = 1.61), poor sleep quality (d = 0.92), postconcussion symptoms (d = 2.21), alcohol use (d = 0.63), traumatic life events (d = 0.42), and combat exposure (d = 0.91). BDNF Val66 Met genotype was significantly associated with risk for sustaining a mild traumatic brain injury (mTBI) and screening positive for traumatic stress. Predeployment traumatic stress, greater combat exposure and sustaining an mTBI while deployed, and the BDNF Met/Met genotype accounted for 22% of the variance of postdeployment PTSD scores (R (2)  = 0.22, P < 0.001). However, predeployment traumatic stress, alone, accounted for 17% of the postdeployment PTSD scores. These findings suggest predeployment traumatic stress, genetic, and environmental factors have unique contributions to the development of combat-related traumatic stress in military service members.

Bridging Services: Drug Abuse, Human Services and the Therapeutic Community. Proceedings of the World Conference of Therapeutic Communities (9th, San Francisco, California, September 1-6, 1985).

ERIC Educational Resources Information Center

Acampora, Alfonso P., Ed.; Nebelkopf, Ethan, Ed.

The World Federation of Therapeutic Communities is an international association of drug treatment centers that use the "Therapeutic Community" (TC) to combat chemical dependency and drug addiction. Their 1985 conference focused on bridging services between the TC and the traditional human service systems. A total of 85 separate papers were…

Hegemonic Masculinity in Sport Education: Case Studies of Experienced In-Service Teachers with Teaching Orientations

ERIC Educational Resources Information Center

Chen, YuChun; Curtner-Smith, Matthew

2013-01-01

Research has revealed that while pre-service teachers (PTs) with coaching orientations reinforce sexism and masculine bias, those with teaching orientations combat and reject it. The purpose of this study was to examine four sport education (SE) seasons taught by two experienced in-service teachers for the presence or absence of sexism and…

Family support, family stress, and suicidal ideation in a combat-exposed sample of Operation Enduring Freedom/Operation Iraqi Freedom veterans.

PubMed

Gradus, Jaimie L; Smith, Brian N; Vogt, Dawne

2015-01-01

Deployment-related risk factors for suicidal ideation among Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans have received a great deal of attention. Studies show that mental health symptoms mediate the association between most deployment stressors and suicidal ideation; however, family-related factors during deployment are largely unexplored. We examined posttraumatic stress disorder (PTSD) and depression symptoms as mediators of the associations between deployment family support and stress and post-deployment suicidal ideation in combat-exposed OEF/OIF veterans. National cross-sectional mail survey. 1046 veterans responded to the survey. The sample for this study was 978 veterans who experienced combat. Regression-based path analyses were conducted. Family support and stress had direct associations with suicidal ideation. When PTSD and depression symptoms were examined as mediators of these associations, results revealed significant indirect paths through these symptoms. This study contributes to the literature on suicidal ideation risk factors among OEF/OIF veterans. Deployment family support and family stress are associated with suicidal ideation; however these associations occur primarily through mental health symptomatology, consistent with findings observed for other deployment factors. This research supports ongoing efforts to treat mental health symptomatology as a means of suicide prevention.

Quantitative EEG during REM and NREM sleep in combat-exposed veterans with and without Posttraumatic Stress Disorder

PubMed Central

Cohen, Daniel J.; Begley, Amy; Alman, Jennie J.; Cashmere, J. David; Pietrone, Regina N.; Seres, Robert J.; Germain, Anne

2012-01-01

Summary Sleep disturbances are a hallmark feature of posttraumatic stress disorder (PTSD), and associated with poor clinical outcomes. Few studies have examined sleep quantitative electroencephalography (qEEG), a technique able to detect subtle differences polysomnography does not capture. We hypothesized greater high-frequency qEEG would reflect “hyperarousal” in in combat veterans with PTSD (n=16) compared to veterans without PTSD (n=13). EEG power in traditional EEG frequency bands was computed for artifact-free sleep epochs across an entire night. Correlations were performed between qEEG and ratings of PTSD symptoms and combat exposure. The groups did not differ significantly in whole night qEEG measures for either REM or NREM. Non-significant medium effect sizes suggest less REM beta (opposite to our hypothesis), less REM and NREM sigma, and more NREM gamma in combat veterans with PTSD. Positive correlations were found between combat exposure and NREM beta (PTSD group only), and REM and NREM sigma (non-PTSD group only). Results did not support global hyperarousal in PTSD as indexed by increased beta qEEG activity. The correlation of sigma activity with combat exposure in those without PTSD, and the non-significant trend towards less sigma activity during both REM and NREM sleep in combat veterans with PTSD suggests that differential information processing during sleep may characterize combat-exposed military veterans with and without PTSD. PMID:22845675

Defense.gov Special Report: National Native American Heritage Month -

Science.gov Websites

non-combat situation), Bronze Star - Operation DESERT STORM Campaign, Defense Meritorious Service Medal - Operation IRAQI FREEDOM, Defense Meritorious Service Medal - Operation ENDURING FREEDOM, and Campaign Medals - Operation IRAQI FREEDOM / Operation ENDURING FREEDOM. Maj. Maureen A. Trujillo U.S. Air

Perspectives on Child Maltreatment in the Mid '80s.

ERIC Educational Resources Information Center

National Center on Child Abuse and Neglect (DHHS/OHDS), Washington, DC.

This book presents 19 papers on child abuse and neglect. A brief introduction by Health and Human Services Secretary, Margaret Heckler is followed by 13 major issue papers: "Combatting Child Abuse and Neglect" by the assistant secretary for Human Development Services, Dorcas R. Hardy; "What Have We Learned about Child…

Cybernetic Service-Learning Course Development: Lessons Learned

ERIC Educational Resources Information Center

Marx, Jonathan I.; Miller, Lee Q.

2009-01-01

Although the title of the course, Combating Loneliness among Older People in Contemporary Society, states a clear goal, our service-learning class was shaped by five guiding parameters. By avoiding certain things, we allowed the course to self-organize and evolve into a learning experience beyond the one originally envisioned. This paper…

To ensure that members of the Armed Forces and civilian employees of the Department of Defense who were killed or wounded in certain attacks in 2009 and 2011 directed at members or employees outside of a combat zone are treated in the same manner as members and employees who are killed or wounded in combat zones.

THOMAS, 112th Congress

Rep. Rooney, Thomas J. [R-FL-16

2011-03-10

House - 03/18/2011 Referred to the Subcommittee on Federal Workforce, U.S. Postal Service, and Labor Policy. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

A Decade of War: Prospective Trajectories of Posttraumatic Stress Disorder Symptoms Among Deployed US Military Personnel and the Influence of Combat Exposure (Publisher’s Version)

DTIC Science & Technology

2017-09-27

physical health (5) of service mem- bers. In addition, previous research indicates that exposure to combat may increase the likelihood of negative health ... physical , and behavioral health , studies have shown few negative effects of deployment with respect to posttraumatic stress disorder (PTSD) (10...American Journal of Epidemiology Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2017. This

Report to Congress on the Review of Laws, Policies and Regulations Restricting the Service of Female Members in the U.S. Armed Forces

DTIC Science & Technology

2012-02-01

of vessels on which enlisted women can serve are more limited than those of their male counterparts. Women in occupations such as yeoman, culinary ...Marine Corps training in skills necessary for managing combat trauma casualties and operating with Marine forces in a combat environment. After this...commanders in dealing [with] the management of military forces and the requirements of military discipline.” Id. at 69. In Rostker, the Court

Combat Leadership: 56th Fighter Group 1943-1944.

DTIC Science & Technology

1986-04-01

September-October 1970, pp. 30-35. Meyer, John C ., Col, USAF. "What Makes a Jet Ace?" Air Trails, October 1952, p. 21. Ritchey, Russell V. "Identifying...A-Ri68 864 COMBAT LEADERSHIP: 56TH FIGHTER GROUP i947-1944(U) AIR 1/1 COMMAND AND STAFF COLL MAXWELL RFB RL T L LENTZ APR 86I ACSC-86-1525...Interlibrary Loan Service (AUL/LDEX, Maxwell AFB, Alabama, 36112) or the Defense Technical Information Center. Request 4 must include the author’s name and

Task Force 62 Medical Brigade combat healthcare support system in the mature Iraq theater of operations.

PubMed

Sargent, Patrick D

2008-01-01

Leading a deployed combat healthcare system is a very complex task and requires a command and control structure that is a unique blend of technical and tactical expertise to efficaciously deliver world-class medical care to America's sons and daughters. The medical task force in Iraq has successfully managed the transformation of the medical footprint from a tactically arrayed set of disparate medical units to a nascent integrated healthcare system with many features similar to the best healthcare systems in the United States. The American public demands, and Soldiers, Marines, Sailors, Airmen, and Coast Guardsmen deserve US quality medical care, whether they are being treated at a military medical center in the US, or a US medical facility in Iraq. This article presents an overview of the 62nd Medical Brigade's development of the combat healthcare support system during its tenure leading the US medical task force in Iraq.

Potential for Pharmacy-Public Health Collaborations Using Pharmacy-Based Point-of-Care Testing Services for Infectious Diseases.

PubMed

Gubbins, Paul O; Klepser, Michael E; Adams, Alex J; Jacobs, David M; Percival, Kelly M; Tallman, Gregory B

Health care professionals must continually identify collaborative ways to combat antibiotic resistance while improving community health and health care delivery. Clinical Laboratory Improvement Amendments of 1988 (CLIA)-waived point-of-care (POC) testing (POCT) services for infectious disease conducted in community pharmacies provide a means for pharmacists to collaborate with prescribers and/or public health officials combating antibiotic resistance while improving community health and health care delivery. To provide a comprehensive literature review that explores the potential for pharmacists to collaborate with public health professionals and prescribers using pharmacy-based CLIA-waived POCT services for infectious diseases. Comprehensive literature review. PubMed and Google Scholar were searched for manuscripts and meeting abstracts for the following key words: infectious disease, community pharmacy, rapid diagnostic tests, rapid assay, and POC tests. All relevant manuscripts and meeting abstracts utilizing POCT in community pharmacies for infectious disease were reviewed. Information regarding the most contemporary evidence regarding CLIA-waived POC infectious diseases tests for infectious diseases and their use in community pharmacies was synthesized to highlight and identify opportunities to develop future collaborations using community pharmacy-based models for such services. Evidence demonstrates that pharmacists in collaboration with other health care professionals can leverage their knowledge and accessibility to provide CLIA-waived POCT services for infectious diseases. Testing for influenza may augment health departments' surveillance efforts, help promote rationale antiviral use, and avoid unnecessary antimicrobial therapy. Services for human immunodeficiency virus infection raise infection status awareness, increase access to health care, and facilitate linkage to appropriate care. Testing for group A streptococcal pharyngitis may curb inappropriate outpatient antibiotic prescribing. However, variance in pharmacy practice statues and the application of CLIA across states stifle collaboration. CLIA-waived POCT services for infectious diseases are a means for pharmacists, public health professionals, and prescribers to collaboratively combat antibiotic resistance and improve community health.

War-related extremity injuries in children: 89 cases managed in a combat support hospital in Afghanistan.

PubMed

Bertani, A; Mathieu, L; Dahan, J-L; Launay, F; Rongiéras, F; Rigal, S

2015-05-01

Meeting paediatric needs is among the priorities of western healthcare providers working in Afghanistan. Insufficient information is available on paediatric wartime injuries to the extremities. Our objective here was to describe these injuries and their management on the field. We retrospectively reviewed consecutive cases of injuries to the extremities in children (< 16 years of age) due to weapons and managed at the Kabul International Airport (KaIA) Combat Support Hospital between June 2009 and April 2013. We identified 89 patients with a mean age of 10.2 ± 3.5 years and a total of 137 elemental lesions. Explosive devices accounted for most injuries (78.6%) and carried a significantly higher risk of multiple lesions. There were 54 bone lesions (traumatic amputations and fractures) and 83 soft-tissue lesions. The amputation rate was 18%. Presence of bone lesions was associated with a higher risk of injury to blood vessels and nerves. Of the 89 patients, four (4.5%) died and eight (9%) were transferred elsewhere. Of the 77 remaining patients, at last follow-up (median, one month; range, 0.1-16 months), 73 (95%) had achieved a full recovery (healed wound and/or fracture) or were recovering with no expectation that further surgery would be needed. Despite the absence of paediatric surgeons, the combat support hospital provided appropriate care at the limb salvage and reconstruction phases. The highly specialised treatments needed to manage sequelae were very rarely provided. These treatments probably deserve to be developed in combat support hospitals. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Effects of social support and battle intensity on loneliness and breakdown during combat.

PubMed

Solomon, Z; Mikulincer, M; Hobfoll, S E

1986-12-01

A sample of 382 Israeli soldiers who developed combat stress reactions (CSR) during the 1982 Israel-Lebanon War were compared with groups of carefully matched controls who did not develop CSR. Lack of social support from officers was found to be related to greater feelings of loneliness and greater likelihood of CSR in soldiers. Lack of social support from buddies was found to be related to greater loneliness. Intensity of battle was also found to be related to greater feelings of loneliness and increased likelihood of CSR. A path model was tested and supported. The model suggests that battle intensity and officer support lead to CSR directly and indirectly by causing increased feelings of loneliness. Possible cognitive and psychodynamic explanations for the findings are offered. The limitations of making causal statements from retrospective perceptions is discussed.

Association of bacterial colonization at the time of presentation to a combat support hospital in a combat zone with subsequent 30-day colonization or infection.

PubMed

Kaspar, Robert L; Griffith, Matthew E; Mann, Paul B; Lehman, Devon J; Conger, Nicholas G; Hospenthal, Duane R; Murray, Clinton K

2009-09-01

U.S. casualties have developed multidrug-resistant (MDR) bacterial infections. A surveillance project to evaluate U.S. military patients for the presence of MDR pathogens from wounding through the first 30 days of care in the military healthcare system (MHS) was performed. U.S. military patients admitted to a single combat support hospital in Iraq during June-July of 2007 had screening swabs obtained for the detection of MDR bacteria and a subsequent retrospective electronic medical records review for presence of colonization or infection in the subsequent 30 days. Screening of 74 U.S. military patients in Iraq found one colonized with methicillin-resistant Staphylococcus aureus. Fifty-six patients of these were screened for Acinetobacter in Germany and one found colonized. Of patients evacuated to the U.S., 9 developed infections. Carefully obtained screening cultures immediately after injury combined with look-back monitoring supports the role of nosocomial transmission. Consistent infection control strategies are needed for the entire MHS.

Perspectives of family and veterans on family programs to support reintegration of returning veterans with posttraumatic stress disorder.

PubMed

Fischer, Ellen P; Sherman, Michelle D; McSweeney, Jean C; Pyne, Jeffrey M; Owen, Richard R; Dixon, Lisa B

2015-08-01

Combat deployment and reintegration are challenging for service members and their families. Although family involvement in mental health care is increasing in the U.S. Department of Veterans Affairs (VA) system, little is known about family members' preferences for services. This study elicited the perspectives of returning Afghanistan and Iraq war veterans with posttraumatic stress disorder and their families regarding family involvement in veterans' mental health care. Semistructured qualitative interviews were conducted with 47 veterans receiving care for posttraumatic stress disorder at the Central Arkansas Veterans Healthcare System or Oklahoma City VA Medical Center and 36 veteran-designated family members. Interviews addressed perceived needs related to veterans' readjustment to civilian life, interest in family involvement in joint veteran/family programs, and desired family program content. Interview data were analyzed using content analysis and constant comparison. Both groups strongly supported inclusion of family members in programs to facilitate veterans' postdeployment readjustment and reintegration into civilian life. Both desired program content focused on information, practical skills, support, and gaining perspective on the other's experience. Although family and veteran perspectives were similar, family members placed greater emphasis on parenting-related issues and the kinds of support they and their children needed during and after deployment. To our knowledge, this is the first published report on preferences regarding VA postdeployment reintegration support that incorporates the perspectives of returning male and female veterans and those of their families. Findings will help VA and community providers working with returning veterans tailor services to the needs and preferences of this important-to-engage population. (c) 2015 APA, all rights reserved).

