A Proposed Conceptual Model of Military Medical Readiness

DTIC Science & Technology

2007-05-01

critical role in complex military operations in which Medical Readiness 22 technological and information demands necessitate a multi-operator environment...Analysis 33 Coding 34 Data Collection 35 Medical Readiness 6 Boundaries 36 Researcher’s Role and Approach 37 Literature Review 37 The Military Health...Within the external environment, strategic shifts, technological advancements, and changing demographics affect how the Military Health System delivers

76 FR 70483 - Gettysburg National Military Park Advisory Commission

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-14

... DEPARTMENT OF THE INTERIOR National Park Service [4400-SZM] Gettysburg National Military Park... notice sets forth the dates of April 19, 2012 and September 6, 2012 of the Gettysburg National Military... Gettysburg National Military Park Museum and Visitor Center, 1195 Baltimore Pike, Gettysburg, Pennsylvania...

Military and VA general dentistry training: a national resource.

PubMed

Atchison, Kathryn A; Bachand, William; Buchanan, C Richard; Lefever, Karen H; Lin, Sylvia; Engelhardt, Rita

2002-06-01

In 1999, HRSA contracted with the UCLA School of Dentistry to evaluate the postgraduate general dentistry (PDG) training programs. The purpose of this article is to compare the program characteristics of the PGD training programs sponsored by the Armed Services (military) and VA. Surveys mailed to sixty-six VA and forty-two military program directors in fall 2000 sought information regarding the infrastructure of the program, the program emphasis, resident preparation prior to entering the program, and a description of patients served and types of services provided. Of the eighty-one returned surveys (75 percent response rate), thirty were received from military program directors and fifty-one were received from VA program directors. AEGDs reported treating a higher proportion of children patients and GPRs more medically intensive, disadvantaged and HIV/AIDS patients. Over half of the directors reported increases in curriculum emphasis in implantology. The program directors reported a high level of inadequate preparation among incoming dental residents. Having a higher ratio of residents to total number of faculty predicted inadequate preparation (p=.022) although the model was weak. Although HRSA doesn't financially support federally sponsored programs, their goal of improved dental training to care for medically compromised individuals is facilitated through these programs, thus making military and VA general dentistry programs a national resource.

[Problems of military medical examination of military servicemen suffering from chronic obstructive pulmonary disease].

PubMed

Chapliuk, A L; Brovkin, S G; Kal'manov, A S; Bulavin, V V

2015-02-01

The authors showed that at the present time military much more servicemen, suffering from obstructive pulmonary disease, may receive medical examination in outpatient conditions. Series of researches allow us to perform a medical examination on an outpatient basis. The calculation of the cost-effectiveness of health services to such patients during a military medical examination in the hospital and clinics was made. Savings during the examination in the clinic for 1 patient was 2829 rubbles.

Transferability of Military-Trained Medical Personnel to the Civilian Sector.

ERIC Educational Resources Information Center

Nathan (Robert R.) Associates, Inc., Washington, DC.

This study addresses itself to the problem of what should be done to increase the civilian medical/health field utilization of men who have received medical training and experience while in military service. It was found that military men were influenced in their decision for or against a civilian health career by: military service branch, length…

Medical civil-military operations: the deployed medical brigade's role in counterinsurgency operations.

PubMed

Bryan, Jeffrey; Miyamoto, Danelle; Holman, Vincent

2008-01-01

Medical civil-military operations are a critical combat multiplier directly supporting the counterinsurgency fight. Army Medical Department Soldiers support medical civil affairs activities at all levels from platoon to the United States Mission-Iraq (Department of State) initiatives enhancing the legitimacy of medical services in the Iraq Ministry of Health, Ministry of Defense, Ministry of the Interior, and Ministry of Justice. The civil-military operations mission of the deployed Task Force 62 Medical Brigade has also evolved into a broad mission encompassing over 120 contractors including Iraqi-American, Bilingual Bicultural Advisors-Subject Matter Experts serving as case management liaison officers and medical trainers, as well as Iraqi Advisor Task Force members providing medical atmospherics, assessments, training, and the overall management of Iraqi linguists supporting all level III medical facilities.

Improving Surgical Complications and Patient Safety at the Nation's Largest Military Hospital: An Analysis of National Surgical Quality Improvement Program Data.

PubMed

Maturo, Steve; Hughes, Charlotte; Kallingal, George; Silvey, Stephen; Johnson, A J; Soderdahl, Douglas; Renz, Evan; Brennan, Joseph

2017-03-01

The U.S. Military Health System cares for over 9 million patients and encompasses 63 hospitals and 413 clinics worldwide. Military medicine balances the simultaneous tasks of caring for those patients wounded in military engagements, treating large numbers of families of service men and women, and training the next generation of health care providers and ancillary staff. Similar to civilian health care delivery in the United States, military medicine has also seen increased scrutiny in the areas of cost and quality. In 2014, the U.S. military medical health care system was criticized for higher than average surgical complication rates and concerns regarding patient safety, quality of care, lack of transparency, and compartmentalized leadership. The San Antonio Military Medical Center was specifically cited as having "a perennial problem with surgical infection control…the infection rate of surgical wounds was 77% higher than expected given the mix of cases, according to a Pentagon-ordered comparison with civilian hospitals." To determine the scope of complication rates, data from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) were analyzed. The goal of this article is to describe the NSQIP surgical outcome data for the U.S. Military's largest medical center from 2009 to 2014 and compare national averages in the areas of mortality, morbidity, cardiac occurrences, pneumonia, unplanned intubation, ventilator use greater than 48 hours, infections, readmissions, and return to operating room. Retrospective data analysis of NSQIP data from 2009 to 2014 at the San Antonio Military Medical Center, a level I trauma center for military members and eligible dependents along with civilian trauma patients. Observed event rates were compared with expected event rates for each year with the 2-tail Fisher's exact test to determine if rates were significantly different from each other. Cochran-Armitage Trend Test was performed to compare

32 CFR Appendix C to Part 57 - Procedures for the Provision of Related Services by the Military Medical Departments to DoDDS...

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 1 2012-07-01 2012-07-01 false Procedures for the Provision of Related Services by the Military Medical Departments to DoDDS Students on IEPs C Appendix C to Part 57 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN...

32 CFR Appendix C to Part 57 - Procedures for the Provision of Related Services by the Military Medical Departments to DoDDS...

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 1 2013-07-01 2013-07-01 false Procedures for the Provision of Related Services by the Military Medical Departments to DoDDS Students on IEPs C Appendix C to Part 57 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN...

32 CFR Appendix C to Part 57 - Procedures for the Provision of Related Services by the Military Medical Departments to DoDDS...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 1 2011-07-01 2011-07-01 false Procedures for the Provision of Related Services by the Military Medical Departments to DoDDS Students on IEPs C Appendix C to Part 57 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN...

32 CFR Appendix C to Part 57 - Procedures for the Provision of Related Services by the Military Medical Departments to DoDDS...

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 1 2014-07-01 2014-07-01 false Procedures for the Provision of Related Services by the Military Medical Departments to DoDDS Students on IEPs C Appendix C to Part 57 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN...

32 CFR Appendix C to Part 57 - Procedures for the Provision of Related Services by the Military Medical Departments to DoDDS...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 1 2010-07-01 2010-07-01 false Procedures for the Provision of Related Services by the Military Medical Departments to DoDDS Students on IEPs C Appendix C to Part 57 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN...

Limits of Military Power for National Security.

