Submarine medicine: An overview of the unique challenges, medical concerns, and gaps

2021 ◽  
pp. 263-278
Author(s):  
Luke A. Beardslee ◽  
Erica T. Casper ◽  
Ben D. Lawson ◽  
Keyword(s):  
Open Space ◽  
Health And Safety ◽  
Medical Personnel ◽  
Medical Department ◽  
Fatigue Management ◽  
Fresh Food ◽  
Ongoing Work ◽  
Support Tools ◽  
Natural Settings ◽  
The U.S

Submariners face many challenges. For example, they “live where they work” and can be called to duty anytime. They have limited access to open space, natural settings, fresh air, fresh food, sunlight, privacy, exercise, and outside communication. They support a wider range of missions than occur aboard most other Navy vessels. At sea or on shore, submariners work long hours under conditions with little margin for error. They may traverse remote or disputed areas of the ocean far from rescue assets, and must remain vigilant for potential encounters with hostile forces, onboard fires, anomalies in the breathing atmosphere, leaks, undersea collisions, or radiation exposures. If any of these factors cause casualties, the Independent Duty Corpsman (with intermittent advice from shore-based medical personnel), must be ready to provide aid as long as necessary. The challenges of submarine service led to the growth of the unique field of submarine medicine, which has maintained an excellent record of health and safety. This review introduces the field of submarine medicine as practiced in the U.S. Navy, describing its major concerns, giving an overview of the operation of a submarine medical department, and identifying several medical gaps that researchers are working to fill. Submarine medicine already has a stellar record in terms of radiation and atmospheric safety and has made strides in fatigue management. Ongoing work will deliver improved psychological screening and support tools. This report summarizes developments in these and other areas of submarine medicine.

Enhancing Interoperability Among Medical Personnel in the U.S. Military

2009 ◽  
Author(s):  
Harry J. Thie ◽  
Sheila Nataraj Kirby ◽  
Adam C. Resnick ◽  
Thomas Manacapilli ◽  
Daniel Gershwin ◽  
...  
Keyword(s):  
Medical Personnel ◽  
The U.S

Changing Places

2019 ◽  
Author(s):  
John MacDonald ◽  
Charles Branas ◽  
Robert Stokes
Keyword(s):  
Open Space ◽  
Urban Landscape ◽  
Health And Safety ◽  
Well Being ◽  
City Life ◽  
New Science ◽  
Science And Art ◽  
Working Together ◽  
Scientific Testing ◽  
Large Groups

The design of every aspect of the urban landscape—from streets and sidewalks to green spaces, mass transit, and housing—fundamentally influences the health and safety of the communities who live there. It can affect people's stress levels and determine whether they walk or drive, the quality of the air they breathe, and how free they are from crime. This book provides a compelling look at the new science and art of urban planning, showing how scientists, planners, and citizens can work together to reshape city life in measurably positive ways. It demonstrates how well-designed changes to place can significantly improve the well-being of large groups of people. The book argues that there is a disconnect between those who implement place-based changes, such as planners and developers, and the urban scientists who are now able to rigorously evaluate these changes through testing and experimentation. It covers a broad range of structural interventions, such as building and housing, land and open space, transportation and street environments, and entertainment and recreation centers. Science shows we can enhance people's health and safety by changing neighborhoods block-by-block. The book explains why planners and developers need to recognize the value of scientific testing, and why scientists need to embrace the indispensable know-how of planners and developers. It reveals how these professionals, working together and with urban residents, can create place-based interventions that are simple, affordable, and scalable to entire cities.

scholarly journals Integrated management is effective in the prevention and control of COVID-19 in the blood purification center: joint efforts from multiple departments

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Jinmei Yin ◽  
Jun Yin ◽  
Zhiwu Tian ◽  
Peiqiu Li ◽  
Xiaoqiu Chen
Keyword(s):  
Medical Staff ◽  
Prevention And Control ◽  
Integrated Management ◽  
Medical Personnel ◽  
Blood Purification ◽  
Medical Department ◽  
Effective Prevention ◽  
Dialysis Center ◽  
Education Of Patients ◽  
And Control

