Experience in organizing epidemic control work in catastrophes

Maintenance of preventive medicine measures is one of the main part of national system of emergency health service in disasters. The priority in this activity belongs to the mobile autonomous units, which take measures for protection of population disaster regions and military personnel from infections diseases.     

军用食品研究进展

目的 分析和综述国外军用食品研发动态,为研制我军航空航天食品提供参考和思路.资料来源与选择国外该领域的相关研究论文、文章、综述以及美国政府AD报告. 资料引用引用论文、文章和综述以及美国政府AD报告共23篇. 资料综合近年来外军军用食品研究进展很快.通过采用多项高新技术,例如超高压杀菌技术、微波技术、微胶囊包埋技术、食品自加热技术和食品包装新材料.包括高阻隔包装材料与吸收氧气材料有机结合以及食品储存技术的综合应用不断推进军用食品革新.其主要目标是提高食品长时间食用的感官接受性,并改进包装以有效延长食品保质期,使食品更加适合在各种战场环境中食用.此外,研发通过皮肤吸收的营养输送系统等新概念食品为研发军用食品提供了崭新的思路和理念,尽管距离实用阶段还有一段距离.外军军用食品研究新思路体现在给食品赋予抗疲劳和增强免疫力等多种功能性;完善餐谱多样化以满足部队战场多样化需求. 结论 外军将高新技术应用于军用食品研发领域,使军用食品不断改进,主要集中在提高食品接受性、延长贮存期、研发新概念食品、开发自热食品和研制营养模块,并且注重系列化、餐谱化、功能化.这些最新研发动向对我军研制航空航天食品具有借鉴和参考价值.     

军用食品研究进展

目的 分析和综述国外军用食品研发动态,为研制我军航空航天食品提供参考和思路.资料来源与选择国外该领域的相关研究论文、文章、综述以及美国政府AD报告. 资料引用引用论文、文章和综述以及美国政府AD报告共23篇. 资料综合近年来外军军用食品研究进展很快.通过采用多项高新技术,例如超高压杀菌技术、微波技术、微胶囊包埋技术、食品自加热技术和食品包装新材料.包括高阻隔包装材料与吸收氧气材料有机结合以及食品储存技术的综合应用不断推进军用食品革新.其主要目标是提高食品长时间食用的感官接受性,并改进包装以有效延长食品保质期,使食品更加适合在各种战场环境中食用.此外,研发通过皮肤吸收的营养输送系统等新概念食品为研发军用食品提供了崭新的思路和理念,尽管距离实用阶段还有一段距离.外军军用食品研究新思路体现在给食品赋予抗疲劳和增强免疫力等多种功能性;完善餐谱多样化以满足部队战场多样化需求. 结论 外军将高新技术应用于军用食品研发领域,使军用食品不断改进,主要集中在提高食品接受性、延长贮存期、研发新概念食品、开发自热食品和研制营养模块,并且注重系列化、餐谱化、功能化.这些最新研发动向对我军研制航空航天食品具有借鉴和参考价值. Abstract： Objective To analyze and overview the latest research and development of foreign military rations so as to provide ideas and references to our aviation and space military ration.Literature iesources and selection Foreign theses,research articles,reviews and U.S.government AD reports in the food related fields.Literature quotation Twenty-three pieces of thesis.paper article and review were cited.Literature synthesis The researches of military ration have been rapidly developed in recent years.Many high-technologies,such as ultra-high pressure sterilization technology,microwave technology,microcapsule embedding technology,self-heating ration technology and new food packing materials,including high-separating packing materials,oxygenabsorbing materials and food storage technology,which brought a great deal of innovations for military food have been adopted.The main aims of these researches are to increase the food acceptance for long time consumption.upgrade packing to prolong the shelf life in order to make rations more suitable to eat in different battle-field environments.Moreover,although it still needs time to step in practical application,but researching on new concept ration,such as delivery system of the nutrients under subcutaneous,is providing brand-new idea for military ration research and development.The new research of military ration also focused on food functions,such as anti-fatigue and immune enhancing function,and the development of more food menus to guarantee the military requirement in different battle fields. Conclusions High technologies have been used in military ration development to constantly improve its applicability.The main research issues have been focused on high acceptability,longer shelf life,new concept ration,self-heating ration and nutriment pack.Special attention has been paid to develop more menus to the ration and more special purpose-ration as well as add the components with physiological function to ration.All these information can be used as reference for our development of aviation and space military ration.     