The Concept of C2 Communication and Information Support

DTIC Science & Technology

2004-06-01

communication and information literacy , • Sensors: technology and systematic development as a branch, • Military prognosis research (combat models...intelligence, • Visualization of actions, suitable forms of information presentation, • Techniques of learning CIS users communication and information ... literacy , • Sensors: technology and systematic development as a branch, • Military prognosis research (combat models), • Man - machine interface. CISu

Instilling Combat Effectiveness during the Italian Campaign (1943-1945): The Allied Experience with Folgore and Friuli Combat Groups

DTIC Science & Technology

2014-06-13

the Chief of the Italian Army, General Mario Roatta, directed the army staff to reorganize some units to take control of Southern Italy in support of...colonies. This concept, codenamed Super - Gymnast and later renamed Torch, worried the Americans due to its demands upon the 20Joint Chiefs of Staff...

Littoral Combat Ship (LCS) Civilian Aviation Alternative Support Study: Report of Findings and Recommendations

DTIC Science & Technology

2006-07-30

instructions for: amphibious class (LHA, LHD, LSD , LPD, LST), combatant class (CG 16, CG 47, DD 963, DDG 51, FFG 7, PHM 1, PG 1), command class (LCC 19...20376-7003Kevin Boissonneault – Kevin.Boissonneault@Navy.Mil NAVAIR 4.10.1.2 48110 Shaw Road Bldg 2187, Suite 1180 49. Patuxent River, MD 20670

Littoral Combat Ship (LCS)

DTIC Science & Technology

2015-12-01

Selected Acquisition Report ( SAR ) RCS: DD-A&T(Q&A)823-374 Littoral Combat Ship (LCS) As of FY 2017 President’s Budget Defense Acquisition...Management Information Retrieval (DAMIR) UNCLASSIFIED LCS December 2015 SAR UNCLASSIFIED 2 Table of Contents Common Acronyms and Abbreviations for...and Support PAUC - Program Acquisition Unit Cost LCS December 2015 SAR UNCLASSIFIED 3 PB - President’s Budget PE - Program Element PEO - Program

Urban Combat Advanced Training Technology (Technologie Avancee d’Entrainement au Combat Urbain)

DTIC Science & Technology

2010-04-01

JRTC Joint Readiness Training Center JRTC-MOUT-IS Joint Readiness Training Center Military Operations in Urbanised Terrain Instrumentation System...did not support or identify joint or multi-national requirements for conducting effective military operations in an urbanised environment. Very few...Requirements Document (ORD) for the Joint Readiness Training Center (JRTC) Military Operations on Urbanised Terrain (MOUT) Instrumentation System

Visual Effects in the High Performance Aircraft Cockpit

DTIC Science & Technology

1988-04-01

The RPE acts in a supportive metabolic role to the photoreceptors and if damaged or artificially aged this...unlimited. 2. Lenses cannot mist and provide minor protection against 4. Provide greater protection against splatter from the firing of MDC and impact...almost opposite requirements: the air combat role and the ground attack role . For the air combat role , the aircraft is used against

Assured communications and combat resiliency: the relationship between effective national communications and combat efficiency

NASA Astrophysics Data System (ADS)

Allgood, Glenn O.; Kuruganti, Phani Teja; Nutaro, James; Saffold, Jay

2009-05-01

Combat resiliency is the ability of a commander to prosecute, control, and consolidate his/her's sphere of influence in adverse and changing conditions. To support this, an infrastructure must exist that allows the commander to view the world in varying degrees of granularity with sufficient levels of detail to permit confidence estimates to be levied against decisions and course of actions. An infrastructure such as this will include the ability to effectively communicate context and relevance within and across the battle space. To achieve this will require careful thought, planning, and understanding of a network and its capacity limitations in post-event command and control. Relevance and impact on any existing infrastructure must be fully understood prior to deployment to exploit the system's full capacity and capabilities. In this view, the combat communication network is considered an integral part of or National communication network and infrastructure. This paper will describe an analytical tool set developed at ORNL and RNI incorporating complexity theory, advanced communications modeling, simulation, and visualization technologies that could be used as a pre-planning tool or post event reasoning application to support response and containment.

Physiological Implications, Performance Assessment and Risk Mitigation Strategies of Women in Combat-Centric Occupations.

PubMed

Greeves, Julie P

2015-11-01

Women have historically featured in military conflicts, but were not formally integrated into the military until the 20th century; occupations were mainly restricted to clerical or support roles. An increasing number of occupations have been opened to women and the higher physical demands of combat roles present new challenges. Inherent biological differences between sexes require women to work harder when undertaking the same tasks as men. This is reflected, in part, by the greater risk of musculoskeletal injuries of women observed notably during integrated military training. Gender "neutral" occupational standards, based on the physical requirements of the role, will ensure that women are suitably selected to cope with the demands of military tasks with a minimal risk of injury and to operational effectiveness. Initiatives such as reduced running mileage and single-sex training have contributed to a reduction in lower-limb musculoskeletal injuries, but the risk of injury remains higher in women. Nevertheless, women experience substantial gains in aerobic power and strength with appropriate and targeted training, narrowing the gap in physical performance between the sexes. Evidence-based occupational standards and optimal training programs provide short-term solutions for integrating women in support combat, and indeed direct combat roles.

Drug use and childhood-, military- and post-military trauma exposure among women and men veterans.

PubMed

Kelley, Michelle L; Brancu, Mira; Robbins, Allison T; D'Lima, Gabrielle M; Strauss, Jennifer L; Curry, John F; Fairbank, John A; Runnals, Jennifer

2015-07-01

The current study was undertaken to examine whether posttraumatic stress symptoms (PTSS) and depressive symptoms mediated the association between trauma exposure (combat-related trauma and non-combat traumas occurring before, during, and after military service), and drug abuse symptoms use among male and female veterans. Participants were 2304 (1851 male, 453 female) veterans who took part in a multi-site research study conducted through the Department of Veterans Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center (VISN 6 MIRECC). Path analytic models were used to determine the association between problematic past-year drug use and combat-related and non-combat trauma experienced before, during, or after the military and whether current post-traumatic stress symptoms or depressive symptoms mediated these associations. For both male and female veterans, depressive symptoms significantly mediated the effects of pre- and post-military trauma on drug abuse symptoms. Mental health providers who work with trauma-exposed Iraq and Afghanistan era veterans should assess for drug use, depressive symptoms, and life-span trauma (i.e., not only combat-related traumas) as part of a thorough trauma-based assessment for both men and women. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

48 CFR 225.7402-3 - Government support.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 3 2014-10-01 2014-10-01 false Government support. 225... States 225.7402-3 Government support. (a) Government support that may be authorized or required for... coordination with the combatant commander that— (1) Such Government support is available and is needed to...

48 CFR 225.7402-3 - Government support.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 3 2013-10-01 2013-10-01 false Government support. 225... States 225.7402-3 Government support. (a) Government support that may be authorized or required for... coordination with the combatant commander that— (1) Such Government support is available and is needed to...

48 CFR 225.7402-3 - Government support.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 3 2011-10-01 2011-10-01 false Government support. 225... States 225.7402-3 Government support. (a) Government support that may be authorized or required for... coordination with the combatant commander that— (1) Such Government support is available and is needed to...

48 CFR 225.7402-3 - Government support.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Government support. 225... States 225.7402-3 Government support. (a) Government support that may be authorized or required for... coordination with the combatant commander that— (1) Such Government support is available and is needed to...

48 CFR 225.7402-3 - Government support.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 3 2012-10-01 2012-10-01 false Government support. 225... States 225.7402-3 Government support. (a) Government support that may be authorized or required for... coordination with the combatant commander that— (1) Such Government support is available and is needed to...

Cost-effectiveness of dryland forest restoration evaluated by spatial analysis of ecosystem services

PubMed Central

Birch, Jennifer C.; Newton, Adrian C.; Aquino, Claudia Alvarez; Cantarello, Elena; Echeverría, Cristian; Kitzberger, Thomas; Schiappacasse, Ignacio; Garavito, Natalia Tejedor

2010-01-01

Although ecological restoration is widely used to combat environmental degradation, very few studies have evaluated the cost-effectiveness of this approach. We examine the potential impact of forest restoration on the value of multiple ecosystem services across four dryland areas in Latin America, by estimating the net value of ecosystem service benefits under different reforestation scenarios. The values of selected ecosystem services were mapped under each scenario, supported by the use of a spatially explicit model of forest dynamics. We explored the economic potential of a change in land use from livestock grazing to restored native forest using different discount rates and performed a cost–benefit analysis of three restoration scenarios. Results show that passive restoration is cost-effective for all study areas on the basis of the services analyzed, whereas the benefits from active restoration are generally outweighed by the relatively high costs involved. These findings were found to be relatively insensitive to discount rate but were sensitive to the market value of carbon. Substantial variation in values was recorded between study areas, demonstrating that ecosystem service values are strongly context specific. However, spatial analysis enabled localized areas of net benefits to be identified, indicating the value of this approach for identifying the relative costs and benefits of restoration interventions across a landscape. PMID:21106761

Cost-effectiveness of dryland forest restoration evaluated by spatial analysis of ecosystem services.

PubMed

Birch, Jennifer C; Newton, Adrian C; Aquino, Claudia Alvarez; Cantarello, Elena; Echeverría, Cristian; Kitzberger, Thomas; Schiappacasse, Ignacio; Garavito, Natalia Tejedor

2010-12-14

Although ecological restoration is widely used to combat environmental degradation, very few studies have evaluated the cost-effectiveness of this approach. We examine the potential impact of forest restoration on the value of multiple ecosystem services across four dryland areas in Latin America, by estimating the net value of ecosystem service benefits under different reforestation scenarios. The values of selected ecosystem services were mapped under each scenario, supported by the use of a spatially explicit model of forest dynamics. We explored the economic potential of a change in land use from livestock grazing to restored native forest using different discount rates and performed a cost-benefit analysis of three restoration scenarios. Results show that passive restoration is cost-effective for all study areas on the basis of the services analyzed, whereas the benefits from active restoration are generally outweighed by the relatively high costs involved. These findings were found to be relatively insensitive to discount rate but were sensitive to the market value of carbon. Substantial variation in values was recorded between study areas, demonstrating that ecosystem service values are strongly context specific. However, spatial analysis enabled localized areas of net benefits to be identified, indicating the value of this approach for identifying the relative costs and benefits of restoration interventions across a landscape.

The Center for Rehabilitation Sciences Research: Advancing the Rehabilitative Care for Service Members With Complex Trauma.

PubMed

Isaacson, Brad M; Hendershot, Brad D; Messinger, Seth D; Wilken, Jason M; Rábago, Christopher A; Esposito, Elizabeth Russell; Wolf, Erik; Pruziner, Alison L; Dearth, Christopher L; Wyatt, Marilynn; Cohen, Steven P; Tsao, Jack W; Pasquina, Paul F

2016-11-01

The Center for Rehabilitation Sciences Research (CRSR) was established to advance the rehabilitative care for service members with combat-related injuries, particularly those with orthopedic, cognitive, and neurological complications. The center supports comprehensive research projects to optimize treatment strategies and promote the successful return to duty and community reintegration of injured service members. The center also provides a unique platform for fostering innovative research and incorporating clinical/technical advances in the rehabilitative care for service members. CRSR is composed of four research focus areas: (1) identifying barriers to successful rehabilitation and reintegration, (2) improving pain management strategies to promote full participation in rehabilitation programs, (3) applying novel technologies to advance rehabilitation methods and enhance outcome assessments, and (4) transferring new technology to improve functional capacity, independence, and quality of life. Each of these research focus areas works synergistically to influence the quality of life for injured service members. The purpose of this overview is to highlight the clinical research efforts of CRSR, namely how this organization engages a broad group of interdisciplinary investigators from medicine, biology, engineering, anthropology, and physiology to help solve clinically relevant problems for our service members, veterans, and their families. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Joint Task Force Headquarters Master Training Guide

DTIC Science & Technology

2003-09-01

roles, and relationships that differ from those of Service organizations. (6) Understand the rotation policy for individual augmentees assigned to the...JTF. Although the Combatant Commander ultimately establishes individual and unit rotation policies, they will not necessarily be uniform. One...Service might have a 90-day rotation policy while the other Services have 120-day or 179-day rotation policies. To stabilize key billets, consider

Shortening and Angulation for Soft-Tissue Reconstruction of Extremity Wounds in a Combat Support Hospital

DTIC Science & Technology

2009-08-01

l\\I ILIT\\R\\’ ’\\ I EDICt E. 174. K:83X. 2009 Shortening and Angulation for Soft-Tissue Reconstruction of Extremity Wounds in a Combat Support...team in theater. Thereafter. they can be rapidly evacuated to treatment facilities in their respective countries for definitive reconstruct ion of...cripl "’"’ rccCI\\ ec.J ft•r re’ 1ew 1n ovcmb.:r 2008. The revbe<.l manu,cnpl "a’ accepted tor publicauon 1n May 2()()9. 838 vide a reconstructive

Decentralizing provision of mental health care in Sri Lanka.

PubMed

Fernando, Neil; Suveendran, Thirupathy; de Silva, Chithramalee

2017-04-01

In the past, mental health services in Sri Lanka were limited to tertiary-care institutions, resulting in a large treatment gap. Starting in 2000, significant efforts have been made to reconfigure service provision and to integrate mental health services with primary health care. This approach was supported by significant political commitment to establishing island-wide decentralized mental health care in the wake of the 2004 tsunami. Various initiatives were consolidated in The mental health policy of Sri Lanka 2005-2015, which called for implementation of a comprehensive community-based, decentralized service structure. The main objectives of the policy were to provide mental health services of good quality at primary, secondary and tertiary levels; to ensure the active involvement of communities, families and service users; to make mental health services culturally appropriate and evidence based; and to protect the human rights and dignity of all people with mental health disorders. Significant improvements have been made and new cadres of mental health workers have been introduced. Trained medical officers (mental health) now provide outpatient care, domiciliary care, mental health promotion in schools, and community mental health education. Community psychiatric nurses have also been trained and deployed to supervise treatment adherence in the home and provide mental health education to patients, their family members and the wider community. A total of 4367 mental health volunteers are supporting care and raising mental health literacy in the community. Despite these important achievements, more improvements are needed to provide more timely intervention, combat myths and stigma, and further decentralize care provision. These, and other challenges, will be targeted in the new mental health policy for 2017-2026.

Help, Resources and Information: National Opioids Crisis

MedlinePlus

... HHS 5-POINT STRATEGY TO COMBAT THE OPIOIDS CRISIS BETTER ADDICTION PREVENTION, TREATMENT, AND RECOVERY SERVICES BETTER DATA BETTER PAIN MANAGEMENT BETTER TARGETING OF OVERDOSE REVERSING DRUGS BETTER RESEARCH ...