ERIC Educational Resources Information Center

Melman, Seymour

1981-01-01

Reviews the post World War II nuclear-military arms race and claims that it is possible to define significant limits of military power for national security. Topics discussed include public opinion regarding the arms race, constraints on military power, conventional forces, checkmating conventional strategy, and the seriousness of nuclear false…

Joint Task Force National Capital Region Medical: Integration of Education, Training, and Research

DTIC Science & Technology

2009-05-01

Defense established the Joint Task Force National Capital Region Medical (JTF CapMed ) on the National Naval Medical Center campus in Bethesda, Maryland in...transfor- mation of military health services in the National Capital Area including education, training, and research activities. JTF CAPMED ...BACKGROUND JTF CapMed was established to lead the integration of mili- tary health care in the National Capital Region. The Command is charged with overseeing

[Iconography of N.I.Pirogov in "Military-medical magazine"].

PubMed

Poddubnyĭ, M V

2010-11-01

The portraits of Pirogov on the covers of the "Military medical magazine" for the period 1944-2010 were analyzed. During this period, we can count at least 11 different covers of "Military medical magazine" and 10 variants of Pirogov's portrait on it. We have no documents about the causes of changing scenes. Obviously, the initiative emanated from the publisher.

38 CFR 17.94 - Outpatient medical services for military retirees and other beneficiaries.

Code of Federal Regulations, 2011 CFR

2011-07-01

... pensioners of nations allied with the United States in World War I and World War II when duly authorized. [32... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Outpatient medical services for military retirees and other beneficiaries. 17.94 Section 17.94 Pensions, Bonuses, and Veterans...

38 CFR 17.94 - Outpatient medical services for military retirees and other beneficiaries.

Code of Federal Regulations, 2014 CFR

2014-07-01

... pensioners of nations allied with the United States in World War I and World War II when duly authorized. [32... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Outpatient medical services for military retirees and other beneficiaries. 17.94 Section 17.94 Pensions, Bonuses, and Veterans...

38 CFR 17.94 - Outpatient medical services for military retirees and other beneficiaries.

Code of Federal Regulations, 2013 CFR

2013-07-01

... pensioners of nations allied with the United States in World War I and World War II when duly authorized. [32... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Outpatient medical services for military retirees and other beneficiaries. 17.94 Section 17.94 Pensions, Bonuses, and Veterans...

38 CFR 17.94 - Outpatient medical services for military retirees and other beneficiaries.

Code of Federal Regulations, 2012 CFR

2012-07-01

... pensioners of nations allied with the United States in World War I and World War II when duly authorized. [32... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Outpatient medical services for military retirees and other beneficiaries. 17.94 Section 17.94 Pensions, Bonuses, and Veterans...

38 CFR 17.94 - Outpatient medical services for military retirees and other beneficiaries.

Code of Federal Regulations, 2010 CFR

2010-07-01

... pensioners of nations allied with the United States in World War I and World War II when duly authorized. [32... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Outpatient medical services for military retirees and other beneficiaries. 17.94 Section 17.94 Pensions, Bonuses, and Veterans...

Observational study of associations between visual imagery and measures of depression, anxiety and post-traumatic stress among active-duty military service members with traumatic brain injury at the Walter Reed National Military Medical Center.

PubMed

Kaimal, Girija; Walker, Melissa S; Herres, Joanna; French, Louis M; DeGraba, Thomas J

2018-06-11

The study aimed tocompare recurring themes in the artistic expression of military service members (SMs) with post-traumatic stress disorder (PTSD), traumatic brain injury and psychological health (PH) conditions with measurable psychiatric diagnoses. Affective symptoms and struggles related to verbally expressing information can limit communication in individuals with symptoms of PTSD and deployment-related health conditions. Visual self-expression through art therapy is an alternative way for SMs with PTSD and other PH conditions to communicate their lived experiences. This study offers the first systematic examination of the associations between visual self-expression and standardised clinical self-report measures. Observational study of correlations between clinical symptoms of post-traumatic stress, depression and anxiety and visual themes in mask imagery. The National Intrepid Center of Excellence at the Walter Reed National Military Medical Center, Bethesda, Maryland, USA. Active-duty military SMs (n=370) with a history of traumatic brain injury, post-traumatic stress symptoms and related PH conditions. The masks used for analysis were created by the SMs during art therapy sessions in week 1 of a 4-week integrative treatment programme. Associations between scores on the PTSD Checklist-Military, Patient Health Questionnaire-9 and Generalized Anxiety Disorder 7-item scale on visual themes in depictions of aspects of individual identity (psychological injury, military symbols, military identity and visual metaphors). Visual and clinical data comparisons indicate that SMs who depicted psychological injury had higher scores for post-traumatic stress and depression. The depiction of military unit identity, nature metaphors, sociocultural metaphors, and cultural and historical characters was associated with lower post-traumatic stress, depression and anxiety scores. Colour-related symbolism and fragmented military symbols were associated with higher anxiety

Military Medical Care: Questions and Answers

DTIC Science & Technology

2013-07-24

services through either Department of Defense (DOD) medical facilities, known as “military treatment facilities” or “MTFs” as space is available, or...Chiefs of Staff, CAE /PEO =Component Acquisition Executive/Program Executive Officer, DHA OGC = Defense Health Agency Office of General Counsel, NCR...funding for all fixed medical treatment facilities/activities, including such costs as real property maintenance, environmental compliance, minor

An examination of the role of military medical chief information officer.

PubMed

Mellott, Mark; Thatcher, Jason; Roberts, Nicholas; Carter, Michelle

2012-07-01

Although research has described the roles, responsibilities, and skills of effective chief information officers (CIOs) in for-profit organizations, little is known regarding the traits and skills that characterize effective military medical CIOs. This study identifies skills a military medical CIO needs to act as a technology strategist who can successfully identify information technology (IT) innovations and convert those innovations into organizational health IT solutions. We assessed the level of necessary informational, decisional, and interpersonal skills in a cross-sectional survey of 48 military medical CIOs. We also compared military medical CIO characteristics to general CIO characteristics. Our results show that both decisional and interpersonal skills are strongly related to informational skills necessary to convert innovations into organizational IT solutions. Further, decisional skills are strongly related to a CIO's ability to act as a technology strategist. Our study provides implications for research and practice.

78 FR 14589 - Gettysburg National Military Park Advisory Commission Meetings (FY2013)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-06

...] Gettysburg National Military Park Advisory Commission Meetings (FY2013) AGENCY: National Park Service... upcoming meetings for the Gettysburg National Military Park Advisory Commission. DATES: The meetings are... Military Park, Ford Education Center, 1195 Baltimore Pike, Gettysburg, Pennsylvania 17325. Call (717) 334...

The cost of pursuing a medical career in the military: a tale of five specialties.

PubMed

Cronin, William A; Morgan, Jessica A; Weeks, William B

2010-08-01

The physician payment system is a focus of potential reform in the United States. The authors explored the effects of the military's method of physician payment on physicians' returns on educational investment for several specialties. This retrospective, observational study used national data from 2003 and standard financial techniques to calculate the net present value-the current value of an expected stream of cash flows at a particular rate of interest-of the educational investments of medical students in ten 30-year career paths: either military or civilian careers in internal medicine, psychiatry, gastroenterology, general surgery, or orthopedics. At a 5% discount rate, in the civilian world, the lowest return on an educational investment accrued to psychiatrists ($1.136 million) and the highest to orthopedists ($2.489 million), a range of $1.354 million. In the military, the lowest returns accrued to internists ($1.377 million) and the highest to orthopedists ($1.604 million); however, the range was only $0.227 million, one-sixth that found in the civilian sector. The authors also found that most military physicians do not remain in the military for their full careers. Choosing a military career substantially decreases the net present value of an educational investment for interventionalists, but it does so only modestly for primary care physicians. Further, a military career path markedly diminishes specialty-specific variation in the net present values of educational investment. Adopting a military structure for engaging medical students might help reverse the current trend of declining interest in primary care.

Relationship between anxiety and medical disorders among compulsory military service candidates between the years 1998-2013.

