Injury and fitness outcomes during implementation of physical readiness training

This study examined injury and physical fitness outcomes in Basic Combat Training (BCT) during implementation of Physical Readiness Training (PRT). PRT is the U.S. Army's emerging physical fitness training program. An experimental group (EG, n = 1284), which implemented the PRT program, was compared to a control group (CG, n = 1296), which used a traditional BCT physical training program during the 9-week BCT cycle. Injury cases were obtained from recruit medical records and physical fitness was measured using the U.S. Army Physical Fitness Test (APFT, consisting of push-ups, sit-ups and a two-mile run). Injury rates were examined using Cox regression after controlled for initial group differences in demographics, fitness and other variables. Compared to the EG, the adjusted relative risk of a time-loss overuse injury in the CG was 1.5 (95 % confidence interval [CI] = 1.0 - 2.1, p < 0.01) for men and 1.4 (95 %CI = 1.1 - 1.8, p < 0.01) for women. There were no differences between groups for traumatic injuries. On the first administration of the final APFT, the EG had a greater proportion of recruits passing the test than the CG (men: 85 % vs. 81 %, p = 0.04; women: 80 % vs. 70 %, p < 0.01). After all APFT retakes, the EG had significantly fewer APFT failures than the CG among the women (1.6 % vs. 4.6 %, p < 0.01) but not the men (1.6 % vs. 2.8 %, p = 0.18); the gender-combined EG had a higher pass rate (1.6 % vs. 3.7 %, p < 0.01). Overall, the PRT program reduced overuse injuries and allowed a higher success rate on the APFT.     

武警部队战士体能训练健康促进的思考

中国人民解放军军事训练条例总则第三条指出：“军事训练是提高部队战斗力的根本途径,是军队履行职能的主要保证,全军必须把军事训练作为和平时期部队工作的中心.”在武警部队,随着《军事训练和考核大纲》的不断完善,对军事训练给予了更多的关注,尤其是对体能训练的关注.在科技练兵的新时期,如何在保障战士身体健康的基础上,提高其体能水平,是部队卫生工作者必须要解决的问题.     

Retention in service of recruits assigned to the army physical fitness test enhancement program in basic combat training

Recruits are assigned to the Army Physical Fitness Test Enhancement Program (APFTEP) if they are unable to pass the final Army physical fitness test at the end of basic combat training (BCT). The U.S. Army Medical Command tasked the U.S. Army Center for Health Promotion and Preventive Medicine to examine the retention in service of individuals completing this program. To accomplish this tasking, the following data were obtained: a list of APFTEP recruits at Fort Jackson, South Carolina between January 1999 and June 2001; a list of BCT graduates from the Army Training Requirements and Resources System; and a comparison group of non-APFTEP recruits matched 3 to 1 on the basis of age, gender, Army entry date (+/- 30 days), BCT location, and active Army status from the Army Medical Surveillance Activity. We found that the proportion of recruits who successfully completed the APFTEP and graduated from BCT (85% of men, 80% of women) was lower than documented graduation rates for all recruits (93% of men, 87% of women). Retention in service after 1 year was also lower for APFTEP recruits than for non-APFTEP recruits among both men (74% vs. 92%, p < 0.01) and women (63% vs. 84%, p < 0.01). Despite the lower BCT graduation success and retention in service for APFTEP recruits, the program does assist in retaining soldiers who would otherwise be discharged for failing the Army physical fitness test. Thus, the program may be a useful tool for limiting attrition.     

美军伊拉克和阿富汗战争战伤救治新理念

“战术战伤救治”的概念最早由美海军特种作战部队于1996年首次提出,在伊拉克和阿富汗战争中成为美军战术环境中伤员救治的标准规范,也是美军伊拉克和阿富汗战争中战伤救治取得的一大进展.战术战伤救治的应用使美军达到了有史以来最低的伤亡率.该文梳理了美军战术战伤救治理念的发展,分析了战术战伤救治的阶段划分,探讨了美军战术战伤救治的组织实施,并提出了对我军的启示.     

A review of radiation countermeasure work ongoing at the Armed Forces Radiobiology Research Institute

Purpose: The hazard of exposure to ionizing radiation is a serious public and military health concern that has justified substantial efforts to develop medically effective radiation countermeasure approaches, including radiation protectors, mitigators, and therapeutics. Although such efforts were initiated more than half a century ago, no safe and effective radiation countermeasure has been approved by the United States Food and Drug Administration (FDA) for the acute radiation syndrome. This situation has prompted intensified research among government laboratories, academic institutions, and pharmaceutical companies to identify a new generation of countermeasures. In this communication we discuss selected promising radiation countermeasures at advanced stages of development.

Conclusion: Other than granulocyte colony-stimulating factor, which has an Emergency Use Investigational New Drug (IND) status, four countermeasures have FDA IND status and other promising countermeasures are in development. Here we review primarily the in vivo efficacy of selected countermeasures in animal models and clinical studies.     

