scholarly journals Musculoskeletal Injuries and United States Army Readiness. Part II: Management Challenges and Risk Mitigation Initiatives

2020 ◽  
Vol 185 (9-10) ◽  
pp. e1472-e1480 ◽  
Author(s):  
Joseph M Molloy ◽  
Timothy L Pendergrass ◽  
Ian E Lee ◽  
Keith G Hauret ◽  
Michelle C Chervak ◽  
...  
Keyword(s):  
United States ◽  
Risk Reduction ◽  
Injury Risk ◽  
Large Scale ◽  
Musculoskeletal Injuries ◽  
Chronic Injury ◽  
Early Management ◽  
The Impact ◽  
The U.S

Abstract Introduction Noncombat injuries (“injuries”) threaten soldier health and United States (U.S.) Army medical readiness, accounting for more than twice as many outpatient medical encounters among active component (AC) soldiers as behavioral health conditions (the second leading cause of outpatient visits). Noncombat musculoskeletal injuries (MSKIs) account for more than 80% of soldiers’ injuries and 65% of medically nondeployable AC soldiers. This review focuses on MSKI risk reduction initiatives, management, and reporting challenges within the Army. The authors will summarize MSKI risk reduction efforts and challenges affecting MSKI management and reporting within the U.S. Army. Materials/Methods This review focuses on (1) initiatives to reduce the impact of MSKIs and risk for chronic injury/pain or long-term disability and (2) MSKI reporting challenges. This review excludes combat or battle injuries. Results Primary risk reduction Adherence to standardized exercise programming has reduced injury risk among trainees. Preaccession physical fitness screening may identify individuals at risk for injury or attrition during initial entry training. Forward-based strength and conditioning coaching (provided in the unit footprint) and nutritional supplementation initiatives are promising, but results are currently inconclusive concerning injury risk reduction. Secondary risk reduction Forward-based access to MSKI care provided by embedded athletic trainers and physical therapists within military units or primary care clinics holds promise for reducing MSKI-related limited duty days and nondeployability among AC soldiers. Early point-of-care screening for psychosocial risk factors affecting responsiveness to MSKI intervention may reduce risk for progression to chronic pain or long-term disability. Tertiary risk reduction Operational MSKI metrics enable commanders and clinicians to readily identify soldiers with nonresolving MSKIs. Monthly injury reports to Army leadership increase command focus on soldiers with nonresolving MSKIs. Conclusions Standardized exercise programming has reduced trainee MSKI rates. Secondary risk reduction initiatives show promise for reducing MSKI-related duty limitations and nondeployability among AC soldiers; timely identification/evaluation and appropriate, early management of MSKIs are essential. Tertiary risk reduction initiatives show promise for identifying soldiers whose chronic musculoskeletal conditions may render them unfit for continued military service. Clinicians must document MSKI care with sufficient specificity (including diagnosis and external cause coding) to enable large-scale systematic MSKI surveillance and analysis informing focused MSKI risk reduction efforts. Historical changes in surveillance methods and injury definitions make it difficult to compare injury rates and trends over time. However, the U.S. Army’s standardized injury taxonomy will enable consistent classification of current and future injuries by mechanism of energy transfer and diagnosis. The Army’s electronic physical profiling system further enables standardized documentation of MSKI-related duty/work restrictions and mechanisms of injury. These evolving surveillance tools ideally ensure continual advancement of military injury surveillance and serve as models for other military and civilian health care organizations.