Lessons learned: Operation Anaconda

With the recent long deployments of our military, a review of lessons learned becomes a vital part of mission success and helps to shape our forces for future conflicts. This article examines some medical issues that were experienced by the Raider Rakkasans of the 101st Airborne (Air Assault) Division during Operation Anaconda in Afghanistan. Topics include nutrition, altitude sickness, medical evacuation requests, and the evacuation of wounded on resupply platforms (back-hauling). When nutritional aspects of war fighting were discussed, an emphasis was placed on making a greater variety of field rations accessible to the force with the addition of a multivitamin to each ration. Also, a meal high in caloric content before infiltration and an education/inspection program to ensure the maximum benefit of each ration was reviewed. The use of acetazolamide to combat altitude sickness was also discussed. Dosing of 250 mg BID 24 hours before a rapid assent, then 125 mg BID for 4 days was suggested. Line three of the medical evacuation request was also reviewed for reporting inaccuracies. Complete physical examinations and direct dialogue between medical personnel and commanders was stressed. Last, a standard medical package to accompany any resupply during hostilities was advised, instead of releasing ground medical personnel to attend the wounded when using this for an evacuation platform.     

Historic aeromedical perspective on left bundle branch block

Military aviators represent a very highly trained, expensive personnel resource. It is incumbent upon the military medical care systems to manage the health aspects of this resource as wisely as possible. This can best be accomplished through a combination of preventive medicine and health promotion oriented clinical care coupled with epidemiologically sound aeromedical standards which ensure that flying safety and mission completion will not be compromised. Epidemiologically sound aeromedical standards, in most cases, can be formulated only through responsible clinical aeromedical research and investigation which is performed within the population for which the aeromedical standards are intended.     

Influence of a carbohydrate drink on nutritional status, body composition and mood during desert training

BACKGROUND: Nutritional intake by military personnel is typically inadequate during field exercises, potentially compromising health and performance. HYPOTHESIS: Drinking a supplemental carbohydrate (CHO) beverage will increase total caloric intake and maintain nutritional status during military training in the desert. METHODS: A total of 63 volunteers were randomly assigned to one of two groups to receive either a CHO or placebo beverage with military rations during an 11-d desert field exercise. Fluid intake was ad libitum and adequate rations were provided. Blood samples were collected twice to assess nutritional status, and nutrient intake was determined with consumption data. Mood state was examined by questionnaire. RESULTS: Energy intake was significantly higher in the CHO group (3050 kcal x d(-1) vs. 2631 kcal x d(-1)), with additional CHO from the beverage providing energy with some compensation by reduced fat and protein intake. Intakes of energy, folacin, calcium, magnesium, iron, and zinc in both groups were inadequate, with intakes significantly lower (p<0.05) for calcium, magnesium, and zinc in the CHO beverage group. Blood parameters of nutritional status remained within normal ranges with no differences between groups, but significant decreases were seen in pre-albumin. No changes in mood were seen during the training, nor after exposure to desert conditions. CONCLUSIONS: The operational ration supplemented with a CHO beverage significantly increases CHO and energy intakes compared with standard rations and maintains nutritional status for short exercises. Fortification with micronutrients most at risk for deficient intake from foods may be needed for longer deployments.     

Battle fatigue identification and management for military medical students.

Battle fatigue, a temporary response to the stress of combat capable of reducing the fighting force by 10% to 50%, is an inevitable consequence of military conflict. Effective application of established preventive and management techniques by line and medical corps personnel can turn this "force reducer" into a "force multiplier," returning 80% or more of these seasoned troops to their original units within 72 hours. The proper management of battle fatigue is an essential readiness element in the medical support mission. The "Battle Fatigue Identification and Management" course prepares future military medical officers for this important contingency role.     

