ABSTRACT

Enhancing unit-mission effectiveness is a priority and challenge in the U.S. military, especially in a landscape of wide-ranging mission capabilities and diverse career-field health and performance needs. The first step to addressing mission-relevant health and performance needs is identifying those needs within context. Capability-based blueprinting (CBB) is designed to address mission-relevant health and performance needs by using a “bottom up” approach, beginning with career-field and unit perspectives at an installation level. Despite the value of a capability-based blueprint to a specific installation, it is unclear if a CBB with a career field at a specific installation provides actionable insight for health and performance personnel and career-field leadership that is transferable to members of the same career field at other installations with different mission requirements. CBB was conducted in collaboration with Weapons Armament System communities at three installations to address this question. Findings across three capability-based blueprints articulate the link between career-field requirements, working environments, and career-field-specific health and performance considerations. Gaining an understanding of career-field-critical tasks and the associated health and performance priorities at one installation can provide some transferable knowledge for health and performance assets at other installations, such as physical, ergonomic, and nutritional demands. Continual learning is still necessary, however, since considerations, such as team dynamics and organizational climate, are likely siteand time-specific and should be explored at each site. Finally, it is important to understand that health and performance domains (e.g., physical, psychological) interact with and impact each other, ultimately shaping health and performance demands and, therefore, readiness.

Keywords: needs assessment; human performance optimization; total force fitness; community-engaged research; community-based participatory research

Hydatid Disease

Jarvis J 25(3). 110

Publication Type: Journal Article (Ongoing Series / Infectious Diseases)

Abstract:

Hydatid disease is a zoonosis in which humans become the accidental host to the larval stage of Echinococcus granulosus, also known as the dog tapeworm. Occurring worldwide, the natural lifecycle of E. granulosus tapeworms consists of a canid definitive host for the adult tapeworm stage, and an herbivorous animal (sheep, in most cases) intermediate host for the tissueinvasive and cyst-forming larval stage. Dogs and other canids harboring gut-resident tapeworms readily transmit the tapeworm eggs (and subsequent formation of larval cysts) to humans in close contact with them. It is this author’s experience that adoption of indigenous dogs as “camp mascots” is a common tradition in the military deployed setting. This practice puts troops in danger of acquiring hydatid disease. The U.S. Veterans Health Ad-ministration 2025 report on echinococcosis in Veterans states there were 1,059 diagnoses of the disease in their system from 2000 to 2024. In addition, deployed healthcare practitioners should include hydatid disease in the differential diagnosis of host-country nationals presenting with spaceoccupying lesions and/or anaphylaxis of uncertain etiology.

Keywords: parasite; hydatid disease; hydatidosis; cystic echinococcosis; Echinococcus granulosus; dog tapeworm; juvenile tapeworm; tapeworm larva; cestode; Platyhelminthes; flatworm; helminth  

ABSTRACT

Introduction: The Department of Defense has continually refined body armor to mitigate battlefield injuries over the last 20 years. Penetrating axilla injuries remain challenging despite adoption of a four-plate ceramic armor system. This study investigates the efficacy of current armor configurations in reducing mortality and morbidity associated with axilla injuries. Methods: This was a retrospective case series using afteraction reports from a single Special Operations unit. Records (786) from 2001-2018 were screened, yielding 11 meeting inclusion criteria. Data included injuries, body armor type, clinical interventions, and outcomes. Results: Analysis revealed significant mortality (45%) among casualties sustaining axilla injuries, with 100% mortality for those struck in uncovered side-plate regions under a two-plate system. In contrast, no fatalities occurred when injuries were within protected side-plate regions of a four-plate system. Injury patterns showed consistent thoracic cavity violations, emphasizing the need for robust protection strategies. This study underscores the efficacy of four-plate systems in reducing mortality compared to older configurations, particularly in protecting vital structures like great vessels and the heart. However, limitations in current side-plate coverage suggest potential gaps in protection, especially superiorly. Balancing protection with mobility remains crucial, as highlighted by operational challenges and weight concerns. Conclusion: Findings support the role of side plates in mitigating axilla injuries but highlight the need for expanded coverage using improved material technologies. Fu-ture research should focus on enhancing ballistic protection without compromising operational agility and refining trauma management protocols for optimal casualty outcomes.

Keywords: axilla; exsanguination; gunshot wound; mediastinal injury; transmediastinal gunshot wound; ballistic plates; body armor; combat injury; military trauma

Current Episode is Fall 2025

Our JSOM podcast team will be reviewing the following articles for our newest podcast: 

Penetrating Axilla Injuries in Ceramic Plate Coverage: Matthew unpacks a compelling case series on the effectiveness of four-plate body armor systems in protecting vital axillary structures, drawing from his own experience as a Ranger medic.

https://jsomonline.org/product/penetrating-axilla-injuries-and-ceramic-plate-coverage-a-special-operations-case-series/

Mitigating Heat Loss in IV Tubing During Austere Blood Transfusions: Sydney reviews a West Point study quantifying how cold environments impact transfusion safety—and what innovations might help preserve blood temperature in the field.

https://jsomonline.org/product/mitigating-heat-loss-in-iv-tubing-during-austere-blood-transfusions/

Lab Evaluation of Four Ukrainian-Manufactured Tourniquets: Jessica breaks down a comparative study assessing the performance, durability, and design of Ukrainian tourniquets under simulated battlefield conditions.

https://jsomonline.org/product/lab-evaluation-of-four-ukrainian-manufactured-tourniquets/

Plus, Dr. Dan Godbee highlights two additional must-read articles on prehospital blood use and JSOM’s ongoing commitment to mentoring medics through the publishing process.



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