Alcohol Use after Combat-Acquired Traumatic Brain Injury: What We Know and Don’t Know

PubMed Central

ADAMS, RACHEL SAYKO; CORRIGAN, JOHN D.; LARSON, MARY JO

2012-01-01

Military personnel engage in unhealthy alcohol use at rates higher than their same age, civilian peers, resulting in negative consequences for the individual and jeopardized force readiness for the armed services. Among those returning from combat deployment, unhealthy drinking may be exacerbated by acute stress reactions and injury, including traumatic brain injury (TBI). Combat-acquired TBI is common among personnel in the current conflicts. Although research suggests that impairments due to TBI leads to an increased risk for unhealthy drinking and consequences among civilians, there has been little research to examine whether TBI influences drinking behaviors among military personnel. This article examines TBI and drinking in both civilian and military populations and discusses implications for clinical care and policy. PMID:22485074

A Brief Exposure-Based Intervention for Service Members with PTSD

ERIC Educational Resources Information Center

Steenkamp, Maria M.; Litz, Brett T.; Gray, Matt J.; Lebowitz, Leslie; Nash, William; Conoscenti, Lauren; Amidon, Amy; Lang, Ariel

2011-01-01

The growing number of service members in need of mental health care requires that empirically based interventions be tailored to the unique demands and exigencies of this population. We discuss a 6-session intervention for combat-related PTSD designed to foster willingness to engage with and disclose difficult deployment memories through a…

32 CFR 1630.11 - Class 1-A-0: Conscientious objector available for noncombatant military service only.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 6 2012-07-01 2012-07-01 false Class 1-A-0: Conscientious objector available for noncombatant military service only. 1630.11 Section 1630.11 National Defense Other Regulations..., or moral belief, to be conscientiously opposed to participation in combatant military tranining and...

32 CFR 1630.11 - Class 1-A-0: Conscientious objector available for noncombatant military service only.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 6 2011-07-01 2011-07-01 false Class 1-A-0: Conscientious objector available for noncombatant military service only. 1630.11 Section 1630.11 National Defense Other Regulations..., or moral belief, to be conscientiously opposed to participation in combatant military tranining and...

32 CFR 1630.11 - Class 1-A-0: Conscientious objector available for noncombatant military service only.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 6 2014-07-01 2014-07-01 false Class 1-A-0: Conscientious objector available for noncombatant military service only. 1630.11 Section 1630.11 National Defense Other Regulations..., or moral belief, to be conscientiously opposed to participation in combatant military tranining and...

32 CFR 1630.11 - Class 1-A-0: Conscientious objector available for noncombatant military service only.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 6 2010-07-01 2010-07-01 false Class 1-A-0: Conscientious objector available for noncombatant military service only. 1630.11 Section 1630.11 National Defense Other Regulations..., or moral belief, to be conscientiously opposed to participation in combatant military tranining and...

32 CFR 1630.11 - Class 1-A-0: Conscientious objector available for noncombatant military service only.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 6 2013-07-01 2013-07-01 false Class 1-A-0: Conscientious objector available for noncombatant military service only. 1630.11 Section 1630.11 National Defense Other Regulations..., or moral belief, to be conscientiously opposed to participation in combatant military tranining and...

A Survey of Library Services to Children and Young Adults in Selected Developing Countries in Africa and Asia.

ERIC Educational Resources Information Center

Craver, Kathleen W.

1985-01-01

Review of developments in children and young adult library services since 1979 discusses three factors that complicate methods used to combat illiteracy problem: population growth, language, and undeveloped readership. Countries studied are Libya, Kenya, Tanzania, Angola, Zambia, Zimbabwe, Ghana, Nigeria, Gambia, Thailand, Singapore, Philippines,…

Prevention and management of infections associated with combat-related extremity injuries.

PubMed

Murray, Clinton K; Hsu, Joseph R; Solomkin, Joseph S; Keeling, John J; Andersen, Romney C; Ficke, James R; Calhoun, Jason H

2008-03-01

Orthopedic injuries suffered by casualties during combat constitute approximately 65% of the total percentage of injuries and are evenly distributed between upper and lower extremities. The high-energy explosive injuries, environmental contamination, varying evacuation procedures, and progressive levels of medical care make managing combat-related injuries challenging. The goals of orthopedic injury management are to prevent infection, promote fracture healing, and restore function. It appears that 2% to 15% of combat-related extremity injuries develop osteomyelitis, although lower extremity injuries are at higher risk of infections than upper extremity. Management strategies of combat-related injuries primarily focus on early surgical debridement and stabilization, antibiotic administration, and delayed primary closure. Herein, we provide evidence-based recommendations from military and civilian data to the management of combat-related injuries of the extremity. Areas of emphasis include the utility of bacterial cultures, antimicrobial therapy, irrigation fluids and techniques, timing of surgical care, fixation, antibiotic impregnated beads, wound closure, and wound coverage with negative pressure wound therapy. Most of the recommendations are not supported by randomized controlled trials or adequate cohorts studies in a military population and further efforts are needed to answer best treatment strategies.

Quantitative electroencephalography during rapid eye movement (REM) and non-REM sleep in combat-exposed veterans with and without post-traumatic stress disorder.

PubMed

Cohen, Daniel J; Begley, Amy; Alman, Jennie J; Cashmere, David J; Pietrone, Regina N; Seres, Robert J; Germain, Anne

2013-02-01

Sleep disturbances are a hallmark feature of post-traumatic stress disorder (PTSD), and associated with poor clinical outcomes. Few studies have examined sleep quantitative electroencephalography (qEEG), a technique able to detect subtle differences that polysomnography does not capture. We hypothesized that greater high-frequency qEEG would reflect 'hyperarousal' in combat veterans with PTSD (n = 16) compared to veterans without PTSD (n = 13). EEG power in traditional EEG frequency bands was computed for artifact-free sleep epochs across an entire night. Correlations were performed between qEEG and ratings of PTSD symptoms and combat exposure. The groups did not differ significantly in whole-night qEEG measures for either rapid eye movement (REM) or non-REM (NREM) sleep. Non-significant medium effect sizes suggest less REM beta (opposite to our hypothesis), less REM and NREM sigma and more NREM gamma in combat veterans with PTSD. Positive correlations were found between combat exposure and NREM beta (PTSD group only), and REM and NREM sigma (non-PTSD group only). Results did not support global hyperarousal in PTSD as indexed by increased beta qEEG activity. The correlation of sigma activity with combat exposure in those without PTSD and the non-significant trend towards less sigma activity during both REM and NREM sleep in combat veterans with PTSD suggests that differential information processing during sleep may characterize combat-exposed military veterans with and without PTSD. © 2012 European Sleep Research Society.

Weight Loss Strategies in Combat Sports and Concerning Habits in Mixed Martial Arts.

PubMed

Barley, Oliver R; Chapman, Dale W; Abbiss, Chris R

2017-12-28

Combat sports are typically divided into weight classes and body mass manipulation to reach a weight class is commonplace. Previous research suggests that mixed martial arts (MMA) weight loss practices may be more extreme than other combat sports. We sought to investigate the magnitude of weight lost and prevalence of weight loss strategies in different combat sports. Competitors (n=637) from Brazilian jiu jitsu (BJJ), boxing, judo, MMA, muay Thai/kickboxing (MT/K), taekwondo (TKD) and wrestling completed an online questionnaire seeking information regarding their weight loss practices. Body mass manipulation was commonly undertaken by all combat sports athletes, with a particularly high incidence of gradual dieting, increased exercise and fluid restriction. Skipping meals was higher in TKD and wrestling (84%) compared with the other combat sports (~58%), whilst training in heated rooms and forced oral fluid loss (spitting) was higher in wrestling (83% and 47%, respectively) compared with other combat sports (~45% and ~19%, respectively). MMA athletes reported the highest usage of sauna (76%) and water loading (67%) whilst also reporting the second highest use of training in rubber/plastic suits (63%). Body mass manipulation was present in all combat sports with the prevalence and magnitude of acute weight loss greater in MMA. The incidence of and practices reported will assist support staff to be fully aware of the variety of methods these athletes and coaches may use to achieve weight loss. Additionally, the results could aid regulatory bodies in the further development of policies on weight cutting.

Developing a Capacity Assessment Framework for Marine Logistics Groups

DTIC Science & Technology

2017-02-20

test the framework for assessing logistics capacity on a Marine Expeditionary Unit (MEU) Combat Logistics Battalion (CLB). The study proceeded along...and (5) test the framework for assessing logistics capacity on a Marine Expeditionary Unit (MEU) Combat Logistics Battalion (CLB), time permitting...Marine Logistics Group 21 Impact of New Organization on Logistics Support Under the FSSG structure prior to 2006, the Marine Corps employed a

Combating isolation: Building mutual mentoring networks

NASA Astrophysics Data System (ADS)

Cox, Anne J.

2015-12-01

Women physicists can often feel isolated at work. Support from a grant through the ADVANCE program of the National Science Foundation (U.S. government funding) created mutual mentoring networks aimed at combating isolation specifically for women faculty at undergraduate-only institutions. This paper will discuss the organization of one such network, what contributed to its success, some of the outcomes, and how it might be implemented in other contexts.

Deployed Analyst History Report, Volume 2. Analytic Support to Combat Operations in the Philippines (2011-2014)

DTIC Science & Technology

2015-12-01

Army Training and Doctrine Command (TRADOC) Analysis Center (TRAC) to the Philippines for Operation ENDURING FREEDOM – Philippines (OEF-P). PROJECT...management, doctrine and force development, training management, system testing, system acquisition, decision analysis, and resource management, as...influenced procurement decisions and reshaped Army doctrine . Additionally, CAA itself has benefited in numerous ways. Combat experience provides analysts

Taking Guns to a Knife Fight: Effective Military Support to COIN

DTIC Science & Technology

2008-03-31

generating superior “relative combat power” at decisive times and places in order to destroy, disrupt and dislocate the enemies they confront. Under...employ forces capable of striking targets of opportunity decisively with minimal collateral damage. When government counterinsurgency efforts are...The COIN force must seize such opportunities decisively . However, applying firepower with the precision needed to avoid non-combatant casualties is

32 CFR 158.3 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... routinely are put in place to provide support to many newly fielded weapons systems, including aircraft, land combat vehicles, and automated command and control systems. Systems support contracting authority... generally has less control over systems support contracts than other types of contracts. Theater business...

32 CFR 158.3 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... routinely are put in place to provide support to many newly fielded weapons systems, including aircraft, land combat vehicles, and automated command and control systems. Systems support contracting authority... generally has less control over systems support contracts than other types of contracts. Theater business...

32 CFR 158.3 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... routinely are put in place to provide support to many newly fielded weapons systems, including aircraft, land combat vehicles, and automated command and control systems. Systems support contracting authority... generally has less control over systems support contracts than other types of contracts. Theater business...

32 CFR 231.1 - Overview.

Code of Federal Regulations, 2010 CFR

2010-07-01

... guidance and procedures governing the establishment, support, operation, and termination of banks and... installations provide, and are provided, support consistent with the guidance and procedures stated herein. 1... Staff (JCS), the Joint Staff and the supporting Joint Agencies, the Combatant Commands, the Inspector...

Access to the US Department of Veterans Affairs health system: self-reported barriers to care among returnees of Operations Enduring Freedom and Iraqi Freedom

PubMed Central

2013-01-01

Background The U.S. Department of Veterans Affairs (VA) implemented the Polytrauma System of Care to meet the health care needs of military and veterans with multiple injuries returning from combat operations in Afghanistan and Iraq. Studies are needed to systematically assess barriers to use of comprehensive and exclusive VA healthcare services from the perspective of veterans with polytrauma and with other complex health outcomes following their service in Afghanistan and Iraq. These perspectives can inform policy with regard to the optimal delivery of care to returning veterans. Methods We studied combat veterans (n = 359) from two polytrauma rehabilitation centers using structured clinical interviews and qualitative open-ended questions, augmented with data collected from electronic health records. Our outcomes included several measures of exclusive utilization of VA care with our primary exposure as reported access barriers to care. Results Nearly two thirds of the veterans reported one or more barriers to their exclusive use of VA healthcare services. These barriers predicted differences in exclusive use of VA healthcare services. Experiencing any barriers doubled the returnees’ odds of not using VA exclusively, the geographic distance to VA barrier resulted in a 7 fold increase in the returnees odds of not using VA, and reporting a wait time barrier doubled the returnee’s odds of not using VA. There were no striking differences in access barriers for veterans with polytrauma compared to other returning veterans, suggesting the barriers may be uniform barriers that predict differences in using the VA exclusively for health care. Conclusions This study provides an initial description of utilization of VA polytrauma rehabilitation and other medical care for veteran returnees from all military services who were involved in combat operations in Afghanistan or Iraq. Our findings indicate that these veterans reported important stigmatization and barriers to receiving services exclusively from the VA, including mutable health delivery system factors. PMID:24289747

Assured Mission Support Space Architecture (AMSSA) study

NASA Technical Reports Server (NTRS)

Hamon, Rob

1993-01-01

The assured mission support space architecture (AMSSA) study was conducted with the overall goal of developing a long-term requirements-driven integrated space architecture to provide responsive and sustained space support to the combatant commands. Although derivation of an architecture was the focus of the study, there are three significant products from the effort. The first is a philosophy that defines the necessary attributes for the development and operation of space systems to ensure an integrated, interoperable architecture that, by design, provides a high degree of combat utility. The second is the architecture itself; based on an interoperable system-of-systems strategy, it reflects a long-range goal for space that will evolve as user requirements adapt to a changing world environment. The third product is the framework of a process that, when fully developed, will provide essential information to key decision makers for space systems acquisition in order to achieve the AMSSA goal. It is a categorical imperative that military space planners develop space systems that will act as true force multipliers. AMSSA provides the philosophy, process, and architecture that, when integrated with the DOD requirements and acquisition procedures, can yield an assured mission support capability from space to the combatant commanders. An important feature of the AMSSA initiative is the participation by every organization that has a role or interest in space systems development and operation. With continued community involvement, the concept of the AMSSA will become a reality. In summary, AMSSA offers a better way to think about space (philosophy) that can lead to the effective utilization of limited resources (process) with an infrastructure designed to meet the future space needs (architecture) of our combat forces.

Use of analgesics in young adults as a predictor of health care utilization and pain prevalence: Israel defense forces experience.

PubMed

Dorfman, Karina; Komargodski, Olga; Magnezi, Racheli; Lifshitz, Stanislav; Tzur, Dorit; Yavnai, Nirit; Ifergane, Gal

2017-06-01

Pain evaluation in large community studies is difficult. Analgesics can be a useful tool in estimating pain-related conditions in which analgesic use is highly regulated. In this study, we evaluated analgesics consumption patterns of regular Israel Defense Force soldiers. We have performed a historical cohort study of 665,137 young adults during active duty in 2002 to 2012. Analgesics were prescribed to 518,242 (78%) soldiers, mostly for musculoskeletal pain (69.3%), abdominal pain (12.7%), and headache (12.1%). Acute (1-14 days), subacute (15-90), and chronic (>90 days) analgesic use episodes were experienced by 396,987 (59.7%), 74,591 (11.2%), and 46,664 (7%) of the population. In a multivariate model, predictors for chronic analgesics use were as follows: low intelligence, service in a combat supporting unit, previous pain diagnosis, male sex, Israeli nativity, low socioeconomic status, and high body mass index. Low intelligence had the highest odds ratio for chronic analgesic consumption (2.1) compared with other predictors. Chronic analgesic use was associated with a significant increase in health care utilization cost per year (911$ per soldier vs 199$ for nonusers), increased sick leave days per year (7.09 vs 0.67 for nonusers), and higher dropout rate from combat units (25% vs 9.2% for nonusers). Chronic use of analgesics is common among young adults, and it is an important predictor for unsuccessful military service and high health care utilization costs. Further studies in other setups are indicated.

[Combined burn trauma in the array of modern civilian and combat burns].

PubMed

Ivchenko, E V; Borisov, D N; Golota, A S; Krassiĭ, A B; Rusev, I T

2015-02-01

The current article positions the combined burn and non-burn injuries in the general array of civilian and combat burns. For that purpose the official state statistics and scientific medical publications, domestic as well as foreign, have been analyzed. It has been shown that in peace time the combined burn/trauma injuries are infrequent. But the same type of injury becomes routine especially among the civilian population in the conditions of the modern so called "hybrid war". And the medical service should be prepared for it.

