US Army Rager handbook Combined with, TRAINING RANGES, US military manual and US Army field manual

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Principles of War for Cyberspace: Joint Force Cyberspace Component Command: Aviation in the U. Additionally, in July , a retrospective anonymous survey designed by the US Army Center for Health Promotion and Preventive Medicine was conducted among the soldiers in the task force following the deployment to ascertain self-reported compliance with malaria countermeasures.

Because the survey was anonymous and administered before the detection of all 38 malaria cases it was not possible to accurately examine noncompliance with preventive measures and other potential risk factors in the context of the disease outcome. Both the clinical case review and survey portions of this study were initially conducted as a public health investigation to protect US military personnel from disease.

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The authors obtained approval to conduct a retrospective review of the data from the institutional review board at the University of Texas Medical Branch, Galveston; and the Uniformed Services University of the Health Sciences, Bethesda, Md. Patient identifiers and protected health information remained confidential throughout the conduct of the study, and participation in the survey was not mandatory.

The exposed population consisted of personnel assigned or attached to the 75th Ranger Regiment, Fort Benning, Ga, which had deployed and conducted operations in eastern Afghanistan from June through September In addition to standard personal protective measures, antimalaria chemoprophylaxis prescribed to soldiers for this deployment consisted of weekly mg mefloquine tablets ingested from 2 weeks predeployment through 4 weeks postdeployment, and daily mg primaquine tablets ingested during the first 2 weeks of the 4-week postdeployment period.

The entire task force was tested for glucosephosphate dehydrogenase G6PD deficiency before the initiation of primaquine, with no affected individuals noted. The attending medical officers made the initial diagnosis of malaria based on clinical signs and symptoms and confirmed each case through demonstration of malaria parasite stages in red blood cells, according to the case definition from the US Centers for Disease Control and Prevention CDC.

Statistical analysis of noncompliance data was performed using SPSS version Thirty-eight active-duty men from the man Ranger Task Force contracted malaria while operating at 2 particular forward-operating bases located in eastern Afghanistan, resulting in an observed attack rate of Nearly all patients presented with fever, with many also reporting additional symptoms including chills, headache, nausea, or myalgias. Diagnosis was confirmed a median of days range, days after returning from the area of operations. The mean age at time of diagnosis was 21 years range, years.

All cases were infected with P vivax. Two cases relapsed and were treated again at and days, respectively, after the end of the deployment or and days, respectively, following initial diagnosis and treatment. A day treatment regimen was prescribed to all patients and consisted of chloroquine, mg on day 1 and mg on days 2 and 3, and primaquine, 15 mg on days 4 through The median and range of each blood count parameter was as follows: Following discharge and recovery, this patient incurred a malarial relapse 6 months later that resulted in hospitalization complicated by a spontaneous pneumothorax and treated with a tube thoracostomy.

Microscopic testing showed no evidence of coinfection with P falciparum on serial blood smears performed during both hospitalizations. This case accounted for 1 of the 2 relapse cases that occurred in the study population. The second patient experienced relapse 9 months after his initial episode but did not incur complications.

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Nonresponse was due to an additional deployment of part of the task force during the time of the survey, absence of some individuals due to other commitments, and also due to several individuals who elected not to respond. Twenty soldiers were known to have contracted malaria at the time the survey was conducted. Self-reported presence of adverse effects and difficulty keeping up with pills were associated with noncompliance with mefloquine OR, 2.

Additionally, a perceived lack of a mosquito problem was associated with noncompliance with both mefloquine and primaquine OR, 1. Soldiers with this reported exposure were significantly more likely to report using both permethrin OR, 2. This outbreak of malaria in a Ranger Task Force appears to be related to an exposure that occurred while conducting operations in eastern Afghanistan during the summer of The transmission rate, incubation of illness, and incidence of relapse are consistent with historical norms for P vivax contracted during the typical season of this region.

On day after returning from Afghanistan, the majority of soldiers from the studied task force deployed again to conduct combat operations in Iraq. Attrition from illness, injury, training, and transfers accounted for turnover and replacement of a minor portion of the task force during and between deployments.

Daily mg doxycycline was the prescribed malaria prophylaxis for the Iraq deployment for all soldiers as per US Army Central Command guidance due to the additional benefit of doxycycline in a possible biological agent attack. After 52 days, the task force returned to the United States, discontinued the doxycycline, and did not initiate a terminal prophylactic regimen because the task force had operated solely in a nonmalarial region and season while in Iraq.

Serious consideration was thus given to the possibility that Iraq may have been the source of some, if not most, of the malaria cases. Factors that contributed to this conclusion were that 1 all documented cases had deployed to either one or both of the 2 particular forward-operating bases in eastern Afghanistan during the summer of ; 2 5 of 38 cases Also, due to suboptimal compliance with primaquine terminal prophylaxis after the Afghanistan deployment, individuals most likely did not eliminate the hypnozoites.

The doxycycline provided in Iraq then suppressed any possible blood-stage malaria until the soldiers returned to the United States. After the soldiers discontinued doxycycline, merozoites could emerge and cause clinical disease.

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Although assigned medical personnel provided a detailed medical threat brief and instituted appropriate malaria preventive measures before and during the deployment, leaders did not consistently observe the application of these countermeasures. Gambel et al 18 reviewed the use of personal preventive measures, to include application of topical insect repellents and permethrin treatment of clothing and netting, among deployed personnel. Their study demonstrated that deployed soldiers do not understand the use of these measures and as a result fail to use them properly, if at all.

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Write a customer review. There was a problem filtering reviews right now. Please try again later. Probably the best US Army training manual ever published. This version has bold, sharp easy to read text. Anyone with a passing interest in US Army Rangers or special forces would enjoy it. This is the bible for the infantry, and the most up to date version. Beware though, this is the large book. Great for reference but does not fit in your cargo pocket. Definitely need to stash this one in your assault pack. The pictures are large and the font is easy to read.

There are a few typos and misprints on some pages that warrant the 4 star review. This is a great learning tool and I am happy with my purchase. One person found this helpful.

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I am still reading this manual and it like most military manuals makes a good reference for its subject. One person found this helpful 2 people found this helpful. Kindle Edition Verified Purchase.

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