THE INFLUENCE OF SCOTTISH ACCOUNTANTS IN THE UNITED STATES: THE EARLY CASE OF THE SOCIETY OF ACCOUNTANTS IN EDINBURGH

1997 ◽  
Vol 24 (1) ◽  
pp. 117-141 ◽  
Author(s):  
T. A. LEE
Keyword(s):  
United States ◽  
General Theory ◽  
Research Program ◽  
The United States ◽  
The World ◽  
Early Case ◽  
The Impact ◽  
Chartered Accountants ◽  
The U.S

This study represents part of a long-term research program to investigate the influence of U.K. accountants on the development of professional accountancy in other parts of the world. It examines the impact of a small group of Scottish chartered accountants who emigrated to the U.S. in the late 1800s and early 1900s. Set against a general theory of emigration, the study's main results reveal the significant involvement of this group in the founding and development of U.S. accountancy. The influence is predominantly with respect to public accountancy and its main institutional organizations. Several of the individuals achieved considerable eminence in U.S. public accountancy.

scholarly journals Musculoskeletal Injuries and United States Army Readiness Part I: Overview of Injuries and their Strategic Impact

2020 ◽  
Vol 185 (9-10) ◽  
pp. e1461-e1471 ◽  
Author(s):  
Joseph M Molloy ◽  
Timothy L Pendergrass ◽  
Ian E Lee ◽  
Michelle C Chervak ◽  
Keith G Hauret ◽  
...  
Keyword(s):  
United States ◽  
Injury Risk ◽  
Mechanical Energy ◽  
Musculoskeletal Injuries ◽  
Injury Surveillance ◽  
Overuse Injuries ◽  
Limit Function ◽  
Injury Rates ◽  
Female Soldiers

Abstract Introduction Noncombat injuries (“injuries”) greatly impact soldier health and United States (U.S.) Army readiness; they are the leading cause of outpatient medical encounters (more than two million annually) among active component (AC) soldiers. Noncombat musculoskeletal injuries (“MSKIs”) may account for nearly 60% of soldiers’ limited duty days and 65% of soldiers who cannot deploy for medical reasons. Injuries primarily affect readiness through increased limited duty days, decreased deployability rates, and increased medical separation rates. MSKIs are also responsible for exorbitant medical costs to the U.S. government, including service-connected disability compensation. A significant subset of soldiers develops chronic pain or long-term disability after injury; this may increase their risk for chronic disease or secondary health deficits potentially associated with MSKIs. The authors will review trends in U.S. Army MSKI rates, summarize MSKI readiness-related impacts, and highlight the importance of standardizing surveillance approaches, including injury definitions used in injury surveillance. Materials/Methods This review summarizes current reports and U.S. Department of Defense internal policy documents. MSKIs are defined as musculoskeletal disorders resulting from mechanical energy transfer, including traumatic and overuse injuries, which may cause pain and/or limit function. This review focuses on various U.S. Army populations, based on setting, sex, and age; the review excludes combat or battle injuries. Results More than half of all AC soldiers sustained at least one injury (MSKI or non-MSKI) in 2017. Overuse injuries comprise at least 70% of all injuries among AC soldiers. Female soldiers are at greater risk for MSKI than men. Female soldiers’ aerobic and muscular fitness performances are typically lower than men’s performances, which could account for their higher injury rates. Older soldiers are at greater injury risk than younger soldiers. Soldiers in noncombat arms units tend to have higher incidences of reported MSKIs, more limited duty days, and higher rates of limited duty days for chronic MSKIs than soldiers in combat arms units. MSKIs account for 65% of medically nondeployable AC soldiers. At any time, 4% of AC soldiers cannot deploy because of MSKIs. Once deployed, nonbattle injuries accounted for approximately 30% of all medical evacuations, and were the largest category of soldier evacuations from both recent major combat theaters (Iraq and Afghanistan). More than 85% of service members medically evacuated for MSKIs failed to return to the theater. MSKIs factored into (1) nearly 70% of medical disability discharges across the Army from 2011 through 2016 and (2) more than 90% of disability discharges within enlisted soldiers’ first year of service from 2010 to 2015. MSKI-related, service-connected (SC) disabilities account for 44% of all SC disabilities (more than any other body system) among compensated U.S. Global War on Terrorism veterans. Conclusions MSKIs significantly impact soldier health and U.S. Army readiness. MSKIs also figure prominently in medical disability discharges and long-term, service-connected disability costs. MSKI patterns and trends vary between trainees and soldiers in operational units and among military occupations and types of operational units. Coordinated injury surveillance efforts are needed to provide standardized metrics and accurately measure temporal changes in injury rates.