Evaluation of the King-Devick Test to Assess Eye Movements and the Performance of Rapid Number Naming in Concussed and Non-Concussed Service Members

DTIC Science & Technology

2016-07-01

individuals who report a history of concussion on their baseline questionnaires vary from the pre-combatives baseline K-D Test assessment of individuals who...given the informed consent and HIPAA documents • Any volunteers that agrees to the consent process will be given a pre-combatives questionnaire and K-D...test before training begins • Volunteers who suffer a concussive event during training will be given a post-incident questionnaire (which includes

Religiosity as a Moderator of Self-Efficacy and Social Support in Predicting Traumatic Stress Among Combat Soldiers.

PubMed

Israel-Cohen, Yael; Kaplan, Oren; Noy, Smadar; Kashy-Rosenbaum, Gabriela

2016-08-01

Based on a sample of 54 Israeli soldiers (51 % non-religious, 49 % religious) surveyed upon their return from combat, this study investigates the moderating role of religiosity as a factor that may strengthen cognitive processing tied to the belief in oneself to persevere (i.e., self-efficacy) after trauma and/or as a factor tied to enhanced external social support that religious individuals in particular may benefit from by their involvement in a religious community. Findings revealed (1) social support was tied to greater resilience within the general sample; (2) religious soldiers were less susceptible to traumatic stress than non-religious soldiers; and (3) religiosity moderated the relationship between self-efficacy and traumatic stress but not the relationship between social support and traumatic stress. Implications of findings are discussed.

Experiences of hearing loss and views towards interventions to promote uptake of rehabilitation support among UK adults

PubMed Central

Rolfe, Crystal; Gardner, Benjamin

2016-01-01

Abstract Objective: Effective hearing loss rehabilitation support options are available. Yet, people often experience delays in receiving rehabilitation support. This study aimed to document support-seeking experiences among a sample of UK adults with hearing loss, and views towards potential strategies to increase rehabilitation support uptake. People with hearing loss were interviewed about their experiences of seeking support, and responses to hypothetical intervention strategies, including public awareness campaigns, a training programme for health professionals, and a national hearing screening programme. Design: Semi-structured qualitative interview design with thematic analysis. Study sample: Twenty-two people with hearing loss, aged 66–88. Results: Three themes, representing barriers to receiving rehabilitation support and potential areas for intervention, were identified: making the journey from realization to readiness, combatting social stigma, and accessing appropriate services. Barriers to receiving support mostly focused on appraisal of hearing loss symptoms. Interventions enabling symptom appraisal, such as routine screening, or demonstrating how to raise the topic effectively with a loved one, were welcomed. Conclusions: Interventions to facilitate realization of hearing loss should be prioritized. Raising awareness of the symptoms and prevalence of hearing loss may help people to identify hearing problems and reduce stigma, in turn increasing hearing loss acceptance. PMID:27379464

Annual Science and Engineering Technology Conference Presentations (8th)

DTIC Science & Technology

2007-04-19

Technology 11:30 am Wrap Up & Adjourn 12:00 pm BUFFET LUNCHEON Session III: Army Future Combat System (Brigade Combat Team) (FCS(BCT)) Program The Future...acquisitions by firms from other nations. Non UK/Canada transactions accounted for 58% of all CFIUS filings. 19 Outline • Industrial Policy • Emerging...requirements are accounted for Document and model the component Minimize inter-component dependencies Support rapid, affordable technology

Installation Restoration Program Decision Document. Site 15. Alpena Combat Readiness Training Center, Michigan Air National Guard, Alpena County Regional Airport, Alpena, Michigan.

DTIC Science & Technology

1996-05-01

This Decision Document (DD) supports the no further action alternative for Site 15 - Oiled Roads at the Alpena Combat Readiness Training Center (CRTC...in Alpena , Michigan. The purpose of the DD is to summarize the existing data for the site and describe the Air National Guard’s rational for selecting the no further action alternative.

Amphibian Engineers in the Southwest Pacific

DTIC Science & Technology

2017-03-08

groups supporting Marine ground combat on small island chains. Such actions dominate the central Pacific. The ideal depiction of combat is Marine...to: first capture Tulagi and Guadalcanal in the Solomon Islands, second capture the remainder of the Solomon Islands plus Lae and Salamaua, and...air, sea, and ground operations from New Guinea through the Solomons and into the Marianas. Seizing Rabaul was critical to the allied forces in the

USSR Report, Political and Sociological Affairs, No. 1297, Current Political Issues.

DTIC Science & Technology

1982-08-26

Sihanouk Visits Pyongyang 9 NAT IONAL Deputy MVD Minister on Combatting Alcoholism (B. Shumilin; PRAVDA, 17 Jul 82) ............................. 10...COMBATTING ALCOHOLISM Moscow PRAVDA in Russian 17 Jul 82 p 3 [Article by B. Shumilin, USSR deputy ’Minister of -internal affairs: "And Persuadeand...work, is occupied by the struggle against alcoholism . An overwhelming majority of the Soviet people does not tolerate drunkenness and supports measures

China’s Near Seas Combat Capabilities (China Maritime Study, Number 11)

DTIC Science & Technology

2014-02-01

Chinese writings stress preemptive attacks on key U.S. power-projection capabili- ties—including aircraft carriers—prior to or quickly following formal...attack craft consistently stress covert, long-range attacks taking advantage of stealth, surprise, and standoff ranges. A final factor that supports...craft tenders, but this is speculative.56 The 2010 Chinese defense white paper does stress , however, that sea-based china’s near seas combat

A Systems Engineering Approach in Providing Air Defense Support to Ground Combat Vehicle Maneuver Forces

DTIC Science & Technology

2015-03-01

Defense DODAF Department of Defense Architecture Framework DOE design of experiment EMMI energy , mass, material wealth, information FNF fire and... energy or blast power (depending on the type of projectile). Tank munitions have significant penetrative ability and can cause serious damage to...survivability of ground combat vehicles during ground force maneuver operations. The simulation results indicated that the presence of air defense

A Baseline Analysis of Combat Logistics Force Scheduling Efficiency

DTIC Science & Technology

2016-06-01

from the data were mostly inconclusive, however; as a result, this paper recommends expanding the research years for further data analysis to include...the warship in the Fifth Fleet area of responsibility. The trends from the data were mostly inconclusive, however; as a result, this paper recommends...Commander, Naval Surface Forces T-AKE dry cargo ammunition ship T-AO fleet replenishment oiler T-AOE fast combat support ship THRSG Theodore

Evolution of the U.S. Army aviation during Operation Enduring Freedom in Afghanistan

DTIC Science & Technology

2015-06-12

my chair, thank you for your continued support and dedicated persistent efforts to guide me through from the beginning till the end of this...ADAM Air Defense and Airspace Management AGI Air Ground Integration AI Air Interdiction AO Area of Operation AVCATT Aviation Combined Arms...Tactical Trainer AW Army Warrior BAE Brigade Aviation Element BAO Brigade Aviation Officer BCT Brigade Combat Team CAB Combat Aviation Brigade

Combating plagiarism: the role of the health librarian.

PubMed

Spring, Hannah; Adams, Rachel

2013-12-01

This feature looks at the issue of plagiarism in health care students and the role of the health librarian in combating the problem. In particular, consideration is given to how plagiarism can occur and provides some examples from two UK universities of approaches health librarians can take in supporting students to avoid these common pitfalls. © 2013 The authors. Health Information and Libraries Journal © 2013 Health Libraries Group.

Combating Violence against Children: Jordanian Pre-Service Early Childhood Teachers' Perceptions towards Child Abuse and Neglect

ERIC Educational Resources Information Center

Fayez, Merfat; Takash, Hanan Mahmoud; Al-Zboon, Eman Khleif

2014-01-01

Early childhood teachers play major roles in defying child abuse and neglect and alleviating its detrimental effects on young children. Therefore, this study aimed at exploring how Jordanian pre-service early childhood teachers define and perceive violence against children and their role in child abuse detection and prevention. Furthermore, the…

Posttraumatic Stress and Growth in Student Service Members and Veterans: The Role of Personal Growth Initiative

ERIC Educational Resources Information Center

Borowa, Dominika; Robitschek, Christine; Harmon, Kevin Andrew; Shigemoto, Yuki

2016-01-01

Objective: This study explored the extent to which personal growth initiative (PGI) may predict posttraumatic stress and growth in student service members/veterans (SSM/V). Participants: Participants were 136 SSM/V (79% men) representing multiple branches of the armed forces. Forty-four percent of participants reported having combat experience.…

Optimizing the Sustainment of U.S. Army Weapon Systems

DTIC Science & Technology

2016-03-17

Current Military Rank/Civilian Grade ................................................................................ 33 Figure 9: Education Level...across the military services from lows experienced in the wake of fiscal year 2013 sequestration when only 2 Army non-missioned brigade combat teams...committee notes that recovery from these ebbs in readiness has taken time, with most military services reporting a return to pre-sequester levels of

Combat veterans with comorbid PTSD and mild TBI exhibit a greater inhibitory processing ERP from the dorsal anterior cingulate cortex.

PubMed

Shu, I-Wei; Onton, Julie A; O'Connell, Ryan M; Simmons, Alan N; Matthews, Scott C

2014-10-30

Posttraumatic stress disorder (PTSD) is common among combat personnel with mild traumatic brain injury (mTBI). While patients with either PTSD or mTBI share abnormal activation of multiple frontal brain areas, anterior cingulate cortex (ACC) activity during inhibitory processing may be particularly affected by PTSD. To further test this hypothesis, we recorded electroencephalography from 32 combat veterans with mTBI-17 of whom were also comorbid for PTSD (mTBI+PTSD) and 15 without PTSD (mTBI-only). Subjects performed the Stop Task, a validated inhibitory control task requiring inhibition of initiated motor responses. We observed a larger inhibitory processing eventrelated potential (ERP) in veterans with mTBI+PTSD, including greater N200 negativity. Furthermore, greater N200 negativity correlated with greater PTSD severity. This correlation was most dependent on contributions from the dorsal ACC. Support vector machine analysis demonstrated that N200 and P300 amplitudes objectively classified veterans into mTBI-only or mTBI+PTSD groups with 79.4% accuracy. Our results support a model where, in combat veterans with mTBI, larger ERPs from cingulate areas are associated with greater PTSD severity and likely related to difficulty controlling ongoing brain processes, including trauma-related thoughts and feelings. Published by Elsevier Ireland Ltd.

Characterization of transit ride quality.

DOT National Transportation Integrated Search

2016-08-01

Strategies often proposed to combat the growing traffic congestion problems of urban environments target enhancements to increase the use of bus transit. Therefore, service providers are keen to identify and understand factors that could attract more...

Combating Military Sexual Assault Act of 2013

THOMAS, 113th Congress

Sen. Murray, Patty [D-WA

2013-05-07

Senate - 06/04/2013 Committee on Armed Services. Hearings held. Hearings printed: S.Hrg. 113-320. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Military sexual trauma, combat exposure, and negative urgency as independent predictors of PTSD and subsequent alcohol problems among OEF/OIF veterans.

PubMed

Hahn, Austin M; Tirabassi, Christine K; Simons, Raluca M; Simons, Jeffrey S

2015-11-01

This study tested a path model of relationships between military sexual trauma (MST), combat exposure, negative urgency, posttraumatic stress disorder (PTSD) symptoms, and alcohol use and related problems. The sample consisted of 86 Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans who reported drinking at least one alcoholic beverage per week. PTSD mediated the relationships between MST and alcohol-related problems, negative urgency and alcohol-related problems, and combat exposure and alcohol-related problems. In addition, negative urgency had a direct effect on alcohol problems. These results indicate that MST, combat exposure, and negative urgency independently predict PTSD symptoms and PTSD symptoms mediate their relationship with alcohol-related problems. Findings support previous literature on the effect of combat exposure and negative urgency on PTSD and subsequent alcohol-related problems. The current study also contributes to the limited research regarding the relationship between MST, PSTD, and alcohol use and related problems. Clinical interventions aimed at reducing emotional dysregulation and posttraumatic stress symptomology may subsequently improve alcohol-related outcomes. (c) 2015 APA, all rights reserved).

Military Sexual Trauma, Combat Exposure, and Negative Urgency as Independent Predictors of PTSD and Subsequent Alcohol Problems among OEF/OIF Veterans

PubMed Central

Tirabassi, Christine K.; Simons, Raluca M.; Simons, Jeffrey S.

2015-01-01

This study tested a path model of relationships between military sexual trauma (MST), combat exposure, negative urgency, posttraumatic stress disorder (PTSD) symptoms, and alcohol use and related problems. The sample consisted of 86 OEF/OIF veterans who reported drinking at least one alcoholic beverage per week. PTSD mediated the relationships between MST and alcohol-related problems, negative urgency and alcohol-related problems, as well as combat exposure and alcohol-related problems. In addition, negative urgency had a direct effect on alcohol problems. These results indicate that MST, combat exposure, and negative urgency independently predict PTSD symptoms and PTSD symptoms mediate their relationship with alcohol-related problems. Findings support previous literature on the effect of combat exposure and negative urgency on PTSD and subsequent alcohol-related problems. The current study also contributes to the limited research regarding the relationship between MST, PSTD, and alcohol use and related problems. Clinical interventions aimed at reducing emotional dysregulation and posttraumatic stress symptomology may subsequently improve alcohol related outcomes. PMID:26524279

Anger in the UK Armed Forces: strong association with mental health, childhood antisocial behavior, and combat role.

PubMed

Rona, Roberto J; Jones, Margaret; Hull, Lisa; MacManus, Deirdre; Fear, Nicola T; Wessely, Simon

2015-01-01

We assessed the strength of the association of several mental health problems, childhood difficulties, and combat role with anger, as well as the contribution of these factors to explain anger assessed by population attributable fraction (PAF). A total of 9885 UK service personnel, some of them deployed to Iraq and Afghanistan, participated in the study. There was a strong or intermediate association between cases and subthreshold cases of symptoms of posttraumatic stress disorder, psychological distress, multiple physical symptoms and alcohol misuse, having a combat role, childhood adversity, and childhood antisocial behavior with anger. The PAF for any mental health problem and combat role and childhood difficulties was 0.64 (95% confidence interval [CI], 0.56-0.70) and increased to 0.77 (95% CI, 0.69-0.83) if subthreshold cases were included. Anger is a frequent component of mental disorders; health care professionals need to be aware of the interference of anger in the management of mental illness and that anger infrequently presents as an isolated phenomenon.

"Heroes' invisible wounds of war:" constructions of posttraumatic stress disorder in the text of US federal legislation.

PubMed

Purtle, Jonathan

2016-01-01

Public policies contribute to the social construction of mental health problems. In this study, I use social constructivist theories of policy design and the methodology of ethnographic content analysis to qualitatively explore how posttraumatic stress disorder (PTSD) has been constructed as a problem in US federal legislation. I analyzed the text of 166 bills introduced between 1989 and 2009 and found that PTSD has been constructed as a problem unique to combat exposures and military populations. These constructions were produced through combat-related language and imagery (e.g., wounds, war, heroism), narratives describing PTSD as a military-specific phenomenon, and reinforced by the absence of PTSD in trauma-focused legislation targeting civilians. These constructions do not reflect the epidemiology of PTSD-the vast majority of people who develop the disorder have not experienced combat and many non-combat traumas (e.g., sexual assault) carry higher PTSD risk-and might constrain public and political discourse about the disorder and reify sociocultural barriers to the access of mental health services. Copyright © 2015 Elsevier Ltd. All rights reserved.

Female Service Members and Symptom Reporting after Combat and Non-Combat-Related Mild Traumatic Brain Injury.

