US Armed Research Articles

Perceived barriers and facilitators to implementation of injury prevention programs in the military: Feedback from inside the trenches

BackgroundMusculoskeletal injuries enact a substantial burden in military settings, incurring high costs, long-term disability, and impacting military readiness. This has led to a prioritization of injury prevention programs. Understanding the challenges faced by those trying to implement these programs could help standardize and better inform future efforts. The purpose was to capture perceptions of barriers and facilitators to implementation of injury prevention programs in the US Armed Forces. MethodsA cross-sectional survey with open-ended questions was circulated to relevant stakeholders; key themes were derived using conceptual content analysis. Four questions were asked concerning injury prevention programs: 1) barriers, 2) facilitators, 3) how can leadership best support, and 4) how can subject matter experts best collaborate to make these programs successful? ResultsThe survey reached at least 300 individuals working with the armed services worldwide; 91 completed the survey. The mean (SD) time working with military service members was 11.5 (8.2) years; 93 % worked with active-duty service members, 71.4 % were licensed healthcare providers, and 55 % worked in settings with established injury prevention programs. Only 45.2 % of participants believed an appropriate, clear way to measure program success currently exists. Nearly 85 % believed that lacking standardization of definitions and metrics hinders program assessment. Wide variability existed in opinions regarding who should be primarily responsible for promoting/supporting injury prevention efforts. Key themes included resources as both a facilitator (when present) and barrier (when absent), organizational culture, and leadership support. Leadership can best help by prioritizing the programs and valuing the programming through modeling the desired behavior. Program staff can collaborate by focusing on enabling change, integrating into organizational/unit culture and collaborating with leaders to change policy. ConclusionsFactors leading to incidence and recovery of musculoskeletal injuries are multifactorial, requiring collaborative multidisciplinary approaches for optimal injury prevention program development and implementation. Leadership support/prioritization, unit-level cultural acceptance and sufficient resources are essential facilitators to implementing prevention programs. Developing standardized, relevant metrics for assessing program effectiveness and establishing organizational best practices are necessary for long term program viability and lasting change.

FORMATION OF LEADERSHIP COMPETENCE OF FUTURE NGU OFFICERS IN THE CONTEXT OF THE NEW PARADIGM OF MILITARY EDUCATION

The article raises the question of the formation of leadership competence of future officers of the NGU in the modern conditions of a complex security environment, the armed aggression of the russian federation against Ukraine, the Euro-Atlantic choice of Ukraine and the modernization of the security and defense sector on the basis of operational interoperability in accordance with NATO standards and procedures. The need to train highly educated, competent, motivated professionals of the security sector, to which NGU belongs, is emphasized, whose success is determined by professionalism, adaptability, mobility and leadership qualities. Leadership as a multifaceted socio-historical phenomenon is considered on the basis of theories of leadership, which provides an understanding of the essence of influence on subordinates and commanders; peculiarities of preparation and training. The development of military leadership is related to its very purpose and the challenges of the modern security situation. The significance of the competence approach in the development of the leadership competence of the future officer of the NGU, which is reflected in the new paradigm of military education, is indicated. The figure of a modern military leader at NGU has been updated taking into account a certain model according to the requirements of NGU, in particular, what a leader should be, what he should know and do (perform), his features that ensure the realization of professional competencies. The concept of leadership competence has been updated and the directions of its formation have been clarified. It is noted that for the formation of the leadership competence of the future officer of the NGU, both existing models of leadership, the experience of Ukrainian higher military educational institutions, and successful practices in the development of military leadership in developed countries are important. In this regard, educational programs on leadership, approaches to the formation of leadership competence at the Kyiv Institute of the National Guard of Ukraine and the National Academy of the US Armed Forces were analyzed.

The physical training programme of the US Armed Forces as an element of the system: experience for the Armed Forces of Ukraine

The physical training programme of the US Armed Forces as an element of the system: experience for the Armed Forces of Ukraine

Exertional rhabdomyolysis: an analysis of 321 hospitalised US military service members and its relationship with heat illness

IntroductionExertional rhabdomyolysis is a syndrome of muscle breakdown following exercise. This study describes laboratory and demographic trends of service members hospitalised for exertional rhabdomyolysis and examines the relationships with heat...

