scholarly journals Seasonal Trends for Environmental Illness Incidence in the U.S. Army

2021 ◽  
Author(s):  
David W DeGroot ◽  
Catherine A Rappole ◽  
Paige McHenry ◽  
Robyn M Englert
Keyword(s):  
Risk Mitigation ◽  
Cold Season ◽  
Incidence Rates ◽  
Cold Weather ◽  
Medical Surveillance ◽  
Piecewise Regression ◽  
Exertional Heat Illness ◽  
Policies And Procedures ◽  
Icd Codes ◽  
The U.S

ABSTRACT Introduction The incidence of and risk factors for exertional heat illness (EHI) and cold weather injury (CWI) in the U.S. Army have been well documented. The “heat season”, when the risk of EHI is highest and application of risk mitigation procedures is mandatory, has been arbitrarily defined as May 1 through September 30, while the “cold season” is understood to occur from October 1 to April 30 each year. The proportions of EHI and CWI that occur outside of the traditional heat and cold seasons are unknown. Additionally, it is unknown if either of the seasonal definitions are appropriate. The primary purpose of this study was to determine the proportion of EHI and of CWI that occur within the commonly accepted seasonal definitions. We also report the location-specific variability, seasonal definitions, and the demographic characteristics of the populations. Methods The U.S. Army installations with the highest frequency of EHI and of CWI from 2008 to 2013 were identified and used for analysis. In total there were 15 installations included in the study, with five installations used for analysis in both the EHI and CWI projects. In- and out-patient EHI and CWI data (ICD-9-CM codes 992.0 to 992.9 and ICD codes 991.0 to 991.9, respectively) were obtained from the Defense Medical Surveillance System. Installation-specific denominator data were obtained from the Defense Manpower Data Center, and incidence rates were calculated by week, for each installation. Segmental (piecewise) regression analysis was used to determine the start and end of the heat and cold seasons. Results Our analysis indicates that the heat season starts around April 22 and ends around September 9. The cold season starts on October 3 and ends on March 24. The majority (n = 6,445, 82.3%) of EHIs were diagnosed during the “heat season” of May 1 to September 30, while 10.3% occurred before the heat season started (January1 to April 30) and 7.3% occurred after the heat season ended (October 1 to December 31). Similar to EHI, 90.5% of all CWIs occurred within the traditionally defined cold season, while 5.7% occurred before and 3.8% occurred after the cold season. The locations with the greatest EHI frequency were Ft Bragg (n = 2,129), Ft Benning (n = 1,560), and Ft Jackson (n = 1,538). The bases with the largest proportion of CWI in this sample were Ft Bragg (17.8%), Ft Wainwright (17.2%), and Ft Jackson (12.7%). There were considerable inter-installation differences for the start and end dates of the respective seasons. Conclusions The present study indicates that the traditional heat season definition should be revised to begin  ∼3 weeks earlier than the current date of May 1; our data indicate that the current cold season definition is appropriate. Inter-installation variability in the start of the cold season was much larger than that for the heat season. Exertional heat illnesses are a year-round problem, with ∼17% of all cases occurring during non-summer months, when environmental heat strain and vigilance are lower. This suggests that EHI mitigation policies and procedures require greater year-round emphasis, particularly at certain locations.

Trends in Metabolic Disorder in U.S. Army Aviators, 20162018

2021 ◽  
Vol 92 (1) ◽  
pp. 43-46
Author(s):  
Claire Goldie ◽  
James McGhee ◽  
Amanda M. Kelley
Keyword(s):  
Metabolic Syndrome ◽  
Metabolic Disorder ◽  
Surveillance System ◽  
Epidemiological Studies ◽  
Incidence Rates ◽  
Medical Surveillance ◽  
Exclusion Criteria ◽  
Electronic Resource ◽  
Defense Medical ◽  
The U.S