PubMed

Shelef, Leah; Dotan, Shron; Kaminsky, Dan; Kedem, Ron; Margulis, Alexander; Hassidim, Ayal

2016-10-30

One of the most common psychiatric diagnoses among adolescents is anxiety disorder. Many of the anxiety symptoms are expressed physiologically, and therefore can mimic other medical conditions. The aim of this study was to examine the association between anxiety disorders and other medical conditions sharing common symptoms with anxiety (MDSCSA: Irritable Bowel Syndrome, asthma, migraine and hyperhidrosis). The study was based on the national database of the candidates for military service in Israel. Data for the years 1998-2013 was retrieved to create the study dataset. The final cohort population was comprised of 1,229,461 military service candidates. Anxiety prevalence and its association with other medical conditions sharing the same symptoms was examined in the cohort. The results showed significant statistical association between anxiety and IBS, asthma, migraine and hyperhidrosis. These findings support the fact that there is a clear association between anxiety disorder and the examined medical conditions. Moreover, in the military setting, the primary care physician has an important role in giving a correct diagnosis for soldiers presenting with symptoms that can be regarded both to anxiety and to other physical illnesses. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Roles for international military medical services in stability operations (security sector reform).

PubMed

Bricknell, M C M; Thompson, D

2007-06-01

This is the second in a series of three papers that examine the role of international military medical services in stability operations in unstable countries. The paper discusses security sector reform in general terms and highlights the interdependency of the armed forces, police, judiciary and penal systems in creating a 'secure environment'. The paper then looks at components of a local military medical system for a counter-insurgency campaign operating on interior lines and the contribution and challenges faced by the international military medical community in supporting the development of this system. Finally the paper highlights the importance of planning the medical support of the international military personnel who will be supporting wider aspects of security sector reform. The paper is based on background research and my personal experience as Medical Director in the Headquarters of the NATO International Stability Assistance Force in Afghanistan in 2006.

Breaching confidentiality to protect the public: evolving standards of medical confidentiality for military detainees.

PubMed

Wynia, Matthew K

2007-08-01

Confidentiality is a core value in medicine and public health yet, like other core values, it is not absolute. Medical ethics has typically allowed for breaches of confidentiality when there is a credible threat of significant harm to an identifiable third party. Medical ethics has been less explicit in spelling out criteria for allowing breaches of confidentiality to protect populations, instead tending to defer these decisions to the law. But recently, issues in military detention settings have raised the profile of decisions to breach medical confidentiality in efforts to protect the broader population. National and international ethics documents say little about the confidentiality of detainee medical records. But initial decisions to use detainee medical records to help craft coercive interrogations led to widespread condemnation, and might have contributed to detainee health problems, such as a large number of suicide attempts several of which have been successful. More recent military guidance seems to reflect lessons learned from these problems and does more to protect detainee records. For the public health system, this experience is a reminder of the importance of confidentiality in creating trustworthy, and effective, means to protect the public's health.

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…

Military medical modeling and simulation in the 21st century.

PubMed

Moses, G; Magee, J H; Bauer, J J; Leitch, R

2001-01-01

As we enter the 21st century, military medicine struggles with critical issues. One of the most important issues is how to train medical personnel in peace for the realities of war. In April, 1998, The General Accounting Office (GAO) reported, "Military medical personnel have almost no chance during peacetime to practice battlefield trauma care skills. As a result, physicians both within and outside the Department of Defense (DOD) believe that military medical personnel are not prepared to provide trauma care to the severely injured soldiers in wartime. With some of today's training methods disappearing, the challenge of providing both initial; and sustainment training for almost 100,000 military medical personnel is becoming insurmountable. The "training gap" is huge and impediments to training are mounting. For example, restrictions on animal use are increasing and the cost of conducting live mass casualty exercises is prohibitive. Many medical simulation visionaries believe that four categories of medical simulation are emerging to address these challenges. These categories include PC-based multimedia, digital mannequins, virtual workbenches, and total immersion virtual reality (TIVR). The use of simulation training can provide a risk = free realistic learning environment for the spectrum of medical skills training, from buddy-aid to trauma surgery procedures. This will, in turn, enhance limited hands on training opportunities and revolutionize the way we train in peace to deliver medicine in war. High-fidelity modeling will permit manufacturers to prototype new devices before manufacture. Also, engineers will be able to test a device for themselves in a variety of simulated anatomical representations, permitting them to "practice medicine".

Quality assurance in military medical research and medical radiation accident management.

PubMed

Hotz, Mark E; Meineke, Viktor

2012-08-01

The provision of quality radiation-related medical diagnostic and therapeutic treatments cannot occur without the presence of robust quality assurance and standardization programs. Medical laboratory services are essential in patient treatment and must be able to meet the needs of all patients and the clinical personnel responsible for the medical care of these patients. Clinical personnel involved in patient care must embody the quality assurance process in daily work to ensure program sustainability. In conformance with the German Federal Government's concept for modern departmental research, the international standard ISO 9001, one of the relevant standards of the International Organization for Standardization (ISO), is applied in quality assurance in military medical research. By its holistic approach, this internationally accepted standard provides an excellent basis for establishing a modern quality management system in line with international standards. Furthermore, this standard can serve as a sound basis for the further development of an already established quality management system when additional standards shall apply, as for instance in reference laboratories or medical laboratories. Besides quality assurance, a military medical facility must manage additional risk events in the context of early recognition/detection of health risks of military personnel on deployment in order to be able to take appropriate preventive and protective measures; for instance, with medical radiation accident management. The international standard ISO 31000:2009 can serve as a guideline for establishing risk management. Clear organizational structures and defined work processes are required when individual laboratory units seek accreditation according to specific laboratory standards. Furthermore, international efforts to develop health laboratory standards must be reinforced that support sustainable quality assurance, as in the exchange and comparison of test results within

The Importance of Military Cultural Competence.

PubMed

Meyer, Eric G; Writer, Brian W; Brim, William

2016-03-01

Military cultural competence has recently gained national attention. Experts have posited that limited outcomes in the treatment of posttraumatic stress disorder and depression in the military may be related to limited familiarity with the military. National surveys have indicated low military cultural competence among providers and limited educational efforts on military culture or pertinent military pathology in medical schools and residency training programs. Military families, with their own unique military cultural identity, have been identified as a population with increased risks associated with deployment. In response to these findings, several curricula regarding military culture have been established and widely distributed. Assessments of military cultural competence have also been developed. The clinical impact of enhanced cultural competence in general has thus far been limited. The military, however, with its highly prescribed cultural identity, may be a model culture for further study.

Postdeployment military mental health training: cross-national evaluations.

PubMed

Foran, Heather M; Garber, Bryan G; Zamorski, Mark A; Wray, Mariane; Mulligan, Kathleen; Greenberg, Neil; Castro, Carl Andrew; Adler, Amy B

2013-05-01

Deployments increase risk for adjustment problems in service members. To mitigate this increased risk, mental health training programs have been developed and implemented in several nations. As part of a coordinated effort, three nations adapted a U.S. mental health training program that had been validated by a series of group randomized trials demonstrating improvement in postdeployment adjustment. Implementation of evidence-based programs in a new context is challenging: How much of the original program needs to remain intact in order to retain its utility? User satisfaction rates can provide essential data to assess how well a program is accepted. This article summarizes service member ratings of postdeployment mental health training and compares ratings from service members across four nations. The participating nations (Canada, New Zealand, United Kingdom, and the United States) administered mental health training to active duty military personnel in their respective nations. Following the training, military personnel completed an evaluation of the training. Overall, across the four nations, more than 70% of military personnel agreed or strongly agreed that they were satisfied with the mental health training. Although some differences in evaluations were observed across nations, components of training that were most important to overall satisfaction with the training were strikingly similar across nations. Fundamentally, it appears feasible that despite cultural and organizational differences, a mental health training program developed in one nation can be successfully adapted for use in other nations. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Satisfaction among soldiers with secondary medical services within military and civilian clinical settings.