FINANCIAL MANAGEMENT IN THE NATIONAL DEFENCE FIELD

The article examines the essence of the defense resources financial management, institutional and legal support, as well as the practice of its modernization in the leading countries of the world and Ukraine under the conditions of a full-scale war. According to the theoretical and institutional aspects analysis results, the concepts of " defense resources financial management" and "defense resources financial management system" were clarified, and the main principles and elements of the mechanism of its implementation were outlined. An assessment of the modern world practice of defense resources financial management was carried out on the example of the US Armed Forces in terms of institutional infrastructure, regulations, standards and tools. The main determinants of the US Armed Forces financial management are established: combat capability, human capital and environmental protection according to ESG principles and Sustainable Development Goals. The components of improving the system of financial management of Ukraine’s defense resources in accordance with the implementation of NATO financial management standards and regulations have been identified. A thorough analysis of the distribution of expenditures and the credits granting under budget programs in accordance with the goals of state policy in 2020-2023 and projected for 2024-2025, of individual defense budget expenditures of the Ministry of Defense of Ukraine in accordance with the budget request for 2024-2026 raised questions about the impact of budget defense expenditures for the development of Ukraine's economy. The existence of the specified positive influence was proved by means of correlation-regression analysis based on the data of budget expenditures in the time horizon of 2014-2023, with the period before the full-scale invasion of the aggressor country being singled out. However, the scientific hypothesis has not been confirmed for the US economy, that is, military spending is not characterized by a significant impact on the US GDP.

Type-specific whole blood still has a role in the era of low-titer O universal donor transfusion for severe trauma hemorrhage.

Whole blood can be ABO-type specific (type-specific whole blood (TSWB)) or low-titer O universal donor (low-titer O whole blood (LTOWB)). Having previously used LTOWB, the US Armed Forces Blood Program began using TSWB in 1965 as a method of increasing the donor pool. In contrast to military practice, the Association for the Advancement of Blood and Biotherapies formerly the American association of blood banks (AABB), from its first guidelines in 1958 until 2018, permitted only TSWB. Attempting to reduce time to transfusion, the US military reintroduced LTOWB in the deployed environment in 2015; this practice was endorsed by the AABB in 2018 and is progressively being implemented by military and civilian providers worldwide. Low-titer O whole blood is the only practical solution prehospital. However, there are several reasons to retain the option of TSWB in hospitals with a laboratory. These include (1) as-yet ill-defined risks of immunological complications from ABO-incompatible plasma (even when this has low titers of anti-A and -B), (2) risks of high volumes of LTOWB including published historical advice (based on clinical experience) not to transfuse type-specific blood for 2 to 3 weeks following a substantial LTOWB transfusion, (3) uncertainty as to the optimal definition of "low titer," and (4) expanding the potential donor pool by allowing type-specific transfusion. Several large randomized controlled trials currently underway are comparing LTOWB with component therapy, but none address the question of LTOWB versus TSWB. There are sufficient data to suggest that the additional risks of transfusing LTOWB to non-group O recipients should be avoided by using TSWB as soon as possible. Combined with the advantage of maintaining an adequate supply of blood products in times of high demand, this suggests that retaining TSWB within the civilian and military blood supply system is desirable. TSWB should be preferred when patient blood group is confirmed in facilities with a hematology laboratory, with LTOWB reserved for patients whose blood group is unknown.