INTRODUCTION: Recent epidemiological studies of U.S. Army aviators have suggested higher than anticipated rates of hyperlipidemia and metabolic disorder. The goal of this study was to determine whether this finding has persisted in 20162018 and to subsequently determine whether this trend is genuine and warrants further evaluation.METHODS: Data were requested from the U.S. Army Aeromedical Electronic Resource Office (AERO) and retrieved from the publicly available Defense Medical Surveillance System (DMSS) utilizing similar inclusion/exclusion criteria, where possible, as the earlier studies. For each year 20162018, incidence rates (per 1000 person years) for hyperlipidemia and metabolic syndrome were retrieved from DMSS, while percentages of aviators with these conditions were retrieved from AERO. The DMSS incidence rates were also age stratified. No formal analyses were conducted.RESULTS: Results from DMSS showed overall rates of hyperlipidemia ranging from 3.18 to 6.83 per 1000 person-years and for metabolic syndrome from 0.16 to 0.69 per 1000 person-years. The age stratified rates increased proportionally with age. AERO data showed a range of 0.81.5% of aviators had hyperlipidemia and for metabolic syndrome this ranged from 0.31 to 0.45%. These rates are broadly comparable to the previous studies findings.DISCUSSION: This studys findings suggest no continued increase in hyperlipidemia or metabolic disorder in aviators. While the exact cause is unknown, one could speculate a number of sources such as preferences in testing or encouragement from specific commanders or flight surgeons.Goldie C, McGhee J, Kelley AM. Trends in metabolic disorder in U.S. Army aviators, 20162018. Aerosp Med Hum Perform. 2021; 92(1):4346.

scholarly journals An economic and disease transmission model of human papillomavirus and oropharyngeal cancer in Texas

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chengxue Zhong ◽  
Li Xu ◽  
Ho-Lan Peng ◽  
Samantha Tam ◽  
Li Xu ◽  
...  
Keyword(s):  
Public Health ◽  
Human Papillomavirus ◽  
Oropharyngeal Cancer ◽  
Hpv Vaccine ◽  
Health Benefits ◽  
Incidence Rates ◽  
Vaccine Uptake ◽  
Males And Females ◽  
Quality Adjusted Life ◽  
The U.S

AbstractIn 2017, 46,157 and 3,127 new oropharyngeal cancer (OPC) cases were reported in the U.S. and Texas, respectively. About 70% of OPC were attributed to human papillomavirus (HPV). However, only 51% of U.S. and 43.5% of Texas adolescents have completed the HPV vaccine series. Therefore, modeling the demographic dynamics and transmission of HPV and OPC progression is needed for accurate estimation of the economic and epidemiological impacts of HPV vaccine in a geographic area. An age-structured population dynamic model was developed for the U.S. state of Texas. With Texas-specific model parameters calibrated, this model described the dynamics of HPV-associated OPC in Texas. Parameters for the Year 2010 were used as the initial values, and the prediction for Year 2012 was compared with the real age-specific incidence rates in 23 age groups for model validation. The validated model was applied to predict 100-year age-adjusted incidence rates. The public health benefits of HPV vaccine uptake were evaluated by computer simulation. Compared with current vaccination program, increasing vaccine uptake rates by 50% would decrease the cumulative cases by 4403, within 100 years. The incremental cost-effectiveness ratio of this strategy was $94,518 per quality-adjusted life year (QALY) gained. Increasing the vaccine uptake rate by 50% can: (i) reduce the incidence rates of OPC among both males and females; (ii) improve the quality-adjusted life years for both males and females; (iii) be cost-effective and has the potential to provide tremendous public health benefits in Texas.

scholarly journals Systemic Management of Pandemic Risks in Dental Practice: A Consolidated Framework for COVID-19 Control in Dentistry

2021 ◽  
Vol 8 ◽  
Author(s):  
Habib Benzian ◽  
Eugenio Beltrán-Aguilar ◽  
Richard Niederman
Keyword(s):  
Infection Control ◽  
Occupational Safety ◽  
Risk Mitigation ◽  
Healthcare Setting ◽  
Mitigation Measures ◽  
Health Administration ◽  
Safety And Health ◽  
Clinical Responses ◽  
And Control ◽  
The U.S

