Serum urate and cholesterol levels in Air Force Academy cadets.

Serum cholesterol and urate levels were measured in 150 young men at 2- to 4-month intervals during their first 18 months at the U.S. Air Force Academy. During the first week of cadet training, mean serum urate levels rose as high as 9.5 mg/100 m/, but decreased after a Sunday break. During this week, urate levels in excess of 8.49 mg/100 m/ were found in 44% of the subjects. Such levels, while definitely exceeding normal limits, were attributed to acute psychosocial stress rather than to an abnormal or pathological process. One month after the completion of basic military training, mean serum urate levels were within normal limits, as were all subsequent mean urate levels. Mean serum cholesterol levels were elevated at three times - during the first week of training, after the first month of the first academic year, and during a week of intense military training in the following spring. Apparently, urate and cholesterol levels were elevated by different aspects of stress. Elevations of uric acid level appeared to reflect stress that excited fear or insecurity. Elevations of cholesterol levels apeared to reflect a stress which the individual perceived as requiring a sustained increase in physical and/or mental performance.     

Immune responsiveness and risk of illness in U.S. Air Force Academy cadets during basic cadet training.

It has been proposed, but not confirmed, that environmental stressors alter immune function and increase the risk of viral infection among healthy individuals. We evaluated this hypothesis, examining the relationship among stress, immune function, and illness in 96 first-year U.S. Air Force Academy cadets during orientation and 4 weeks later during the stressful environment of Basic Cadet Training (BCT). Perceived stress and well-being levels of cadets were assessed via questionnaire. Immune responsiveness was analyzed by PHA-stimulated thymidine uptake in mononuclear leucocytes and by serologic evidence of reactivation of the Epstein-Barr virus (EBV). We documented significant declines in in vitro PHA-induced lymphocyte transformation (-35%; p less than 0.05) and subjective well-being (-19%; p less than 0.05) from orientation to BCT with corresponding, significant increases in perceived stress (+32%; p less than 0.05). Despite significantly altered in vitro immune responsiveness, there was no serologic evidence of EBV reactivation nor was there an association between these measures and risk of illness as determined by medical chart review and self-reported symptoms. These results suggest that reduced in vitro immune responsiveness during a moderate stressor may not necessarily lead to an increased risk of infection and/or reactivation of EBV in normal individuals.     

Health practices in United States Air Force personnel compared to United States adult civilians

Seven physical health practices have been found to be related to both physical health and mortality in cross-sectional and longitudinal studies. The practices include adequate rest, sufficient exercise, eating breakfast, no snacking, maintaining a reasonable body weight, no smoking, and use of alcohol in moderation. The purpose of this study was to describe physical health practices in the United States Air Force (USAF) and to compare them to those in the US adult population. In 1977 the USAF conducted a Health Survey that included questions concerning the seven physical health practices, and the National Center for Health Statistic's Health Interview Survey included a Health Practices Supplement. The results indicated a lower level of breakfast eating and more snacking in the USAF compared to other U.S. adults, but the difference may have been due to the relatively younger age distribution in the USAF. Air Force members reported sleeping less, and the females and older persons in both populations reported less physical activity. Air Force females reported drinking more than other females, but there appeared to be less heavy drinking in the USAF. Cigarette smoking in the USAF was slightly higher. The validity of self-reported health practice data is of considerable importance in these studies. However, there is no reason to suspect meaningful differences in reporting between the USAF and US populations.     

Vision readiness in the United States Air Force revisited

A study was conducted to determine the prevalence of substandard visual acuity in a sample of the diverse communities of the United States Air Force. In addition, mobility readiness (visual), ocular disease, time since last visual examination, and adherence to ocular requirements per AFR 160-43 were assessed. Comprehensive eye examinations were performed in the Optometry Clinic on 207 randomly chosen members scheduled by Squadron Schedulers using random computer lists of personnel generated by Military Personnel Flight. Of the 207 individuals, 112 (54%) had not had a professional eye examination in the last 2 years, 51 (24%) were not mobility ready, 6 (3%) had inadequate visual acuity per AFR 160-43, and 4 (1.9%) had ocular disease. The study reinforces the concept that comprehensive, periodic ocular examinations should be performed by an optometrist or ophthalmologist on all active duty members to ensure that they see properly to perform assigned duties, that members on mobility have required optical materials to be deployment ready, and that members who develop ocular disease are identified in a timely manner.     