The principles of physical training organisation of US Army officers

The article is devoted to the analysis of the principles of physical training organization of commissioned officers of the US Army, their implementation and effectiveness in the context of ensuring a high level of combat readiness. The US Armed Forces uses advanced technologies and scientific researches to continuously improve the physical training system, which includes the use of special training programs, monitoring of physical indicators and the development of new training methods based on scientific researches. The importance of an individual approach in training process training, as well as the integration of officers' physical training, is considered. The main goal is to understand and define the most effective and modern principles that ensure the optimal physical readiness of officers to perform their combat tasks. The article contains recommendations on optimizing the process of physical training, with the aim of increasing the functional capabilities of officers and ensuring their readiness to perform combat and training tasks in various conditions. The considerable attention is paid to the individual needs and capabilities of the US Armed Forces officers. The training programs can be adapted to specific needs and capabilities of officers, ensuring an efficient and safe physical fitness process. Physical training in the US Army is based on a high level of professionalism and motivation. This is stimulated by a system of recognition and awards, career development and provision of optimal conditions for training.

Self-Perception of Risk for HIV Acquisition and Calculated Risk for HIV Acquisition Among Active Duty Air Force Members With Newly Diagnosed HIV Infection.

There have been nearly 1,600 new diagnoses of Human Immunodeficiency Virus (HIV) across the US Armed Forces between 2017 and 2022. While treatment has improved overall survival, self-perception of acquiring HIV may not align with actual risk of acquiring HIV, thus slowing diagnosis and treatment. We aim to evaluate self-perceived risk (SPR) versus calculated risk (CR) of HIV infection in US Air Force (USAF) members with incident HIV diagnosis. All USAF members with new HIV diagnosis evaluated at a specialty care military medical center between January 2015 and March 2020 with case report forms were included (n = 142). SPR was compared to CR using the Denver HIV Risk Score (DHRS). The study was approved by the Army Public Health Center's Public Health Review Board (#14-311) and the Walter Reed Army Institute of Research Human Subjects Protection Branch (#1861E). Patients were predominantly male (98%), with a median age of 26 (IQR 22-30) years, and the majority (85%) reported same-sex partners. Most patients reported a low SPR (n = 78; 55%). A higher proportion of low SPR patients were married or partnered than high SPR patients (29% versus 14%; P = 0.04). Both groups had median DHRS scores in the highest risk category with similar results by reason for HIV screening. The majority of USAF members with incident HIV infection reported a low SPR despite risk factors and CRs identical to high SPR patients. In order to inform HIV prevention strategies in the military, further efforts are needed to educate the military population and providers about HIV risk perception.

Ethnic speech originality of the linguistic personality of the US Armed Forces servicemen

Ethnic speech originality of the linguistic personality of the US Armed Forces servicemen

Prevalence of Urogenital Mycoplasma genitalium Infection at 2 US Army Medical Facilities.

Sexually transmitted infections (STIs) have a high incidence in the US Armed Forces and can adversely impact service members' ability to perform their duties. Better knowledge of Mycoplasma genitalium (MG) epidemiology in the military is needed to understand the potential impact of this emerging pathogen on force readiness. We conducted cross-sectional analyses of data from US Army service members and other Military Health System beneficiaries participating in a trial of an STI/HIV behavioral intervention at Fort Liberty, NC, and Joint Base Lewis-McChord, WA. At enrollment, participants completed questionnaires and provided biological specimens for nucleic acid amplification testing for MG, Chlamydia trachomatis (CT), and Neisseria gonorrhoeae (NG). We used principal component analysis and robust Poisson regression to examine associations between participant characteristics and prevalent urogenital MG. Among 432 participants enrolled between November 2020 and February 2023, 43 had MG (prevalence, 10.0%), of whom 13 had coinfection with another bacterial STI (all 13 were positive for CT, with 1 also positive for NG). The prevalence of MG was significantly higher among female (13.5%) versus male (7.6%; P = 0.048) participants and non-Hispanic Black (14.9%) versus non-Hispanic White participants (6.6%; P = 0.045). Single relationship status and increased number of recent sexual partners were correlated, and their component was associated with higher MG prevalence (adjusted prevalence ratio, 2.11; 95% confidence interval, 1.29-3.48). The high prevalence of urogenital MG among Military Health System beneficiaries highlights the importance of understanding the potential clinical sequelae of MG and conducting additional epidemiologic research in military settings.