Dental teams and their workplaces are among the most exposed to airborne and bloodborne infectious agents, and therefore at the forefront of pandemic-related changes to how dental care is organized and provided to patients. The increasing complexity of guidelines makes is challenging for clinicians to navigate the multitude of COVID-19 guidelines issued by different agencies. A comparative analysis of guidance issued for managing COVID-19 in dental settings leading U.S. agencies was conducted, including documents of the Occupational Safety and Health Administration (OSHA), an agency of the U.S. Secretary of Labor, and of the U.S. Centers for Disease Prevention and Control (CDC), an agency of the U.S. Secretary of Health and Human Services. Details of infection control and other risk mitigation measures were reviewed for consistency, overlaps and similarities, then clustered according to thematic areas covering all domains of managing a dental healthcare setting. The analysis revealed five distinct areas of pandemic control, comprising (1) planning and protocols, (2) patient screening, (3) preparation of facilities, (4) PPE and infection control, and (5) procedures and aerosol control; thereby covering systematically all aspects requiring adaptation in a pandemic context. The “Pandemic-5 Framework for COVID-19 Control in Dentistry” provides an opportunity to simplify comprehensive decision-making from a clinical practitioner perspective. The framework supports a comprehensive systems-driven approach by using dental clinics as a setting to integrate pandemic clinical responses with the implementation of appropriate infection control protocols. Traditionally these two aspects are addressed independently from each other in separate concepts.

scholarly journals The Temporal Variation of the Microclimate and Human Thermal Comfort in Urban Wetland Parks: A Case Study of Xixi National Wetland Park, China

Forests ◽  
2021 ◽  
Vol 12 (10) ◽  
pp. 1322
Author(s):  
Zhiyong Zhang ◽  
Jianhua Dong ◽  
Qijiang He ◽  
Bing Ye
Keyword(s):  
Thermal Comfort ◽  
Urban Areas ◽  
Temporal Variations ◽  
Cold Season ◽  
Scientific Data ◽  
Cold Weather ◽  
Recreational Activities ◽  
Human Thermal Comfort ◽  
Island Effect ◽  
Urban Wetland

As an important part of the ecological infrastructure in urban areas, urban wetland parks have the significant ecological function of relieving the discomfort of people during their outdoor activities. In recent years, the specific structures and ecosystem services of urban wetland parks have been investigated from different perspectives. However, the microclimate and human thermal comfort (HTC) of urban wetland parks have rarely been discussed. In particular, the changing trends of HTC in different seasons and times have not been effectively presented. Accordingly, in this research, a monitoring platform was established in Xixi National Wetland Park, China, to continually monitor its microclimate in the long term. Via a comparison with a control site in the downtown area of Hangzhou, China, the temporal variations of the microclimate and HTC in the urban wetland park are quantified, and suggestions for clothing are also provided. The results of this study demonstrate that urban wetland parks can mitigate the heat island effect and dry island effect in summer. In addition, urban wetland parks can provide ecological services at midday during winter to mitigate the cold island effect. More importantly, urban wetland parks are found to exhibit their best performance in improving HTC during the daytime of the hot season and the midday period of the cold season. Finally, the findings of this study suggest that citizens should take protective measures and enjoy their activities in the morning, evening, or at night, not at midday in hot weather. Moreover, extra layers are suggested to be worn before going to urban wetland parks at night in cold weather, and recreational activities involving accommodation are not recommended. These findings provide not only basic scientific data for the assessment of the management and ecological health value of Xixi National Wetland Park and other urban wetland parks with subtropical monsoon climates, but also a reference for visitor timing and clothing suggestions for recreational activities.

scholarly journals Value of Injuries in the Northridge Earthquake

2006 ◽  
Vol 22 (2) ◽  
pp. 555-563 ◽  
Author(s):  
Keith Porter ◽  
Kim Shoaf ◽  
Hope Seligson
Keyword(s):  
Risk Mitigation ◽  
Economic Value ◽  
Northridge Earthquake ◽  
Confidence Bounds ◽  
Earthquake Research ◽  
Future Earthquake ◽  
The Cost ◽  
Nonfatal Injuries ◽  
The U.S ◽  
1994 Northridge Earthquake

