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Sample records for military health system

  1. TRICARE, Military Health System

    MedlinePlus

    ... Change My Primary Care Manager Book Appointments Getting Care When Traveling Information about Quality, Patient Safety, and Access Costs Health Plan Costs Prescription Costs Dental Costs Pay My ...

  2. [Military medical and health care system in the Song Dynasty].

    PubMed

    DU, J

    2016-05-01

    The military medical and health care system in the Song Dynasty manifested as two aspects, namely disease prevention and medical treatment. Disease prevention included ensuring food and drink safety, avoiding dangerous stations and enjoying regular vacations, etc. Medical treatment included sending medical officials to patrol, stationing military physicians to follow up, applying emergency programs, establishing military medical and pharmacy centers, dispensing required medicines, and accommodating and nursing sick and injured personnel, etc. Meanwhile, the imperial court also supervised the implementation of military medical mechanism, in order to check the soldiers' foods, check and restrict the military physicians' responsibilities, etc., which did play a positive role in protecting soldier's health, guaranteeing the military combat effectiveness, and maintaining national security. PMID:27485867

  3. Patient care outcomes: implications for the Military Health Services System.

    PubMed

    Jennings, B M

    1993-05-01

    Policy makers are targeting patient outcomes and the effectiveness of interventions as possible ways to curb spiraling health care costs. Quality assurance/improvement programs are focusing on patient outcomes as a way to evaluate and improve care delivery. Consequently, members of the Military Health Services System need a solid understanding of the current emphasis on the outcomes of care to be knowledgeable participants in the health care changes precipitated by highlighting patient outcomes. PMID:8502389

  4. Leveraging the military health system as a laboratory for health care reform.

    PubMed

    Dorrance, Kevin A; Ramchandani, Suneil; Neil, Nancy; Fisher, Harry

    2013-02-01

    The Patient Protection and Affordable Care Act recently passed into law is poised to profoundly affect the provision of medical care in the United States. In today's environment, the foundation for most ongoing comparative effectiveness research is financial claims data. However, there is an alternative that possesses much richer data. That alternative, uniquely positioned to serve as a test system for national health reform efforts, is the Department of Defense Military Health System. This article describes how to leverage the Military Health System and provide effective solutions to current health care reform challenges in the United States. PMID:23495458

  5. The military health system's personal health record pilot with Microsoft HealthVault and Google Health

    PubMed Central

    Barnhill, Rick; Heermann-Do, Kimberly A; Salzman, Keith L; Gimbel, Ronald W

    2011-01-01

    Objective To design, build, implement, and evaluate a personal health record (PHR), tethered to the Military Health System, that leverages Microsoft® HealthVault and Google® Health infrastructure based on user preference. Materials and methods A pilot project was conducted in 2008–2009 at Madigan Army Medical Center in Tacoma, Washington. Our PHR was architected to a flexible platform that incorporated standards-based models of Continuity of Document and Continuity of Care Record to map Department of Defense-sourced health data, via a secure Veterans Administration data broker, to Microsoft® HealthVault and Google® Health based on user preference. The project design and implementation were guided by provider and patient advisory panels with formal user evaluation. Results The pilot project included 250 beneficiary users. Approximately 73.2% of users were <65 years of age, and 38.4% were female. Of the users, 169 (67.6%) selected Microsoft® HealthVault, and 81 (32.4%) selected Google® Health as their PHR of preference. Sample evaluation of users reflected 100% (n=60) satisfied with convenience of record access and 91.7% (n=55) satisfied with overall functionality of PHR. Discussion Key lessons learned related to data-transfer decisions (push vs pull), purposeful delays in reporting sensitive information, understanding and mapping PHR use and clinical workflow, and decisions on information patients may choose to share with their provider. Conclusion Currently PHRs are being viewed as empowering tools for patient activation. Design and implementation issues (eg, technical, organizational, information security) are substantial and must be thoughtfully approached. Adopting standards into design can enhance the national goal of portability and interoperability. PMID:21292705

  6. School-Based Health Center Model Within the Military Health System: The Role of the Adolescent Medicine Physician.

    PubMed

    Greene, Jeffery P; Dawson, Rachel

    2016-09-01

    Adolescents are less motivated to seek medical care for various reasons. Within the military health care system, access barriers, although less encountered, can still be a burden not only to the adolescent, but also the school system. This article describes the development of a school-based health center within a school district on a military installation. The school clinic was created by adolescent medicine specialists to maximize access to care. Students of adolescent age utilized the clinic for evaluation of acute and chronic conditions, preventative services, preparticipation evaluation, and other general complaints. After receiving signed consent forms, 30% of students were eligible for health care. There was minimal cost to initiate the service. Development of school-based health center programs at other military installations could potentially improve the status of the military health system during a time of high stress among military dependents. PMID:27612351

  7. WAR & Military Mental Health

    PubMed Central

    Pols, Hans; Oak, Stephanie

    2007-01-01

    Involvement in warfare can have dramatic consequences for the mental health and well-being of military personnel. During the 20th century, US military psychiatrists tried to deal with these consequences while contributing to the military goal of preserving manpower and reducing the debilitating impact of psychiatric syndromes by implementing screening programs to detect factors that predispose individuals to mental disorders, providing early intervention strategies for acute war-related syndromes, and treating long-term psychiatric disability after deployment. The success of screening has proven disappointing, the effects of treatment near the front lines are unclear, and the results of treatment for chronic postwar syndromes are mixed. After the Persian Gulf War, a number of military physicians made innovative proposals for a population-based approach, anchored in primary care instead of specialty-based care. This approach appears to hold the most promise for the future. PMID:17971561

  8. The military health services system model for pharmacoeconomic decision making.

    PubMed

    Ries, A J; Potyk, R P; Brier, K L; Miller, M R; Tornow, J J; Weber, M P; Finder, S F; Reeves, C S

    1995-05-01

    Pharmaceutical expenditures have been increasing over the last few decades, both in the private sector and the Department of Defense (DoD). The Pharmacoeconomic Center (PEC), staffed with personnel from the Army, Navy, and Air Force, was established in 1993 to develop the means to control these pharmaceutical expenditures and to develop the DoD TriService Formulary (TSF). The TSF serves as the basis for a consistent and equitable pharmacy benefit for DoD patients. The initial TSF contains medications that are well accepted as standard therapy and are currently available at most military facilities. Revisions to the initial TSF are based on pharmacoeconomic analyses of ambulatory disease states accounting for the majority of pharmaceutical expenditures. The PEC also develops treatment guidelines, preferred drug lists, and drug use evaluation criteria based on the results of each disease state analysis. PMID:10142786

  9. Cost drivers and resource allocation in military health care systems.

    PubMed

    Fulton, Larry; Lasdon, Leon S; McDaniel, Reuben R

    2007-03-01

    This study illustrates the feasibility of incorporating technical efficiency considerations in the funding of military hospitals and identifies the primary drivers for hospital costs. Secondary data collected for 24 U.S.-based Army hospitals and medical centers for the years 2001 to 2003 are the basis for this analysis. Technical efficiency was measured by using data envelopment analysis; subsequently, efficiency estimates were included in logarithmic-linear cost models that specified cost as a function of volume, complexity, efficiency, time, and facility type. These logarithmic-linear models were compared against stochastic frontier analysis models. A parsimonious, three-variable, logarithmic-linear model composed of volume, complexity, and efficiency variables exhibited a strong linear relationship with observed costs (R(2) = 0.98). This model also proved reliable in forecasting (R(2) = 0.96). Based on our analysis, as much as $120 million might be reallocated to improve the United States-based Army hospital performance evaluated in this study. PMID:17436766

  10. Evaluating the Impact of Hospital Efficiency on Wellness in the Military Health System.

    PubMed

    Bastian, Nathaniel D; Kang, Hyojung; Swenson, Eric R; Fulton, Lawrence V; Griffin, Paul M

    2016-08-01

    Like all health care delivery systems, the U.S. Department of Defense Military Health System (MHS) strives to achieve top preventative care and population health outcomes for its members while operating at an efficient level and containing costs. The objective of this study is to understand the overall efficiency performance of military hospitals and investigate the relationship between efficiency and wellness. This study uses data envelopment analysis and stochastic frontier analysis to compare the efficiency of 128 military treatment facilities from the Army, Navy, and Air Force during the period of 2011 to 2013. Fixed effects panel regression is used to determine the association between the hospital efficiency and wellness scores. The results indicate that data envelopment analysis and stochastic frontier analysis efficiency scores are congruent in direction. Both results indicate that the majority of the MHS hospitals and clinics can potentially improve their productive efficiency by managing their input resources better. When comparing the performance of the three military branches of service, Army hospitals as a group outperformed their Navy and Air Force counterparts; thus, best practices from the Army should be shared across service components. The findings also suggest no statistically significant, positive association between efficiency and wellness over time in the MHS. PMID:27483520

  11. HIPAA and the military health system: organizing technological and organizational reform in large enterprises

    NASA Astrophysics Data System (ADS)

    Collmann, Jeff R.

    2001-08-01

    The global scale, multiple units, diverse operating scenarios and complex authority structure of the Department of Defense Military Health System (MHS) create social boundaries that tend to reduce communication and collaboration about data security. Under auspices of the Defense Health Information Assurance Program (DHIAP), the Telemedicine and Advanced Technology Research Center (TATRC) is contributing to the MHS's efforts to prepare for and comply with the Health Insurance Portability and Accountability Act (HIPAA) of 1996 through organizational and technological innovations that bridge such boundaries. Building interdisciplinary (clinical, administrative and information technology) medical information security readiness teams (MISRT) at each military treatment facility (MTF) constitutes the heart of this process. DHIAP is equipping and training MISRTs to use new tools including 'OCTAVE', a self-directed risk assessment instrument and 'RIMR', a web-enabled Risk Information Management Resource. DHIAP sponsors an interdisciplinary, triservice workgroup for review and revision of relevant DoD and service policies and participates in formal DoD health information assurance activities. These activities help promote a community of proponents across the MHS supportive of improved health information assurance. The MHS HIPAA-compliance effort teaches important general lessons about organizational reform in large civilian or military enterprises.

  12. Estimating diabetes prevalence in the Military Health System population from 2006 to 2010.

    PubMed

    Chao, Susan Y; Zarzabal, Lee A; Walker, Sandra M; Herzog, Catherine M; Eilerman, Patricia A; Luce, Beverly K; Carnahan, David H

    2013-09-01

    Evidence-based articles have demonstrated an increase in diabetes prevalence, but diabetes prevalence in the enrolled Military Health System population was previously understudied. Variability in diabetes prevalence rates calculated from 5 groups of algorithms was examined in the Military Health System population (3 million enrollees per year) from fiscal years 2006 to 2010. Time trend analysis and rate comparisons to the U.S. population were also performed. Increasing linear trends in diabetes prevalence from 2006 to 2010 were seen in all algorithms, though considerable rate variation was observed within each study year. Prevalence increased with age, except for a slight decrease in those ≥75 years. Overall diagnosed diabetes prevalence ranged from 7.26% to 11.22% in 2006 and from 8.29% to 13.55% in 2010. Prevalence among active duty members remained stable, but a significant upward trend was observed among nonactive duty members across study years. Age-standardized rates among nonactive duty females were higher than the U.S. population rates from 2006 to 2010. This study demonstrates prevalence rate variability because of differing case algorithms and shows evidence of a growing diabetes population in the Military Health System, specifically within the nonactive duty 45 years and older demographic groups. Further research of this population should focus on validation of case definitions. PMID:24005548

  13. U.S. Army-Baylor University Health Care Administration Program: evidenced-based outcomes in the military health system.

    PubMed

    Mangelsdorff, A David; Rogers, Jody; Finstuen, Kenn; Pryor, Rene

    2004-01-01

    The purpose of this research is to assess the impact of an educational program on the Military Health System on some of the evidence-based educational outcomes for the Individual (student) and the Society (all Army Medical Treatment Facilities). The U.S. Army-Baylor University HCA program provides a unique opportunity to assess the impact of an educational program on the Military Health System (MHS). Since the majority of the graduate students are military officers who serve in military medical treatment facilities (MTFs), tracking their career progression allows assessing the value added of the U.S. Army-Baylor University HCA experience from 1951 to 2001 (n = 2234). The context of Society outcomes includes all the Army MTFs where U.S. Army-Baylor University HCA graduates execute their leadership skills. During the time from 1994 to 2001, all of the Army MTFs in the MHS (n = 38) were examined by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). In a similar but shorter time frame (1997-2001), DoD patient satisfaction assessments were conducted. The Individual outcomes (career advancement, increase in status, higher professional association membership) demonstrate that the selection criteria used for program admission appear to be successful. The Society outcomes showed higher JCAHO scores and satisfied consumers in Army facilities with Baylor graduates as the Deputy Commander for Administration (DCA). Continued internal program assessments (curriculum reviews) and external reviews (Accrediting Commission on Education for Health Services Administration accreditations of 5 years in 1987, 8 years in 1993 and 7 years in 2001, and 7 ACHE student chapter awards) attest to the strengths of the U.S. Army-Baylor University HCA program. Educating the MHS shareholders (patients, beneficiaries, professional and support staff, senior leaders) and leveraging technology to. share best practices for all administrators (including non-Baylor graduates) will

  14. Lessons Learned from Implementation of Voice Recognition for Documentation in the Military Electronic Health Record System

    PubMed Central

    Hoyt, Robert; Yoshihashi, Ann

    2010-01-01

    This study evaluated the implementation of voice recognition (VR) for documenting outpatient encounters in the electronic health record (EHR) system at a military hospital and its 12 outlying clinics. Seventy-five clinicians volunteered to use VR, and 64 (85 percent) responded to an online questionnaire post implementation to identify variables related to VR continuance or discontinuance. The variables investigated were user characteristics, training experience, logistics, and VR utility. Forty-four respondents (69 percent) continued to use VR and overall felt that the software was accurate, was faster than typing, improved note quality, and permitted closing a patient encounter the same day. The discontinuation rate of 31 percent was related to location at an outlying clinic and perceptions of inadequacy of training, decreased productivity due to VR inaccuracies, and no improvement in note quality. Lessons learned can impact future deployment of VR in other military and civilian healthcare facilities. PMID:20697464

  15. Holistic Care in the US Military I—The Epidaurus Project: An Initiative in Holistic Medicine for the Military Health System, 2001–2012

    PubMed Central

    Bulger, Roger J.; Frampton, Susan B.; Pellegrino, Edmund D.

    2012-01-01

    This article describes the history and findings of the Epidaurus Project, a Uniformed Services University–affiliated project to bring holistic care and evidence-based design into the Military Health System (MHS). A distinguished group of civilian thought leaders contributed. The 2005 Base Realignment and Closure process offered a chance to implement the Epidaurus agenda. A new integrated healthcare delivery system, centered around the Walter Reed National Military Medical Center at Bethesda, Maryland, was the result. These facilities will be templates for a new generation of MHS “healing environments” and a model for innovative systems of healthcare nationwide. The Epidaurus Project represents a significant collaboration between civilian medicine and the military in times of war. PMID:24278818

  16. Assessing the Dengue Diagnosis Capability Gap in the Military Health System.

    PubMed

    Pal, Subhamoy; Jasper, Louis E; Lawrence, Kendra L; Walter, Maureen; Gilliland, Theron; Dauner, Allison L; Palys, Thomas J; Wu, Shuenn-Jue L

    2016-08-01

    Dengue, one of the most widespread infectious diseases, has affected U.S. military readiness throughout history. We explored the dengue diagnosis capability gap by circulating a questionnaire among military end users to determine in what capacity diagnostic test results are needed and how these results would be used at various roles of care in the Military Health System. Results were used to generate target product profiles for potential diagnostic tests. We determined that at far-forward locations, diagnostic tests need to be rugged and easy to use and are primarily needed to inform medical evacuation decisions. In mobile or fixed hospitals, diagnostics can be less portable but must be accurate enough to inform patient care decisions reliably. We then evaluated the suitability of using rapid diagnostic tests and enzyme-linked immunosorbent assays based on published performance characteristics, and we used a model to determine positive and negative predictive values in certain simulated deployments. In far-forward settings, a rapid diagnostic test comprising both antigen- and antibody-based detection can fulfill the capability gap with reasonable accuracy, whereas at higher roles of care immunoglobulin M-enzyme-linked immunosorbent assay was determined to be the most suitable option. PMID:27483511

  17. The ability of military health systems applications to coordinate combat casualty care.

    PubMed

    Seeley, Benjamin Eli

    2013-01-01

    On February 23, 2007, Former Secretary of Defense Robert Gates said, "Our nation is truly blessed that so many talented and patriotic young people have stepped forward to serve. They deserve the very best facilities and care to recuperate from their injuries and ample assistance to navigate the next step in their lives, and that is what we intend to give them. Apart from the war itself, this department and I have no higher priority" (p. e1). Veterans and active duty Armed Forces personnel operate in a complex continuum that often requires being in harm's way to perform their duties. In doing so, their injuries encountered can be complex. Caring for those with more common injuries, such as injuries to the extremities (30% to 39.6%), is difficult; caring for those with less common injuries, such as genitourinary (0.5% to 8%), takes on an added level of complexity (Fisher, 2009). A complete picture of the injury can only be gained by visualizing their entire record of care. Traditionally, members of the health care team have not been able to link the episodes of care together seamlessly, preventing the ability to see the entire picture. The electronic health record enables better continuity of care and enhances quality (Menachemi, 2008). The availability of a system to document health care provided in austere environments and connect these data with care provided in tertiary military medical care centers using records available throughout the Veterans Health Administration (VHA) will enhance the care provided. Members of the Department of Defense, the VHA, and private sector organizations are collaborating to provide world-class seamless health care. Although the end goal of a completely integrated record has not been reached, the advent of several recent initiatives has placed military health care firmly on the track to reach those goals. PMID:23734552

  18. Women and Reproductive Health: A Challenge for the Military.

    ERIC Educational Resources Information Center

    Bassoff, Betty Z.; Ortiz, Elizabeth T.

    Although the military health care system is the second largest in the nation serving approximately 6,000,000 people, little research has examined military reproductive health care services or their quality. Medical services can be provided by regional military medical centers and by base infirmaries and dispensaries. Often base infirmaries and…

  19. Veterans and Military Health

    MedlinePlus

    ... a risk of health problems from exposure to environmental hazards, such as contaminated water, chemicals, and infections. Being in combat and being separated from your family can be stressful. The stress can put service members and veterans at risk ...

  20. The military healthcare system.

    PubMed

    Shelton, H H

    2001-09-01

    Throughout our Nation's history, healthcare has been a prominent issue for the military. TRICARE is the managed healthcare program for active duty and retired members of the uniformed services, their families, and survivors. During the past few years, the Joint Chiefs of Staff have put forth a concerted effort to work with the Congress and the Administration to ensure that TRICARE provides high quality healthcare for all members of the uniformed services, our retirees, and their families. Ensuring quality medical care for military retirees honors a promise made to those currently serving and to those who served their country in the past. PMID:11569432

  1. The long-term burden of military deployment on the health care system.

    PubMed

    Eekhout, Iris; Geuze, Elbert; Vermetten, Eric

    2016-08-01

    Health care providers need to be aware that stress complaints that result from deployment can emerge even after many years. This has important implications for health care policies. The main aim of this study is to investigate the relation between the development of posttraumatic stress and other mental health complaints and the burden on (mental) health care after a deployment. For this study we used data from a large prospective cohort study on stress-factors related to deployment in 1007 Dutch soldiers, who were deployed to Afghanistan. Participants were assessed at six follow up times up until five years after deployment. In a Generalized Estimated Equations model we estimated the relation between mental health complaints and the utilization of psychological treatment and a general practitioner, respectively. Moreover, we studied the relation between mental health complaints and health care costs using bootstrap techniques. The results showed that higher scores for PTSD, depression and fatigue relate to increased use of a psychologist. And lower PTSD scores and higher depression, anxiety and somatization scores relate to increased odds to visit a GP. Furthermore, mental health complaints relate to higher costs. In conclusion, monitoring soldiers is important in order to be informed on the current demand for (mental) health care to satisfy the health care need of veterans. Early treatment, which is enabled by lowering barriers to care, relates to positive results and therefore, lower health care costs. PMID:27214524

  2. Satellite Power System (SPS) military implications

    NASA Technical Reports Server (NTRS)

    Bain, C. N.

    1978-01-01

    The military implications of the reference satellite power system (SPS) were examined is well as important military related study tasks. Primary areas of investigation were the potential of the SPS as a weapon, for supporting U.S. military preparedness, and for affecting international relations. In addition, the SPS's relative vulnerability to overt military action, terrorist attacks, and sabotage was considered.

  3. Appendicitis and appendectomies among non-service member beneficiaries of the Military Health System, 2002-2011.

    PubMed

    2012-12-01

    Among non-service member beneficiaries of the Military Health System, there were 79,820 cases of appendicitis and 98,385 appendectomies during 2002 to 2011; from the fi rst to last year of the period, the annual number of appendicitis cases increased by 61.1 percent. Perforated acute appendicitis occurred in one quarter of all cases; the proportion of perforated cases was higher among males (30.2%) than females (23.3%). The annual number of total appendectomies decreased during the period; however, outpatient appendectomies increased 5-fold. Th e proportion of inpatient appendectomies that were incidental was greater in females (15.6%) than males (8.8%). During the period, the number of nonincidental appendectomies that were not associated with diagnoses of appendicitis ("negative appendectomies") decreased by 65 percent, and the mean number of inpatient bed days per appendicitis case decreased by one day (21.1%). The findings likely reflect more frequent uses of and advances in diagnostic imaging to detect and characterize appendicitis and a shift in surgical treatment to the outpatient setting with increasing use of laparoscopy for appendectomies. PMID:23311331

  4. Natural Interaction Based Online Military Boxing Learning System

    ERIC Educational Resources Information Center

    Yang, Chenglei; Wang, Lu; Sun, Bing; Yin, Xu; Wang, Xiaoting; Liu, Li; Lu, Lin

    2013-01-01

    Military boxing, a kind of Chinese martial arts, is widespread and health beneficial. In this paper, the authors introduce a military boxing learning system realized by 3D motion capture, Web3D and 3D interactive technologies. The interactions with the system are natural and intuitive. Users can observe and learn the details of each action of the…

  5. Veterans and Military Family Health

    MedlinePlus

    Service members and veterans face some different health issues from civilians. Their families also face some unique challenges. Families may have to cope with Separation from their loved ones Anxiety over ...

  6. Mental Health Among Military Personnel and Veterans.

    PubMed

    Pickett, Treven; Rothman, David; Crawford, Eric F; Brancu, Mira; Fairbank, John A; Kudler, Harold S

    2015-01-01

    This commentary describes the prevalence of mental health problems affecting military service members and veterans in North Carolina and the rest of the nation, with a special emphasis on those who served in the recent wars in Iraq and Afghanistan. Approximately 1.9 million of these veterans have become eligible for Veterans Affairs health care since 2002, and an estimated 1.16 million veterans have registered for this care. PMID:26946859

  7. Safeguardsing our military space systems.

    PubMed

    May, M M

    1986-04-18

    The vulnerability military space systems depends on their orbits, functions, and other characteristics. The high-altitude satellites needed for warning and communications in particular could be vulnerable to prompt destruction by certain space-based systems and, in the future, possibly by ground-based high power lasers. A combination of passive countermeasures and arms control agreements could give these satellites some protection against such attack. Deployment of strategic defensive systems with the capability to reach far into space would invalidate this approach. PMID:17792142

  8. The military social health index: a partial multicultural validation.

    PubMed

    Van Breda, Adrian D

    2008-05-01

    Routine military deployments place great stress on military families. Before South African soldiers can be deployed, they undergo a comprehensive health assessment, which includes a social work assessment. The assessment focuses on the resilience of the family system to estimate how well the family will cope when exposed to the stress of deployments. This article reports on the development and validation of a new measuring tool, the Military Social Health Index, or MSHI. The MSHI is made up of four scales, each comprising 14 items, viz social support, problem solving, stressor appraisal, and generalized resistance resources. An initial, large-scale, multicultural validation of the MSHI revealed strong levels of reliability (Cronbach a and standard error of measurement) and validity (factorial, construct, convergent, and discriminant). PMID:18543570

  9. Review of mobile health technology for military mental health.

    PubMed

    Shore, Jay H; Aldag, Matt; McVeigh, Francis L; Hoover, Ronald L; Ciulla, Robert; Fisher, Ashley

    2014-08-01

    Mental health problems pose challenges for military veterans, returning service members, and military family members including spouses and children. Challenges to meeting mental health needs include improving access to care and improving quality of care. Mobile Health, or "mHealth," can help meet these needs in the garrison and civilian environments. mHealth brings unique capabilities to health care provision through the use of mobile device technologies. This report identifies high-priority mHealth technology development considerations in two categories. First, priority considerations specific to mental health care provision include safety, privacy, evidence-based practice, efficacy studies, and temperament. Second, priority considerations broadly applicable to mHealth include security, outcomes, ease of use, carrier compliance, hardware, provider perspectives, data volume, population, regulation, command policy, and reimbursement. Strategic planning for the advancement of these priority considerations should be coordinated with stated Department of Defense capability needs to maximize likelihood of adoption. This report also summarizes three leading, military programs focused on mHealth projects in mental health, The Telemedicine and Advanced Technology Research Center, The Military Operational Medicine Research Program, United States Army Medical Research and Materiel Command, and The National Center for Telehealth and Technology. PMID:25102529

  10. Principles of military communication systems

    NASA Astrophysics Data System (ADS)

    Torrieri, D. J.

    This book is devoted to an analytical study of those aspects of communication theory which have special relevance to military systems. The book is intended for graduate students and practicing engineers with a background in communication theory. Aspects of communication warfare are considered, taking into account power and propagation, analog communications, digital communications, and pulsed jamming. Pseudonoise spread-spectrum systems are examined, giving attention to principles, pseudonoise sequences, the concealment of pseudonoise waveforms, error probabilities in presence of interference, jamming, code synchronization, pseudonoise networks, and burst-communication systems. Frequency hopping is discussed along with interception, adaptive antenna systems, and cryptographic digital communications. Topics reviewed in an appendix are related to derivations of conditional bit error probabilities for frequency-shift keying, and the noncentral chi-squared distribution.

  11. Military Exceptionalism or Tobacco Exceptionalism: How Civilian Health Leaders' Beliefs May Impede Military Tobacco Control Efforts

    PubMed Central

    Malone, Ruth E.

    2013-01-01

    Smoking impairs the readiness and performance of military personnel, yet congressional opposition has thwarted military tobacco control initiatives. Involvement of civilian organizations might alter this political dynamic. We interviewed 13 leaders of national civilian public health and tobacco control organizations to explore their perspectives on military tobacco control, inductively analyzing data for themes. Leaders believed that military tobacco use was problematic but lacked specific knowledge. Most supported smoke-free policies and prohibiting smoking in uniform; however, they opposed banning tobacco use, arguing that it would violate smokers’ rights. Most leaders inappropriately applied civilian models of policy development to the military context. A tobacco-free military is unlikely to be achieved without military–civilian partnerships that include educating civilian health leaders about military policy development and implementation. PMID:23409898

  12. Health, SES, and the Timing of Education among Military Retirees

    ERIC Educational Resources Information Center

    Edwards, Ryan D.

    2016-01-01

    The timing of education across the life cycle is differentially associated with older age health outcomes and socioeconomic status among military retirees, a subpopulation with common levels of adolescent health, but variation in educational timing. A year of education obtained before military service lowers the probability of poor health in…

  13. Satellite Power System (SPS) military applications

    NASA Technical Reports Server (NTRS)

    Ozeroff, M. J.

    1978-01-01

    The potential military role, both offensive and defensive, of a Satellite Power System (SPS) is examined. A number of potential military support possibilities are described. An SPS with military capabilities may have a strong negative impact on international relations if it is not internationalized. The SPS satellite would be vulnerable to military action of an enemy with good space capability, but would experience little or no threat from saboteurs or terrorists, except via the ground controls. The paper concludes with an outline of some of the key issues involved, and a number of recommendations for future study, including some areas for long term efforts.

  14. Field bioassessments for selecting test systems to evaluate military training lands in tallgrass prairie. Ecosystem health. V

    NASA Astrophysics Data System (ADS)

    Schaeffer, D. J.; Seastedt, T. R.; Gibson, D. J.; Hartnett, D. C.; Hetrick, B. A. D.; James, S. W.; Kaufman, D. W.; Schwab, A. P.; Herricks, E. E.; Novak, E. W.

    1990-01-01

    Ecosystem responses to physical or chemical stress may vary from changes in single organisms to alteration of the structure and function of the ecosystem. These responses to stress cannol be predicted exactly. Ecosystems repeatedly exposed to physical and/or chemical stress can be used to study the separate and combined environmental effects of stress. Such studies also allow the development of procedures to select test systems for the analysis of stress in ecosystems. A preliminary field survey of six military training sites at Fort Riley, Kansas, USA, was conducted to identify and verify ecological test systems for evaluating ecosystem responses to physical and/or chemical stress. Comparisons of these data with data collected concurrently from Konza Prairie Research Natural Area reference sites showed that soil microarthropods, some species of macroarthropods, small mammals, and native earthworm species were negatively affected by stress. In contrast, plant species diversity, plant foliage biomass, soil mycorrhizae, and many soil characteristics were within the boundaries of nominal variations observed on “pristine” Konza Prairie. Introduced European earthworms appeared to be positively affected by training activities. This study provided a test of systematic procedures to support impact analysis, ecological toxicology, and ecosystem risk assessments.

  15. Cigarette Prices in Military Retail: A Review and Proposal for Advancing Military Health Policy

    PubMed Central

    Haddock, Christopher K.; Jahnke, Sara A.; Poston, Walker S.C.; Williams, Larry N.

    2013-01-01

    Tobacco use is the leading cause of preventable death in the United States (US) and has been demonstrated to significantly harm the combat readiness of military personnel. Unfortunately, recent research demonstrated that cigarettes are sold at substantial discounts in military retail outlets. In fact, the military is the only retailer which consistently loses money on tobacco. Cheap tobacco prices have been identified by enlisted personnel and Department of Defense health policy experts as promoting a culture of tobacco use in the US Military. This paper provides an analysis of why current military tobacco pricing policy has failed to eliminate cheap tobacco prices as an incentive for use. A rationale for increasing tobacco prices also is presented along with recommendations for improved military tobacco control policy. PMID:23756017

  16. Military Experience Directed into Health Careers. Executive Summary.

    ERIC Educational Resources Information Center

    Health Research and Educational Fund of New Jersey, Princeton, NJ.

    Operation MEDIHC's (Military Experience Directed into Health Careers) program to help veterans trained in health skills while in military service capitalize on those skills when they return to civilian life is examined. The goal of the program was to help find civilian career opportunities and to provide free counseling and vocational guidance to…

  17. Measles and mumps among service members and other beneficiaries of the U.S. Military Health System, January 2007-December 2014.

    PubMed

    Daniele, Denise O; Clark, Leslie L; Hunt, Devin J; O'Donnell, Francis L

    2015-02-01

    Measles and mumps are highly communicable infectious diseases whose causative viruses are spread through airborne droplets and infected surfaces. Individuals at highest risk are infants and unvaccinated individuals. Despite effective vaccines, there have been recent increases in incidence in the U.S. of both infections. During the surveillance period, there were 14 confirmed measles cases and 99 confirmed mumps cases among U.S. military members and other beneficiaries of the U.S. Military Health System. Only one of the confirmed cases of measles was in a service member. Children aged 5 years and younger accounted for the greatest proportion of confirmed measles cases (50.0%); the greatest proportions of confirmed mumps cases were for children aged 1-5 years and adults aged 26-30 years (22.2% and 17.2%, respectively). California had more cases of both measles and mumps than any other state. Recent trends in measles and mumps in civilian populations in the U.S. highlight the importance of primary and booster vaccinations. PMID:25734620

  18. Family Relational Health, Psychological Resources, and Health Behaviors: A Dyadic Study of Military Couples.

    PubMed

    O'Neal, Catherine Walker; Lucier-Greer, Mallory; Mancini, Jay A; Ferraro, Anthony J; Ross, D Bruce

    2016-02-01

    In addition to facing stressors that are typical of life course development (e.g., marital struggles, balancing work/family demands), military families face additional stress attributed to their military context (e.g., deployments, relocations). Using a systems framework and stress process perspective, this study examined military couples' relational health, as a gauge for how couples collectively cope and address challenges as a united front and how their relational health influences crucial health behaviors (sleeping and eating) through the promotion or erosion of psychological resources (N = 236 couples). This study evaluated a latent variable structural equation dyadic model whereby each partner's perspective of their family's relational health was hypothesized to influence their own eating and sleeping behaviors (actor effects), as well as the eating and sleeping behaviors of their spouse (partner effects). The role of psychological resources (high self-efficacy, few depressive symptoms, and minimal anxiety) as a mechanism linking family functioning to health behaviors was also examined. Overall, the findings supported the hypothesized model, particularly for actor (intraindividual) effects. Discussion is provided pertinent to service providers and researchers, including the importance of improving, or maintaining, family relational health, as a means for encouraging positive health behaviors among active duty military members and their spouses. PMID:26837084

  19. The US Military Child Care System: A Model Worth Replicating

    ERIC Educational Resources Information Center

    Neugebauer, Roger

    2005-01-01

    Military child care has not always been a model system. The services were inconsistent, many programs had serious deficiencies thus were failing to meet basic health and safety standards, and caregivers were poorly trained and poorly paid. However, in the late 1980's, the Government Accounting Office exposed the seriousness of the situation.…

  20. Moving upstream: why rehabilitative justice in military discharge proceedings serves a public health interest.

    PubMed

    Seamone, Evan R; McGuire, James; Sreenivasan, Shoba; Clark, Sean; Smee, Daniel; Dow, Daniel

    2014-10-01

    The cultural divide between US military and civilian institutions amplifies the consequences of military discharge status on public health and criminal justice systems in a manner that is invisible to a larger society. Prompt removal of problematic wounded warriors through retributive justice is more expedient than lengthy mental health treatment. Administrative and punitive discharges usually preclude Department of Veterans Affairs eligibility, posing a heavy public health burden. Moving upstream--through military rehabilitative justice addressing military offenders' mental health needs before discharge--will reduce the downstream consequences of civilian maladjustment and intergenerational transmission of mental illness. The public health community can play an illuminating role by gathering data about community effect and by advocating for policy change at Department of Veterans Affairs and community levels. PMID:25122020

  1. Operation MEDIHC (Military Experience Directed into Health Careers). Final Report.

    ERIC Educational Resources Information Center

    Colorado Hospital Association, Denver.

