National Defense Authorization Research Articles

Foreword: U.S. Marine Gender Integration in Recruit Training.

The 2020 National Defense Authorization Act mandated that the Marine Corps not segregate recruit training by gender. This Military Medicine supplement details an independent academic study contracted by the Marine Corps Training and Education Command to inform the Marine Corps' future approaches to gender integration at recruit training. The authors conclude that with proper science-based training and an intentional approach to gender integration, the Marine Corps can bolster gender integration without losing its traditions, high standards, or warrior ethos in recruit training. A feasible path lies ahead to enhance the Corps' legacy of success. This special issue supports the Marine Corps Training and Education Command 2030 posture statement for leveraging science and technology for policy and doctrine to prepare and modernize the Marine Corps for the future operating environment.

Outsourcing national defense: an impediment to the US strategy of great power competition

ABSTRACT My goals in this paper are to elaborate further an approach to civil-military relations going beyond control to include effectiveness; and, to argue that outsourcing by the Department of Defense (DoD) results in opportunity costs making very difficult the implementation of the national security strategy of “great power competition.” The current acquisition authority for outsourcing impedes DoD accessing cutting-edge technology generated by “startups.” In an earlier era of strategic competition, the main US response was to create the National Aeronautics and Space Agency with a new acquisition authority – “other transaction authority” (OTA). In the National Defense Authorization Act of FY 2018 Congress stipulated that OTAs should be the preference for DoD in science and technology and prototyping, and education in OTAs be provided. This education has not been implemented. Consequently, a key element of the US great power competition strategy, which is the acquisition of new technology, goes wanting.

This Is Not Your Grandparents’ Military Justice System: The 2022 and 2023 National Defense Authorization Acts

This Is Not Your Grandparents’ Military Justice System: The 2022 and 2023 National Defense Authorization Acts

Transforming Military Justice: The 2022 and 2023 National Defense Authorization Acts

Transforming Military Justice: The 2022 and 2023 National Defense Authorization Acts

Acute Hearing Deficits associated with Weapons Exposure inSection734 Blast Overpressure Study (BOS).

This prospective, multi-site, observational study describes ongoing efforts in support of the Fiscal Year 2018 National Defense Authorization Act (NDAA) Section734 Blast Overpressure Study (BOS) to identify the acute effects impulse and blast exposure have on hearing abilities of the Warfighter in various military training environments. Hearing thresholds, a binaural tone detection task, and auditory symptoms were collected before and immediately following weapons exposure across nine military training environments from January 2020 to October 2022. An additional 25 non-exposed control participants also completed the behavioral test battery. A boothless audiometer was used to measure hearing ability in the field. Sound level meters were attached on-body to record the exposure environment throughout training. Mean threshold change for the blast-exposed group was worse than the control group. Of the 188 blast-exposed participants, 23 experienced a temporary threshold shift (TTS) acutely after exposure. A decrease in binaural tone detection performance and increased symptom severity was found when comparing blast-exposed participants with a TTS versus those without a significant change in hearing. A complex but consistent relationship between measured exposure level (LAeq8hr) and the magnitude of the resulting TTS is suggested in the available data. Recent discussions on Section734 studies examining the effects of repetitive blast exposure have indicated that hearing-related issues were a critical problem that needed additional research. Study outcomes provide highly repeatable results across various weapons systems with hazardous blast exposure. This standardized set of hearing assessment tools for evaluating acute effects of noise under field conditions has been critically important in improving our understanding of TTS in prospective human subject research.

Fiscal Year 2018 National Defense Authorization Act, Section734, Weapon Systems Line ofInquiry: Overview andBlast Overpressure Tool-A Module forHuman Body Blast Wave Exposure forSafer Weapons Training.

