JOINT STRIKE FIGHTER

http://www.dtic.mil/cgi-bin/GetTRDoc?AD=ADA499592&Location=U2&doc=GetTRDoc.pdf

JOINT STRIKE FIGHTER
Strong Risk Management
Essential as Program
Enters Most Challenging
Phase


Testimony
Before the Subcommittee on Air and Land
Forces, Committee on Armed Services,
House of Representatives

Pictorial Display Design to Enhance Spatial Awareness

http://www.dtic.mil/cgi-bin/GetTRDoc?AD=ADA467707&Location=U2&doc=GetTRDoc.pdf


AUTHOR(S) Thomas Zirkelbach

In aviation, spatial awareness and spatial orientation are essential for performing the task of recovering from an unusual attitude. Degraded spatial awareness, particularly in extreme flight situations, may lead to lower operational effectiveness and to loss of equipment and, in manned aviation, loss of life. Therefore, improvements in spatial awareness are important in complex 3D
environments, including both manned and unmanned aviation. The main goal of this thesis was to determine whether a new prototype display design, called WEBER-Box, is a useful alternative or supplement to traditional flight instruments for unmanned aviation. In addition we combined the traditional flight instrument as well as the WEBER-Box with a colored-coded indication when the aircraft entered an unusual attitude. In this experiment, the participants executed typical tasks of a UAV-operator. We investigated the influence of the WEBER-Box on UAV operator’s orientation performance. The important results can be summarized as follows:
1. significant improvement in correctly solving the orientation tasks
2. significant reduction in time to solve orientation tasks
3. color coded indication of unusual attitude significantly decreased the response time and reduced the error
4. the proposed display design was accepted, interpreted, and used to solve 3D-orientation tasks efficiently

Physician Retention in the Army Medical Department

http://www.dtic.mil/cgi-bin/GetTRDoc?AD=ADA499087&Location=U2&doc=GetTRDoc.pdf

Army physicians are voting with their feet and leaving the Army in staggering numbers upon completion of their active duty service obligations. Chief among the reasons given for leaving are deployments, the current electronic medical record known as AHLTA, and inadequate pay. The Army's answer over the last year has been to increase special pays for physicians as an incentive for staying. However, the ultimate answer must be multi-faceted and comprehensively balanced. Although the corporate AMEDD can make a difference via various incentives, physician leaders at all levels must place retention in their top priorities.

Review of National Work Programme on the long term effects of Sustained high G on the Cervical Spine

http://www.dtic.mil/cgi-bin/GetTRDoc?AD=ADA499773&Location=U2&doc=GetTRDoc.pdf




Empirical evidence, as well as long term studies with radiographic techniques, suggests that flying high performance aircraft has an adverse effect on the cervical spine of aviators. The load an aviator’s neck supports is also exacerbated by the increasing use of head supported devices. As such, the effects of acceleration, vibration and repeated jolt also increase the risk of cervical injury to the cervical spines of helicopter pilots and crew. Thus, the RTO-group HFM-083 was created to determine the extent of the effects due to long term exposures to sustained G levels and to develop mitigation recommendations. As causes, consequences and counteracting measures are multidimensional and complex, different nations have focused on diverse aspects of the problem. The contributions from seven national programmes are reported. These comprise Aircrew questionnaires, countermeasures, treatment, characterisation of the
spinal pain beyond questionnaires, muscular activity (EMG), imaging (MRI), and modelling.
Recommendations for future work are provided. One of these is the creation of a common database of biomechanical analyses, methodologies, and human responses to apply to common areas of concern across the member nations. The database should comprise standardized data capture and management and linked to information about intrinsic factors and medical issues, ergonomic and equipment issues (helmets and seating), and modelling. Such a system could be used within NATO to facilitate evidence-based decisions (e.g., procurement, policy, training, interventions for injury) and help to identify future research requirements.

