Tracing algorithmic harm: from innovation to deployment and impact on civilians

Historical experience demonstrates that periods of conflict often stimulate significant advancements in various fields of science and technology. The ongoing Russian-Ukrainian War is no exception. Drawing upon open sources, the authors of the article trace the development and implementation of Ukrainian and foreign equipment in military medicine within the Ukrainian Defence Forces during the first decade of this war. The article evaluates and summarizes the initial experience of their battlefield application, analyzes challenges encountered by equipment developers and military personnel in implementing scientific and technical advancements, and proposes ways to address these issues. The primary focus is on developments related to electrical engineering. Specifically, the article highlights the equipment in medical electrical engineering and telemedicine screening, the creation of mobile hospitals equipped with modern electrical devices, and various models of evacuation drones and electric stretchers operating on principles of automation and telemechanics, including robotic systems for medical evacuation. Examples of new organisational forms for conducting research and implementing promising projects related to the scientific synthesis of the medical science experience and practice in wartime are given. This underscores the significant and diverse contributions of Ukrainian scientists, engineers, technicians, entrepreneurs, investors, and military personnel. The authors conclude that the development of electrical engineering for military medicine in Ukraine holds international significance. This is particularly relevant given the increasing number of ‘hot spots’ globally. Electrical engineering for the needs of war is developing dynamically and very rapidly. Ukrainian developments provide a powerful impetus to this process. Based on the experience of the ongoing Russian-Ukrainian War, several areas of electrical engineering in Ukrainian military medicine are poised to make a significant impact on the history of science and technology. This includes remote diagnostics based on telemedicine, robotic systems for evacuating the wounded (evacuation drones), and mobile hospitals equipped with advanced electrical equipment. Ukrainian medical electrical engineering, stimulated by the ongoing war, offers an invaluable impetus to the development of both the theory and practice of civilian medicine.

The article is devoted to the topical problem of integration of veterans into high-tech sectors of the Ukrainian economy, in particular into the spheres of Industry 4.0 and 5.0. In the context of a prolonged cyber war and the expected increase in the number of veterans to 5-6 million people, the issue of their effective reintegration into civilian life is of strategic importance for the country. The aim of the study is to generalize the theoretical and applied aspects and develop scientifically based recommendations for the formation of strategic aspects of human capital development in Ukraine in the context of the integration of veterans in the spheres of Industry 4.0 and 5.0, improving the mechanisms of public administration in Ukraine in this area. The study is further aimed at analyzing the current state of implementation of Industry 4.0 and 5.0 technologies in Ukraine, assessing the potential of veterans as a human resource for the development of high-tech industries and identifying ways to adapt the education system to the needs of the labor market in the context of technological modernization. The article analyzes the current state of implementation of Industry 4.0 and 5.0 technologies in Ukraine, examines the educational level of veterans and identifies the main challenges of their integration in the labor market. On the basis of the carried out analysis, the stages of implementation of the strategy of integration of veterans into the spheres of Industry 4.0 and 5.0 are proposed, which can be considered as local strategies, the systematic consistent implementation of which is meaningful and forms their efficiency and effectiveness, which is aimed at the effective integration of veterans into high-tech sectors of the economy. This can become a powerful catalyst for Ukraine’s innovative development, contributing to the creation of a highly skilled workforce and technological modernization of the economy. In addition, the directions for further research are outlined, in particular, on the mechanisms of implementation of the proposed strategy and assessment of its long-term impact on the structure of the Ukrainian economy. Thus, the study lays the groundwork for further steps towards creating an inclusive, technologically advanced economy where the potential of every citizen, including veterans, can be fully realized for the benefit of society as a whole.