PubMed

Goldberg, Avishay; Pliskin, Joseph S; Peterburg, Yitzhak

2002-08-01

The medical services system of the Israel Defense Forces (IDF) is founded on a principle that by definition considers it the military's role to maintain the health of its personnel in uniform. The 1994 Compulsory Health Insurance Law, Section 55 addresses health services for soldiers, stating that a soldier is entitled to health services from the Medical Corps of the IDF or an agent operating on its behalf. In the implementation of its responsibilities, the IDF Medical Corps operates an array of medical services, including secondary care. This study deals with the scope of utilization of secondary medical services by IDF personnel visiting military medical clinics and civilian hospital outpatient clinics: their character, the subjective health status of the respondents, and their degree of satisfaction with medical services. The results indicate that most of those seeking medical treatment at military and civilian clinics are not chronically ill. Most consider their health status to be good to excellent, but many of those referred for secondary care--more than half of the respondents who visited military specialist clinics-visited the clinics many times and even visited other clinics. No problem of access to clinics was found, but availability was problematic. There was a marked preference among patients to receive secondary health sevices from outside civilian agents rather than the military system.

[I.P. Pavlov and L.A. Orbeli: new materials in stocks of the military medical museum].

PubMed

Budko, A A; Nazartsev, B I

2013-01-01

The article presents the previously unpublished letter of I.P. Pavlov to L.A. Orbeli being kept in stocks of the Military medical museum of military medical museum of the S.M. Kirov military medical academy. The needed commentaries are given.

Transitioning from military medics to registered nurses.

PubMed

Keita, Mohamed D; Diaz, Valerie J; Miller, Audrey P; Olenick, Maria; Simon, Sharon R

2015-01-01

The nursing shortage in the USA is expected to reach 260,000 registered nurses (RNs) by 2025. The most profound shortages are expected in California and Florida, translating into 109,779 and 128,364 RN jobs, respectively. Despite a foreseen growth in nursing career opportunities nationwide, the supply of nurses will be insufficient to meet the corresponding demand. Capitalizing on prior education, experience, and skills of military clinical personnel to fill these jobs could significantly reduce the projected nursing shortage. Florida International University's Nicole Wertheim College of Nursing and Health Sciences is circumventing barriers to recruit, retain, and graduate transitioning veteran medics and corpsmen as Bachelor of Science in Nursing prepared RNs who reintegrate into the civilian workforce. The Veteran Bachelor of Science in Nursing (VBSN) program is in the form of a cooperative agreement between Florida International University and the US Health Resources and Services Administration. The VBSN program's main objective is to build upon the unique leadership skills, clinical education, and training of military medics and corpsmen to ensure successful completion of the Bachelor of Science in Nursing curriculum. VBSN students, as veterans themselves, have unique knowledge and exposure to the specific health issues and needs of the veteran population overall. They are poised and best prepared to effectively care for the US population, particularly the current 22 million US veterans and 1.6 million Florida veterans. Additionally, the VBSN program will alleviate the challenges, such as the lack of recognition of military skills, unemployment, the substandard income, and homelessness that many former service members face after separation from the military.

Duty Hour Compliance: A Survey of U.S. Military Medical Interns and Residents.

PubMed

Blitz, Jason B; Rogers, Amy E; Polmear, Michael M; Owings, Alfred J

2017-11-01

In 2011, the Accreditation Council for Graduate Medical Education (ACGME) modified its duty hour standards for interns and residents. This was done, in part, because of a belief that increased compliance with these standards was needed to positively impact resident fatigue, resident quality of life, and patient safety. However, several studies indicate that duty hour noncompliance and false reporting by interns and residents remains a significant concern for residency program directors. This study examined the compliance of interns and residents with ACGME duty hour standards at a large military graduate medical education (GME) training program. We conducted a survey of 535 trainees assigned to 24 GME programs within the National Capital Consortium (NCC). Statistical analysis for descriptive parameters used a standard error of measure on the basis of sample and target population sizes to calculate two-sided 95% confidence intervals (CIs). A χ 2 analysis was performed to compare response differences for particular survey questions. A Cronbach α coefficient was calculated to compare the internal consistency of responses for questions in which individual responses were expected to correlate. This study was reviewed by the Offices of Research at the Walter Reed National Military Medical Center and the Uniformed Services University and adjudicated as "Not Research." Overall, 41.3% (N = 221) of those contacted completed all survey questions. From the available responses, 31.6% (95% CI, 26.9-36.2) reported at least one occurrence of implicit pressure to alter duty hour reporting, and 32.0% (95% CI, 27.3-36.7) reported at least one occurrence of altering reported duty hours. In addition, 37.2 (95% CI, 32.5-41.9) reported being unable to always follow duty hour limits and 58.1% (95% CI, 53.1-63.1) felt time working at home on residency requirements should be included in reported duty hours. Our results indicate that a significant portion of interns and residents within

[Management of military medical service in Ukraine: origin, trends, and mechanism of development (1992-2004)].

PubMed

Radysh, Ia F

2005-01-01

Three periods of the development of military medical service management in Ukraine can be outlined according to the findings of the conducted study, they are the following: formation (1992-1994), consolidation and development (the end of 1994-2003), functional and structural transformation (2004). Leading tendencies of the formation of the management of medical military service in the period are shown in the article to be democratization and structural order of units of the system of the management of military service, integration of efforts and resources of medical military service in one medically covered area of the state, introduction and intensive expansion in army prophylactic and treatment institutions of wide spectrum of requiring payment medical service, rendering out-patient medical service to armed forces personnel and pensioner of Ministry of Defense by family physicians, orientation toward effective management.

A Hospice Rotation for Military Medical Residents: A Mixed Methods, Multi-Perspective Program Evaluation

PubMed Central

Boyden, Jackelyn Y.; Kalish, Virginia B.; Muir, J. Cameron; Richardson, Suzanne; Connor, Stephen R.

2016-01-01

Abstract Background: An estimated 6,000 to 18,000 additional hospice and palliative medicine (HPM) physicians are needed in the United States. A source could be the military graduate medical education system where 15% of U.S. medical residents are trained. A community-based hospice and palliative care organization created a one-week rotation for military residents including participation in interdisciplinary group visits at patients' homes, facilities, and an inpatient hospice unit. Objective: Our goal was to evaluate the effectiveness of a one-week community HPM rotation for military medical residents. Methods: A mixed-methods, multi-stakeholder perspective program evaluation model was used for program years 2011 to 2013. Data were managed and analyzed using Microsoft Excel and Atlas.ti. Participants in the rotation were residents training at two local military hospitals. Program evaluation data were collected from residents, military program liaisons, and hospice clinical preceptors. Quantitative data included pre- and post-tests based on Accreditation Council for Graduate Medical Education competencies completed by residents. Qualitative data included resident essays and semi-structured interviews with hospice preceptors and military program liaisons. Results: Quantitative and qualitative data suggested that the rotation increased military residents' knowledge, attitudes, and comfort level with HPM. Quantitative analysis of test scores indicated improvements from pre- to post-tests in each of five areas of learning. Qualitative data indicated the rotation created a greater appreciation for the overall importance of HPM and increased understanding of eligibility and methods for pain and symptom management. Conclusions: A one-week community hospice rotation for medical military residents impacts participant's knowledge of and attitudes toward HPM. PMID:27139524

Drug Abuse in the Military Impacts National Security.