Experiences by service members in recent conflicts and training environments illuminate concerns about the possible effects of blast overpressure (BOP) exposure on brain health. Section734 of the National Defense Authorization Act for Fiscal Year (FY) 2018 (Public Law 115-91) requires that the Secretary of Defense conducts a longitudinal medical study on blast pressure exposure of members of the Armed Forces during combat and training, and the Assistant Secretary of Defense for Health Affairs was assigned responsibility for fulfilling requirements. The study's goal is to improve DoD's understanding of the impact of BOP exposure from weapon systems on service members' brain health and inform policy for risk mitigation, unit readiness, and health care decisions. This article focuses on the activities of the Weapon Systems Line of Inquiry (LOI) and the development of a prototype BOP Tool. The DoD established the Section734 Workgroup, which developed a program structure with five LOIs. The Weapon Systems LOI coordinated, collated, and analyzed information on BOP resulting from heavy weapons and blast events to inform strategies, and accounted for emerging research on health effects and performance. Ongoing research was leveraged to develop a BOP Tool as a standalone module and for integration into the Range Managers Toolkit. The effort identified opportunities for the DoD to improve the clarity of communications about BOP exposure, risk, and safety; establish methods to leverage emerging research; and develop a prototype BOP Tool to predict exposure loads when firing heavy weapons in training. It is recommended that the DoD revises requirements and policy to improve and standardize safety guidance throughout research, development, testing, and evaluation; acquisition; and training. The validated BOP Tool allows users to generate a scenario to predict BOP exposure and allows service members to modify them during planning for safer training.

The Impact ofResilience onEmployment Among Post-9/11 Veterans With andWithout Military Sexual Trauma Exposure.

Successful employment is a functional outcome of high importance for veterans after military discharge. There is a significant rising concern regarding exposure to military sexual trauma (MST) and related mental health outcomes that can impair functional outcomes, such as employment. Although resilience training is a key component of preparing for military service, to date the impact of resilience on employment outcomes for veterans with exposure to MST has yet to be examined. We sought to examine the relationship between resilience and employment in a national sample of post-9/11 veterans with and without MST exposure. A national survey was conducted between October 2021 and January 2022 to respond to the 2021 National Defense Authorization Act mandate to identify factors affecting post-9/11 women veteran's unemployment. Of veterans, 1,185 completed the survey. Of these, 565 (47.6%) were post-9/11 veterans. The survey collected data on demographics and employment; MST, adult sexual trauma (AST, outside of military), and childhood sexual trauma (CST) exposure; resilience (Response to Stressful Experiences Scale); Post Traumatic Stress Disorder (PTSD) Checklist (PCL-5); and depression (Patient Health Questionnaire-2). Multivariable logistic regression models identified gender-specific associations of resilience with employment among those exposed and not exposed to MST, adjusting for AST, CST, PTSD, and depression. Significance was set at P < .05. Of 322 women and 243 men post-9/11 veterans, 86.5% were employed. MST exposure (MST[+]) was reported by 31.4% (n = 101) of women and 16.9% (n = 41) of men. MST(+) women veterans were more likely to report CST (35.6% vs. 14.5%; P < .001), AST (68.3% vs. 17.2%; P < .001), and both CST and AST (19.8% vs. 7.2%; P < .001) than MST(-) women. MST(+) men were more likely to report AST (65.9% vs. 7.9%; P < .001), and both CST and AST (14.6% vs. 1.0%; P < .001) than MST(-) men. Levels of self-reported resilience were similar for MST(+) women and men and their MST(-) counterparts (women: 11.1 vs. 11.0; men: 11.5 vs. 12.0). For MST(+) women, each unit increase in resilience was associated with a 36% increase in odds of employment (OR: 1.36, 95% CI, 1.08-1.71); resilience was not associated with increased odds of employment among MST(-) women. Among MST(+) men veterans, each unit increase in resilience was associated with an 83% increase in odds of employment (aOR: 1.83, 95% CI, 1.13-2.98), and like women veterans, resilience was not associated with employment among MST(-) men. Among MST(+) women and men post-9/11 veterans, higher resilience was associated with increased odds of employment, whereas resilience was not associated with employment in MST(-) veterans. These findings suggest that resiliency during and after military service is a key component for potentially improving long-term outcomes. Improving resilience using evidence-based approaches among post-9/11 veterans exposed to MST may be an important avenue for increasing successful functional outcomes such as employment. Moreover, MST(+) women and men veterans may benefit from trauma-informed care as a substantial proportion of these individuals also report exposure to CST, AST, PTSD, and depression.