Socially significant infectious diseases (SSID) remain a serious medical and social burden for military personnel in many countries worldwide, including Ukraine. This part of the message is about HIV/AIDS. Objective. To analyze literature data on the history of HIV/AIDS in the world’s armies, their prevalence, and epidemic risks for military personnel; to characterize the current state of morbidity from HIV/AIDS in Ukraine compared to the pre-war period; and to summarize quantitative information on the provision of medical care to military personnel with socially significant infectious pathologies at the Clinical Unit (Clinic) of the State Institution “L. V. Hromashevskyi Institute of Epidemiology and Infectious Diseases of the National Academy of Medical Sciences of Ukraine” (Institute). Methods. The study used bibliosemantic, systematic approach and analysis, and retrospective epidemiological analysis of HIV/AIDS morbidity in Ukraine from 2015 to 2024, based on statistical reporting data. Results. An analysis of literature data on the issue of SSID among military personnel was conducted, both from a historical perspective and in the present day. The chronology of studies on the seroprevalence of HIV infection among military personnel from various countries worldwide was separately examined, taking into account age, branch of service, length of service, participation in combat operations, and other factors. It was demonstrated that the primary risk factors for these infections among military personnel are those characteristic of pathogens with a parenteral transmission mechanism. However, under military service conditions, including active combat, these risk factors may overlap, enhancing the likelihood of transmission (sexual transmission, artificial parenteral transmission during medical and non-medical invasive procedures). Among the transmission routes: HIV is more actively spread sexually. As in the civilian population, the prevalence of HIV infection is higher among individuals with deviant behavior, as well as among those with coexisting SSID, including sexually transmitted infections (STIs). The prevalence of HIV infection among military personnel has historically been lower than that of HCV infection and significantly lower than HBV infection. It was shown that the epidemiс situation of HIV infection in Ukraine remains unstable, and the country ranks among the leading nations in the WHO European Region for these infections based on morbidity and the number of new cases. At the Institute’s Clinic, which has been involved in the treatment of viral hepatitis and HIV infection among military personnel since 2014, specialized medical assistance to this category of individuals is provided as a priority and to the fullest extent possible. Before the full-scale war, from 2015 to 2021, a total of 450 participants of the Anti- Terrorist Operation (ATO) and the Joint Forces Operation (JFO) received consultative care, while 142 military personnel underwent inpatient treatment. In 2022–2024, the number of military personnel with SSID receiving medical assistance significantly increased. Since the start of full-scale hostilities, 1,892 military personnel have received outpatient care, and 269 have undergone inpatient treatment. Most military personnel with SSID suffer from advanced stages of viral hepatitis and HIV infection, as well as comorbidities, requiring highly specialized and professional medical assistance, which they receive at the Institute’s Clinic. Conclusions. SSID continue to be a serious medical and social burden for military personnel in many countries, including Ukraine. Russia’s full-scale invasion of Ukraine has significantly increased the traditional risks of HBV, HCV, and HIV infection. Given the adverse epidemiological situation of parenterally transmitted viral hepatitis and HIV/AIDS in Ukraine, combined with the ongoing war, risk situations for HBV, HCV, and HIV infection will persist and recur, putting both military personnel and civilians at increased risk. Military personnel with this socially significant pathology require primary and comprehensive medical assistance. The Institute’s Clinic, which has been actively involved in medical assistance to military personnel, including those with SSID, during the eight years of conflict in eastern Ukraine and throughout Russia’s full-scale invasion, has significantly expanded its medical support. During 2022–2024, the number of consultations and inpatient treatments increased by 3.4 and 2.7 times, respectively. Keywords: socially significant infections, hepatitis B, hepatitis C, HIV/AIDS, military personnel, medical assistance.

One might take the view that at least within some general areas of philosophical thought, Democritus did take a systematic line. It seems clear that, despite various particular difficulties of reconstruction or interpretation, Democritus’ physics and epistemology were intended to form a coherent body of thought. Democritus can be offered a coherent and consistent account of the effects of crime and other forms of harm and their social and political importance. This chapter suggests in turn a tantalising clue to a possible interconnection between Democritus’ ethical and political thoughts and his psychological theories and the famous doctrine of atomic emanations, or eidola . Democritus cites the presence of ‘ancestral laws’ as support for his recommendation. Democritus was able to offer a physical, atomist account of the mechanism of interpersonal psychic harm. Keywords: Democritus; eidola ; psychological harm; social harm

How will emerging technologies impact crisis escalation? What has been the escalatory – or de-escalatory – effect of emerging technologies in contemporary crises? And can the use of emerging technologies increase risks of nuclear use? To answer these questions, we use the ongoing war in Ukraine as a case study to identify how emerging technologies are being used in modern conflicts and the associated risks of escalation, potentially to include nuclear use. We argue that emerging technologies gave Russia a false sense of supremacy in the lead-up to the war in Ukraine and have largely failed to deliver Russia battlefield victories. As a result, Moscow has increased reliance on nuclear weapons and nuclear threats. This reliance could be exacerbated in the aftermath of the war in Ukraine when Russia is conventionally weakened. Therefore, it is not the technologies themselves that increase risks of escalation, but their impact on decisionmakers’ perceptions of the potential costs of offensive military operations and escalation. Nonetheless, the role of emerging technologies in Ukraine should not inspire complacency because of the impact of new actors, new escalation pathways, and compressed timescales. These trends will have implications for nuclear policy and require more inclusive approaches to risk reduction and arms control, to include an increased focus on behaviors rather than capabilities.