A review of radiation countermeasure work ongoing at the Armed Forces Radiobiology Research Institute

PURPOSE: The hazard of exposure to ionizing radiation is a serious public and military health concern that has justified substantial efforts to develop medically effective radiation countermeasure approaches, including radiation protectors, mitigators, and therapeutics. Although such efforts were initiated more than half a century ago, no safe and effective radiation countermeasure has been approved by the United States Food and Drug Administration (FDA) for the acute radiation syndrome. This situation has prompted intensified research among government laboratories, academic institutions, and pharmaceutical companies to identify a new generation of countermeasures. In this communication we discuss selected promising radiation countermeasures at advanced stages of development. CONCLUSION: Other than granulocyte colony-stimulating factor, which has an Emergency Use Investigational New Drug (IND) status, four countermeasures have FDA IND status and other promising countermeasures are in development. Here we review primarily the in vivo efficacy of selected countermeasures in animal models and clinical studies.     

Prevention of tobacco addiction in the Armed Forces

The problems of tobacco smoking among servicemen are analyzed from the position of their interrelations with the quality of service duties performance. On the basis of received data the conclusion is drawn that the servicemen with tobacco dependence are characterized by lower level of mental resilience, adjustment capacities and are related to lower category of fitness for duty. Based on analyzes of the world and own country experience the program of tobacco smoking prevention among servicemen is proposed.     

Adapting the Swedish Armed Forces medical services to meet new challenges

The land battle today is different from that of 20 years ago. It now occurs over vast areas, the fluid battlefield. Tanks have undergone important changes (cross-country capability, improved armor, and more lethal weapons). The combat units contain armored personnel carriers, providing protection for the soldier. The weapon effects on armored vehicle personnel are well studied and include ballistic, blast, thermal, and toxic injury. However, casualty statistics for armored units are not extensively reported. The public acceptance of casualties, especially in peacekeeping operations, today is much lower than in the past. A study by the Swedish Armed Forces has identified the need for a new organizational structure. Casualties will be picked up on the battlefield by armored medical evacuation vehicles and transported directly to the battalion aid station. The training level of all medical personnel must be increased, using battlefield-related trauma courses and making better use of existing resources in the form of qualified medical practitioners.     

Increasing the physical fitness of low-fit recruits before basic combat training: an evaluation of fitness, injuries, and training outcomes

Recruits arriving for basic combat training (BCT) between October 1999 and May 2004 were administered an entry-level physical fitness test at the reception station. If they failed the test, then they entered the Fitness Assessment Program (FAP), where they physically trained until they passed the test and subsequently entered BCT. The effectiveness of the FAP was evaluated by examining fitness, injury, and training outcomes. Recruits who failed the test, trained in the FAP, and entered BCT after passing the test were designated the preconditioning (PC) group (64 men and 94 women). Recruits who failed the test but were allowed to enter BCT without going into the FAP were called the no preconditioning (NPC) group (32 men and 73 women). Recruits who passed the test and directly entered BCT were designated the no need of preconditioning (NNPC) group (1,078 men and 731 women). Army Physical Fitness Test (APFT) scores and training outcomes were obtained from a company-level database, and injured recruits were identified from cases documented in medical records. The proportions of NPC, PC, and NNPC recruits who completed the 9-week BCT cycle were 59%, 83%, and 87% for men (p < 0.01) and 52%, 69%, and 78% for women (p < 0.01), respectively. Because of attrition, only 63% of the NPC group took the week 7 APFT, compared with 84% and 86% of the PC and NNPC groups, respectively. The proportions of NPC, PC, and NNPC recruits who passed the final APFT after all retakes were 88%, 92%, and 98% for men (p < 0.01) and 89%, 92%, and 97% for women (p < 0.01), respectively. Compared with NNPC men, injury risk was 1.5 (95% confidence interval, 1.0-2.2) and 1.7 (95% confidence interval, 1.0-3.1) times higher for PC and NPC men, respectively. Compared with NNPC women, injury risk was 1.2 (95% confidence interval, 0.9-1.6) and 1.5 (95% confidence interval, 1.1-2.1) times higher for PC and NPC women, respectively. This program evaluation showed that low-fit recruits who preconditioned before BCT had reduced attrition and tended to have lower injury risk, compared with recruits of similar low fitness who did not precondition.     

Predictors of successful physical readiness testing under the new standard: OPNAV Instruction 6110.1F

A new physical readiness testing (PRT) instruction, OPNAV Instruction 6110.1F, specifying tougher standards compared with the previous standard was issued in May 2000. The purpose of this research was to describe differences in PRT results under the old and new standards, to describe body mass index (BMI) results, to compare BMI results with body composition assessment results, and to elucidate predictors of successful PRT results under the new standards. Using a retrospective cohort design, cross-sectional analysis was performed on data from 1,564 active duty subjects at the Naval Medical Center Portsmouth. Whereas, under the old standards, the distribution of PRT results was skewed toward high scores, the distribution of scores was normal under the new standards. BMI results demonstrated a problem with obesity in the cohort and correlated poorly with body composition assessment. Predictors of successful PRT were normal/underweight BMI, body composition within standards, officer rank, and age > or = 30 years.     

美军战现场纸质医疗文书的演变及启示

该文通过介绍美军战现场纸质医疗文书的演变过程,比较了美军野战医疗卡、2009年及2013年版战术战伤救治卡填写的主要内容、填写人员和方式及伤病员携带方式,归纳总结了美军战现场医疗后送文书的发展趋势与特点,为我军未来纸质及电子伤票的优化提供借鉴。