PubMed

Brickell, Tracey A; Lippa, Sara M; French, Louis M; Kennedy, Jan E; Bailie, Jason M; Lange, Rael T

2017-01-15

Females are often excluded from military-related mild traumatic brain injury (mTBI) research because of its relatively low prevalence in this population. The purpose of this study was to focus on outcome from mTBI in female service members, compared with males. Participants were 172 United States military service members selected from a larger sample that had sustained an mTBI, and were evaluated within 24 months of injury (Age: mean = 28.9, SD = 8.1) at one of six military medical centers. Eighty-six women were matched to 86 men on nine key variables: TBI severity, mechanism of injury, bodily injury severity, days post-injury, age, number of deployments, theater where wounded, branch of service, and rank. Participants completed the Neurobehavioral Symptom Inventory (NSI) and the Posttraumatic Stress Disorder Checklist (PCL-C). There were no meaningful gender differences across all demographic and injury-related variables (p > 0.05). There were significant group differences and medium effect sizes for the NSI total score and all four NSI cluster scores. Symptoms most affected related to nausea, sensitivity to light, change in taste/smell, change in appetite, fatigue, and poor sleep. There were significant group differences and small-medium effect sizes for the PCL-C total score and two of the three PCL-C cluster scores. Symptoms most affected related to poor concentration, trouble remembering a stressful event, and disturbing memories/thoughts/images. Females consistently experienced more symptoms than males. As females become more active in combat-related deployments, it is critical that future studies place more emphasis on this important military population.

Educational and service partnerships: an example of global flattening.

PubMed

Finkelman, Anita; Kenner, Carole

2008-01-01

Educational and service partnerships are not new, but many of these partnerships occurred in the same town or state in the past. Today, with the heightened use of technology, these partnerships are spanning the globe (e.g., outsourcing of services is growing, with India becoming the call center for the world). What does this global flattening trend mean for nursing education and service? How will this trend impact nursing faculty and service shortages? We explored the current global flattening and its use as a potential strategy to combat nursing workforce issues.

Disordered eating and weight changes after deployment: longitudinal assessment of a large US military cohort.

PubMed

Jacobson, Isabel G; Smith, Tyler C; Smith, Besa; Keel, Pamela K; Amoroso, Paul J; Wells, Timothy S; Bathalon, Gaston P; Boyko, Edward J; Ryan, Margaret A K

2009-02-15

The effect of military deployments to combat environments on disordered eating and weight changes is unknown. Using longitudinal data from Millennium Cohort Study participants who completed baseline (2001-2003) and follow-up (2004-2006) questionnaires (n=48,378), the authors investigated new-onset disordered eating and weight changes in a large military cohort. Multivariable logistic regression was used to compare these outcomes among those who deployed and reported combat exposures, those who deployed but did not report combat exposures, and those who did not deploy in support of the wars in Iraq and Afghanistan. Deployment was not significantly associated with new-onset disordered eating in women or men, after adjustment for baseline demographic, military, and behavioral characteristics. However, in subgroup comparison analyses of deployers, deployed women reporting combat exposures were 1.78 times more likely to report new-onset disordered eating (95% confidence interval: 1.02, 3.11) and 2.35 times more likely to lose 10% or more of their body weight compared with women who deployed but did not report combat exposures (95% confidence interval: 1.17, 4.70). Despite no significant overall association between deployment and disordered eating and weight changes, deployed women reporting combat exposures represent a subgroup at higher risk for developing eating problems and weight loss.

The Hotel Industrys Role In Combatting Sex Trafficking

DTIC Science & Technology

2017-12-01

expectations that society has of organizations at a given point in time.”10 Carroll posits that businesses must first, “produce goods and services that...reuse programs that offer guests the option to forego daily laundering services are now commonly used throughout the lodging industry to conserve...million in funding—which represents an increase of $5.9 million over FY2015—to 33 victim service providers.47 Government funding offers agencies and NGOs

Evaluation of a family-centered prevention intervention for military children and families facing wartime deployments.

PubMed

Lester, Patricia; Saltzman, William R; Woodward, Kirsten; Glover, Dorie; Leskin, Gregory A; Bursch, Brenda; Pynoos, Robert; Beardslee, William

2012-03-01

We evaluated the Families OverComing Under Stress program, which provides resiliency training designed to enhance family psychological health in US military families affected by combat- and deployment-related stress. We performed a secondary analysis of Families OverComing Under Stress program evaluation data that was collected between July 2008 and February 2010 at 11 military installations in the United States and Japan. We present data at baseline for 488 unique families (742 parents and 873 children) and pre-post outcomes for 331 families. Family members reported high levels of satisfaction with the program and positive impact on parent-child indicators. Psychological distress levels were elevated for service members, civilian parents, and children at program entry compared with community norms. Change scores showed significant improvements across all measures for service member and civilian parents and their children (P < .001). Evaluation data provided preliminary support for a strength-based, trauma-informed military family prevention program to promote resiliency and mitigate the impact of wartime deployment stress.

Shakespeare in Prison: affecting health and wellbeing.

PubMed

Marie Heard, Emma; Mutch, Allyson; Fitzgerald, Lisa; Pensalfini, Rob

2013-01-01

This research aimed to investigate the impacts of the Queensland Shakespeare Ensemble Prison Project (QSEPP) on the health and wellbeing of participants, specifically with regard to social support. Semi-structured interviews were conducted with prisoners participating in the project to gain insight into perceived sense of support within the QSEPP and across the prison context more broadly. The QSEPP encouraged participants to foster a range of support networks through the development of relationships built on trust, respect and shared experiences. Participants also developed communication skills which may assist with establishing and maintaining supportive relationships inside and outside of prison. This research highlights the inevitable challenges for researchers working within the prison context, including: correctional services' limitations, time and space restrictions and small sample sizes. This research offers some potentially innovative ways to combat such challenges. The study highlights the potential of theatre-based interventions in the prison context and their role in fostering social support and enhancing wellbeing. The research explores the potential role theatre may play in improving the health and wellbeing of a disadvantaged and marginalised group, providing skills to enhance access to supportive networks inside and outside prison. To the best of our knowledge this is the first research of its kind and provides valuable insights into the role that theatre may play in fostering social support in the prison context.

Spine-area pain in military personnel: a review of epidemiology, etiology, diagnosis, and treatment.

PubMed

Cohen, Steven P; Gallagher, Rollin M; Davis, Shelton A; Griffith, Scott R; Carragee, Eugene J

2012-09-01

Nonbattle illnesses and injuries are the major causes of unit attrition in modern warfare. Spine-area pain is a common disabling injury in service members associated with a very low return-to-duty (RTD) rate. To provide an overview of the current understanding of epidemiology, possible causes, and relative prognosis of spine-area pain syndromes in military personnel, including a discussion of various treatment options available in theaters of operation. Literature review. Search focusing on epidemiology, etiology and associative factors, and treatment of spinal pain using electronic databases, textbooks, bibliographic references, and personal accounts. Spine-area pain is the most common injury or complaint "in garrison" and appears to increase during training and combat deployments. Approximately three-quarters involve low back pain, followed by cervical and midback pain syndromes. Some predictive factors associated with spine-area pain are similar to those observed in civilian cohorts, such as psychosocial distress, heavy physical activity, and more sedentary lifestyle. Risk factors specific to military personnel include concomitant psychological trauma, g-force exposure in pilots and airmen, extreme shock and vibration exposure, heavy combat load requirements, and falls incurred during airborne, air assault, and urban dismounted ground operations. Effective forward-deployed treatment has been difficult to implement, but newer strategies may improve RTD rates. Spine-area pain syndromes comprise a major source of unit attrition and are often the result of duty-related burdens incurred during combat operations. Current strategies in theaters of operation that may improve the low RTD rates include individual and unit level psychological support, early resumption of at least some forward-area duties, multimodal treatments, and ergonomic modifications. Published by Elsevier Inc.

Prospective risk factors for new-onset post-traumatic stress disorder in National Guard soldiers deployed to Iraq.

PubMed

Polusny, M A; Erbes, C R; Murdoch, M; Arbisi, P A; Thuras, P; Rath, M B

2011-04-01

National Guard troops are at increased risk for post-traumatic stress disorder (PTSD); however, little is known about risk and resilience in this population. The Readiness and Resilience in National Guard Soldiers Study is a prospective, longitudinal investigation of 522 Army National Guard troops deployed to Iraq from March 2006 to July 2007. Participants completed measures of PTSD symptoms and potential risk/protective factors 1 month before deployment. Of these, 81% (n=424) completed measures of PTSD, deployment stressor exposure and post-deployment outcomes 2-3 months after returning from Iraq. New onset of probable PTSD 'diagnosis' was measured by the PTSD Checklist - Military (PCL-M). Independent predictors of new-onset probable PTSD were identified using hierarchical logistic regression analyses. At baseline prior to deployment, 3.7% had probable PTSD. Among soldiers without PTSD symptoms at baseline, 13.8% reported post-deployment new-onset probable PTSD. Hierarchical logistic regression adjusted for gender, age, race/ethnicity and military rank showed that reporting more stressors prior to deployment predicted new-onset probable PTSD [odds ratio (OR) 2.20] as did feeling less prepared for deployment (OR 0.58). After accounting for pre-deployment factors, new-onset probable PTSD was predicted by exposure to combat (OR 2.19) and to combat's aftermath (OR 1.62). Reporting more stressful life events after deployment (OR 1.96) was associated with increased odds of new-onset probable PTSD, while post-deployment social support (OR 0.31) was a significant protective factor in the etiology of PTSD. Combat exposure may be unavoidable in military service members, but other vulnerability and protective factors also predict PTSD and could be targets for prevention strategies.

Advanced electro-mechanical micro-shutters for thermal infrared night vision imaging and targeting systems

NASA Astrophysics Data System (ADS)

Durfee, David; Johnson, Walter; McLeod, Scott

2007-04-01

Un-cooled microbolometer sensors used in modern infrared night vision systems such as driver vehicle enhancement (DVE) or thermal weapons sights (TWS) require a mechanical shutter. Although much consideration is given to the performance requirements of the sensor, supporting electronic components and imaging optics, the shutter technology required to survive in combat is typically the last consideration in the system design. Electro-mechanical shutters used in military IR applications must be reliable in temperature extremes from a low temperature of -40°C to a high temperature of +70°C. They must be extremely light weight while having the ability to withstand the high vibration and shock forces associated with systems mounted in military combat vehicles, weapon telescopic sights, or downed unmanned aerial vehicles (UAV). Electro-mechanical shutters must have minimal power consumption and contain circuitry integrated into the shutter to manage battery power while simultaneously adapting to changes in electrical component operating parameters caused by extreme temperature variations. The technology required to produce a miniature electro-mechanical shutter capable of fitting into a rifle scope with these capabilities requires innovations in mechanical design, material science, and electronics. This paper describes a new, miniature electro-mechanical shutter technology with integrated power management electronics designed for extreme service infra-red night vision systems.

Focused Logistics; What the Air Force Brings to the Fight

DTIC Science & Technology

2002-04-09

Agency partnered to develop a Strategic Distribution Management Initiative that support the Air Force’s logistics transformation and is linked by Global Command and Control System and Global Combat Support System-Air Force.

48 CFR 202.101 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Education Activity TRICARE Management Activity Washington Headquarters Services, Acquisition and Procurement... Command Air Force Reserve Command Air Combat Command Air Mobility Command Air Education and Training..., Management Defense Business Transformation Agency Contracting Office Defense Commissary Agency Directorate of...

A Psychoeducational Support Group for Serious Mental Illness

ERIC Educational Resources Information Center

Lefley, Harriet P.

2009-01-01

The formation, structure, and goals of an open-ended psychoeducational support group for people with serious and persistent mental illnesses are described, differentiating psychoeducation from psychotherapy, and professional from peer-led support groups. Major goals are to provide education for illness management and help members combat social…

Guidebook for Supporting Economic Development in Stability Operations

DTIC Science & Technology

2009-01-01

purpose. Gravel roads with single-lane bridges are ade- quate to connect rural villages to major roads where traffic is light. Asphalt or concrete is suit...It is updated annually and can be purchased directly from the World Bank through the inter- net site at http://publications.worldbank.org/ ecommerce ...providing grants to help ex-combatants and rural workers to start their own businesses. Most ex-combatants and unskilled civilian laborers do not have the

Options for the Navy’s Future Fleet

DTIC Science & Technology

2006-05-01

capability than most of those options by other than for inflation, how big and how capable can the most measures of capability. But even under the Navy’s...The most prominent of those vessels are fast combat support ships, which operate with carrier strike groups to resupply them with fuel, dry Supply...categories of ships-submarines and large surface Similarly, the ship construction schedule for large surface combatants-are responsible for most of the

Detention of American Citizens as Enemy Combatants

DTIC Science & Technology

2005-03-31

Padilla a limited right to meet with his attorney under government monitoring and appealed the decision to the Supreme Court, which heard the case on...an individual is an enemy combatant is conclusive, so long as it is supported by some evidence.182 In the first interlocutory appeal , the Fourth...a hearing to determine the status of those captured during hostilities. See CRS Report RL31367. 186 See Government’s Motion for Interlocutory Appeal

Landmine Warfare in Support of Multi-domain Battle: Balancing Discrimination and Military Effectiveness

DTIC Science & Technology

2017-05-25

Combat Team CCW Convention on Certain Conventional Weapons CTC Combat Training Center EMS Electro- Magnetic Spectrum FASCAM Family of...of a person or vehicle .”13 In the immediate aftermath of WWII, the economy of force, counter- mobility, and protection functions of landmines were...threat posed by the Soviet Union and the need for discrimination in the employment of persistent landmines by organizing them into well-marked fields

The radar eye blinded: The USAF and electronic warfare, 1945-1955

NASA Astrophysics Data System (ADS)

Kuehl, Daniel T.

This study concentrates on the doctrinal and operational elements of the Air Force's use of ECM to support offensive combat operations. It does not directly address such factors as intelligence gathering or technology development except as they pertain to the primary topic. As a result, the study focuses closely on the activities of the Air Force's two primary combat commands, the Strategic Air Command (SAC), and Tactical Air Command (TAC).