The ongoing war on the territory of Ukraine revealed a special group of pa-tients who may experience hypoglycemia — military personnel. Moreover, hypoglycemia can occur both in those who already had diabetes before, and in those who did not and did not get sick at the time of service in the Armed Forces. The article presents an analysis of the causes and features of this condition in servicemen. The aim is to investigate the causes of development, peculiarities of the course and methods of prevention of hypoglycemic states in military per-sonnel. Methods. To solve the task, full-text articles were searched and analyzed in the databases PubMed, Web of Science, Google Scholar, and Scopus. The search was conducted using the keywords “hypoglycemia”, “military personnel”, “soldiers” and “officers” and covered English and Ukrainian publications over the last 78 years (from March 1946 to June 2024).The results. The article provides data on the etiology, pathogenesis, clin-ical picture and treatment of hypoglycemia occurring in military personnel. The paper presents the main causes of the hypoglycemic syndrome and features of diagnosis and emergency care for patients with hypoglycemia of varying degrees of severity in cases with and without diabetes.Key words: hypoglycemia, military personnel, causes, diagnosis, emergency care, prevention

The Integrated Service Center for the Empowerment of Women and Children (P2TP2A) is expected to function as a community-based service institution. This community-based service acts as a crisis center unit by providing complaints, health, rehabilitation, social, counseling, legal assistance, repatriation, and social reintegration services (for trafficking victims). Sexual violence encompasses any action that diminishes, belittles, intimidates, or assaults an individual's body or reproductive capabilities, stemming from imbalanced power dynamics or gender inequalities. Such acts inflict psychological or physical harm, potentially disrupting reproductive health and impeding educational opportunities. Examples include rape and sexual abuse. This research focuses on examining legal protection efforts and identifying obstacles faced by P2TP2A (Integrated Service Center for Women and Children) in handling cases of sexual violence against children, utilizing an empirical juridical approach. The findings reveal that legal protection for children experiencing sexual violence is enshrined in Article 13 of Law Number 35 of 2014, which emphasizes the rights of children to be protected from various forms of harm, including discrimination, exploitation, neglect, cruelty, violence, abuse, and injustice. Supporting factors include the availability of financial assistance to fund P2TP2A activities, the dedication of officers and volunteers who prioritize the welfare of women and children, and the provision of office facilities by the government. However, there are inhibiting factors such as inadequate budget allocation, the unrealized Community-Free Integrated Child Protection Program (PATBN), insufficient human resources, the need for improvement in office facilities and infrastructure, and the lack of safe housing for victims who are still renting.

This qualitative study aims to find common themes that may suggest portrayals of former service members’ psychological development and their reintegration. We have found their cognitive dissonance from experiencing two very different cultures: the highly structured collective culture of military life and the individualistic culture of civilian life. Former service members tend to develop and maintain the strong ideology of “service to others” in civilian life as their goal or purpose of life. It became clear to us how they have reached to this ideology when we used our ethnic backgrounds and understandings as Japanese researchers who came from a society where collective well-being is highly valued. We came to the conclusion that the macroscopic as well as spiritual views would be beneficial to incorporate when counselors, support organizations, or health care providers are assisting former service members’ transition into civilian life.

A stranger in the pub bumps into you spilling your drink and then doesn't apologize, or someone pushes past to grab a seat on the train. A colleague makes a dismissive remark about your work in front of your boss. A man catcalls a woman on the street, or wears a T-shirt declaring, "keep calm, watch lesbians." One reaction to affronts like these is to take offense. Philosophers have said a great deal about causing offense, especially whether we should punish or prevent it, but very little about what is to take offense, let alone whether we should. 1 Hitherto, the focus of moral and legal philosophy has tended to be the offender, not the offended. Meanwhile, taking offense has captured popular attention, with a multitude of books and opinion pieces condemning "oversensitive millennials" and "generation