Career History Archival Medical and Personnel System

The Career History Archival Medical and Personnel System is a database that provides information on cancer, chronic diseases, occupational and preventive medicine, epidemiological research, and the use of health care in the Navy and Marine Corps. It was created at the Naval Health Research Center for enlisted Navy personnel, and it is being expanded to encompass all military personnel. Its objective is to provide a comprehensive, chronologically ordered database of career and medical events in all active duty military service members and to track career and disease events in order from the date of entry to service to the date service ended. Events include the dates of beginning and ending of each specific military occupation, all assignments to a military units or ships, all hospitalized diseases, and other events. The database contains detailed epidemiological data on more than six million members of the military services. It is the largest known epidemiological database in the United States.     

Attendances at a field hospital emergency department during operations in Iraq November 2003 to March 2004 (Operation Telic III)

OBJECTIVE: This study investigated the types of presentations; time lines and disposal of patients from the international, local and military community in Southern Iraq. METHODS: All presentations to the Emergency Department (ED) were clinically and demographically coded and entered onto an electronic database. RESULTS: During the period studied the emergency department dealt with 1455 new presentations of which 75% were UK Armed Forces personnel. CONCLUSIONS: This represented a busy period in the field hospitals time in Iraq and offered valuable training to emergency medicine trainees in an unusual environment.     

Common sense strategies for accident and injury prevention

The author presents a comprehensive set of initiatives and strategies for military line and medical commanders for developing effective injury prevention programs. These are not necessarily taken from preexisting written policies and instructions. Rather, they are based on his experiences in the preventive and occupational medicine field. These recommendations are for military personnel, their dependents, and federal civilian employees, and should be applied at work, at home, and during recreation.     

Military internal medicine resident performance on the American Board of Internal Medicine Certifying Examination

The mission of military graduate medical education in internal medicine is to produce high-quality military internists prepared to practice in military environments. Board certification in internal medicine is an important outcome of internal medicine residency training. The American Board of Internal Medicine Certifying Examination (ABIMCE) first-taker pass rate of the graduates of an internal medicine residency program is a key measure of the quality of the program. We compared the ABIMCE first-taker pass rates for military and civilian internal medicine residency program graduates. Military internal medicine residency graduates had higher first-taker pass rates than their civilian counterparts. This is likely a reflection of the high-quality residents and the faculty at military programs. These results support the notion that military internal medicine residency programs continue to fulfill their mission of training high-quality internists.     

The Recruit assessment Program: a program to collect comprehensive baseline health data from U.S. military personnel.

Pilot testing has begun on the Recruit Assessment Program (RAP). The RAP is a proposed Department of Defense (DoD) program for the routine collection of baseline demographic, medical, psychosocial, occupational, and health risk factor data from all U.S. military personnel at entry into the armed forces. The RAP currently uses an optically scannable paper questionnaire, which will provide data for the first building block of an electronic medical record within the DoD and the Department of Veterans Affairs. The RAP will serve several important functions, including automating enrollment into the military health care system, improving patient care and preventive medicine efforts, and providing critical data for investigations of health problems among military personnel and veterans. If the feasibility of the RAP is demonstrated and the program is fully implemented throughout the DoD, it could provide a substantial improvement in health care delivery. For the first time, DoD and Department of Veterans Affairs physicians, public health officers, and researchers will have access to comprehensive baseline health status data.     

武警某部特种分队饮食及营养素供给和能量消耗调查

 目的了解武警某部特种分队战士的饮食状况,提出饮食营养建议,保障官兵身体健康,提高战斗力.方法采用3 d饮食称量法进行饮食调查,应用生活观察法进行24 h能量消耗量计算.结果参照军标二类灶供给能量及营养供给量,该连队能量及生热营养素均超标,这与中队战士实测人均能量消耗不符,执行军标二类灶标准无法满足战士正常军事训练强度.参照军人饮食能量及营养素供给量标准陆勤极重度劳动进行评价,该中队的饮食供应情况基本良好,能量供应能满足日常训练的要求,除脂肪摄入量超标外其他生热营养素的摄入量及产热比基本达标;矿物质中钙摄入量略显不足,为标准的92.2%,其余达标,维生素均未达标.结论该中队能量供应基本达标,但饮食结构欠合理.建议调整饮食结构,适当增加动物内脏及牛羊肉等食物,减少动物脂肪的摄入,提倡食物品种多样化.     

Laser surgery procedures in the operational KC-135E aviation environment.