Abstract Background During the outbreak of new coronavirus pneumonia, many hospitals in China became the designated hospitals for the treatment of new coronavirus pneumonia. The goal was to develop rapid and effective prevention and control methods for blood purification centers. Research design and methods The medical department, hospital department, nursing department, and blood purification center jointly set up a multi-department integrated COVID-19 prevention and control management team to manage the blood purification center. The efforts included the establishment of the continuous renal replacement therapy (CRRT) team for COVID-19, the integrated training and assessment of medical personnel, the integrated education of patients and their families, and the integrated management of the workflow of the hemodialysis room. Results No infected persons, including medical staff, patients, and their families, have been found in the dialysis center. After multi-departmental integrated training, the theoretical performance of medical staff in our dialysis center has increased from 82.36 ± 8.10 to 95.29 ± 4.95 (p < 0.05), and the unqualified rate dropped from 23.21 to 1.78% (p < 0.05). In addition, the three operational skills evaluation scores have also been significantly improved, from 86.00 ± 4.02, 88.01 ± 6.20, 92.01 ± 2.46 to 95.90 ± 0.30, 97.21 ± 0.87, 96.00 ± 1.00 (p < 0.01), and the passing rate from 80.36 to 100% (p < 0.05). Conclusion Medical staff’s knowledge of novel coronavirus pneumonia prevention and control can be improved by multi-sectoral integrated management, and CRRT treatment of COVID-19 patients is effective.

Commissioned Corps Deployments & Family Resiliency

2020 ◽  
Vol 25 (1) ◽  
Author(s):  
Janice Arceneaux ◽  
James Dickens ◽  
Wanza Bacon
Keyword(s):  
Public Health ◽  
Health And Safety ◽  
United States Public Health ◽  
Disease Outbreaks ◽  
The United States ◽  
Humanitarian Assistance ◽  
Family Resiliency ◽  
Public Health Emergencies ◽  
National Public Health ◽  
The U.S

Established in 1889, the United States Public Health Service Commissioned Corps (Corps) is one of the seven uniformed services and is part of the U.S. Department of Health and Human Services. The Corps is committed to protecting, promoting and advancing the health and safety of the nation with a history that dates back over two centuries, beginning as the U.S. Marine Hospital Service. Today, the Corps responds and serves in many areas impacted by natural disasters, disease outbreaks, terrorist attacks and public health emergencies. Corps officers have deployed to provide assistance during national public health emergencies (e.g., hurricanes, bombings, flooding and wild fires); to combat the Ebola epidemic in West Africa; and to provide humanitarian assistance in Latin America and the Caribbean. Corps deployments impact not only service members but also their families. This article offers a brief overview of the Corps and discusses how deployments impact families. Family resiliency and future implications for research and practice will also be examined.

2B-Alert Web 2.0: An Open-Access Tool for Predicting Alertness and Optimizing the Benefits of Caffeine (Preprint)

2021 ◽  
Author(s):  
Jaques Reifman ◽  
Kamal Kumar ◽  
Luke Hartman ◽  
Andrew Frock ◽  
Tracy J. Doty ◽  
...  
Keyword(s):  
Night Shift ◽  
Sleep Loss ◽  
Time Of Day ◽  
Caffeine Consumption ◽  
Fatigue Management ◽  
Potential Benefits ◽  
Computer Based ◽  
Evening Shift ◽  
Alertness Level ◽  
The U.S

BACKGROUND One-third of the U.S. population experiences sleep loss, with the potential to impair physical and cognitive performance, and result in reduced productivity and imperil safety during work and daily activities. Computer-based fatigue-management systems, with the ability to predict the effects of sleep schedules on alertness and identify safe and effective caffeine interventions that maximize its stimulating benefits, could help mitigate cognitive impairment due to limited sleep. To provide these capabilities to broad communities, we previously released the 2B-Alert Web, a publicly available tool for predicting the average alertness level of a group of individuals as a function of time of day, sleep history, and caffeine consumption. OBJECTIVE Here, we aimed to enhance the capability of the 2B-Alert Web by providing the means for the tool to automatically recommend safe and effective caffeine interventions (time and dose) that lead to optimal alertness levels at user-specified times, under any sleep-loss condition. METHODS We incorporated a recently developed caffeine-optimization algorithm into the predictive models of the original 2B-Alert Web, allowing the system to search for and identify viable caffeine interventions that result in user-specified alertness levels at desired times of the day. To assess the potential benefits of this new capability, we simulated four sleep-deprivation conditions (sustained operations, restricted sleep with morning or evening shift, and night shift with daytime sleep) and compared the alertness levels resulting from the algorithm’s recommendations with those based on the U.S. Army caffeine-countermeasure guidelines. In addition, we enhanced the usability of the tool by adopting a drag-and-drop graphical interface for the creation of sleep and caffeine schedules. RESULTS For the four simulated conditions, the 2B-Alert Web-proposed interventions increased average alertness by 36 to 94% and decreased peak alertness impairment by 31 to 71%, while using equivalent or smaller doses of caffeine as the corresponding U.S. Army guidelines. CONCLUSIONS The enhanced capability of this evidence-based, publicly available tool increases the efficiency by which diverse communities of users can identify safe and effective caffeine interventions to mitigate the effects of sleep loss in the design of research studies and work/rest schedules. 2B-Alert Web is accessible at: <https://2b-alert-web.bhsai.org>.

