Airway ultrasound for the confirmation of endotracheal tube placement in cadavers by military flight medic trainees – A pilot study

Objective

Confirming correct endotracheal tube (ETT) placement is a key component of successful airway management. Ultrasound (US) as a tool for the confirmation of ETT placement has been investigated in the hospital setting but not in the pre-hospital setting. We hypothesized that after a short educational session, military flight medic trainees would be able to accurately identify ETT placement in a cadaver model.

Combating an invisible enemy:The American military response to global pandemics

The present moment is not the first time that America has found itself at war with a pathogen during a time of international conflict.Between crowded barracks at home and trenches abroad,wartime conditions helped enable the spread of influenza in the fall of 1918 during World War Ⅰ such that an estimated 20％-40％ of U.S.military members were infected.While the coronavirus disease 2019 (COVID-19) pandemic is unparalleled for most of today's population,it is essential to not view it as unprecedented lest the lessons of past pandemics and their effect on the American military be forgotten.This article provides a historical perspective on the effect of the most notable antecedent pandemic,the Spanish Influenza epidemic,on American forces with the goal of understanding the interrelationship of global pandemics and the military,highlighting the unique challenges of the current pandemic,and examining how the American military has fought back against pandemics both at home and abroad,both 100 years ago and today.     

The feasibility of implementing an evidence-based physical training program during a Canadian Armed Forces basic infantry course

ObjectivesDetermine the feasibility of implementing an evidence-based training program compared to a control during a basic infantry training course, and compare their effectiveness on measures of injuries and associated burdens.DesignProspective, cohort, feasibility study.MethodsInfantry candidates awaiting course between 01-April-2019 and 31-March-2020 were invited to participate while those releasing from the military, awaiting occupational transfer or having >5 medical employment limitation days were excluded. Consenting participants were allocated to an infantry course prospectively scheduled to host either the evidence-based program or a control. The evidence-based program adapted modified physical training strategies from previous studies reporting reduced injuries in recruits and was supervised by certified fitness professionals, while the control was at the discretion of infantry instructors.ResultsWith the exception of intervention duration which was limited due to operational factors, all feasibility outcomes were met including a recruitment rate of 171/203 = 84.2% and an intervention adherence of 126/144 = 87.5%. Stakeholders reported that the evidence-based program implementation was feasible, posing a manageable demand on resources without compromising operations. Evidence-based program participants reported 68% fewer overuse musculoskeletal injuries, 296 fewer medical employment limitation days and 11 fewer attritions than control participants.ConclusionsAn evidence-based training program is feasible to implement on a basic infantry training course, and results in fewer musculoskeletal injuries, medical employment limitation days and attrition. Given these results, this program should be generalizable for a full experimental trial, and may be scaled for intermediate/advanced infantry and/or other combat occupation courses to promote an evolution towards evidence-based training.     

Sex and occupation are salient factors associated with lateral ankle sprain risk in military tactical athletes

ObjectivesTo assess the risk of lateral ankle sprain (LAS) in male and female tactical athletes across different military occupations in the US military.DesignRetrospective cohort.MethodsThe Defense Medical Epidemiology Database was queried for the number of individuals with ICD-9 diagnosis codes 845.00 (sprain of ankle, unspecified) and 845.02 (calcaneofibular ligament sprain) on their initial encounter from 2006 to 2015. Relative risk (RR) and chi-square statistics were calculated assessing sex and occupational category on LAS risk.Results272,970 enlisted males (27.9 per 1000 person-years), 56,732 enlisted females (34.5 per 1000 person-years), 24,534 male officers (12.6 per 1000 person-years), and 6020 female officers (16.4 per 1000 person-years) incurred a LAS. Enlisted females in all occupational groups were at significantly higher risk for LAS than their male counterparts (RR 1.09–1.68; p < 0.001), except for Engineers (p = 0.15). Female officers had consistently higher risk for LAS in all occupational groups (RR 1.10–1.42; p < 0.001) compared with male officers, except Ground/Naval Gunfire (p = 0.23). Contrasted with Infantry, enlisted tactical athletes in the Special Operations Forces, Mechanized/Armor, Aviation, Maintenance, and Maritime/Naval Specialties were at lower risk (RR 0.38?0.93; p < 0.001), Artillery, Engineers, and Logistics Specialties were at higher risk (RR 1.04–1.18; p < 0.001), and Administration, Intelligence, and Communications were no different (p = 0.69). Compared with Ground/Naval Gunfire officers, Aviation officers were at significantly lower risk (RR, 0.75; p < 0.001), and Engineers, Maintenance, Administration, Operations/Intelligence, and Logistics officers were at higher risk (RR, 1.08–1.20; p < 0.001).ConclusionsSex and military occupation were salient factors associated with LAS risk.     