Evaluation of possible microwave-induced lens changes in the United States Air Force.

An Air Force examination team performed ophthalmologic examinations on 817 subjects in a double blind fashion. The subjects included 477 workers in the microwave radiation field and 340 control subjects with no known history of occupational exposure to microwave radiation. The intent of the study was to determine if a significant difference existed between the two groups for the presence of three lenticular findings equated with early cataract formation. No significant difference was found. Thus, this study does not support the contention that microwave exposure in the military environment is causing human cataracts at levels permitted by U.S. Safety Standards.     

The history of the United States Air Force Pilot-Physician Program

Individuals trained as both military physicians and military pilots have existed in the armed forces of the world since 1911. This paper traces the history of pilot-physicians in the United States Air Force. The USAF pilot-physician program was founded by Harry G. Armstrong in 1947 and continues to the present time. This article was researched using largely unpublished references and personal interviews.     

美国空军飞行人员主要疾病特许飞行统计分析

目的 了解美国空军飞行人员心血管、骨与关节、眼、精神与神经等疾病特许飞行情况.方法 以美国空军航空医学咨询部(Aeromedical Consultation Service,ACS)2015年9月发布的疾病案例数据为统计对象,按人员类别进行特许人数分析.结果 5类主要疾病统计结果 显示,心血管疾病鉴定3456例,特许2929例,占85.15%,其中FCⅡ类特许1664例,占56.81%,冠心病鉴定人数为185例,特许115例,占62.16%;眼科疾病鉴定17620例,特许14220例,占80.70%;骨与关节疾病鉴定3699例,特许2983例,占80.64%,其中FCⅡ类特许1638例,占54.36%;精神疾病鉴定4676例,特许2164例,占46.28%,情绪障碍、适应障碍、酒精滥用、焦虑症、注意力缺陷型(伴)多动症(障碍)5种疾病占鉴定的90.93%,FCⅠ类、FCⅡ类、FCⅢ类特许分别为55.41%、60.63%、45.93%;神经疾病鉴定3868例,特许2588例,占66.91%.发病率较高为头痛、创伤性脑损伤、睡眠障碍及晕厥,其中头痛鉴定1643例,特许785例,占47.78%,FCⅠ类、FCⅡ类、FCⅢ类特许分别为77.43%、76.12%、62.03%.结论 航空医学鉴定科学管理大大提升了飞行人员疾病特许的精准性,航空医学专家鉴定工作成效明显,使80%以上的患病人员返回飞行岗位,为最大化保留有作战经验的现役飞行人员,维护空军战斗力作出了贡献.     

Prevalence and predictors of discharge in United States Air Force Basic Military Training

The purpose of the current investigation was to determine the prospective predictors of discharge in a population of individuals entering U.S. Air Force Basic Military Training (BMT). Subjects were 32,144 consecutive individuals entering Air Force BMT. In the first week, subjects filled out a comprehensive lifestyle and behavioral assessment. Over time, a total of 1,999 subjects (6.2%) dropped out of BMT for a variety of reasons, the most common being medical (33.6%), psychiatric (21.3%), legal (20%), and poor performance (13.1%). Overall, discharges by gender were equal, but the reasons for discharge varied by gender. Ethnicity predicted for medical, psychiatric, and legal discharge. Results suggest that women and ethnic minorities are not biased in favor of discharge and that both lifestyle and psychosocial variables are consistent predictors of discharge. Future research could potentially yield other significant predictors of success versus discharge in the U.S. military.     

The measurement of visual efficiency standards for pilots in the United States Air Force

Military aviation requires a high degree of visual skill and efficiency. The current visual standards for flying status in the United States Air Force employ static tests of visual function. Visual factors utilized in flight are continually changing to meet the demands of the situation. This study evaluates the performance of two carefully matched samples of people on a test of dynamic visual change, i.e., vergence facility. We compared the ability of a sample of military pilots to make rapid fusional movements in a base-in and base-out direction with a group of nonpilots matched for other normal visual characteristics. The number of times each subject could reestablish fusion while viewing an anaglyph target through alternating 16 delta base-out and 4 delta base-in prism lenses was recorded over a 1-minute time interval. We found the pilot's ability to initiate and sustain fusional vergence movements to be similar to that of their nonrated military counterparts. Our work does not indicate that this test of visual efficiency would discriminate between the pilots and nonpilots in our sample if it were included in a test battery to identify individuals with exceptional visual proficiency.     

