Air National Guard Research Articles

Per- and Polyfluoroalkyl Substances in the Duluth, Minnesota Area: Exposure to and Biomarker Responses in Tree Swallows Relative to Known Fire-Fighting Foam Sources.

Tree swallow nest boxes were deployed at sites proximal to two putative aqueous film forming foam (AFFF) sources in the Duluth, MN area, as well as along the St. Louis River and a reference lake for comparative purposes in 2019, 2020 and 2021. The two AFFF sites were the current Duluth Air National Guard Base (ANG) and the Lake Superior College Emergency Response Training Center. Between 13 and 40 per- and polyfluoroalkyl substances (PFAS), depending on year, were detected and quantified in tree swallow egg, nestling carcasses, and stomach contents. Assessments were made of oxidative stress and ethoxyresorufin-O-dealkylase activity in liver tissue, thyroid hormone levels in plasma and thyroid glands, DNA damage in red blood cells, and two measures of immune response (haptoglobin-like activity and immunoglobulin) in plasma of the nestlings. Additionally, other contaminants, such as polychlorinated biphenyls, legacy organochlorine pesticides, and trace elements, were assessed at sites with no previous data. Total egg PFAS concentrations at the ANG site and north of that site were 30-40 times higher than at the reference lake, while nestling PFAS concentrations were 10-15 times higher. In contrast, the St. Louis River sites had slightly, but non-statistically significant, elevated egg and nestling PFAS concentrations relative to the reference lake (2-5 times higher). One PFAS, perfluorohexane sulfonate (PFHxS), was higher, as a proportion of total PFAS, at sites with a known AFFF source compared to the reference lake, as well as compared to sites along the St. Louis River with mainly urban and industrial sources of PFAS. The ratio of total carboxylates to total sulfonates also distinguished between PFAS sources. There were few to no differences in biomarker responses among sites, and no association with PFAS exposure.

Transfer of a leadership training intervention prior to COVID-19 on leadership support during the pandemic

PurposeWe examined the impact of a leadership support training intervention implemented prior to the coronavirus (COVID-19) pandemic on support behaviors specific to COVID-19 during the pandemic. Primary intervention targets (i.e. family-supportive supervisor behaviors and sleep leadership behaviors) were explored as mediators between the intervention and supportive COVID-19 leadership behaviors.Design/methodology/approachA cluster randomized controlled trial intervention was implemented with service members and their supervisors in the Army and Air National Guard throughout 2017–2019. Follow-up survey data were collected after the intervention, including during the COVID-19 pandemic in 2020. Direct and indirect intervention effects were tested.FindingsA pre-COVID intervention targeting leader support for family and sleep health had a direct effect on leader support specific to the COVID-19 pandemic. Additionally, sleep leadership, but not family-supportive supervisor behaviors, mediated the intervention effects on supportive COVID-19 leadership. These findings suggest that certain leadership training interventions can transfer across knowledge domains and time.Practical implicationsFindings from this study demonstrate that training leaders on support behaviors improves their ability to support employees during the COVID-19 pandemic and may translate to crisis leadership in other contexts.Originality/valueWe examined the long-term effects of an intervention that was implemented approximately 1–2 years prior to the COVID-19 pandemic on leadership support behaviors specific to the pandemic. Our findings contribute to the leadership, training, and organizational intervention literatures, and have implications for how leaders can support employees during crises.

Maximizing the Potential ofAir National Guard International Health Specialists forGlobal Health Engagement.

The Air Force International Health Specialist program provides expert medical and public health support to enhance global health engagement efforts. National Guardsmen possess unique civilian health care expertise to support global health engagement. The DoD must increase support for Air National Guard International Health Specialist involvement, including training and development opportunities.

National Guard service members decedent recovery and processing operations during the COVID-19 pandemic in New York City

ABSTRACT In Spring 2020, the New York Army and Air National Guard (NYNG) rapidly deployed to New York City (NYC) to assist in the recovery, processing, and transport of COVID-19 decedents. This study reports on a survey conducted by NYNG service members three to six months post-mission (n = 177). Data showed that there was a dose–response relationship between mission stress exposure and decremented mental health, but certain activities were associated with better mental health outcomes. The paper also reviews resources provided by behavioral health personnel to support service members during the mission and lessons learned to inform future decedent recovery missions.

