Incorporating new recipes into the Armed Forces Recipe File: determination of acceptability

As part of a project of decrease fat, cholesterol, and sodium in soldiers' diets, new ethnic and breakfast items were developed and standardized for 100 portions. Acceptability data were collected after initial recipe development, during recipe validation at a collaborating university, and in an actual Army garrison. Acceptability was determined using a nine-point hedonic scale; products rating > or = 6.0 in initial tests were prepared in garrison. Acceptability data were compared among test settings, ethnic categories, and food type. When grouped by ethnic categories, acceptability ratings varied more than when grouped by food type. Ratings varied most between development and validation settings (7.2 vs. 6.6; p < 0.05) and least between validation and actual Army settings (6.6 vs. 6.6; not significant). Because acceptability ratings were similar between the validation site and the Army garrison, future recipe development may continue without additional testing at actual Army garrisons, leading to more timely armed forces recipe file additions.     

Mentoring and monitoring: the use of unit watch in the 4th Infantry Division

A unit watch is an intervention used by Army mental health care clinicians to assist soldiers in regaining mastery over impulsive or dangerous behaviors. Although widely used, it is controversial because of concerns for soldiers' safety and lack of formal study into its efficacy as a treatment option. A retrospective chart review conducted at the 4th Infantry Division Mental Health Section gathered demographic and diagnostic information on soldiers placed on unit watch during the year 2000. The results showed the intervention to be used most commonly with young, junior-grade enlisted soldiers without serious psychiatric diagnoses. Its effectiveness appeared to arise from increased social support during times of stress (mentoring) as well as close observation of the soldier by unit members to discourage impulsive or dangerous behavior and ensure immediate assistance if necessary (monitoring). This article will discuss these benefits as well as highlight potential problems and suggest areas for further study.     

The psychologist's role in the Garrison mission of combat stress control units

Active duty psychologists frequently are called upon to provide services that extend beyond the model of direct patient care. Army psychologists in combat stress control teams or division mental health services, Navy psychologists deployed to surgical companies, and Air Force psychologists deployed with air-transportable hospitals or mental health rapid response teams may find themselves acting as organizational consultants as well as clinicians. Psychologists assigned to hospitals and clinics also have opportunities to make contact with their units for purposes of consultation and education. Organizational consultations that offer interventions for improving unit readiness and/or increasing combat effectiveness are often welcomed by commanders and provide a mechanism for the application of training and experience directly to military populations. Transferring skills from patient care to performance enhancement may not be a clear progression for many clinicians. This article describes the strategies and materials developed as part of a combat stress control garrison mission at Fort Lewis, Washington, as an example of one approach to working with combat units. The article also calls for the development of a formal mechanism to train psychologists for such roles and for the maintenance and dissemination of research materials to support organizational interventions.     

The Neurocognition Deployment Health Study: a prospective cohort study of Army Soldiers

Questions remain regarding the effects of military operational deployment on health. The Neurocognition Deployment Health Study addresses several gaps in the deployment health literature, including lack of baseline health data, reliance on subjective measures of exposure and health variables, prolonged intervals between redeployment and health assessments, and lack of a uniform case definition. The Neurocognition Deployment Health Study uses a prospective cohort design to assess neuropsychological outcomes associated with Iraq deployment. Methods incorporate administration of performance-based neuropsychological measures to Army soldiers before and after Iraq deployment and to nondeployed Army Soldiers assessed during comparable periods of garrison duty. Findings should have the potential to delineate neuropsychological outcomes related to combat theater deployment and to identify potential risk and protective factors related to health outcomes.     

Walter Reed Army Medical Center and unit healthcare administration--the historical rationale for developing this organizational structure

This article looks at the historical rationale behind the development of the healthcare administration structure currently used at Walter Reed Army Medical Center (WRAMC). This type of healthcare administration structure is unique to WRAMC and is not found in any other United States Army Medical Department healthcare treatment facility. It is the intent of this article to expose the military medical community-at-large to the historical factors that lead to the implementation of this healthcare administration structure. The purpose of this article is to serve as an historical treatise with the sole intent of providing an insight into one aspect of the organizational development and history of a national treasure--Walter Reed Army Medical Center.     