Профессиональная языковая личность военнослужащих Вооруженных сил США (по материалам текстов американских военных блогеров)

The aim of the research is to determine the features of written colloquial speech of bloggers serving in the US Armed Forces in the system of traditional speech interaction. The paper focuses on the essence of the professional communication language in the concept of modern scholars of the second half of the 20th and the first two decades of the 21st century within the study of the linguistic personality of a particular social group as a subject of professional activity. The content of the notions of “a linguistic personality” and “a professional linguistic personality” is determined. The main focus is on identifying units of military jargon and military slang in the speech of American military bloggers as a way of expressing the attitude of military personnel to military service. The scientific novelty lies in the approach to the study of the professional linguistic personality of the US Armed Forces representatives from the perspective of its ethnic identity. In addition, an original feature of American servicemen is found – the presence of explication linguistic means of lexical features of speech. As a result, positive and negative images of a professional linguistic personality were recreated based on the texts of American military bloggers, in particular, emotionally charged elements of vocabulary (military jargon and military slang).

ПОГЛЯДИ АМЕРИКАНСЬКОГО СУСПІЛЬСТВА НА ВИВЕДЕННЯ СПОЛУЧЕНИМИ ШТАТАМИ ВІЙСЬК ІЗ АФГАНІСТАНУ В 2021 Р.

The aim of the article is to analyze and compare the differences and similarities in the reactions of various groups of American society to the end of the military campaign in Afghanistan. The groups in question are the general public, whose opinion is measured through social surveys, various political experts and think tanks, as well as the American politicians of a wide spectrum of views. The scientific novelty of the article is that the authors research the phenomenon of American public opinion on the aforementioned issue from various angles. The article describes in detail the views of the American public in general and its ideologically differentiated groups; the views of political experts as well as the politicians themselves. The methodological basis of the article. The authors use the analysis method as a general scientific method to explore the opinions of various public groups, including American war veterans, political experts, and politicians. Another method (peculiar for historical analysis) is the comparative-historical method, which is used to compare different societal perspectives on this historical event to discern similarities and differences between those perspectives. The systematic approach is also used to describe the view of American society as a system. The principle of objectivity is also applied to promote the unbiased nature of the authors’ conclusions. Results. The article helps to understand the reaction of different societal groups, including politicians and experts, on the US Armed Forces withdrawal from Afghanistan in 2021. Conclusions of the authors of this article demonstrate that the majority of the ordinary citizens as well as of the politicians were dissatisfied with the realities of the process of the evacuation of troops and civilians from Afghanistan. The actions of the American government in this regard also received critical appraisal. On the other hand, the majority of the population generally supported the end of the war. The political experts and members of think tanks were divided among themselves on the question of what influence this withdrawal may have on the US popularity and image in the world.

Development of the rear support system of the US Armed Force

The article discusses trends in the development of advanced rear systems of the US Armed Forces. New technologies of the material and technical support system of the US Armed Forces are analyzed. An analysis of legal normative documents, military doctrine, materials published in the media is carried out. According to military experts of the US Armed Forces, the resolution in the rear largely outlined ways to Impro e Information Systems.

Leadership Styles Experienced During Military Service Predict Later Anhedonic Depressive Symptoms andSelf-Efficacy inVeterans With Alcohol Use Disorder.