A Perspective On The Impact of COVID-19 Pandemic in Basic Science Research and its Future implications

Coronaviruses ◽  
2020 ◽  
Vol 01 ◽  
Author(s):  
Yam Nath Paudel ◽  
Efthalia Angelopoulou ◽  
Bhupendra Raj Giri ◽  
Christina Piperi ◽  
Iekhsan Othman ◽  
...  
Keyword(s):  
Basic Science ◽  
Large Scale ◽  
Preventive Measure ◽  
Science Research ◽  
Research Institutes ◽  
Basic Science Research ◽  
Long Term Consequences ◽  
Long Term Impact ◽  
The Impact

: COVID-19 has emerged as a devastating pandemic of the century that the current generations have ever experienced. The COVID-19 pandemic has infected more than 12 million people around the globe and 0.5 million people have succumbed to death. Due to the lack of effective vaccines against the COVID-19, several nations throughout the globe has imposed a lock-down as a preventive measure to lower the spread of COVID-19 infection. As a result of lock-down most of the universities and research institutes has witnessed a long pause in basic science research ever. Much has been talked about the long-term impact of COVID-19 in economy, tourism, public health, small and large-scale business of several kind. However, the long-term implication of these research lab shutdown and its impact in the basic science research has not been much focused. Herein, we provide a perspective that portrays a common problem of all the basic science researchers throughout the globe and its long-term consequences.

Situational Breakdowns

2019 ◽  
Author(s):  
Anne Nassauer
Keyword(s):  
United States ◽  
Large Scale ◽  
Contextual Factors ◽  
The United States ◽  
Social Outcomes ◽  
Dynamic Processes ◽  
Collective Decisions ◽  
Different Types ◽  
The Impact

This book provides an account of how and why routine interactions break down and how such situational breakdowns lead to protest violence and other types of surprising social outcomes. It takes a close-up look at the dynamic processes of how situations unfold and compares their role to that of motivations, strategies, and other contextual factors. The book discusses factors that can draw us into violent situations and describes how and why we make uncommon individual and collective decisions. Covering different types of surprise outcomes from protest marches and uprisings turning violent to robbers failing to rob a store at gunpoint, it shows how unfolding situations can override our motivations and strategies and how emotions and culture, as well as rational thinking, still play a part in these events. The first chapters study protest violence in Germany and the United States from 1960 until 2010, taking a detailed look at what happens between the start of a protest and the eruption of violence or its peaceful conclusion. They compare the impact of such dynamics to the role of police strategies and culture, protesters’ claims and violent motivations, the black bloc and agents provocateurs. The analysis shows how violence is triggered, what determines its intensity, and which measures can avoid its outbreak. The book explores whether we find similar situational patterns leading to surprising outcomes in other types of small- and large-scale events: uprisings turning violent, such as Ferguson in 2014 and Baltimore in 2015, and failed armed store robberies.

scholarly journals Anti-meningococcal B vaccination in Italian adolescents: a cost-effective health opportunity

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Panatto ◽  
P Landa ◽  
D Amicizia ◽  
P L Lai ◽  
E Lecini ◽  
...  
Keyword(s):  
Large Scale ◽  
Public Health Problem ◽  
Vaccination Strategy ◽  
Cost Effective ◽  
Dose Schedule ◽  
Developed Countries ◽  
Invasive Disease ◽  
International Setting ◽  
The Impact