    This Region VIII Operation MEDIHC (Military Experience Directed into Health Careers) comprehensive report covers the program's efforts to provide a state focal point of advice and assistance to all health-trained veterans seeking entrance into the civilian health services field during the period of June 1, 1970, through December 31, 1978. The…

  2. [Commune prison camp's health care and Versailles military hospital share].

    PubMed

    Delahaye, R P

    1995-01-01

    Between June 1871 and December 1872, about five thousand prisoners were kept in Versailles among some places of detention. This high death rate was indebted for worst hygienic states (individual or collective) and food wretched quality during first weeks. Military Health Service, under Hippolyte Larrey's management with Adolphe Thiers and staff assent involved living conditions owing to tubs and toilets not forgiving accurate clothes and well-balanced food. In every prison was fitted and infirmary managed by a military physician. Sick people were sent into hospital. Versailles city's archives show that, during 1871, 154 insurgent people died in the military hospital while the number dropped to 55 during 1872. PMID:11640451

  3. Creating and sustaining a military women's Health Research Interest Group.

    PubMed

    Wilson, Candy; Trego, Lori; Rychnovsky, Jacqueline; Steele, Nancy; Foradori, Megan

    2015-01-01

    In 2008, four doctorate military nurse scientists representing the triservices (Army, Navy, and Air Force) identified a common interest in the health and care of all women in the armed forces. For 7 years, the team's shared vision to improve servicewomen's health inspired them to commit to a rigorous schedule of planning, developing, and implementing an innovative program that has the capability of advancing scientific knowledge and influencing health policy and practice through research. The ultimate goal of the Military Women's Health Research Interest Group (MWHRIG) is to support military clinicians and leaders in making evidence-based practice and policy decisions. They developed a 4-pronged approach to cultivate the science of military women's healthcare: evaluate the existing evidence, develop a research agenda that addresses gaps in knowledge, facilitate the collaboration of multidisciplinary research, and build the bench of future researchers. The MWHRIG has been a resource to key leaders; its value has been validated by multiservice and multidisciplinary consultations. However, the journey to goal attainment has only been achieved by the enduring commitment of these MWHRIG leaders and their passion to ensure the health and wellbeing of the many women who serve in the United States military. This article describes their journey of dedication. PMID:26101911

  4. Occupational health and safety issues in military field hospitals.

    PubMed

    Bricknell, M C

    2001-10-01

    This paper considers the occupational health and safety issues that apply within a military field hospital. It considers NHS occupational health and safety activities and examines how these might be applied within an Army Medical Services unit. Areas that are unique to field hospitals are highlighted in comparison with a static NHS hospital. Some issues for future work are also considered. PMID:11766206

  5. IRB and Research Regulatory Delays Within the Military Health System: Do They Really Matter? And If So, Why and for Whom?

    PubMed

    Freed, Michael C; Novak, Laura A; Killgore, William D S; Rauch, Sheila A M; Koehlmoos, Tracey P; Ginsberg, J P; Krupnick, Janice L; Rizzo, Albert Skip; Andrews, Anne; Engel, Charles C

    2016-08-01

    Institutional review board (IRB) delays may hinder the successful completion of federally funded research in the U.S. military. When this happens, time-sensitive, mission-relevant questions go unanswered. Research participants face unnecessary burdens and risks if delays squeeze recruitment timelines, resulting in inadequate sample sizes for definitive analyses. More broadly, military members are exposed to untested or undertested interventions, implemented by well-intentioned leaders who bypass the research process altogether. To illustrate, we offer two case examples. We posit that IRB delays often appear in the service of managing institutional risk, rather than protecting research participants. Regulators may see more risk associated with moving quickly than risk related to delay, choosing to err on the side of bureaucracy. The authors of this article, all of whom are military-funded researchers, government stakeholders, and/or human subject protection experts, offer feasible recommendations to improve the IRB system and, ultimately, research within military, veteran, and civilian populations. PMID:27366845

  6. A call to action for evidence-based military women's health care: developing a women's health research agenda that addresses sex and gender in health and illness.

    PubMed

    Trego, Lori; Wilson, Candy; Steele, Nancy

    2010-10-01

    Women in the Army, Navy, Air Force, and Marines are serving in complex occupational specialties that sustain national policy and ensure combat effectiveness of our forces. Their roles have evolved from supportive roles during early conflicts to active roles in combat support and counterinsurgency operations today. Although women have received military health care over the past three decades, sex- and gender-specific care has been limited to reproductive needs and has rarely addressed military-specific health risks and outcomes. The complexity of military jobs and increased deployments to combat operations has led to increased occupational and health risks for women. As differences have been noted between men and women's deployment-related health outcomes, it is incumbent on the Military Health Care System (MHS) to create an evidence base that addresses sex and gender differences in the health of its service members. A working group of military women's health advanced practice nurses (APN) and research experts proposes to address this gap in knowledge and practices through sex- and gender-specific research. A sex-and gender-based research agenda for military women's health will be a valuable instrument to those who are dedicated to the health of this population, including members of the Army, Navy, and Air Force military nursing community. Using the knowledge that the research agenda generates, military health care providers can develop clinical practice guidelines, influence policy, and participate in program development to improve the health of servicewomen. Shaping a sex- and gender-specific military women's health research agenda will create the foundation for future evidence-based care. PMID:20798161

  7. Global health diplomacy training for military medical researchers.

    PubMed

    Katz, Rebecca; Blazes, David; Bae, Jennifer; Puntambekar, Nisha; Perdue, Christopher L; Fischer, Julie

    2014-04-01

    Given the unprecedented growth of global health initiatives in the past decade, informal diplomacy between technical partners plays an increasingly important role in shaping opportunities and outcomes. This article describes a course developed and executed specifically to equip U.S. military health professionals with core skills in practical diplomacy critical to help them successfully plan and implement public health surveillance, research, and capacity building programs with partner nation governments and organizations. We identified core competencies in practical diplomacy for laboratory and public health researchers, catalogued and evaluated existing training programs, and then developed a pilot course in global health diplomacy for military medical researchers. The pilot course was held in June 2012, and focused on analyzing contemporary issues related to global health diplomacy through the framework of actors, drivers, and policies that affect public health research and capacity-building, beginning at the level of global health governance and cooperation and moving progressively to regional (supranational), national, and institutional perspective. This course represents an approach geared toward meeting the needs specific to U.S. military public health personnel and researchers working in international settings. PMID:24690959

  8. Health response of two communities to military antennae in Cyprus

    PubMed Central

    Preece, A W; Georgiou, A G; Dunn, E J; Farrow, S C

    2007-01-01

    Objectives This study investigated concerns that have been raised about past and future health effects caused by high power transmissions of high frequency (7–30 MHz) radio waves from military antenna systems at Akrotiri, Cyprus. Methods A cross‐sectional study of three villages (two exposed, one unexposed) collected longitudinal and short‐term radiofrequency measurements. Health data were collected using questionnaires containing information on demographic factors, specific illnesses, general health (SF‐36 well‐being questionnaire), reproductive history, childhood illnesses, risk perception and mortality. Analysis was with SPSS v11.5 using cross tabulations of non‐parametric data and tests for significance. Key health outcomes were subjected to logistic regression analysis. Results Field strengths within the two “exposed” villages were a maximum of 0.30 (Volts/Vm−1 metre) from the 17.6 MHz military transmissions and up to 1.4 Vm−1 from unspecified sources, mainly cell phone frequencies. The corresponding readings in the control village were <0.01 Vm−1. Compared with the control village there were highly significant differences in the reporting of migraine (OR 2.7, p<0.001), headache (OR 3.7, p<0.001), and dizziness (OR 2.7, p<0.001). Residents of the exposed villages showed greater negative views of their health in all eight domains of the SF‐36. There were also higher levels of perceived risk, particularly to noise and electromagnetic “pollution”. All three villages reported higher values of risk perception than a UK population. There was no evidence of birth abnormalities or differences in gynaecological or obstetric history. Numbers of cancers were too small to show differences. Conclusion It was clear that even this close (1–3 km) to powerful transmissions, the dominant sources of radiofrequency fields were cell phone and national broadcast systems. There was no excess of cancer, birth defects or obstetric problems

  9. Demographic, Clinical, and Health System Characteristics Associated With Pain Assessment Documentation and Pain Severity in U.S. Military Patients in Combat Zone Emergency Departments, 2010-2013.

    PubMed

    Blackman, Virginia Schmied; Cooper, Bruce A; Puntillo, Kathleen; Franck, Linda S

    2016-01-01

    Emergency department (ED) pain assessment documentation in trauma patients is critical to ED pain care. This retrospective, cross-sectional study used trauma registry data to evaluate U.S. military combat zone trauma patients injured between 2010 and 2013 requiring ≥ 24-hr inpatient care. Study aims were to identify the frequency of combat zone ED pain assessment documentation and describe pain severity. Secondary aims were to construct statistical models to explain variation in pain assessment documentation and pain severity.Pain scores were documented in 60.5% (n = 3,339) of the 5,518 records evaluated. The proportion of records with ED pain scores increased yearly. Pain assessment documentation was associated with documentation of ED vital signs, comprehensive facility, more recent year, prehospital (PH) heart rate of 60-100 beats/min, ED Glasgow Coma Scale score of 15 vs. 14, blunt trauma, and lower injury severity score (ISS).Pain severity scores ranged from 0 to 10; mean = 5.5 (SD = 3.1); median = 6. Higher ED pain scores were associated with Army service compared with Marine Corps, no documented PH vital signs, higher PH pain score, ED respiratory rate < 12 or >16, moderate or severe ISS compared with minor ISS, treatment in a less-equipped facility, and injury in 2011 or 2012 vs. 2010. The pain severity model explained 20.4% of variance in pain severity.Overall, frequency of pain assessment documentation in combat-zone EDs improved yearly, but remained suboptimal. Pain severity was poorly predicted by demographic, clinical, and health system variables available from the trauma registry, emphasizing the importance of individual assessment. PMID:27618374

  10. Health Potential of Female Candidates to the Professional Military Service

    ERIC Educational Resources Information Center

    Kaiser, Alicja; Sokolowski, Marek

    2011-01-01

    Study aim: To assess health and social characteristics of female candidates for professional officers and non-commissioned officers of Polish Army. Material and methods: All female students of officer and non-commissioned officer Military Academies (16 each) were studied in 2009. Two questionnaires were applied in the study: IPAQ (short) for…

  11. Suicide and the military justice system.

    PubMed

    Lande, R G

    1992-01-01

    The United States military is sensitive to suicide. There are military policies that direct the formation of active suicide prevention programs. The U.S. military emphasizes a humanitarian approach. Modern military law, however, may view suicidal behavior as deviant. The prosecution of this behavior, although theoretically possible, has never occurred until recently. The U.S. military has now convicted soldiers for attempted suicide and assisted suicide. This article reviews these recent court decisions and suggests revisions in the military law. PMID:1440748

  12. A CONTENT ANALYSIS OF MILITARY COMMANDER MESSAGES ABOUT TOBACCO AND OTHER HEALTH ISSUES IN MILITARY INSTALLATION NEWSPAPERS: WHAT DO MILITARY COMMANDERS SAY ABOUT TOBACCO?

    PubMed Central

    Poston, Walker S.C.; Haddock, Christopher K.; Jahnke, Sara A.; Hyder, Melissa L.; Jitnarin, Nattinee

    2014-01-01

    Military installation newspapers are a primary means used by military commanders to communicate information about topics important to military personnel including leadership, training issues, installation events, safety concerns, and vital health issues. We conducted a content analysis of military commanders’ messages about health issues that were published in online military installation newspapers/newsfeeds. We identified a total of 75 publicly accessible installation newspapers/newsfeeds with commanders’ messages (n=39 Air Force, n=19 Army, n=7 Navy, n=1 Marine, and n=9 Joint Bases). Commander messages published between January 2012–December 2012 were collected, screened, and coded. Coder inter-rater reliability was 98.9%. Among the 2,479 coded commanders’ messages, 132 (5.3%) addressed a health topic as the primary focus. There were no significant differences between service branches in the percentage of health-oriented messages (χ2=5.019, p=0.285). The most commonly addressed health topics were exercise/fitness (23.5%), other mental health concerns (19.7%), alcohol/DUI (13.6%), and suicide (12.1%). Tobacco use was directly addressed as a primary health aim in only two commanders’ messages (1.5%). Health topics, and particularly tobacco-related content, are rarely written about by military commanders. The absence of tobacco-related health messages from line leadership contributes to the perception that tobacco control is a low priority. PMID:26032388

  13. Suicide and the Military Justice System.

    ERIC Educational Resources Information Center

    Lande, Raymond G.

    1992-01-01

    Notes that U.S. military policies emphasize humanitarian approach to issue of suicide, yet military law may view suicidal behavior as deviant and may prosecute suicide attempters. Cites convictions of soldiers for attempted and assisted suicides. Reviews recent court decisions and suggests revisions in military law. (Author/NB)

  14. Military hardiness as a buffer of psychological health on return from deployment.

    PubMed

    Dolan, Carol A; Adler, Amy B

    2006-02-01

    Military hardiness, the context-specific adaptation of psychological hardiness, is explored as it relates to military occupational stressors. It was hypothesized that military hardiness would moderate the effects of deployment stressors on soldier health. In a survey study of 629 U.S. soldiers, deployment stressors, military hardiness, and psychological and physical health were assessed during a peacekeeping deployment. Health was measured again after deployment. Results of moderated regression analyses partially supported the hypotheses; military hardiness moderated the impact of deployment stressors on depression after deployment, after controlling for depression during deployment. Implications for training military hardiness and applications to other occupational settings are discussed. PMID:16578974

  15. Use of Ubiquitous Technologies in Military Logistic System in Iran

    NASA Astrophysics Data System (ADS)

    Jafari, P.; Sadeghi-Niaraki, A.

    2013-09-01

    This study is about integration and evaluation of RFID and ubiquitous technologies in military logistic system management. Firstly, supply chain management and the necessity of a revolution in logistic systems especially in military area, are explained. Secondly RFID and ubiquitous technologies and the advantages of their use in supply chain management are introduced. Lastly a system based on these technologies for controlling and increasing the speed and accuracy in military logistic system in Iran with its unique properties, is presented. The system is based on full control of military logistics (supplies) from the time of deployment to replenishment using sensor network, ubiquitous and RFID technologies.

  16. Military Applicability of Interval Training for Health and Performance.

    PubMed

    Gibala, Martin J; Gagnon, Patrick J; Nindl, Bradley C

    2015-11-01

    Militaries from around the globe have predominantly used endurance training as their primary mode of aerobic physical conditioning, with historical emphasis placed on the long distance run. In contrast to this traditional exercise approach to training, interval training is characterized by brief, intermittent bouts of intense exercise, separated by periods of lower intensity exercise or rest for recovery. Although hardly a novel concept, research over the past decade has shed new light on the potency of interval training to elicit physiological adaptations in a time-efficient manner. This work has largely focused on the benefits of low-volume interval training, which involves a relatively small total amount of exercise, as compared with the traditional high-volume approach to training historically favored by militaries. Studies that have directly compared interval and moderate-intensity continuous training have shown similar improvements in cardiorespiratory fitness and the capacity for aerobic energy metabolism, despite large differences in total exercise and training time commitment. Interval training can also be applied in a calisthenics manner to improve cardiorespiratory fitness and strength, and this approach could easily be incorporated into a military conditioning environment. Although interval training can elicit physiological changes in men and women, the potential for sex-specific adaptations in the adaptive response to interval training warrants further investigation. Additional work is needed to clarify adaptations occurring over the longer term; however, interval training deserves consideration from a military applicability standpoint as a time-efficient training strategy to enhance soldier health and performance. There is value for military leaders in identifying strategies that reduce the time required for exercise, but nonetheless provide an effective training stimulus. PMID:26506197

  17. Why treat the wounded? Warrior care, military salvage, and national health.

    PubMed

    Gross, Michael L

    2008-02-01

    Because the goal of military medicine is salvaging the wounded who can return to duty, military medical ethics cannot easily defend devoting scarce resources to those so badly injured that they cannot return to duty. Instead, arguments turn to morale and political obligation to justify care for the seriously wounded. Neither argument is satisfactory. Care for the wounded is not necessary to maintain an army's morale. Nor is there any moral or logical connection between the right to health care (a universal human right) and the duty to defend one's nation (a local political duty). Once badly wounded, soldiers enjoy the same right to medical care as any similarly ill or injured individual. National health care systems grasp this point and offer few additional health care benefits to veterans. In the United States, however, lack of universal health coverage skews the debate to focus on special entitlements for veterans without considering the health care rights that other citizens enjoy. PMID:18570066

  18. Health and mental health needs of children in US military families.

    PubMed

    Siegel, Benjamin S; Davis, Beth Ellen

    2013-06-01

    The wars in Afghanistan and Iraq have been challenging for US uniformed service families and their children. Almost 60% of US service members have family responsibilities. Approximately 2.3 million active duty, National Guard, and Reserve service members have been deployed since the beginning of the wars in Afghanistan and Iraq (2001 and 2003, respectively), and almost half have deployed more than once, some for up to 18 months' duration. Up to 2 million US children have been exposed to a wartime deployment of a loved one in the past 10 years. Many service members have returned from combat deployments with symptoms of posttraumatic stress disorder, depression, anxiety, substance abuse, and traumatic brain injury. The mental health and well-being of spouses, significant others, children (and their friends), and extended family members of deployed service members continues to be significantly challenged by the experiences of wartime deployment as well as by combat mortality and morbidity. The medical system of the Department of Defense provides health and mental health services for active duty service members and their families as well as activated National Guard and Reserve service members and their families. In addition to military pediatricians and civilian pediatricians employed by military treatment facilities, nonmilitary general pediatricians care for >50% of children and family members before, during, and after wartime deployments. This clinical report is for all pediatricians, both active duty and civilian, to aid in caring for children whose loved ones have been, are, or will be deployed. PMID:23713100

  19. The Social Determinants of Health in Military Forces of Iran: A Qualitative Study

    PubMed Central

    Bahadori, Mohammadkarim; Sanaeinasab, Hormoz; Ghanei, Mostafa; Mehrabi Tavana, Ali; Ravangard, Ramin; Karamali, Mazyar

    2015-01-01

    Providing effective health interventions and achieving equity in health need to apply the community-based approaches such as social determinants of health. In the military organizations, these determinants have received less attention from the military health researchers and policymakers. Therefore, this study aimed to identify and explain the social determinants affecting the health of military forces in Iran. This was a qualitative study which was conducted in 2014. The required data were collected through semistructured interviews and analyzed through Conventional Content Analysis. The studied sample consisted of 22 military health experts, policymakers, and senior managers selected using purposeful sampling method with maximum variation sampling. MAXQDA.2007 was used to analyze the collected data. After analyzing the collected data, two main contents, that is, “general social determinants of health” and “military social determinants of health,” with 22 themes and 90 subthemes were identified as the social determinants of military forces' health. Main themes were religious rule, spirituality promotion policies, international military factors, military command, and so forth. Given the role and importance of social factors determining the military forces' health, it can be recommended that the military organizations should pay more attention to these determinants in making policies and creating social, economic, and cultural structures for their forces. PMID:26379716

  20. The application status of Chinese herbal medicine in military health service in China.

    PubMed

    Yang, Ge-Liang; Gu, Wei; Zhang, Hui-Qing; Zhai, Xiao-Feng; Li, Xiao-Qian; Ling, Chang-Quan

    2016-07-01

    Military medicine has had a long history in China since the emergence of the war. Chinese medicine, especially Chinese herbs, was widely used in China as well as other Asian countries for the prevention and treatment of diseases in the military for hundreds of years. However, the use of Chinese medicine in military health service has never been well studied. In this article, we briefly summarize the application status of Chinese herbal medicine in military health service in China, putting particular emphasis on special military environment, in an attempt to build a bridge between Chinese medicine and military health service and promote the quality of health service for the military and maintain world peace. PMID:26264570

  1. Barriers to Seeking Mental Health Services among Adolescents in Military Families

    PubMed Central

    Becker, Sara J.; Swenson, Rebecca; Esposito-Smythers, Christianne; Cataldo, Andrea; Spirito, Anthony

    2014-01-01

    Military families with adolescents experience high levels of stress associated with parental deployment, but many of these families do not seek or utilize mental health services. The current qualitative study was designed to better understand barriers to mental health treatment experienced by adolescents in military families. Focus groups and individual interviews were conducted with military adolescents (n = 13), military (non-enlisted) parents (n = 12), and mental health service providers who treat adolescents in military families (n = 20). Discussions primarily explored barriers to seeking treatment, with supplemental questions assessing the ideal elements of mental health services for this population. Seven barriers to engaging in mental health services were identified: four internal (confidentiality concerns, stigma, ethic of self-reliance, lack of perceived relevance) and three external (time and effort concerns, logistical concerns, financial concerns). Challenges engaging military adolescents in mental health services are discussed and several recommendations are offered for service providers attempting to work with this population. PMID:25574070

  2. Mental Health Among Reserve Component Military Service Members and Veterans

    PubMed Central

    Cohen, Gregory H.; Fink, David S.; Sampson, Laura; Galea, Sandro

    2015-01-01

    Since 2001, the US military has increasingly relied on National Guard and reserve component forces to meet operational demands. Differences in preparation and military engagement experiences between active component and reserve component forces have long suggested that the psychiatric consequences of military engagement differ by component. We conducted a systematic review of prevalence and new onset of psychiatric disorders among reserve component forces and a meta-analysis of prevalence estimates comparing reserve component and active component forces, and we documented stage-sequential drivers of psychiatric burden among reserve component forces. We identified 27 reports from 19 unique samples published between 1985 and 2012: 9 studies reporting on the reserve component alone and 10 reporting on both the reserve component and the active component. The pooled prevalence for alcohol use disorders of 14.5% (95% confidence interval: 12.7, 15.2) among the reserve component was higher than that of 11.7% (95% confidence interval: 10.9, 12.6) among the active component, while there were no component differences for depression or post-traumatic stress disorder. We observed substantial heterogeneity in prevalence estimates reported by the reserve component. Published studies suggest that stage-sequential risk factors throughout the deployment cycle predicted alcohol use disorders, post-traumatic stress disorder and, to a lesser degree, depression. Improved and more standardized documentation of the mental health burden, as well as study of explanatory factors within a life-course framework, is necessary to inform mitigating strategies and to reduce psychiatric burden among reserve component forces. PMID:25595172

  3. Mental health among reserve component military service members and veterans.

    PubMed

    Cohen, Gregory H; Fink, David S; Sampson, Laura; Galea, Sandro

    2015-01-01

    Since 2001, the US military has increasingly relied on National Guard and reserve component forces to meet operational demands. Differences in preparation and military engagement experiences between active component and reserve component forces have long suggested that the psychiatric consequences of military engagement differ by component. We conducted a systematic review of prevalence and new onset of psychiatric disorders among reserve component forces and a meta-analysis of prevalence estimates comparing reserve component and active component forces, and we documented stage-sequential drivers of psychiatric burden among reserve component forces. We identified 27 reports from 19 unique samples published between 1985 and 2012: 9 studies reporting on the reserve component alone and 10 reporting on both the reserve component and the active component. The pooled prevalence for alcohol use disorders of 14.5% (95% confidence interval: 12.7, 15.2) among the reserve component was higher than that of 11.7% (95% confidence interval: 10.9, 12.6) among the active component, while there were no component differences for depression or post-traumatic stress disorder. We observed substantial heterogeneity in prevalence estimates reported by the reserve component. Published studies suggest that stage-sequential risk factors throughout the deployment cycle predicted alcohol use disorders, post-traumatic stress disorder and, to a lesser degree, depression. Improved and more standardized documentation of the mental health burden, as well as study of explanatory factors within a life-course framework, is necessary to inform mitigating strategies and to reduce psychiatric burden among reserve component forces. PMID:25595172

  4. [Blood transfusion in emergency settings: French military health service experience].

    PubMed

    Sailliol, A; Ausset, S; Peytel, E

    2010-12-01

    Blood transfusion is required in a number of emergency settings and the French military health service (FMHS) has issued specific guidelines for the treatment of war casualties. These guidelines take into account European standards and laws, NATO standards, and also public sentiment regarding transfusion. These guidelines reflect a determination to control the process and to avoid the improvisation frequently associated with wartime transfusion. The evolution in warfare (terrorism and bombing more frequent than gunshot) and the wide use of body armor have deeply changed the clinical presentation of war injuries. These now involve the extremities in 80% of cases, with extensive tissue damage and heavy blood loss. The FMHS recommends that war casualties with hemorrhagic shock be brought quickly to a medical treatment facility (MTF) after first-line treatment applied through buddy aid or by medics. In the MTF, before an early Medevac, a damage control surgery will be performed, with resuscitation using freeze-dried plasma, red blood cells and fresh whole blood. The French military blood bank is responsible for blood product supply, training and medical advice regarding transfusion therapy during wartime, as well as hemovigilance. All transfusion therapy practices are periodically assessed but research on whole blood pathogen reduction is being conducted in order to reduce the residual infectious risk associated with this product. PMID:21051268

  5. [A priceless contribution to the theory and practice of military public health].

    PubMed

    Chizh, I M

    1994-09-01

    The article is dedicated to the outstanding figure in national medicine--colonel-general MD E.I. Smirnov (1904-1989), the Hero of Socialist Labour, member of the Academy of Medical Sciences of the USSR, who was the Head of the Main Military Sanitary Department of the Red Army during the Great Patriotic war, and the Minister of Health of the USSR in the post-war period. The main attention of the author is drawn on the contribution of E.I. Smirnov to the development of military medicine. The article makes a detailed analysis of the role of E. Smirnov in the development and practical implementation of military medical doctrine and the antiepidemic support system during the years of the Great Patriotic War, as well as his contribution for organizational arrangement of field therapy as an independent scientific discipline and as a subject of study in the system of medical education; his merits in organization of specialized medical care; formation of an institution of senior medical specialists; reforms in military medical education. The article contains many concrete examples which characterize a celebrated personality of E.I. Smirnov and his leadership qualities. PMID:7825285

  6. Committee Opinion No. 547: Health care for women in the military and women veterans.

    PubMed

    2012-12-01

    Military service is associated with unique risks to women's reproductive health. As increasing numbers of women are serving in the military, and a greater proportion of United States Veterans are women, it is essential that obstetrician-gynecologists are aware of and well prepared to address the unique health care needs of this demographic group. Obstetrician-gynecologists should ask about women's military service, know the Veteran status of their patients, and be aware of high prevalence problems (eg, posttraumatic stress disorder, intimate partner violence, and military sexual trauma) that can threaten the health and well-being of these women. Additional research examining the effect of military and Veteran status on reproductive health is needed to guide the care for this population. Moreover, partnerships between academic departments of obstetrics and gynecology and local branches of the Veterans Health Administration are encouraged as a means of optimizing the provision of comprehensive health care to this unique group of women. PMID:23168794

  7. [Modern ways of actualisation of military formulary system].

    PubMed

    Miroshnichenko, Iu V; Goriachev, A B; Krasavin, K D; Golubenko, R A; Gaĭnov, V S; Tikhonov, V S; Stavila, A G; Klochkova, I V

    2014-06-01

    Authors presented a historical summary about formation and development of military formulary system and quantitative and qualitative characteristics of the fifth edition of the Drug formulary. The new Drug formulary is a list of drugs developed on the basis of multi-criteria choice of optimal alternatives according clinical and pharmacoeconomic effectiveness, costs with due regard to possible pharmacological support for troops. The fifth edition of the Drug Formulary fully covers medical and social demands of military servicemen, of military retirees and members of their families for the effective drugs during the treatment of socially important and common aliments within the framework of established government guarantee. PMID:25286576

  8. [Marketing in the system of military-medical facilities].

    PubMed

    Kostiuchenko, O M; Sviridova, T B

    2014-02-01

    Military medical facilities of the Ministry of Defence of the Russian, have received the right to provide additional services and have been involved in the sphere of market relations. The strong influence of market relations - an objective reality that must be used for the development of military medical institutions and improving quality of care.Effective commercial activity can improve capabilities of the military medical institutions. This requires constant study of market mechanisms to implement and develop their competitive advantage. The paper substantiates the need for the participation of military medical institutions in the provision of health services to the public on the terms of compensation incurred by financial institutions costs (paid medical services, medical assistance program of compulsory and voluntary health insurance). Taking into account the specifics of military medical institutions set out basic principles and recommendations have been implementing marketing approach in their management, the practical application of which will not only increase efficiency, but also create conditions to improve the financial and economic indicators. This knowledge will help the mechanism of functioning health care market and the rules of interaction of market counterparties. PMID:25046919

  9. Do shorter delays to care and mental health system renewal translate into better occupational outcome after mental disorder diagnosis in a cohort of Canadian military personnel who returned from an Afghanistan deployment?

    PubMed Central

    Boulos, David; Zamorski, Mark A

    2015-01-01

    Objective Mental disorders in military personnel result in high rates of attrition. Military organisations have strengthened their mental health systems and attempted to overcome barriers to care in order to see better outcomes. This study investigated the roles of mental health services renewal and delay to care in Canadian Armed Forces (CAF) personnel diagnosed with mental disorders. Design Administrative data were used to identify a retrospective cohort of 30 513 CAF personnel who deployed in support of the mission in Afghanistan. Study participants included 508 individuals with a mental disorder diagnosis identified from CAF medical records of a weighted, stratified random sample of 2014 individuals selected from the study cohort. Weighted Cox proportional hazards regression assessed the association of diagnosis era and delay to care with the outcome, after controlling for a broad range of potential confounders (eg, disorder severity, comorbidity). Taylor series linearisation methods and sample design weights were applied in generating descriptive and regression analysis statistics. Primary outcome The outcome was release from military service for medical reasons, assessed using administrative data for the 508 individuals with a mental disorder diagnosis. Results 17.5% (95% CI 16.0% to 19.0%) of the cohort had a mental disorder diagnosis after an Afghanistan-related deployment, of which 21.3% (95% CI 17.2% to 25.5%) had a medical release over a median follow-up of 3.5 years. Medical release risk was elevated for individuals diagnosed before 30 April 2008 relative to those with recent diagnoses (adjusted HR (aHR)=1.77 (95% CI 1.01 to 3.11)) and for individuals with a long delay to care (>21 months after return) relative to those with intermediate delays (8–21 months, aHR 2.47=(95% CI 1.28 to 4.76)). Conclusions Mental health services renewal in the CAF was associated with a better occupational outcome for those diagnosed with mental disorders. Longer

  10. Advanced U. S. military aircraft battery systems

    SciTech Connect

    Flake, R.A.; Eskra, M.D.

    1990-01-01

    While most USAF aircraft currently use vented Ni-Cd for dc electrical power and emergency power, as well as the powering of lights and instruments prior to engine starting, these batteries have high maintenance requirements, low reliability, and no built-in testing capability with which to check battery health prior to flight. The USAF Wright R D Center accordingly initiated its Advanced Maintenance-Free NiCd Battery System development program in 1986, in order to develop a sealed Ni-Cd battery which would remain maintenance-free over a period of three years. Attention is being given to a high power bipolar battery design in which there are no individual cell cases or cell interconnects.