Women in Combat Compendium

DTIC Science & Technology

2008-01-01

support area • Location of unit TOC or HQ • Location of actual combat operations • No basis to answer this question 4. Given the U.S. Army’s current...welfare issue. I recall that part of General Order #1 was no sexual relations when deployed. Obviously, soldiers discovering pregnancy in the middle of...and had discussion about sexual relations and the 60 effect on unit cohesion, pregnancy testing, and affairs of the heart; whether appropriate or

Combat Rescue Helicopter (CRH)

DTIC Science & Technology

2015-12-01

Selected Acquisition Report ( SAR ) RCS: DD-A&T(Q&A)823-479 Combat Rescue Helicopter (CRH) As of FY 2017 President’s Budget Defense Acquisition...Management Information Retrieval (DAMIR) March 17, 2016 15:16:47 UNCLASSIFIED CRH December 2015 SAR March 17, 2016 15:16:47 UNCLASSIFIED 2 Table of...Office of the Secretary of Defense O&S - Operating and Support PAUC - Program Acquisition Unit Cost CRH December 2015 SAR March 17, 2016 15:16:47

Strategic Studies Quarterly. Volume 5, Number 2, Summer 2011

DTIC Science & Technology

2011-01-01

Afghanistan. We also made progress in our support of operational planning by the combatant commanders and in building processes for them to issue...transformation of the department’s networks; • work with the combatant commands to synchronize processes and planning to deliver the joint effects...own actions and forces. Note that these and many other factors determining the process of deter- rence have as much to do with an opponent’s unique

Gone to Fiddler’s Green: Reconnaissance and Security for the Corps

DTIC Science & Technology

2011-05-01

based reconnaissance and security organization. A U.S. corps in major combat operations must contend with an enemy’s armored advance guard or...screen, guard, and cover. Andrew D. Goldin, “ Ruminations on Modular Cavalry,” Armor Magazine, (September-October 2006): 14. 22 Goldin, “ Ruminations ...on Modular Cavalry,” 15. 23 Goldin, “ Ruminations on Modular Cavalry,” 16. 10 capabilities compared to modular force brigade combat teams in support

Linking Logistics and Operations: A Case Study of World War II Air Power

DTIC Science & Technology

1991-01-01

Weapon System Evaluation Group, 1951, p. 30). The logistic innovation greatly extended the time that combat ships could remain on station and...presented. This Note was produced under the Project AIR FORCE Resource Management and System Acquisition Program in the project "Combat Support C3 Needs...maintenance workload data suggest either unacceptable system performance or excessive costs. The predictive power of these models is so poor as to

Cost Estimation of Post Production Software Support in Ground Combat Systems

DTIC Science & Technology

2007-09-01

request, year of the request, EINOMEN (a word description of the system), and a PRON (a unique identifier containing the year and weapons system...variance. The fiscal year of request, descriptive name (coded as EINOMEN), unique program identifier ( PRON ), amount funded, and total amount requested...entire data set loses this sophistication. Most of the unique PRONs in the database map to a specific ground combat system, as described in the

COMBAT: Initial experience with a randomized clinical trial of plasma-based resuscitation in the field for traumatic hemorrhagic shock

PubMed Central

Chapman, Michael P.; Moore, Ernest E.; Chin, Theresa L; Ghasabyan, Arsen; Chandler, James; Stringham, John; Gonzalez, Eduardo; Moore, Hunter B.; Banerjee, Anirban; Silliman, Christopher C; Sauaia, Angela

2015-01-01

The existing evidence shows great promise for plasma as the first resuscitation fluid in both civilian and military trauma. We embarked on the Control of Major Bleeding After Trauma (COMBAT) trial with the support of the Department of Defense, in order to determine if plasma-first resuscitation yields hemostatic and survival benefits. The methodology of the COMBAT study represents not only three years of development work, but the integration of nearly two-decades of technical experience with the design and implementation of other clinical trials and studies. Herein, we describe the key features of the study design, critical personnel and infrastructural elements, and key innovations. We will also briefly outline the systems engineering challenges entailed by this study. COMBAT is a randomized, placebo controlled, semi-blinded prospective Phase IIB clinical trial, conducted in a ground ambulance fleet based at a Level I trauma center, and part of a multicenter collaboration. The primary objective of COMBAT is to determine the efficacy of field resuscitation with plasma first, compared to standard of care (normal saline). To date we have enrolled 30 subjects in the COMBAT study. The ability to achieve intervention with a hemostatic resuscitation agent in the closest possible temporal proximity to injury is critical and represents an opportunity to forestall the evolution of the “bloody vicious cycle”. Thus, the COMBAT model for deploying plasma in first response units should serve as a model for RCTs of other hemostatic resuscitative agents. PMID:25784527

Invisible Wounds: Serving Service Members and Veterans with PTSD and TBI

ERIC Educational Resources Information Center

National Council on Disability, 2009

2009-01-01

More than 1.6 million American service members have deployed to Iraq and Afghanistan in Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). As of December 2008, more than 4,000 troops have been killed and over 30,000 have returned from a combat zone with visible wounds and a range of permanent disabilities. In addition, an…

Hegemonic Masculinity in Sport Education: Case Studies of Pre-Service Physical Education Teachers with Teaching Orientations

ERIC Educational Resources Information Center

Chen, YuChun; Curtner-Smith, Matthew D.

2015-01-01

Previous research had indicated that pre-service teachers (PTs) with coaching orientations reinforced sexism and masculine bias while employing the sport education (SE) model. The purpose of the current study was to examine whether or not and the degree to which SE delivered by PTs with teaching orientations served to combat or reinforce sexism…

Sunburn among active component service members, U.S. Armed Forces, 2002-2013.

PubMed

2014-07-01

Sunburn is caused by acute overexposure to ultraviolet (UV) radiation directly from the sun or from artificial UV sources. Service members are at risk of excessive exposure to sunlight due to the nature of their military duties, which often involve working and training outdoors, and deployment to environments where UV radiation is more intense. From January 2002 through December 2013, a total of 19,172 incident cases of clinically significant sunburn were diagnosed among active component service members. Most of the cases (80.2%) were first degree sunburn. The incidence rates of sunburn diagnoses were higher among females, white non-Hispanics, younger age groups, individuals in the Marine Corps or Army, and among enlisted service members. Additionally, the rate among recruits was more than 3.5 times the rate for non-recruits. Sixty-one percent of all diagnosed cases occurred from May through July. Sunburn cases occurred in all areas of the U.S., particularly near major recruit and combat training locations. Service members are strongly advised to practice sun safety as a part of heat illness prevention, including properly using broad-spectrum sunscreen, finding or constructing shade during work and rest, wearing protective clothing and military combat eye protection items, and avoiding tanning booths and sun lamps.

What explains post-traumatic stress disorder (PTSD) in UK service personnel: deployment or something else?

PubMed

Jones, M; Sundin, J; Goodwin, L; Hull, L; Fear, N T; Wessely, S; Rona, R J

2013-08-01

In previous studies an association between deployment to Iraq or Afghanistan and an overall increased risk for post-traumatic stress disorder (PTSD) in UK armed forces has not been found. The lack of a deployment effect might be explained by including, in the comparison group, personnel deployed on other operations or who have experienced traumatic stressors unrelated to deployment. The sample comprised 8261 regular UK armed forces personnel who deployed to Iraq, Afghanistan or other operational areas or were not deployed. Participants completed the PTSD CheckList-Civilian Version (PCL-C) and provided information about deployment history, demographic and service factors, serious accidents and childhood experiences. Deployment to Iraq or Afghanistan [odds ratio (OR) 1.2, 95% confidence interval (CI) 0.6-2.2] or elsewhere (OR 1.1, 95% CI 0.6-2.0) was unrelated to PTSD although holding a combat role was associated with PTSD if deployed to Iraq or Afghanistan (OR 2.7, 95% CI 1.9-3.9). Childhood adversity (OR 3.3, 95% CI 2.1-5.0), having left service (OR 2.7, 95% CI 1.9-4.0) and serious accident (OR 2.1, 95% CI 1.4-3.0) were associated with PTSD whereas higher rank was protective (OR 0.3, 95% CI 0.12-0.76). For the majority of UK armed forces personnel, deployment whether to Iraq, Afghanistan or elsewhere confers no greater risk for PTSD than service in the armed forces per se but holding a combat role in those deployed to Iraq or Afghanistan is associated with PTSD. Vulnerability factors such as lower rank, childhood adversity and leaving service, and having had a serious accident, may be at least as important as holding a combat role in predicting PTSD in UK armed forces personnel.

Compelling Evidence that Exposure Therapy for PTSD Normalizes Brain Function.

PubMed

Roy, Michael J; Costanzo, Michelle E; Blair, James R; Rizzo, Albert A

2014-01-01

Functional magnetic resonance imaging (fMRI) is helping us better understand the neurologic pathways involved in posttraumatic stress disorder (PTSD). We previously reported that military service members with PTSD after deployment to Iraq or Afghanistan demonstrated significant improvement, or normalization, in the fMRI-measured activation of the amygdala, prefrontal cortex and anterior cingulate gyrus following exposure therapy for PTSD. However, our original study design did not include repeat scans of control participants, rendering it difficult to discern how much of the observed normalization in brain activity is attributable to treatment, rather than merely a practice effect. Using the same Affective Stroop task paradigm, we now report on a larger sample of PTSD-positive combat veterans that we treated with exposure therapy, as well as a combat-exposed control group of service members who completed repeat scans at 3-4 month intervals. Findings from the treatment group are similar to our prior report. Combat controls showed no significant change on repeat scanning, indicating that the observed differences in the intervention group were in fact due to treatment. We continue to scan additional study participants, in order to determine whether virtual reality exposure therapy has a different impact on regional brain activation than other therapies for PTSD.

Frequent Binge Drinking After Combat-Acquired Traumatic Brain Injury Among Active Duty Military Personnel With a Past Year Combat Deployment

DTIC Science & Technology

2012-01-01

sis were sex , and dummy variables for age cate- gory (17-20, 21-25, 26-34, and 35+), service branch (Army, Navy, Marine Corps, Air Force, and Coast...Design-based F Test, P-value Sex ≤.0001 Male 5754 (89.0%) 1420 (94.1%) 4334 (87.2%) Age, y ≤.001 17-20 366 (7.5%) 100 (9.2%) 266 (6.9%) 21-25 2386 (36.9...Substance Abuse Research. Military personnel more likely to binge drink than household residents; largest dis- crepancy seen among underage youth and

Evaluation and management of combat-related spinal injuries: a review based on recent experiences.

PubMed

Schoenfeld, Andrew J; Lehman, Ronald A; Hsu, Joseph R

2012-09-01

The current approach to the evaluation and treatment of military casualties in the Global War on Terror is informed by medical experience from prior conflicts and combat encounters from the last 10 years. In an effort to standardize the care provided to military casualties in the ongoing conflicts, the Department of Defense (DoD) has published Clinical Practice Guidelines (CPGs) that deal specifically with the combat casualty sustaining a spinal injury. However, the combat experience with spine injuries in the present conflicts remains incompletely described. To describe the CPGs for the care of the combat casualty with suspected spine injuries and discuss them in light of the published military experience with combat-related spinal trauma. Literature review. A literature review was conducted regarding published works that discussed the incidence, epidemiology, and management of combat-related spinal trauma. The CPGs, established by the DoD, are discussed in light of actual military experiences with spine trauma, the present situation in the forward surgical teams and combat support hospitals treating casualties in theater, and recent publications in the field of spine surgery. In the conventional wars fought by the United States between 1950 and 1991 (Korea, Vietnam, Gulf War I), the incidence of spine injuries remained close to 1% of all combat casualties. However, in the Global War on Terror, the enemy has relied on implements of asymmetric warfare, including sniper attacks, ambush, roadside bombs, and improvised explosive devices. The increase in explosive mechanisms of injury has elevated the number of soldiers exposed to blunt force trauma and, consequently, recent publications reported the highest incidence of combat-related spinal injuries in American military history. Wounded soldiers are expeditiously evacuated through the echelons of care but typically do not receive surgical management in theater. The current CPGs for the care of soldiers with combat-related spinal injuries should be re-examined in light of data regarding the increasing number of spine injuries, new injury patterns, such as lumbosacral dissociation and low lumbar burst fractures, and recent reports within the field of spine surgery as a whole. American and coalition forces are sustaining the highest spine combat casualty rates in recorded history and previously unseen injuries are being encountered with increased frequency. While the CPGs provide useful direction in terms of the evaluation and management of combat casualties with spine injuries, such recommendations may warrant periodic re-evaluation in light of recent combat experiences and evolving scientific evidence within the spine literature. Published by Elsevier Inc.

21st Century Combat Post-Traumatic Stress: An Effective and Resilient Military Force

DTIC Science & Technology

2012-03-30

STATEMENT Unlimited 13. SUPPLEMENTARY NOTES N/A 14. ABSTRACT The risks and sacrifices of military service members are great. Some men and women will...training. Discussion: For the past decade this nation has been at war. And yet, thousands of young men and women continue to volunteer their...The risks and sacrifices of military service members are great. Some service men and women will return home and resume a normal life with a greater

Southwest Research Institute assistance to NASA in biomedical areas of the technology utilization program

NASA Technical Reports Server (NTRS)

1973-01-01

Applications of aerospace technology to biomedical science are described. Recent research and development of specific techniques, services, and equipment adopted by physicians to help combat disease and disability are reviewed.

Mental health problems, use of mental health services, and attrition from military service after returning from deployment to Iraq or Afghanistan.

PubMed

Hoge, Charles W; Auchterlonie, Jennifer L; Milliken, Charles S

2006-03-01

The US military has conducted population-level screening for mental health problems among all service members returning from deployment to Afghanistan, Iraq, and other locations. To date, no systematic analysis of this program has been conducted, and studies have not assessed the impact of these deployments on mental health care utilization after deployment. To determine the relationship between combat deployment and mental health care use during the first year after return and to assess the lessons learned from the postdeployment mental health screening effort, particularly the correlation between the screening results, actual use of mental health services, and attrition from military service. Population-based descriptive study of all Army soldiers and Marines who completed the routine postdeployment health assessment between May 1, 2003, and April 30, 2004, on return from deployment to Operation Enduring Freedom in Afghanistan (n = 16,318), Operation Iraqi Freedom (n = 222,620), and other locations (n = 64,967). Health care utilization and occupational outcomes were measured for 1 year after deployment or until leaving the service if this occurred sooner. Screening positive for posttraumatic stress disorder, major depression, or other mental health problems; referral for a mental health reason; use of mental health care services after returning from deployment; and attrition from military service. The prevalence of reporting a mental health problem was 19.1% among service members returning from Iraq compared with 11.3% after returning from Afghanistan and 8.5% after returning from other locations (P<.001). Mental health problems reported on the postdeployment assessment were significantly associated with combat experiences, mental health care referral and utilization, and attrition from military service. Thirty-five percent of Iraq war veterans accessed mental health services in the year after returning home; 12% per year were diagnosed with a mental health problem. More than 50% of those referred for a mental health reason were documented to receive follow-up care although less than 10% of all service members who received mental health treatment were referred through the screening program. Combat duty in Iraq was associated with high utilization of mental health services and attrition from military service after deployment. The deployment mental health screening program provided another indicator of the mental health impact of deployment on a population level but had limited utility in predicting the level of mental health services that were needed after deployment. The high rate of using mental health services among Operation Iraqi Freedom veterans after deployment highlights challenges in ensuring that there are adequate resources to meet the mental health needs of returning veterans.

The fog of war: decrements in cognitive performance and mood associated with combat-like stress.

PubMed

Lieberman, Harris R; Bathalon, Gaston P; Falco, Christina M; Morgan, Charles A; Niro, Philip J; Tharion, William J

2005-07-01

Anecdotal reports from military conflicts suggest cognitive performance and mood are severely degraded by the stress of combat. However, little objective information is available to confirm these observations. Our laboratory had several unique opportunities to study cognitive function in warfighters engaged in exercises designed to simulate the stress of combat. These studies were conducted in different environments with two different types of military volunteers. In one study, subjects were officers, with an average 9 yr of military service, who were members of an elite U.S. Army unit, the Rangers. In the other study, participants were younger, mostly enlisted, trainees with only 3 yr of military experience on average, in training to determine if they would qualify for an elite U.S. Navy unit, the SEALS. We administered a variety of identical, computer-based cognitive tests to both groups. In both groups, during stressful combat-like training, every aspect of cognitive function assessed was severely degraded compared with baseline, pre-stress performance. Relatively simple cognitive functions such as reaction time and vigilance were significantly impaired, as were more complex functions, including memory and logical reasoning. The deficits observed were greater than those typically produced by alcohol intoxication, treatment with sedating drugs, or clinical hypoglycemia. Undoubtedly, such decrements would severely degrade operational effectiveness. Furthermore, it is likely such cognitive decrements would be greater during actual combat. War planners, doctrine developers, and warfighters, especially leaders, need to be aware that combat stress will result in extensive and severe deficits in cognitive performance.

The Reduction of Bullying in an Elementary Program: An Action Research Study

ERIC Educational Resources Information Center

Brock, Jacqueline M.

2013-01-01

Bully Prevention in Positive Behavior Support (BP-PBS) is a prevention-oriented program created to support students with strategies to combat bullying. BP-PBS supports the idea that all students should have access to positive behavior support to minimize problem behavior at school (Horner, 2011). The goal of this study was to investigate the…

Littoral Combat Ship Mission Modules (LCS MM)

DTIC Science & Technology

2015-12-01

Selected Acquisition Report ( SAR ) RCS: DD-A&T(Q&A)823-443 Littoral Combat Ship Mission Modules (LCS MM) As of FY 2017 President’s Budget Defense...Acquisition Management Information Retrieval (DAMIR) March 9, 2016 08:50:12 UNCLASSIFIED LCS MM December 2015 SAR March 9, 2016 08:50:12 UNCLASSIFIED...Document OSD - Office of the Secretary of Defense O&S - Operating and Support PAUC - Program Acquisition Unit Cost LCS MM December 2015 SAR March 9

Catecholamine responses to virtual combat: implications for post-traumatic stress and dimensions of functioning.