Abstract Background Invasive disease due to Neisseria meningitidis (Nm) is a serious public health problem even in developed countries, owing to its high lethality rate (8-15%) and the invalidating sequelae suffered by many (up to 60%) survivors. As the microorganism is transmitted via the airborne route, the only available weapon in the fight against Nm invasive disease is vaccination. Our aim was to carry out an HTA to evaluate the costs and benefits of anti-meningococcal B (MenB) vaccination with Trumenba® in adolescents in Italy, while also considering the impact of this new vaccination strategy on organizational and ethics aspects. Methods A lifetime Markov model was developed. MenB vaccination with the two-dose schedule of Trumenba® in adolescents was compared with 'non-vaccination'. Two perspectives were considered: the National Health Service (NHS) and society. Three disease phases were defined: acute, post-acute and long-term. Epidemiological, economic and health utilities data were taken from Italian and international literature. The analysis was conducted by means of Microsoft Excel 2010®. Results Our study indicated that vaccinating adolescents (11th year of life) with Trumenba® was cost-effective with an ICER = € 7,912/QALY from the NHS perspective and € 7,758/QALY from the perspective of society. Vaccinating adolescents reduces the number of cases of disease due to meningococcus B in one of the periods of highest incidence of the disease, resulting in significant economic and health savings. Conclusions This is the first study to evaluate the overall impact of free MenB vaccination in adolescents both in Italy and in the international setting. Although cases of invasive disease due to meningococcus B are few, if the overall impact of the disease is adequately considered, it becomes clear that including anti-meningococcal B vaccination into the immunization program for adolescents is strongly recommended from the health and economic standpoints. Key messages Free, large-scale MenB vaccination is key to strengthening the global fight against invasive meningococcal disease. Anti-meningococcal B vaccination in adolescents is a cost-effective health opportunity.

scholarly journals Variability of Cloudiness over Mountain Terrain in the Western United States

2017 ◽  
Vol 18 (5) ◽  
pp. 1227-1245 ◽  
Author(s):  
Edwin Sumargo ◽  
Daniel R. Cayan
Keyword(s):  
United States ◽  
Large Scale ◽  
Spatial Scales ◽  
High Elevation ◽  
Empirical Orthogonal Functions ◽  
Western United States ◽  
Spatial And Temporal Variability ◽  
Regional Patterns ◽  
Cloud Albedo

Abstract This study investigates the spatial and temporal variability of cloudiness across mountain zones in the western United States. Daily average cloud albedo is derived from a 19-yr series (1996–2014) of half-hourly Geostationary Operational Environmental Satellite (GOES) images. During springtime when incident radiation is active in driving snowmelt–runoff processes, the magnitude of daily cloud variations can exceed 50% of long-term averages. Even when aggregated over 3-month periods, cloud albedo varies by ±10% of long-term averages in many locations. Rotated empirical orthogonal functions (REOFs) of daily cloud albedo anomalies over high-elevation regions of the western conterminous United States identify distinct regional patterns, wherein the first five REOFs account for ~67% of the total variance. REOF1 is centered over Northern California and Oregon and is pronounced between November and March. REOF2 is centered over the interior northwest and is accentuated between March and July. Each of the REOF/rotated principal components (RPC) modes associates with anomalous large-scale atmospheric circulation patterns and one or more large-scale teleconnection indices (Arctic Oscillation, Niño-3.4, and Pacific–North American), which helps to explain why anomalous cloudiness patterns take on regional spatial scales and contain substantial variability over seasonal time scales.

scholarly journals Impact of the first COVID-19 shelter-in-place order in the United States on emergency department utilization, Marin County, California

2020 ◽  
Author(s):  
Brett R. Bayles ◽  
Michaela F George ◽  
Haylea Hannah ◽  
Patti Culross ◽  
Rochelle R. Ereman ◽  
...  
Keyword(s):  
United States ◽  
San Francisco ◽  
Large Scale ◽  
Temporal Dynamics ◽  
The United States ◽  
Emergency Department Utilization ◽  
Marin County ◽  
Before And After ◽  
Ed Visits ◽  
The Impact