Opioid prescribing and use in the Military Health System: a framework synthesis, FY2016-FY2021.

Opioid misuse is a nationwide issue and is of particular concern with regard to military readiness. The 2017 National Defense Authorization Act charges the Military Health System with greater oversight of opioid use and mitigation of misuse. We synthesized published articles using secondary analysis of TRICARE claims data, a nationally representative database of 9.6 million beneficiaries. We screened 106 articles for inclusion and identified 17 studies for data abstraction. Framework analysis was conducted, which assessed prescribing practices, patient use, and optimum length of opioid prescriptions after surgery, trauma, and common procedures, as well as factors leading to sustained prescription opioid use. Across the studies, sustained prescription opioid use after surgery was low overall, with <1% of opioid-naïve patients still receiving opioids more than 1 year after spinal surgery or trauma. In opioid-exposed patients who had undergone spine surgery, sustained use was slightly lower than 10%. Higher rates of sustained use were associated with more severe trauma and depression, as well as with prior use and initial opioid prescriptions for low back pain or other undefined conditions. Black patients were more likely to discontinue opioid use than were White patients. Prescribing practices are well correlated with degree of injury or intensity of intervention. Sustained prescription opioid use beyond 1 year is rare and is associated with diagnoses for which opioids are not the standard of care. More efficient coding, increased attention to clinical practice guidelines, and use of tools to predict risk of sustained prescription opioid use are recommended.

DOD updates firefighting foam requirements

The US Department of Defense has new specifications for firefighting foam used to put out jet fuel and other class B hydrocarbon liquid fuel fires. Under the requirements, concentrated firefighting agents cannot contain more than 1 ppb per- and polyfluoroalkyl substances (PFAS) , and the concentrate must be diluted with freshwater to create foam at the time of use. The National Defense Authorization Act of 2020 required the DOD to update the standards by Jan. 31, 2023. The department must stop purchasing PFAS-containing foams by Oct. 1 and use existing stocks by Oct. 1, 2024. Hundreds of military bases are contaminated with PFAS from aqueous film–forming foam used for decades to extinguish jet fuel fires. “The new standard marks critical progress toward finally eliminating this source of PFAS contamination from military installations,” Melanie Benesh, vice president for government affairs at the Environmental Working Group, an advocacy organization, says in a

Congress Reforms Military Sentencing, Creating an Opportunity for a Productive Sentencing Reform Dialogue Between the Military and Civilian Criminal Justice Systems

In recently-enacted legislation, Congress drew upon the 35-year experience with sentencing reform in the federal civilian criminal courts to reform significant aspects of the sentencing process in the military justice system. The article reviews the sentencing reform provisions contained in the National Defense Authorization Act for FY2022 and the Military Justice Act of 2016, which address many of the core elements of sentencing, including: (1) the principles governing sentencing in courts-martial; (2) the use of sentencing “parameters” and “criteria” in the adjudication of sentences by general and special courts-martial; (3) the role of the military judge in the adjudication of sentences; (4) consideration of plea agreements at the trial level; (5) appellate review of sentences; (6) clemency and related actions on the sentence, and more. After summarizing the history of military and civilian sentencing, the article reviews the newly-enacted military justice sentencing provisions, comparing them to the relevant provisions in the federal civilian sentencing system that were enacted as part of the Sentencing Reform Act of 1984 and subsequent legislation, and implemented by the U.S. Sentencing Commission. Although some of these newly-enacted reforms mirror similar elements of the federal civilian sentencing system, others follow a different approach, reflecting a decision by Congress to adapt rather than simply adopt current civilian practices. As Congress, the Administration, and a new Sentencing Commission focus on criminal justice reform, including possible changes to civilian sentencing law and policy, the recent reforms in military justice sentencing provide an important source of insights worthy of consideration.