Lifetime and past-year alcohol use disorder (AUD) prevalence is significantly higher in US Armed Services Veterans than in non-veterans across adulthood. This study examined the associations of perceived transformational leadership styles (TLS) experienced during military service and anhedonic depression and self-efficacy related to confidence to abstain or reduce alcohol consumption in Veterans seeking treatment for AUD. The ramifications of perceived leadership styles on multiple aspects of follower psychiatric functioning, including depressive and PTSD symptomatology, during and after military service, may be substantial and enduring. Higher anhedonic depression and lower abstinence self-efficacy are related to increased risk of relapse after treatment. We predicted Veterans, in treatment for AUD, who reported higher perceived levels of transformational leadership during military service, demonstrate lower anhedonic depressive symptoms and higher alcohol abstinence self-efficacy. Veterans with AUD (n = 60; 50 ± 14 years of age) were recruited from residential treatment at the VA Palo Alto Health Care System. All procedures were approved by the VA Palo Alto Health Care System and Stanford University institutional review boards. A series of mediation analyses were completed with The Multifactor Leadership Questionnaire measures of TLS (average across leadership measures [transformational leadership average; TLS average]) as predictor and the Alcohol Abstinence Self-Efficacy Scale, Mood and Anxiety Symptom Questionnaire, anhedonic depression subscale, as dependent measures. PTSD Checklist for DSM-5 score was tested as a mediator variable. Higher reported perceived TLS average during military service was significantly related to lower anhedonic depressive symptoms. Higher TLS average was related to higher self-efficacy to resist alcohol use in contexts involving experience of physical issues and withdrawal/cravings and urges. These relationships were not mediated by PTSD symptomatology or duration of military service, age, education, time since military service, military branch, combat exposure, or current psychiatric diagnosis. The significant associations of perceived TLS during military service with anhedonic depression and alcohol use self-efficacy are clinically relevant because these measures are associated with relapse risk after AUD treatment. Further study of the implications of perceived TLS during military service for AUD and other substance use disorder treatment outcome is warranted in Veterans.

Barriers to Academic Surgery in the US Armed Forces: A Study of the AAS Military Committee

IntroductionThe purpose of this study is to explore current perceptions within the military surgery community to stratify key obstacles to pursuing a career in academic surgery and identify opportunities for mitigation. MethodsAfter receiving institutional review board approval, an anonymous electronic survey was distributed to military surgeons across all branches. Survey response data were collected and analyzed using chi-square test. ResultsThe response rate was approximately 22%. Of those who responded to the survey, most are interested in an academic career (61.5%); however, 64% believe this to be much more difficult as a military surgeon than as a civilian surgeon. The top three perceived obstacles include administrative obstacles (76.4%), operational commitments (65.8%), and lack of funding for academic pursuits (62.7%). Most respondents indicated that they have never received formal education regarding how to apply for research funding (84.5%) and most do not have a research mentor (60.9%). Additionally, 42.9% state that obstacles to an academic career in surgery impact their decision to leave the military. Younger surgeons were more likely to leave the military upon completion of their service commitment (67.9% versus 46.4% aged 20-39 y, P = 0.02). ConclusionsWe characterized the perceived challenges to academic surgery within the military. These barriers between academic surgery and military service risk medical force attrition, particularly in future generations of surgeons. Dedicated faculty billets (positions) with limited operational demands as well as associated mentorship and research funding may enhance the retention and productivity of military surgeons.

Supporting military-connected teens to thrive: a qualitative evaluation of a leadership program from the perspective of teens and adult advisors

For teens growing up in military-connected families, challenges relating to relocation, parental deployment, and reintegration add layers of stress to an already complex time of life. Out-of-school time programs provide military-connected teens opportunities to utilize existing strengths, develop new skills, and build support networks, as exemplified in the Military Teen Ambassador (MTA) program – a positive youth development program developed by the Boys and Girls Clubs of America in collaboration with the US Armed Forces. This study investigates the developmental benefits experienced by the teens serving on the MTA Steering Committee – a youth-adult collaboration designed to plan and deliver the MTA program. Interviews with teen and adult participants were analyzed through the lenses of relational developmental systems theory and a structured evaluation framework. Findings contribute insights into developmental processes and outcomes for programs targeting military-connected youth and provide applied implications that extend to broader youth and adult populations.

Striking for Victory

Abstract By the 1940s, the Women's International Bowling Congress (WIBC) was the largest sports membership organization for women in the world. At the advent of World War II, the WIBC implemented a nationwide fundraising campaign to support the war effort resulting in the direct purchase of a bomber, an ambulance, and three air evacuation planes for the US Armed Forces. The WIBC war effort unified, engaged, and connected more than two hundred thousand members to a common cause, while contributing to a significant growth in women's organized bowling nationwide. The effort helped usher in the “modern era” of women's organized bowling. Through it all, the WIBC emerged a more cohesive, stable group of state and local affiliations. The story of how WIBC leadership marshaled resources to contribute to the war effort while continuing their commitment to membership growth in wartime is important for the value it adds to the history of women's sports.