  11. Active coatings technologies for tailorable military coating systems

    NASA Astrophysics Data System (ADS)

    Zunino, J. L., III

    2007-04-01

    The main objective of the U.S. Army's Active Coatings Technologies Program is to develop technologies that can be used in combination to tailor coatings for utilization on Army Materiel. The Active Coatings Technologies Program, ACT, is divided into several thrusts, including the Smart Coatings Materiel Program, Munitions Coatings Technologies, Active Sensor packages, Systems Health Monitoring, Novel Technology Development, as well as other advanced technologies. The goal of the ACT Program is to conduct research leading to the development of multiple coatings systems for use on various military platforms, incorporating unique properties such as self repair, selective removal, corrosion resistance, sensing, ability to modify coatings' physical properties, colorizing, and alerting logistics staff when tanks or weaponry require more extensive repair. A partnership between the U.S. Army Corrosion Office at Picatinny Arsenal, NJ along with researchers at the New Jersey Institute of Technology, NJ, Clemson University, SC, University of New Hampshire, NH, and University of Massachusetts (Lowell), MA, are developing the next generation of Smart Coatings Materiel via novel technologies such as nanotechnology, Micro-electromechanical Systems (MEMS), meta-materials, flexible electronics, electrochromics, electroluminescence, etc. This paper will provide the reader with an overview of the Active Coatings Technologies Program, including an update of the on-going Smart Coatings Materiel Program, its progress thus far, description of the prototype Smart Coatings Systems and research tasks as well as future nanotechnology concepts, and applications for the Department of Defense.

  12. Spouse Psychological Well-Being: A Keystone to Military Family Health

    PubMed Central

    Green, Sara; Nurius, Paula S.; Lester, Patricia

    2013-01-01

    Understanding predictors of military spouse psychosocial vulnerability informs efforts to assess, identify, and support at-risk spouses and families. In this analysis we test the effects of family stress and strain on military spouse psychological health, using a sample of female civilian spouses (n=161). Regression findings confirm expectations of the significant contribution of family stressors, strain, and resources in explaining variation in spouses' psychological health, controlling for deployment and socioeconomic factors. Identifying the effects of family stress on military spouse psychological health supports the need for family-centered interventions and prevention programs. PMID:24415897

  13. Spouse Psychological Well-Being: A Keystone to Military Family Health.

    PubMed

    Green, Sara; Nurius, Paula S; Lester, Patricia

    2013-01-01

    Understanding predictors of military spouse psychosocial vulnerability informs efforts to assess, identify, and support at-risk spouses and families. In this analysis we test the effects of family stress and strain on military spouse psychological health, using a sample of female civilian spouses (n=161). Regression findings confirm expectations of the significant contribution of family stressors, strain, and resources in explaining variation in spouses' psychological health, controlling for deployment and socioeconomic factors. Identifying the effects of family stress on military spouse psychological health supports the need for family-centered interventions and prevention programs. PMID:24415897

  14. Stigma as a barrier to seeking health care among military personnel with mental health problems.

    PubMed

    Sharp, Marie-Louise; Fear, Nicola T; Rona, Roberto J; Wessely, Simon; Greenberg, Neil; Jones, Norman; Goodwin, Laura

    2015-01-01

    Approximately 60% of military personnel who experience mental health problems do not seek help, yet many of them could benefit from professional treatment. Across military studies, one of the most frequently reported barriers to help-seeking for mental health problems is concerns about stigma. It is, however, less clear how stigma influences mental health service utilization. This review will synthesize existing research on stigma, focusing on those in the military with mental health problems. We conducted a systematic review and meta-analysis of studies between 2001 and 2014 to examine the prevalence of stigma for seeking help for a mental health problem and its association with help-seeking intentions/mental health service utilization. Twenty papers met the search criteria. Weighted prevalence estimates for the 2 most endorsed stigma concerns were 44.2% (95% confidence interval: 37.1, 51.4) for "My unit leadership might treat me differently" and 42.9% (95% confidence interval: 36.8, 49.0) for "I would be seen as weak." Nine studies found no association between anticipated stigma and help-seeking intentions/mental health service use and 4 studies found a positive association. One study found a negative association between self-stigma and intentions to seek help. Counterintuitively, those that endorsed high anticipated stigma still utilized mental health services or were interested in seeking help. We propose that these findings may be related to intention-behavior gaps or methodological issues in the measurement of stigma. Positive associations may be influenced by modified labeling theory. Additionally, other factors such as self-stigma and negative attitudes toward mental health care may be worth further attention in future investigation. PMID:25595168

  15. Choosing the right video interface for military vision systems

    NASA Astrophysics Data System (ADS)

    Phillips, John

    2015-05-01

    This paper discusses how GigE Vision® video interfaces - the technology used to transfer data from a camera or image sensor to a mission computer or display - help designers reduce the cost and complexity of military imaging systems, while also improving usability and increasing intelligence for end-users. The paper begins with a detailed review of video connectivity approaches commonly used in military imaging systems, followed by an overview on the GigE Vision standard. With this background, the design, cost, and performance benefits that can be achieved when employing GigE Vision-compliant video interfaces in a vetronics retrofit upgrade project are outlined.

  16. Family Child Care Programs within the Military System of Care

    ERIC Educational Resources Information Center

    Stevens, Carolyn S.

    2011-01-01

    Military families face challenges not found in other work environments. Shifting work schedules that are often longer than the typical 8-hour day, as well as the ever-present possibility of being deployed anywhere in the world on a moment's notice, require a child care system that is flexible but maintains high-quality standards. The U.S.…

  17. Search and detection modeling of military imaging systems

    NASA Astrophysics Data System (ADS)

    Maurer, Tana; Wilson, David L.; Driggers, Ronald G.

    2013-04-01

    For more than 50 years, the U.S. Army RDECOM CERDEC Night Vision and Electronic Sensors Directorate (NVESD) has been studying the science behind the human processes of searching and detecting, and using that knowledge to develop and refine its models for military imaging systems. Modeling how human observers perform military tasks while using imaging systems in the field and linking that model with the physics of the systems has resulted in the comprehensive sensor models we have today. These models are used by the government, military, industry, and academia for sensor development, sensor system acquisition, military tactics development, and war-gaming. From the original hypothesis put forth by John Johnson in 1958, to modeling time-limited search, to modeling the impact of motion on target detection, to modeling target acquisition performance in different spectral bands, the concept of search has a wide-ranging history. Our purpose is to present a snapshot of that history; as such, it will begin with a description of the search-modeling task, followed by a summary of highlights from the early years, and concluding with a discussion of search and detection modeling today and the changing battlefield. Some of the topics to be discussed will be classic search, clutter, computational vision models and the ACQUIRE model with its variants. We do not claim to present a complete history here, but rather a look at some of the work that has been done, and this is meant to be an introduction to an extensive amount of work on a complex topic. That said, it is hoped that this overview of the history of search and detection modeling of military imaging systems pursued by NVESD directly, or in association with other government agencies or contractors, will provide both the novice and experienced search modeler with a useful historical summary and an introduction to current issues and future challenges.

  18. Women's Health Identities in the Transition From Military Member to Service Veteran.

    PubMed

    Villagran, Melinda; Ledford, Christy J W; Canzona, Mollie Rose

    2015-01-01

    As servicewomen leave behind their military rank and status to become veterans, they must learn to effectively navigate a fragmented structure of care and communicate their health care needs. This study proposes a culture-centered approach to understanding how structural changes contribute to a reduction in positive health perception and behavior as active duty servicewomen transition to a veteran status. Results suggest during the process of disengagement from military cultural norms, women veterans' health care prevention service utilization decreases, and their physical and mental health decreases through the transition. These findings highlight the need for widely available and culturally appropriate programs to meet the needs of this unique patient population. PMID:26305865

  19. Military Youth and the Deployment Cycle: Emotional Health Consequences and Recommendations for Intervention

    PubMed Central

    Esposito-Smythers, Christianne; Wolff, Jennifer; Lemmon, Keith M.; Bodzy, Mary; Swenson, Rebecca R.; Spirito, Anthony

    2011-01-01

    The United States military force includes over 2.2 million volunteer service members. Three out of five service members who are deployed or are preparing for deployment have spouses and/or children. Stressors associated with the deployment cycle can lead to depression, anxiety, and behavior problems in children, as well as psychological distress in the military spouse. Further, the emotional and behavioral health of family members can affect the psychological functioning of the military service member during the deployment and re-integration periods. Despite widespread acknowledgement of the need for emotional and behavioral health services for youth from military families, many professionals in a position to serve them struggle with how to best respond and select appropriate interventions. The purpose of this paper is to provide an empirically-based and theoretically informed review to guide service provision and the development of evidence based treatments for military youth in particular. This review includes an overview of stressors associated with the deployment cycle, emotional and behavioral health consequences of deployment on youth and their caretaking parent, and existing preventative and treatment services for youth from military families. It concludes with treatment recommendations for older children and adolescents experiencing emotional and behavioral health symptoms associated with the deployment cycle. PMID:21707172

  20. Evaluation of a psychological health and resilience intervention for military spouses: A pilot study.

    PubMed

    Kees, Michelle; Rosenblum, Katherine

    2015-08-01

    The decade long conflicts in Iraq and Afghanistan have placed considerable strain on military families. Given robust data showing high rates of deployment-related psychological health problems in spouses and children, and the near absence of evidence-based psychological health programs for military families in the community, interventions are urgently needed to support and strengthen spouses as they adjust to deployment transitions and military life experiences. This Phase 1 pilot study evaluated the feasibility and acceptability of a resiliency intervention for military spouses in civilian communities (HomeFront Strong; HFS), and generated preliminary efficacy data regarding impacts on psychological health and adjustment. Through two group cohorts, 14 women completed the intervention, with 10 women providing pre- and postgroup assessment data. Findings support feasibility of the intervention and high rates of program satisfaction. Participants reported learning new strategies and feeling more knowledgeable in their ability to use effective coping skills for managing deployment and military-related stressors. Participation in HFS was also associated with reduction in levels of anxiety and perceived stress, and improvements in life satisfaction and life engagement. HFS is a promising community-based intervention for military spouses designed to enhance resiliency, reduce negative psychological health symptoms, and improve coping. PMID:26213791

  1. Health Care Expenditures Attributable to Smoking in Military Veterans

    PubMed Central

    Hamlett-Berry, Kim; Sung, Hai-Yen; Max, Wendy

    2015-01-01

    Introduction: The health effects of cigarette smoking have been estimated to account for between 6%–8% of U.S. health care expenditures. We estimated Veterans Health Administration (VHA) health care costs attributable to cigarette smoking. Methods: VHA survey and administrative data provided the number of Veteran enrollees, current and former smoking prevalence, and the cost of 4 types of care for groups defined by age, gender, and region. Cost and smoking status could not be linked at the enrollee level, so we used smoking attributable fractions estimated in sample of U.S. residents where the linkage could be made. Results: The 7.7 million Veterans enrolled in VHA received $40.2 billion in VHA provided health services in 2010. We estimated that $2.7 billion in VHA costs were attributable to the health effects of smoking. This was 7.6% of the $35.3 billion spent on the types of care for which smoking-attributable fractions could be determined. The fraction of inpatient costs that was attributable to smoking (11.4%) was greater than the fraction of ambulatory care cost attributable to smoking (5.3%). More cost was attributable to current smokers ($1.7 billion) than to former smokers ($983 million). Conclusions: The fraction of VHA costs attributable to smoking is similar to that of other health care systems. Smoking among Veterans is slowly decreasing, but prevalence remains high in Veterans with psychiatric and substance use disorders, and in younger and female Veterans. VHA has adopted a number of smoking cessation programs that have the potential for reducing future smoking-attributable costs. PMID:25239960

  2. Answering the call to address chronic pain in military service members and veterans: Progress in improving pain care and restoring health.

    PubMed

    Schoneboom, Bruce A; Perry, Susan M; Barnhill, William Keith; Giordano, Nicholas A; Wiltse Nicely, Kelly L; Polomano, Rosemary C

    2016-01-01

    Chronic noncancer pain (CNCP) in military and veteran populations mirrors the experience of chronic pain in America; however, these two populations have unique characteristics and comorbid conditions such as traumatic brain injuries, postconcussive syndrome, posttraumatic stress disorder, and behavioral health disorders that complicate the diagnosis and treatment of chronic pain. Military members and veterans may also be stigmatized about their conditions and experience problems with integration back into healthy lifestyles and society as a whole following deployments and after military service. The military and veteran health care systems have made chronic pain a priority and have made substantial strides in addressing this condition through advances in practice, education, research, and health policy. Despite this progress, significant challenges remain in responding to the wide-spread problem of chronic pain. The purpose of this article is to: (a) examine the state of CNCP in military and veteran populations; (b) discuss progress made in pain practice, education, research, and health policy; and (c) examine research, evidence-based practice guidelines, and expert consensus reports that are foundational to advancing pain care and improving health for military service members and veterans with CNCP. In addition, recommendations are proposed to address this widespread health problem through the expanded use of advanced practice registered nurses, the implementation of models of care, and use of national resources to educate health care providers, support practice, and promote effective pain care. PMID:27427406

  3. Expert system aid for military finance

    SciTech Connect

    Morris, J.D.; Emrich, M.L.; Hwang, Ho-Ling; Meador, M.

    1987-09-14

    Historically, budget preparation processes have been difficult to accomplish. Errors and inconsistencies cause problems for the analyst during budget review. This paper discusses the development and testing of an expert system to aid budget preparation. The prototyping tool, its capabilities, and their application are discussed. Shown are the pilot testing procedures and their role in system development. Current status and enhancements (including software updates and future testing) are also presented. 12 refs., 3 figs.

  4. Requirements and applications for robotic servicing of military space systems

    NASA Technical Reports Server (NTRS)

    Ledford, Otto C., Jr.; Bennett, Rodney G.

    1992-01-01

    The utility of on-orbit servicing of spacecraft has been demonstrated by NASA several times using shuttle-based astronaut EVA. There has been interest in utilizing on-orbit servicing for military space systems as well. This interest has been driven by the increasing reliance of all branches of the military upon space-based assets, the growing numbers, complexity, and cost of those assets, and a desire to normalize support policies for space-based operations. Many military satellites are placed in orbits which are unduly hostile for astronaut operations and/or cannot be reached by the shuttle. In addition, some of the projected tasks may involve hazardous operations. This has led to a focus on robotic systems, instead of astronauts, for the basis of projected servicing systems. This paper describes studies and activities which will hopefully lead to on-orbit servicing being one of the tools available to military space systems designers and operators. The utility of various forms of servicing has been evaluated for present and projected systems, critical technologies have been identified, and strategies for the development and insertion of this technology into operational systems have been developed. Many of the projected plans have been adversely affected by budgetary restrictions and evolving architectures, but the fundamental benefits and requirements are well understood. A method of introducing servicing capabilities in a manner which has a low impact on the system designer and does not require the prior development of an expensive infrastructure is discussed. This can potentially lead to an evolutionary implementation of the full technology.

  5. Overview of 'Omics Technologies for Military Occupational Health Surveillance and Medicine.

    PubMed

    Bradburne, Christopher; Graham, David; Kingston, H M; Brenner, Ruth; Pamuku, Matt; Carruth, Lucy

    2015-10-01

    Systems biology ('omics) technologies are emerging as tools for the comprehensive analysis and monitoring of human health. In order for these tools to be used in military medicine, clinical sampling and biobanking will need to be optimized to be compatible with downstream processing and analysis for each class of molecule measured. This article provides an overview of 'omics technologies, including instrumentation, tools, and methods, and their potential application for warfighter exposure monitoring. We discuss the current state and the potential utility of personalized data from a variety of 'omics sources including genomics, epigenomics, transcriptomics, metabolomics, proteomics, lipidomics, and efforts to combine their use. Issues in the "sample-to-answer" workflow, including collection and biobanking are discussed, as well as national efforts for standardization and clinical interpretation. Establishment of these emerging capabilities, along with accurate xenobiotic monitoring, for the Department of Defense could provide new and effective tools for environmental health monitoring at all duty stations, including deployed locations. PMID:26444891

  6. Integration of micro-fabricated atomic magnetometers on military systems

    NASA Astrophysics Data System (ADS)

    Schultz, Gregory; Mhaskar, Rahul; Prouty, Mark; Miller, Jonathan

    2016-05-01

    A new generation of ultra-high sensitivity magnetic sensors based on innovative micro-electromechanical systems (MEMS) are being developed and incorporated into military systems. Specifically, we are currently working to fully integrate the latest generation of MicroFabricated Atomic Magnetometers (MFAMs) developed by Geometrics on defense mobility systems such as unmanned systems, military vehicles and handheld units. Recent reductions in size, weight, and power of these sensors has enabled new deployment opportunities for improved sensitivity to targets of interest, but has also introduced new challenges associated with noise mitigation, mission configuration planning, and data processing. Our work is focused on overcoming the practical aspects of integrating these sensors with various military platforms. Implications associated with utilizing these combined sensor systems in working environments are addressed in order to optimize signal-to-noise ratios, detection probabilities, and false alarm mitigation. Specifically, we present collaborative work that bridges the gap between commercial specialists and operation platform integration organizations including magnetic signature characterization and mitigation as well as the development of simulation tools that consider a wide array of sensor, environmental, platform, and mission-level parameters. We discuss unique deployment concepts for explosive hazard target geolocation, and data processing. Applications include configurations for undersea and underground threat detection - particularly those associated with stationary or mobile explosives and compact metallic targets such as munitions, subsea threats, and other hazardous objects. We show the potential of current and future features of miniaturized magnetic sensors including very high magnetic field sensitivities, bandwidth selectivity, and array processing.

  7. Intelligent Instructional Systems in Military Training.

    ERIC Educational Resources Information Center

    Fletcher, J.D.; Zdybel, Frank

    Intelligent instructional systems can be distinguished from more conventional approaches by the automation of instructional interaction and choice of strategy. This approach promises to reduce the costs of instructional materials preparation and to increase the adaptability and individualization of the instruction delivered. Tutorial simulation…

  8. [Medicinal formulary, edited by the Health Board for Military Hospitals (1788)].

    PubMed

    Bourrinet, Patrick; Gaudron, Sylvain

    2014-10-01

    A royal decree in 1788 created a Health Board for military hospitals. The board members included Bayen, assisted by Pagmentier. A collection of "Medicinal formulae" was then published with a view to standardizing and simplifying the remedies prepared in pharmacies. It comprised 159 formulae for internal and external medicines together with a nomenclature for 249 simple and compound drugs used in military hospitals. PMID:25671979

  9. Military nutrition: maintaining health and rebuilding injured tissue

    PubMed Central

    Hill, Neil; Fallowfield, Joanne; Price, Susan; Wilson, Duncan

    2011-01-01

    Food and nutrition are fundamental to military capability. Historical examples demonstrate that a failure to supply adequate nutrition to armies inevitably leads to disaster; however, innovative measures to overcome difficulties in feeding reap benefits, and save lives. In barracks, UK Armed Forces are currently fed according to the relatively new Pay As You Dine policy, which has attracted criticism from some quarters. The recently introduced Multi-Climate Ration has been developed specifically to deal with issues arising from Iraq and the current conflict in Afghanistan. Severely wounded military personnel are likely to lose a significant amount of their muscle mass, in spite of the best medical care. Nutritional support is unable to prevent this, but can ameliorate the effects of the catabolic process. Measuring and quantifying nutritional status during critical illness is difficult. A consensus is beginning to emerge from studies investigating the effects of nutritional interventions on how, what and when to feed patients with critical illness. The Ministry of Defence is currently undertaking research to address specific concerns related to nutrition as well as seeking to promote healthy eating in military personnel. PMID:21149358

  10. Military personnel recognition system using texture, colour, and SURF features

    NASA Astrophysics Data System (ADS)

    Irhebhude, Martins E.; Edirisinghe, Eran A.

    2014-06-01

    This paper presents an automatic, machine vision based, military personnel identification and classification system. Classification is done using a Support Vector Machine (SVM) on sets of Army, Air Force and Navy camouflage uniform personnel datasets. In the proposed system, the arm of service of personnel is recognised by the camouflage of a persons uniform, type of cap and the type of badge/logo. The detailed analysis done include; camouflage cap and plain cap differentiation using gray level co-occurrence matrix (GLCM) texture feature; classification on Army, Air Force and Navy camouflaged uniforms using GLCM texture and colour histogram bin features; plain cap badge classification into Army, Air Force and Navy using Speed Up Robust Feature (SURF). The proposed method recognised camouflage personnel arm of service on sets of data retrieved from google images and selected military websites. Correlation-based Feature Selection (CFS) was used to improve recognition and reduce dimensionality, thereby speeding the classification process. With this method success rates recorded during the analysis include 93.8% for camouflage appearance category, 100%, 90% and 100% rates of plain cap and camouflage cap categories for Army, Air Force and Navy categories, respectively. Accurate recognition was recorded using SURF for the plain cap badge category. Substantial analysis has been carried out and results prove that the proposed method can correctly classify military personnel into various arms of service. We show that the proposed method can be integrated into a face recognition system, which will recognise personnel in addition to determining the arm of service which the personnel belong. Such a system can be used to enhance the security of a military base or facility.

  11. Challenges Faced by Undergraduate Military Students at American Public University System

    ERIC Educational Resources Information Center

    Machuca, Ana; Torres, Karin; Morris, Pamela; Whitley, William

    2014-01-01

    This paper will summarize some of challenges faced by military students enrolled in an associate and bachelors online program at American Public University System (APUS). The survey results on which the study is based exposed the following problems faced by military personnel: 48.7% had difficulties working around military obligations, 33.3%…

  12. Voice interactive electronic warning system (Views). [onboard military helicopter

    NASA Technical Reports Server (NTRS)

    Voorhees, J. W.; Bucher, N. M.; Huff, E. M.; Simpson, C. A.; Williams, D. H.

    1983-01-01

    The ability of military helicopters to penetrate the Forward Line of Troops (FLOT) has increased in connection with the utilization of low-level 'Nap-of-the-Earth' (NOE) flying procedures. However, the workload of the pilot engaged in the implementation of the required maneuvers is very high. Possibilities for reducing this workload are being investigated. The present study is concerned with the introduction of an integrated warning system in the cockpit. An integrated warning system simulation study is discussed, taking into account aspects of methodology, and results. Three voice types were evaluated, including male digitized, female digitized, and digitized.

  13. Physicochemical characterization and failure analysis of military coating systems

    NASA Astrophysics Data System (ADS)

    Keene, Lionel Thomas

    Modern military coating systems, as fielded by all branches of the U.S. military, generally consist of a diverse array of organic and inorganic components that can complicate their physicochemical analysis. These coating systems consist of VOC-solvent/waterborne automotive grade polyurethane matrix containing a variety of inorganic pigments and flattening agents. The research presented here was designed to overcome the practical difficulties regarding the study of such systems through the combined application of several cross-disciplinary techniques, including vibrational spectroscopy, electron microscopy, microtomy, ultra-fast laser ablation and optical interferometry. The goal of this research has been to determine the degree and spatial progression of weathering-induced alteration of military coating systems as a whole, as well as to determine the failure modes involved, and characterizing the impact of these failures on the physical barrier performance of the coatings. Transmission-mode Fourier Transform Infrared (FTIR) spectroscopy has been applied to cross-sections of both baseline and artificially weathered samples to elucidate weathering-induced spatial gradients to the baseline chemistry of the coatings. A large discrepancy in physical durability (as indicated by the spatial progression of these gradients) has been found between older and newer generation coatings. Data will be shown implicating silica fillers (previously considered inert) as the probable cause for this behavioral divergence. A case study is presented wherein the application of the aforementioned FTIR technique fails to predict the durability of the coating system as a whole. The exploitation of the ultra-fast optical phenomenon of femtosecond (10-15S) laser ablation is studied as a potential tool to facilitate spectroscopic depth profiling of composite materials. Finally, the interferometric technique of Phase Shifting was evaluated as a potential high-sensitivity technique applied to the

  14. Psychological morbidity, quality of life, and self-rated health in the military personnel

    PubMed Central

    Chou, Han-Wei; Tzeng, Wen-Chii; Chou, Yu-Ching; Yeh, Hui-Wen; Chang, Hsin-An; Kao, Yu-Cheng; Tzeng, Nian-Sheng

    2014-01-01

    Objective The mental health of military personnel varies as a result of different cultural, political, and administrative factors. The purpose of this study was to evaluate the psychological morbidity and quality of life of military personnel in Taiwan. Materials and methods This cross-sectional study utilized the World Health Organization Quality of Life Instrument, brief version, Taiwan version, the General Health Questionnaire-12, Chinese version, and the Visual Analog Scale (VAS) in several military units. Results More than half of the subjects (55.3%) identified themselves as mentally unhealthy on the General Health Questionnaire-12, Chinese version; however, a higher percentage of officers perceived themselves as healthy (57.4%) than did noncommissioned officers (38.5%) or enlisted men (42.2%). Officers also had higher total quality of life (QOL) scores (83.98) than did enlisted men (79.67). Scores on the VAS also varied: officers: 72.5; noncommissioned officers: 67.7; and enlisted men: 66.3. The VAS and QOL were positively correlated with perceived mental health among these military personnel. Conclusion Our subjects had higher rates of perceiving themselves as mentally unhealthy compared to the general population. Those of higher rank perceived themselves as having better mental health and QOL. Improving mental health could result in a better QOL in the military. The VAS may be a useful tool for the rapid screening of self-reported mental health, which may be suitable in cases of stressful missions, such as in disaster rescue; however, more studies are needed to determine the optimal cut-off point of this measurement tool. PMID:24570587

  15. Should We End Military Recruiting in High Schools as a Matter of Child Protection and Public Health?

    PubMed Central

    Barker, Kathy

    2011-01-01

    Recruiters for the various US armed forces have free access to our nation's high schools, as mandated by the No Child Left Behind Act. Military recruiter behaviors are disturbingly similar to predatory grooming. Adults in the active military service are reported to experience increased mental health risks, including stress, substance abuse, and suicide, and the youngest soldiers consistently show the worst health effects, suggesting military service is associated with disproportionately poor health for this population. We describe the actions of a high school parent teacher student association in Seattle, Washington, which sought to limit the aggressive recruitment of children younger than 18 years into the military. PMID:21088269

  16. Promoting Health During the American Occupation of Japan The Public Health Section, Kyoto Military Government Team, 1945-1949

    PubMed Central

    Nishimura, Sey

    2008-01-01

    During the American occupation of Japan (1945–1952), young public health officers from the US Army Medical Corps were posted in local US Army military government teams. These young doctors (aged 25 to 27 years), who had not absorbed the strong anti-Japanese tradition of the US military during World War II, seem to have alleviated the initial resentment felt by the Japanese toward the new governors of their homeland. The case of the Kyoto Military Government Team illustrates the Kyoto citizenry’s positive view of some American-directed public health measures. The team’s services helped to counter widely held negative views on colonialism, occupation, and public health; lessened resentment toward the unilateral command structure of the occupation forces; and contributed to improved relations between the United States and Japan at the local level. PMID:18235076

  17. Role of Human Health Care Providers and Medical Treatment Facilities in Military Working Dog Care and Accessibility Difficulties with Military Working Dog Blood Products.

    PubMed

    Giles Iii, James T

    2016-01-01

    The use of military working dogs (MWDs) in support of military operations has increased dramatically over recent years, as they have proven to be our most reliable deterrent to improvised explosive devices. Healthcare delivery for MWDs in combat presents unique challenges and requires extensive collaboration between veterinarians and human health care providers (HCPs). A successful example is the incorporation of MWD emergency care for nonveterinary HCPs into the Joint Trauma System Clinical Practice Guidelines, which has proven to be a helpful product. Additional challenges that need further solutions include MWDs as patients in human medical treatment facilities (MTFs) and the procurement of appropriate canine blood components in an operational environment. It is often necessary for MWDs to be treated as patients in human MTFs, however, there is no Department of Defense guidance to support this activity. Access to MWD blood products is limited to collection of fresh whole blood in the operational setting. Similar to humans, specific blood component therapy, such as fresh frozen plasma, is often indicated for sick or injured MWDs. Currently there is no formal system in place to deliver any blood products for MWDs or to facilitate collection in theater. PMID:27215885

  18. Cost effective, weight sensitive design for military airborne electronic systems

    SciTech Connect

    Peck, W.M.

    1996-12-31

    Thermal management of Military airborne electronic systems is governed by many trade-offs. While the trade-offs may change depending on the customer and system requirements, minimizing weight is usually the primary engineering concern because it saves aircraft fuel. Fuel savings provides increased range and time aloft for the aircraft. The most common approach to achieving meaningful reductions in equipment weight is to reduce system volume. Reduced volume is achieved by increasing electronic packaging density which is accomplished by incorporating new materials, processes, and technologies into the system design. The following four considerations are currently under study in the development of an 8 KW high altitude Military electronic system in order to reduce system volume: (1) identifying design parameters and performing trade-off studies between the use of liquid vs. forced air for system cooling; (2) modeling the total system thermal resistance path to identify possible areas for reducing component temperature rise in order to provide enhanced system reliability; (3) substituting commercial plastic integrated circuits (ICs) for Mil ceramic components to reduce material cost while still meeting system requirements; and (4) using TC1050 material technology in: Militarizing Commercial Off The Shelf (COTS) Circuit Card Assemblies (CCAs), developing high conductivity ceramic packaging for Multi Chip Modules (MCMs), and for developing low coefficient of thermal expansion (CTE) composites for use at both the chip and chassis level. Current results from these studies have yielded a design that has a 2:1 reduction in system volume and a weight reduction of 480 lbs from a currently fielded system.

  19. Health in the news: an analysis of magazines coverage of health issues in veterans and military service organizations.

    PubMed

    Jitnarin, Nattinee; Poston, Walker S C; Haddock, Christopher K; Jahnke, Sara

    2015-05-01

    The purpose of this study was to conduct a content analysis of Veterans and Military Service Organizations (VMSOs) magazines to determine what health-related topics VMSOs target and how they inform their constituencies about health issues. Health-related topics in 288 VMSOs' magazines from 21 VMSOs published in 2011 and 2012 were coded by trained raters using a standardized manual. The top three most addressed health topics were Health Services (Health care, Insurance), Disability and Disability benefits, and post-traumatic stress disorder. Topics least frequently covered were Tobacco and Smoking cessation, Illegal drugs, Alcohol, Gulf War Syndrome, and Weight and Body composition. VMSOs are concerned about the health and well-being of their members given the considerable amount of content devoted to certain health topics such as health insurance concerns, disability, and post-traumatic stress disorder. However, other health concerns that affect a considerable number of both current military personnel and veterans and cost both the Department of Veterans Affairs and the Department of Defense millions annually, such as drug and alcohol problems, and tobacco use and smoking cessation, are infrequently covered. The results of this study improve our understanding of the health-related information that reaches the military and veteran populations through this important media outlet. PMID:25939108

  20. Military Service Absences and Family Members’ Mental Health: A Timeline Followback Assessment

    PubMed Central

    Rodriguez, Aubrey J.; Margolin, Gayla

    2015-01-01

    Though military service, and particularly absence due to deployment, has been linked to risk for depression and anxiety among some spouses and children of active duty service members, there is limited research to explain the heterogeneity in family members’ reactions to military service stressors. The current investigation introduces the Timeline Followback Military Family Interview (TFMFI) as a clinically useful strategy to collect detailed time-linked information about the service member’s absences. Two dimensions of parent absence—the extent to which absences coincide with important family events and cumulative time absent—were tested as potential risks to family members’ mental health. Data from 70 mother-adolescent pairs revealed that the number of important family events missed by the service member was linked to elevated youth symptoms of depression, even when accounting for the number of deployments and cumulative duration of the service member’s absence. However, youth who reported more frequent contact with the service member during absences were buffered from the effects of extensive absence. Mothers’ symptoms were associated with the cumulative duration of the service members’ time away, but not with family events missed by the service member. These results identify circumstances that increase the risk for mental health symptoms associated with military family life. The TFMFI provides an interview-based strategy for clinicians wishing to understand military family members’ lived experience during periods of service member absence. PMID:26075736

  1. Military service absences and family members' mental health: A timeline followback assessment.

    PubMed

    Rodriguez, Aubrey J; Margolin, Gayla

    2015-08-01

    Although military service, and particularly absence due to deployment, has been linked to risk for depression and anxiety among some spouses and children of active duty service members, there is limited research to explain the heterogeneity in family members' reactions to military service stressors. The current investigation introduces the Timeline Followback Military Family Interview (TFMFI) as a clinically useful strategy to collect detailed time-linked information about the service member's absences. Two dimensions of parent absence--the extent to which absences coincide with important family events and cumulative time absent--were tested as potential risks to family members' mental health. Data from 70 mother-adolescent pairs revealed that the number of important family events missed by the service member was linked to elevated youth symptoms of depression, even when accounting for the number of deployments and cumulative duration of the service member's absence. However, youth who reported more frequent contact with the service member during absences were buffered from the effects of extensive absence. Mothers' symptoms were associated with the cumulative duration of the service members' time away, but not with family events missed by the service member. These results identify circumstances that increase the risk for mental health symptoms associated with military family life. The TFMFI provides an interview-based strategy for clinicians wishing to understand military family members' lived experience during periods of service-member absence. PMID:26075736

  2. Health-related quality of life and related factors of military police officers

    PubMed Central

    2014-01-01

    Purpose The present study aimed to determine the effect of demographic characteristics, occupation, anthropometric indices, and leisure-time physical activity levels on coronary risk and health-related quality of life among military police officers from the State of Santa Catarina, Brazil. Methods The sample included 165 military police officers who fulfilled the study’s inclusion criteria. The International Physical Activity Questionnaire and the Short Form Health Survey were used, in addition to a spreadsheet of socio-demographic, occupational and anthropometric data. Statistical analyses were performed using descriptive analysis followed by Spearman Correlation and multiple linear regression analysis using the backward method. Results The waist-to-height ratio was identified as a risk factor low health-related quality of life. In addition, the conicity index, fat percentage, years of service in the military police, minutes of work per day and leisure-time physical activity levels were identified as risk factors for coronary disease among police officers. Conclusions These findings suggest that the Military Police Department should adopt an institutional policy that allows police officers to practice regular physical activity in order to maintain and improve their physical fitness, health, job performance, and quality of life. PMID:24766910

  3. Designing Web-based Telemedicine Training for Military Health Care Providers.

    ERIC Educational Resources Information Center

    Bangert, David; Doktor, Boert; Johnson, Erik

    2001-01-01

    Interviews with 48 military health care professionals identified 20 objectives and 4 learning clusters for a telemedicine training curriculum. From these clusters, web-based modules were developed addressing clinical learning, technology, organizational issues, and introduction to telemedicine. (Contains 19 references.) (SK)

  4. Family Impact of Military Mental Health Stigma: A Narrative Ethical Analysis.

    PubMed

    Gibbons, Susanne W; Howe, Edmund Randy

    2016-01-01

    Our past lessons from war trauma have taught us that mental health-care stigma and other issues surrounding mental health-seeking behaviors can negatively impact the healing trajectory and long-term function for service members and their families. It can take years to decades before a service member seeks professional help for psychological distress, if he or she seeks it at all. Unfortunately, signs of personal and family problems can be subtle, and consequences, such as suicide, tragic. In this chapter, we consider the story one military health-care provider submitted in response to a study solicitation that read: Please provide your personal story telling me about any psychological distress you may have experienced after returning from deployment and your personal challenges accessing care and/or remaining in treatment. This story is analyzed to explore the moral implications of his experience for the military and for other service members. The main points to be highlighted are that altruism can leave altruists more vulnerable, military mental health stigma may exacerbate this risk, and military families may profoundly be affected. PMID:26673375

  5. [Role of researchers and employees of the Military Medical Academy in development of the system of military medical supply].

