Military medicine
-
Casualty evacuation has been identified as a typical and essential single military task which every soldier should be able to perform rapidly during combat. Previous studies suggest that casualty evacuation is typically conducted by dragging and demands e.g., lean body mass and anaerobic performance. Association of physical fitness with casualty evacuation by dragging has been studied widely but previous studies lack comprehensive assessment of all physical fitness determinants. The purpose of the present study was to examine comprehensively how casualty emergency evacuation (CEE) performance associates with physical fitness and body composition. ⋯ This study examined thoroughly how different physical fitness dimensions and body composition relate to a CEE test performed by a combination of dragging while crawling and in upright position. Casualty emergency evacuation was discovered as a high-intensity military task, which demands most importantly high anaerobic performance, lean body mass, and maximal strength capabilities. Improving these dimensions of physical fitness should be considered highly important as CEE is essential and possibly one of the most demanding military tasks which every soldier should be able to conduct in combat. From operational perspective, it is relevant that soldiers are able to perform CEE during operations; therefore, further research is needed on how acute operational stress changes the nature of CEE and its physical determinants.
-
Lyme disease (LD) is an underrated threat to the military that negatively impacts mission readiness. Lyme disease has traditionally been thought to only be a risk in an operational context, where training or deployments are frequently conducted in heavily wooded environments. However, this view diminishes risks posed by many off-duty outdoor recreational activities. Furthermore, although the Army introduced a permethrin factory-treated Army Combat Uniform in 2012, permethrin retention and subsequent protection have been shown to decrease significantly after 3 months of wear. Thus, although LD is a known health risk that threatens unit readiness, beyond using treated uniforms there has been little progress at the unit level to address this threat. ⋯ Lyme disease poses a genuine threat to the health and careers of service members and is an often-overlooked disruptor to military operations. Simple, feasible prevention strategies that are tailored to high-risk geographic regions can be emphasized by military units to reduce the incidence of on-duty and off-duty cases. Additionally, there remains a critical need for new preventative and diagnostic measures for LD.
-
The future of warfare is changing with anticipation of moving toward Agile Combat Employment in contested, degraded, and operationally limited environments. This will require some changes for behavioral health provision within the Air Force during deployments. With over a century of development and refinement, Combat and Operational Stress Control (COSC) has proven to be a sustainable model for behavioral health asset utilization to maximize unit combat effectiveness and individual personnel performance. ⋯ COSC teams are versatile: Both enlisted and officer providers have a dynamic opportunity to influence and shape the wellness of an entire population of service members. To maximize this potential, the Air Force needs to formally train for the COSC mission and consider realigning the active duty mental health personnel from working almost exclusively in the Mental Health clinic to primarily working in the units. Employing the key principles of COSC in garrison is possible; however, it will take significant effort and purpose to change from the current policy.
-
After an anterior cruciate ligament (ACL) injury, service members often undergo ACL reconstruction (ACLR) to restore knee stability, which is critical for performing physically demanding and unconventional military-specific tasks. Despite advancements in surgical techniques and rehabilitation protocols, a large portion of service members will not fully return to duty (RTD) post-ACLR and will receive a permanent profile restriction (PP) or undergo a medical evaluation board (MEB). The timing of ACLR is a modifiable factor that can potentially impact RTD and remains underexplored in this population. This study aimed to assess the relationship between the timing of ACLR and its impact on RTD and meniscal procedures performed at index ACLR. ⋯ The findings from this novel study suggest that ACLR within 3 months after injury can improve the likelihood of RTD without limitations. The timing of ACLR can also impact the incidence and type of meniscal procedures, as patients who did not undergo any concomitant meniscal procedures underwent ACLR within 6 months after injury. This study offers valuable insight into the importance of earlier ACLR among service members to improve RTD rates and decrease additional concomitant meniscal procedures.
-
The emergence of coronavirus disease 2019 (COVID-19) pandemic, driven by severe acute respiratory syndrome coronavirus 2, precipitated an unprecedented public health crisis, necessitating comprehensive response worldwide. The Ile-De-France region has been particularly affected, leading to rapid health care system strain and hospital saturation. Within this context, the 1st Armed Forces Medical Centre swiftly adapted its primary care services to cater to the unique needs of military personnel, leveraging telemedicine technologies for efficient health care delivery. ⋯ This study provides valuable insights into the clinical course of non-severe COVID-19 cases among military personnel receiving outpatient care, delineating five distinct symptom profiles. This complexity underscores the challenges in predicting and managing symptomatology effectively. Our findings align with existing literature but offer a unique perspective on military cohorts. Notably, in confined military settings with predominantly young and healthy individuals, symptomatic presentations tend to be milder. Robust public health interventions, including quarantine and contact tracing, are crucial to maintaining operational readiness amidst the pandemic's challenges.