Charles C Engel

Battlefield medical advances, improvements in protective equipment, and progress in surgical reconstruction and rehabilitation have led to questions about when to emphasize limb salvage over other treatment options-such as amputation-for individuals with severe blast-related limb injuries. This literature review summarizes recent research on limb salvage and recovery after severe blast-related injury.

RAND researchers report key findings from the 2015 Health Related Behaviors Survey of active-duty service members. The report details the survey's methodology and sample demographics, as well as policy implications. The results are intended to supplement data already collected by the Department of Defense and to inform policy initiatives to help improve the readiness, health, and well-being of the force.

Acute and chronic pain are common among service members, with musculoskeletal pain and injuries being the leading cause of nondeployability among active-duty service members. Interviews with Military Health System (MHS) administrators, providers, and service member patients provide on-the-ground perspectives on MHS pain care policies, highlighting strengths and potential areas for improvement and innovation in pain care across the MHS.

Behavioral health (BH) problems are common in the military. Research suggests that primary care?behavioral health (PCBH) integration can improve BH outcomes. The authors conducted a process evaluation of the PCBH program in the military health system to understand program implementation and inform quality improvement. Findings are in four key areas: staffing/capabilities, valued tasks, program stewardship, and fostering program awareness/support.

The U. S. Department of Defense is considering a change in policy to allow transgender military personnel to serve openly. A RAND study examined the health care needs of transgender personnel, the costs of gender transition-related care, and the potential readiness implications of a policy change. The experiences of foreign militaries that permit transgender service members to serve openly also point to some best practices for U. S. policymakers.

The dramatic evolution in information and communication technologies (ICTs) online and on smartphones has led to rapid innovations in behavioral health care. To assist the U. S. Air Force in developing a strategy for use of ICTs, the authors reviewed the scientific literature on applications of ICTs to prevent and treat behavioral health conditions.