PubMed

Highland, Krista B; Costanzo, Michelle E; Jovanovic, Tanja; Norrholm, Seth D; Ndiongue, Rochelle B; Reinhardt, Brian J; Rothbaum, Barbara; Rizzo, Albert A; Roy, Michael J

2015-01-01

Posttraumatic stress disorder (PTSD) symptoms can result in functional impairment among service members (SMs), even in those without a clinical diagnosis. The variability in outcomes may be related to underlying catecholamine mechanisms. Individuals with PTSD tend to have elevated basal catecholamine levels, though less is known regarding catecholamine responses to trauma-related stimuli. We assessed whether catecholamine responses to a virtual combat environment impact the relationship between PTSD symptom clusters and elements of functioning. Eighty-seven clinically healthy SMs, within 2 months after deployment to Iraq or Afghanistan, completed self-report measures, viewed virtual-reality (VR) combat sequences, and had sequential blood draws. Norepinephrine responses to VR combat exposure moderated the relationship between avoidance symptoms and scales of functioning including physical functioning, physical-role functioning, and vitality. Among those with high levels of avoidance, norepinephrine change was inversely associated with functional status, whereas a positive correlation was observed for those with low levels of avoidance. Our findings represent a novel use of a virtual environment to display combat-related stimuli to returning SMs to elucidate mind-body connections inherent in their responses. The insight gained improves our understanding of post-deployment symptoms and quality of life in SMs and may facilitate enhancements in treatment. Further research is needed to validate these findings in other populations and to define the implications for treatment effectiveness.

The Long War and Parental Combat Deployment: Effects on Military Children and At-Home Spouses

PubMed Central

Lester, Patricia; Peterson, Kris; Reeves, James; Knauss, Larry; Glover, Dorie; Mogil, Catherine; Duan, Naihua; Saltzman, William; Pynoos, Robert; Wilt, Katherine; Beardslee, William

2010-01-01

OBJECTIVE Given the growing number of military service members with families and the multiple combat deployments characterizing current war time duties, the impact of deployments on military children requires clarification. Behavioral and emotional adjustment problems were examined in children (aged 6 –12) of an active duty Army or Marine Corps parent currently deployed (CD) or recently returned (RR) from Afghanistan or Iraq. METHOD Children (N=272) and their at-home civilian (AHC) (N=163) and/or recently returned active duty (AD) parent (N=65) were interviewed. Child adjustment outcomes were examined in relation to parental psychological distress and months of combat deployment (of the AD) using mixed effects linear models. RESULTS Parental distress (AHC and AD) and cumulative length of parental combat-related deployments during the child’s lifetime independently predicted increased child depression and externalizing symptoms. Although behavioral adjustment and depression levels were comparable to community norms, anxiety was significantly elevated in children in both deployment groups. In contrast, AHC parental distress was greater in those with a CD (vs. RR) spouse. CONCLUSIONS Findings indicate parental combat deployment has a cumulative effect on children which remains even after the deployed parent returns home, and is predicted by psychological distress of both the AD and AHC parent. Such data may be informative for screening, prevention and intervention strategies. PMID:20410724

European Policies to Promote Children's Rights and Combat Child Poverty.

PubMed

Sandbæk, Mona

2017-07-26

The upbringing of children relies heavily on shared responsibilities between parents and society. The Council of Europe Recommendation (2006) 19 on Policy to Support Positive Parenting and the European Commission Recommendation (2013) Investing in Children: Breaking the Cycle of Disadvantage, both aim at supporting parents to care and provide for their children in accordance with the UN Convention on the Rights of the Child. By means of a document analysis this article examines what kind of parental practices and provision to parents the recommendations suggest to safeguard children's rights in the family. Three findings are highlighted: first, both recommendations reflect a commitment to respecting children's rights while at the same time acknowledging parents as children's primary caregivers. Second, both recognize parents' rights to work, while also recognizing the necessity of adequate income support if work is not available or income too low. Third, adequate resources are defined as a combination of universal policies and services, which guarantee a minimum level for all, and targeted measures reaching out to the most disadvantaged. The recommendations' emphasis on children and parents as partners and on the families' economic situations are valuable for future development of family and child policy and support programs.

European Policies to Promote Children’s Rights and Combat Child Poverty

PubMed Central

Sandbæk, Mona

2017-01-01

The upbringing of children relies heavily on shared responsibilities between parents and society. The Council of Europe Recommendation (2006) 19 on Policy to Support Positive Parenting and the European Commission Recommendation (2013) Investing in Children: Breaking the Cycle of Disadvantage, both aim at supporting parents to care and provide for their children in accordance with the UN Convention on the Rights of the Child. By means of a document analysis this article examines what kind of parental practices and provision to parents the recommendations suggest to safeguard children’s rights in the family. Three findings are highlighted: first, both recommendations reflect a commitment to respecting children’s rights while at the same time acknowledging parents as children’s primary caregivers. Second, both recognize parents’ rights to work, while also recognizing the necessity of adequate income support if work is not available or income too low. Third, adequate resources are defined as a combination of universal policies and services, which guarantee a minimum level for all, and targeted measures reaching out to the most disadvantaged. The recommendations’ emphasis on children and parents as partners and on the families’ economic situations are valuable for future development of family and child policy and support programs. PMID:28933743

[Exercising sexual and reproductive rights: a qualitative study of heterosexual people with HIV in Mexico].

PubMed

Campero, Lourdes; Kendall, Tamil; Caballero, Marta; Mena, Ana Lorena; Herrera, Cristina

2010-01-01

To analyze experiences of heterosexual Mexican people living with HIV (PLWHA) related to the exercise of their sexual and reproductive rights. Qualitative study based on 40 in-depth interviews with PLWHA in four Mexican States. Lack of support and counseling limits the exercise of sexual and reproductive rights by PLWHA, especially women. Principal limitations include feelings of frustration and confusion, fear of re-infection, scanty information, lack of power to negotiate condom use, social stigma and discrimination, and limited access to services and adequate technologies. To increase awareness and exercise of rights by PLWHA it is necessary to: improve sexual education; promote processes of cultural change to combat gender inequality and stigma and discrimination; and provide timely and scientific information about HIV prevention.

Supporting our military families: a case for a larger role for occupational therapy in prevention and mental health care.

PubMed

Cogan, Alison M

2014-01-01

More than 2 million U.S. military servicemembers have deployed to Afghanistan or Iraq since September 11, 2001. Unlike during prior conflicts, many servicemembers leave spouses and children behind. Long, multiple deployments cause strain on family at home, with new challenges arising when servicemembers return from combat and reintegrate into family and civilian life. In World Wars I and II, occupational therapy practitioners played a significant role in supporting servicemember reintegration. However, their presence in program delivery in this practice area is limited. Occupational therapy researchers and practitioners can make a valuable contribution by helping families tailor daily activities and routines to address challenges and optimize health and wellness. However, barriers such as reimbursement for services, workforce availability, and access to military families have limited the profession's full engagement. Advocacy is needed to help establish occupational therapy as a key component of the mental and preventive health care teams serving military servicemembers. Copyright © 2014 by the American Occupational Therapy Association, Inc.

Military and VA telemedicine systems for patients with traumatic brain injury.

PubMed

Girard, Philip

2007-01-01

Telemedicine plays a critical role within the Department of Veterans Affairs (VA) Veterans Health Administration by allowing the surveillance and care of patients who are isolated by geography, poverty, and disability. In military settings, telemedicine is being widely used to identify injury and illness and aid in the treatment, rehabilitation, and recovery of combat-wounded soldiers in theater. Rapid advances in both domains are transforming the way clinicians provide care, education, and support to patients with traumatic brain injury (TBI) and their families. This article discusses the military and VA telemedicine capabilities that are supporting the care of service members and veterans with TBI. These capabilities include new technologies that enhance the identification of TBI, management of symptoms in theater, and application of proven technologies (interactive video, Internet, and World Wide Web) to improve overall care coordination throughout military and VA systems. The impact of distance learning, teleconsultation, telerehabilitation, and home telehealth programs is also described within this context.

Randomized, Sham-Controlled, Feasibility Trial of Hyperbaric Oxygen for Service Members With Postconcussion Syndrome: Cognitive and Psychomotor Outcomes 1 Week Postintervention.

PubMed

Walker, William C; Franke, Laura Manning; Cifu, David X; Hart, Brett B

2014-06-01

Background Mild traumatic brain injury (mTBI) and residual postconcussion syndrome (PCS) are common among combatants of the recent military conflicts in Iraq and Afghanistan. Hyperbaric oxygen (HBO2) is a proposed treatment but has not been rigorously studied for this condition. Objectives In a secondary analysis, examine for possible effects on psychomotor (balance and fine motor) and cognitive performance 1 week after an HBO2 intervention in service members with PCS after mTBI. Methods A randomized, double-blind, sham control, feasibility trial comparing pretreatment and posttreatment was conducted in 60 male active-duty marines with combat-related mTBI and PCS persisting for 3 to 36 months. Participants were randomized to 1 of 3 preassigned oxygen fractions (10.5%, 75%, or 100%) at 2.0 atmospheres absolute (ATA), resulting in respective groups with an oxygen exposure equivalent to (1) breathing surface air (Sham Air), (2) 100% oxygen at 1.5 ATA (1.5 ATAO2), and (3) 100% oxygen at 2.0 ATA (2.0 ATAO2). Over a 10-week period, participants received 40 hyperbaric chamber sessions of 60 minutes each. Outcome measures, including computerized posturography (balance), grooved pegboard (fine motor speed/dexterity), and multiple neuropsychological tests of cognitive performance, were collected preintervention and 1-week postintervention. Results Despite the multiple sensitive cognitive and psychomotor measures analyzed at an unadjusted 5% significance level, this study demonstrated no immediate postintervention beneficial effect of exposure to either 1.5 ATAO2 or 2.0 ATAO2 compared with the Sham Air intervention. Conclusions These results do not support the use of HBO2 to treat cognitive, balance, or fine motor deficits associated with mTBI and PCS. © The Author(s) 2013.

Operative treatment of new onset radiculopathy secondary to combat injury.

PubMed

Wagner, Scott C; Van Blarcum, Gregory S; Kang, Daniel G; Lehman, Ronald A

2015-02-01

We set out to describe combat-related spine trauma over a 10-year period, and thereby determine the frequency of new onset radiculopathy secondary to injuries sustained in support of combat operations. We performed a retrospective analysis of a surgical database at three military institutions. Patients undergoing spine surgery following a combat-related injury in Afghanistan or Iraq between July 2003 and July 2013 were evaluated. We identified 105 patients with combat-related (Operations Enduring and Iraqi Freedom) spine trauma requiring operative intervention. Of these, 15 (14.3%) patients had radiculopathy as their primary complaint after injury. All patients were diagnosed with herniated nucleus pulposus. The average age was 39 years, with 80% injured in Iraq and 20% in Afghanistan. The most common mechanism of injury was mounted improvised explosive device (33%). The cervical spine was most commonly involved (53%), followed by lumbar spine (40%). Average time from injury to surgery was 23.4 months; 53% of patients had continued symptoms following surgery, and two patients had at least one revision surgery. Two patients were medically retired because of their symptoms. This study is the only of its kind evaluating the operative treatment of traumatic radiculopathy following combat-related trauma. We identified a relatively high rate of radiculopathy in these patients. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Insufficient dollars and qualified personnel to meet United States mental health needs.

PubMed

Weil, Thomas P

2015-04-01

The American populace currently supports the need for providing additional mental health services for adolescents who frequently express anger and mood instability and maybe are at risk for major psychiatric disorders and behavioral problems; Vietnam, Iraqi, and Afghanistan veterans or military personnel still on duty diagnosed with posttraumatic stress disorder, depression, or other similar combat-related disabilities; the approximately 1 million prisoners currently incarcerated primarily because of substance abuse and needing medically related rehabilitative services; and senior citizens who experience dementia and depression and require improved therapeutics. The problems outlined herein are as follows: far too limited monies are being spent for mental health services (5.6% of total US expenditures for health or roughly one fifth of what is consumed for hospital care); effective therapies are often lacking; and there is a shortage of qualified mental health personnel except in upscale urban and suburban areas. Unfortunately, these problems are so immense that, even with enhanced prioritization of our available resources, they are still not entirely solvable. The American public may continue to impart lip service when attempting to respond to our nation's mental health needs or may decide to spend vastly more money for such care. The latter choice may not be forthcoming in the near future for various cultural-societal-clinical-fiscal reasons.

Surgical and Resuscitation Capabilities for the "Next War" Based on Lessons Learned From "This War".

PubMed

Freel, David; Warr, Bradley J

2016-01-01

The Army gleaned many lessons regarding the provision of medical care to casualties during the past 14 years of combat. Using these lessons learned in the Joint Capabilities and Integration Development process and through the analysis of an integrated process action team, the Army recently approved 3 changes to medical organizations that are intended to provide trauma management farther forward on the battlefield. These changes include the substitution of an emergency medicine trained physician and emergency medicine physician assistant (PA) in lieu of a general medical officer and primary care PA within the brigade combat team; reorganization of the forward surgical team into a forward surgical and resuscitative team; and the modularization of the traditional 248 bed combat support hospital. The Army anticipates that these changes related to personnel, organizations, doctrine, and materiel will enable Army medicine to provide enhanced trauma management closer to the point of a combatant's injury. These modifications are projected to begin in fiscal year 2016.

Accelerated Resolution Therapy for treatment of pain secondary to symptoms of combat-related posttraumatic stress disorder

PubMed Central

Kip, Kevin E.; Rosenzweig, Laney; Hernandez, Diego F.; Shuman, Amy; Diamond, David M.; Girling, Sue Ann; Sullivan, Kelly L.; Wittenberg, Trudy; Witt, Ann M.; Lengacher, Cecile A.; Anderson, Brian; McMillan, Susan C.

2014-01-01

Background As many as 70% of veterans with chronic pain treated within the US Veterans Administration (VA) system may have posttraumatic stress disorder (PTSD), and conversely, up to 80% of those with PTSD may have pain. We describe pain experienced by US service members and veterans with symptoms of PTSD, and report on the effect of Accelerated Resolution Therapy (ART), a new, brief exposure-based therapy, on acute pain reduction secondary to treatment of symptoms of PTSD. Methods A randomized controlled trial of ART versus an attention control (AC) regimen was conducted among 45 US service members/veterans with symptoms of combat-related PTSD. Participants received a mean of 3.7 sessions of ART. Results Mean age was 41.0 + 12.4 years and 20% were female. Most veterans (93%) reported pain. The majority (78%) used descriptive terms indicative of neuropathic pain, with 29% reporting symptoms of a concussion or feeling dazed. Mean pre-/post-change on the Pain Outcomes Questionnaire (POQ) was −16.9±16.6 in the ART group versus −0.7±14.2 in the AC group (p=0.0006). Among POQ subscales, treatment effects with ART were reported for pain intensity (effect size = 1.81, p=0.006), pain-related impairment in mobility (effect size = 0.69, p=0.01), and negative affect (effect size = 1.01, p=0.001). Conclusions Veterans with symptoms of combat-related PTSD have a high prevalence of significant pain, including neuropathic pain. Brief treatment of symptoms of combat-related PTSD among veterans by use of ART appears to acutely reduce concomitant pain. PMID:24959325

Acquiring Combat Capability through Innovative Uses of Public-Private Partnerships

DTIC Science & Technology

2006-06-01

needed for a vital fiber -optic link near the Arctic Circle. Then, we will explore the history of the Energy Saving Performance Contracts (ESPCs...research examines Hannon Armstrong’s “fee for service contract” solution to funding the vital fiber -optic link near the Arctic Circle. The second...5 A. INNOVATIVE USE OF FEE FOR SERVICE CONTRACT .....................5 1. Introduction to the Arctic Circle Fiber

Response to White's "Shadow Scholars and the Rise of the Dissertation Service Industry"

ERIC Educational Resources Information Center

Gallant, Tricia Bertram

2016-01-01

The consideration of the impact of the dissertation services industry on the academy is a welcome piece by Jeffry L. White. White raises interesting questions and calls on educators and researchers to think deeply about the role they play in encouraging or combating the use of this industry by graduate students. In this piece, I respond to White's…

Guidelines for the Prevention of Infections Associated With Combat-Related Injuries: 2011 Update

DTIC Science & Technology

2011-08-01

of information, including suggestions for reducing this burden, to Washington Headquarters Services , Directorate for Information Operations and...Infectious Disease Service (MCHE-MDI),3851 Roger Brooke Drive,Fort Sam Houston,TX,78234 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING...Guidelines TABLE 1. GRADE* Systematic Weighting of the Quality of Evidence and Grading of Recommendations Strength of Recommendation and Quality of

Stakeholders' perspectives on facilitators of and barriers to the utilisation of and access to maternal health services in Eritrea: a qualitative study.

