? Question: How many have been to New York, San Francisco, or Germany? Note: In these areas where transportation by rail is heavy, there will be three or more mainline tracks paralleling each other. This means that there can be two trains moving in the same or opposite direction at the same time. DOUBLE OR MULTIPLE TRACKS: A multiple track railroad is two solid black lines intersected with perpendicular tick marks. This means that there can be only one train moving in one direction at any given time. 2. SINGLE TRACK: A single-track railroad is a single black line intersected with perpendicular tick marks. ? Question: What would be another example of a prominent fence? Answer: A fence around a farm or cattle area in the Midwest or a fence around an airfield. These fences can be used as navigational aids, if you can locate them on the map and on the ground. C. PROMINENT FENCE: A prominent fence is a fence that provides a definite landmark in an area where sparse culture is shown. The map shows important footpaths foot trails, and pack trails which can accommodate 1/4 ton trucks in dry weather. B. As stated before, black denotes man-made structures and red classifies them as to their use. 1. The colors red and brown are combined to identify cultural features, all relief features, non-surveyed spot elevations, and elevation, such as contour lines on red-light readable maps. Blue is used to show water and drainage, green is used to show vegetation and brown is used to show relief. Black show's natural and man-made objects and red classifies those objects as to their use. The military map has six basic colors.All maps are not the same, so it becomes necessary every time a different map is used to examine the marginal information carefully. These instructions are placed around the edge of the map and are known as the marginal information. TRANSITION: A map can be compared to any piece of equipment, in that before it is placed into operation the user must read the instructions.Standards: Plot, navigate and find a minimum 3 out of 5 points within 3 hours during daylight and/or night. Conditions: During day and night, given a classroom and training area, 1:50,000 map (Tenino) for the classroom, 1:50,000 map (Local) for the local training area, protractor, pencil, compass and or PLGR and FM 3-25.26. NOTE: Inform the students of the following Terminal Learning Objective requirements.At the completion of this lesson, you will: Action: Navigate from one point on the ground to another while dismounted.Later you will learn how to use the lensatic compass, determine a pace count, and navigate using the dead reckoning technique. Today you will learn to identify topographic symbols, identify terrain features on a map, determine grid coordinates, measure distance, determine and convert azimuths, and locate unknown points using resection and modified resection. In the near future you will be required to navigate from one point on the ground to another while dismounted. Through the mastery of the skills presented today, you will be better prepared to proceed successfully through the complex and operational type of instructions that will follow. This will be your refresher period of instruction on Map reading. NOTE: It is the responsibility of all Soldiers and DA civilians to protect the environment from damage.Performance oriented training. Soldiers will be briefed on indentified hazards and required controls. It will be prepared prior to the block of instructions, event or activity. Low - The Primary Instructor will prepare a risk assessment using the before, during, and after checklist IAW FM 5-19. In the event of severe weather or tornado, Soldiers will exit the classroom in an orderly manner move to the location the Small Group Instructor has designated (basement or center of building) class leader will hold an accountability formation and report his findings to Small Group Instructor. In the event of a fire, Soldiers will exit the classroom in an orderly manner (last one out closes the door) meet at the location the Small Group Instructor has designated class leader will hold an accountability formation and report his findings to Small Group Instructor. 3. Solders will react to any emergency situation IAW the SOP. 2. Small Group Instructors will use the local safety Standard Operating Procedures to provide a safety brief as part of the introduction. There are no special safety considerations for this lesson.
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Various studies evaluating the presence of cognitive deficits at admission using MoCA have found patient`s age, severity of injury and educational status to be important factors affecting the patients score 8. MoCA is a freely available tool for use by medical professionals, clinics and hospitals involved in the care of such patients. This screening tool uses various tasks to assess higher-level language abilities, memory and visuospatial and executive functions. Montreal Cognitive Assessment (MoCA) score is a brief assessment tool of global cognitive function which was originally designed for early detection of mild cognitive deficits in patients with Alzheimer disease 7 which has been subsequently validated in different cohorts. There is no single standard easily administrable tool to address these issues in TBI patients. The importance of early assessment of cognitive function post TBI lies in establishing a cognitive prognosis for patients and formulating early intervention plan. In a recent study, TBI has been seen to be associated with later development of dementia and Alzheimer disease 6. The level of resultant cognitive impairment post TBI is seen to correlate with the severity of the brain injury 4, with more grievous injuries resulting in severe and persistent cognitive dysfunction 5. With progressive evolution and introduction of modern monitoring systems and management strategies for TBI, patient survival has increased with concomitant increase in the number of TBI survivors battling with its long-term complications including cognitive dysfunction 3. It affects the physical, psychosocial and cognitive skills in varying degrees thus causing significant deterioration in the quality of life and impairment of social and economic productivity 2. Traumatic Brain injury (TBI) is one of the most important global health issues which constitutes an increasingly common cause of mortality and a leading cause of morbidity in all age group, especially in young adults 1. Applied on TBI population, it reliably detects cognitive impairment in mild TBI, compared to normal controls and also differentiates cognitive disturbances between mild and severe TBI but its ability to differentiate cognitive function between mild and moderate TBI is equivocal. Montreal cognitive assessment Score (MoCA) is a brief screening tool designed to assess various cognitive domains which has been found to be more sensitive than Mini Mental State Examination (MMSE) score both in Alzheimer disease and subsequently in TBI population. Assessment of cognitive function using classically designed scales is time and resource intensive undertaking which also requires expert neuropsychiatrist referral. Keshav Mishra 1, Devendra Purohit 1*, Somnath Sharma 1ġDepartment of Neurosurgery, SMS Medical College, Jaipur, IndiaĬognitive impairment is a major cause of morbidity and impaired quality of life in traumatic brain Injury (TBI) patients. Montreal cognitive Assessment Score: A Screening Tool for Cognitive Function in Traumatic Brain Injury (TBI) Population |
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