Improved Outcomes for Trauma Patients in a Military Treatment Facility After Initiation of an American College of Surgeons-Verified Trauma Program.

The National Defense Authorization Act of 2017 indicated the need for a national strategy to improve trauma care among military treatment facilities (MTFs). Part of the proposed strategy to improve trauma outcomes was to convert identified MTFs into verified trauma centers. The American College of Surgeons (ACS) verifies trauma centers through an evaluation process based on available resources at a facility. It has been proven that trauma centers, specifically those verified by the ACS, have improved trauma outcomes. In 2017, we implemented steps to become a level III trauma program, according to the standards for designation by the state and verification through the ACS. The goal of this retrospective review is to evaluate the impact of this implementation with regard to both patient care and the MTF. Data from a single-MTF trauma registry from 2018, at the initiation of the trauma program, to present were reviewed. Outcomes were selected based upon the ACS verification criteria. Specifically, emergency department length of stay (ED LOS), nonsurgical admissions, injury severity score, diversion rates, and time to operating room were reviewed. Statistical analyses were performed using Student's t-tests. Institutional review board (IRB) approval was not required for this study as it was performed as a quality improvement project using deidentified data. ED LOS decreased significantly after implementation of the trauma program from an average of 6.43 h in 2018 to 4.73 h in 2019 and 4.6 h in 2020 (P < .04). Nonsurgical admissions decreased significantly from 57.8% in 2018, with rates of <20% in all subsequent years (P < .01). The average injury severity score increased from 5.61 in 2018 to 7.52 in 2020 (P < .01) and 7.27 in 2021 (P < .01). Diversion rates also decreased from >5% in 2018 to 0% in 2021. The establishment of a trauma program in accordance with the standards of the ACS for verification improved metrics of care for trauma patients at our MTF. This implementation as part of the local trauma system also led to increased injury severity seen by the MTF, which enhances readiness for its providers.

Department of Defense Trauma Registry Infectious Disease Module Impact on Clinical Practice.

The Joint Trauma System (JTS) is a DoD Center of Excellence for Military Health System trauma care delivery and the DoD's reference body for trauma care in accordance with National Defense Authorization Act for Fiscal Year 2017. Through the JTS, evidence-based clinical practice guidelines (CPGs) have been developed and subsequently refined to standardize and improve combat casualty care. Data are amassed through a single, centralized DoD Trauma Registry to support process improvement measures with specialty modules established as the registry evolved. Herein, we review the implementation of the JTS DoD Trauma Registry specialty Infectious Disease Module and the development of infection-related CPGs and summarize published findings on the subsequent impact of the Infectious Disease Module on combat casualty care clinical practice and guidelines. The DoD Trauma Registry Infectious Disease Module was developed in collaboration with the Infectious Disease Clinical Research Program (IDCRP) Trauma Infectious Disease Outcomes Study (TIDOS). Infection-related information (e.g., syndromes, antibiotic management, and microbiology) were collected from military personnel wounded during deployment June 1, 2009 through December 31, 2014 and medevac'd to Landstuhl Regional Medical Center in Germany before transitioning to participating military hospitals in the USA. To support process improvements and reduce variation in practice patterns, data collected through the Infectious Disease Module have been utilized in TIDOS analyses focused on assessing compliance with post-trauma antibiotic prophylaxis recommendations detailed in JTS CPGs. Analyses examined compliance over three time periods: 6 months, one-year, and 5 years. The five-year analysis demonstrated significantly improved adherence to recommendations following the dissemination of the 2011 JTS CPG, particularly with open fractures (34% compliance compared to 73% in 2013-2014). Due to conflicting recommendations regarding use of expanded Gram-negative coverage with open fractures, infectious outcomes among patients with open fractures who received cefazolin or expanded Gram-negative coverage (cefazolin plus fluoroquinolones and/or aminoglycosides) were also examined in a TIDOS analysis. The lack of a difference in the proportion of osteomyelitis (8% in both groups) and the significantly greater recovery of Gram-negative organisms resistant to aminoglycosides or fluoroquinolones among patients who received expanded Gram-negative coverage supported JTS recommendations regarding the use of cefazolin with open fractures. Following recognition of the outbreak of invasive fungal wound infections (IFIs) among blast casualties injured in Afghanistan, the ID Module was refined to capture data (e.g., fungal culture and histopathology findings, wound necrosis, and antifungal management) needed for the TIDOS team to lead the DoD outbreak investigation. These data captured through the Infectious Disease Module provided support for the development of a JTS CPG for the prevention and management of IFIs, which was later refined based on subsequent TIDOS IFI analyses. To improve combat casualty care outcomes and mitigate high-consequence infections in future conflicts, particularly in the event of prolonged field care, expansion, refinement, and a mechanism for sustainability of the DoD Trauma Registry Infectious Disease Module is needed to include real-time surveillance of infectious disease trends and outcomes.