    PubMed

    Miroshnichenko, Iu V; Kononov, V N; Perfil'ev, A B

    2013-12-01

    The Military Medical Academy has been solving theoretical and practical issues, concerning development of military medical supply, for 215 years. At different time periods and according to needs of military medicine and pharmacy researches and employees of the Academy aimed efforts to: development of the theory and practice of medical supply organization, regulatory basis of the system of medical supply, development of new samples of medical equipment, development of medicine manufacturing technologies and methods of quality control, researches in the area of medicine radiochemistry, forensic chemistry and toxicology, herbal and mineral water analysis and etc. At the present time there are the following education programs at the Academy: "Pharmacy", magister program "Management of medical supply", program for resident physicians "Management and economics of pharmacy". PMID:24738281

  6. Factors influencing a health promoting lifestyle in spouses of active duty military.

    PubMed

    Padden, Diane L; Connors, Rebecca A; Posey, Sheena M; Ricciardi, Richard; Agazio, Janice G

    2013-01-01

    The purpose of this study was to understand the factors influencing the health promoting behaviors (HPBs) of military spouses. Pender's Health Promotion Model provided the theoretical framework guiding this study. One hundred twelve female spouses were surveyed regarding their perceived health status, perceived stress, self-efficacy, social support, and participation in HPBs. Perceived health status, self-efficacy, social support, and HPBs were positively related, whereas perceived stress was negatively related. Hierarchical multiple regression analysis showed perceived stress and social support to be predictive of an overall health promoting lifestyle (HPLPII), with the full model explaining 49.7% of the variance. PMID:23531168

  7. Analysis of Factors Influencing Inpatient and Outpatient Satisfaction with the Chinese Military Health Service

    PubMed Central

    Ye, Feng; Liu, Xu; Liu, Yuan; Zhang, Lulu

    2016-01-01

    Background Relatively few articles have focused on exploring factors influencing soldiers’ overall satisfaction and differences between inpatients’ and outpatients’ satisfaction, particularly in the Chinese army. Elucidating factors influencing military inpatient and outpatient care separately and analyzing their differences may provide more information for the healthsystem. Methods The Revised China National Health Service Survey questionnaire was used in the survey. The questionnaire included 5 sections and 32 items concerning demographic, inpatient, and outpatient characteristics and perception variables for both inpatients and outpatients. Bivariate and multivariate techniques were used to reveal relationships between satisfaction and the variables assessed. Results Outpatients’ and inpatients’ overall satisfaction rates were 19.0% and 18.5%, respectively. The strongest determinant of outpatients’ satisfaction was satisfaction with doctor’s communication regarding therapeutic regimen followed by length of military service, level of trust in medical staff, and disease severity. Determinants of inpatients’ satisfactionincludedstaff categories, satisfaction with environment, and satisfaction with medical quality. Conclusion The factors influencing military outpatients’ satisfaction differed from those of inpatients. Exploring the causes of satisfaction and dissatisfaction with military health institutions is important in their fulfillment of their responsibility to maintain soldiers’ health. PMID:27007805

  8. Secondary traumatic stress in military primary and mental health care providers.

    PubMed

    Kintzle, Sara; Yarvis, Jeffrey S; Bride, Brian E

    2013-12-01

    The purpose of this study was to explore rates of secondary traumatic stress (STS) in a sample of 70 military primary and mental health care providers. The sample included working professionals within two military hospitals. Participants completed surveys containing a demographic questionnaire and the Secondary Traumatic Stress Scale. Results of data analysis found military participants in the sample to be experiencing relatively low rates of STS. Over half of the sample reported endorsing at least one symptom of STS occurring within the last week, whereas 8% of participants indicated moderate to high symptomatology. The most frequently reported symptoms were feeling emotionally numb and trouble sleeping followed by the intrusive thoughts about clients. The least frequently reported symptom was feeling jumpy. Implications of study findings and recommendations for future research are outlined. PMID:24306012

  9. Health impact of US military service in a large population-based military cohort: findings of the Millennium Cohort Study, 2001-2008

    PubMed Central

    2011-01-01

    Background Combat-intense, lengthy, and multiple deployments in Iraq and Afghanistan have characterized the new millennium. The US military's all-volunteer force has never been better trained and technologically equipped to engage enemy combatants in multiple theaters of operations. Nonetheless, concerns over potential lasting effects of deployment on long-term health continue to mount and are yet to be elucidated. This report outlines how findings from the first 7 years of the Millennium Cohort Study have helped to address health concerns related to military service including deployments. Methods The Millennium Cohort Study was designed in the late 1990s to address veteran and public concerns for the first time using prospectively collected health and behavioral data. Results Over 150 000 active-duty, reserve, and National Guard personnel from all service branches have enrolled, and more than 70% of the first 2 enrollment panels submitted at least 1 follow-up survey. Approximately half of the Cohort has deployed in support of operations in Iraq and Afghanistan. Conclusion The Millennium Cohort Study is providing prospective data that will guide public health policymakers for years to come by exploring associations between military exposures and important health outcomes. Strategic studies aim to identify, reduce, and prevent adverse health outcomes that may be associated with military service, including those related to deployment. PMID:21281496

  10. Mental Health, Quality of Life, and Health Functioning in Women Veterans: Differential Outcomes Associated with Military and Civilian Sexual Assault

    ERIC Educational Resources Information Center

    Suris, Alina; Lind, Lisa; Kashner, T. Michael; Borman, Patricia D.

    2007-01-01

    The present study examined psychiatric, physical, and quality-of-life functioning in a sample of 270 women veterans receiving outpatient treatment at a Veterans Affairs medical center. Participants were interviewed regarding their civilian (CSA) and military sexual assault (MSA) histories, and data regarding quality of life and health outcomes…

  11. Military Veterans in the Criminal Justice System: Partner Violence and the Impact of Relationships With Fathers.

    PubMed

    Schaffer, Bradley J

    2016-01-01

    The objective of this study is to examine the health characteristics of military veterans identified through the Criminal Justice System (CJS) with partner violence and their relationships with their fathers. The 282 veterans involved in the CJS participated to complete a psycho-social assessment which included partner violence and ascertained their relationships with their fathers. The mean age of the men in the study was 44.9 years old. The majority were divorced, Caucasian, had a high school education, and served in the Army. This sample shows the benefit of integrating partner violence and relationships with fathers into the assessment process and highlights the need for more research. PMID:25976170

  12. [A spectacular revolution: evolution of French military health service].

    PubMed

    Lefort, Hugues; Ferrandis, Jean-Jacques; Tabbagh, Xavier; Lanoe, Vincent; Tourtier, Jean-Pierre

    2014-06-01

    After the sanitary disaster caused by the first months of the conflict, the Health service of the French armies undertook a true revolution. By 1918, it had become the most efficient of all the opposing armies. At the end of 1914, through the spacing out of the evacuating hospitals within the zone of the armies, the most efficient teams were placed as close as possible to the front. Injured soldiers were categorized at every step of the chain. Technical progress, especially in war surgery, pushed medicine into the moderne era. PMID:25069356

  13. Enhancing technology development through integrated environmental analysis: toward sustainable nonlethal military systems.

    PubMed

    Saulters, Oral S; Erickson, Larry E; Leven, Blase A; Pickrel, John A; Green, Ryan M; Jamka, Leslie; Prill, Amanda

    2010-04-01

    New technologies are not only critical in supporting traditional industrial and military success but also play a pivotal role in advancing sustainability and sustainable development. With the current global economic challenges, resulting in tighter budgets and increased uncertainty, synergistic paradigms and tools that streamline the design and dissemination of key technologies are more important than ever. Accordingly, a proactive and holistic approach can facilitate efficient research, design, testing, evaluation, and fielding for novel and off-the-shelf products, thereby assisting developers, end users, and other diverse stakeholders in better understanding tradeoffs in the defense industry and beyond. By prioritizing mechanisms such as strategic life-cycle environmental assessments (LCEA); programmatic environment, safety, and occupational health evaluations (PESHE); health hazard assessments (HHA); and other innovative platforms and studies early within systems engineering, various nonlethal military technologies have been successfully developed and deployed. These efforts provide a framework for addressing complex environment, safety, and occupational health risks that affect personnel, infrastructure, property, socioeconomic, and natural/cultural resources. Moreover, integrated, comprehensive, multidisciplinary, and iterative analyses involving flexible groups of specialists/subject matter experts can be applied at various spatiotemporal scales in support of collaborations. This paper highlights the Urban Operations Laboratory process utilized for inclusive and transformative environmental analysis, which can translate into advantages and progress toward sustainable systems. PMID:19886729

  14. Operational Stress and Correlates of Mental Health Among Joint Task Force Guantanamo Bay Military Personnel.

    PubMed

    Webb-Murphy, Jennifer A; De La Rosa, Gabriel M; Schmitz, Kimberly J; Vishnyak, Elizabeth J; Raducha, Stephanie C; Roesch, Scott C; Johnston, Scott L

    2015-12-01

    Military personnel deployed to Joint Task Force Guantanamo Bay (JTF-GTMO) faced numerous occupational stressors. As part of a program evaluation, personnel working at JTF-GTMO completed several validated self-report measures. Personnel were at the beginning, middle, or end of their deployment phase. This study presents data regarding symptoms of posttraumatic stress disorder, alcohol abuse, depression, and resilience among 498 U.S. military personnel deployed to JTF-GTMO in 2009. We also investigated individual and organizational correlates of mental health among these personnel. Findings indicated that tenure at JTF-GTMO was positively related to adverse mental health outcomes. Regression models including these variables had R2 values ranging from .02 to .11. Occupation at JTF-GTMO also related to mental health such that guards reported poorer mental health than medical staff. Reluctance to seek out mental health care was also related to mental health outcomes. Those who reported being most reluctant to seek out care tended to report poorer mental health than those who were more willing to seek out care. Results suggested that the JTF-GTMO deployment was associated with significant psychological stress, and that both job-related and attitude-related variables were important to understanding mental health symptoms in this sample. PMID:26595460

  15. Augmentation of a commercial satellite system for military communications

    NASA Astrophysics Data System (ADS)

    Butte, Eric G.; Thorburn, Michael

    2005-06-01

    Future U.S. MILSATCOM will rely on a complex satellite design to implement the TSAT satellite system that was developed on the Transformational Communication Architecture program. TSAT will deliver secured IP based, on-demand communication system to meet the needs of the military and the warfighter and will demand a very large satellite system, program, and an anticipated lengthy deployment time. An alternate system is proposed that can give IP based communications in a significantly shorter time frame. A constellation of commercial-like satellites, with transponded Ka-, Ku- and X-band, would nicely complement the MILSATCOM fleet. The services provided by these satellites would enable widespread communications services such as IP to the theatre, augmenting the DSCS, Wideband Gapfiller, and protected communications systems of MILSTAR and Advanced EHF. The capacity provided by the dedicated commercial satellites would help provide the capacity demanded by the warfighter as MILSATCOM transitions from today's technology to the TSAT system of tomorrow's Transformational Communications Architecture. This paper will discuss the satellite concept design and how it can augment the MILSATCOM fleet and show a more flexible approach of bandwidth management to support fixed and COTM terminals.

  16. [Specificities of war surgery, and capacities of the military health service].

    PubMed

    de Saint-Julien, Jacques; Auroy, Yves; Pons, François

    2013-12-01

    In view of the recent evolution of military conflicts, particularly in the Afghan theater, and the conditions in which wounded warriors are managed in the field prior to hospitalization, the authors examine the technical specificities of medical teams, based on studies of avoidable mortality. War surgery has become a separate specialty, following the disappearance in France of the general surgical specialty, of which it was the military coun-terpart. The authors stress the role of hemorrhaging and its treatment, based on three strategies: damage control resuscitation, blood transfusion, and early evacuation within the "golden hour ". The French Armed Forces Health Service, in a new strategic plan, is refocusing its activity on war traumatology, through better education and training of medical-surgical teams and by opening up its scholarship structures to the French civilian public health service sector. PMID:26137816

  17. Tuberculosis as a force health protection threat to the United States military.

    PubMed

    Sanchez, Jose L; Sanchez, Joyce L; Cooper, Michael J; Hiser, Michelle J; Mancuso, James D

    2015-03-01

    Tuberculosis (TB) is a communicable disease that poses a threat to force health protection to the U.S. military. The rate of TB disease in the military is low; however, there are unique challenges for its control in this setting. As a low-risk population, TB testing in the U.S. military can be scaled back from the universal testing approach used previously. Reactivation of latent TB infection (LTBI) present at accession into service is the most important factor leading to TB disease; therefore, its diagnosis and treatment among recruits should be given a high priority. Deployment and overseas military service is an uncommon but important source of TB infection, and rigorous surveillance should be ensured. Case management of TB disease and LTBI can be improved by the use of cohort reviews at the service and installation levels and case finding and delays in the diagnosis of TB disease can be improved by education of providers, as well as increased use of molecular diagnostic tests. Program outcomes can be improved by making LTBI treatment compulsory, offering shorter treatment regimens, and increasing accountability through oversight and evaluation. The diagnosis of LTBI can be improved by implementing targeted testing in all settings and reducing confirmatory interferon-gamma release assay testing. PMID:25735017

  18. Effect of Dwell Time on the Mental Health of US Military Personnel With Multiple Combat Tours

    PubMed Central

    Han, Peggy P.; Dougherty, Amber L.; Galarneau, Michael R.

    2012-01-01

    Objective. We investigated the association of the length of time spent at home between deployments, or dwell time, with posttraumatic stress disorder (PTSD) and other mental health disorders. Methods. We included US Marine Corps personnel identified from military deployment records who deployed to Operation Iraqi Freedom once (n = 49 328) or twice (n = 16 376). New-onset mental health diagnoses from military medical databases were included. We calculated the ratio of dwell-to-deployment time (DDR) as the length of time between deployments divided by the length of the first deployment. Results. Marines with 2 deployments had higher rates of PTSD than did those with 1 deployment (2.1% versus 1.2%; P < .001). A DDR representing longer dwell times at home relative to first deployment length was associated with reduced odds of PTSD (odds ratio [OR] = 0.47; 95% confidence interval [CI] = 0.32, 0.70), PTSD with other mental health disorder (OR = 0.56; 95% CI = 0.33, 0.94), and other mental health disorders (OR = 0.62; 95% CI = 0.51, 0.75). Conclusions. Longer dwell times may reduce postdeployment risk of PTSD and other mental health disorders. Future research should focus on the role of dwell time in adverse health outcomes. PMID:22390601

  19. [Health state in women engaged in professional military service in European North].

    PubMed

    Myznikov, I L; Ustimenko, L I; Askerko, N V; Bourtsev, N N; Miloshevsky, A V; Volkova, L V

    2015-01-01

    The authors analysed health state and morbidity of women engaged into professional navy service in North Fleet, age features of health state in these servicewomen, and results of medical stationary examination and checkup results, regular medical examination results and the servicewomen morbidity over 12 years (about 15.5 thousand cases), and 697 reports on the servicewomen diseases according to military medical (navy) commission. The article covers causes of changes in navy fitness category for the servicewomen, analysis of comorbidity, suggestions of new approaches to comorbidity analysis. PMID:26369247

  20. An infrared/video fusion system for military robotics

    SciTech Connect

    Davis, A.W.; Roberts, R.S.

    1997-08-05

    Sensory information is critical to the telerobotic operation of mobile robots. In particular, visual sensors are a key component of the sensor package on a robot engaged in urban military operations. Visual sensors provide the robot operator with a wealth of information including robot navigation and threat assessment. However, simple countermeasures such as darkness, smoke, or blinding by a laser, can easily neutralize visual sensors. In order to provide a robust visual sensing system, an infrared sensor is required to augment the primary visual sensor. An infrared sensor can acquire useful imagery in conditions that incapacitate a visual sensor. A simple approach to incorporating an infrared sensor into the visual sensing system is to display two images to the operator: side-by-side visual and infrared images. However, dual images might overwhelm the operator with information, and result in degraded robot performance. A better solution is to combine the visual and infrared images into a single image that maximizes scene information. Fusing visual and infrared images into a single image demands balancing the mixture of visual and infrared information. Humans are accustom to viewing and interpreting visual images. They are not accustom to viewing or interpreting infrared images. Hence, the infrared image must be used to enhance the visual image, not obfuscate it.

  1. Does the Military Child Care System Serve Its Purpose? Research Brief

    ERIC Educational Resources Information Center

    Zellman, Gail L.; Gates, Susan M.; Cho, Michelle; Shaw Rebecca

    2008-01-01

    This research brief summarizes research suggesting that the U.S. Department of Defense may wish to consider expanding its child care benefits to cover more military families and a broader set of child care needs. [For "Options for Improving the Military Child Care System. Occasional Paper Summary", see ED502782. For the full paper, see ED502783.

  2. Prevalence and Mental Health Correlates of Insomnia in First-Encounter Veterans with and without Military Sexual Trauma

    PubMed Central

    Jenkins, Melissa M.; Colvonen, Peter J.; Norman, Sonya B.; Afari, Niloofar; Allard, Carolyn B.; Drummond, Sean P.A.

    2015-01-01

    Study Objectives: There is limited information about prevalence of insomnia in general populations of veterans of recent wars in Iraq and Afghanistan. No studies have examined insomnia in veterans with military sexual trauma (MST). We assess prevalence of insomnia, identify types of services sought by veterans with insomnia, and examine correlates of insomnia in veterans with and without MST. Design: A cross-sectional study of first-encounter veterans registering to establish care. Setting: Veteran Affairs San Diego Healthcare System. Participants: Nine hundred seventeen veterans completed questionnaires assessing insomnia, MST, service needs, traumatic brain injury, resilience, and symptoms of depression, posttraumatic stress disorder (PTSD), pain, alcohol misuse, and hypomania. Interventions: N/A. Measurements and Results: 53.1% of veterans without MST and 60.8% of veterans with MST had clinically significant insomnia symptoms, with the MST subsample reporting more severe symptoms, P < 0.05. Insomnia was more prevalent than depression, hypomania, PTSD, and substance misuse. Veterans with insomnia were more likely to seek care for physical health problems and primary care versus mental health concerns, P < 0.001. For the veteran sample without MST, age, combat service, traumatic brain injury, pain, and depression were associated with worse insomnia, P < 0.001. For the MST subsample, employment status, pain, and depression were associated with worse insomnia, P < 0.001. Conclusions: Study findings indicate a higher rate of insomnia in veterans compared to what has been found in the general population. Insomnia is more prevalent, and more severe, in veterans with military sexual trauma. Routine insomnia assessments and referrals to providers who can provide evidence-based treatment are crucial. Citation: Jenkins MM, Colvonen PJ, Norman SB, Afari N, Allard CB, Drummond SP. Prevalence and mental health correlates of insomnia in first-encounter veterans with and

  3. [Approaches to development and implementation of the medical information system for military-medical commission of the multidisciplinary military-medical organisation].

    PubMed

    Kuvshinov, K E; Klipak, V M; Chaplyuk, A L; Moskovko, V M; Belyshev, D V; Zherebko, O A

    2015-06-01

    The current task of the implementation of medical information systems in the military and medical organizations is an automation of the military-medical expertise as one of the most important activities. In this regard, noteworthy experience of the 9th Medical Diagnostic Centre (9th MDC), where on the basis of medical information system "Interi PROMIS" for the first time was implemented the automation of the work of military medical commission. The given paper presents an algorithm for constructing of the information system for the military-medical examination; detailed description of its elements is given. According to military servicemen the implementation of the Military Medical Commission (MMC) subsystem of the medical information system implemented into the 9th MDC has reduced the time required for the MMC and paperwork, greatly facilitate the work of physicians and medical specialists on military servicemen examination. This software can be widely applied in ambulatory and hospital practice, especially in case of mass military-medical examinations. PMID:26442309

  4. Extreme health sensing: the challenges, technologies, and strategies for active health sustainment of military personnel during training and combat missions

    NASA Astrophysics Data System (ADS)

    Buller, Mark; Welles, Alexander; Chadwicke Jenkins, Odest; Hoyt, Reed

    2010-04-01

    Military personnel are often asked to accomplish rigorous missions in extremes of climate, terrain, and terrestrial altitude. Personal protective clothing and individual equipment such as body armor or chemical biological suits and excessive equipment loads, exacerbate the physiological strain. Health, over even short mission durations, can easily be compromised. Measuring and acting upon health information can provide a means to dynamically manage both health and mission goals. However, the measurement of health state in austere military environments is challenging; (1) body worn sensors must be of minimal weight and size, consume little power, and be comfortable and unobtrusive enough for prolonged wear; (2) health states are not directly measureable and must be estimated; (3) sensor measurements are prone to noise, artifact, and failure. Given these constraints we examine current successful ambulatory physiological status monitoring technologies, review maturing sensors that may provide key health state insights in the future, and discuss unconventional analytical techniques that optimize health, mission goals, and doctrine from the perspective of thermal work strain assessment and management.

  5. Integration of Chiropractic Services in Military and Veteran Health Care Facilities: A Systematic Review of the Literature.

    PubMed

    Green, Bart N; Johnson, Claire D; Daniels, Clinton J; Napuli, Jason G; Gliedt, Jordan A; Paris, David J

    2016-04-01

    This literature review examined studies that described practice, utilization, and policy of chiropractic services within military and veteran health care environments. A systematic search of Medline, CINAHL, and Index to Chiropractic Literature was performed from inception through April 2015. Thirty articles met inclusion criteria. Studies reporting utilization and policy show that chiropractic services are successfully implemented in various military and veteran health care settings and that integration varies by facility. Doctors of chiropractic that are integrated within military and veteran health care facilities manage common neurological, musculoskeletal, and other conditions; severe injuries obtained in combat; complex cases; and cases that include psychosocial factors. Chiropractors collaboratively manage patients with other providers and focus on reducing morbidity for veterans and rehabilitating military service members to full duty status. Patient satisfaction with chiropractic services is high. Preliminary findings show that chiropractic management of common conditions shows significant improvement. PMID:26677851

  6. Military sexual trauma: a review of prevalence and associated health consequences in veterans.

    PubMed

    Suris, Alina; Lind, Lisa

    2008-10-01

    This article reviews the literature documenting the prevalence of military sexual trauma (MST) and its associated mental and physical health consequences. Existing research indicates that prevalence rates of MST vary depending on method of assessment, definition of MST used, and type of sample. Risk factors for MST have been identified as including age, enlisted rank, negative home life, and previous assault history. MST has been associated with increased screening rates of depression and alcohol abuse, in addition to significantly increased odds of meeting criteria for post-traumatic stress disorder. In addition, MST has been associated with reporting increased number of current physical symptoms, impaired health status, and more chronic health problems in veterans. Available research on health care utilization and MST is also discussed. Researchers are encouraged to utilize standardized definitions of MST, employ standardized assessment methodology, and utilize more male veterans in future research. Policy and practice implications are discussed. PMID:18936282

  7. Preparing MSW Students to Provide Mental and Behavioral Health Services to Military Personnel, Veterans, and Their Families in Rural Settings

    ERIC Educational Resources Information Center

    Rishel, Carrie W.; Hartnett, Helen P.

    2015-01-01

    The prevalence of mental health disorders constitutes a nationwide public health crisis. Estimates suggest that more than 90 million people live in areas designated mental health professional shortage areas, with almost 6,000 additional practitioners needed to meet the service needs in these areas. Military personnel and veterans have greater…

  8. Prevalence of mental health problems, treatment need, and barriers to care among primary care-seeking spouses of military service members involved in Iraq and Afghanistan deployments.

    PubMed

    Eaton, Karen M; Hoge, Charles W; Messer, Stephen C; Whitt, Allison A; Cabrera, Oscar A; McGurk, Dennis; Cox, Anthony; Castro, Carl A

    2008-11-01

    Military spouses must contend with unique issues such as a mobile lifestyle, rules and regulations of military life, and frequent family separations including peacekeeping and combat deployments. These issues may have an adverse effect on the health of military spouses. This study examined the mental health status, rates of care utilization, source of care, as well as barriers and stigma of mental health care utilization among military spouses who were seeking care in military primary care clinics. The data show spouses have similar rates of mental health problems compared to soldiers. Spouses were more likely to seek care for their mental health problems and were less concerned with the stigma of mental health care than were soldiers. Services were most often received from primary care physicians, rather than specialty mental health professionals, which may relate to the lack of availability of mental health services for spouses on military installations. PMID:19055177

  9. An Analysis of Personal Technology Use by Service Members and Military Behavioral Health Providers.

    PubMed

    Edwards-Stewart, Amanda; Smolenski, Derek J; Reger, Greg M; Bush, Nigel; Workman, Don E

    2016-07-01

    Personal technology use is ubiquitous in the United States today and technology, in general, continues to change the face of health care. However, little is known about the personal technology use of military service members and the behavioral health care providers that treat them. This study reports the technology use of 1,101 active duty service members and 45 behavioral health care providers at a large military installation. Participants reported Internet usage; ownership of smartphones, tablets, and e-readers; usage of mobile applications (apps); and basic demographic information. Compared with providers, service members reported higher rates of smartphone ownership, were more likely to own Android smartphones than iPhones, and spent more time gaming. Both groups spent a comparable amount of time using social media. With the exception of gaming, however, differences between service members and providers were not statistically significant when demographics were matched and controlled. Among service members, younger respondents (18-34) were statistically more likely than older respondents (35-58) to own smartphones, spend time gaming, and engage in social media. Our findings can help inform provider's technology-based education and intervention of their patients and guide the development of new technologies to support the psychological health of service members. PMID:27391625

  10. Health hazards in areas of military operations conducted in different climatic and sanitary conditions.

    PubMed

    Korzeniewski, Krzysztof

    2011-01-01

    This paper reviews the most common health hazards occurring among personnel of peacekeeping and stabilization missions functioning within armed conflicts in the contemporary world. Military operations have been executed in diverse climatic and sanitary conditions, which are frequently unfamiliar for their participants. Some of them, e.g. the UN peacekeeping missions in the Middle East (Lebanon, the Golan Heights), have been carried out in a relatively stable geopolitical environment; whereas, stabilization missions in Iraq and Afghanistan, which are actually combat activities, undoubtedly fall into the group of the most perilous military operations in the world. Hot or cold climate, poor sanitary and hygienic conditions along with warfare facilitate the occurrence of numerous diseases and body injuries not only among the local people but also among peacekeepers, who represent the population of immigrants. Health hazards which pose major epidemiological threats in combat zones are arthropod-borne, food and water-borne, respiratory tract diseases, sexually transmitted diseases, enzootic diseases, battle injuries, and non- -battle injuries, e.g. traffic accidents. Another considerable health problem are psychiatric disorders, which can either appear directly after the occurrence of a traumatic event in a combat zone or indirectly, after some time had elapsed. In addition to the health hazards listed above, environmental factors such as changeable weather conditions and local fauna may also be life threatening. PMID:21534225

  11. Trends in suicidal behaviour and use of mental health services in Canadian military and civilian populations

    PubMed Central

    Sareen, Jitender; Afifi, Tracie O.; Taillieu, Tamara; Cheung, Kristene; Turner, Sarah; Bolton, Shay-Lee; Erickson, Julie; Stein, Murray B.; Fikretoglu, Deniz; Zamorski, Mark A.

    2016-01-01

    Background: In the context of the Canadian mission in Afghanistan, substantial media attention has been placed on mental health and lack of access to treatment among Canadian Forces personnel. We compared trends in the prevalence of suicidal behaviour and the use of mental health services between Canadian military personnel and the general population from 2002 to 2012/13. Methods: We obtained data for respondents aged 18–60 years who participated in 4 nationally representative surveys by Statistics Canada designed to permit comparisons between populations and trends over time. Surveys of the general population were conducted in 2002 (n = 25 643) and 2012 (n = 15 981); those of military personnel were conducted in 2002 (n = 5153) and 2013 (n = 6700). We assessed the lifetime and past-year prevalence of suicidal ideation, plans and attempts, as well as use of mental health services. Results: In 2012/13, but not in 2002, military personnel had significantly higher odds of both lifetime and past-year suicidal ideation than the civilian population (lifetime: adjusted odds ratio [OR] 1.32, 95% confidence interval [CI] 1.17–1.50; past year: adjusted OR 1.34, 95% CI 1.09–1.66). The same was true for suicidal plans (lifetime: adjusted OR 1.64, 95% CI 1.35–1.99; past year: adjusted OR 1.66, 95% CI 1.18–2.33). Among respondents who reported past-year suicidal ideation, those in the military had a significantly higher past-year utilization rate of mental health services than those in the civilian population in both 2002 (adjusted OR 2.02, 95% CI 1.31–3.13) and 2012/13 (adjusted OR 3.14, 95% CI 1.86–5.28). Interpretation: Canadian Forces personnel had a higher prevalence of suicidal ideation and plans in 2012/13 and a higher use of mental health services in 2002 and 2012/13 than the civilian population. PMID:27221270

  12. The role of military social support in understanding the relationship between PTSD, physical health, and healthcare utilization in women veterans.

    PubMed

    Lehavot, Keren; Der-Martirosian, Claudia; Simpson, Tracy L; Shipherd, Jillian C; Washington, Donna L

    2013-12-01

    Posttraumatic stress disorder (PTSD) is a significant predictor of both poorer physical health and increased health care utilization, whereas adequate social support is associated with better physical health and less health care utilization. However, research has not previously examined the simultaneous effects of PTSD and social support on health and health care utilization. This study examined both the independent and interactive effects of PTSD and a particular type of social support (postactive-duty social support from military friends) on self-reported physical health and number of Veterans Health Administration (VHA) visits in the last year. These relationships were examined in a representative, national sample of 3,524 women veterans who completed telephone interviews as part of the National Survey of Women Veterans in 2008-2009. Regression analyses were conducted using these cross-sectional data to examine main effects of PTSD and military social support on physical health and VHA utilization and their interaction. Screening positive for PTSD was associated with poorer health (B = -3.19, SE = 1.47) and increased VHA utilization (B = 0.98, SE = 0.16), whereas greater military social support was associated with better health (B = 0.97, SE = 0.44) and less frequent VHA utilization (B = -0.15, SE = 0.05). Neither moderation model was significant, such that military social support behaved in a similar way regardless of PTSD status. PMID:24203114

  13. Overview of the Affordable Care Act's impact on military and veteran mental health services: nine implications for significant improvements in care.