Enhancing Interoperability Among Medical Personnel in the U.S. Military: A Case Study of Military Surgical Technologists

http://www.rand.org/pubs/monographs/2009/RAND_MG774.pdf


How feasible is it to consolidate medical training for all of the military services? Currently, the Air Force, Army, and Navy each runs its own school and trains its enlisted medical personnel differently. Following the recommendation of the 2005 Defense Base Closure and Realignment Commission, a joint medical education and training campus is now being established at Fort Sam Houston, Texas. The aim is to collocate the services’ three schools and training programs for almost all enlisted medical specialties with a view to consolidating the programs, where feasible. Consolidation will offer both short- and long-term benefits: By reducing the overall costs of training, efficiency will increase; by training medical specialists to a common standard, the interoperability of the services will be enhanced over time.
The RAND Corporation was asked (1) to develop a methodology for defining a joint standard of practice that can be applied to any medical specialty and (2) to consider options for either training individuals to that common standard or obtaining individuals already trained to that standard. The standard of practice is a set of tasks that individuals with a certain level of proficiency must be able to perform, along with an inventory of the knowledge and skills required for competence. The RAND team illustrated the methodology by applying it to the surgical technologist specialty.

Occupational safety and health for public safety employees

http://www.dtic.mil/cgi-bin/GetTRDoc?AD=ADA496656&Location=U2&doc=GetTRDoc.pdf

Police officers, firefighters, and other public safety workers are asked to put their lives at risk to protect the general public, so it is not surprising that they face exceptionally high rates of injury and fatality relative to the general workforce. To help protect public safety employees from work-related injuries and illnesses without compromising their ability to do their jobs, policymakers need a better understanding of the specific risk factors associated with different aspects of public safety occupations. To further such understanding, LaTourrette, Loughran, and Seabury conducted a literature review of research on this topic; held roundtable discussions with representatives from several public safety departments in California; and analyzed national survey data, as well as administrative data from California, to illuminate how the injury, illness, and fatality rates for public safety employees differ from those of the general workforce. The authors highlight opportunities and challenges to improving the health and safety of public safety workers.

A COMPARISON OF THE US AIR FORCE FITNESS TEST AND Sister Services' combat-oriented fitness tests

http://www.dtic.mil/cgi-bin/GetTRDoc?AD=ADA496773&Location=U2&doc=GetTRDoc.pdf

A COMPARISON OF THE US AIR FORCE FITNESS TEST AND
SISTER SERVICES’ COMBAT-ORIENTED FITNESS TESTS
THESIS

Thomas E. Worden, BS
Captain, USAF
March 2009


Abstract
This research explores how the United States Air Force Physical Fitness Test
(AFPFT) events compare to sister-services’ physical fitness test events with respect to their predictability of combat capability. Multiple regression tools, non-parametric analyses, and chi2 contingency table hypothesis testing were utilized to test hypotheses about performances and determine associations between involved variables. AFPFT scores had minimal predictability (adj R2 0.2045) [but improved when
raw data replaced scoring sheets, pushups have no maximum, and abdominal circumference and age are removed (adj R2 0.7703)]. Higher Body Mass Index (BMI)
predicts higher combat capability (p-value 0.0208). The best two-event model
incorporated a 1/2-mile run and 30-lb. dumbbell lifts (adj R2 0.8514), and the best threeevent model also incorporates pushups with no maximum (adj R2 0.8819).
Completion of the fireman’s carry has a dependency on both BMI >25 (p-value
0.00152) or a waist >32.5” (p-value 0.00521). Improvement in peer stratifications from the AFPFT to combat capability has a dependency on BMI >25 (p-value 3.19E-7), even with abdominal circumference excluded from the scoring (p-value 0.00586). Women
were found to have lower combat capability than men (p-value 0.0003). Those who
could not pass the fireman’s carry were found to have lower combat capability (p-value 0.0002).

INJURY PREVENTION REPORT NO. 12-HF-04MT-08, DEC 08

http://www.dtic.mil/cgi-bin/GetTRDoc?AD=ADA496266&Location=U2&doc=GetTRDoc.pdf


A SYSTEMATIC EVIDENCE-BASED PROCESS FOR SETTING PRIORITIES AND
PREVENTING INJURIES: RECOMMENDATIONS FOR THE MILITARY.
A. INTRODUCTION. Injuries are the biggest health problem confronting U.S. military forces in peacetime and combat operations, resulting in over 1.8 million medical encounters annually across the Services and affecting more than 800,000 individual Service members. Not only are injuries the biggest health problem of the Services, but they are also a complex problem. The leading causes of deaths are different from those that result in hospitalization, which are different from those that result in outpatient care. As a consequence, it is not possible to focus on just one level of injury severity if the impact of injuries on military personnel is to be reduced. To effectively reduce the impact of a problem as big and complex as injuries requires a systematic approach. The purpose of this summary is to introduce the concepts behind a systematic approach to injury prevention.