高原边防驻营区及野外驻训部队军人体格健康状况的研究

目的 调查高原低氧环境对军人身体指标的影响,以及高原驻训期间军人体格指标的变化,为保障人员体格强健提供参考依据.方法 根据《军队营养调查与评价方法》(GJB 1636A-2016)和《中国人民解放军战士身体发育测量及评价》(GJB 1102-91)的方法对驻高原4000~4600 m营区及4300 m野外驻训部队官兵进行体格指标的检测,并根据标准对相关结果进行评价.结果 与10年前阿里地区驻训部队人员指标相比,其BMI、上臂肌围、皮褶厚度、体脂含量均增加且接近平原值.4000和4600 m海拔两个单位人员的体格指标无显著差异.野外驻训部队人员上臂肌围显著高于驻营区部队,且BMI、皮褶厚度和体脂含量显著低于驻营区部队.与驻营区部队相比,驻训部队BMI和上臂肌围的构成比无显著差异,而体脂含量偏低的人员比例显著高于驻营区部队,体脂含量正常和偏胖人员比例显著低于驻营区部队.结论 驻高原地区军人体格指标不受海拔影响,而随着营养膳食保障力量的提高,军人身体指标得到改善,体内蛋白质和脂肪储备增加.野外驻训部队与驻营区部队军人相比,其肌肉含量更高,体脂更低,体格更健硕.     

Becoming a successful division psychiatrist: the sequel

Psychiatric residents in military residency programs participate in military-oriented training designed to help them prepare for military operational positions. One such position is that of the division psychiatrist. There are many differences in the duties of such an operational psychiatrist and those of their civilian counterparts. This article is meant to outline guidelines and tactics for success in a military operational environment. The article covers the topics of personal preparation, clinical and preventive duties, and leadership roles of the division psychiatrist. Much of the article may be generalized and beneficial to mental health and non-mental health Army, Navy, and Air Force personnel as well.     

A model for marketing in the military health care setting

Current literature demonstrates a lack of discussion relative to the marketing of military health care. This is unfortunate, as marketing should be approached as a valuable tool for showing the quality of work provided by a medical facility and for improving consumer relations. The benefit is a public better educated about the military health services system and more attuned to the rationale behind various types of access and availability decisions. This article provides a marketing process usable by military hospitals and health care organizations.     

Occupational health development in the Army.

Occupational Health (OH) in the Army is provided as part of an integrated primary healthcare service. When compared to the International Labour Organisation criteria for the provision of OH, it can be seen that the Army provides all of the OH elements expected in a large national organisation. However, there is a need to enhance the clinical element of the service and to provide a focus for implementing OH policy at unit level. The use of qualified OH nurses based at GP group practices and providing a visiting service to units would rectify this balance as this would enable workplace assessments to be carried out on a regular basis, enhance the ability to carry out occupational health assessments and facilitate health surveillance data collection. The result would be the improved delivery of OH services to Army personnel, thus helping to maximise the number of soldiers and officers fit to carry out their military duties.     

Fluid consumption and the potential role of canteen shape in minimizing dehydration

Hypohydration can unknowingly occur in military personnel during exertion, especially in the heat. Such dehydration can impair cognitive and physical performance. Some portion of exercise-induced dehydration may be offset by changing the perceptual biases of soldiers when filling and drinking from canteens. Using comparably sized water bottles, we investigated this perceptual bias with 50 Army and Marine ROTC students by showing that those given short, wide, clear water bottles poured and drank more water than those given taller bottles that held the same volume. Even although those given short, wide water bottles poured 38% more water, they did not perceive themselves as having poured or drunk more. The implications for decreasing dehydration in the field and in garrison are discussed.     

Use of surgisis for abdominal wall reconstruction/closure in battlefield casualties during Operation Iraqi Freedom

A case series and discussion based on experiences gained during Operation Iraqi Freedom are presented. The Army previously published an article on the use of Gore-Tex mesh in the staged closure of open abdominal wounds. We thought that use of a biomaterial could shorten the overall course of abdominal closure and improve outcomes. This is mainly a "proof of concept" type of study. Although class I data are not presented, a useful concept is discussed. To our knowledge, no other report of the use of biomaterials for battle casualties has been published. Several issues that are faced by the military medical system are presented. The use of Surgisis (lyophilized porcine small intestinal submucosa; Cook Biotech, West Lafayette, Indiana) in the described setting is presented as one possible solution.     

The Army Medical Department and the Civil War: historical lessons for current medical support

With the resurgent interest in the operational level of war and the art of military campaigning, how the United States Army updates its combat service support doctrine could have a significant impact on future field medical support concepts. Historically, the Civil War provides important lessons that must not be forgotten by today's military medical leaders concerning casualty evacuation and its control during military campaigns. To prevent the repetition of earlier mistakes in future conflicts, military medical leaders must appreciate the painful lessons of war and actively communicate these lessons to the larger military community. This article provides some insight into that history and those lessons.     