The Nature Cure

2019 ◽  
pp. 79-100
Author(s):  
John Macdonald ◽  
Charles Branas ◽  
Robert Stokes
Keyword(s):  
Public Health ◽  
Open Space ◽  
Health And Safety ◽  
Green Spaces ◽  
Open Spaces ◽  
Space Planning ◽  
Local Residents ◽  
Mere Presence ◽  
Human Desire ◽  
Public Health And Safety

This chapter looks at interventions for land and open spaces and their impact on public health and safety. Abandoned, vacant, and neglected land is of great and growing concern in many cities. The chapter considers recent efforts to address this sort of land-based blight and how planners can partner with scientists to implement and evaluate land-remediation and zoning strategies to best improve public health and safety. In many ways, these changes represent the innate human desire for nature and green spaces. Without action from planners and landscape architects, such natural spaces would not exist in many of the cities. The chapter then showcases several studies that provide evidence that the mere presence of green spaces have healing and calming effects, an effect that occurs even if residents do not actively use these spaces. Indeed, there have been myriad efforts over the past decade or so by cities to revisit and reinvigorate their green and open-space planning efforts. Much of this effort has been to insert managed green spaces into smaller parcels and equitably distribute them across neighborhoods that lack access to larger green spaces. This pocket-park movement has economic drivers but, in some cities, also seeks to leverage the likely health benefits to local residents.

scholarly journals Use of personal protective equipment among farmers in Nebraska, Lithuania, Latvia, and Slovenia

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
C Achutan ◽  
L Girdžiūtė ◽  
G Vasiliauskas ◽  
K Kampuss ◽  
J Starič ◽  
...  
Keyword(s):  
Personal Protective Equipment ◽  
Health And Safety ◽  
Agricultural Cooperatives ◽  
Protective Equipment ◽  
Eye Injuries ◽  
Effective Interventions ◽  
Safety And Health ◽  
Increased Risk ◽  
Agricultural Safety ◽  
The U.S

Abstract Background Farmers in the U.S. and in Europe are at a high risk for injury and illness. Farmers have an increased risk of respiratory disease, noise-induced hearing loss, skin disorders, and eye injuries. Many of these health risks can be prevented or reduced through proper use of personal protective equipment (PPE). However, studies show low compliance of PPE use among farmers. The purpose of this study was to identify barriers to wearing PPE, and current health and safety training as potential targets for future intervention, in farmers in Nebraska, Lithuania, Latvia, and Slovenia. The European Cooperation in Science and Technology and the Central States Center for Agricultural Safety and Health collaborated on this study. Methods We administered a 7-item questionnaire to 57 farmers in Nebraska (n = 10), Lithuania (n = 22), Latvia (n = 10) and Slovenia (n = 15). The farmers primarily grew crops (corn, soy) and some raised livestock. Results We found that gloves, respirators, and safety glasses were the PPE most commonly worn; use of face shields were only reported in Nebraska and Lithuania. Only 45% reported wearing PPE always when they needed them. In Nebraska and Latvia, most farmers reported not wearing PPE because they are not readily available although they have them on the farm; in Lithuania and Slovenia, farmers cited time to don PPE and discomfort as primary reasons. The percentage of farmers who reported receiving training on the selection, use, and maintenance of PPE varied widely-13% in Nebraska, 14% in Lithuania, 40% in Latvia, and 67% in Slovenia. Farmers purchased PPE over the internet, supermarkets, and agricultural cooperatives. Conclusions This study provided an opportunity to understand current perceptions of PPE use and challenges, among a cross section of farmers in the U.S. and Europe. We recommend enhancing training through creative modules to address the needs of farmers. Key messages By identifying why farmers do not always wear PPE, we can design effective interventions to overcome this barrier; by knowing where they purchase them, we can provide education at these venues. This study is a joint collaboration between U.S. and European researchers. This global cooperation has highlighted some similarities but also differences within European countries.