PubMed

Chol, Chol; Hunter, Cynthia; Debru, Berhane; Haile, Berhana; Negin, Joel; Cumming, Robert G

2018-01-19

Wars affect maternal health services by destroying health systems. Eritrea experienced two wars with neighbouring Ethiopia. Despite this, the maternal mortality ratio (MMR) in Eritrea fell by 69% from 1590 per 100,000 live births in 1990 to 501 in 2015. This study aimed to examine facilitators of and barriers to the utilisation of and access to maternal health services in Eritrea. Using in-depth interviews and field observations for data collection, this qualitative study was conducted in five healthcare facilities in Asmara, the capital of Eritrea, in February and March 2016. The participants were: women (n = 40), husbands (n = 5), healthcare providers (n = 10), and decision makers (n = 5). There were two perceived facilitators of utilisation of and access to maternal health services: health education (related to the WHO health service delivery building blocks) and improvement in gender equality driven by the role played by Eritrean women as combatants during the War of Independence (1961-1991). The only perceived barrier was poor quality of care due to lack of ultrasound machines, short clinic opening hours, and shortage of healthcare workers (related to the WHO health workforce building block). This study assessed women and their husbands/partners' perceptions and the possible effects of contemporary Eritrean culture and the history of war on the utilisation of and access to maternal health services in the country. As well, we examined healthcare providers' and decision makers' perspectives. The two key facilitators of women's utilisation of and access to maternal health services were health education and women's empowerment driven by their role as combatants during the War of Independence. One main barrier was poor quality of care due to lack of ultrasound machines, short clinic opening hours, and a shortage of healthcare workers. As only a limited number of qualitative studies have been published about maternal health services in war-affected sub-Saharan African countries, our findings regarding health education and women's empowerment could be considered in other war-affected countries similar to Eritrea. Nevertheless, further research is needed to investigate our findings - particularly regarding female empowerment driven by women's role in combat in relation to their maternal health.

Organizational characteristics of the austere intensive care unit: the evolution of military trauma and critical care medicine; applications for civilian medical care systems.

PubMed

Grathwohl, Kurt W; Venticinque, Steven G

2008-07-01

Critical care in the U.S. military has significantly evolved in the last decade. More recently, the U.S. military has implemented organizational changes, including the use of multidisciplinary teams in austere environments to improve outcomes in severely injured polytrauma combat patients. Specifically, organizational changes in combat support hospitals located in combat zones during Operation Iraqi Freedom have led to decreased intensive care unit mortality and length of stay as well as resource use. These changes were implemented without increases in logistic support or the addition of highly technologic equipment. The mechanism for improvement in mortality is likely attributable to the adherence of basic critical care medicine fundamentals. This intensivist-directed team model provides sophisticated critical care even in the most austere environments. To optimize critically injured patients' outcomes, intensive care organizational models similar to the U.S. military, described in this article, can possibly be adapted to those of civilian care during disaster management to meet the challenges of emergency mass critical care.

Coagulopathy and shock on admission is associated with mortality for children with traumatic injuries at combat support hospitals.

PubMed

Patregnani, Jason T; Borgman, Matthew A; Maegele, Marc; Wade, Charles E; Blackbourne, Lorne H; Spinella, Philip C

2012-05-01

In adults, early traumatic coagulopathy and shock are both common and independently associated with mortality. There are little data regarding both the incidence and association of early coagulopathy and shock on outcomes in pediatric patients with traumatic injuries. Our objective was to determine whether coagulopathy and shock on admission are independently associated with mortality in children with traumatic injuries. A retrospective review of the Joint Theater Trauma Registry from U.S. combat support hospitals in Iraq and Afghanistan from 2002 to 2009 was performed. Coagulopathy was defined as an international normalized ratio of ≥1.5 and shock as a base deficit of ≥6. Laboratory values were measured on admission. Primary outcome was inhospital mortality. Univariate analyses were performed on all admission variables followed by reverse stepwise multivariate logistic regression to determine independent associations. Combat support hospitals in Iraq and Afghanistan. Patients <18 yrs of age with Injury Severity Score, international normalized ratio, base deficit, and inhospital mortality were included. Of 1998 in the cohort, 744 (37%) had a complete set of data for analysis. None. The incidence of early coagulopathy and shock were 27% and 38.3% and associated with mortality of 22% and 16.8%, respectively. After multivariate logistic regression, early coagulopathy had an odds ratio of 2.2 (95% confidence interval 1.1-4.5) and early shock had an odds ratio of 3.0 (95% confidence interval 1.2-7.5) for mortality. Patients with coagulopathy and shock had an odds ratio of 3.8 (95% confidence interval 2.0-7.4) for mortality. In children with traumatic injuries treated at combat support hospitals, coagulopathy and shock on admission are common and independently associated with a high incidence of inhospital mortality. Future studies are needed to determine whether more rapid and accurate methods of measuring coagulopathy and shock as well as if early goal-directed treatment of these states can improve outcomes in children.

After abduction: exploring access to reintegration programs and mental health status among young female abductees in Northern Uganda

PubMed Central

2014-01-01

Background Reintegration programs are commonly offered to former combatants and abductees to acquire civilian status and support services to reintegrate into post-conflict society. Among a group of young female abductees in northern Uganda, this study examined access to post-abduction reintegration programming and tested for between group differences in mental health status among young women who had accessed reintegration programming compared to those who self-reintegrated. Methods This cross-sectional study analysed interviews from 129 young women who had previously been abducted by the Lords Resistance Army (LRA). Data was collected between June 2011-January 2012. Interviews collected information on abduction-related experiences including age and year of abduction, manner of departure, and reintegration status. Participants were coded as ‘reintegrated’ if they reported ≥1 of the following reintegration programs: traditional cleansing ceremony, received an amnesty certificate, reinsertion package, or had gone to a reception centre. A t-test was used to measure mean differences in depression and anxiety measured by the Acholi Psychosocial Assessment Instrument (APAI) to determine if abductees who participated in a reintegration program had different mental status from those who self-reintegrated. Results From 129 young abductees, 56 (43.4%) had participated in a reintegration program. Participants had been abducted between 1988–2010 for an average length of one year, the median age of abduction was 13 years (IQR:11–14) with escaping (76.6%), being released (15.6%), and rescued (7.0%) being the most common manner of departure from the LRA. Traditional cleansing ceremonies (67.8%) were the most commonly accessed support followed by receiving amnesty (37.5%), going to a reception centre (28.6%) or receiving a reinsertion package (12.5%). Between group comparisons indicated that the mental health status of abductees who accessed ≥1 reintegration program were not significantly different from those who self-reintegrated (p > 0.05). Conclusions Over 40% of female abductees in this sample had accessed a reintegration program, however significant differences in mental health were not observed between those who accessed a reintegration program and those who self-reintegrated. The successful reintegration of combatants and abductees into their recipient community is a complex process and these results support the need for gender-specific services and ongoing evaluation of reintegration programming. PMID:24855489

Oxytocin selectively modulates brain response to stimuli probing social synchrony.

PubMed

Levy, Jonathan; Goldstein, Abraham; Zagoory-Sharon, Orna; Weisman, Omri; Schneiderman, Inna; Eidelman-Rothman, Moranne; Feldman, Ruth

2016-01-01

The capacity to act collectively within groups has led to the survival and thriving of Homo sapiens. A central group collaboration mechanism is "social synchrony," the coordination of behavior during joint action among affiliative members, which intensifies under threat. Here, we tested brain response to vignettes depicting social synchrony among combat veterans trained for coordinated action and following life-threatening group experience, versus controls, as modulated by oxytocin (OT), a neuropeptide supporting social synchrony. Using a randomized, double-blind, within-subject design, 40 combat-trained and control male veterans underwent magnetoencephalography (MEG) twice following OT/placebo administration while viewing two social vignettes rated as highly synchronous: pleasant male social gathering and coordinated unit during combat. Both vignettes activated a wide response across the social brain in the alpha band; the combat scene triggered stronger activations. Importantly, OT effects were modulated by prior experience. Among combat veterans, OT attenuated the increased response to combat stimuli in the posterior superior temporal sulcus (pSTS) - a hub of social perception, action observation, and mentalizing - and enhanced activation in the inferior parietal lobule (IPL) to the pleasant social scene. Among controls, OT enhanced inferior frontal gyrus (IFG) response to combat cues, demonstrating selective OT effects on mirror-neuron and mentalizing networks. OT-enhanced mirror network activity was dampened in veterans reporting higher posttraumatic symptoms. Results demonstrate that the social brain responds online, via modulation of alpha rhythms, to stimuli probing social synchrony, particularly those involving threat to survival, and OT's enhancing versus anxiolytic effects are sensitive to salient experiences within social groups. Copyright © 2015 Elsevier Inc. All rights reserved.

Evaluating the Effect of Holding Time and Storage Temperature on the Chemical Stability of Drinking Water Samples Collected from Military Forward Deployed Environments

DTIC Science & Technology

2013-04-30

Uniformed Services University of the Health Sciences In partial fulfillment of the requirements for the degree of Master of Science in Public Health 2013...1 UNIFORMED SERVICES UNIVERSITY, SCHOOL OF MEDICINE GRADUATE PROGRAMS Graduate Education Office (A 1045), 4301 Jones Bridge Road, Bethesda, MD 20814...Since 1991 the US military has deployed Service Members in various overseas contingency operations from armed combat to peacekeeping missions. During

Evaluation of Why the Air Force Dedicated Personnel Recovery Mission Should Remain with Air Combat Command

DTIC Science & Technology

2016-03-01

Many of the tactics still in use today were tested and executed in combat during the Vietnam War. One of the major benefits that resulted from...AFSOF to support the planning for Project Honey Badger, the re-attempt at recovering the hostages in Iran.43 Project Honey Badger would eventually be...14 scrapped as the hostages would be released in early 1981. The damage for the ARRS had been done. Even with the termination of Project Honey

Surface Warfare: A Total Force. Volume 19. Number 4, July/August 1994

DTIC Science & Technology

1994-08-01

USS Puget Sound (AD 38) (AOE 1) Support USS Grasp (ARS 51) Combat Logistics (med/small) USS Mauna Lea (AE 22) COMINEWARCOM: Repair USS Acadia (AD 42...structure is Operational Reserve Carrier ( ORC ). When USS John being shaped to expand this role. In the recently P. Eznnedy (CV 67) joins the NRF in...A typical Aegis engagement sequence begins as a engineer and test the fought in the waters of Port RoyalAegis Combat System. Sound and on the adjacent

Co-occurring Mental Health and Alcohol Misuse Symptoms: Dual Disorder Symptoms in Combat Injured Veterans

DTIC Science & Technology

2014-03-03

required from Department of Veterans Af fairs hospitals. The rate of alcohol misuse among veterans screening for PTSD or de pression in the present...facilities only (casualties treated at forward deployed Army facilities, and those transported directly to Combat Support Hospitals from the point of injury...Psychiatry, 163, 1777–1783. Hien, D. A., Jiang, H., Campbell, A. N. C., Hu, M. C., Miele , G. M., Cohen, L. R., et al. (2010). Do treatment improvements

Postconcussive Symptom Reporting Among US Combat Veterans With Mild Traumatic Brain Injury From Operation Iraqi Freedom

DTIC Science & Technology

2012-01-01

memory problems (OR = 1.86; 95% CI = 1.20-2.88), tinnitus (OR = 1.63; 95% CI = 1.10-2.41), and dizziness (OR = 2.13; 95% CI = 1.06-4.29) compared with...consequences among combat veterans even when accounting for co-occurring psychological morbidity. The identification of postconcussive symptoms related to...Research Center, San Diego, California. This work was supported by the US Navy Bureau of Medicine under the Wounded, Ill and Injured/ Psychological Health

United States Counterinsurgency Doctrine and Implementation in Iraq

DTIC Science & Technology

2004-06-18

combat force until the host nation can stabilize the situation and that, The primary role for US military forces in combat operations is to support...they are to the insurgent as the water is to a fish . Not only does water sustain the life of the fish , it also drowns the enemy. Discipline in the...the populous by building trust and then sharing ideology. Because this process can take time, he makes the point in his Primer on Guerrilla War that

Future Combat System Spinout 1 Technical Field Test - Establishing and Implementing Models and Simulations System of Systems Verification, Validation and Accreditation Practices, Methodologies and Procedures

DTIC Science & Technology

2009-11-24

assisted by the Brigade Combat Team (BCT) Modernization effort, the use of Models and Simulations ( M &S) becomes more crucial in supporting major...in 2008 via a slice of the Current Force (CF) BCT structure. To ensure realistic operational context, a M &S System-of- Systems (SoS) level...messages, and constructive representation of platforms, vehicles, and terrain. The M &S federation also provided test control, data collection, and live

An Analysis of Hospitalization Length of Stay Within a Multi-Echelon System of Care During Combat Operations

DTIC Science & Technology

1999-09-22

Respiratory system Bronchitis 3107 660 5.2% 1.1% 7.0 8.0 13.2 20.1 20.7 28.2 Digestive system Gastroenteritis and colitis exc. ulcer , of noninf...distribution is unlimited. Summary Problem The medical resources needed to support combat operations are dependent upon the time patients spend within...of patients seen at each level of care is an essential component of efficient resource planning. Objective To obtain summary length of stay

Disaster Workers: Trauma and Social Support

DTIC Science & Technology

1992-05-01

coming back, the smell of dead flesh." "I think about the disaster quite a bit. I think about the 6 year old girl I had helpe and of her family. The...estimated 7% of the U.S. population is exposed to traumas/disasters each year . In the military, traumatic events caused by training, war, and combat, are...exposed to traumas and disasters each year . In the military, traumatic events caused by training, as well as war and combat, are an expected part of

Use of Tourniquets and their Effects on Limb Function in the Modern Combat Environment

DTIC Science & Technology

2010-03-01

pressure by tightening a tourniquet, the pressure can soon damage nerves (>500 mm Hg) while remaining ineffective. Many tourniquet manufacturers are unaware...testing, and clinical use.2,57 TOURNIQUET USE, TISSUE ISCHEMIA, AND LIMB FUNCTION Skin , bone, tendon, fat, fascia, joints, and vessels tolerate ischemia...injury in a combat support hospital: results of a case control study. J Trauma 2008;64(Suppl 2):S99–106 [discussion: S106–7]. 21. Bellamy RF . The

User accpetance of ATIS products and services : a report of qualitative research

DOT National Transportation Integrated Search

1992-08-01

In recent years, transportation planning has been experiencing an escalating emphasis towards increasing capacity and improving traffic management on urban streets and arterials to combat the effects of congestion. One measure which has proven to be ...

Safe Haven

ERIC Educational Resources Information Center

Miranda, Maria Eugenia

2011-01-01

In this article, the author discusses how college administrators are increasingly prioritizing dating violence prevention and intervention services. To combat dating violence, campus groups and programming are becoming more prevalent as increased awareness of dating violence forces students and administrators alike to address a problem that…