The operational aviation and space environments present a potential for surgical trauma to aircrew and passengers. Current wound care techniques for trauma in the aviation and space medicine environment focus on classical surgical management of wounds. Medical lasers used in these environments can provide rapid control of bleeding wounds, reduce aircraft environmental contamination from body fluids and secretions, and foster rapid triage of injured personnel. Self-contained and reusable medical lasers have the potential to reduce the material supply of medical kits in the aviation and space environment. A miniaturized carbon dioxide laser was used to establish protocols and procedures for use on operational military KC-135E aircraft. Laser surgery was performed to demonstrate laser efficacy and safety in flight.     

Primary care enrollment levels in staff- and group-model health maintenance organizations: a standard to compare military enrollment with civilian organizations

A literature review was conducted to determine civilian staff- and group-model health maintenance organization (HMO) primary care provider staffing. Civilian staff- and group-model HMOs enroll an average of 1,473 members per primary care physician. When physician extenders are considered, the average enrollment is 1,156 members per primary care provider. Despite the similarities between the staff- and group-model HMO and military medicine, military medical care is significantly different and may decrease the capability for enrollment as a result of mission support, occupational medicine, and other military-unique factors. Comparisons between military and civilian enrollment should be tempered with these considerations.     

Veterinary services in disasters and emergencies

Potential man-made or natural disasters could overwhelm the residual medical and surgical capacity. Veterinarians have the training and experience to augment physicians in caring for human casualties, and dispersed veterinary hospitals constitute survivable facilities that are equipped to provide medical and surgical care. Veterinarians can also serve public health and preventive medicine and maintain the health of agricultural livestock as food sources. Civil defense planning must include veterinarians so that these valuable medical care resources can be used to save lives that might otherwise be lost.     

An operationally oriented approach to medical care in space.

As plans to bring the United States into the realm of continuously manned space operations are written, questions concerning the medical support of those operations have been raised. A review of the simple, time-tested principles that guide military operational medicine can be applied to medical care in space. Based on this operational approach, I conclude that a successful medical team must understand the mission, identify medical resources, define medical evacuation capabilities, anticipate medical issues and plan solutions, and develop facility requirements. Once all this has been accomplished, appropriate selection and training of medical personnel completes the preparation.     

某部潜艇人员长航期间膳食结构调查分析

目的 了解某部潜艇人员长航期间膳食营养状况和存在问题,为保障潜艇官兵健康以及制定军人营养素供给量、食物定量标准提供依据.方法 膳食调查采用记帐法,能量消耗采用能量平衡法.结果 (1)猪肉、牛羊肉、脏腑、禽蛋、鱼虾、乳粉、豆类及制品、食糖、蔬菜、木耳、海带、紫菜摄入量偏低.(2)热能71.1%来源于植物性食物,而摄入动物性蛋白质占摄入蛋白质总量的50.1%,符合军标要求,动物性脂肪占摄入脂肪总量的69.9%,超过军标要求.(3)人均每日维生素A、维生素E和维生素B1的摄入量明显低于军标,胆固醇摄入量明显超过军标.另外,人均每日摄人大量钠.结论 受调查的潜艇部队长航期间能量和多数营养素的摄入量能达到军标要求,维生素A、维生素E和维生素B1的摄入量偏低,胆固醇摄入量偏高,应增加牛羊肉、蔬菜、牛奶、禽蛋、鱼虾等水产品的供应,减少动物脂肪的摄人,减少食盐等调味品的摄入.     

Description of risk and resilience factors among military medical personnel before deployment to Iraq

Military medical personnel preparing for deployment to Iraq (N = 328) participated in a survey concerning predeployment risk and resilience factors. Participants reported exposure to an average of 2.5 potentially traumatic events before deployment and 76% (n = 229) reported at least two current concerns about predeployment stressors. Military personnel also endorsed a series of positive appraisals of the military, the mission, and their unit. Fairly low levels of post-traumatic stress disorder symptoms before deployment were reported and positive affect was significantly higher than reported negative affect. Post-traumatic stress disorder symptoms that were present before deployment were most strongly associated with risk factors, whereas positive affect was most strongly associated with resilience factors. Predeployment negative affect was associated with a combination of risk and resilience factors. These findings have implications for possible interventions and preparation of medical personnel before military deployment. A better understanding of the factors related to risk and resilience in military medical personnel will allow for improved screening, educational, training, and clinical programs aimed at increasing resilience before military deployments.