DTIC Science & Technology

1988-03-30

types of drugs - cannabis , hallucinogens, opiates, stimulants, hypnotics, and cocaine. Subscores were derived for each drug, based upon the product of a...he was interviewed by medical personnel. The soldiers who were Judged to be not drug dependent continued their military service. Soldiers who were...separated as "not meeting the medical 8 fitness standards at time of entry. These separated soldiers along with all others with medical and non

77 FR 64544 - Minor Boundary Revision at Chickamauga and Chattanooga National Military Park

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-22

... DEPARTMENT OF THE INTERIOR National Park Service [NPS-SER-CHCH-10687; 5220-726] Minor Boundary Revision at Chickamauga and Chattanooga National Military Park AGENCY: National Park Service, Interior.... 460l- 9(c)(1)(ii), the boundary of Chickamauga and Chattanooga National Military Park is modified to...

The Evolution of Medical Training Simulation in the U.S. Military.

PubMed

Linde, Amber S; Kunkler, Kevin

2016-01-01

The United States has been at war since 2003. During that time, training using Medical Simulation technology has been developed and integrated into military medical training for combat medics, nurses and surgeons. Efforts stemming from the Joint Programmatic Committee-1 (JPC-1) Medical Simulation and Training Portfolio has allowed for the improvement and advancement in military medical training by focusing on research in simulation training technology in order to achieve this. Based upon lessons learned capability gaps have been identified concerning the necessity to validate and enhance combat medial training simulators. These capability gaps include 1) Open Source/Open Architecture; 2) Modularity and Interoperability; and 3) Material and Virtual Reality (VR) Models. Using the capability gaps, JPC-1 has identified important research endeavors that need to be explored.

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…

[Improvement of the system of medical equipmet rationing for military units during the wartime].

PubMed

Miroshnichenko, Iu V; Goriachev, A B; Popov, A A; Morgunov, V A; Ryzhikov, M V; Merkulov, A V

2013-07-01

The authors analyze new legal regulatory document--Medical equipment and reserves supply rate for military units and organisations of the Armed Forces of the Russian Federation, developed in the process of modernization of the system of medical equipment rationing for military units. New legal regulatory document was developed with the aim to replace the similar document d.d 1996-1997. The authors came to conclusion that costs of new medical equipment and reserves supply rates are similar to previous rates. At the same time costs new medical equipment supply rates for medical service increased more than 25%. It is related to change of the role of medical service in the system of medical supply of the Armed Forces of the Russian Federation. Modernization of the system of medical equipment supply rates for military unit of the Armed Forces of the Russian Federation, performed for the purpose of medical supplement for military unit in accordance with new state of the Armed Forces of the Russian Federation, allowed to actualize the regulatory framework of medical supply by means of development and adoption of new Supply and reserves rates be the Ministry of defence. Use if these rates will increase effectiveness and quality of medical supply during the wartime, provide a commonality of reserves of medical equipment and maintenance of established level of combat readiness of medical service of the Armed Forces of the Russian Federation.

The Military and National Reconciliation: German Lessons for Koreas Reunification

DTIC Science & Technology

2017-05-25

the need to unify Korea eventually presents itself. When considering the military as a crucial driving factor of national power in the DPRK, the...before the need to unify Korea eventually presents itself. When considering the military as a crucial driving factor of national power in the DPRK...the South, thus providing a cause around which the North Korean people can collectively rally. Since 1953, when the armistice was signed, the DPRK

Prevalence of use of erectile dysfunction medication by Dutch military personnel between 2003 and 2012.

PubMed

Janssen, D G A; Vermetten, E; Egberts, T C G; Heerdink, E R

2017-03-01

Use of ED medication can be seen as a marker for ED. ED is associated with increasing age, exposure to traumatic events and physical injuries in military veterans. The objective of this study was to assess the prevalence of use of ED medication in Dutch military personnel in the period 2003-2012 and to assess its association with age and psychotropic medication use. Data on dispensing of ED medication, age and co-medication with psychotropic medication of all Dutch military personnel between 2003 and 2012 were collected. The prevalence of ED medication use in each year was estimated, stratified for age and use of psychotropic medication. The number of ED medication users increased a hundredfold from 0.09 to 9.29 per 1000 per year between 2003 and 2012. ED medication was more often used by men over 40 than under 40 (prevalence in 2012: 2.4% vs 0.2%, OR (2003-2012, adjusted for calendar year) 15.6, 95% CI 13.5-17.9) and by men using psychotropic medication (prevalence in 2012: 3.8% vs 0.9%, OR (2003-2012, adjusted for calendar year) 3.13, 95% CI 2.66-3.67). This study shows a strong increase between 2003 and 2012 in a number of ED medication users in male Dutch military personnel. ED medication use increases with age and with psychotropic medication use.

The new military medical ethics: legacies of the Gulf Wars and the War on Terror.

PubMed

Miles, Steven H

2013-03-01

United States military medical ethics evolved during its involvement in two recent wars, Gulf War I (1990-1991) and the War on Terror (2001-). Norms of conduct for military clinicians with regard to the treatment of prisoners of war and the administration of non-therapeutic bioactive agents to soldiers were set aside because of the sense of being in a 'new kind of war'. Concurrently, the use of radioactive metal in weaponry and the ability to measure the health consequences of trade embargos on vulnerable civilians occasioned new concerns about the health effects of war on soldiers, their offspring, and civilians living on battlefields. Civilian medical societies and medical ethicists fitfully engaged the evolving nature of the medical ethics issues and policy changes during these wars. Medical codes of professionalism have not been substantively updated and procedures for accountability for new kinds of abuses of medical ethics are not established. Looking to the future, medicine and medical ethics have not articulated a vision for an ongoing military-civilian dialogue to ensure that standards of medical ethics do not evolve simply in accord with military exigency. © 2011 Blackwell Publishing Ltd.

Transitioning Former Military Medics to Civilian Health Care Jobs: A Novel Pilot Program to Integrate Medics Into Ambulatory Care Teams for High-Risk Patients.

PubMed

Watts, Brook; Lawrence, Renée H; Schaub, Kimberley; Lea, Erin; Hasenstaub, Mary; Slivka, Judy; Smith, Todd I; Kirsh, Susan

2016-11-01

Despite their medical training, record of military service, and the unmet needs within the health care sector, numerous challenges face veterans who seek to leverage their health care skills for employment after leaving the military. Creative solutions are necessary to successfully leverage these skills into jobs for returning medics that also meet the needs of health care systems. To achieve this goal, we created a novel ambulatory care health technician position on the basis of existing literature and modeled after a program which incorporates former military medics in emergency departments. Through a quality improvement approach, a position description, interview process, training program with clinical competencies, and team integration plan were developed and implemented. To date, two medics have been hired, successfully trained on relevant skill sets, and are currently caring for medical outpatients (under the supervision of licensed clinical personnel) as crucial interdisciplinary team members. Taken together, a multifaceted approach is required to effectively harness military medics' skills and experiences to meet identified health delivery needs. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Prevalence of Psychotropic Medication Use Among Dutch Military Personnel Between 2003 and 2012 and Its Comparison to the Dutch General Population.

PubMed

Janssen, Debbie G A; Vermetten, Eric; Egberts, Toine C G; Heerdink, Eibert R

2017-01-01

The armed forces work under high pressure and in stressful environments and it is well known that being in the military is a risk factor for psychiatric problems. However, it remains unknown how prevalent psychotropic medication use is in military personnel. To assess prevalence of psychotropic medication use in Dutch military personnel and compare to the Dutch general population. Data were obtained from the military pharmacy. From 2003 to 2012, the year-prevalence of psychotropic medication use was calculated from the number of distributed psychotropic medications and the number of Dutch military personnel. For the year 2011, the year-prevalence of psychotropic medication use in the military was compared to that of the Dutch general population. The year-prevalence of psychotropic medication use increased by 55%, from 1.64% in 2003 to 2.54% in 2012 in Dutch military personnel. An increase is seen in the number of users of psychotropic medication. Also the use of antidepressants and attention deficit hyperactivity disorder medication increased. Over the last decade, there has been a 1.5-fold increase in psychotropic medication dispensed to Dutch military personnel. However, Dutch military personnel were significantly less likely to use psychotropic medications compared to the Dutch general population. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

The influence of military service on outpatient care use among racial/ethnic groups in Department of Veterans Affairs medical centers.