Building a sustainable Mil-Civ partnership to ensure a ready medical force: A single partnership site's experience.

One of the challenges in military medicine is ensuring that the medical force deployed to the theater of combat operations is prepared to perform life, limb, and eyesight saving care at a level of care comparable to our top civilian Level I trauma centers. There is increasingly more evidence demonstrating that the majority of military physicians are not exposed to trauma or combat casualty care-relevant surgical cases on a consistent basis in their daily practice at their garrison military treatment facility (MTF). To prevent this widening skills and experience gap from become more of a reality, the 2017 National Defense Authorization Act called for the expansion of military and civilian (Mil-Civ) medical partnerships, working toward embedding military medical providers and surgical teams in busy civilian trauma centers. Vanderbilt University Medical Center is one of the busiest trauma centers in the country and being in close proximity to the local MTF at Fort Campbell, KY, it is primed to become one of the premier Mil-Civ partnerships. Creating a strategy that builds the partnership in a calculated and stepwise fashion through multiple avenues with centralized leadership has resulted in the early success of the program. However, Vanderbilt University Medical Center is not immune to challenges similar to those at other Mil-Civ partnerships, but only by sharing best practices can we continue to make progress.

The 117th Congress

From infrastructure to assistance for low-income customers to regulation mandates, the 117th session of the US Congress is shaping up to be busy for the drinking water community. A key driver has been the COVID-19 pandemic and the economic havoc it has caused. Investment in infrastructure is a traditional government strategy during economic slumps, and investment in water infrastructure has the added benefit of protecting public health and the environment. Hence, the American Rescue Plan Act (ARPA) of 2021, enacted last spring, provided US$10 billion to invest in water, broadband, and health sector infrastructure. The challenge for our sector was the broad strokes Congress used to paint this legislation and the fact that the water infrastructure provision channeled funds through city governments and failed to account for the regional nature of many water systems. This use of infrastructure investment to kick-start economic growth appeared again this fall as Congress considered two pieces of legislation in tandem: the Bipartisan Infrastructure Framework (BIF), or H.R. 3684, and the ambitious Build Back Better Act, or H.R. 5376. The BIF would reauthorize the drinking water and wastewater state revolving loan fund programs, reauthorize the Water Infrastructure Finance and Innovation Act program, and provide $15 billion for lead service line replacement. It also would extend the “buy American” requirements for manufactured products to projects receiving federal support. The Build Back Better Act would provide an additional $9 billion to address lead in drinking water, either by replacing lead service lines in economically distressed areas or by replacing lead pipes and fountains at schools and day care centers. AWWA has developed a very conservative estimate that it will cost at least $60 billion to replace all of the service lines that will likely require replacement under the upcoming revised Lead and Copper Rule. That means the money in this year's legislation would be a nice down payment on that effort, but not a cure-all. The economic stress the country felt this year also gave new life to efforts to create an assistance program for customers having difficulty paying their water bills. An omnibus federal funding bill passed last December provided $638 million to help low-income customers pay their water bills. ARPA provided another $500 million. The BIF would mandate a study of the needs of low-income water customers and create a pilot grant program involving up to 40 water systems. The Build Back Better Act would provide $250 million for low-income customers. If these two bills pass, we