USAF Flight Surgeon Survey: Aircrew Mental Health Referrals and Satisfaction with Local Mental Health Providers Response

http://www.dtic.mil/cgi-bin/GetTRDoc?AD=ADA495616&Location=U2&doc=GetTRDoc.pdf
This study surveyed USAF flight surgeons world-wide regarding their experiences with aircrew needing mental health services. Participants were asked to review their caseload of active duty aircrew members over the past 12 months to answer survey items assessing: a. common psychological problems among aircrew leading to mental health referrals, b. referral rates and frequency of mental health referrals, c. modality of referrals, d. satisfaction with availability, timeliness and quality of mental health care provided to aircrew, as well as e. perceived difficulties with mental health provider response to referrals for aircrew mental health care. Out of 1504 aircrew members identified as needing mental health care, only 879 (58%) were referred to their local clinics, and reasons for lower referral rates were addressed. Common psychological problems leading to aircrew referrals included: marital difficulties, anxiety/depression related symptoms, alcoh! ol related incidences, adjustment disorders, and operational stress. Difficulties with mental health provider responses included: lack of understanding of aeromedical policy, failure to coordinate with flight surgeons when placing an aviator on a psychiatric profile, and a general lack of understanding of the aircrew community and culture. Implications and recommendations are discussed to overcome identified obstacles and improve the partnership between flight surgeons and mental health providers at USAF installations.

How Should Air Force Expeditionary Medical Capabilities Be Expressed

http://www.dtic.mil/cgi-bin/GetTRDoc?AD=ADA495434&Location=U2&doc=GetTRDoc.pdf

Snyder, Don, Chan, Edward W., Burks, James J., Amouzegar, Mahyar A., Resnick, Adam C.


The Air Force Medical Service (AFMS) provides care both at home stations and in deployment missions. Two platforms provide its deployment component: Expeditionary Medical Support (EMEDS) and the aeromedical evacuation system. These have evolved over the years to provide increasingly better care to service members during deployments. Much of this success can be credited to the concept of operations (CONOPS) of these systems and the tailoring of manpower and equipment to that concept. The operational emphasis of expeditionary medicine is on patient flow. An injured patient receives limited treatment locally and is then moved from the point of injury to an EMEDS facility as quickly as possible. There, the patient is further evaluated, stabilized, triaged, treated, and evacuated to a higher level of care. Each level of care is designed to be sufficient for immediate needs, not to provide definitive care. This emphasis on flow streamlines capabilities ! that need to be deployed and places the definitive care in the most capable facilities. Although this framework has functioned well for the mission of supporting the warfighter, two areas need improvement. First, the most common current measure of capability, both within but especially outside the Air Force, is the number of available "beds." Yet, other than the final inpatient facilities that provide definitive care, the components of the expeditionary en route medical system are not intended to hold patients per se. Rather, patients are processed as quickly as is prudent and handed off to the next level to receive further care. The measure of beds does not adequately reflect this concept of operations, and requests that are stated in terms of beds are not likely to deliver the proper set of resources to meet the real requirements.

Accelerated Decompression from Saturation at 132 Feet of Sea Water With Isobaric oxygenation at 60 Feet of Sea Water

http://www.dtic.mil/cgi-bin/GetTRDoc?AD=ADA495419&Location=U2&doc=GetTRDoc.pdf

Survivors of a disabled submarine (DISSUB) would experience a rise in internal pressure, and, if awaiting rescue long enough, become saturated increasing their risk of decompression sickness (DCS) to nearly 80% Previous work has demonstrated that breathing hyperbaric oxygen before decompression reduces the risk of DCS. A combination of oxygen pre-breathe, coupled with a shorter decompression schedule would enable the safe extraction of survivors from a DISSUB for subsequent re-pressurization in a chamber for a controlled decompression on the surface. Yorkshire swine (70 kg) were catheterized with an external jugular catheter via the Seldinger technique and allowed to recover. Subjects were exposed to 132 feet of seawater (fsw) in a hyperbaric chamber for 22 hr, then decompressed on one of 3 possible profiles (staged, rapid, mixed gas). The accelerated decompression examined here supports its consideration in emergency situations such as DISSUB. Fu! rther decompression schedules with oxygen pre-breathing merit additional study.