消防员明尼苏达多相人格量表测量

目的分析明尼苏达多种人格量表(MMPI)在消防部队的适用性以及消防员的个性心理特征和影响因素。方法通过分层比例抽样在全国消防基层中队抽取1500名官兵进行MMPI测试。结果有82.7%的个体测量可靠性佳;与全国常模相比,除Hs、Pd、Ma分量表外,其它量表的差异都达到了统计显著水平(t=-32.94～19.56,P<0.001)。效度量表L、K和临床量表Hy的得分比常模高,而F量表和其余6个临床量表(D、Mf、Pa、Pt、Sc、Si)得分低于常模;把临床量表中有1项以上T分>60的人员记为偏常人员,则偏常人员约占总数的36.9%。职别对MMPI量表的测量结果影响较为广泛,干部在Hs、D、Pt、Sc、Si等临床量表上有更低的得分(P<0.05)。结论消防员整体的心理健康状态尚好,但有较多的躯体不适和心理压力。职别是影响消防员心理状况的重要人口学因素。MMPI用于消防部队筛选效率较低,应用还需慎重。     

军校学员学习风格调查

目的探讨军校学员的学习风格。方法通过Myers-Briggs心理量表和感官偏爱测试表,调查某军校2010-2012年选修《时间管理与学习技巧》课程的所有学员的个性类型和感官偏爱等。结果军校学员的个性类型以内向为主,并呈逐年下降的趋势(χ2=7.320,P=0.026);2010年学员的感官偏爱主要是运动知觉,其次是听觉、阅读/写作、视觉,差别有统计学意义(χ2=12.400,P=0.006)。结论军校学员的个性类型以ISFJ(内向-直觉-情感-判断)为主,感官偏爱以运动知觉为主。掌握学员的学习风格,是科学有效的进行教学和学习的基础。     

某部女新兵集训期性激素变化、月经紊乱及相关研究

目的研究某部女新兵集训引起性激素、体质量及心理变化等对月经的影响。方法选取45名女新兵分别在集训前、集训第3个月时检测体内性激素;对女新兵用问卷调查、症状自评量表测评及磅秤测量体质量等方法调查分别在集训前、中、后半年及1年月经、心理及体质量等变化。结果集训中,女兵黄体期及卵泡期FSH、HL、P显著降低,E2、T、PRL显著升高;月经期E2、P升高显著,FSH、HL、T及PRL无显著性差异;月经紊乱及月经疾患发生率显著增高;体质量减少者显著增多。结论集训中女新兵性激素、体质量及心理变化对月经影响明显,故重视集训中女兵生殖卫生保健十分必要。     

Impact of the supine position versus left horizontal position on colonoscopy insertion: a 2-center,randomized controlled trial

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应用2014西雅图心电图判读标准筛查部队心血管高危患者的可行性研究

目的：探讨部队心血管高危患者筛查方法,以减少高强度军事训练中急性心血管事件乃至猝死的发生。方法采用问卷调查、查体、12导联心电图和心脏彩色多普勒超声综合筛选法对参加军事训练的320名官兵进行健康体检。分别依据2014西雅图心电图判读标准(西雅图组)、美国心脏学会(AHA)标准(AHA 组)以及二者综合判断(综合组),进行心血管高危患者筛查。比较各组筛查敏感性、特异性及阳性预测值、阴性预测值,并绘制受试者工作特征(ROC)曲线,计算曲线下面积。结果西雅图组和综合组筛查敏感性高于 AHA 组,且西雅图组筛查特异性高于其余两组,差异均有统计学意义(P <0．05);阳性预测值西雅图组较高,阴性预测值综合组较高。西雅图组、综合组 ROC 曲线下面积均高于 AHA 组,差异均有统计学意义(P <0．05)。结论采用2014西雅图心电图判读标准预测部队心血管高危患者优于 AHA 标准,联合应用两种方法有助于提高筛查的敏感性。