PubMed

Harada, Nancy D; Villa, Valentine M; Damron-Rodriguez, JoAnn; Washington, Donna; Makinodan, Takashi; Dhanani, Shawkat; Shon, Herbert; Liu, Honghu; Andersen, Ronald

2002-07-01

This study examines race-specific military service effects on outpatient care utilization in the Department of Veterans Affairs (VA) using data from the 1992 National Survey of Veterans. The study population consisted of 4,791 male veterans. After controlling for predisposing, enabling, and need variables, black veterans were 3.7 times more likely than white veterans to use VA outpatient care. Veterans discharged from the military for medical release were less likely to use VA outpatient care (odds ratio = 0.76) than veterans discharged at the end of their normal terms. Hispanic veterans discharged for medical release were 5.3 times more likely than white veterans discharged for the same reason to use VA outpatient care. Korean conflict and mixed war period veterans were more likely to use VA outpatient care than World War II veterans. Racial/ethnic differences in military service characteristics influence the use of VA outpatient care and should be understood in delivering outpatient care to veterans.

The "new" military and income inequality: A cross national analysis.

PubMed

Kentor, Jeffrey; Jorgenson, Andrew K; Kick, Edward

2012-05-01

Military expenditures have escalated over the last three decades in both developed and less developed countries, without a corresponding expansion of military personnel. Spending has instead been directed towards hi-tech weaponry, what we refer to as the "new" military. We hypothesize that this new, increasingly capital-intensive military is no longer a pathway of upward mobility or employer of last resort for many uneducated, unskilled, or unemployed people, with significant consequences for those individuals and society as a whole. One such consequence, we argue, is an increase in income inequality. We test this hypothesis with cross-national panel models, estimated for 82 developed and less developed countries from 1970 to 2000. Findings indicate that military capital-intensiveness, as measured by military expenditures per soldier, exacerbates income inequality net of control variables. Neither total military expenditures/GDP nor military participation has a significant effect. It appears from these findings that today's "new" military establishment is abrogating its historical role as an equalizing force in society, with important policy implications. Copyright © 2011 Elsevier Inc. All rights reserved.

Sleep Disorders and Associated Medical Comorbidities in Active Duty Military Personnel

PubMed Central

Mysliwiec, Vincent; McGraw, Leigh; Pierce, Roslyn; Smith, Patrick; Trapp, Brandon; Roth, Bernard J.

2013-01-01

Study Objectives: Describe the prevalence of sleep disorders in military personnel referred for polysomnography and identify relationships between demographic characteristics, comorbid diagnoses, and specific sleep disorders. Design: Retrospective cross-sectional study. Setting: Military medical treatment facility. Participants: Active duty military personnel with diagnostic polysomnogram in 2010. Measurements: Primary sleep disorder rendered by review of polysomnogram and medical record by a board certified sleep medicine physician. Demographic characteristics and conditions of posttraumatic stress disorder (PTSD), mild traumatic brain injury (mTBI), anxiety, depression, and pain syndromes determined by medical record review. Results: Primary sleep diagnoses (n = 725) included: mild obstructive sleep apnea (OSA), 207 (27.2%); insomnia, 188 (24.7%); moderate-to-severe OSA, 183 (24.0 %); and paradoxical insomnia,39 (5.1%); behaviorally induced insufficient sleep syndrome, 68 (8.9%) and snoring, 40 (5.3%) comprised our control group. Short sleep duration (< 5 h) was reported by 41.8%. Overall 85.2% had deployed, with 58.1% having one or more comorbid diagnoses. Characteristics associated with moderate-to-severe OSA were age (adjusted odds ratio [OR], 1.03 [95% confidence interval {CI}, 1.0–1.05], sex (male) (adjusted OR, 19.97 [95% CI, 2.66–150.05], anxiety (adjusted OR, 0.58 [95% CI, 0.34–0.99]), and body mass index, BMI (adjusted OR 1.19 [95% CI, 1.13–1.25]; for insomnia, characteristics included PTSD (adjusted OR, 2.12 [95% CI, 1.31–3.44]), pain syndromes (adjusted OR, 1.48 [95%CI, 1.01–2.12]), sex (female) (adjusted OR, 0.22 [95% CI, 0.12–0.41]) and lower BMI (adjusted OR, 0.91 [95% CI, 0.87, 0.95]). Conclusions: Service-related illnesses are prevalent in military personnel who undergo polysomnography with significant associations between PTSD, pain syndromes, and insomnia. Despite having sleep disorders, almost half reported short sleep duration

Sleep disorders and associated medical comorbidities in active duty military personnel.

PubMed

Mysliwiec, Vincent; McGraw, Leigh; Pierce, Roslyn; Smith, Patrick; Trapp, Brandon; Roth, Bernard J

2013-02-01

Describe the prevalence of sleep disorders in military personnel referred for polysomnography and identify relationships between demographic characteristics, comorbid diagnoses, and specific sleep disorders. Retrospective cross-sectional study. Military medical treatment facility. Active duty military personnel with diagnostic polysomnogram in 2010. Primary sleep disorder rendered by review of polysomnogram and medical record by a board certified sleep medicine physician. Demographic characteristics and conditions of posttraumatic stress disorder (PTSD), mild traumatic brain injury (mTBI), anxiety, depression, and pain syndromes determined by medical record review. Primary sleep diagnoses (n = 725) included: mild obstructive sleep apnea (OSA), 207 (27.2%); insomnia, 188 (24.7%); moderate-to-severe OSA, 183 (24.0 %); and paradoxical insomnia,39 (5.1%); behaviorally induced insufficient sleep syndrome, 68 (8.9%) and snoring, 40 (5.3%) comprised our control group. Short sleep duration (< 5 h) was reported by 41.8%. Overall 85.2% had deployed, with 58.1% having one or more comorbid diagnoses. Characteristics associated with moderate-to-severe OSA were age (adjusted odds ratio [OR], 1.03 [95% confidence interval {CI}, 1.0-1.05], sex (male) (adjusted OR, 19.97 [95% CI, 2.66-150.05], anxiety (adjusted OR, 0.58 [95% CI, 0.34-0.99]), and body mass index, BMI (adjusted OR 1.19 [95% CI, 1.13-1.25]; for insomnia, characteristics included PTSD (adjusted OR, 2.12 [95% CI, 1.31-3.44]), pain syndromes (adjusted OR, 1.48 [95%CI, 1.01-2.12]), sex (female) (adjusted OR, 0.22 [95% CI, 0.12-0.41]) and lower BMI (adjusted OR, 0.91 [95% CI, 0.87, 0.95]). Service-related illnesses are prevalent in military personnel who undergo polysomnography with significant associations between PTSD, pain syndromes, and insomnia. Despite having sleep disorders, almost half reported short sleep duration. Multidisciplinary assessment and treatment of military personnel with sleep disorders and service

The expanding role of military entomologists in stability and counterinsurgency operations.