will be studying how customer assistance programs work while at the same time rolling out more money for the programs. That's a reflection of how some members of Congress aren't sure how such programs should be structured, while others are adamant that low-income customers need help now. AWWA and its partner water organizations typically are not involved in defense legislation. However, there have been recent attempts to force regulation of per- and polyfluoroalkyl substances (PFAS) in drinking water via the annual legislation authorizing programs at the US Department of Defense. Each year, these bills are called the National Defense Authorization Act (NDAA). A bonus for the water community last year was NDAA's requirement for better reporting of PFAS discharges by industry. In this year's NDAA deliberations, the House version of that legislation would require drinking water regulations for two PFAS compounds, which may be irrelevant since the US Environmental Protection Agency is well on track to do that anyway. The Senate version would not have that requirement, but would do something beneficial for drinking water providers: require US defense facilities to notify nearby water systems when PFAS are detected on or near their sites. A House–Senate conference committee will iron out a single NDAA and AWWA will be communicating its members’ concerns to conferees. Another topic to watch in the NDAA deliberations is cybersecurity. Requirements to report certain cyberattacks at critical infrastructure facilities—and that obviously includes drinking water systems—are in the House version and may end up in the Senate bill. AWWA and other organizations are communicating with Congress on such a program should be structured. As we approach 2022, expect deliberations on infrastructure, customer assistance, cybersecurity, and the pace of regulatory development to continue. Then add to that upcoming deliberations for the next version of the five-year Farm Bill. In the last Farm Bill, AWWA was successful in getting agricultural conservation programs to do a better job of protecting sources of drinking water. We will want to keep that momentum going and possibly make some administrative tweaks. The 117th Congress will be one to remember. Tommy Holmes is director of legislative affairs at the AWWA Government Affairs Office in Washington, D.C. He can be reached at [email protected].

Pioneering a Value-Based Purchasing Initiative for Ambulatory Surgery Centers in TRICARE West.

Pioneering a Value-Based Purchasing Initiative for Ambulatory Surgery Centers in TRICARE West.

Aligning Program Management Competencies to Industry Standards

The 2020 National Defense Authorization Act mandated that acquisition career fields realign their certification requirements to be based on the nationally recognized standards of an accredited third party. This study offers recommendations for improving the DoD program management (PM) training standards by providing traceability between the DoD PM competencies and the Project Management Institute (PMI)’s standards for project, program, and portfolio management. The study elaborates on the extent of alignment, finding that 96% of the DoD PM competency elements align to PMI standards. Areas of misalignment identify opportunities to augment DoD PM training and highlight areas where DoD PM training deviates from industry standards.

Aligning Program Management Competencies to Industry Standards

The 2020 National Defense Authorization Act mandated that acquisition career fields realign their certification requirements to be based on the nationally recognized standards of an accredited third party. This study offers recommendations for improving the DoD program management (PM) training standards by providing traceability between the DoD PM competencies and the Project Management Institute (PMI)’s standards for project, program, and portfolio management. The study elaborates on the extent of alignment, finding that 96% of the DoD PM competency elements align to PMI standards. Areas of misalignment identify opportunities to augment DoD PM training and highlight areas where DoD PM training deviates from industry standards.

