Military medicine
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The Office of Naval Research sponsored the Blast Load Assessment Sense and Test (BLAST) program to develop a rapid, in-field solution that could be used by team leaders, commanders, and medical personnel to provide a standardized approach to operationally relevant monitoring and analysis of service members exposed to single or repeated low-level blast. A critical piece of the BLAST team's solution was the development of the Brain Gauge technology which includes a cognitive assessment device that measures neurofunctional changes by testing sensory perceptions and a suite of mathematical algorithms that analyze the results of the test. The most recent versions of the technology are easily portable; the device is in the size and shape of a computer mouse. Tests can be administered in a matter of minutes and do not require oversight by a clinician, making Brain Gauge an excellent choice for field use. This paper describes the theoretical underpinnings and performance of a fieldable Brain Gauge technology for use with military populations. ⋯ The overall objective of the work was to provide an efficient tool, or tools, that can be effectively used for (1) determining stand-down criteria when critical levels of blast exposure have been reached and (2) tracking the brain health history until return-to-duty status is achieved. Neurofunctional outcome measures will provide the scientific link between blast sensors and the impact of blast on biological health. This calibration process is strengthened with outcome measures that have a biological basis that are paralleled in animal models. The integrative approach that utilizes the Brain Gauge technology will provide a significant advance for assessing the impact of blast exposure and support rapid, science-based decision-making that will ensure mission success and promote the protection of brain health in service members.
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The lack of an integrated approach to data capture, information management, and analysis limits the contribution of occupational and environmental medicine to protecting 2.3 million uniformed and civilian DoD workers. Despite an abundance of military information systems that include the terms "Safety" and "Occupational Health" in their names, none of these systems provide capabilities needed to aggregate and analyze the results of occupational medicine exams, use medical surveillance to mitigate exposure incidents, provide enterprise-level management of occupational medicine services, or comply with privacy and recordkeeping law and regulation. ⋯ Bridging these capability gaps will improve the occupational health care of the DoD workforce, improve the quality of occupational medicine services, increase public trust in the DoD management of exposure incidents, and potentially generate hundreds of millions of dollars through cost-avoidance on workers' compensation claims and through identification and elimination of non-value-added medical certification exams. The ongoing Military Health System transformation represents a unique opportunity to bridge these long-recognized but persistent capability gaps.
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Decreases in routine healthcare practices have been shown to occur during disasters. However, research regarding the impacts of natural disasters, pandemics, or military conflicts on emergency medical services (EMS) is scarce. ⋯ This study shows decreasing trends in routine daily calls for EMS during both Operation Protective Edge and COVID-19. However, different patterns of needs for EMS were evidenced for medical illnesses, MVC, or calls concerning other injuries. These results are instrumental for managing the operational demands of EMS during military conflicts and pandemics.
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Directed energy exposure is a phenomenon that has been reported in Cuba and China by both U. S. and Canadian government employees. Persons exposed to directed energy report symptoms that resemble mild traumatic brain injury (concussion). ⋯ A 43-year-old male with suspected directed energy exposure developed progressively worsening headaches, dizziness, auditory/vestibular symptoms, balance problems, difficulty sleeping, and cognitive/emotional complaints while assigned by the Department of State to Guangzhou, China. His physical therapy care is outlined and discussed to provide an in-depth understanding of his care and additional ideas that might benefit future diplomats and government employees who experience dizziness, visual complaints, and balance problems after suspected directed energy exposure. Coordinated multidisciplinary care with benchmarks of function before deployment is advised by the National Academies of Sciences.
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Marines must complete an intensive Assessment and Selection (A&S) course before becoming a U.S. Marine Forces Special Operations Command (MARSOC) Raider. Following selection, marines are given training recommendations designed to maintain performance characteristics deemed relevant to successfully complete a rigorous 9-month Individualized Training Course (ITC). However, training strategies are individually implemented by the marine, and the time between the two courses is highly irregular, ranging between 2 months and 24 months based on operational factors related to military occupational specialty (MOS). The purpose of this study was to evaluate changes in performance between the completion of A&S and the start of ITC and to examine if the duration between courses and previous MOS influenced changes in performance. ⋯ Current training strategies appear effective at addressing performance deficits that occur as a result of A&S, while maintaining high levels of KF, KE, TE, TF, AC, and VO2max. However, pre-ITC students still exhibited AP deficits compared to active marine raiders, so forthcoming programming may benefit from an increased emphasis on AP. Assessment of additional selectees at these timepoints, as well as students before A&S may provide valuable information to MARSOC human performance specialists to develop programing, ultimately leading to a higher ITC graduation rate, increased force readiness, and decreased financial burden forcewide.