Military medicine
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The propensity for air mobility missions to exhaust aircrews is strongly dependent on operational tempo. Most flying is performed during periods of low to moderate operational tempo, but a major flight safety risk can emerge when operational tempo becomes very high. This risk can be managed by software tools that contain fatigue and sleep behavior modeling, but optimization/validation of the model using the specific target population is required to ensure that the modeled predictions are accurate. The goal of the study was to validate the sleep behavior model settings for a fatigue modeling tool that is used within the RCAF, the Fatigue Avoidance Scheduling Tool, taking into account the organizational requirements for pre- and postflight routines, especially within the Air Mobility force. ⋯ Current Fatigue Risk Management Systems require accurate fatigue and sleep behavior modeling, which can only be achieved by studying specific target populations to determine their culture of work/rest routines, and optimizing sleep behavior model settings accordingly.
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In August 2017, the USS Bataan received a mass casualty incident (MCI) of 6 foreign special forces operators after a helicopter crash. All 6 patients were medically evacuated successfully to the USS Bataan, and all patients survived and were successfully returned to their allied country. Four of the patients received whole blood with 2 receiving over 10 units of blood or massive transfusions. ⋯ In the era of distributed maritime operations, where casualty-receiving ships will experience more geographic and resource isolation, there is a potential for the need for prolonged stabilization above the 6 to 12-hour window typical of role II platforms. The known increase in cardiac and pulmonary morbidity and mortality with medical evacuation delay highlights the importance of internal medicine physicians in the role II setting. It is critical that we emphasize the inpatient and critical care principles of these patients in the prolonged field care environment.
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The Uniformed Services University of the Health Sciences coordinates a 2-week Summer Operational Experience (SOE) during the first year of medical school. The SOE aims to provide students with operational context and enhance familiarity with service-specific operational environments, the services' medical department capabilities, and/or general warfighter skills. One overarching goal of the SOE is to provide an experience that may motivate students to pursue an operational medicine assignment at some point in their military career. However, to date, little evaluation data have been collected regarding the effectiveness of the SOE in encouraging medical students to pursue operational medicine assignments. The purpose of this project was to develop and collect initial validity evidence for a survey instrument designed to assess various aspects of students' attitudes and behavioral intentions to pursue an operational medicine assignment at some point in their military career. ⋯ Findings from this study suggest the developed survey yields scores that can reliably assess students' attitudes, subjective norms, perceived behavioral control, and intentions to pursue operational medicine. Using this survey, course leaders have a tool for evaluating the success of the SOE and identifying potential areas for improvement within the curriculum. More broadly, other educators can use the theoretical framework and instrument design process described here to evaluate students' behavioral intentions in their own contexts.