The 75th Anniversary of the Nevada Air National Guard 1948-2023: Building a Total Force for National Security

Abstract: The year 2023 marks the 75th anniversary of the Nevada Air National Guard. When Congress created the United States Air Force in 1947, it also authorized the various states to establish Air National Guards. Nevada did so immediately in 1948. The Nevada Air Guard took its place alongside the newly reestablished Nevada State Militia under the command of the governor and subject to activation by the president whenever local or national emergencies threatened the peace and security of the United States. As a reserve force, the Nevada Air National Guard assumed a role in the Cold War with the Soviet Union, served in the Korean War, and responded to crises associated with the Vietnam War in the turbulent 1960s. After the downfall of the Soviet Union, it served in Kosovo in the 1990s amidst the violent breakup of the former Yugoslavia. During the 21st century members of the Nevada Air Guard have been called to Iraq and Afghanistan in the War on Terror. At home the Air Guard has assisted the U.S. Forest Service's efforts to fight wildfires in the face of climate change.

Different Drummers: Military Culture and Its Discontents

Different Drummers: Military Culture and Its Discontents

Revolution and Power in Puerto Rican Nonfiction

Revolution and Power in Puerto Rican Nonfiction

PAs in the National Guard and Reserves: Army, Navy, Air Force, Coast Guard.

ABSTRACTThe role of physician assistants (PAs) in the United States extends to the Army National Guard; Air National Guard; and reserves of the Army, Navy, Air Force, and Coast Guard (collectively known as reserve components). To understand the duality of civilian-military PA roles, a census of the armed forces was undertaken, drawing on knowledgeable senior PA medical officers in each of the services. The survey was supplemented with data from the National Commission on Certification of Physician Assistants. In 2020, there were 1,944 PAs in the five military reserve components with the majority (1,597) in the Army. Most National Guard, Air National Guard, and Reserve PAs fill medical officer roles, drill with units, and are subject to active duty. As soldiers, sailors, and airmen, military PAs are trained in health, safety, warfare readiness, casualty, trauma, and crisis response. The tenure of a reserve component PA in the military ranged between 10.2 and 17.8 years. In their civilian roles, most PAs are licensed and clinically active—the majority report they work in family/general medicine, emergency medicine, general surgery, or orthopedic medicine and surgery. This dual-career role and responsibility suggests the utility and flexibility of the PA is broader than previously reported. The findings set the stage for additional research on healthcare professionals during times of domestic and international emergencies.

Commentary: Graft flow assessment—Friend, not foe, preventing vertigo and crash

In 2007, during a routine training flight off the Oregon coast, an experienced 34-year-old pilot of the Air National Guard flew his F-15A fighter right into the Pacific Ocean at a speed of more than 600 mph. The pilot was killed, and the $32 million aircraft was destroyed.1

Friendlier Skies: Development of Electronic Checklists for Emergency Procedures for the KC-135 Stratotanker

The KC-135 Stratotanker has been a workhorse aircraft for the U.S. Air Force and Air National Guard for over 60 years. The aircraft and its technologies have had many modifications and updates over the decades, but the Emergency Procedures (EPs) section of the KC-135 In-Flight Manual has only been updated based on engineering modifications and incident and accident reports. The goal of this project was to systematically assess, identify, and document issues in the KC-135 EPs using aviation checklist design guidance and a crew-centric human factors approach. Electronic checklists were then created to address the issues in the KC-135 EPs. The number of emergency procedures was reduced by over 50%: 351 KC-135 EPs were streamlined into 154 electronic checklists. The revised electronic checklists for emergency procedures will optimize KC-135 crew responses to non-normal situations and ensure safe and efficient operation of the KC-135 beyond its projected sunset in 2040.

The mindful shield: The effects of mindfulness training on resilience and leadership in military leaders.