Medical support of the Armed Forces of Russia: results of the activities and major tasks for 2012

The article presents whole range of activity of medical service of the Army and Navy. There were defined main directions and peculiarities of medical supply of the Armed Forces in conditions of forming of a new image. A special attention was paid to questions of combat and mobile readiness of medical armed units and institutes taking into account optimization of structure and quantity of medical service of the AF of RF. The main direction of activity of the medical service is organization of treatment-prophylaxis work for saving of life and health of the staff of Army and Navy. The article informs about stabilization of morbidity by the most popular diseases, about capabilities of medical service of armed unit in a new organization-staff structure, about ways of increasing of effectiveness of activeness of military treatment-prophylaxis institutes.     

The oldest military hospitals of Saint-Petersburg: good round figure in history

In 1710 in a under construction capital of the Russian state the first central military hospital for treatment the soldier of garrison has been organized. Its initial device differed from existed regimental infirmaries a little; however personal home nursing of tsar has helped development of hospital. In 1715 the hospital has been solemnly consecrated. Since 1735 in hospital have started to spend training of future doctors and with the basis in 1798 of Army medical college it became its clinical base. During teamwork the hospital became high-grade clinical base of academy, has developed and became the modem well equipped clinic-diagnostic centre.     

Origin of flight nursing in the United States Army Air Forces

The years of World War II mark the first extensive use of flight nurses in the United States military. These select flight nurses in the United States Army Air Forces during World War II, set the precedent for a unique field of nursing which has continued to the present day. This historical study traces the origin of flight nursing in the United States Army Air Forces from 1937, when the need for specially designated flight nurses could not be justified, until 1942, when flight nursing in the United States Army Air Forces became a reality.     

Personality types among experienced military pilots

Three distinct personality subtypes were empirically identified in a sample of 170 experienced U.S. Army pilots, using a new measure of personality developed for use in occupational settings. The subtypes are similar to those previously derived in a sample of military aviation trainees. No significant differences across the clusters were found for the types of missions flown, years of aviation or military service, or number of flight hours. A significantly greater number of instructor pilots was found among a cluster which comprised the smallest percentage of pilots in the sample. Overall, the results support the notion that no one type of personality is a prerequisite for success in military aeronautics, and highlight the need for additional studies of personality type in military and commercial aviation, using more sophisticated measures of aeronautical adaptability.     

Ryazan hospital--80 years

In December 2011 marked 80 years of the founding of the Ryazan garrison hospital, originally housed in two buildings: "Redut housed"--a monument of architecture of the XVIII century and the former almshouses room "for the maimed in the war", was built in 1884 now Ryazan garrison hospital (from 2010--Branch No 6 FSI "in 1586 the district military hospital in the Western Military District", the Defense Ministry of Russia)--a multi-field medical preventive institution on the basis of which soldiers, military retirees, family members and military retirees from Ryazan, Moscow, Tambov regions are treated. Every year more than 7 thousand patients get treatment here. During the counterterrorism operations in Chechnya over 800 wounded were brought to the hospital from the battle area.     

西沙某岛420名官兵心理健康调查分析

目的 了解海岛官兵心理健康状况及相关因素,提出防治对策.方法 采取症状自评量表(SCL-90)对西沙某岛420名官兵和内地海军某部450名官兵进行心理测试,比较2组人员心理健康状况.结果 西沙官兵一定程度上存在心理健康问题,且常见心理异常症状的发生率高于内地组,尤其以情绪低落、焦虑、恐惧、失眠、纳差等更为显著(P＜0.01).结论 影响心理健康状况的因素包括人员身份、文化程度、城乡来源和驻岛时间等.因此要加大对西沙官兵心理健康教育力度,严格新兵入伍心理检测,提高基层医务人员诊疗心理疾病水平,改善生活条件,丰富精神文化生活,以缓解小岛官兵心理问题,提高部队战斗力.     

Challenges and considerations for managing suicide risk in combat zones

As suicide rates in the military rise, increased attention has been placed on the effective management of high-risk service members. Military mental health professionals deployed to combat zones face a number of challenges and barriers for effective risk management that are unique to the deployed setting. To date, there exists no body of literature identifying areas in which suicide risk management differs between garrison and combat settings to guide mental health professionals in improving clinical decision making with respect to managing suicidal service members in combat zones. On the basis of experience gained during deployments to combat zones, the authors outline several key features of the deployed context that can impact suicide risk and its effective management in combat zones and integrate empirical findings relevant to each issue. Considerations for clinical care and risk management are discussed.