Injuries and Referral Patterns During Basic Combat Training: An Examination of Data From the Certified Athletic Trainer-Forward Program

ABSTRACT Introduction Injuries sustained during basic combat training (BCT) result in large economic costs to the U.S. Army. The inclusion of athletic trainers (ATs) in other military branches has reduced Troop Medical Clinic (TMC) referrals. However, the inclusion of ATs during BCT has yet to be studied. The purpose of this study was to describe the frequency and nature of sick call visits during BCT and determine how the presence of an AT affects referrals to the TMC. Materials and Methods A prospective cohort study was conducted at the Fort Jackson Army Training Center for one calendar year. Soldiers in BCT, aged 18–42, who reported to sick call were included. Independent variables collected included: Soldier demographics (sex and age), visit reason, and provider impression. Training battalions were placed in three conditions: control (CON), full-time medic (FTM), and part-time athletic trainer (PAT). The dependent variable was disposition (referred or returned to duty [RTD]). Frequencies and proportions were calculated. Logistic regression compared conditions while considering the other independent variables. Return on investment was calculated. Results Fourteen thousand three hundred and four visits were documented. Most soldiers were female (n = 7,650; 53.5%) and under 20 years old (n = 5,328; 37.2%). Visits were most commonly due to physical injury (n = 7,926; 55.4%), injuries affecting the knee (n = 2,264; 15.8%) and chronic/overuse conditions (n = 2,031; 14.2%). By condition, the FTM and PAT conditions resulted in 1.303 (95%CI: 1.187, 1.430; P < .001) and 1.219 (95%CI: 1.103, 1.348; P < .001), or 30.3% and 21.9% higher, odds of being RTD compared to the CON condition, respectively. Return on investment was $23,363,596 overall and $2,423,306 for musculoskeletal-related cases. Conclusions Injuries were common in BCT, particularly in females. Soldiers in both the PAT and FTM conditions were more likely to be RTD compared to those in the CON condition. Athletic trainers (ATs) are effective at reducing potentially unnecessary referrals, demonstrating their value as healthcare providers in the BCT environment. Understanding variables associated with recruit disposition may aid medics and ATs in the development of triage protocols and further reduction of potentially unnecessary soldier referrals. The Certified Athletic Trainer-Forward Program resulted in significant return on investment, further supporting the inclusion of ATs in BCT.

Towards Spatially Explicit Quantification of Pre- and Postfire Fuels and Fuel Consumption from Traditional and Point Cloud Measurements

Methods to accurately estimate spatially explicit fuel consumption are needed because consumption relates directly to fire behavior, effects, and smoke emissions. Our objective was to quantify sparkleberry (Vaccinium arboretum Marshall) shrub fuels before and after six experimental prescribed fires at Fort Jackson in South Carolina. We used a novel approach to characterize shrubs non-destructively from three-dimensional (3D) point cloud data collected with a terrestrial laser scanner. The point cloud data were reduced to 0.001 m–3 voxels that were either occupied to indicate fuel presence or empty to indicate fuel absence. The density of occupied voxels was related significantly by a logarithmic function to 3D fuel bulk density samples that were destructively harvested (adjusted R2 = .32, P < .0001). Based on our findings, a survey-grade Global Navigation Satellite System may be necessary to accurately associate 3D point cloud data to 3D fuel bulk density measurements destructively collected in small (submeter) shrub plots. A recommendation for future research is to accurately geolocate and quantify the occupied volume of entire shrubs as 3D objects that can be used to train models to map shrub fuel bulk density from point cloud data binned to occupied 3D voxels.

Heroes and Cowards

This chapter explores how ideas about honor and shame shaped how Civil War era Americans understood surrender. Robert Anderson was celebrated as a hero for his honorable surrender at Fort Sumter. By contrast, Union surrenders at San Antonio, San Augustin Springs, and Harpers Ferry, and Confederate surrenders at Fort Donelson and Fort Jackson, were seen as dishonorable.

Getting Together

This chapter details the specific actions taken by GIs and civilians at antiwar coffeehouse projects. From publishing and distributing underground newspapers, to organizing major strikes, boycotts, and demonstrations, activists at coffeehouses brought the style and force of the youth antiwar movement to major sites of the Vietnam War effort, like Killeen, Texas (home of Fort Hood), Columbia, South Carolina (near Fort Jackson), and Tacoma, Washington (near Fort Lewis). By profiling a number of specific actions and their consequences, this chapter demonstrates the diverse range of issues that concerned American GIs during the Vietnam War, and reflects on the strategies of the individuals and organizations that attempted to address them.