The purpose of this study was to address military leader perceptions of their resilience, transformational leadership behaviors, and leadership effectiveness before and after experiencing Mindfulness-Based Attention Training (MBAT). Participants were formal and informal leaders in the Kansas Air National Guard. The study used a mixed-methods sequential exploratory design. Phase I involved analyzing pretest and posttest results obtained from a Jha Lab study for three self-report assessments in an intervention group (n = 36) vs a control group (n = 37). The qualitative data in phase II was obtained from individual interviews of participants (n = 12) following the Jha Lab study. The phase I quantitative results confirmed the null hypotheses-no significant differences found-for all research questions. Phase II resulted in eight thematic codes, six of which were central to the experiences described by participants (Halting, Sensing, Being, Shielding, Considering, and Engaging) and two that were not (Obstructing, and Escaping). The key finding was that the descriptions of mindful thoughts and behaviors were consistent across participants indicating that MBAT accurately presents mindfulness during the course and the training had positive effects on participant mindfulness, primarily in the areas of being present to self, shielding the self through reperceiving, and then consciously altering behavior based on the new perspective. Results should direct future resiliency course development, leadership course curricula, and aid understanding of how leaders mentally conceptualize stress, incorporate resilient behaviors and then apply that knowledge to their own leadership behaviors.

Utilization of Supportive Programs in the National Guard

Military service poses stressors for many service members (SMs). Accordingly, support programs exist to address these demands, but these services are often underused. This article uses data from a needs assessment survey of SMs from the Idaho and Utah Air and Army National Guard (NG; N = 997). SMs were asked if they had heard of and used available mental health or transition assistance programs. Although usage rates were low overall, our analyses supported a “target population” hypothesis. We found that increases in mental health symptoms predicted mental health program use and military deployment was associated with increased transition assistance program use. Social workers can benefit from knowledge of available yet underused military programs to assist SMs. This study also sheds light on which subpopulations of the NG are less likely to use supportive programs and may benefit from additional outreach. This information can be used as a starting point for interventions to increase support given to SMs.

Assisting the Improvement of a Military Safety System: An Application of Rapid Assessment Procedures to the Automatic Ground Collision Avoidance System

This article describes an iterative application of Rapid Assessment Procedures (RAP) to study human-machine interaction issues with a recently implemented, highly automatic system on the F-16 fighter aircraft known as the Automatic Ground Collision Avoidance System (Auto-GCAS). Auto-GCAS is a sophisticated technology that has the ability to detect an imminent ground collision threat and automatically execute a last-moment maneuver to avoid a crash. We employed RAP methods at multiple United States Air Force and Air National Guard sites in the United States and abroad. Over a three-year period, we conducted semi-structured interviews with 402 F-16 pilots experienced with the system. The method we employed, termed here iterative RAP, is reviewed in detail and evaluated in the framework of Utarini, Winkvist, and Pelto's (2001) eleven criteria for quality RAP studies. Results from this study include assisting in correcting system misunderstandings and anomalies, improving information flow about Auto-GCAS, and contributing towards the perception of military safety systems as valuable. This article concludes by (1) discussing positive effects that iterative RAP can contribute to the defense community and (2) arguing our method's utility towards the study of complex bureaucracies and multi-sited research, particularly following the introduction of new technology or policy.

A Preliminary Study of U.S. Air Force Pilot Perceptions of the Pilot-Flight Surgeon Relationship.

Flight surgeons play a vital role in U.S. Air Force aviation operations by ensuring that pilots are medically prepared to meet the demands of military aviation. However, there is natural tension between pilots and flight surgeons. A pilot may be reluctant to share medical information with a flight surgeon who could negatively impact the pilot's career or flight status. In this preliminary study, we sought to identify pilot-perceived strengths and weaknesses in the relationship between U.S. Air Force aviators and their flight surgeons. An online survey regarding pilot-flight surgeon confidence and perceived values was distributed electronically to a convenience sample of U.S. Air Force aviators. Participants included U.S. Air Force active duty and Air Reserve Component (Air Force Reserve and Air National Guard) military aviators in addition to U.S. Air Force Academy aviation cadets. One hundred and seventy-three aviators participated in the survey. Respondents reported variable comfort in approaching flight surgeons with medical concerns and suggested that they believed other pilots might be withholding medical information from flight surgeons or seeking care from civilian physicians for career protection. We sought to examine the pilot-flight surgeon relationship and its impact on daily flying operations. While limited, results suggest that there may be gaps in trust between pilots and their flight surgeons. These findings could present an opportunity to improve the pilot-flight surgeon relationship by identifying factors that contribute to closer pilot-flight surgeon relationships.