    PubMed

    Russell, Mark C; Figley, Charles R

    2014-01-01

    On March 23, 2010, President Barack Obama signed the Affordable Care Act (ACA) into law. Implications of the ACA on mental health care for 9.7 million military active-duty, reserve, and family members and 22.2 million veterans, as well as 1.3 uninsured veterans, is reviewed in light of a major crisis. The authors trace historical roots of the ACA to the World War II generation and efforts to transform the mental health care system by implementing hard-won war trauma lessons. The authors posit 9 principles reflected in the ACA that represent unfulfilled generational war trauma lessons and potential transformation of the military and national mental health care systems. PMID:24669877

  14. The impact of U.S. military operations in Kuwait, Bosnia, and Kosovo (1991-2000) on environmental health surveillance.

    PubMed

    Kirkpatrick, Jeffrey S

    2011-07-01

    Deployments of U.S. Forces to the Persian Gulf (1991), Bosnia and Herzegovina (1995), and Kosovo (1999) were associated with diverse, potential environmental exposures. Health effects possibly associated with these exposures were cause for concern among service members, veterans, and military and civilian leaders. A need for the military to effectively respond to these exposures, and more importantly, to assess and mitigate exposures before deployments and to conduct environmental surveillance during deployments was identified. The Department of Defense encountered many obstacles in dealing with the exposures of 1991. Even though these obstacles were being identified, and in some cases, addressed, responses to historical exposure concerns continued to be reactive. In 1996, efforts were intensified to improve policy and doctrine, field sampling equipment, risk assessment processes, geographic information systems, and other tools needed to effectively identify and reduce the impact of exposures before troops deploy and to conduct environmental surveillance while deployed. Success in these efforts resulted in a comprehensive, planned approach being implemented to address environmental health concerns during the 1999 Kosovo deployment. PMID:21916329

  15. Puumala hantavirus outbreak among U.S. military health care beneficiaries, Stuttgart, Germany--2012.

    PubMed

    McCormic, Zachary D; Balihe, Michele N; Havas, Karyn A; Baty, Steven A

    2013-12-01

    Hantaviruses are viruses of the family Bunyaviridae that are transmitted to humans via inhalation of the aerosolized excrement of rodents. The geographic distribution of hantavirus includes the Americas, Asia, and Europe. An outbreak of Puumala hantavirus infections among U.S. military health care beneficiaries was identified by the U.S. Army Public Health Command Region-Europe at U.S. Army installations in Stuttgart, Germany, during 2012. Overall, five cases (one probable and four confirmed) were identified in three service members, one U.S. civilian employee, and one dependent family member. Four cases were hospitalized, one of whom required dialysis. The outbreak investigation revealed that all cases exercised in forested areas and most were active smokers (4 out of 5). This report reviews the types of hantaviruses found worldwide and suggests that health care providers should suspect and consider possible hantavirus infections when evaluating patients with histories and clinical presentations consistent with such infections. PMID:24428538

  16. War, its aftermath, and U.S. health policy: toward a comprehensive health program for America's military personnel, veterans, and their families.

    PubMed

    Jackonis, Michael J; Deyton, Lawrence; Hess, William J

    2008-01-01

    This essay discusses the challenges faced by veterans returning to society in light of the current organization and structure of the military, veterans', and overall U.S. health care systems. It also addresses the need for an integrated health care financing and delivery system to ensure a continuum of care for service members, veterans, dependents, and other family members. The health care systems of both the Department of Defense and the Department of Veterans Affairs execute their responsibilities to active duty service members, while their families and retirees/veterans are under separate legal authorities. Although they perform their mandates with extraordinary commitment and demonstrably high quality, both systems need to explore improved communication, coordination, and sharing, as well as increased collaboration with the Department of Health and Human Services programs serving the same populations, far beyond current efforts. The health care-related missions and the locus of health care delivery of each agency are admittedly unique, but their distinctions must not be permitted to impede system integration and coordination of a continuum of care provided to the men and women who serve the nation, and their families. PMID:19093991

  17. Biomedical research on health and performance of military women: accomplishments of the Defense Women's Health Research Program (DWHRP).

    PubMed

    Friedl, Karl E

    2005-11-01

    In 1994, Congress provided dollar 40 M for biomedical research on issues of importance for military women. This supported 104 intramural and 30 extramural studies and launched an era of research to narrow the knowledge gap on protection and enhancement of health and performance of military women. Projects addressed issues specific to female physiology (e.g., gynecological health in the field, maternal malaria), problems with higher prevalence for women (e.g., marginal iron deficiency, stress fracture), and issues of drug and materiel safety that had only been extrapolated from studies of men (e.g., chemical agent prophylaxis, fatigue countermeasures). Several important assumptions about female physiology and occupational risks were found to be astoundingly wrong. Hormonal changes through the menstrual cycle were less important to acute health risks and performance than predicted, exercise did not increase risk for amenorrhea and consequent bone mineral loss, and women tolerated G-forces and could be as safe as men in the cockpit if their equipment was designed for normal size and strength ranges. Data on personal readiness issues, such as body fat, physical fitness, nutrition, and postpartum return to duty, allowed reconsideration of standards that were gender appropriate and not simply disconnected adjustments to existing male standards. Other discoveries directly benefited men as well as women, including development of medical surveillance databases, identification of task strength demands jeopardizing safety and performance, and greater understanding of the effects of psychosocial stress on health and performance. This surge of research has translated into advances for the welfare of service women and the readiness of the entire force; relevant gender issues are now routine considerations for researchers and equipment developers, and some key remaining research gaps of special importance to military women continue to be investigated. PMID:16313206

  18. [Theoretic and applicative aspects of applying of formulary system in military medicine].

    PubMed

    Belevitin, A E; Miroshnichenko, Iu V; Goriachev, A B; Bunin, S A; Krasavin, K D

    2010-08-01

    Development of the medicamental aid in military medicine can be realized only through the introduction of the formulary system. This system forms the informative-methodological basis of the achievement of socially necessary level of drug usage. On the basis of medical standards and analysis of sick rate the formulary of pharmaceuticals which can help to reduce the nomenclature of applying drugs, improve efficiency of medicamental aid is worked out. Medical service of Armed Forces of the Russian Federation has an experience in the development of formularies, but it is early to speak about the introduction of the formulary system into routine of military medicine. Development of the medicamental aid in military medicine on the basis of the formulary system will conduce to satisfying of medical and social requirements of servicemen, military retiree and members of their families. PMID:21089425

  19. Military Medical Students' Awareness and Practice Concerning Occupational Health and Safety.

    PubMed

    Babayigit, Mustafa Alparslan; Ilhan, Mustafa Necmi; Oysul, Fahrettin Guven

    2016-09-01

    This study aimed to investigate the awareness and practices of military medical students concerning occupational health and safety. In this cross-sectional study, a questionnaire composed of 20 open- and closed-ended questions was administered to medical students of the Gulhane Military Medical Faculty (n = 754). The response rate of the questionnaire was 82.4% (n = 622/754). The mean age of the participants was 21.5 ± 1.84 years, and the majority of participants were male (94.1%). A substantial number of participants (41.1%) described their level of awareness and practice as "low/very low," although 95.0% and 76.7% of them had never acquired any occupational disease or had any work accidents, respectively. In total, 28.1% of all students had at least one vaccination, and 5th- and 6th-year students were 92 times and 63 times more likely to have been vaccinated than 1st-year students, respectively (odds ratio = 92.66, 95% confidence interval = 26.70-321.59; odds ratio = 63.01, 95% confidence interval = 17.96-221.01). The knowledge and practice level of medical students concerning occupational health and safety appeared to be increasing by the grades of medical faculty, however students expressed themselves as insufficient about their knowledge and practice level. PMID:27612358

  20. “It’s Not a Priority When We’re in Combat”: Public Health Professionals and Military Tobacco Control Policy

    PubMed Central

    Grundy, Quinn; Malone, Ruth E.

    2015-01-01

    Tobacco use is prevalent among service members, but civilian public health groups have not effectively addressed military tobacco control policy issues. We conducted focus groups in 2010 and 2012 with participants from public health and tobacco control organizations regarding their understanding of the military and of tobacco use in that context. Misperceptions were common. Military personnel were believed to be young, from marginalized populations, and motivated to join by lack of other options. Tobacco use was considered integral to military life; participants were sometimes reluctant to endorse stronger tobacco control policies than those applied to civilians, although some believed the military could be a social policy leader. Engaging public health professionals as effective partners in tobacco-free military efforts may require education about and reframing of military service and tobacco control policy. PMID:25713938

  1. Be All That We Can Be: Lessons from the Military for Improving Our Nation's Child Care System.

    ERIC Educational Resources Information Center

    Campbell, Nancy Duff; Appelbaum, Judith C.; Martinson, Karin; Martin, Emily

    In response to increasing demands for military child care and lack of comprehensive care standards, the Military Child Care Act of 1989 (MCCA) mandated improvements in military child care. Today, the Department of Defense runs a model child care system serving over 200,000 children daily at over 300 locations worldwide. Noting that most of the…

  2. Prediction of Peaks of Seasonal Influenza in Military Health-Care Data.

    PubMed

    Buczak, Anna L; Baugher, Benjamin; Guven, Erhan; Moniz, Linda; Babin, Steven M; Chretien, Jean-Paul

    2016-01-01

    Influenza is a highly contagious disease that causes seasonal epidemics with significant morbidity and mortality. The ability to predict influenza peak several weeks in advance would allow for timely preventive public health planning and interventions to be used to mitigate these outbreaks. Because influenza may also impact the operational readiness of active duty personnel, the US military places a high priority on surveillance and preparedness for seasonal outbreaks. A method for creating models for predicting peak influenza visits per total health-care visits (ie, activity) weeks in advance has been developed using advanced data mining techniques on disparate epidemiological and environmental data. The model results are presented and compared with those of other popular data mining classifiers. By rigorously testing the model on data not used in its development, it is shown that this technique can predict the week of highest influenza activity for a specific region with overall better accuracy than other methods examined in this article. PMID:27127415

  3. Prediction of Peaks of Seasonal Influenza in Military Health-Care Data

    PubMed Central

    Buczak, Anna L.; Baugher, Benjamin; Guven, Erhan; Moniz, Linda; Babin, Steven M.; Chretien, Jean-Paul

    2016-01-01

    Influenza is a highly contagious disease that causes seasonal epidemics with significant morbidity and mortality. The ability to predict influenza peak several weeks in advance would allow for timely preventive public health planning and interventions to be used to mitigate these outbreaks. Because influenza may also impact the operational readiness of active duty personnel, the US military places a high priority on surveillance and preparedness for seasonal outbreaks. A method for creating models for predicting peak influenza visits per total health-care visits (ie, activity) weeks in advance has been developed using advanced data mining techniques on disparate epidemiological and environmental data. The model results are presented and compared with those of other popular data mining classifiers. By rigorously testing the model on data not used in its development, it is shown that this technique can predict the week of highest influenza activity for a specific region with overall better accuracy than other methods examined in this article. PMID:27127415

  4. Mental health of Asian American and Pacific Islander military veterans: brief review of an understudied group.

    PubMed

    Tsai, Jack; Kong, Grace

    2012-11-01

    The mental health of American military soldiers and veterans is of widespread concern; yet, there has been no prior review of studies on Asian Americans and Pacific Islanders (AAPIs) veterans. This article provides a brief, but comprehensive review of the mental health of AAPI veterans. An exhaustive literature search was conducted using the major medical and mental health literature databases. Of 13 identified articles, nine were empirical studies on either post-traumatic stress disorder among AAPI Vietnam veterans or health functioning of AAPI veterans based on national veteran surveys. Findings from these studies showed that some AAPI veterans who served during the Vietnam War encountered racism from fellow soldiers and race-related stressors were associated with more severe post-traumatic stress disorder symptoms. As a group, AAPI veterans were found to be physically healthier than other veterans, but reported poorer mental health and were less likely to use mental health services. However, these findings were limited by the paucity of studies on AAPI veterans and suggest a need for more research on this subpopulation. PMID:23198528

  5. Honoring their service: behavioral health services in North Carolina for military service members, veterans, and their families.

    PubMed

    Alexander-Bratcher, Kimberly M; Martin, Grier; Purcell, William R; Watson, Michael; Silberman, Pam

    2011-01-01

    The North Carolina Institute of Medicine Task Force on Behavioral Health Services for the Military and Their Families examined the adequacy of Medicaid- and state-funded services for mental health conditions, developmental disabilities (including traumatic brain injury), and substance abuse that are currently available in North Carolina to military service members, veterans, and their families. The task force determined that there are several gaps in services and made 13 recommendations related to federal, state, and local community resources. This article reviews the work of the task force and current efforts to improve services in North Carolina. PMID:21678686

  6. The role of the US Army Veterinary Corps in military family pet health.

    PubMed

    Vincent-Johnson, Nancy A

    2013-01-01

    Even though privately-owned pet care is a lower priority mission than military working dog care, food inspection,and the public health mission, it is still very important,and the one that many Veterinary Corps officers, civil-ian veterinarians, and technicians enjoy the most. The vast majority of veterinarians and technicians went into veterinary medicine because of a love for animals. It is fulfilling to offer guidance to a client with a new puppy or kitten, see a sick pet improve after treatment, and interact with dozens of animals and clients in a day. The services provided by the Army Veterinary Corps in car-ing for pets has expanded over the years and the standard of care has improved as well. It is truly a privilege to serve those who dedicate themselves to the protection of our Nation. The Army Veterinary Corps is indeed proud to provide care to the pets of Warfighters of the Army,Navy, Marine Corps, Air Force, and Coast Guard; their family members; and our military retirees. PMID:23277448

  7. Gender Differences Among Military Combatants: Does Social Support, Ostracism, and Pain Perception Influence Psychological Health?

    PubMed

    McGraw, Kate

    2016-01-01

    The literature on gender differences related to psychological health among in-theater service members who are deployed in a combatant role is limited. Much focuses on retrospective reports of service members who have returned from deployment. Potential key factors that contribute to gender differences in psychological health among combatants are found in literature across several topic areas, but integration of findings across disciplines is lacking. A growing body of literature on gender differences related to psychological health of postdeployment military populations suggests males and females respond differently to perceived levels of social support pre-and postdeployment. One study on service members who were deployed suggested no significant gender differences related to reported psychological health symptoms, but did appear to find significant gender differences related to reported perception of unit morale. In another related area, research explores how ostracism impacts physical and psychological health of individuals and organizations, and can result in perceptions of physical pain, although research on gender differences related to the impact of ostracism is scarce. Research has also begun to focus on sex differences in pain responses, and has identified multiple biopsychosocial, genetic, and hormonal factors that may contribute as potential underlying mechanisms. In this brief review, we focus on and begin to integrate relevant findings related to the psychological health of females in combat roles, gender differences in the impact of perception of social support on psychological health, the psychological and physical impact of ostracism on individuals and organizations, and the current literature on sex differences in pain perception. We conclude with a synthesis and discussion of research gaps identified through this review, implications for clinical practice, and potential future research directions. In conclusion, there appear to be gender

  8. Supporting our military families: a case for a larger role for occupational therapy in prevention and mental health care.

    PubMed

    Cogan, Alison M

    2014-01-01

    More than 2 million U.S. military servicemembers have deployed to Afghanistan or Iraq since September 11, 2001. Unlike during prior conflicts, many servicemembers leave spouses and children behind. Long, multiple deployments cause strain on family at home, with new challenges arising when servicemembers return from combat and reintegrate into family and civilian life. In World Wars I and II, occupational therapy practitioners played a significant role in supporting servicemember reintegration. However, their presence in program delivery in this practice area is limited. Occupational therapy researchers and practitioners can make a valuable contribution by helping families tailor daily activities and routines to address challenges and optimize health and wellness. However, barriers such as reimbursement for services, workforce availability, and access to military families have limited the profession's full engagement. Advocacy is needed to help establish occupational therapy as a key component of the mental and preventive health care teams serving military servicemembers. PMID:25005512

  9. Widening health inequalities among U.S. military retirees since 1974.

    PubMed

    Edwards, Ryan

    2008-12-01

    I explore trends in mortality among U.S. military retirees using a new dataset of payroll records that include pay grade. Trends in mortality by pay grade reveal that health inequalities steadily widened between 1974 and 2004. Additive differentials in mortality rates remained stable, but since mortality declined exponentially, by a factor of about one third, proportional differentials in mortality and thus additive differentials in life expectancy have widened. The advantage in life expectancy enjoyed by retired officers grew roughly from 3 to 4 years. The sources of these trends remain unclear and are beyond the ability of the data to inform, but the results bear implications for trends in inequality and for policy. PMID:18708275

  10. Effect of Short-Term Separation on the Behavioral Health of Military Wives.

    PubMed

    Oblea, Pedro N; Badger, Terry A; Hopkins-Chadwick, Denise L

    2016-06-01

    In the current prospective observational study, the impact of short-term separation on female spouses of male military officers who were scheduled to participate in a resident training program was evaluated. Using pre- and post-survey designs, participants were assessed 2 weeks prior to separation and 2 weeks prior to their husbands' returns. Participants completed the following scales: the Multidimensional Scale of Perceived Social Support, Connor-Davidson Resilience Scale, Perceived Stress Scale, Relationship Assessment Scale, and Beck Depression Inventory II Scale. No significant differences were found in perceived social support, resilience, perceived stress, relationship satisfaction, or depression scores pre- and post-separation. As predicted, depression scores were positively correlated with perceived stress scores and negatively correlated with resiliency and relationship satisfaction scores. Women with higher levels of resilience experienced lower levels of post-separation stress. [Journal of Psychosocial Nursing and Mental Health Services, 54(6), 45-51.]. PMID:27245252

  11. The prevalence of mental health disorders in (ex-)military personnel with a physical impairment: a systematic review

    PubMed Central

    Stevelink, S A M; Malcolm, E M; Mason, C; Jenkins, S; Sundin, J; Fear, N T

    2015-01-01

    Background Having a visual, hearing or physical impairment (defined as problems in body function or structure) may adversely influence the mental well-being of military personnel. This paper reviews the existing literature regarding the prevalence of mental health problems among (ex-)military personnel who have a permanent, predominantly, physical impairment. Method Multiple electronic literature databases were searched for relevant studies (EMBASE (1980–January 2014), MEDLINE (1946–January 2014), PsycINFO (2002–January 2014), Web of Science (1975–January 2014)). Results 25 papers were included in the review, representing 17 studies. Studies conducted among US military personnel (n=8) were most represented. A range of mental health disorders were investigated; predominately post-traumatic stress disorder (PTSD), but also depression, anxiety disorder (excluding PTSD), psychological distress and alcohol misuse. The findings indicate that mental health disorders including PTSD (range 2–59%), anxiety (range 16.1–35.5%), depression (range 9.7–46.4%) and psychological distress (range 13.4–36%) are frequently found whereby alcohol misuse was least common (range 2.2–26.2%). Conclusions Common mental health disorders were frequently identified among (ex-)military personnel with a physical impairment. Adequate care and support is necessary during the impairment adaptation process to facilitate the psychosocial challenges (ex-)military personnel with an impairment face. Future research should be directed into factors impacting on the mental well-being of (ex-)military personnel with an impairment, how prevalence rates vary across impairment types and to identify and act on specific needs for care and support. PMID:25227569

  12. Mental health screening at temporary military health clinics in low income Hispanic communities within the Rio Grande Valley of Texas.

    PubMed

    Morecook, Robert; Greenstone, James L; Hays, J Ray

    2011-01-01

    Behavioral and mental health problems are not always considered in temporary medical clinics nor are instruments readily available to provide medical practitioners in these settings with information relevant to mental health conditions. This study provided preliminary data on the utility of the Mini Mental Screen in temporary military medical clinics in the Texas Rio Grande Valley. This instrument was administered to individuals who may have behavioral or mental health problems. In a sample of mostly Hispanic patients (N = 75) seen at a temporary medical clinic, 12% were at significant risk of mental health problems, with an additional 9% at moderate risk using published cut-off scores for the risk of such problems. The results for each patient were provided to a medical practitioner who further evaluated the risk, treated the problem, or made a referral. When asked, three of four medical practitioners found that screening data was helpful in their work with patients. One practitioner was concerned that the screening instrument might have too high a false positive rate to be useful. Cultural issues of openness about mental health and behavioral problems need to be considered in such settings. PMID:21957754

  13. Toward Innovative, Cost-Effective, and Systemic Solutions to Improve Outcomes and Well-Being of Military Families Affected by Autism Spectrum Disorder

    PubMed Central

    Klin, Ami; Wetherby, Amy M.; Woods, Juliann; Saulnier, Celine; Stapel-Wax, Jennifer; Klaiman, Cheryl; Jones, Warren; Rubin, Emily; Scahill, Lawrence; Call, Nathan; Bearss, Karen; Gunter, Chris; Courtemanche, Charles J.; Lemieux, Anthony; Cox, James C.; Mandell, David S.; Van Decar, James P.; Miller, Ronald A.; Shireman, Cherri L.

    2015-01-01

    The burdens faced by military families who have a child with autism are unique. The usual challenges of securing diagnostic, treatment, and educational services are compounded by life circumstances that include the anxieties of war, frequent relocation and separation, and a demand structure that emphasizes mission readiness and service. Recently established military autism-specific health care benefits set the stage for community-viable and cost-effective solutions that can achieve better outcomes for children and greater well-being for families. Here we argue for implementation of evidence-based solutions focused on reducing age of diagnosis and improving access to early intervention, as well as establishment of a tiered menu of services, individualized to the child and family, that fit with the military ethos and system of health care. Absence of this new model of care could compromise the utility and sustainability of the autism-specific benefit. PMID:25745376

  14. Toward innovative, cost-effective, and systemic solutions to improve outcomes and well-being of military families affected by autism spectrum disorder.

    PubMed

    Klin, Ami; Wetherby, Amy M; Woods, Juliann; Saulnier, Celine; Stapel-Wax, Jennifer; Klaiman, Cheryl; Jones, Warren; Rubin, Emily; Scahill, Lawrence; Call, Nathan; Bearss, Karen; Gunter, Chris; Courtemanche, Charles J; Lemieux, Anthony; Cox, James C; Mandell, David S; Van Decar, James P; Miller, Ronald A; Shireman, Cherri L

    2015-03-01

    The burdens faced by military families who have a child with autism are unique. The usual challenges of securing diagnostic, treatment, and educational services are compounded by life circumstances that include the anxieties of war, frequent relocation and separation, and a demand structure that emphasizes mission readiness and service. Recently established military autism-specific health care benefits set the stage for community-viable and cost-effective solutions that can achieve better outcomes for children and greater well-being for families. Here we argue for implementation of evidence-based solutions focused on reducing age of diagnosis and improving access to early intervention, as well as establishment of a tiered menu of services, individualized to the child and family, that fit with the military ethos and system of health care. Absence of this new model of care could compromise the utility and sustainability of the autism-specific benefit. PMID:25745376

  15. Health, stabilization and securitization: towards understanding the drivers of the military role in health interventions.

    PubMed

    Gordon, Stuart

    2011-01-01

    In the post-Cold War world, health issues have become firmly rooted in state foreign policies through initiatives such as the UK's 'Health is Global' strategy. However, since 9/11, there has also been growing interest in the interactions between health sector interventions and state fragility. Whilst fragility clearly has a negative impact upon both health outcomes and the capacity of the state to respond to health issues generally, there has been a growing assumption amongst policy makers and practitioners alike that carefully formulated health programmes contribute both to social stability and more widely to a state- and peace-building agenda. This process risks being co-opted by the debates on 'stabilization'--a discourse configured around addressing state fragility and often associated with the interventions in Iraq and Afghanistan. Consequently, this article explores the emergence of health interventions as 'strategic tools' linked to the stabilization debate, explores the emergence of the 'health as a bridge for peace' (HBP) debate, assesses some of the evidence available for HBP and finally focuses on the issues arising from the use of militarized health interventions, particularly in Helmand. PMID:21721347

  16. The influence of military service on auditory health and the efficacy of a Hearing Conservation Program.

    PubMed

    Muhr, Per; Rosenhall, Ulf

    2011-01-01

    The influence of military service on self-assessed hearing symptoms and measured auditory function was studied as well as the efficacy of the Hearing Conservation Program (HCP) of the Swedish Armed Forces. 839 conscripts were recruited for the study at reporting to military service. They were all exposed to noise over the risk-limits from weapons and vehicles and used earmuffs and/or earplugs. Questionnaires and pure tone screening audiometry were studied at the start and the end of the military service. Retrospective information regarding audiometry at conscription before military service was included as control. The prevalence values of tinnitus were 23% before and 32% after the service and of sensitivity to noise 16% and 19% respectively. The prevalence values of hearing impairment were 6.3% at conscription, 14.5% at reporting to military service, and 24% after the training period. The incidence values of hearing decline were 3.7% during the period with no military noise exposure and 6.6% during the military service. Acoustic accident increased the risk of worsened tinnitus and sensitivity to noise four times and for a high frequency hearing decline six times. We observed elevated prevalence values of tinnitus, sensitivity to noise and hearing impairment at discharge compared to before military service. We observed an elevated risk of hearing decline during military service. Acoustic accident increased the risk of tinnitus, noise sensitivity and hearing decline. We suggest improvements regarding inclusion criteria for military service, and for education regarding the HCP. PMID:21768736

  17. Is military sexual trauma associated with trading sex among women veterans seeking outpatient mental health care?

    PubMed

    Strauss, Jennifer L; Marx, Christine E; Weitlauf, Julie C; Stechuchak, Karen M; Straits-Troster, Kristy; Worjoloh, Ayaba W; Sherrod, Christina B; Olsen, Maren K; Butterfield, Marian I; Calhoun, Patrick S

    2011-01-01

    A robust association between sexual trauma and trading sex has been documented in civilian samples but has not been examined in veterans. Women veterans experience high rates of sexual victimization across the lifespan, including during military service (military sexual trauma [MST]). Associations between MST and trading sex were examined in 200 women enrolled in a crosssectional study of HIV risks and seroprevalence among women receiving outpatient mental health care at a Veterans Affairs (VA) medical center. Each woman completed an assessment interview composed of validated measures that queried childhood sexual trauma; substance use; and risk behaviors, including trading sex for money, drugs, shelter, food, or other things. History of MST was derived from mandated VA screening results and chart notes. Overall, 19.7% reported a history of trading sex. Those who reported trading sex had a higher rate of MST than those who did not report trading sex (87.2% vs. 62.9%, respectively). A multivariable logistic regression model examined the relationship between trading sex and MST, controlling a priori for substance abuse and childhood sexual trauma (both associated with trading sex in civilian samples) and education, which was associated with trading sex in our sample. In this adjusted model, MST was associated with trading sex: odds ratio = 3.26, p = .025, 95% confidence interval = [1.16, 9.18]. To our knowledge, this is the 1st report of an association between MST and trading sex. Results extend previously observed associations between sexual trauma and trading sex in civilian cohorts and underscore the pernicious influence of sexual victimization across the lifespan. PMID:21534097

  18. Apprentice Heating Systems Specialist, 11-1. Military Curriculum Materials for Vocational and Technical Education.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. National Center for Research in Vocational Education.

    This military-developed text consists of four volumes of materials for use by those studying to become apprentice heating system specialists. Covered in the individual volumes are the following topics: related subjects (basic electricity, electrical controls, pipe and copper tubing, the principles of heating, fuels, and fuel systems); heating…

  19. Analysis of human factors case studies of complex military systems: surely we can do better

    NASA Astrophysics Data System (ADS)

    Hutchins, Susan G.

    2000-11-01

    People in nearly ever occupational setting can provide examples of poor system design. The focus for this paper is on an analysis of design problems found in complex military command and control systems and the ways in which these types of problems can be avoided in future system design. The source of data for this analysis was a group of case studies of sixteen U.S. military systems written by officer-students at the Naval Postgraduate School, Monterey, CA. Systems analyzed span the four military services and include aircraft systems, communications systems, the M-16 rifle, a missile defense system, a message processing system, weapon systems, and decision support systems. Documented problems with system use were categorized according to the following measures of effectiveness: Performance, Safety, Usability, Reliability, Maintainability, Time and Cost to Train, and Workload. The number of problems encountered per system ranged from one to nine; the mean number of reported problems per system was 4.9 IEEE 1220-1998 includes a revised systems engineering approach with an increased emphasis on engineering the system for the human. Adhering to a user-centered design approach should have a positive impact on system design by significantly reducing the types of system problems described in this paper.

  20. Secondary Traumatic Stress Among Mental Health Providers Working With the Military

    PubMed Central

    Cieslak, Roman; Anderson, Valerie; Bock, Judith; Moore, Bret A.; Peterson, Alan L.; Benight, Charles C.

    2013-01-01

    Abstract Our research assessed the prevalence of secondary traumatic stress (STS) among mental health providers working with military patients. We also investigated personal, work-related, and exposure-related correlates of STS. Finally, using meta-analysis, the mean level of STS symptoms in this population was compared with the mean level of these symptoms in other groups. Participants (N = 224) completed measures of indirect exposure to trauma (i.e., diversity, volume, frequency, ratio), appraisal of secondary exposure impact, direct exposure to trauma, STS, and work characteristics. The prevalence of STS was 19.2%. Personal history of trauma, complaints about having too many patients, and more negative appraisals of the impact caused by an indirect exposure to trauma were associated with higher frequency of STS symptoms. A meta-analysis showed that the severity of intrusion, avoidance, and arousal symptoms of STS was similar across various groups of professionals indirectly exposed to trauma (e.g., mental health providers, rescue workers, social workers). PMID:24177477

  1. Henry Ford Health Systems

    Cancer.gov

    Henry Ford Health Systems evolved from a hospital into a system delivering care to 2.5 million patients and includes the Cancer Epidemiology, Prevention and Control Program, which focuses on epidemiologic and public health aspects of cancer.

  2. Engine health monitoring: An advanced system

    NASA Technical Reports Server (NTRS)

    Dyson, R. J. E.

    1981-01-01

    The advanced propulsion monitoring system is described. The system was developed in order to fulfill a growing need for effective engine health monitoring. This need is generated by military requirements for increased performance and efficiency in more complex propulsion systems, while maintaining or improving the cost to operate. This program represents a vital technological step in the advancement of the state of the art for monitoring systems in terms of reliability, flexibility, accuracy, and provision of user oriented results. It draws heavily on the technology and control theory developed for modern, complex, electronically controlled engines and utilizes engine information which is a by-product of such a system.

  3. Ukraine: Health system review.

    PubMed

    Lekhan, Valery; Rudiy, Volodymyr; Richardson, Erica

    2010-01-01

    The HiT profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. The Ukrainian health system has preserved the fundamental features of the Soviet Semashko system against a background of other changes, which are developed on market economic principles. The transition from centralized financing to its extreme decentralization is the main difference in the health system in comparison with the classic Soviet model. Health facilities are now functionally subordinate to the Ministry of Health, but managerially and financially answerable to the regional and local self-government, which has constrained the implementation of health policy and fragmented health financing. Health care expenditure in Ukraine is low by regional standards and has not increased significantly as a proportion of gross domestic product (GDP) since the mid 1990s; expenditure cannot match the constitutional guarantees of access to unlimited care. Although prepaid schemes such as sickness funds are growing in importance, out-of-pocket payments account for 37.4% of total health expenditure. The core challenges for Ukrainian health care therefore remain the ineffective protection of the population from the risk of catastrophic health care costs and the structural inefficiency of the health system, which is caused by the inefficient system of health care financing. Health system weaknesses are highlighted by increasing rates of avoidable mortality. Recent political impasse has complicated health system reforms and policy-makers face significant challenges in overcoming popular distrust and

  4. Embedded Fragments from U.S. Military Personnel—Chemical Analysis and Potential Health Implications

    PubMed Central

    Centeno, José A.; Rogers, Duane A.; van der Voet, Gijsbert B.; Fornero, Elisa; Zhang, Lingsu; Mullick, Florabel G.; Chapman, Gail D.; Olabisi, Ayodele O.; Wagner, Dean J.; Stojadinovic, Alexander; Potter, Benjamin K.