Medical Surveillance Monthly Report (MSMR). Volume 16, Number 01, January 2009

http://www.dtic.mil/cgi-bin/GetTRDoc?AD=ADA495050&Location=U2&doc=GetTRDoc.pdf

According to the 2005 DoD Survey of Health Related Behaviors, 61% of men and 39% of women serving in the active component of the U.S. military had a body mass index above 25 kg/m2 and thus were nominally ?overweight?. Twelve percent of active service members were nominally obese (BMI>30 kg/m2), up from less than 5% in 1995. Stress and return from deployment were the most frequently cited reasons for recent weight gain. To ensure a mission-ready force with a "military appearance," the Department of Defense mandates that each military Service implement "body composition programs," including enforcement of weight-for-height standards required for accession and advancement. An increasing number of young adults in the general population do not meet the current weight-for-height standards. Among 18-year olds who applied for military service in 2006, 35% of males and 28% of females had a BMI above 25 kg/m.4 Eighteen-year old military applicants may have ! a higher prevalence of overweight than eighteen-year olds in the general population. Despite physical fitness and body fat standards, many active service members receive clinical diagnoses of overweight during routine medical examinations and other outpatient encounters. This report documents prevalences and trends of outpatient medical encounters for overweight/obesity among active component members of the U.S. Armed Forces during the past 11 years. Th e surveillance period was January 1998-December 2008. Th e surveillance population included all individuals who served in the active component of the U.S. military any time during the surveillance period. Outpatient records routinely maintained in the Defense Medical Surveillance System were searched to identify U.S. military members with diagnoses of ?overweight/obesity.? For this report, the endpoint of data summaries and analyses were outpatient medical encounters with diagnoses specifi c for/suggestive of overweight/obes! ity (?clinical overweight?).

Effects of Extreme Sleep Deprivation on Human Performance

http://www.isu.edu/ias/documents/24_Tran.pdf
Sleep is a fundamental recuperative process for the nervous system. Disruption of this homeostatic drive can lead to severe impairments of the operator’s ability to perceive, recognize, and respond to emergencies and/or unanticipated events, putting the operator at risk. Therefore, establishing a comprehensive understanding of how sleep deprivation influences human performance is essential in order to counter fatigue or to develop mitigation strategies. The goal of the present study was to examine the psychological effects of prolonged sleep deprivation (approx. 75 hrs) over a four-day span on a general aviation pilot flying a fixed-based flight simulator. During the study, a series of tasks were employed every four hours in order to examine the pilot’s perceptual and higher level cognitive abilities. Overall, results suggest that the majority of cognitive and perceptual degradation occurs between 30-40 hours into the flight. Limitations and future research directions are also discussed.

Fatigue and Sleep Management

http://www.eurocontrol.be/humanfactors/gallery/content/public/docs/BROCHURES/Fatigue_Brochure.pdf



For shift workers, fatigue and sleep debt can become a challenge and difficult to cope with.
We have designed this booklet to provide knowledge and strategies that you can use to
manage your lifestyle, in order to help you better manage your sleep.
When reading through this booklet keep in mind that whilst some of the ideas/suggestions
may seem a little eccentric, people are different, and something that may work for one
person may not work for another. Find what works for you, then you will be one step closer
of getting a good nights sleep and feeling less tired.

Experience-Based Mitigation of Age-Related Performance Declines: Evidence From Air Traffic Control

http://www.apa.org/journals/releases/xap15112.pdf

Ashley Nunes and Arthur F. Kramer


Older air traffic controllers can head off mid-air collisions at least as well as younger controllers, using experience to compensate for age-related declines in mental sharpness, a new study finds. The evidence that experience triumphs over the normal changes of aging could help to overturn myths about older workers that are contributing to the draining of the pool of skilled professionals.