The economic equivalent value of deaths and injuries in the 1994 Northridge earthquake has not previously been calculated, although number of injuries by category of treatment has. Using dollar-equivalent values for injuries accepted and used by the U.S. government for evaluating the cost-effectiveness of risk-mitigation efforts, the value of injuries in the 1994 Northridge earthquake is estimated to be $1.3 to 2.2 billion in 1994 (90% confidence bounds, equivalent to $1.8 to 2.9 billion in 2005). This is equivalent to 3–4% of the estimated $50 billion (in 1994) estimated direct capital losses and direct business interruption losses. If injuries in the 1994 Northridge earthquake are representative of injuries in future U.S. events, then the economic value of future earthquake injuries—the amount that the U.S. government would deem appropriate to expend to prevent all such injuries—is on the order of $200 million per year (in 2005 constant dollars). Of this figure, 96% is associated with nonfatal injuries, an issue overlooked by current experimental research. Given the apparently high cost of this type of loss, this appears to represent an important gap in the present earthquake research agenda.

Abstract 3039: Temporal Trends in the Prevalence of Dermatoses in Patients with Stroke and Transient Ischemic Attack in the United States

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Erine A Kupetsky ◽  
Mitch Maltenfort ◽  
Scott Waldman ◽  
Fred Rincon
Keyword(s):  
Temporal Trends ◽  
Progressive Systemic Sclerosis ◽  
The United States ◽  
Primary Diagnosis ◽  
Incidence Rates ◽  
Secondary Diagnosis ◽  
Cross Sectional ◽  
Total Prevalence ◽  
Skin Conditions ◽  
The U.S

Background. We sought to determine the prevalence of skin conditions traditionally associated with acute ischemic stroke (AIS) and transient ischemic attacks (TIA) in the U.S. Methods. This is a cross-sectional study of data derived from the National Inpatient Sample from 1988-2008. We searched for admissions of patients <18 years, with a primary diagnosis of AIS, TIA, and the following secondary diagnoses (dermatoses): Psoriasis, Behcet’s Disease (BD), Dermatomyositis (DM), Systemic Lupus Eythematosis (SLE), Pseudoxanthoma Elasticum (PXE), Progressive Systemic Sclerosis or Scleroderma (SCD), and Bullous Pemphigoid (BP). Definitions were based on ICD9CM codes, and adjusted incidence rates for the U.S census and prevalence proportions were then calculated. Results. Over the 20-year period, we identified 9,085,147 admissions that corresponded to a primary diagnosis of AIS and TIA of which 53,060 had a secondary diagnosis of dermatoses, for a total prevalence of 0.6%. The adjusted rate of AIS/TIA increased from 71/100,000 in 1988 to 200/100,000 in 2008. Among the secondary diagnosis, the most prevalent condition after AIS/TIA admissions was SLE (54%), psoriasis (34%), SCD (9%), BP (2%), DM (1%), PXE (0.5%), and BD (0.14%). The prevalence of these dermatoses increased from 0.2% in 1988 to 0.8% in 2008 ( Figure 1 ). Conclusion. Despite an overall increase in the prevalence of dermatoses, these skin conditions remain a rare occurrence in AIS/TIA. The over-representation of traditional risk factors for AIS/TIA in patients with these dermatoses, may explain the observed epidemiological phenomenon.

Incidence of insomnia and obstructive sleep apnea in active duty United States military service members

SLEEP ◽  
2021 ◽  
Author(s):  
Brian A Moore ◽  
Lynn M Tison ◽  
Javier G Palacios ◽  
Alan L Peterson ◽  
Vincent Mysliwiec
Keyword(s):  
United States ◽  
Obstructive Sleep Apnea ◽  
Military Service ◽  
Active Duty ◽  
Incidence Rates ◽  
Service Members ◽  
United States Military ◽  
Obstructive Sleep ◽  
Military Service Members ◽  
The U.S