Background: The first shelter-in-place (SIP) order in the United States was issued across six counties in the San Francisco Bay Area to reduce the impact of COVID-19 on critical care resources. We sought to assess the impact of this large-scale intervention on emergency departments (ED) in Marin County, California. Methods: We conducted a retrospective descriptive and trend analysis of all ED visits in Marin County, California from January 1, 2018 to May 4, 2020 to quantify the temporal dynamics of ED utilization before and after the March 17, 2020 SIP order. Results: The average number of ED visits per day decreased by 52.3% following the SIP order compared to corresponding time periods in 2018 and 2019. Both respiratory and non-respiratory visits declined, but this negative trend was most pronounced for non-respiratory admissions. Conclusions: The first SIP order to be issued in the United States in response to COVID-19 was associated with a significant reduction in ED utilization in Marin County.

scholarly journals The Influence of Logistics Mode on Cross Border E-commerce Business Scale

2021 ◽  
Vol 235 ◽  
pp. 03006
Author(s):  
Xiaohui Hu
Keyword(s):  
United States ◽  
Regression Analysis ◽  
The United States ◽  
Intermodal Transportation ◽  
Road Transportation ◽  
Cross Border ◽  
Logistics Mode ◽  
Transportation Logistics ◽  
The Impact

China’s cross-border e-commerce companies are facing the problem of high logistics cost caused by excessive reliance on road transportation in domestic logistics link. In the long-term development, crossborder e-commerce companies in the United States have adopted the intermodal transportation logistics mode, which can reduced the domestic logistics costs. In order to study the impact of intermodal-transportation logistics mode on the scale of cross-border e-commerce companies, this paper selects the relevant data of Hub Group, the first intermodal marketing company in North America, makes multiple regression analysis, and draws the following conclusion: the intermodal-transportation logistics mode of highway and railway collaborative transportation is conducive to the expansion of cross-border e-commerce business scale.

scholarly journals Language and translation practices of Spanish-language newspapers published in the U.S. borderlands between 1808 and 1930

2019 ◽  
Vol 14 (2) ◽  
pp. 218-242 ◽  
Author(s):  
Laura Gasca Jiménez ◽  
Maira E. Álvarez ◽  
Sylvia Fernández
Keyword(s):  
United States ◽  
Language Use ◽  
The United States ◽  
Spanish Language ◽  
Hispanic American ◽  
Language Policies ◽  
The Creation ◽  
The Impact ◽  
The U.S

Abstract This article examines the impact of the anglicizing language policies implemented after the annexation of the U.S. borderlands to the United States on language use by describing the language and translation practices of Spanish-language newspapers published in the U.S. borderlands across different sociohistorical periods from 1808 to 1930. Sixty Hispanic-American newspapers (374 issues) from 1808 to 1980 were selected for analysis. Despite aggressive anglicizing legislation that caused a societal shift of language use from Spanish into English in most borderland states after the annexation, the current study suggests that the newspapers resisted assimilation by adhering to the Spanish language in the creation of original content and in translation.

scholarly journals Sample-Selection Biases and the Industrialization Puzzle

2017 ◽  
Vol 77 (1) ◽  
pp. 171-207 ◽  
Author(s):  
Howard Bodenhorn ◽  
Timothy W. Guinnane ◽  
Thomas A. Mroz
Keyword(s):  
United States ◽  
Selection Bias ◽  
Meta Analysis ◽  
Sample Selection ◽  
Well Being ◽  
The United States ◽  
Compelling Evidence ◽  
Long Term Changes ◽  
The U.S

Understanding long-term changes in human well-being is central to understanding the consequences of economic development. An extensive anthropometric literature purports to show that heights in the United States declined between the 1830s and the 1890s, which is when the U.S. economy modernized. Most anthropometric research contends that declining heights reflect the negative health consequences of industrialization and urbanization. This interpretation, however, relies on sources subject to selection bias. Our meta-analysis shows that the declining height during industrialization emerges primarily in selected samples. We also develop a parsimonious diagnostic test that reveals, but does not correct for, selection bias in height samples. When applied to four representative height samples, the diagnostic provides compelling evidence of selection.

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