    2014-01-01

    Background: The majority of modern war wounds are characterized by high-energy blast injuries containing a wide range of retained foreign materials of a metallic or composite nature. Health effects of retained fragments range from local or systemic toxicities to foreign body reactions or malignancies, and dependent on the chemical composition and corrosiveness of the fragments in vivo. Information obtained by chemical analysis of excised fragments can be used to guide clinical decisions regarding the need for fragment removal, to develop therapeutic interventions, and to better anticipate future medical problems from retained fragment related injuries. In response to this need, a new U.S Department of Defense (DoD) directive has been issued requiring characterization of all removed fragments to provide a database of fragment types occurring in combat injuries. Objectives: The objective of this study is to determine the chemical composition of retained embedded fragments removed from injured military personnel, and to relate results to histological findings in tissue adjacent to fragment material. Methods: We describe an approach for the chemical analysis and characterization of retained fragments and adjacent tissues, and include case examples describing fragments containing depleted uranium (DU), tungsten (W), lead (Pb), and non-metal foreign bodies composed of natural and composite materials. Fragments obtained from four patients with penetrating blast wounds to the limbs were studied employing a wide range of chemical and microscopy techniques. Available adjacent tissues from three of the cases were histologically, microscopically, and chemically examined. The physical and compositional properties of the removed foreign material surfaces were examined with energy dispersive x-ray fluorescence spectrometry (EDXRF), scanning electron microscopy (SEM), laser ablation inductively-coupled plasma mass-spectrometry (LA-ICP-MS), and confocal laser Raman

  5. A Comprehensive Evaluation System for Military Hospitals' Response Capability to Bio-terrorism.

    PubMed

    Wang, Hui; Jiang, Nan; Shao, Sicong; Zheng, Tao; Sun, Jianzhong

    2015-05-01

    The objective of this study is to establish a comprehensive evaluation system for military hospitals' response capacity to bio-terrorism. Literature research and Delphi method were utilized to establish the comprehensive evaluation system for military hospitals' response capacity to bio-terrorism. Questionnaires were designed and used to survey the status quo of 134 military hospitals' response capability to bio-terrorism. Survey indicated that factor analysis method was suitable to for analyzing the comprehensive evaluation system for military hospitals' response capacity to bio-terrorism. The constructed evaluation system was consisted of five first-class and 16 second-class indexes. Among them, medical response factor was considered as the most important factor with weight coefficient of 0.660, followed in turn by the emergency management factor with weight coefficient of 0.109, emergency management consciousness factor with weight coefficient of 0.093, hardware support factor with weight coefficient of 0.078, and improvement factor with weight coefficient of 0.059. The constructed comprehensive assessment model and system are scientific and practical. PMID:25605265

  6. Health Services Management Education On-Site at a Military Medical Center

    ERIC Educational Resources Information Center

    Williams, Stephen J.; Poss, W. Bradley; Cupp, Craig L.

    2014-01-01

    A cooperative educational program with the U.S. military is described to illustrate a unique opportunity that confronted a graduate healthcare management program. The resulting degree program supported the military's operational medical mission but also presented interesting and unexpected challenges resulting from the wars in Iraq and…

  7. Slovenia: Health System Review.

    PubMed

    Albreht, Tit; Pribakovic Brinovec, Radivoje; Josar, Dusan; Poldrugovac, Mircha; Kostnapfel, Tatja; Zaletel, Metka; Panteli, Dimitra; Maresso, Anna

    2016-06-01

    This analysis of the Slovene health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The health of the population has improved over the last few decades. While life expectancy for both men and women is similar to EU averages, morbidity and mortality data show persistent disparities between regions, and mortality from external causes is particularly high. Satisfaction with health care delivery is high, but recently waiting times for some outpatient specialist services have increased. Greater focus on preventive measures is also needed as well as better care coordination, particularly for those with chronic conditions. Despite having relatively high levels of co-payments for many services covered by the universal compulsory health insurance system, these expenses are counterbalanced by voluntary health insurance, which covers 95% of the population liable for co-payments. However, Slovenia is somewhat unique among social health insurance countries in that it relies almost exclusively on payroll contributions to fund its compulsory health insurance system. This makes health sector revenues very susceptible to economic and labour market fluctuations. A future challenge will be to diversify the resource base for health system funding and thus bolster sustainability in the longer term, while preserving service delivery and quality of care. Given changing demographics and morbidity patterns, further challenges include restructuring the funding and provision of long-term care and enhancing health system efficiency through reform of purchasing and provider-payment systems. PMID:27467813

  8. Psychological health of military children: longitudinal evaluation of a family-centered prevention program to enhance family resilience.

    PubMed

    Lester, Patricia; Stein, Judith A; Saltzman, William; Woodward, Kirsten; MacDermid, Shelley W; Milburn, Norweeta; Mogil, Catherine; Beardslee, William

    2013-08-01

    Family-centered preventive interventions have been proposed as relevant to mitigating psychological health risk and promoting resilience in military families facing wartime deployment and reintegration. This study evaluates the impact of a family-centered prevention program, Families OverComing Under Stress Family Resilience Training (FOCUS), on the psychological adjustment of military children. Two primary goals include (1) understanding the relationships of distress among family members using a longitudinal path model to assess relations at the child and family level and (2) determining pathways of program impact on child adjustment. Multilevel data analysis using structural equation modeling was conducted with deidentified service delivery data from 280 families (505 children aged 3-17) in two follow-up assessments. Standardized measures included service member and civilian parental distress (Brief Symptom Inventory, PTSD Checklist-Military), child adjustment (Strengths and Difficulties Questionnaire), and family functioning (McMaster Family Assessment Device). Distress was significantly related among the service member parent, civilian parent, and children. FOCUS improved family functioning, which in turn significantly reduced child distress at follow-up. Salient components of improved family functioning in reducing child distress mirrored resilience processes targeted by FOCUS. These findings underscore the public health potential of family-centered prevention for military families and suggest areas for future research. PMID:23929043

  9. Kazakhkstan health system review.

    PubMed

    Katsaga, Alexandr; Kulzhanov, Maksut; Karanikolos, Marina; Rechel, Bernd

    2012-01-01

    Since becoming independent, Kazakhstan has undertaken major efforts in reforming its post-Soviet health system. Two comprehensive reform programmes were developed in the 2000s: the National Programme for Health Care Reform and Development 2005-2010 and the State Health Care Development Programme for 2011-2015 Salamatty Kazakhstan. Changes in health service provision included a reduction of the hospital sector and an increased emphasis on primary health care. However, inpatient facilities continue to consume the bulk of health financing. Partly resulting from changing perspectives on decentralization, levels of pooling kept changing. After a spell of devolving health financing to the rayon level in 2000-2003, beginning in 2004 a new health financing system was set up that included pooling of funds at the oblast level, establishing the oblast health department as the single-payer of health services. Since 2010, resources for hospital services under the State Guaranteed Benefits Package have been pooled at the national level within the framework of implementing the Concept on the Unified National Health Care System. Kazakhstan has also embarked on promoting evidence-based medicine and developing and introducing new clinical practice guidelines, as well as facility-level quality improvements. However, key aspects of health system performance are still in dire need of improvement. One of the key challenges is regional inequities in health financing, health care utilization and health outcomes, although some improvements have been achieved in recent years. Despite recent investments and reforms, however, population health has not yet improved substantially. PMID:22894852

  10. Transport aircraft loading and balancing system: Using a CLIPS expert system for military aircraft load planning

    NASA Technical Reports Server (NTRS)

    Richardson, J.; Labbe, M.; Belala, Y.; Leduc, Vincent

    1994-01-01

    The requirement for improving aircraft utilization and responsiveness in airlift operations has been recognized for quite some time by the Canadian Forces. To date, the utilization of scarce airlift resources has been planned mainly through the employment of manpower-intensive manual methods in combination with the expertise of highly qualified personnel. In this paper, we address the problem of facilitating the load planning process for military aircraft cargo planes through the development of a computer-based system. We introduce TALBAS (Transport Aircraft Loading and BAlancing System), a knowledge-based system designed to assist personnel involved in preparing valid load plans for the C130 Hercules aircraft. The main features of this system which are accessible through a convivial graphical user interface, consists of the automatic generation of valid cargo arrangements given a list of items to be transported, the user-definition of load plans and the automatic validation of such load plans.

  11. Military Curricula for Vocational & Technical Education. Computer System Operation, 4-3.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. National Center for Research in Vocational Education.

    This program on instruction and programmed student texts for a secondary-postsecondary-level computer system operator course are one of a number of military-developed curriculum packages selected for adaptation to vocational instruction and curriculum development in a civilian setting. Purpose stated for the ten-lesson course is to provide the…

  12. Electronic Computer Systems Repairman, 7-4. Military Curriculum Materials for Vocational and Technical Education.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. National Center for Research in Vocational Education.

    These military-developed curriculum materials consist of three volumes of self-paced, individualized training manuals for use by those studying to be electronic computer systems technicians. Covered in the individual volumes are the following topics: computer principles (number sytems, computer circuits, computer components, computer units,…

  13. Contraceptive Provision in the VA Healthcare System to Women Who Report Military Sexual Trauma

    PubMed Central

    Mattocks, Kristin; Schwarz, Eleanor Bimla; Borrero, Sonya; Skanderson, Melissa; Zephyrin, Laurie; Brandt, Cynthia; Haskell, Sally

    2014-01-01

    Abstract Background: Women Veterans who suffered military sexual trauma (MST) may be at high risk for unintended pregnancy and benefit from contraceptive services. The objective of this study is to compare documented provision of contraceptives to women Veterans using the Department of Veterans Affairs (VA) health system who report or deny MST. Methods: This retrospective cohort study included women Veterans aged 18–45 years who served in Operation Enduring or Iraqi Freedom and had at least one visit to a VA medical center between 2002 and 2010. Data were obtained from VA administrative and clinical databases. Chi-squared tests and logistic regression were conducted to evaluate the association between MST, ascertained by routine clinical screening, and first documented receipt of hormonal or long-acting contraception. Results: Of 68,466 women Veterans, 13% reported, 59% denied and 28% had missing data for the MST screen. Among the entire study cohort, 30% of women had documented receipt of a contraceptive method. Women reporting MST were significantly more likely than those denying MST to receive a method of contraception (adjusted odds ratio [aOR] 1.12, 95% confidence interval [CI] 1.07–1.18) including an intrauterine device (odds ratio [OR] 1.29, 95% CI 1.17–1.41) or contraceptive injection (OR 1.17, 95% CI 1.05–1.29). Women who were younger, unmarried, seen at a women's health clinic, or who had more than one visit were more likely to receive contraception. Conclusions: A minority of women Veterans of reproductive age receive contraceptive services from the VA. Women Veterans who report MST, and particularly those who seek care at VA women's health clinics, are more likely to receive contraception. PMID:24787680

  14. Latvia: Health system review.

    PubMed

    Mitenbergs, Uldis; Taube, Maris; Misins, Janis; Mikitis, Eriks; Martinsons, Atis; Rurane, Aiga; Quentin, Wilm

    2012-01-01

    This analysis of the Latvian health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health-system performance. Latvia has been constantly reforming its health system for over two decades. After independence in 1991, Latvia initially moved to create a social health insurance type system. However, problems with decentralized planning and fragmented and inefficient financing led to this being gradually reversed, and ultimately the establishment in 2011 of a National Health Service type system. These constant changes have taken place against a backdrop of relatively poor health and limited funding, with a heavy burden for individuals; Latvia has one of the highest rates of out-of-pocket expenditure on health in the European Union (EU). The lack of financial resources resulting from the financial crisis has posed an enormous challenge to the government, which struggled to ensure the availability of necessary health care services for the population and to prevent deterioration of health status. Yet this also provided momentum for reforms: previous efforts to centralise the system and to shift from hospital to outpatient care were drastically accelerated, while at the same time a social safety net strategy was implemented (with financial support from the World Bank) to protect the poor from the negative consequences of user charges. However, as in any health system, a number of challenges remain. They include: reducing smoking and cardiovascular deaths; increasing coverage of prescription pharmaceuticals; reducing the excessive reliance on out-of-pocket payments for financing the health system; reducing inequities in access and health status; improving efficiency of hospitals through implementation of DRG-based financing; and monitoring and improving quality. In the face of these challenges at a time of financial crisis, one further challenge emerges: ensuring adequate funding for the health

  15. A system architecture for long duration free floating flight for military applications

    SciTech Connect

    Epley, L.E. )

    1990-08-31

    Accessibility is today's space frontier. Our need for wide-band global communications, earth imaging an sensing, atmospheric measurements and military reconnaissance is endless but growing dependence on space-based systems raises concerns about potential vulnerability. Military commanders want space assets more accessible and under direct local control. As a result, a robust and low cost access to space-like capability has become a national priority. Buoyant vehicles, free floating in the middle stratosphere could provide the kind of cost effective access to space-like capability needed for a verity of missions. These vehicles are inexpensive, invisible and easily launched. Developments in payload electronics, atmospheric wind modeling and materials combined with ever-improving communications and navigation infrastructure are making balloon-borne concepts more attractive. The fundamental question is whether a free floating balloon, used in a pseudo-satellite role, has value in a military system. Flight tests are ongoing under NASA sponsorship. Following these tests NASA intends to use the vehicles for research in the Antarctic. The concept is being reviewed by other agencies interested in stratospheric research. We believe that LDFFF systems have applications in areas of communications, surveillance and other traditional satellite missions. Dialogue with the broader community of space users is needed to expand the applications. This report reviews the status of the recent flight tests and presents an overview of the concept of Long Duration Free Floating Flight for military applications. 12 refs., 13 figs.

  16. Proceedings of the Military Communications System Control Symposium

    NASA Astrophysics Data System (ADS)

    Harris, S.; Heller, J.

    1980-11-01

    Contents: Perspective on Communications System Control, Navy Force Coordination and the Requirements for Communications Network Management, On the Functions of a Network Management Agency, Improved Control and Technical Management of DCS Theater Assets Under Crisis and Wartime Conditions, Survivability Performance of MX Communication System, System Control for the Tactical/Strategic Interface, Tactical Circuit-Switched Network Control, Systems Control in Tactical Digital Communications Systems - a Study in Distributed Control, the NATO III Satellite Communications Control System, Network Control in NATO Integrated Communications Systems - Stage I, Evolution of Control in the Defense Satellite Communication System, System Control Considerations for Next Generation DCS Switches, Evolving Approaches to System control in the Defense Communications Systems(DCS), and Network control and the CRM Make Possible Automated Digital Patching.

  17. Germany: Health system review.

    PubMed

    Busse, Reinhard; Blümel, Miriam

    2014-01-01

    This analysis of the German health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. In the German health care system, decision-making powers are traditionally shared between national (federal) and state (Land) levels, with much power delegated to self-governing bodies. It provides universal coverage for a wide range of benefits. Since 2009, health insurance has been mandatory for all citizens and permanent residents, through either statutory or private health insurance. A total of 70 million people or 85% of the population are covered by statutory health insurance in one of 132 sickness funds in early 2014. Another 11% are covered by substitutive private health insurance. Characteristics of the system are free choice of providers and unrestricted access to all care levels. A key feature of the health care delivery system in Germany is the clear institutional separation between public health services, ambulatory care and hospital (inpatient) care. This has increasingly been perceived as a barrier to change and so provisions for integrated care are being introduced with the aim of improving cooperation between ambulatory physicians and hospitals. Germany invests a substantial amount of its resources on health care: 11.4% of gross domestic product in 2012, which is one of the highest levels in the European Union. In international terms, the German health care system has a generous benefit basket, one of the highest levels of capacity as well as relatively low cost-sharing. However, the German health care system still needs improvement in some areas, such as the quality of care. In addition, the division into statutory and private health insurance remains one of the largest challenges for the German health care system, as it leads to inequalities. PMID:25115137

  18. A decision support system for the Military Airlift Command, the Airlift Deployment Analysis System

    SciTech Connect

    Kraemer, R.D.; Harrison, I.G.

    1989-09-01

    Oak Ridge National Laboratory (ORNL) is assisting the Military Airlift Command (MAC) with the development of the Airlift Deployment Analysis System (ADANS). ADANS will improve MAC's automated capabilities for scheduling peacetime airlift missions, deliberate planning, execution planning, and analysis of the airlift system. ADANS will consist of four subsystems: airlift planning and scheduling algorithms, database management, user interface, and communications. This paper describes MAC's current airlift planning and scheduling operations, the current automated systems used to develop airlift schedules and plans, approaches to developing ADANS, and major improvements that will result from the implementation of ADANS. This report is based on a series of in-depth interviews and working sessions that were conducted with MAC staff, a review of airlift scheduling literature, and the ongoing research effort at ORNL for the ADANS project. 9 refs., 2 figs., 2 tabs.

  19. Assessment of fish health in Ashumet and Johns Ponds adjacent to the Massachusetts Military Reservation

    SciTech Connect

    Greeley, M.S. Jr.; Adams, S.M.; Hinton, D.E.

    1995-12-31

    Ashumet and Johns Ponds are located adjacent to the Massachusetts Military Reservation (MMR) on Cape Cod, and lie in or near the paths of several plumes of groundwater contamination flowing from the MMR. This study had the objective of documenting the present status of fish in both ponds in efforts to establish base-line conditions for any future biological monitoring activities and to determine whether evidence exists for current contaminant impacts. This objective was addressed through three complimentary approaches, including the determination of Health Assessment Index (HAI) scores for fish sampled from Ashumet and Johns Ponds and several reference ponds in the area, measurement of various biochemical and physiological indicators in fish tissues and fluids and histopathological examinations of fish organs. For each of the three primary fish species examined in this study, largemouth bass, brown bullhead catfish, and yellow perch, many similarities were noted in the physiological, biochemical and histopathological condition of fish in all the study ponds. However, mean HAIs tended to be slightly higher (indicative of poorer health) in Ashumet and Johns Ponds, due in part to pathologies related to a higher incidence of parasitic infection at these sites. The most striking differences between the ponds were very high prevalences of oral and body surface papillomas in brown bullhead catfish from Johns Pond (59%) and Ashumet Pond (34%). Although pesticides, PCBs, and other chemical contaminants were present in fish from all of ponds, there was no obvious relationship between chemical body burdens and the responses of any of the measured indicator parameters, nor was there any conclusive evidence of current impacts on fish from the contaminant plumes.

  20. Refining the Instructional Systems Concept: Some Experiences from Military Training.

    ERIC Educational Resources Information Center

    Renckly, Thomas

    1980-01-01

    The systems approach to instruction is studied through an analysis of the use of this approach by the U.S. Air Force's Air Training Command. An explanation of the USAF Instructional Systems Development (ISD) model is given. (RAO)

  1. [The "Écoute Défense" helpline, a new care tool within the military health service].

    PubMed

    Gault, Caroline; Leduc, Caroline

    2015-01-01

    The "Écoute Défense" helpline was launched on 23rd January 2013. This freephone number, available 24/7, is aimed at soldiers, former soldiers and their families. The main objective of the service is to listen, provide information and guide those suffering from psychological traumas which have arisen during service. Carried out by clinical psychologists from the military health service, the mission raises discussion around the challenges of this new channel for accessing care for soldiers. PMID:25975164

  2. Treatment of persistent post-concussive symptoms after mild traumatic brain injury: a systematic review of cognitive rehabilitation and behavioral health interventions in military service members and veterans.

    PubMed

    Cooper, Douglas B; Bunner, Anne E; Kennedy, Jan E; Balldin, Valerie; Tate, David F; Eapen, Blessen C; Jaramillo, Carlos A

    2015-09-01

    Increased prevalence of traumatic brain injury (TBI) has been associated with service members and veterans who completed combat deployments in support of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF). Management of persistent post-concussive symptoms (PCS) has been a challenge to healthcare providers throughout the Military and Veterans Healthcare Systems, as well as civilian healthcare providers, due in part to the chronic nature of symptoms, co-occurrence of behavioral health disorders such as depression, Posttraumatic Stress Disorder (PTSD), and substance use disorders, and fear of a potential stigma associated with psychiatric diagnoses and behavioral health treatment(s). This systematic review examined non-pharmacologic behavioral health interventions and cognitive rehabilitation interventions for PCS in military service members and veterans with a history of mild TBI (mTBI). Six electronic databases were searched with specific term limitations, identifying 121 citations. Ultimately, 19 articles met criteria for inclusion in this systematic review. Studies were broadly categorized into four subtypes: psychoeducational interventions, cognitive rehabilitation, psychotherapeutic approaches, and integrated behavioral health interventions for PCS and PTSD. The review provides an update of the empirical evidence for these four types of interventions for PCS in active duty service members and veterans. Recommendations for future research are discussed, including the need to expand and improve the limited evidence basis on how to manage persistent post-concussive symptoms in this population. PMID:26330376

  3. Design and vibration control of military vehicle suspension system using magnetorheological damper and disc spring

    NASA Astrophysics Data System (ADS)

    Ha, Sung Hoon; Seong, Min-Sang; Choi, Seung-Bok

    2013-06-01

    This paper proposes a new type of magnetorheological (MR) fluid based suspension system and applies it to military vehicles for vibration control. The suspension system consists of a gas spring, a MR damper and a safety passive damper (disc spring). Firstly, a dynamic model of the MR damper is derived by considering the pressure drop due to the viscosity and the yield stress of the MR fluid. A dynamic model of the disc spring is then established for its evaluation as a safety damper with respect to load and pressure. Secondly, a full military vehicle is adopted for the integration of the MR suspension system. A skyhook controller associated with a semi-active actuating condition is then designed to reduce the imposed vibration. In order to demonstrate the effectiveness of the proposed MR suspension system, a computer simulation is undertaken showing the vibration control performance of such properties as vertical displacement and pitch angle, evaluated for a bumpy road profile.

  4. The military space system technology model - A guidance, navigation and control perspective

    NASA Astrophysics Data System (ADS)

    Dannenberg, K.; Daly, K. C.; Dorroh, W. E.; Fosth, D.; Iwens, R.; Pelka, G.; Williamson, R. K.

    The Military Space Systems Technology Model (MSSTM) represents a systematic approach to identify future technology needs based on perceived mission requirements. In provides help in the planning of technology programs which support the mission of the Space Division, Air Force Systems Command. The MSSTM represents a broad range of information concerning the projected military space missions systems, and technology requirements for the next 20 years. In an attempt to obtain an industry view of the MSSTM, the AIAA was asked by Space Division to review this model. The activity was divided into 15 different functional areas. The present investigation is concerned with the Guidance Navigation and Control (GNC) results. Attention is given to attitude determination and navigation, acquisition, pointing, tracking, large space structure control, GNC space operations, and questions of systems design. It is concluded that new GNC technology is needed to enable 17 of the considered missions to be performed.

  5. Time generation and distribution system for a military national synchronization

    NASA Astrophysics Data System (ADS)

    Mourier, V.

    1992-06-01

    The requirements, concept, and principle of a French air force time generation and distribution system are presented. The system provides homogeneous dating of events throughout the country. It generates and distributes time codes and precise frequency used for high precision measurements, telecommunications, etc. Accordingly the need is to provide on each operational site an accurate and stable time reference based on UTC time scale. The system consists of a common reference (GPS (Global Positioning System)) independent clocks and time distribution that provides time to all the user equipment on each operational site.

  6. Architecting the Future U.S. Military Psychological Health Enterprise via Policy and Procedure Analysis.

    PubMed

    Glover, Wiljeana J; Plmanabhan, Jayaprasad; Rhodes, Donna; Nightingale, Deborah

    2015-08-01

    Although researchers suggest that a systems approach is required to make meaningful advances in the U.S. psychological health care system for service members, limited research has considered such an approach. This research uses an enterprise architecting framework to identify the system's strengths and areas for opportunity as they relate to the Ecosystem, Stakeholders, Strategy, Process, Organization, Knowledge, Information, and Infrastructure. Codifying qualitative data from publicly available U.S. Defense Health Agency and U.S. Service Branch doctrine, policy guidance, and concepts of operations, our findings indicate that the psychological health care system is strongly process-oriented and mentions a variety of key stakeholders and their roles and responsibilities in the enterprise. Potential opportunities of improvement for the system include a stronger emphasis on the development and transfer of knowledge capabilities, and a stronger information-based infrastructure. PMID:26226534

  7. Lithuania: health system review.

    PubMed

    Murauskiene, Liubove; Janoniene, Raimonda; Veniute, Marija; van Ginneken, Ewout; Karanikolos, Marina

    2013-01-01

    This analysis of the Lithuanian health system reviews the developments in organization and governance, health financing, health-care provision, health reforms and health system performance since 2000.The Lithuanian health system is a mixed system, predominantly funded from the National Health Insurance Fund through a compulsory health insurance scheme, supplemented by substantial state contributions on behalf of the economically inactive population amounting to about half of its budget. Public financing of the health sector has gradually increased since 2004 to 5.2 per cent of GDP in 2010.Although the Lithuanian health system was tested by the recent economic crisis, Lithuanias counter-cyclical state health insurance contribution policies (ensuring coverage for the economically inactive population) helped the health system to weather the crisis, and Lithuania successfully used the crisis as a lever to reduce the prices of medicines.Yet the future impact of cuts in public health spending is a cause for concern. In addition, out-of-pocket payments remain high (in particular for pharmaceuticals) and could threaten health access for vulnerable groups.A number of challenges remain. The primary care system needs strengthening so that more patients are treated instead of being referred to a specialist, which will also require a change in attitude by patients. Transparency and accountability need to be increased in resource allocation, including financing of capital investment and in the payer provider relationship. Finally, population health,albeit improving, remains a concern, and major progress can be achieved by reducing the burden of amenable and preventable mortality. PMID:23902994

  8. Ukraine: health system review.

    PubMed

    Lekhan, Valery; Rudiy, Volodymyr; Shevchenko, Maryna; Nitzan Kaluski, Dorit; Richardson, Erica

    2015-03-01

    This analysis of the Ukrainian health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. Since the country gained independence from the Soviet Union in 1991, successive governments have sought to overcome funding shortfalls and modernize the health care system to meet the needs of the population's health. However, no fundamental reform of the system has yet been implemented and consequently it has preserved the main features characteristic of the Semashko model; there is a particularly high proportion of total health expenditure paid out of pocket (42.3 % in 2012), and incentives within the system do not focus on quality or outcomes. The most recent health reform programme began in 2010 and sought to strengthen primary and emergency care, rationalize hospitals and change the model of health care financing from one based on inputs to one based on outputs. Fundamental issues that hampered reform efforts in the past re-emerged, but conflict and political instability have proved the greatest barriers to reform implementation and the programme was abandoned in 2014. More recently, the focus has been on more pressing humanitarian concerns arising from the conflict in the east of Ukraine. It is hoped that greater political, social and economic stability in the future will provide a better environment for the introduction of deep reforms to address shortcomings in the Ukrainian health system. PMID:26106880

  9. The integrated petroleum, oil lubricants data system for the military

    SciTech Connect

    Purdy, E.M.

    1994-02-01

    This report describes a proposed system of a comprehensive database that identifies the correct petroleum, oils, and lubricants (POL) required to operate, maintain, and sustain all army equipment. The POL products identified by the system for each item ofequipment will represent the optimum POL basic load components. Equivalent alternative products wil be identified to account for possible shortages of the recommended materials, and compatibility data for host nation support agreements will also be available.

  10. Iceland: health system review.

    PubMed

    Sigurgeirsdóttir, Sigurbjörg; Waagfjörð, Jónína; Maresso, Anna

    2014-01-01

    This analysis of the Icelandic health system reviews the developments in its organization and governance, health financing, health care provision, health reforms and health system performance. Life expectancy at birth is high and Icelandic men and women enjoy longer life in good health than the average European. However, Icelanders are putting on weight, more than half of adult Icelanders were overweight or obese in 2004, and total consumption of alcohol has increased considerably since 1970. The health care system is a small, state centred, publicly funded system with universal coverage, and an integrated purchaser provider relationship in which the state as payer is also the owner of most organizations providing health care services. The country's centre of clinical excellence is the University Hospital, Landspitali, in the capital Reykjavik, which alone accounts for 70 percent of the total national budget for general hospital services. However, since 1990, the health system has become increasingly characterized by a mixed economy of care and service provision, in which the number and scope of private non profit and private for profit providers has increased. While Iceland's health outcomes are some of the best among OECD countries, the health care system faces challenges involving the financial sustainability of the current system in the context of an ageing population, new public health challenges, such as obesity, and the continued impact of the country's financial collapse in 2008. The most important challenge is to change the pattern of health care utilization to steer it away from the most expensive end of the health services spectrum towards more cost efficient and effective alternatives. To a large degree, this will involve renewed attempts to prioritize primary care as the first port of call for patients, and possibly to introduce a gatekeeping function for GPs in order to moderate the use of specialist services. PMID:25720021

  11. Belgium: Health system review.

    PubMed

    Gerkens, Sophie; Merkur, Sherry

    2010-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. The Belgian population continues to enjoy good health and long life expectancy. This is partly due to good access to health services of high quality. Financing is based mostly on proportional social security contributions and progressive direct taxation. The compulsory health insurance is combined with a mostly private system of health care delivery, based on independent medical practice, free choice of physician and predominantly fee-for-service payment. This Belgian HiT profile (2010) presents the evolution of the health system since 2007, including detailed information on new policies. While no drastic reforms were undertaken during this period, policy-makers have pursued the goals of improving access to good quality of care while making the system sustainable. Reforms to increase the accessibility of the health system include measures to reduce the out-of-pocket payments of more vulnerable populations (low-income families and individuals as well as the chronically ill). Quality of care related reforms have included incentives to better integrate different levels of care and the establishment of information systems, among others. Additionally, several measures on pharmaceutical products have aimed to reduce costs for both the National Institute for Health and Disability Insurance (NIHDI) and patients, while maintaining the quality of care. PMID:21224177

  12. France: Health System Review.

    PubMed

    Chevreul, Karine; Berg Brigham, Karen; Durand-Zaleski, Isabelle; Hernandez-Quevedo, Cristina

    2015-01-01

    This analysis of the French health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The French population has a good level of health, with the second highest life expectancy in the world for women. It has a high level of choice of providers, and a high level of satisfaction with the health system. However, unhealthy habits such as smoking and harmful alcohol consumption remain significant causes of avoidable mortality. Combined with the significant burden of chronic diseases, this has underscored the need for prevention and integration of services, although these have not historically been strengths of the French system. Although the French health care system is a social insurance system, it has historically had a stronger role for the state than other Bismarckian social insurance systems. Public financing of health care expenditure is among the highest in Europe and out-of-pocket spending among the lowest. Public insurance is compulsory and covers the resident population; it is financed by employee and employer contributions as well as increasingly through taxation. Complementary insurance plays a significant role in ensuring equity in access. Provision is mixed; providers of outpatient care are largely private, and hospital beds are predominantly public or private non-profit-making. Despite health outcomes being among the best in the European Union, social and geographical health inequities remain. Inequality in the distribution of health care professionals is a considerable barrier to equity. The rising cost of health care and the increasing demand for long-term care are also of concern. Reforms are ongoing to address these issues, while striving for equity in financial access; a long-term care reform including public coverage of long-term care is still pending. PMID:26766545

  13. Austria: health system review.

    PubMed

    Hofmarcher, Maria M; Quentin, Wilm

    2013-01-01

    This analysis of the Austrian health system reviews recent developments in organization and governance, health financing, health-care provision, health reforms and health-system performance. The Austrian health system provides universal coverage for a wide range of benefits and high-quality care. Free choice of providers and unrestricted access to all care levels (general practitioners, specialist physicians and hospitals) are characteristic features of the system. Unsurprisingly, population satisfaction is well above EU average. Income-related inequality in health has increased since 2005, although it is still relatively low compared to other countries. The health-care system has been shaped by both the federal structure of the state and a tradition of delegating responsibilities to self-governing stakeholders. On the one hand, this enables decentralized planning and governance, adjusted to local norms and preferences. On the other hand, it also leads to fragmentation of responsibilities and frequently results in inadequate coordination. For this reason, efforts have been made for several years to achieve more joint planning, governance and financing of the health-care system at the federal and regional level. As in any health system, a number of challenges remain. The costs of the health-care system are well above the EU15 average, both in absolute terms and as a percentage of GDP. There are important structural imbalances in healthcare provision, with an oversized hospital sector and insufficient resources available for ambulatory care and preventive medicine. This is coupled with stark regional differences in utilization, both in curative services (hospital beds and specialist physicians) and preventative services such as preventive health check-ups, outpatient rehabilitation, psychosocial and psychotherapeutic care and nursing. There are clear social inequalities in the use of medical services, such as preventive health check-ups, immunization or dentistry

  14. Military markets for solar thermal electric power systems

    NASA Technical Reports Server (NTRS)

    Hauger, J. S.

    1980-01-01

    The Department of Defense maintains an inventory of over 1,800 MW of engine-generators 15 KW and larger, with an estimated procurement rate of over 140 MW/year. Nearly the entire requirement could be met by advanced heat engines of the types being developed as point-focussing, distributed receiver power plants. A conceptual system consisting of a heat engine which efficiently burns liquid fossil or synthetic fuels, with a 'solarization kit' for conversion to hybrid solar operation could meet existing DOD requirements for new systems which are quieter, lighter, and multi-fueled. An estimated 24 percent (33 MW/year) or more could operationally benefit from the solar option. Baseline cost projections indicate levelized energy cost goals of 210 to 120 mills/KWh (15 to 1000 KW systems). Fuel cost escalation is the major factor affecting the value of the solar option. A baseline calculation for fuel at $0.59/gal in spring, 1979, escalating at 8 percent above general inflation indicates a value of $2700/KWe for a solarization kit.