This study aimed to investigate the prevalence of different forms of harm from others' drinking (HFOD), predictors and the relationship with multi-dimensional quality of life among young adults in an emerging alcohol market in Asia-Taiwan. Data were extracted from a 2018 household survey with national representativeness on substance use experiences. The analytic sample comprised 4901 participants aged 18-34. Eight items were used to measure HFOD experiences. Five-dimensional quality of life was assessed by the EQ-5D-5L. Multivariable regressions with complex survey analyses were performed to estimate the prevalence and risk association. Almost 4.2% of young adults experienced any form of HFOD; psychological harm occurred more prevalently than physical harm (3.7% and 1.5%, respectively). Those aged 25-29 and 30-34 had a two- to three-fold risk of HFOD compared with those aged 18-24. Both non-drunk drinking and drunk drinking were associated with an increased risk of psychological HFOD (adjusted odds ratio 2.36 and 5.89, respectively), whereas the risk of physical HFOD was related only to drunk drinking (adjusted odds ratio 7.8). Psychological HFOD victimisation emerged as the strongest predictor for deteriorated quality of life (adjusted b -0.14; 95% confidence interval -0.24, -0.04), especially in the dimensions of pain/discomfort and anxiety/depression. Among HFOD victims, only 33% sought help. The HFOD among young adults, commonly exhibited in psychological form, was linked with deteriorated quality of life; nonetheless, young HFOD victims are under-recognised. When devising interventions for alcohol harm, developmental perspectives should be integrated into policies implemented in healthcare and community settings.

A Road Map for Advancing the Practice of Respect in Health Care: The Results of an Interdisciplinary Modified Delphi Consensus Study

In this paper I consider whether structural injustice can capture the harms of the beauty ideal and recognize their significance. This is done in three sections. In Section 2, I set out the rising costs and harms which attach to beauty engagement in an increasingly visual and virtual culture. In Section 2.1, I outline how beauty harms are typically understood. In Sections 2.2 and 2.3, I argue that there are two communal or shared harms which are not easy to capture on individual models: first that more is required to meet minimal appearance standards; and second body image anxiety. In Section 2.4, in order to give an accurate account, I highlight beauty benefits. In Section 2.5, I show that increasingly the demands fall across genders. In Section 3, I apply Iris Marion Young’s account of structural injustice to beauty. In Section 3.1, I set out the three core features of structural injustice. In the following three sections, Sections 3.2–3.4, 3.2–3.4, 3.2–3.4, I show beauty harms have the features of structural injustice. In Section 4, I consider two benefits of this approach and one challenge to it.

Over thepast 13 years,more than two million United Statesmilitary service members have been deployed to combat operations overseas, primarily in Iraq and Afghanistan. In addition to over 6,000deaths and several thousandcombat injuries, several hundred thousand service members (and their families) continue to struggle with deployment-related readjustment and medical and mental health challenges. These recent operations and their sequelae are a reminder of the longstanding issues faced by military service members, veterans, and their families in the United States and worldwide from previous wars, in addition to newly returning veterans who present newchallenges inhealingthewoundsassociatedwithmodern warfare. The recent conflicts have also inspired significant efforts to develop new knowledge regarding treatment approaches and new systems of prevention and care delivery that are better suited to effectively support service members and their families. However, more research, infrastructure changes, and resources are required to meet current and future needs. This book is a timely and an important milestone in the literature on the care ofmilitarymembers, veterans, and their families. Its strength lies in the collective expertise of its authors and editors who have produced unified and clear messages, including the message that the health and wellbeing of military service members and veterans is closely linked to that of their familymembers.Thebodyof information about military service, culture, families, and unique challenges (such as frequent separations, relocations and deployments, changes in family roles, stigma, access to care, and injuries and deaths), aswell as about themanystrengthsof servicemembers (such as a sense of pride and belonging, financial stability, role flexibility, family extendedness, and resilience) is a highlight of this book. TheDepartment ofDefense and related communitybased partners have made impressive progress in research, interventions, andresources in thecareofmilitary families(e.g., Child and Youth Services, Family Readiness Groups, Military OneSource, and FOCUS [Families OverComing Under Stress]) that should be widely disseminated. This aspect of this volume will help community providers better understand the needs of their service member and veteran patients and their families and is a considerable contribution to the field. Themost important conceptual contributions of this book are outlined in three fundamental factors: that combat exposure impactsmental and physical health; that deployment/ combat experiences of service members are closely linked to the health and well-being of their family members; and that themilitary is in constantfluxdue to changeand transitioning of members between military and civilian communities. Constant change between military and civilian communities is particularly important among National Guard and Reserve members (who constitute close to one-half of the ready force). Militarymembers/veteranswhomoveto theciviliansectormay live in areas where there is inadequate expertise specifically related to the needs of military members/veterans and their families. Thus, the health and care of military members, veterans,andfamilies isanationalandcommunityconcern,not just aconcern for theDepartmentofDefenseor theVeteransHealth Administration or a few agencies. This volume’s conceptualization and focus is an excellent initial blueprint for the community to support these service members and veterans. Other strengths include the organization of this volume into three broad sections: Fundamentals for Treating Military Service Members, Veterans, and Families; Military Service-Related Conditions and Interventions; and Meeting the Needs of Military and Veteran Children and Families. This greatly helps in enhancing conceptual clarity, knowledge, and awareness for community providers with limited exposure to military members/veterans to effectively direct attention and resources toward addressing the needs of military members/ veterans and their families. The chapters on Collaborative Care and Suicide in the second section are particularly impressive and informative. The ambitiousness of this book is commendable, although there were clearly challenges in deciding what to include in this volume.The authors have negotiated this challenge quite well, striking a good balance between in-depth coverage of important topics, including theoretical and recent research advances, while also offering a lot of practical information and resources for providers. Potentially future editions of this book could expand by including an international perspective of the issues facing veterans so that we might benefit from research and practice in other parts of the world. Additional attention to thewide range ofVeteransHealthAdministration services would be important as well (1). The timeof transitionbetween theDepartment ofDefense and civilian life as a veteran is one of opportunity in which returning service members can be screened, provided information about resources, and connected with services. Lack of basic needs, such as housing and employment support, can potentially exacerbate and contribute to readjustment challengesandshouldbeaddressedinconjunctionwithhealthcare needs. Every Veterans Health Administration medical center has a seamless transition team that provides outreach, case management, and coordination services to support returning veterans and their families. In summary, the experts who contributed to and edited this book have provided an important and much needed contribution to the field of military, veteran, and family care. This book will serve as an excellent resource for a wide range of medical and nonmedical service providers, increasing awareness of resources and new directions in meeting the unique needs of service members, veterans, and their families.