Sources of Stress and Psychological Health Outcomes Among U.S. Air Force Total Force Distributed Common Ground System Operators.

U.S. Air Force Distributed Common Ground Station (DCGS) intelligence (Intel) operators sustain 24/7 battlefield situational awareness and facilitate precision-strike operations. DCGS operations are global, synergistic, Total Force (TF) endeavors by active duty, Air National Guard (ANG) and Reserve units, providing combatant commanders with critical real-time intelligence and shaping operational and tactical decisions. Continual surveillance of this community's psychological health is important to its military leaders. This study re-examines the most frequently reported occupational stressors, as well as the prevalence of occupational burnout (i.e., high-emotional exhaustion and cynicism, and low professional efficacy), and psychological distress within this population. Active duty (n = 1717), ANG (n = 139), and Reserve (n = 173) Intel operators participated in a comprehensive, online, occupational health assessment. Results reveal that occupational stressors contributing to elevated rates of distress, regardless of TF status (i.e., low manning, long work hours, excessive workload, and organizational communication concerns) are consistent with previous research. The prevalence of high-emotional exhaustion (AD: 29%/ANG: 25%/RES: 14%) and psychological distress (AD: 19%/ANG: 17%/RES: 5%) are above estimates for other military communities. These findings combined with demographic and occupational risk factors lay the foundation for improving psychological health within this Total Force community.

Sleep deprivation in Air National Guard medical personnel responding to simulated disaster-training exercises

ABSTRACT National Guard personnel remain largely unstudied within the sleep research community, despite their unique and important role. In response, the purpose of this study was to investigate the extent of sleep deprivation in National Guard medical personnel from two separate Air Force Bases (AFBs) responding to simulated disaster-training exercises. National Guard medical personnel (N = 77) were fitted with wrist activity monitors (actigraphy) to objectively measure their sleep for 4 days of their civilian time (baseline), followed by a 4-day transition period from civilian to military duty, and a 3–5-day disaster-training exercise. Differences in sleep quantity, quality, and “cognitive effectiveness” were analyzed using generalized linear mixed models. Participants’ sleep quantity was significantly reduced from civilian to disaster-training periods, and their cognitive effectiveness also dropped significantly. National Guard medical personnel were sleep-deprived during a simulated disaster-training exercise, which, although a valid proxy for real-world disasters, is likely to be a conservative approximation of the stress and fatigue National Guard personnel experience during crisis response. As such, the need for targeted fatigue-related interventions to safeguard our service members during these critical times is clear.

An Occupational Paradox: Why Do We Love Really Tough Jobs?

Sometimes we come upon unexpected or counterfactual results during research that make us wonder and lead us into unknown territory. Such was the experience of a team of Air Force researchers exploring aeromedical evacuation crew members' experiences of safety and patient care concerns throughout the en route care system. To explore what it is about the aeromedical evacuation crew members' occupation that generates a strong motivation to the mission despite the demands it places on its workers. Eight focus groups were conducted with 69 Air Force aeromedical evacuation and staging facility active duty, Air National Guard, and Air Force Reserve Command nurses and medical technicians between May 2012 and April 2013 at 5 locations in the contiguous and outside the contiguous United States. An unexpected finding was that despite the austere nature of the Air Force en route care mission and the acuity of the patients being transported, nurses and medical technicians were passionate about bringing home the wounded, sick, and injured warriors and were committed to providing the best and safest care possible. It is plausible that a high level of commitment and mission focus contributes significantly to the safety and well-being of those transported. Still, we must wonder why nurses and technicians voluntarily serve in such a demanding and sometimes dangerous occupation, and yet find such a high degree of satisfaction and contentment with this type of job.

Risk Factors for Incident Postdeployment Mental Health Conditions Among U.S. Air Force Medical Service Personnel.