  15. Israel: Health System Review.

    PubMed

    Rosen, Bruce; Waitzberg, Ruth; Merkur, Sherry

    2015-12-01

    Israel is a small country, with just over 8 million citizens and a modern market-based economy with a comparable level of gross domestic product per capita to the average in the European Union. It has had universal health coverage since the introduction of a progressively financed statutory health insurance system in 1995. All citizens can choose from among four competing, non-profit-making health plans, which are charged with providing a broad package of benefits stipulated by the government. Overall, the Israeli health care system is quite efficient. Health status levels are comparable to those of other developed countries, even though Israel spends a relatively low proportion of its gross domestic product on health care (less than 8%) and nearly 40% of that is privately financed. Factors contributing to system efficiency include regulated competition among the health plans, tight regulatory controls on the supply of hospital beds, accessible and professional primary care and a well-developed system of electronic health records. Israeli health care has also demonstrated a remarkable capacity to innovate, improve, establish goals, be tenacious and prioritize. Israel is in the midst of numerous health reform efforts. The health insurance benefits package has been extended to include mental health care and dental care for children. A multipronged effort is underway to reduce health inequalities. National projects have been launched to measure and improve the quality of hospital care and reduce surgical waiting times, along with greater public dissemination of comparative performance data. Major steps are also being taken to address projected shortages of physicians and nurses. One of the major challenges currently facing Israeli health care is the growing reliance on private financing, with potentially deleterious effects for equity and efficiency. Efforts are currently underway to expand public financing, improve the efficiency of the public system and constrain

  16. System requirements for head down and helmet mounted displays in the military avionics environment

    SciTech Connect

    Flynn, M.F.; Kalmanash, M.; Sethna, V.

    1996-12-31

    The introduction of flat panel display technologies into the military avionics cockpit is a challenging proposition, due to the very difficult system level requirements which must be met. These relate to environmental extremes (temperature and vibrational), sever ambient lighting conditions (10,000 fL to nighttime viewing), night vision system compatibility, and wide viewing angle. At the same time, the display system must be packaged in minimal space and use minimal power. The authors will present details on the display system requirements for both head down and helmet mounted systems, as well as information on how these challenges may be overcome.

  17. Access control within military C4ISR systems

    NASA Astrophysics Data System (ADS)

    Maschino, Mike

    2003-07-01

    Command, Control, Communications, Computers, Intelligence, Surveillance and Reconnaissance (C4ISR) tactical battlefield systems must provide the right information and resources to the right individuals at the right time. At the same time, the C4ISR system must enforce access controls to prevent the wrong individuals from obtaining sensitive information, or consuming scarce resources. Because lives, missions and property depend upon them, these access control mechanisms must be effective, reliable, efficient and flexible. The mechanisms employed must suit the nature of the items that are to be protected, as well as the varieties of access policies that must be enforced, and the types of access that will be made to these items. Some access control technologies are inherently centralized, while others are suitable for distributed implementation. The C4ISR architect must select from among the available technologies a combination of mechanisms that eases the burden of policy administration, but is inherently survivable, accurate, resource efficient, and which provides low latency. This paper explores various alternative access enforcement mechanisms, and assesses their effectiveness in managing policy-driven access control within the battlespace.

  18. Poland health system review.

    PubMed

    Sagan, Anna; Panteli, Dimitra; Borkowski, W; Dmowski, M; Domanski, F; Czyzewski, M; Gorynski, Pawel; Karpacka, Dorota; Kiersztyn, E; Kowalska, Iwona; Ksiezak, Malgorzata; Kuszewski, K; Lesniewska, A; Lipska, I; Maciag, R; Madowicz, Jaroslaw; Madra, Anna; Marek, M; Mokrzycka, A; Poznanski, Darius; Sobczak, Alicja; Sowada, Christoph; Swiderek, Maria; Terka, A; Trzeciak, Patrycja; Wiktorzak, Katarzyna; Wlodarczyk, Cezary; Wojtyniak, B; Wrzesniewska-Wal, Iwona; Zelwianska, Dobrawa; Busse, Reinhard

    2011-01-01

    Since the successful transition to a freely elected parliament and a market economy after 1989, Poland is now a stable democracy and is well represented within political and economic organizations in Europe and worldwide. The strongly centralized health system based on the Semashko model was replaced with a decentralized system of mandatory health insurance, complemented with financing from state and territorial self-government budgets. There is a clear separation of health care financing and provision: the National Health Fund (NFZ) the sole payer in the system is in charge of health care financing and contracts with public and non-public health care providers. The Ministry of Health is the key policy-maker and regulator in the system and is supported by a number of advisory bodies, some of them recently established. Health insurance contributions, borne entirely by employees, are collected by intermediary institutions and are pooled by the NFZ and distributed between the 16 regional NFZ branches. In 2009, Poland spent 7.4% of its gross domestic product (GDP) on health. Around 70% of health expenditure came from public sources and over 83.5% of this expenditure can be attributed to the (near) universal health insurance. The relatively high share of private expenditure is mostly represented by out-of-pocket (OOP) payments, mainly in the form of co-payments and informal payments. Voluntary health insurance (VHI) does not play an important role and is largely limited to medical subscription packages offered by employers. Compulsory health insurance covers 98% of the population and guarantees access to a broad range of health services. However, the limited financial resources of the NFZ mean that broad entitlements guaranteed on paper are not always available. Health care financing is overall at most proportional: while financing from health care contributions is proportional and budgetary subsidies to system funding are progressive, high OOP expenditures

  19. Italy: health system review.

    PubMed

    Ferre, Francesca; de Belvis, Antonio Giulio; Valerio, Luca; Longhi, Silvia; Lazzari, Agnese; Fattore, Giovanni; Ricciardi, Walter; Maresso, Anna

    2014-01-01

    Italy is the sixth largest country in Europe and has the second highest average life expectancy, reaching 79.4 years for men and 84.5 years for women in 2011. There are marked regional differences for both men and women in most health indicators, reflecting the economic and social imbalance between the north and south of the country. The main diseases affecting the population are circulatory diseases, malignant tumours and respiratory diseases. Italy's health care system is a regionally based national health service that provides universal coverage largely free of charge at the point of delivery. The main source of financing is national and regional taxes, supplemented by copayments for pharmaceuticals and outpatient care. In 2012, total health expenditure accounted for 9.2 percent of GDP (slightly below the EU average of 9.6 percent). Public sources made up 78.2 percent of total health care spending. While the central government provides a stewardship role, setting the fundamental principles and goals of the health system and determining the core benefit package of health services available to all citizens, the regions are responsible for organizing and delivering primary, secondary and tertiary health care services as well as preventive and health promotion services. Faced with the current economic constraints of having to contain or even reduce health expenditure, the largest challenge facing the health system is to achieve budgetary goals without reducing the provision of health services to patients. This is related to the other key challenge of ensuring equity across regions, where gaps in service provision and health system performance persist. Other issues include ensuring the quality of professionals managing facilities, promoting group practice and other integrated care organizational models in primary care, and ensuring that the concentration of organizational control by regions of health-care providers does not stifle innovation. PMID:25471543

  20. Use of composite materials, health monitoring and self-healing concepts to refurbish our civil and military infrastructure.

    SciTech Connect

    Roach, Dennis Patrick; Delong, Waylon Anthony; White, Scott; Yepez, Esteban; Rackow, Kirk A.; Reedy, Earl David, Jr.

    2007-09-01

    An unavoidable by-product of a metallic structure's use is the appearance of crack, corrosion, erosion and other flaws. Economic barriers to the replacement of these structures have created an aging civil and military infrastructure and placed even greater demands on efficient and safe repair and inspection methods. As a result of Homeland Security issues and these aging infrastructure concerns, increased attention has been focused on the rapid repair and preemptive reinforcement of structures such as buildings and bridges. This Laboratory Directed Research and Development (LDRD) program established the viability of using bonded composite patches to repair metallic structures. High modulus fiber-reinforced polymer (FRP) material may be used in lieu of mechanically fastened metallic patches or welds to reinforce or repair damaged structures. Their use produces a wide array of engineering and economic advantages. Current techniques for strengthening steel structures have several drawbacks including requiring heavy equipment for installation, poor fatigue performance, and the need for ongoing maintenance due to continued corrosion attack or crack growth. The use of bonded composite doublers has the potential to correct the difficulties associated with current repair techniques and the ability to be applied where there are currently no rehabilitation options. Applications include such diverse structures as: buildings, bridges, railroad cars, trucks and other heavy machinery, steel power and communication towers, pipelines, factories, mining equipment, ships, tanks and other military vehicles. This LDRD also proved the concept of a living infrastructure by developing custom sensors and self-healing chemistry and linking this technology with the application of advanced composite materials. Structural Health Monitoring (SHM) systems and mountable, miniature sensors were designed to continuously or periodically assess structural integrity. Such systems are able to detect

  1. Incidence of Salmonella infections among service members of the active and reserve components of the U.S. Armed Forces and among other beneficiaries of the Military Health System, 2000-2013.

    PubMed

    Clark, Leslie L; Daniele, Denise O; O'Donnell, Francis L

    2015-01-01

    This report reviews the incidence of cases of typhoidal and non-typhoidal Salmonella infections based on diagnoses recorded in healthcare records and reported through the Armed Forces reportable medical event (RME) system. During 2000-2013, there were 1,815 incident cases of non-typhoidal Salmonella and 456 incident cases of typhoidal Salmonella diagnosed in the active component force. The crude incidence rate for non-typhoidal Salmonella was 0.91 cases per 10,000 person years (p-yrs) and the rate for typhoidal Salmonella was 0.23 cases per 10,000 p-yrs. Among retirees and family members, children under 5 years of age and those aged 75 years or older comprised the greatest number of non-typhoidal Salmonella cases. Preventive measures for reducing the risk of infection with Salmonella are discussed. PMID:25646599

  2. Circumpolar Inuit health systems

    PubMed Central

    Ellsworth, Leanna; O'Keeffe, Annmaree

    2013-01-01

    Background The Inuit are an indigenous people totalling about 160,000 and living in 4 countries across the Arctic – Canada, Greenland, USA (Alaska) and Russia (Chukotka). In essence, they are one people living in 4 countries. Although there have been significant improvements in Inuit health and survival over the past 50 years, stark differences persist between the key health indicators for Inuit and those of the national populations in the United States, Canada and Russia and between Greenland and Denmark. On average, life expectancy in all 4 countries is lower for Inuit. Infant mortality rates are also markedly different with up to 3 times more infant deaths than the broader national average. Underlying these statistical differences are a range of health, social, economic and environmental factors which have affected Inuit health outcomes. Although the health challenges confronting the Inuit are in many cases similar across the Arctic, the responses to these challenges vary in accordance with the types of health systems in place in each of the 4 countries. Each of the 4 countries has a different health care system with varying degrees of accessibility and affordability for Inuit living in urban, rural and remote areas. Objective To describe funding and governance arrangements for health services to Inuit in Canada, Greenland, USA (Alaska) and Russia (Chukotka) and to determine if a particular national system leads to better outcomes than any of the other 3 systems. Study design Literature review. Results It was not possible to draw linkages between the different characteristics of the respective health systems, the corresponding financial investment and the systems’ effectiveness in adequately serving Inuit health needs for several reasons including the very limited and inadequate collection of Inuit-specific health data by Canada, Alaska and Russia; and second, the data that are available do not necessarily provide a feasible point of comparison in terms of

  3. Bulgaria health system review.

    PubMed

    Dimova, Antoniya; Rohova, Maria; Moutafova, Emanuela; Atanasova, Elka; Koeva, Stefka; Panteli, Dimitra; van Ginneken, Ewout

    2012-01-01

    In the last 20 years, demographic development in Bulgaria has been characterized by population decline, a low crude birth rate, a low fertility rate, a high mortality rate and an ageing population. A stabilizing political situation since the early 2000s and an economic upsurge since the mid-2000s were important factors in the slight increase of the birth and fertility rates and the slight decrease in standardized death rates. In general, Bulgaria lags behind European Union (EU) averages in most mortality and morbidity indicators. Life expectancy at birth reached 73.3 years in 2008 with the main three causes of death being diseases of the circulatory system, malignant neoplasms and diseases of the respiratory system. One of the most important risk factors overall is smoking, and the average standardized death rate for smoking-related causes in 2008 was twice as high as the EU15 average. The Bulgarian health system is characterized by limited statism. The Ministry of Health is responsible for national health policy and the overall organization and functioning of the health system and coordinates with all ministries with relevance to public health. The key players in the insurance system are the insured individuals, the health care providers and the third party payers, comprising the National Health Insurance Fund, the single payer in the social health insurance (SHI) system, and voluntary health insurance companies (VHICs). Health financing consists of a publicprivate mix. Health care is financed from compulsory health insurance contributions, taxes, outofpocket (OOP) payments, voluntary health insurance (VHI) premiums, corporate payments, donations, and external funding. Total health expenditure (THE) as a share of gross domestic product (GDP) increased from 5.3% in 1995 to 7.3% in 2008. At the latter date it consisted of 36.5% OOP payments, 34.8% SHI, 13.6% Ministry of Health expenditure, 9.4% municipality expenditure and 0.3% VHI. Informal payments in the health

  4. Switzerland: Health System Review.

    PubMed

    De Pietro, Carlo; Camenzind, Paul; Sturny, Isabelle; Crivelli, Luca; Edwards-Garavoglia, Suzanne; Spranger, Anne; Wittenbecher, Friedrich; Quentin, Wilm

    2015-01-01

    This analysis of the Swiss health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The Swiss health system is highly complex, combining aspects of managed competition and corporatism (the integration of interest groups in the policy process) in a decentralized regulatory framework shaped by the influences of direct democracy. The health system performs very well with regard to a broad range of indicators. Life expectancy in Switzerland (82.8 years) is the highest in Europe after Iceland, and healthy life expectancy is several years above the European Union (EU) average. Coverage is ensured through mandatory health insurance (MHI), with subsidies for people on low incomes. The system offers a high degree of choice and direct access to all levels of care with virtually no waiting times, though managed care type insurance plans that include gatekeeping restrictions are becoming increasingly important. Public satisfaction with the system is high and quality is generally viewed to be good or very good. Reforms since the year 2000 have improved the MHI system, changed the financing of hospitals, strengthened regulations in the area of pharmaceuticals and the control of epidemics, and harmonized regulation of human resources across the country. In addition, there has been a slow (and not always linear) process towards more centralization of national health policy-making. Nevertheless, a number of challenges remain. The costs of the health care system are well above the EU average, in particular in absolute terms but also as a percentage of gross domestic product (GDP) (11.5%). MHI premiums have increased more quickly than incomes since 2003. By European standards, the share of out-of-pocket payments is exceptionally high at 26% of total health expenditure (compared to the EU average of 16%). Low and middle-income households contribute a greater share of their income to

  5. Global tracking and inventory of military hardware via LEO satellite: A system approach and likely scenario

    NASA Technical Reports Server (NTRS)

    Bell, David; Estabrook, Polly; Romer, Richard

    1995-01-01

    A system for global inventory control of electronically tagged military hardware is achievable using a LEO satellite constellation. An equipment Tag can communicate directly to the satellite with a power of 5 watts or less at a data rate of 2400 to 50,000 bps. As examples, two proposed commercial LEO systems, IRIDIUM and ORBCOMM, are both capable of providing global coverage but with dramatically different telecom capacities. Investigation of these two LEO systems as applied to the Tag scenario provides insight into satellite design trade-offs, constellation trade-offs and signal dynamics that effect the performance of a satellite-based global inventory control system.

  6. Incidence of Campylobacter infections among service members of the active and reserve components of the U.S. Armed Forces and among other beneficiaries of the Military Health System, 2000-2013.

    PubMed

    2014-12-01

    This report reviews the incidence of illness due to Campylobacter bacteria based on diagnoses recorded in healthcare records and reported through the Armed Forces reportable medical event (RME) system. During 2000-2013, incident cases of Campylobacter infection were diagnosed in 1,393 active component service members, 188 members of the reserve component, and 3,891 retirees and family members. Among members of the active component, incidence rates tended to be higher among females, those aged 40 years or older, members of the Army and Air Force, and offi cers. Incidence rates declined from 2002 through 2007 but have risen steadily since, especially from 2010 through 2013. Among retirees and family members, the highest numbers of cases were diagnosed among those aged 5 years or younger and those aged 75 years or older. Cases identifi ed through RME reports (n=2,938) showed the highest numbers of cases in May-August, especially July, and that cases reported from Fort Shafter, HI, accounted for 20% of all cases. Measures and precautions important in preventing Campylobacter infections as well as other food- and waterborne infections are discussed. PMID:25555210

  7. Estonia: health system review.

    PubMed

    Lai, Taavi; Habicht, Triin; Kahur, Kristiina; Reinap, Marge; Kiivet, Raul; van Ginneken, Ewout

    2013-01-01

    This analysis of the Estonian health system reviews recent developments in organization and governance, health financing, health-care provision, health reforms and health system performance. Without doubt, the main issue has been the 2008 financial crisis. Although Estonia has managed the downturn quite successfully and overall satisfaction with the system remains high, it is hard to predict the longer-term effects of the austerity package. The latter included some cuts in benefits and prices, increased cost sharing for certain services, extended waiting times, and a reduction in specialized care. In terms of health outcomes, important progress was made in life expectancy, which is nearing the European Union (EU) average, and infant mortality. Improvements are necessary in smoking and alcohol consumption, which are linked to the majority of avoidable diseases. Although the health behaviour of the population is improving, large disparities between groups exist and obesity rates, particularly among young people, are increasing. In health care, the burden of out-of-pocket payments is still distributed towards vulnerable groups. Furthermore, the number of hospitals, hospital beds and average length of stay has decreased to the EU average level, yet bed occupancy rates are still below EU averages and efficiency advances could be made. Going forwards, a number of pre-crisis challenges remain. These include ensuring sustainability of health care financing, guaranteeing a sufficient level of human resources, prioritizing patient-centred health care, integrating health and social care services, implementing intersectoral action to promote healthy behaviour, safeguarding access to health care for lower socioeconomic groups, and, lastly, improving evaluation and monitoring tools across the health system. PMID:24334730

  8. Regional Health Information Systems

    PubMed Central

    Fuller, Sherrilynne

    1997-01-01

    Abstract In general, there is agreement that robust integrated information systems are the foundation for building successful regional health care delivery systems. Integrated Advanced Information Management System (IAIMS) institutions that, over the years, have developed strategies for creating cohesive institutional information systems and services are finding that IAIMS strategies work well in the even more complex regional environment. The key elements of IAIMS planning are described and lessons learned are discussed in the context of regional health information systems developed. The challenges of aligning the various information agencies and agendas in support of a regional health information system are complex ; however, the potential rewards for health care in quality, efficacy, and cost savings are enormous. PMID:9067887

  9. Application of a bi-modal PBR nuclear propulsion and power system to military missions

    NASA Astrophysics Data System (ADS)

    Venetoklis, Peter S.

    1995-01-01

    The rapid proliferation of arms technology and space access combined with current economic realities in the United States are creating ever greater demands for more capable space-based military assets. The paper illustrates that bi-modal nuclear propulsion and power based on the Particle Bed Reactor (PBR) is a high-leverage tehcnology that can maximize utility while minimizing cost. Mission benefits offered by the bi-modal PBR, including enhanced maneuverability, lifetime, survivability, payload power, and operational flexibility, are discussed. The ability to deliver desired payloads on smaller boosters is also illustrated. System descriptions and parameters for 10 kWe and 100 kWe power output levels are summarized. It is demonstrated via design exercise that bi-modal PBR dramtically enhances performance of a military satellite in geosynchronous orbit, increasing payload mass, payload power, and maneuverability.

  10. Use of complementary health approaches at military treatment facilities, active component, U.S. Armed Forces, 2010-2015.

    PubMed

    Williams, Valerie F; Clark, Leslie L; McNellis, Mark G

    2016-07-01

    Survey-based research has demonstrated the increasing use and acceptance of complementary and alternative medicine (CAM) in general and military populations. This report summarizes the use of three CAM procedures (chiropractic/osteopathic manipulation, acupuncture, and biofeedback) among active component service members from 2010 through 2015. Findings document a marked increase in the use of chiropractic/osteopathic manipulation and acupuncture procedures since 2010. The majority of the 240 military installations in this analysis provided chiropractic/osteopathic manipulation; more than three-quarters provided acupuncture; and approximately one-third provided biofeedback procedures. "Other and unspecified disorders of the back" was the most frequent condition for which chiropractic/osteopathic manipulation and acupuncture were used. "Non-allopathic lesions not elsewhere classified" was the second most frequent diagnosis during chiropractic/osteopathic manipulation-related visits. The second and third most frequent diagnoses during acupuncture-related visits were "acute and chronic pain" and "adjustment reaction," respectively. "Adjustment reaction" was the second most frequent diagnosis associated with biofeedback. Continued research is needed to gain a better understanding of why military personnel are using CAM and the role these procedures play in their health care. PMID:27501938

  11. Technical analysis of US Army Weapons Systems and related advanced technologies of military interest. Final report

    SciTech Connect

    1991-06-14

    This report summarizes the activities and accomplishments of an US Army technology security project designed to identify and develop effective policy guidelines for militarily critical technologies in specific Army systems and in broad generic technology areas of military interest, Individual systems analyses are documented in separate Weapons Systems Technical Assessments (WSTAs) and the general generic technology areas are evaluated in the Advanced Technology Assessment Reports (ATARs), However, specific details of these assessments are not addressed here, only recommendations regarding aspects of the defined approach, methodology, and format are provided and discussed.

  12. Romania: Health System Review.

    PubMed

    Vladescu, Cristian; Scintee, Silvia Gabriela; Olsavszky, Victor; Hernandez-Quevedo, Cristina; Sagan, Anna

    2016-08-01

    This analysis of the Romanian health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The Romanian health care system is a social health insurance system that has remained highly centralized despite recent efforts to decentralize some regulatory functions. It provides a comprehensive benefits package to the 85% of the population that is covered, with the remaining population having access to a minimum package of benefits. While every insured person has access to the same health care benefits regardless of their socioeconomic situation, there are inequities in access to health care across many dimensions, such as rural versus urban, and health outcomes also differ across these dimensions. The Romanian population has seen increasing life expectancy and declining mortality rates but both remain among the worst in the European Union. Some unfavourable trends have been observed, including increasing numbers of new HIV/AIDS diagnoses and falling immunization rates. Public sources account for over 80% of total health financing. However, that leaves considerable out-of-pocket payments covering almost a fifth of total expenditure. The share of informal payments also seems to be substantial, but precise figures are unknown. In 2014, Romania had the lowest health expenditure as a share of gross domestic product (GDP) among the EU Member States. In line with the government's objective of strengthening the role of primary care, the total number of hospital beds has been decreasing. However, health care provision remains characterized by underprovision of primary and community care and inappropriate use of inpatient and specialized outpatient care, including care in hospital emergency departments. The numbers of physicians and nurses are relatively low in Romania compared to EU averages. This has mainly been attributed to the high rates of workers emigrating abroad over the

  13. Denmark health system review.

    PubMed

    Olejaz, Maria; Juul Nielsen, Annegrete; Rudkjøbing, Andreas; Okkels Birk, Hans; Krasnik, Allan; Hernández-Quevedo, Cristina

    2012-01-01

    Denmark has a tradition of a decentralized health system. However, during recent years, reforms and policy initiatives have gradually centralized the health system in different ways. The structural reform of 2007 merged the old counties into fewer bigger regions, and the old municipalities likewise. The hospital structure is undergoing similar reforms, with fewer, bigger and more specialized hospitals. Furthermore, a more centralized approach to planning and regulation has been taking place over recent years. This is evident in the new national planning of medical specialties as well as the establishment of a nationwide accreditation system, the Danish Healthcare Quality Programme, which sets national standards for health system providers in Denmark. Efforts have also been made to ensure coherent patient pathways - at the moment for cancer and heart disease - that are similar nationwide. These efforts also aim at improving intersectoral cooperation. Financially, recent years have seen the introduction of a higher degree of activity-based financing in the public health sector, combined with the traditional global budgeting.A number of challenges remain in the Danish health care system. The consequences of the recent reforms and centralization initiatives are yet to be fully evaluated. Before this happens, a full overview of what future reforms should target is not possible. Denmark continues to lag behind the other Nordic countries in regards to some health indicators, such as life expectancy. A number of risk factors may be the cause of this: alcohol intake and obesity continue to be problems, whereas smoking habits are improving. The level of socioeconomic inequalities in health also continues to be a challenge. The organization of the Danish health care system will have to take a number of challenges into account in the future. These include changes in disease patterns, with an ageing population with chronic and long-term diseases; ensuring sufficient staffing

  14. Hungary health system review.

    PubMed

    Gaal, Peter; Szigeti, Szabolcs; Csere, Marton; Gaskins, Matthew; Panteli, Dimitra

    2011-01-01

    Hungary has achieved a successful transition from an overly centralized, integrated Semashko-style health care system to a purchaser provider split model with output-based payment methods. Although there have been substantial increases in life expectancy in recent years among both men and women, many health outcomes remain poor, placing Hungary among the countries with the worst health status and highest rate of avoidable mortality in the EU (life expectancy at birth trailed the EU27 average by 5.1 years in 2009). Lifestyle factors especially the traditionally unhealthy Hungarian diet, alcohol consumption and smoking play a very important role in shaping the overall health of the population.In the single-payer system, the recurrent expenditure on health services is funded primarily through compulsory, non-risk-related contributions made by eligible individuals or from the state budget. The central government has almost exclusive power to formulate strategic direction and to issue and enforce regulations regarding health care. In 2009 Hungary spent 7.4% of its gross domestic product (GDP) on health, with public expenditure accounting for 69.7% of total health spending, and with health expenditure per capita ranking slightly above the average for the new EU Member States, but considerably below the average for the EU27 in 2008. Health spending has been unstable over the years, with several waves of increases followed by longer periods of cost-containment and budget cuts. The share of total health expenditure attributable to private sources has been increasing, most of it accounted for by out-of-pocket (OOP) expenses. A substantial share of the latter can be attributed to informal payments, which are a deeply rooted characteristic of the Hungarian health system and a source of inefficiency and inequity. Voluntary health insurance, on the other hand, amounted to only 7.4% of private and 2.7% of total health expenditure in 2009. Revenue sources for health have been

  15. Early Childhood Military Education?

    ERIC Educational Resources Information Center

    Pelo, Ann

    2011-01-01

    Does the country's national security rely on top-quality early childhood education? Yes, say the military leaders of Mission: Readiness, an organization led by retired military commanders that promotes investment in education, child health, and parenting support. Actually, the generals are right, but for all the wrong reasons. The generals' aim is…

  16. Netherlands: Health System Review.

    PubMed

    Kroneman, Madelon; Boerma, Wienke; van den Berg, Michael; Groenewegen, Peter; de Jong, Judith; van Ginneken, Ewout

    2016-03-01

    This analysis of the Dutch health system reviews recent developments in organization and governance, health financing, healthcare provision, health reforms and health system performance. Without doubt, two major reforms implemented since the mid-2000s are among the main issues today. The newly implemented long-term care reform will have to realize a transition from publicly provided care to more self-reliance on the part of the citizens and a larger role for municipalities in its organization. A particular point of attention is how the new governance arrangements and responsibilities in long-term care will work together. The 2006 reform replaced the division between public and private insurance by one universal social health insurance and introduced managed competition as a driving mechanism in the healthcare system. Although the reform was initiated almost a decade ago, its stepwise implementation continues to bring changes in the healthcare system in general and in the role of actors in particular. In terms of performance, essential healthcare services are within easy reach and waiting times have been decreasing. The basic health insurance package and compensations for lower incomes protect citizens against catastrophic spending. Out-of-pocket payments are low from an international perspective. Moreover, the Dutch rate the quality of the health system and their health as good. International comparisons show that the Netherlands has low antibiotic use, a low number of avoidable hospitalizations and a relatively low avoidable mortality. National studies show that healthcare has made major contributions to the health of the Dutch population as reflected in increasing life expectancy. Furthermore, some indicators such as the prescription of generics and length of stay reveal improvements in efficiency over the past years. Nevertheless, the Netherlands still has one of the highest per capita health expenditures in Europe, although growth has slowed considerably after

  17. Turkey. Health system review.

    PubMed

    Tatar, Mehtap; Mollahaliloğlu, Salih; Sahin, Bayram; Aydin, Sabahattin; Maresso, Anna; Hernández-Quevedo, Cristina

    2011-01-01

    Turkey has accomplished remarkable improvements in terms of health status in the last three decades, particularly after the implementation of the Health Transformation Program (HTP (Saglikta Donus, um Programi)). Average life expectancy reached 71.8 for men and 76.8 for women in 2010. The infant mortality rate (IMR) decreased to 10.1 per 1000 live births in 2010, down from 117.5 in 1980. Despite these achievements, there are still discrepancies in terms of infant mortality between rural and urban areas and different parts of the country, although these have been diminishing over the years. The higher infant mortality rates in rural areas can be attributed to low socioeconomic conditions, low female education levels and the prevalence of infectious diseases. The main causes of death are diseases of the circulatory system followed by malignant neoplasms. Turkeys health care system has been undergoing a far-reaching reform process (HTP) since 2003 and radical changes have occurred both in the provision and the financing of health care services. Health services are now financed through a social security scheme covering the majority of the population, the General Health Insurance Scheme (GHIS (Genel Saglik Sigortasi)), and services are provided both by public and private sector facilities. The Social Security Institution (SSI (Sosyal Guvenlik Kurumu)), financed through payments by employers and employees and government contributions in cases of budget deficit, has become a monopsonic (single buyer) power on the purchasing side of health care services. On the provision side, the Ministry of Health (Saglik Bakenligi) is the main actor and provides primary, secondary and tertiary care through its facilities across the country. Universities are also major providers of tertiary care. The private sector has increased its range over recent years, particularly after arrangements paved the way for private sector provision of services to the SSI. The most important reforms since

  18. Long-term health effects of Vietnam-era military service: A quasi-experiment using Australian conscription lotteries.

