Military medicine
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The U.S. Air Force's Intercontinental Ballistic Missile (ICBM) force stands ready to launch weapons 365 days per year. Since its inception, missileers vigilantly operate launch consoles on a 3-day cycle: minimum 24-hour alert-shift/24-hour travel-admin/24-hour off, leading to concerns that health, morale, and alertness are chronically impacted. In 2020, a Missileer Occupational Health Assessment (OHA) revealed 76% of respondents struggle with being rested for duty and 29% of respondents never feel adequately rested for duty. Later that year, 20th Air Force initiated long-duration operations to safeguard from the SARS CoV-2 (COVID-19) Pandemic, resulting in increased operations tempo, and exacerbating crew fatigue.341st Operations Group and 341st Medical Group at Malmstrom Air Force Base enacted interventions to mitigate crew fatigue and support continued readiness during pandemic operations. They recorded, analyzed, and compiled findings in this report, including recommendations for long-term ICBM operations at Missile Wings. ⋯ This analysis has identified a sustainable alert rotation of 7/7/7 with emphasis on protected recovery and training time and has been continued after concluding pandemic operations, creating consistent schedule stability where there once was none. If executed properly, this alert rotation, regardless of shift-length selected, has potential to improve trust between crews and leadership, provides adequate recovery time between alerts to maintain health, and improves wellness, family stability, morale, unit cohesion, and crew force retention. Notably, all Air Force Global Strike Missile Operations Groups adjusted scheduling practices to align with these findings.
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The U.S. Army fell 25% short of its recruitment goal in 2022 and therefore, increasing the eligibility pool for potential recruits is of interest. Raising the body mass index (BMI) standards for eligibility presents a path to increase the recruitable population; however, there may be additional costs incurred due to attendant health risks that may be present in individuals with higher BMI. ⋯ Potential recruits from Cluster 1 have excessive health risk and may incur substantial cost to the U.S. Army if enlisted. However, potential recruits from Cluster 3 appear to add little risk and offer an opportunity to increase the pool for recruiting.
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Global surgery and anesthesia is an emerging field in global health and academic medicine. Promoting the education of global surgery and anesthesia among uniformed medical students is imperative and will prepare the next generation of uniformed physicians for global surgical missions through both the DoD and civilian opportunities.
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During training and deployment, service members (SMs) experience blast exposure, which may potentially negatively impact brain health in the short and long term. This article explores if blast exposure mitigation can be effectively achieved for four different weapon training scenarios that are being monitored as part of the CONQUER (COmbat and traiNing QUeryable Exposure/event Repository) program. The training scenarios considered here are a detonating cord linear (det linear) breaching charge, a water breaching charge, a shoulder-fired weapon, and a 120-mm mortar. ⋯ Results show that the modification of the SMs' position effectively mitigated blast exposures for all considered weapon scenarios. There was at least a 50% overpressure reduction from the initial to modified standoff distances and a 35% reduction from the change in SM body posture. Based on these observations, new locations and body positioning of SMs during training have been suggested for blast mitigation.
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Research and development of military-required innovations are usually funded through the issuance of grants and contracts. The limitations of these funding methods are the a priori specifications and objectives that limit creativity and often do not produce capabilities beyond the desired outcomes or leverage the best ideas and solutions available. This limited engagement of commercial industry to develop military-required innovations usually relies solely on government funding and receipt of proposals from companies whose business model is built on receiving government grants and contracts, with the government owning most of the risks. ⋯ This often under-utilized pathway has several notable strengths such as (1) reduced risks and costs for the military to develop novel capabilities and products; (2) new and novel creative solutions to solve military problems; (3) utilizing a results-oriented approach that funds the successful achievement of acceptance criteria versus funding of potential to achieve; (4) enticing investors by increased competition for a successful product or capability; and (5) delivery of a commercially available, affordable, field-tested, and viable capabilities and products. Prize competitions may be used by any/all federal agencies as authorized by Congressional Public Laws and Federal regulations. The specifics of this pathway for funding pathway and applications for use by medical researchers, developers, and project/program managers are spelled out in the article, along with the regulatory guidance and resources for finding out more about current and past prize competitions.