The prevalence of postdeployment mental health (PDMH) conditions in military health care personnel appears to be on par with that of other military personnel. However, there is no comprehensive analysis of incident PDMH conditions within the overall population of U.S. Air Force Medical Service personnel. This study explored the epidemiology of incident PDMH conditions among Air Force Medical Service personnel returning from deployment. A cohort survival analysis was conducted of 24,409 subjects without preexisting mental health conditions and at least one deployment during 2003-2013. Electronic health record data were used to ascertain the diagnosis of a PDMH condition. The primary outcome measure was an incident PDMH condition defined as a mental health diagnosis on at least two separate clinical encounters. The incidence of PDMH conditions was 59.74 per 1,000 person-years. Adjustment, anxiety, mood, sleep, and post-traumatic stress disorders accounted for 78% diagnoses. Protective factors included officer, surgeon, specific enlisted career fields, Air National Guard or Air Force Reserve, and multiple deployments. Risk factors included nurse, other specific enlisted career fields, female, and unmarried with dependents. Most subjects (73%) were diagnosed within the standard 30-month surveillance time period; median time to diagnosis was 13 months.

Clinical Experience and Learning Style of Flight Nurse and Aeromedical Evacuation Technician Students

The clinical experience and preferred learning style of U.S. Air Force flight nurses and aeromedical evacuation technicians are unknown. Using a cross-sectional survey design, we gathered data regarding the clinical experience, level of comfort providing clinical care, and preferred learning style of 77 active duty (AD), Air Force Reserve (AFR), and Air National Guard (ANG) nurses enrolled in the U.S. Air Force School of Aerospace Medicine Flight Nurse course, and 121 AD, AFR, and ANG medical technicians enrolled in the Aeromedical Evacuation Technician course. Nurses and medical technicians reported 7.6 ± 5.5 and 3.9 ± 4.5 yr of experience, respectively. AD, AFR, and ANG nurses had comparable years of experience: 5.8 ± 3.2, 8.3 ± 6.6, and 7.9 ± 4.2 yr, respectively; however, AD medical technicians had more years of experience (5.6 ± 4.4 yr) than AFR (3.1 ± 4.8 yr) and ANG (1.9 ± 2.8 yr) medical technicians. Both nurses and medical technicians reported infrequently caring for patients with various disease processes and managing equipment or devices that they will routinely encounter when transporting patients as an aeromedical evacuation clinician. Nurses and medical technicians preferred a kinesthetic learning style or a multimodal learning style that included kinesthetic learning. Nearly all (99%) nurses and 97% of medical technicians identified simulation as their preferred teaching method. These findings confirm faculty concerns regarding the clinical experience of flight nurse and aerospace evacuation technician students.De Jong MJ, Dukes SF, Dufour KM, Mortimer DL. Clinical experience and learning style of flight nurse and aeromedical evacuation technician students. Aerosp Med Hum Perform. 2017; 88(1):23-29.

Embouchure Dysfunction in Air Force Band Brass Musicians.

Occupational injuries and medical problems in musicians are well described, but relatively less attention has been paid to orofacial and embouchure-related problems in professional brass players. This study addressed embouchure-related problems in Air Force Band members, a population of musicians with an intense practice and performance schedule. A survey was developed and distributed via the Air Force Survey Office to 599 active-duty Air Force Band members and 201 Air National Guard members. The survey assessed practice patterns, practice and performance venues, and presence of symptoms suggesting embouchure dysfunction. Responses were obtained from 167 Air Force Band brass players. Of the 157 responding to the question about embouchure dysfunction, 42% reported having experienced an embouchure problem at some point in the past, and 53% of those respondents reported that they were currently experiencing an embouchure problem. Forty-one percent of those with embouchure problems cited practice venues that were not conducive to effective and efficient practice at the time their embouchure problems began, and 48% of those with embouchure problems reported having to overblow in rehearsal at the time their problems began. Embouchure disorders were reported in a large proportion of Air Force Band brass survey respondents, and specific concerns related to practice venues and the need to overblow in practice settings suggest factors suitable to remediation and preventive strategies.