    PubMed

    Johnston, David W; Shields, Michael A; Siminski, Peter

    2016-01-01

    This paper estimates the long-term health effects of Vietnam-era military service using Australia's National conscription lotteries for identification. Our primary contribution is the quality and breadth of our health outcomes. We use several administrative sources, containing a near-universe of records on mortality (1994-2011), cancer diagnoses (1982-2008), and emergency hospital presentations (2005-2010). We also analyse a range of self-reported morbidity indicators (2006-2009). We find no significant long-term effects on mortality, cancer or emergency hospital visits. In contrast, we find significant detrimental effects on a number of morbidity measures. Hearing and mental health appear to be particularly affected. PMID:26705967

  19. Strengthening health systems by health sector reforms

    PubMed Central

    Senkubuge, Flavia; Modisenyane, Moeketsi; Bishaw, Tewabech

    2014-01-01

    Background The rising burden of disease and weak health systems are being compounded by the persistent economic downturn, re-emerging diseases, and violent conflicts. There is a growing recognition that the global health agenda needs to shift from an emphasis on disease-specific approaches to strengthening of health systems, including dealing with social, environmental, and economic determinants through multisectoral responses. Methods A review and analysis of data on strengthening health sector reform and health systems was conducted. Attention was paid to the goal of health and interactions between health sector reforms and the functions of health systems. Further, we explored how these interactions contribute toward delivery of health services, equity, financial protection, and improved health. Findings Health sector reforms cannot be developed from a single global or regional policy formula. Any reform will depend on the country's history, values and culture, and the population's expectations. Some of the emerging ingredients that need to be explored are infusion of a health systems agenda; development of a comprehensive policy package for health sector reforms; improving alignment of planning and coordination; use of reliable data; engaging ‘street level’ policy implementers; strengthening governance and leadership; and allowing a holistic and developmental approach to reforms. Conclusions The process of reform needs a fundamental rather than merely an incremental and evolutionary change. Without radical structural and systemic changes, existing governance structures and management systems will continue to fail to address the existing health problems. PMID:24560261

  20. Building a better warbot: ethical issues in the design of unmanned systems for military applications.

    PubMed

    Sparrow, Robert

    2009-06-01

    Unmanned systems in military applications will often play a role in determining the success or failure of combat missions and thus in determining who lives and dies in times of war. Designers of UMS must therefore consider ethical, as well as operational, requirements and limits when developing UMS. I group the ethical issues involved in UMS design under two broad headings, Building Safe Systems and Designing for the Law of Armed Conflict, and identify and discuss a number of issues under each of these headings. As well as identifying issues, I offer some analysis of their implications and how they might be addressed. PMID:19048395

  1. Personal values in soldiers after military deployment: associations with mental health and resilience

    PubMed Central

    Zimmermann, Peter; Firnkes, Susanne; Kowalski, Jens T.; Backus, Johannes; Siegel, Stefan; Willmund, Gerd; Maercker, Andreas

    2014-01-01

    Background After military deployment, soldiers are at an increased risk of developing posttraumatic psychiatric disorders. The correlation of personal values with symptoms, however, has not yet been examined within a military context. Method Schwartz’s Portrait Values Questionnaire (PVQ), the Posttraumatic Stress Diagnostic Scale (PDS), and the 11-item version of the Resilience Scale (RS-11) were completed by 117 soldiers of the German Armed Forces who had recently been deployed to Afghanistan (n=40 undergoing initial psychiatric treatment, n=77 untreated). Results Logistic regression showed that the value types of hedonism (−), power (−), tradition (+), and universalism (+) were significantly correlated with the probability and severity of PTSD and whether the participant was in treatment or not. The effects were partially mediated by the RS-11 scale values. Conclusions Value types seem to be associated with psychiatric symptoms in soldiers after deployment. These results could contribute to the further development of therapeutic approaches. PMID:24808938

  2. Belarus: health system review.

    PubMed

    Richardson, Erica; Malakhova, Irina; Novik, Irina; Famenka, Andrei

    2013-01-01

    This analysis of the Belarusian health system reviews the developments in organization and governance, health financing, healthcare provision, health reforms and health system performance since 2008. Despite considerable change since independence, Belarus retains a commitment to the principle of universal access to health care, provided free at the point of use through predominantly state-owned facilities, organized hierarchically on a territorial basis. Incremental change, rather than radical reform, has also been the hallmark of health-care policy, although capitation funding has been introduced in some areas and there have been consistent efforts to strengthen the role of primary care. Issues of high costs in the hospital sector and of weaknesses in public health demonstrate the necessity of moving forward with the reform programme. The focus for future reform is on strengthening preventive services and improving the quality and efficiency of specialist services. The key challenges in achieving this involve reducing excess hospital capacity, strengthening health-care management, use of evidence-based treatment and diagnostic procedures, and the development of more efficient financing mechanisms. Involving all stakeholders in the development of further reform planning and achieving consensus among them will be key to its success. PMID:24334702

  3. Sweden health system review.

    PubMed

    Anell, Anders; Glenngård, Anna H; Merkur, Sherry

    2012-01-01

    Life expectancy in Sweden is high and the country performs well in comparisons related to disease-oriented indicators of health service outcomes and quality of care. The Swedish health system is committed to ensuring the health of all citizens and abides by the principles of human dignity, need and solidarity, and cost-effectiveness. The state is responsible for overall health policy, while the funding and provision of services lies largely with the county councils and regions. The municipalities are responsible for the care of older and disabled people. The majority of primary care centres and almost all hospitals are owned by the county councils. Health care expenditure is mainly tax funded (80%) and is equivalent to 9.9% of gross domestic product (GDP) (2009). Only about 4% of the population has voluntary health insurance (VHI). User charges fund about 17% of health expenditure and are levied on visits to professionals, hospitalization and medicines. The number of acute care hospital beds is below the European Union (EU) average and Sweden allocates more human resources to the health sector than most OECD countries. In the past, the Achilles heel of Swedish health care included long waiting times for diagnosis and treatment and, more recently, divergence in quality of care between regions and socioeconomic groups. Addressing long waiting times remains a key policy objective along with improving access to providers. Recent principal health reforms over the past decade relate to: concentrating hospital services; regionalizing health care services, including mergers; improving coordinated care; increasing choice, competition and privatization in primary care; privatization and competition in the pharmacy sector; changing co-payments; and increasing attention to public comparison of quality and efficiency indicators, the value of investments in health care and responsiveness to patients needs. Reforms are often introduced on the local level, thus the pattern of

  4. The health-care system: an assessment and reform agenda.

    PubMed

    Mataria, Awad; Khatib, Rana; Donaldson, Cam; Bossert, Thomas; Hunter, David J; Alsayed, Fahed; Moatti, Jean-Paul

    2009-04-01

    Attempts to establish a health plan for the occupied Palestinian territory were made before the 1993 Oslo Accords. However, the first official national health plan was published in 1994 and aimed to regulate the health sector and integrate the activities of the four main health-care providers: the Palestinian Ministry of Health, Palestinian non-governmental organisations, the UN Relief and Works Agency, and a cautiously developing private sector. However, a decade and a half later, attempts to create an effective, efficient, and equitable system remain unsuccessful. This failure results from arrangements for health care established by the Israeli military government between 1967 and 1994, the nature of the Palestinian National Authority, which has little authority in practice and has been burdened by inefficiency, cronyism, corruption, and the inappropriate priorities repeatedly set to satisfy the preferences of foreign aid donors. Although similar problems exist elsewhere, in the occupied Palestinian territory they are exacerbated and perpetuated under conditions of military occupation. Developmental approaches integrated with responses to emergencies should be advanced to create a more effective, efficient, and equitable health system, but this process would be difficult under military occupation. PMID:19268349

  5. System health monitoring

    SciTech Connect

    Reneke, J.A.; Fryer, M.O.

    1995-08-01

    Well designed large systems include many instrument taking data. These data are used in a variety of ways. They are used to control the system and its components, to monitor system and component health, and often for historical or financial purposes. This paper discusses a new method of using data from low level instrumentation to monitor system and component health. The method uses the covariance of instrument outputs to calculate a measure of system change. The method involves no complicated modeling since it is not a parameter estimation algorithm. The method is iterative and can be implemented on a computer in real time. Examples are presented for a metal lathe and a high efficiency particulate air (HEPA) filter. It is shown that the proposed method is quite sensitive to system changes such as wear out and failure. The method is useful for low level system diagnostics and fault detection.

  6. Military Service, Exposure to Trauma, and Health in Older Adulthood: An Analysis of Northern Vietnamese Survivors of the Vietnam War

    PubMed Central

    Teerawichitchainan, Bussarawan

    2014-01-01

    Objectives. We sought to better understand the association between early life exposure to war and trauma and older adult health status in a developing setting. Methods. We analyzed data of 405 Vietnamese men and women in 1 northern Vietnam commune who entered early adulthood during the Vietnam War and who are now entering late adulthood (i.e., ages 55 years and older in 2010). Results. The toll of war’s trauma in the aging northern Vietnamese population was perceptible in the association between exposure to war trauma and various measures of physical health, including negative self-reported health and somatic symptoms. Killing another person and being exposed to toxic substances in warfare was especially detrimental to health in older adulthood. War traumas were likely implicated more strongly as determinants of late adulthood health in men than in women. The weak association between trauma exposure and reported depressive symptoms raised questions about measuring mental health. Conclusions. Military service and war trauma were important determinants of older adult health beyond the US context, given the widespread waging of war and concentration of recent armed conflicts within developing societies. PMID:24922129

  7. The combined influence of hardiness and cohesion on mental health in a military peacekeeping mission: A prospective study.

    PubMed

    Thomassen, Ådne G; Hystad, Sigurd W; Johnsen, Bjørn Helge; Johnsen, Grethe E; Laberg, Jon C; Eid, Jarle

    2015-10-01

    A large number of studies have shown that hardiness and cohesion are associated with mental health in a military context. However, most of them are presented without controlling for baseline mental health symptoms, which is their most significant source of error. The present study investigates the combined effect of hardiness and cohesion in a prospective design, controlling for baseline levels of symptoms among Norwegian personnel serving in a peacekeeping operation in Kosovo. Multivariate regression analyses were performed in which self-reported mental health complaints were regressed on our explanatory variables. Our findings suggest that both cohesion and hardiness contributed to increased stress resiliency, as measured by a lower level of reported mental health complaints. Our baseline measure of mental health accounted for a larger proportion of the variance than our other predictors. A significant interaction between cohesion and hardiness suggested a combined effect, over and above the individual contributions of the predictors. For individuals who scored high on hardiness, cohesion levels did not influence levels of mental health complaints. Individuals who scored low on hardiness, on the other hand, reported lower levels of mental health complaints when cohesion levels were high. PMID:26079844

  8. [Military telemedicine: a network of networks].

    PubMed

    Menu, Jean-Pierre; Comtet, Gérald; Di Giusto, Vincent; Colomb, François; de Saint-Julien, Jacques

    2006-02-01

    Military telemedicine is a form of collaborative medicine based on the use of communication and information networks. It is more a network of networks than of independent systems. It comprises electronic medical files, epidemiological networks, and surgical and medical databases. Each system must be able to communicate with the others, thereby enabling the development of remote consultation, expertise and assistance. This requires networking between the army, the navy, and the air force communication networks, especially during special operations conducted abroad. We must also develop interoperability with systems in other countries, and with the French civilian health service. This means respecting the general rules governing these networks. The military health network is unique, in that it focuses on battlefield injuries. In addition, the French military health service operates under a single headquarters, governing nurses, paramedics and physicians. PMID:17001864

  9. Greece: Health system review.

    PubMed

    Economou, Charalambos

    2010-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. The health status of the Greek population has strongly improved over the last few decades and seems to compare relatively favourably with other OECD and European Union (EU) countries. The health system is a mixture of public integrated, public contract and public reimbursement models, comprising elements from both the public and private sectors and incorporating principles of different organizational patterns. Access to services is based on citizenship as well as on occupational status.The system is financed by the state budget, social insurance contributions and private payments.The largest share of health expenditure constitutes private expenditure, mainly in the form of out of pocket payments which is also the element contributing most to the overall increase in health expenditure. The delivery of health care services is based on both public and private providers. The presence of private providers is more obvious in primary care,especially in diagnostic technologies, private physicians' practices and pharmaceuticals. Despite success in improving the health of the population, the Greek health care system faces serious structural problems concerning the organization, financing and delivery of services. It suffers from the absence of cost-containment measures and defined criteria for funding, resulting in sickness funds experiencing economic constraints and budget deficits. The high percentage of private expenditure goes against the principle of fair

  10. Help-Seeking Behaviors Among Active-Duty Military Personnel: Utilization of Chaplains and Other Mental Health Service Providers.

    PubMed

    Morgan, Jessica Kelley; Hourani, Laurel; Lane, Marian E; Tueller, Stephen

    2016-01-01

    Military chaplains not only conduct religious services, but also provide counseling and spiritual support to military service members, operating as liaisons between soldiers and mental health professionals. In this study, active-duty soldiers (N = 889) reported help-seeking behaviors and mental health. Using logistic regressions, we describe the issues for which soldiers reported seeking help, then outline the characteristics of those who are most likely to seek help from a chaplain. Of the soldiers who sought help from a chaplain within the previous year, 29.9% reported high levels of combat exposure, 50.8% screened positive for depression, 39.1% had probable PTSD, and 26.6% screened positive for generalized anxiety disorder. The participant's unit firing on the enemy, personally firing on the enemy, and seeing dead bodies or human remains predicted seeing a chaplain. Future research should examine ways to engage soldiers who have had more combat experiences with the chaplain community to address spiritual issues. PMID:27191375

  11. Help-Seeking Behaviors Among Active-Duty Military Personnel: Utilization of Chaplains and Other Mental Health Service Providers

    PubMed Central

    Morgan, Jessica Kelley; Hourani, Laurel; Lane, Marian E.; Tueller, Stephen

    2016-01-01

    Military chaplains not only conduct religious services, but also provide counseling and spiritual support to military service members, operating as liaisons between soldiers and mental health professionals. In this study, active-duty soldiers (N = 889) reported help-seeking behaviors and mental health. Using logistic regressions, we describe the issues for which soldiers reported seeking help, then outline the characteristics of those who are most likely to seek help from a chaplain. Of the soldiers who sought help from a chaplain within the previous year, 29.9% reported high levels of combat exposure, 50.8% screened positive for depression, 39.1% had probable PTSD, and 26.6% screened positive for generalized anxiety disorder. The participant’s unit firing on the enemy, personally firing on the enemy, and seeing dead bodies or human remains predicted seeing a chaplain. Future research should examine ways to engage soldiers who have had more combat experiences with the chaplain community to address spiritual issues. PMID:27191375

  12. Development of a portable therapeutic and high intensity ultrasound system for military, medical, and research use.

    PubMed

    Lewis, George K; Olbricht, William L

    2008-11-01

    We have developed a portable high power ultrasound system with a very low output impedance amplifier circuit (less than 0.3 Omega) that can transfer more than 90% of the energy from a battery supply to the ultrasound transducer. The system can deliver therapeutic acoustical energy waves at lower voltages than those in conventional ultrasound systems because energy losses owing to a mismatched impedance are eliminated. The system can produce acoustic power outputs over the therapeutic range (greater then 50 W) from a PZT-4, 1.54 MHz, and 0.75 in diameter piezoelectric ceramic. It is lightweight, portable, and powered by a rechargeable battery. The portable therapeutic ultrasound unit has the potential to replace "plug-in" medical systems and rf amplifiers used in research. The system is capable of field service on its internal battery, making it especially useful for military, ambulatory, and remote medical applications. PMID:19045903

  13. Development of a portable therapeutic and high intensity ultrasound system for military, medical, and research use

    PubMed Central

    Lewis, George K.; Olbricht, William L.

    2008-01-01

    We have developed a portable high power ultrasound system with a very low output impedance amplifier circuit (less than 0.3 Ω) that can transfer more than 90% of the energy from a battery supply to the ultrasound transducer. The system can deliver therapeutic acoustical energy waves at lower voltages than those in conventional ultrasound systems because energy losses owing to a mismatched impedance are eliminated. The system can produce acoustic power outputs over the therapeutic range (greater then 50 W) from a PZT-4, 1.54 MHz, and 0.75 in diameter piezoelectric ceramic. It is lightweight, portable, and powered by a rechargeable battery. The portable therapeutic ultrasound unit has the potential to replace “plug-in” medical systems and rf amplifiers used in research. The system is capable of field service on its internal battery, making it especially useful for military, ambulatory, and remote medical applications. PMID:19045903

  14. [Health system of Vietnam].

    PubMed

    Matsuda, S

    1994-01-01

    Vietnam's health system consists of four levels: national, provincial/special city, prefecture/ward, and basic unit of town or village. Health care is managed by the Health Department at the national level and by the health and welfare section of the People's Committee at all other levels. Actual medical services are provided by the National Central Hospital at the national level, by general hospitals at the provincial/special city level, by general hospitals and multi-purpose health clinics at the prefecture/ward level, and by health stations at the basic unit level. Health services provide not only doctors, nurses, and pharmacists, but also paramedical staff, especially at the basic unit level. Just as with other developing countries, infectious diseases are the most important priorities in health/medical care policies; especially malaria, which is the number one priority followed by diarrhea. Because of well-established health stations at the basic unit level throughout the country and a relatively sufficient supply of medication, the mortality rate due to the above is low. The maternal/infant health care index of 1988 shows the following: low birth weight (14%); maternal mortality (1.4/1000); neonatal mortality (33.5/1000); and perinatal mortality (22.5/1000). Malnutrition of children under 3 years of age in farming areas, insufficient supply of drinking water, and lack of industrial health insurance are some of the problems yet to be solved. It is hoped that medical services can be a significant part of the comprehensive economic development program within the framework of Japan's international cooperation/assistance. PMID:8111100

  15. Norway: health system review.

    PubMed

    Ringard, Ånen; Sagan, Anna; Sperre Saunes, Ingrid; Lindahl, Anne Karin

    2013-01-01

    Norways five million inhabitants are spread over nearly four hundred thousand square kilometres, making it one of the most sparsely populated countries in Europe. It has enjoyed several decades of high growth, following the start of oil production in early 1970s, and is now one of the richest countries per head in the world. Overall, Norways population enjoys good health status; life expectancy of 81.53 years is above the EU average of 80.14, and the gap between overall life expectancy and healthy life years is around half the of EU average. The health care system is semi decentralized. The responsibility for specialist care lies with the state (administered by four Regional Health Authorities) and the municipalities are responsible for primary care. Although health care expenditure is only 9.4% of Norways GDP (placing it on the 16th place in the WHO European region), given Norways very high value of GDP per capita, its health expenditure per head is higher than in most countries. Public sources account for over 85% of total health expenditure; the majority of private health financing comes from households out-of-pocket payments.The number of practitioners in most health personnel groups, including physicians and nurses, has been increasing in the last few decades and the number of health care personnel per 100 000 inhabitants is high compared to other EU countries. However, long waiting times for elective care continue to be a problem and are cause of dissatisfaction among the patients. The focus of health care reforms has seen shifts over the past four decades. During the 1970s the focus was on equality and increasing geographical access to health care services; during the 1980s reforms aimed at achieving cost containment and decentralizing health care services; during the 1990s the focus was on efficiency. Since the beginning of the millennium the emphasis has been given to structural changes in the delivery and organization of health care and to policies

  16. Sexual Trauma in Military May Lead to Homelessness

    MedlinePlus

    ... Services, or federal policy. More Health News on: Veterans and Military Health Recent Health News Related MedlinePlus Health Topics Homeless Health Concerns Sexual Assault Veterans and Military Health About MedlinePlus Site Map FAQs Contact Us Get ...

  17. M-Health: Emerging Mobile Health Systems

    NASA Astrophysics Data System (ADS)

    Istepanian, Robert; Laxminarayan, Swamy; Pattichis, Constantinos S.

    M-health can be defined as the "emerging mobile communications and network technologies for healthcare systems.' This book paves the path toward understanding the future of m-health technologies and services and also introducing the impact of mobility on existing e-health and commercial telemedical systems. M-Health: Emerging Mobile Health Systems presents a new and forward-looking source of information that explores the present and future trends in the applications of current and emerging wireless communication and network technologies for different healthcare scenaria.

  18. Dishwashing water recycling system and related water quality standards for military use.

    PubMed

    Church, Jared; Verbyla, Matthew E; Lee, Woo Hyoung; Randall, Andrew A; Amundsen, Ted J; Zastrow, Dustin J

    2015-10-01

    As the demand for reliable and safe water supplies increases, both water quality and available quantity are being challenged by population growth and climate change. Greywater reuse is becoming a common practice worldwide; however, in remote locations of limited water supply, such as those encountered in military installations, it is desirable to expand its classification to include dishwashing water to maximize the conservation of fresh water. Given that no standards for dishwashing greywater reuse by the military are currently available, the current study determined a specific set of water quality standards for dishwater recycling systems for U.S. military field operations. A tentative water reuse standard for dishwashing water was developed based on federal and state regulations and guidelines for non-potable water, and the developed standard was cross-evaluated by monitoring water quality data from a full-scale dishwashing water recycling system using an innovative electrocoagulation and ultrafiltration process. Quantitative microbial risk assessment (QMRA) was also performed based on exposure scenarios derived from literature data. As a result, a specific set of dishwashing water reuse standards for field analysis (simple, but accurate) was finalized as follows: turbidity (<1 NTU), Escherichia coli (<50 cfu mL(-1)), and pH (6-9). UV254 was recommended as a surrogate for organic contaminants (e.g., BOD5), but requires further calibration steps for validation. The developed specific water standard is the first for dishwashing water reuse and will be expected to ensure that water quality is safe for field operations, but not so stringent that design complexity, cost, and operational and maintenance requirements will not be feasible for field use. In addition the parameters can be monitored using simple equipment in a field setting with only modest training requirements and real-time or rapid sample turn-around. This standard may prove useful in future development

  19. Uzbekistan: health system review.

    PubMed

    Ahmedov, Mohir; Azimov, Ravshan; Mutalova, Zulkhumor; Huseynov, Shahin; Tsoyi, Elena; Rechel, Bernd

    2014-01-01

    Uzbekistan is a central Asian country that became independent in 1991 with the break-up of the Soviet Union. Since then, it has embarked on several major health reforms covering health care provision, governance and financing, with the aim of improving efficiency while ensuring equitable access. Primary care in rural areas has been changed to a two-tiered system, while specialized polyclinics in urban areas are being transformed into general polyclinics covering all groups of the urban population. Secondary care is financed on the basis of past expenditure and inputs (and increasingly self-financing through user fees), while financing of primary care is increasingly based on capitation. There are also efforts to improve allocative efficiency, with a slowly increasing share of resources devoted to the reformed primary health care system. Health care provision has largely remained in public ownership but nearly half of total health care expenditure comes from private sources, mostly in the form of out-of-pocket expenditure. There is a basic benefits package, which includes primary care, emergency care and care for certain disease and population categories. Yet secondary care and outpatient pharmaceuticals are not included in the benefits package for most of the population, and the reliance on private health expenditure results in inequities and catastrophic expenditure for households. While the share of public expenditure is slowly increasing, financial protection thus remains an area of concern. Quality of care is another area that is receiving increasing attention. PMID:25689490

  20. Design of Instantaneous High Power Supply System with power distribution management for portable military devices

    NASA Astrophysics Data System (ADS)

    Kwak, Kiho; Kwak, Dongmin; Yoon, Joohong

    2015-08-01

    A design of an Instantaneous High Power Supply System (IHPSS) with a power distribution management (PDM) for portable military devices is newly addressed. The system includes a power board and a hybrid battery that can not only supply instantaneous high power but also maintain stable operation at critical low temperature (-30 °C). The power leakage and battery overcharge are effectively prevented by the optimal PDM. The performance of the proposed system under the required pulse loads and the operating conditions of a Korean Advanced Combat Rifle employed in the battlefield is modeled with simulations and verified experimentally. The system with the IHPSS charged the fuse setter with 1.7 times higher voltage (8.6 V) than the one without (5.4 V) under the pulse discharging rate (1 A at 0.5 duty, 1 ms) for 500 ms.

  1. Wearable Health Monitoring Systems

    NASA Technical Reports Server (NTRS)

    Bell, John

    2015-01-01

    The shrinking size and weight of electronic circuitry has given rise to a new generation of smart clothing that enables biological data to be measured and transmitted. As the variation in the number and type of deployable devices and sensors increases, technology must allow their seamless integration so they can be electrically powered, operated, and recharged over a digital pathway. Nyx Illuminated Clothing Company has developed a lightweight health monitoring system that integrates medical sensors, electrodes, electrical connections, circuits, and a power supply into a single wearable assembly. The system is comfortable, bendable in three dimensions, durable, waterproof, and washable. The innovation will allow astronaut health monitoring in a variety of real-time scenarios, with data stored in digital memory for later use in a medical database. Potential commercial uses are numerous, as the technology enables medical personnel to noninvasively monitor patient vital signs in a multitude of health care settings and applications.

  2. Report of the Defense Science Board task force on military system applications of superconductors

    NASA Astrophysics Data System (ADS)

    1988-10-01

    The Task Force found a number of superconductivity applications that could result in significant new military capabilities, including electronics and high power applications. In particular, superconducting materials could enable significant military improvements in: Magnetic Field Sensors with greatly increased sensitivity for improved detection and identification capability; Passive Microwave and Millimeter-wave Components enabling increased detection range and discrimination in clutter; Staring Infrared Focal Plane Array sensors incorporating superconducting electronics permitting significant range and sensitivity increases over current scanning IR sensors; Wideband Analog and Ultra-Fast Digital Signal Processing for radar and optical sensors; High Power Motors and Generators for ship and aircraft propulsion leading to: decreased displacement; drive system flexibility; increased range; or longer endurance on station; Magnets/Energy Storage for high power microwave, millimeter-wave or optical generators (e.g., free electron laser); capability for powering quiet propulsion systems; Electro-Magnetic Launchers capable of launching hypervelocity projectiles for antiarmor weapons and close-in ship defense weapons; and Magnetohydrodynamic (MHD) Propulsion enabling ultra quiet drives for submarines, torpedoes, and surface ships.

  3. [Perceptions of nursing service managers in the South African Military Health Service on their level of motivation].

    PubMed

    Fischer, A; Muller, M

    2000-12-01

    The process of transformation in the South African Military Health Services, has influenced the nursing service managers' level of motivation and the following research question is applicable: what are the perceptions of the nursing service managers within the South African Military Health Services on their level of motivation? The purpose with this study was to explore and describe the perceptions of nursing service managers on their level of motivation within these health services. A qualitative research design was utilized and four focus group interviews were conducted with 33 nursing service managers country wide. The transcribed interviews were exposed to a content analysis. The results confirm that the level of motivation amongst these nursing service managers is low. The demotivators relate mainly to the following: inadequate acknowledgement, job insecurity in relation to the future, problems with the process of integration, transformation and rationalization, problems with management, many labour related issues, poor/inadequate communication, inadequate support, increased work load, poor physical environment, negative publicity and poor self motivation. Although there were a few motivators identified, they were of less importance. These results were interpreted within Herzberg's motivation theory to identify the hygiene/maintenance factors and to assess whether the important motivators were in place. During any process of change, and/or when the level of motivation amongst employees is low, it is important to adequately manage the environment (hygiene/maintenance factors within the Herzberg theory). But it is even more important to ensure that the motivators are in place or to intensify them. It is therefore recommended that a motivation strategy, based on the Herzberg theory as well as the Hackman-Oldham job enrichment model, be developed, implemented and evaluated. PMID:11949294

  4. Canada: Health system review.

    PubMed

    Marchildon, Gregory

    2013-01-01

    Canada is a high-income country with a population of 33 million people. Its economic performance has been solid despite the recession that began in 2008. Life expectancy in Canada continues to rise and is high compared with most OECD countries; however, infant and maternal mortality rates tend to be worse than in countries such as Australia, France and Sweden. About 70% of total health expenditure comes from the general tax revenues of the federal, provincial and territorial governments. Most public revenues for health are used to provide universal medicare (medically necessary hospital and physician services that are free at the point of service for residents) and to subsidise the costs of outpatient prescription drugs and long-term care. Health care costs continue to grow at a faster rate than the economy and government revenue, largely driven by spending on prescription drugs. In the last five years, however, growth rates in pharmaceutical spending have been matched by hospital spending and overtaken by physician spending, mainly due to increased provider remuneration. The governance, organization and delivery of health services is highly decentralized, with the provinces and territories responsible for administering medicare and planning health services. In the last ten years there have been no major pan-Canadian health reform initiatives but individual provinces and territories have focused on reorganizing or fine tuning their regional health systems and improving the quality, timeliness and patient experience of primary, acute and chronic care. The medicare system has been effective in providing Canadians with financial protection against hospital and physician costs. However, the narrow scope of services covered under medicare has produced important gaps in coverage and equitable access may be a challenge in these areas. PMID:23628429

  5. Use of non-petroleum fuels to reduce military energy vulnerabilities: self-sufficient bases and new weapon propulsion systems

    SciTech Connect

    Freiwald, D.A.

    1980-01-01

    The US fossil synfuels program may not have significant impact on domestic fuel supplies until near the year 2000, resulting in a continuing mobility fuels vulnerability for the US military until then. But there are other mobility fuel options for both propulsion systems and stationary base-energy sources, for which the base technology is commercially available or at least demonstrated. For example, for surface propulsion systems, hydrogen-fuel-cell/battery-electric hybrids may be considered; for weapons systems these may offer some new flexibilities, standardization possibilities, and multiple military-controlled fuel-supply options. Hydrogen-fueled aircraft may provide interesting longer-term possibilities in terms of military energy self-sufficiency and multiple supply options, as well as performance specifications. These scenarios will be discussed, along with possibilities for demonstrations in the MX-system ground vehicles.

  6. Modeling and simulation for small system integration of military and homeland security applications

    NASA Astrophysics Data System (ADS)

    Bennahmias, Mark; Esterkin, Vladimir; Lee, Kang; Koziol, Richard; Kostrzewski, Andrew; Savant, Gajendra; Jannson, Tomasz

    2007-04-01

    A highly productive approach to small systems design and integration (SSDI), and modeling and simulation (M&S), based on rapid/interactive prototyping has been effectively used at Physical Optics Corporation (POC) to support small system development of "intellectual products" that cover a broad range of electromagnetic spectra (X-ray, optical, infrared, and microwave). In particular, the implementation of an accelerated interactive modeling (AIM) environment produces effective engineering solutions for tackling difficult and complex technical issues for combining 3D mechanical design and microwave engineering. In addition, using established small systems engineering principles and the effective use of collaborative input at the start of a development effort that incorporates a diverse range of areas like optics, mechanics, electronics, software, thermal modeling, electromagnetism, surface chemistry, and manufacturing plays an important role in the success of future military and homeland security applications.

  7. The Role of Natural Support Systems in the Post-deployment Adjustment of Active Duty Military Personnel.

    PubMed

    Welsh, Janet A; Olson, Jonathan; Perkins, Daniel F; Travis, Wendy J; Ormsby, LaJuana

    2015-09-01

    This study examined the relations among three different types of naturally occurring social support (from romantic partners, friends and neighbors, and unit leaders) and three indices of service member well-being (self reports of depressive symptoms, satisfaction with military life, and perceptions of unit readiness) for service members who did and did not report negative experiences associated with military deployment. Data were drawn from the 2011 Community Assessment completed anonymously by more than 63,000 USAF personnel. Regression analyses revealed that higher levels of social support was associated with better outcomes regardless of negative deployment experiences. Evidence of moderation was also noted, with all forms of social support moderating the impact of negative deployment experiences on depressive symptoms and support from unit leaders moderating the impact of negative deployment experience on satisfaction with military life. No moderation was found for perceptions of unit readiness. Subgroup analyses revealed slightly different patterns for male and female service members, with support providing fewer moderation effects for women. These findings may have value for military leaders and mental health professionals working to harness the power of naturally occurring relationships to maximize the positive adjustment of service members and their families. Implications for practices related to re-integration of post-deployment military personnel are discussed. PMID:26148977

  8. Croatia: health system review.

    PubMed

    Džakula, Aleksandar; Sagan, Anna; Pavić, Nika; Lonćčarek, Karmen; Sekelj-Kauzlarić, Katarina

    2014-01-01

    Croatia is a small central European country on the Balkan peninsula, with a population of approximately 4.3 million and a gross domestic product (GDP) of 62% of the European Union (EU) average (expressed in purchasing power parity; PPP) in 2012. On 1 July 2013, Croatia became the 28th Member State of the EU. Life expectancy at birth has been increasing steadily in Croatia (with a small decline in the years following the 1991 to 1995 War of Independence) but is still lower than the EU average. Prevalence of overweight and obesity in the population has increased during recent years and trends in physical inactivity are alarming. The Croatian Health Insurance Fund (CHIF), established in 1993, is the sole insurer in the mandatory health insurance (MHI) system that provides universal health coverage to the whole population. The ownership of secondary health care facilities is distributed between the State and the counties. The financial position of public hospitals is weak and recent reforms were aimed at improving this. The introduction of concessions in 2009 (public private partnerships whereby county governments organize tenders for the provision of specific primary health care services) allowed the counties to play a more active role in the organization, coordination and management of primary health care; most primary care practices have been privatized. The proportion of GDP spent on health by the Croatian government remains relatively low compared to western Europe, as does the per capita health expenditure. Although the share of public expenditure as a proportion of total health expenditure (THE) has been decreasing, at around 82% it is still relatively high, even by European standards. The main source of the CHIFs revenue is compulsory health insurance contributions, accounting for 76% of the total revenues of the CHIF, although only about a third of the population (active workers) is liable to pay full health care contributions. Although the breadth and scope

  9. Effectiveness of virtual reality exposure therapy for active duty soldiers in a military mental health clinic.

    PubMed

    Reger, Greg M; Holloway, Kevin M; Candy, Colette; Rothbaum, Barbara O; Difede, JoAnn; Rizzo, Albert A; Gahm, Gregory A

    2011-02-01

    Exposure therapy is an evidence-based treatment for posttraumatic stress disorder (PTSD), but research evaluating its effectiveness with active duty service members is limited. This report examines the effectiveness of virtual reality exposure therapy (VRE) for active duty soldiers (N = 24) seeking treatment following a deployment to Iraq or Afghanistan. Relative to their pretreatment self-reported symptoms on the PTSD Checklist, Military Version (M = 60.92; SD = 11.03), patients reported a significant reduction at posttreatment (M = 47.08; SD = 12.70; p < .001). Sixty-two percent of patients (n = 15) reported a reliable change of 11 points or more. This study supports the effectiveness of exposure therapy for active duty soldiers and extends previous research on VRE to this population. PMID:21294166

  10. Inductive System Health Monitoring

    NASA Technical Reports Server (NTRS)

    Iverson, David L.

    2004-01-01

    The Inductive Monitoring System (IMS) software was developed to provide a technique to automatically produce health monitoring knowledge bases for systems that are either difficult to model (simulate) with a computer or which require computer models that are too complex to use for real time monitoring. IMS uses nominal data sets collected either directly from the system or from simulations to build a knowledge base that can be used to detect anomalous behavior in the system. Machine learning and data mining techniques are used to characterize typical system behavior by extracting general classes of nominal data from archived data sets. IMS is able to monitor the system by comparing real time operational data with these classes. We present a description of learning and monitoring method used by IMS and summarize some recent IMS results.