对空军飞行学员心理选拔工作的看法和建议

空军飞行学员心理选拔工作可以1987年招收飞行员体制改革为界，划分为两个阶段。第一阶段可追溯到50年代，但只有纸笔试验得到了推广应用。1987年以来心理选拔受到前所未有重视。从1988年起开展了飞行学员“筛选一控制”选拔体系研究。目前，提出了“分级选拔”和“选拔与训练相结合”的系统构想。心理选拔具体方法已从过去使用的单纯的纸笔测验，发展到纸笔测验、双重任务测验、心理会谈和个性问卷等多种方法。建议进一步完善心理学“筛选一控制”选拔体系。     

Quantification of the 5-year incidence of thromboembolic events in U.S. Air Force Academy cadets in comparison to the U.S. Naval and Military Academies

The medical literature is replete with case reports of thromboembolic events related to high altitude exposure. Studies have shown an increased risk of thromboembolic events at high and very high altitudes. Most of these case reports and studies have been documented at altitudes between 3,000 m and 8,000 m (9,843-26,247 ft). The U.S. Air Force Academy (USAFA) rests at moderate altitude of 7,250 ft (2,210 m). This study was designed to quantify the incidence of thromboembolic events in USAFA cadets over a 5-year period and then compare the incidence of events to those in the age-matched, similarly screened midshipmen and cadet populations of the U.S. Naval and U.S. Military Academies living at sea level. Our study showed an increased incidence of thromboemoblic events in USAFA cadet outpatients compared with that in the U.S. Military Academy cadets and U.S. Naval Academy midshipmen. This implicates moderate altitude as a potential risk factor for thrombosis.     

Epidemiology of injuries and illnesses during the United States Air Force Academy 2002 Basic Cadet Training program: documenting the need for prevention

The rapid physical and emotional conditioning that occurs during Basic Cadet Training (BCT) creates ample opportunity for injuries and illnesses. The goal of this analysis will be to document the magnitude of injury and illness problems during BCT at the Air Force Academy and to identify potential risk factors for targeted prevention efforts. Data used in this study were collected on the basic cadet population from various sources during BCT 2002. Data analysis for this retrospective observational study included cumulative incidences, chi2 analysis, and logistic regression. Risk factors for injuries included being of the female gender, being an intercollegiate athlete, being overweight, and having an obese body mass index (BMI). Female gender, military preparatory school attendance, and obese BMI were risk factors for illnesses. Future BCT medical surveillance should focus on females, recruited athletes, and those with high BMIs. Prevention efforts should focus on reducing ankle sprains and respiratory infections to limit the amount of lost training time.     

美国空中急救概况

美军大规模使用直升飞机转运伤员开始于朝鲜战争及后来的越南战争。根据已取得的成功经验,空中急救(air medicine)现已成为美国平时完整创伤急救系统不可分割的重要组成部分。笔者重点介绍美国空中急救的方法与经验,以供国内创伤急救医学有关人员在决策或开展中国的空中急救项目．时参考。     

The adequacy of corrective lenses worn by United States Air Force aviators for annual flight medical examinations.

Aviators presenting for annual flight medical examinations at the 379th Strategic Hospital at Wurtsmith Air Force Base were studied to determine the prevalence of substandard visual acuity. The prevalence of the use of outdated (superseded) corrective lenses was also studied. We conducted 342 examinations on different aviators and 92 (26.9%) of these aviators were found to require corrective lenses. There were 23 (6.7%) aviators who were found to have inadequate visual acuity and 14 of these (4.1%) were found to be wearing superseded lenses. The visual screening method prescribed by the United States Air Force did not identify four of the aviators who wore superseded lenses. Three aviators were found to be wearing lenses obtained from civil sources. The study suggests that improvements could be made in U.S. Air Force visual screening and care.