Lessons Learned at the Rocky Flats Closure Project and Their Applicability to the Emerging Cleanup of the United Kingdom’s Civil Nuclear Liabilities

2003 ◽  
Author(s):  
Nany Tuor ◽  
Allen Schubert
Keyword(s):  
Nuclear Weapons ◽  
Health And Safety ◽  
Hazardous Materials ◽  
Shared Vision ◽  
Lessons Learned ◽  
Department Of Energy ◽  
Nuclear Materials ◽  
Rocky Flats ◽  
Enriched Uranium ◽  
The U.S

The Rocky Flats Environmental Technology Site is a former nuclear weapons production facility owned by the U.S. Department of Energy (DOE). Located in central Colorado near Denver, the facility produced nuclear and non-nuclear components for weapons from 1953 to 1989. During this period, Rocky Flats grew to more than 800 facilities and structures situated on 2,500 hectares. Production activities and processes contaminated a number of facilities, soil, groundwater and surface water with radioactive and hazardous materials. In 1989, almost all radioactive weapons component production activities at Rocky Flats were suspended due to safety and environmental concerns related to operations, and the site was placed on the U.S. Environmental Protection Agency’s National Priorities List (also known as the Superfund list). In 1992, the nuclear weapons production role at Rocky Flats officially ended and the mission changed from weapons production to one of risk reduction. In 1995, Kaiser-Hill, LLC (Kaiser-Hill) was awarded a five-year contract to reduce the urgent health and safety risks at the site, as well as begin the cleanup. At that time, the U.S. government estimated that it would cost more than $36 billion and take more than 70 years to cleanup and close Rocky Flats. Beginning in the summer of 1995, Kaiser-Hill developed a series of strategic planning models which demonstrated that accelerated cleanup of the site could be achieved while dramatically reducing cleanup costs. Within a few years, Kaiser-Hill developed a cleanup plan or lifecycle baseline that described how cleanup could be accomplished by 2010 for about $7.3 billion. Additionally, between 1995 and 2000, Kaiser-Hill made significant progress toward stabilizing special nuclear materials, cleaning up environmental contamination, demolishing buildings and shipping radioactive and hazardous waste for disposal. This initial contract was completed for approximately $2.8 billion. In January 2000, based its record of successes, Kaiser-Hill was awarded DOE’s first “closure contract” to close the site no later than December 2006, at a target cost of $3.96 billion. To date, some of the key enablers of the accelerated closure project concept and successful closure project execution include: • Shared vision of the end state; • Flexible, consultative regulatory agreement; • Credible project plan and robust project management systems; • Closure contract; • Empowered and motivated workforce; • Commitment to safety; • Closure-enhancing technologies. The scope of the closure project encompasses the following key completion metrics: • Disposition of 21 metric tons of weapons-grade nuclear materials; • Treatment of more than 100 metric tons of high-content plutonium wastes called residues; • Processing of 30,000 liters of plutonium and enriched uranium solutions; • Demolition of more than 800 facilities and structures totaling more that 325,000 square meters — many of which are contaminated with radioactive and/or hazardous materials; • Offsite shipment of more than 250,000 cubic meters of radioactive waste; • Disposition of approximately 370 environmental sites.

scholarly journals Outdoor Fitness Equipment Usage Behaviors in Natural Settings

2019 ◽  
Vol 16 (3) ◽  
pp. 391 ◽  
Author(s):  
Hsueh-wen Chow ◽  
Dai-Rong Wu
Keyword(s):  
Open Space ◽  
Video Content ◽  
Video Content Analysis ◽  
User Behaviors ◽  
Coding Schemes ◽  
Safety Risks ◽  
Potential Safety ◽  
Crucial Information ◽  
Potential Risks ◽  
Natural Settings

Outdoor fitness equipment (OFE) areas have become a popular form of built environment infrastructure in public open spaces as a means to improve public health through increased physical activity. However, the benefits of using OFE are not consistent, and several OFE accidents have been reported. In this study, we videotaped how OFE users operate OFE in parks and selected four types of popular OFE (the waist twister, air walker, ski machine, and waist/back massager) for video content analysis. Furthermore, we established coding schemes and compared results with the instructions provided by OFE manufacturers. The results revealed various usage behaviors for the same OFE types. In addition, we observed that a significant portion of user behaviors did not follow manufacturers’ instructions, which might pose potential risks or actually cause injuries. Children are especially prone to act improperly. This study provides empirical evidence indicating the existence of potential safety risks due to inappropriate usage behaviors that might lead to accidents and injuries while using OFE. This study provides crucial information that can be used to evaluate the effectiveness of OFE and to develop future park or open space initiatives.

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