Abstract Study Objectives Epidemiologic studies of obstructive sleep apnea (OSA) and insomnia in the U.S. military are limited. The primary aim of this study was to report and compare OSA and insomnia diagnoses in active duty the United States military service members. Method Data and service branch densities used to derive the expected rates of diagnoses on insomnia and OSA were drawn from the Defense Medical Epidemiology Database. Single sample chi-square goodness of fit tests and independent samples t-tests were conducted to address the aims of the study. Results Between 2005 and 2019, incidence rates of OSA and insomnia increased from 11 to 333 and 6 to 272 (per 10,000), respectively. Service members in the Air Force, Navy, and Marines were diagnosed with insomnia and OSA below expected rates, while those in the Army had higher than expected rates (p &lt; .001). Female service members were underdiagnosed in both disorders (p &lt; .001). Comparison of diagnoses following the transition from ICD 9 to 10 codes revealed significant differences in the amounts of OSA diagnoses only (p &lt; .05). Conclusion Since 2005, incidence rates of OSA and insomnia have markedly increased across all branches of the U.S. military. Despite similar requirements for overall physical and mental health and resilience, service members in the Army had higher rates of insomnia and OSA. This unexpected finding may relate to inherent differences in the branches of the military or the role of the Army in combat operations. Future studies utilizing military-specific data and directed interventions are required to reverse this negative trend.

Office for Protection from Research Risks (OPRR)

1994 ◽  
Vol 13 (2) ◽  
pp. 271-273 ◽  
Author(s):  
Gary B. Ellis
Keyword(s):  
Human Services ◽  
Public Health Service ◽  
Human Subjects ◽  
Laboratory Animals ◽  
Department Of Health ◽  
Research Risks ◽  
Policies And Procedures ◽  
Primary Responsibility ◽  
Protection Of Human Subjects ◽  
The U.S

The Office for Protection from Research Risks (OPRR) has primary responsibility within the U.S. Department of Health and Human Services (DHHS) for developing and implementing policies, procedures, and regulations for the protection of human subjects involved in research. It also has primary responsibility within the U.S. Public Health Service for developing and implementing policies and procedures for the care and use of laboratory animals. And, it has responsibility for coordinating the development and implementation of policies, procedures, and regulations for the protection of human subjects involved in research for all U.S. federal departments and agencies that conduct or support such research.

scholarly journals Differences Among Incidence Rates of Invasive Listeriosis in the U.S. FoodNet Population by Age, Sex, Race/Ethnicity, and Pregnancy Status, 2008–2016

2019 ◽  
Vol 16 (4) ◽  
pp. 290-297 ◽  
Author(s):  
Aurelie M. Pohl ◽  
Régis Pouillot ◽  
Michael C. Bazaco ◽  
Beverly J. Wolpert ◽  
Jessica M. Healy ◽  
...  
Keyword(s):  
Incidence Rates ◽  
Pregnancy Status ◽  
Race Ethnicity ◽  
The U.S

scholarly journals Gemini T-20G-8 XM1 Tank APU

1981 ◽  
Author(s):  
C. Rodgers ◽  
J. Zeno ◽  
E. A. Drury ◽  
A. Karchon
Keyword(s):  
Gas Turbine ◽  
Power Unit ◽  
Weather Conditions ◽  
Cold Weather ◽  
Turbine Engine ◽  
Auxiliary Power Unit ◽  
Auxiliary Power ◽  
Generator Sets ◽  
Main Engine ◽  
The U.S

Auxiliary power is often provided on combat vehicles in the U.S. Army for battery charging, operation of auxiliary vehicle equipment when the main engine is not running, or to provide assistance in starting the main engine in extreme cold weather conditions. The use of a gas turbine for these applications is particularly attractive, due to its small size and lightweight. In November 1978, the U.S. Army Tank-Automotive Research and Development Command, Warren, MI awarded a contract to the Turbomach Division of Solar Turbines International, San Diego, CA, for the development of a 10 kW 28 vdc gas turbine powered auxiliary power unit (APU) for installation in the XM1 main battle tank. This paper describes the general features of the Solar Turbomach T-20G-8 Auxiliary Power Unit, a single-shaft gas turbine driven generator set which has been developed under this contract. This APU is one of the family of Gemini powered APUs and is a derivative of the U.S. Army 10 kW gas turbine engine-driven, 60 and 400 Hz generator sets developed by Solar. The electrical components were newly developed for this particular application. Currently, the APU is in qualification testing both in the laboratory and in the XM1 main battle tank.

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