Blast-related burns, which accounted for most burns suffered by service members in the recent conflict in Afghanistan, are difficult to treat. These conference proceedings describe a meeting held at RAND to identify gaps in blast-injury research.
Advances in trauma care have accelerated over the past decade, spurred by the significant burden of injury from the wars in Afghanistan and Iraq. Between 2005 and 2013, the case fatality rate for United States service members injured in Afghanistan decreased by nearly 50 percent, despite an increase in the severity of injury among U.S. troops during the same period of time. But as the war in Afghanistan ends, knowledge and advances in trauma care developed by the Department of Defense (DoD) over the past decade from experiences in Afghanistan and Iraq may be lost. This would have implications for the quality of trauma care both within the DoD and in the civilian setting, where adoption of military advances in trauma care has become increasingly common and necessary to improve the response to multiple civilian casualty events. Intentional steps to codify and harvest the lessons learned within the military's trauma system are needed to ensure a ready military medical force for future combat and to prevent death from survivable injuries in both military and civilian systems. This will require partnership across military and civilian sectors and a sustained commitment from trauma system leaders at all levels to assure that the necessary knowledge and tools are not lost. A National Trauma Care System defines the components of a learning health system necessary to enable continued improvement in trauma care in both the civilian and the military sectors. This report provides recommendations to ensure that lessons learned over the past decade from the military's experiences in Afghanistan and Iraq are sustained and built upon for future combat operations and translated into the U.S. civilian system.
Designed for health care professionals in multiple disciplines and clinical settings, this comprehensive, evidence-based wound care text provides basic and advanced information on wound healing and therapies and emphasizes clinical decision-making. The text integrates the latest scientific findings with principles of good wound care and provides a complete set of current, evidence-based practices. This edition features a new chapter on wound pain management and a chapter showing how to use negative pressure therapy on many types of hard-to-heal wounds. Technological advances covered include ultrasound for wound debridement, laser treatments, and a single-patient-use disposable device for delivering pulsed radio frequency.
The National Academies of Sciences, Engineering, and Medicine held a workshop on August 22â€"23, 2018, in Washington, DC, to explore medical and public health preparedness for a nuclear incident. The event brought together experts from government, nongovernmental organizations, academia, and the private sector to explore current assumptions behind the status of medical and public health preparedness for a nuclear incident, examine potential changes in these assumptions in light of increasing concerns about the use of nuclear warfare, and discuss challenges and opportunities for capacity building in the current threat environment. This publication summarizes the presentations and discussions from the workshop.
With “groundbreaking research on the psychology of resilience” (Adam Grant), a top expert on human trauma argues that we vastly overestimate how common PTSD is in and fail to recognize how resilient people really are. After 9/11, mental health professionals flocked to New York to handle what everyone assumed would be a flood of trauma cases. Oddly, the flood never came. In The End of Trauma, pioneering psychologist George A. Bonanno argues that we failed to predict the psychological response to 9/11 because most of what we understand about trauma is wrong. For starters, it’s not nearly as common as we think. In fact, people are overwhelmingly resilient to adversity. What we often interpret as PTSD are signs of a natural process of learning how to deal with a specific situation. We can cope far more effectively if we understand how this process works. Drawing on four decades of research, Bonanno explains what makes us resilient, why we sometimes aren’t, and how we can better handle traumatic stress. Hopeful and humane, The End of Trauma overturns everything we thought we knew about how people respond to hardship.
Nearly 1.9 million U.S. troops have been deployed to Afghanistan and Iraq since October 2001. Many service members and veterans face serious challenges in readjusting to normal life after returning home. This initial book presents findings on the most critical challenges, and lays out the blueprint for the second phase of the study to determine how best to meet the needs of returning troops and their families.
Over the past two decades, there has been a major increase in research into the effects of the arts on health and well-being, alongside developments in practice and policy activities in different countries across the WHO European Region and further afield. This report synthesizes the global evidence on the role of the arts in improving health and well-being, with a specific focus on the WHO European Region. Results from over 3000 studies identified a major role for the arts in the prevention of ill health, promotion of health, and management and treatment of illness across the lifespan. The reviewed evidence included study designs such as uncontrolled pilot studies, case studies, small-scale cross-sectional surveys, nationally representative longitudinal cohort studies, community-wide ethnographies and randomized controlled trials from diverse disciplines. The beneficial impact of the arts could be furthered through acknowledging and acting on the growing evidence base; promoting arts engagement at the individual, local and national levels; and supporting cross-sectoral collaboration.
Includes a foreword by Major General David A. Rubenstein. From the editor: "71F, or "71 Foxtrot," is the AOC (area of concentration) code assigned by the U.S. Army to the specialty of Research Psychology. Qualifying as an Army research psychologist requires, first of all, a Ph.D. from a research (not clinical) intensive graduate psychology program. Due to their advanced education, research psychologists receive a direct commission as Army officers in the Medical Service Corps at the rank of captain. In terms of numbers, the 71F AOC is a small one, with only 25 to 30 officers serving in any given year. However, the 71F impact is much bigger than this small cadre suggests. Army research psychologists apply their extensive training and expertise in the science of psychology and social behavior toward understanding, preserving, and enhancing the health, well being, morale, and performance of Soldiers and military families. As is clear throughout the pages of this book, they do this in many ways and in many areas, but always with a scientific approach. This is the 71F advantage: applying the science of psychology to understand the human dimension, and developing programs, policies, and products to benefit the person in military operations. This book grew out of the April 2008 biennial conference of U.S. Army Research Psychologists, held in Bethesda, Maryland. This meeting was to be my last as Consultant to the Surgeon General for Research Psychology, and I thought it would be a good idea to publish proceedings, which had not been done before. As Consultant, I'd often wished for such a document to help explain to people what it is that Army Research Psychologists "do for a living." In addition to our core group of 71Fs, at the Bethesda 2008 meeting we had several brand-new members, and a number of distinguished retirees, the "grey-beards" of the 71F clan. Together with longtime 71F colleagues Ross Pastel and Mark Vaitkus, I also saw an unusual opportunity to capture some of the history of the Army Research Psychology specialty while providing a representative sample of current 71F research and activities. It seemed to us especially important to do this at a time when the operational demands on the Army and the total force were reaching unprecedented levels, with no sign of easing, and with the Army in turn relying more heavily on research psychology to inform its programs for protecting the health, well being, and performance of Soldiers and their families."