Over thepast 13 years,more than two million United Statesmilitary service members have been deployed to combat operations overseas, primarily in Iraq and Afghanistan. In addition to over 6,000deaths and several thousandcombat injuries, several hundred thousand service members (and their families) continue to struggle with deployment-related readjustment and medical and mental health challenges. These recent operations and their sequelae are a reminder of the longstanding issues faced by military service members, veterans, and their families in the United States and worldwide from previous wars, in addition to newly returning veterans who present newchallenges inhealingthewoundsassociatedwithmodern warfare. The recent conflicts have also inspired significant efforts to develop new knowledge regarding treatment approaches and new systems of prevention and care delivery that are better suited to effectively support service members and their families. However, more research, infrastructure changes, and resources are required to meet current and future needs. This book is a timely and an important milestone in the literature on the care ofmilitarymembers, veterans, and their families. Its strength lies in the collective expertise of its authors and editors who have produced unified and clear messages, including the message that the health and wellbeing of military service members and veterans is closely linked to that of their familymembers.Thebodyof information about military service, culture, families, and unique challenges (such as frequent separations, relocations and deployments, changes in family roles, stigma, access to care, and injuries and deaths), aswell as about themanystrengthsof servicemembers (such as a sense of pride and belonging, financial stability, role flexibility, family extendedness, and resilience) is a highlight of this book. TheDepartment ofDefense and related communitybased partners have made impressive progress in research, interventions, andresources in thecareofmilitary families(e.g., Child and Youth Services, Family Readiness Groups, Military OneSource, and FOCUS [Families OverComing Under Stress]) that should be widely disseminated. This aspect of this volume will help community providers better understand the needs of their service member and veteran patients and their families and is a considerable contribution to the field. Themost important conceptual contributions of this book are outlined in three fundamental factors: that combat exposure impactsmental and physical health; that deployment/ combat experiences of service members are closely linked to the health and well-being of their family members; and that themilitary is in constantfluxdue to changeand transitioning of members between military and civilian communities. Constant change between military and civilian communities is particularly important among National Guard and Reserve members (who constitute close to one-half of the ready force). Militarymembers/veteranswhomoveto theciviliansectormay live in areas where there is inadequate expertise specifically related to the needs of military members/veterans and their families. Thus, the health and care of military members, veterans,andfamilies isanationalandcommunityconcern,not just aconcern for theDepartmentofDefenseor theVeteransHealth Administration or a few agencies. This volume’s conceptualization and focus is an excellent initial blueprint for the community to support these service members and veterans. Other strengths include the organization of this volume into three broad sections: Fundamentals for Treating Military Service Members, Veterans, and Families; Military Service-Related Conditions and Interventions; and Meeting the Needs of Military and Veteran Children and Families. This greatly helps in enhancing conceptual clarity, knowledge, and awareness for community providers with limited exposure to military members/veterans to effectively direct attention and resources toward addressing the needs of military members/ veterans and their families. The chapters on Collaborative Care and Suicide in the second section are particularly impressive and informative. The ambitiousness of this book is commendable, although there were clearly challenges in deciding what to include in this volume.The authors have negotiated this challenge quite well, striking a good balance between in-depth coverage of important topics, including theoretical and recent research advances, while also offering a lot of practical information and resources for providers. Potentially future editions of this book could expand by including an international perspective of the issues facing veterans so that we might benefit from research and practice in other parts of the world. Additional attention to thewide range ofVeteransHealthAdministration services would be important as well (1). The timeof transitionbetween theDepartment ofDefense and civilian life as a veteran is one of opportunity in which returning service members can be screened, provided information about resources, and connected with services. Lack of basic needs, such as housing and employment support, can potentially exacerbate and contribute to readjustment challengesandshouldbeaddressedinconjunctionwithhealthcare needs. Every Veterans Health Administration medical center has a seamless transition team that provides outreach, case management, and coordination services to support returning veterans and their families. In summary, the experts who contributed to and edited this book have provided an important and much needed contribution to the field of military, veteran, and family care. This book will serve as an excellent resource for a wide range of medical and nonmedical service providers, increasing awareness of resources and new directions in meeting the unique needs of service members, veterans, and their families.