PubMed

Robert, Leon L; Rankin, Steven E

2011-01-01

Military entomologists function as part of medical civil-military operations and are an essential combat multiplier direction supporting COIN operations. They not only directly support US and coalition military forces by performing their traditional wartime mission of protecting personnel from vector-borne and rodent-borne diseases but also enhance the legitimacy of medical services by the host nation government such as controlling diseases promulgated by food, water, vectors, and rodents. These unique COIN missions demand a new skill set required of military entomologists that are not learned from existing training courses and programs. New training opportunities must be afforded military entomologists to familiarize them with how to interact with and synergize the efforts of host nation assets, other governmental agencies, nongovernmental organizations, and international military partners. Teamwork with previously unfamiliar groups and organizations is an essential component of working in the COIN environment and can present unfamiliar tasks for entomologists. This training should start with initial entry training and be a continual process throughout a military entomologist's career. Current COIN operations require greater tactical and operational flexibility and diverse entomological expertise. The skills required for today's full spectrum medical operations are different from those of the past. Counterinsurgency medical operations demand greater agility, rapid task-switching, and the ability to adequately address unfamiliar situations and challenges.

32 CFR 644.408 - Interchange of national forest and military and civil works lands.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Interchange of national forest and military and... Property and Easement Interests § 644.408 Interchange of national forest and military and civil works lands. 16 U.S.C. 505a, 505b authorizes the Secretary of Agriculture, with respect to national forest lands...

[Development of clinical radiology in the Military field therapy Department of the Military Medical Academy (the 90th anniversary of the birth of G. I. Alekseyev)].

PubMed

Khalimov, Iu Sh; Vlasenko, A N; Matveev, S Iu

2012-08-01

On August 18, 2012, 90 years have passed since the birth of the former head of the Military field therapy Department of The Military-Medical Academy named after S. M. Kirov--the main radiologist of the Ministry of Defence of Russian Federation, the corresponding member of the Soviet Union Academy of Medical Science and the Russian Academy of Medical Science, the major- general of a medical service G. I. Alekseyev, who had been working in the department since its foundation till the last day of his life. Being the head of the department for twelve years, G. I. Alekseyev made a considerable contribution to the formation and development of native military radiology, training of medical and scientific skilled specialists. Professor G. I. Alekseyev's scientific ideas and views in the sphere of radiology were realized and developed in further educational, research and medical work of the department. Nowadays the staff of the Military field therapy Department remembers G. I. Alekseyev with special gratitude and appreciation and successfully realizes his ideas and plans in work.

Activities of an ethics consultation service in a Tertiary Military Medical Center.

PubMed

Waisel, D B; Vanscoy, S E; Tice, L H; Bulger, K L; Schmelz, J O; Perucca, P J

2000-07-01

The Joint Commission on Accreditation of Healthcare Organizations requires hospitals to have a mechanism to address issues of medical ethics. Most hospitals, especially those in the military, have an ethics committee composed solely of members who serve as an additional duty. To enhance the ethics consultation service, the 59th Medical Wing created a position under the chief of the medical staff for a full-time, fellowship-trained, medical ethicist. After establishment of this position, the number of consultations increased, a systematic program for caregiver education was developed and delivered, and an organizational presence was achieved by instituting positions on the institutional review board, the executive committee of the medical staff, and the credentials committee. Issues in medical care are becoming increasingly complicated, due in large part to financial stresses and technological advancements. Ethics consultation can help prevent and resolve many of these problems. This report discusses the activities of the first year of a full-time ethicist in a tertiary military medical center.

Factor Analysis of Teacher Professional Development in Chinese Military Medical Universities

ERIC Educational Resources Information Center

Yue, Juan-Juan; Chen, Gang; Wang, Zhen-Wei; Liu, Wei-Dong

2017-01-01

Background and purpose: Teacher professional development potentially enhances teachers' professional morale, knowledge, skills and autonomy, which helps improve the quality of education. The military medical university is an important medical education institution in China; however, studies of teacher professional development within military…

U.S. Military Technology Dependence: The Hidden Vulnerability to National Security

DTIC Science & Technology

2016-06-10

10-06-2016 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER U.S. MILITARY TECHNOLOGY DEPENDENCE : THE HIDDEN Sb. GRANT NUMBER VULNERABILITY TO NATIONAL...14. ABSTRACT Because the U.S. has a technological culture, the U.S. military has become technology dependent . This dependence has made the military...technology dependent that the organization no longer recognizes that technology has made it more vulnerable strategically, operationally, and tactically. The

Telemedicine deployments within NATO military forces: a data analysis of current and projected capabilities.

PubMed

Lam, David M; Poropatich, Ronald K

2008-11-01

Since the creation of the NATO Telemedicine Expert Panel (now renamed the TMED Expert Team) in 2000, when few nations had deployed telemedicine systems to support military field operations, this group has been encouraging the nations to deploy telemedicine (TMED) in support of their forces, and to write the use of TMED into NATO doctrine. This has been a relatively successful effort, and TMED is increasingly being used within the military medical structures of some NATO and Partnership for Peace nations to provide medical care to deployed military personnel. We report the results of a multinational survey of current and projected availability of various telemedicine modalities within the NATO medical services that are participating in the work of the TMED expert team (ET). Though only a "snapshot in time," and not representing all NATO nations, this is the first attempt to identify both current and planned TMED utilization within the multinational military medical community. Participating nations report that communication systems now in place at the lowest levels of medical support increasingly enable the routine use of Web-based teleconsultation modalities. Teleradiology is now being seen as the de facto standard for imaging support. While a number of nations report they have deployed capabilities for obtaining clinical consultations at a distance, most responding nations do not have a formal organizational structure to control and manage remote consultation and rely on informal clinical relationships (e.g., requesting consults from the deployed clinician's home hospital or from friends). Military electronic health records are in use by only a minority of nations and fewer still are capable of civilian interface. Less common TMED capabilities (e.g., tele-microbiology, tele-pathology, tele-medical maintenance) are being increasingly used, but are still rarely deployed. As a result of the findings of this survey, specific recommendations for expanding the use of

[Improvement of work of chiefs of therapeutic and diagnostic hospital departments--chief medical specialists of military districts (fleet)].

PubMed

Tregubov, V N; Kostiuchenko, A I; Stetsenko, B G

2009-03-01

In now-day conditions, on the background of enlargement and complication of tasks', solved by military health service, it's supervised the increase of significance of qualitative and effective administration by collectives of military-medical organizations. An important role belongs to activity of chiefs of treatment-diagnostic units (centers) of military hospitals. These chiefs in the same time are staff or inorganic medical specialists of military regions (NAVYs).

Descriptive analysis of the medical care performed in the Spanish military Role 1 Medical Treatment Facility deployed in Operation 'Inherent Resolve' (Iraq), 2015-2016.

PubMed

García Cañas, Rafael; Navarro Suay, R

2017-12-01

Operation 'Inherent Resolve' was approved by the United Nations in August 2014 with the objective of suppressing the Islamic State in Iraq and the Levant and increasing the region's stability. The mission of the Spanish military forces within this was to direct training missions for the Iraqi Army. The aim of this study is to analyse the medical care provided in the Spanish Role 1 deployed medical treatment facility during Operation 'Apoyo a Irak'. A cross-sectional, descriptive and retrospective study was conducted between 15 December 2015 and 18 November 2016. The study population comprised all personnel treated at the Spanish Role 1 medical treatment facility of the 'Gran Capitan' base in Besmaya, Iraq. During the study period, a total of 2208 consultations were performed, 1547 of which were first consultations. The predominant type of medical care was categorised as 'traumatology' (n=438; 19.8%), followed by 'healing of wounds and minor surgical processes' (n=332; 15%), 'acute upper respiratory tract infections' (n=267; 12%), 'dermatology' (n=214; 9.6%) and 'gastroenterology' (n=214; 9.6%). Twenty-eight patients (1.2%) required care in the upper medical echelon of care, three of whom were urgently evacuated. Oral diseases were the main reason for evacuation to the next medical echelon. Four patients were repatriated to the national territory for medical reasons. One death was recorded due to a vehicle accident. The results of our study reinforce those found in similar recent international missions in which the Spanish Armed Forces and other allied armies have deployed a Role 1 medical treatment facility. Military physicians deploying on operations such as Iraq should have up-to-date training in emergency and primary care medicine, with special emphasis on basic trauma knowledge and performing minor surgical processes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is

The Defence Medical Library Service and military medicine.

