Hemorrhage-control Tourniquets: How Intuitive are They?

Introduction:According to the Federal Bureau of Investigation (FBI), there were fifty active shooter incidents in 2016 and 2017. In the first five months of 2018, there have been 23 school shootings where someone was injured or killed. Hemorrhage-control tourniquets have proven their life-saving capability in the military and civilian EMS. Now, they are being advocated for use by civilians – the true “first responders.” Since Combat Application Tourniquets (CATs) are strap-and-windlass devices, the question remains whether a naïve population can intuitively apply them efficaciously.Aim:To determine the efficacy (speed, correct placement) of a CAT by an interprofessional group of healthcare students naïve to tourniquet hemorrhage control.Methods:Consenting students attempted to apply a CAT to a standardized patient with a simulated hemorrhaging brachial artery. No instruction was given except for the directions included in the package. Timing began upon removal of the tourniquet from the package and ended when the participants stated they completed their attempt. Errors in application were documented. Afterward, students received education and an opportunity to properly re-apply the tourniquet. The completion times of the students were compared to ten emergency medical technicians (EMT-P), serving as subject matter experts. Errors in application were categorized.Results:50 students from the following professions participated: Medicine, Nursing, Public Health, and Respiratory Therapy. The mean time of tourniquet application was 96.16 seconds (range: 25.12-226.31). This was statistically different from the EMT-Ps’ time of 42.83 seconds (range: 23.89-82.94). Additionally, only five (10%) placed the tourniquet correctly. Errors included improper location and windlass misuse or non-use. The instructions were frequently critiqued for being difficult to read and containing confusing graphics.Discussion:Provision of commercial tourniquets in public access areas must be accompanied by civilian education and the creation of CAT instructions that are simplistic, comprehensible, and suitably graphic.

Pedagogical system of future reserve officers’ training in higher education institutions

It is critical to understand that any pedagogical system should be effective and efficient to involve a set of interrelated elements and processes necessary to positively affect students’ performance and outcomes as well as favor their personal self-establishment. There has been considerable interest in adapting military training packages for application in civilian education and training institutions. The rapid changes in technology, tactics, and missions that are characteristic of today’s military operations require matching agility in the design and development of training and education system. These changes must be made quickly and efficiently. In this context, it is worthwhile to consider all favorable conditions for designing a pedagogical system as the integrity of the educational process. Accordingly, it is necessary to achieve the harmonious interaction of all its elements both horizontally (within the period of training, the semester or the academic year), and vertically – for all time training with reserve officers’ training packages. Respectively, changing one element of the teaching system will involve the others. Noteworthy, this is exemplified in the gradual improvement of the teaching and learning process, including the syllabi, approaches and assessments. The authors believe that it is critical to enable a more systematic approach to educate future officers at HEI with approaches to systematization of the process of military training of students/civilians according to the syllabus of reserve officers’ training in military institutions of higher education (HEI) and military training units of institutions of higher education (ROTC of HEI). The scientific and methodological analysis, conducted at the philosophical, scientific and professional levels proved the feasibility of developing a purposeful and powerful integrative pedagogical system for future reserve officers’ preparedness for military-related activities. It accentuates the realization that although students/civilians are learning mainly for the purpose of serving the Ukraine Armed Forces, they are also a part of the Ukrainian society. In this respect, they need to be given the experience as cadets and regular citizens. This can be obtained from the learning environment at the HEI; the academics and supporting staff and the rapport built between them and the academics and military instructors. What is more, a balance of learning theories of behaviorism and constructivism that allows the graduates to develop as followers and eventually leaders.

Reporting to the Sage: Military Monuments in the Imperial Academy in Qing China

This article presents a study of a unique kind of commemorative stele erected by Qing emperors in the Imperial Academy—the symbol of Confucian culture and civilian education—and also replicated in schools across China. Before the Qing dynasty (1644-1911), Chinese rulers did not install military monuments at the academy. In this article, I argue that the Qing emperors erected war monuments in the Imperial Academy to justify and commemorate their wars of conquest. As the emperors required the stelae to be replicated at some of the local schools across China, they became widely accessible to the public. However, the Qing emperors, particularly the Qianlong emperor, were concerned that the stelae could become symbols of abusive warfare, thereby undermining their claims to rule in accordance with Confucian ideals. For this reason, they carefully selected the campaigns to commemorate and ensured that inscriptions on the stelae explained that they had no choice but to embark on war in these instances.

Civil War, Reintegration, and Gender in Northern Uganda

What are the impacts of war on the participants, and do they vary by gender? Are ex-combatants damaged pariahs who threaten social stability, as some fear? Existing theory and evidence are both inconclusive and focused on males. New data and a tragic natural quasi-experiment in Uganda allow us to estimate the impacts of war on both genders, and assess how war experiences affect reintegration success. As expected, violence drives social and psychological problems, especially among females. Unexpectedly, however, most women returning from armed groups reintegrate socially and are resilient. Partly for this reason, postconflict hostility is low. Theories that war conditions youth into violence find little support. Finally, the findings confirm a human capital view of recruitment: economic gaps are driven by time away from civilian education and labor markets. Unlike males, however, females have few civilian opportunities and so they see little adverse economic impact of recruitment.