Automotive Ground Vehicles' Resilience to HEMP Attack: An Emergency Management Mitigation Plan

United States exposure to attack from a nuclear weapon of mass destruction (WMD) optimized to generate a high‐altitude electromagnetic pulse (HEMP) is a concern in national security forums. Such an attack could lead to widespread damage to the electrical components of many critical infrastructures. The purpose of this study was to develop a framework to better understand the hazard risks from a HEMP attack on non‐military (non‐MIL), “electronics‐heavy” automotive ground vehicles that could inform an effective emergency management response and recovery plan. A hybrid emergency management and engineering hazards risk analysis utilizing a Failure Modes and Effects Analysis (FMEA) format helped visualize the critical vehicle electronics subsystems and components, and their respective potential failure modes. A design of experiments test plan was developed to quantify the risks, and to develop a pathway to validate cost‐effective mitigation countermeasures based on present‐day best practices for HEMP hardening. The proposed emergency management plan emphasized strategic implementation of HEMP mitigation countermeasures to support continuity in emergency services and delivery of community lifelines to the public. The results of this study will serve as a foundation for future HEMP projects with automotive ground vehicles that will support the FEMA National Preparedness Goal, Presidential Executive Order 13865, and the recent FY2020 National Defense Authorization Act (NDAA) legislation. The methodologies can also apply to other critical infrastructure segments.

Getting on the Same Page: Consolidating Terminology to Facilitate Cross-Disciplinary Health-Related Blast Research.

The consequences of blast exposure (including both high-level and low-level blast) have been a focal point of military interest and research for years. Recent mandates from Congress (e.g., National Defense Authorization Act for Fiscal Year 2018, section 734) have further accelerated these efforts, facilitating collaborations between research teams from a variety of disciplinary backgrounds. Based on findings from a recent scoping review, we argue that the scientific field of blast research is plagued by inconsistencies in both conceptualization of relevant constructs and terminology used to describe them. These issues hamper our ability to interpret study methods and findings, hinder efforts to integrate findings across studies to reach scientific consensus, and increase the likelihood of redundant efforts. We argue that multidisciplinary experts in this field require a universal language and clear, standardized terminology to further advance the important work of examining the effects of blast exposure on human health, performance, and well-being. To this end, we present a summary of descriptive conventions regarding the language scientists currently use when discussing blast-related exposures and outcomes based on findings from a recent scoping review. We then provide prescriptive conventions about how these terms should be used by clearly conceptualizing and explicitly defining relevant constructs. Specifically, we summarize essential concepts relevant to the study of blast, precisely distinguish between high-level blast and low-level blast, and discuss how the terms acute, chronic, exposure, and outcome should be used when referring to the health-related consequences of blast exposure.

Unpacking the SEC’s new disgorgement powers

PurposeTo analyze the impact of recent legislation that amended the Securities Exchange Act of 1934 to expressly empower the U.S. Securities and Exchange Commission (SEC) to seek disgorgement in federal district court proceedings and to codify applicable statutes of limitations.Design/methodology/approachThis article provides an overview of the authors’ prior work analyzing courts’ treatment of SEC disgorgement and summarizes how the scope of the remedy has evolved since Kokesh v. SEC (2017). Then, the article analyzes the changes to the Securities Exchange Act of 1934 contained in Section 6501 the 2021 National Defense Authorization Act (NDAA), which statutorily empowered the SEC to seek and obtain disgorgement in federal court actions. Finally, the authors discuss the impact of the legislation on the Supreme Court’s decisions in Kokesh and Liu v. SEC (2020).FindingsThe availability and appropriateness of SEC disgorgement have been the subject of vigorous debate. Just as courts began to iron out the contours of SEC disgorgement in the wake of Kokesh and Liu, Congress intervened by granting to the SEC explicit statutory authority to seek a remedy traditionally obtained at equity. In passing this legislation, Congress answered some questions that remained after Liu but also raised many new ones. These new questions will likely take years to resolve through subsequent litigation and potentially additional legislation.Originality/valueOriginal, practical analysis and guidance from experienced lawyers in financial services regulatory and enforcement practices, many of whom have previously worked in the SEC’s Division of Enforcement.