“In Accord with the Spirit of American Democracy”: Tracing the Network of the US Armed Services Editions

This essay explores the possibilities of thinking about the production, circulation, and reception of books through the form of the network. Using archival material of the Council of Books in Wartime, the essay reassembles some of the many attachments that formed the Armed Services Editions during World War II, one of the largest enterprises in the history of publishing. The essay traces the selections of the council, the networks of soldier-readers created by the books themselves, and the acts of reading constrained and made possible by these attachments across front lines and through bureaucratic memos. This assembly provides the backdrop for a consideration of the text of Thomas Mann’s “Mario and the Magician,” a short story published in the Armed Services Editions in 1944, whose plot not only mirrors the tension between authority and free will manifested in the geopolitical conflict of World War II, but also elucidates the dialectic of power and agency modeled by the form of the network as articulated in the council’s reader-producing experiment itself. What is ultimately at stake in positing an uneven network of actors who negotiate, maintain, extend, and possibly even subvert vectors of cultural power is a reconsideration of the agency attributed to readers in sociological studies of literature.

Understanding Medical Standards for Entrance Into Military Service and Disqualifying Dermatologic Conditions.

The military is a desirable career field for many young adults; however, the Department of Defense (DoD) requires its members to maintain a level of health necessary to meet the physical demands of military duties and be able to deploy to austere environments. The strict standards are designed to protect the health of the individual and maximize mission success. Standards for entrance into the US Armed Forces, called accession standards, are codified in DoD Instruction 6130.03, Volume 1 and include a section dedicated to skin and soft tissue conditions. This document lists medical conditions that do not meet the standard due to current and prior diagnoses and is regularly updated by a board using the best available scientific evidence. Applicants who do not meet the physical and medical standards can be considered for a medical waiver, although not guaranteed. Generally, retention standards differ for those already serving in the military and will not be addressed here. The focus of this article is to inform the general dermatologic community that these standards exist, to discuss specific dermatologic conditions that are disqualifying at the current time, and to provide resources for the dermatologist or primary care physician to access current information.

РЕКОМЕНДАЦІЇ ЩОДО УДОСКОНАЛЕННЯ РУХОМИХ ЗАСОБІВ ТЕХНІЧНОГО ОБСЛУГОВУВАННЯ І РЕМОНТУ ОЗБРОЄННЯ ТА ВІЙСЬКОВОЇ ТЕХНІКИ

After the full-scale invasion of the Russian Federation on the territory of Ukraine, the issue of repair and restoration of weapons and military equipment of all types that are in service with the Armed Forces of Ukraine and those that come as material and technical assistance from partner countries has become acute, more than ever in the entire existence of the Armed Forces of Ukraine. In particular, there is the issue of repair and restoration of all types of weapons and military equipment by temporary repair and restoration bodies. In this article, an analysis of the composition and order of use of mobile means of maintenance and repair of missile and artillery weapons in the Armed Forces of Ukraine was carried out, and a comparison was made with the composition and order of use of mobile means of maintenance and repair of the US Armed Forces. Also, during the work, attention was paid to the improvement of the existing mobile means of maintenance and repair of weapons of the missile and artillery nomenclature. This issue was investigated by substantiating the prospects for the development of mobile means of maintenance and repair of missile and artillery weapons. The mentioned questions have significant problems and cause curiosity and exploratory research among specialists in the technical direction of logistics support in view of the need to make such qualitative changes to the restoration system that would allow to ensure the maximum coverage by proper repair of all defective samples of weapons and military equipment, including samples of foreign production, i.e. those that are in service with NATO countries. But first of all, it is necessary to develop specific recommendations for a prospective complex of mobile vehicles, which will include not only a qualitative update of repair equipment, but also take into account the principle of unification, interoperability and modularity of the sample under study. Keywords: maintenance, repair, restoration, mobile vehicle, missile and artillery weapons.