Longitudinal research regarding the pre- and post-separation experience has been relatively limited, despite its potential as a major life transition. Separating from the military and re-integration to civilian life is noted to be a period of increased risk of significant adjustment challenges, which impacts a service member in a multitude of areas. Active duty service members with combat-related physical or mental health or pre-existing adjustment conditions may be more likely to separate from service and more at risk for post-military service adjustment problems. This is a secondary data analysis from a prospective, observational, longitudinal, multicohort study involving deployed service members originally enrolled between 2008 and 2013 in combat or following medical evacuation to Landstuhl, Germany. Two combat-deployed cohorts were examined: non-head-injured control without blast exposure (n = 109) and combat-related concussion arising from blast (n = 165). Comprehensive clinical evaluations performed at 1 year and 5 year follow-up included identical assessment batteries for neurobehavioral, psychiatric, and cognitive outcomes. In addition to demographics collected at each study visit, the current analysis leveraged the Glasgow Outcome Scale Extended (GOS-E), a measure of overall global disability. For neurobehavioral impairment, the Neurobehavioral Rating Scale-Revised (NRS) was used as well as the Headache Impact Test (HIT-6) to assess headache burden. To compare psychiatric symptom burden between those separated to those still serving, the Clinician-Administered PTSD Scale for DSM-IV (CAPS) and Montgomery-Asberg Depression Rating Scale (MADRS) for depression were used as well as the Michigan Alcohol Screening Test (MAST) to be able to compare alcohol misuse across groups. Overall cognitive function/performance was defined for each service member by aggregating the 19 neuropsychological measures. Overall comparisons following adjustment by linear regression and correction for multiple comparisons by separation status subgroup for non-blast control or blast traumatic brain injury (TBI) identified significant differences at 5 years post-enrollment in measures of global disability, neurobehavioral impairment, and psychiatric symptom burden. Those who separated had worse global disability, worse neurobehavioral symptoms, worse Post-Traumatic Stress Disorder symptoms, and worse depression symptoms than active duty service members. While service members who sustain a mild blast TBI during combat are more likely to separate from service within 5 years, there is a proportion of those non-injured who also leave during this time frame. Clinical profiles of both groups suggest service members who separated have elevated psychiatric and neurobehavioral symptoms but not cognitive dysfunction. Interestingly, the symptom load in these same domains is lower for those without blast TBI who separated during this time frame. These results appear to support previous research depicting that, for some service members, transitioning out of the military and re-integrating into civilian life can be a challenging adjustment. Many factors, including personal and social circumstances, prior mental or emotional difficulties, availability of social or community support or resources, can influence the adjustment outcomes of veterans. Service members with prior adjustment difficulties and/or those with blast TBI history (and ongoing neurobehavioral symptoms) may find the transition from military to civilian life even more challenging, given the potential substantial changes in lifestyle, structure, identity, and support.