PubMed

Walker, S B

2005-01-01

The Defence Medical Library Service (DMLS) supports the clinical practice and career development of military health professionals across the world. Clinical governance and the need for medical knowledge to be evidence-based means the DMLS has a central role to play in support of defence medicine. The DMLS is important for enabling health professionals to make sense of the evidence-based pyramid and the hierarchy of medical knowledge. The Royal Centre for Defence Medicine (RCDM) in Birmingham is recognised as an international centre of excellence. The information, knowledge and research requirements of the RCDM will provide opportunities for the DMLS to support and engage with the academic community.

National surveys of military personnel, nursing students, and the public: drivers of military nursing careers.

PubMed

Donelan, Karen; Romano, Carol; Buerhaus, Peter; DesRoches, Catherine; Applebaum, Sandra; Ward, Johanna Rm; Schoneboom, Bruce A; Hinshaw, Ada Sue

2014-05-01

The U.S. health care system is facing a projected nursing shortage of unprecedented magnitude. Although military nursing services recently have been able to meet their nursing recruitment quotas, national studies have predicted a long-term nursing shortage that may affect future recruitment for the Nurse Corps of the three military services. Data are needed to plan for recruitment incentives and the impact of those incentives on targeted populations of likely future nurses. Data are drawn from three online surveys conducted in 2011-2012, including surveys of 1,302 Army, Navy, and Air Force personnel serving on major military bases, 914 nursing students at colleges with entry Bachelor of Science in Nursing programs located nearby major military bases, and a qualitative survey of 1,200 young adults, age 18-39, in the general public. The three populations are different in several demographic characteristics. We explored perceptions of military careers, nursing careers and barriers, and incentives to pursue military nursing careers in all populations. Perceptions differ among the groups. The results of this study may help to inform strategies for reaching out to specific populations with targeted messages that focus on barriers and facilitators relevant to each to successfully recruit a diverse Nurse Corps for the future. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Kings Mountain National Military Park : acoustical monitoring 2012

DOT National Transportation Integrated Search

2014-11-01

During the winter of 2012(November-December) baseline acoustical data were collected at Kings Mountain National Military Park (KIMO)at two sites deployed for approximately 30 days each. The baseline data collected during these periods will help park ...

Military Personnel: Enhanced Collaboration and Process Improvements Needed for Determining Military Treatment Facility Medical Personnel Requirements

DTIC Science & Technology

2010-07-01

Department of Defense (DOD) are in great demand due to projected nationwide medical personnel shortages over the next decade and are essential to...for the first year, in order to assist the services in addressing near- term personnel shortages . It also provides a consistent staffing standard...dentists, medical service corps, and veterinarians , to name a few, at the work center level across Army fixed military treatment facilities. The model uses

How medical students use the computer and Internet at a Turkish military medical school.

PubMed

Kir, Tayfun; Ogur, Recai; Kilic, Selim; Tekbas, Omer Faruk; Hasde, Metin

2004-12-01

The aim of this study was to determine how medical students use the computer and World Wide Web at a Turkish military medical school and to discuss characteristics related to this computer use. The study was conducted in 2003 in the Department of Public Health at the Gulhane Military Medical School in Ankara, Turkey. A survey developed by the authors was distributed to 508 students, after pretest. Responses were analyzed statistically by using a computer. Most of the students (86.4%) could access a computer and the Internet and all of the computers that were used by students had Internet connections, and a small group (8.9%) had owned their own computers. One-half of the students use notes provided by attending stuff and textbooks as assistant resources for their studies. The most common usage of computers was connecting to the Internet (91.9%), and the most common use of the Internet was e-mail communication (81.6%). The most preferred site category for daily visit was newspaper sites (62.8%). Approximately 44.1% of students visited medical sites when they were surfing. Also, there was a negative correlation between school performance and the time spent for computer and Internet use (-0.056 and -0.034, respectively). It was observed that medical students used the computer and Internet essentially for nonmedical purposes. To encourage students to use the computer and Internet for medical purposes, tutors should use the computer and Internet during their teaching activities, and software companies should produce assistant applications for medical students. Also, medical schools should build interactive World Wide Web sites, e-mail groups, discussion boards, and study areas for medical students.

[The contribution of the Archive of the Military Medical Museum in summarizing the experience of the Great Patriotic War].

PubMed

Budko, A A; Gribovskaya, G A

2015-06-01

During 70 years of existence of the Military Medical Museum one of its main goals was to create an archive of military medical documents, the formation of his ideology and collecting funds, saving and promotion of unique materials related to the history of Russia, feat of arms Defenders of the Fatherland in the wars of the XX century. Creating a military medical museum archive was conceived in the beginning of the Great Patriotic War by leading figures of the military medicine--E.I.Smirnov, S.M.Bagdasaryan, V.N.Shevkunenko, A.N.Maksimenkov, who offered to collect all materials about the work of physicians at the front and in the rear, to consider the archive as a base for scientific works on the history of the military health care. Today the archive was removed from the Army Medical Museum and now it is a branch of the Central Archive of the Ministry of Defence of the Russian Federation (military medical records). His staff keeps the traditions established by predecessors and use in their activities a wealth of experience and background research.

A Policy Analysis: Military Medical Treatment Facility Contingency Inpatient Expansion

DTIC Science & Technology

2005-06-06

Immunology 3 71B Biochemistry 2 Nurse Corps 66H Medical Surgical Nurse 688 66E Operating Room Nurse 72 66C Psychiatry 30 66N Nurse Administration 18...To) 06-06-2005 Final Report I July 2005 to July 2005 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER A Policy Analysis: Military Medical Treatment Facility...Contingency Inpatient Expansion 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER Kalamaras, Peter Jr., Major, Medical

[Errors in medical care rendered by military treatment and prevention institutions (according to the data of forensic medical expertise].

PubMed

Kolkutin, V V; Fetisov, V A

2003-12-01

The authors discuss one of the important aspects of military medicolegal laboratory activities connected with the quality control of medical care rendered in the military treatment-and-prophylactic institutions in the nineties of the XX century. The example of medical care defects (MCD) permitted to reveal their nature, causes and sites of origin at pre-hospital (PHS) and hospital (HS) stages. Despite some decrease in the total number of MCD revealed HS defects prevail (more than 75%); the organizational defects at PHS and diagnostic defects at HS are predominant. The main MCD causes are inadequate qualification of medical workers, defects in organization of treatment-and-diagnostic process and inadequate examination of patients.

[The 175th anniversary of the District Military Clinical Hospital of the Leningrad Military District].

PubMed

Liutov, V V

2010-09-01

For 175 years a hospital made a great contribution to the development of national health care, gaining a wealth experience in high quality health care for the soldiers. Especially the biggest merit was made by the hospital during the Great Patriotic War of 1941-1945, when 82% of the wounded soldiers ware returned for further service. The hospital was glorified by famous medical scientists of XIX-XX-centuries, such as: V. Bekhterev, R. Wreden, N. Sklifosovsky, P. Kupriyanov, N. Petrov and others. Currently, the hospital takes a worthy place among the best military medical agencies of Russian Armed Forces. The hospital is equipped with modern medical equipment. There work highly qualified personnel: 17 distinguished doctors of the Russian Federation, 2 doctors and 27 candidates of medical sciences. In practice the hospital successfully uses achievements of the leading Russian military medical facilities. The staff treat with care historical traditions of the hospital.

Gettysburg National Military Park alternative transportation system planning study

DOT National Transportation Integrated Search

2004-06-01

This project identifies and evaluates transit service alternatives in the Gettysburg, Pennsylvania area, including Gettysburg National Military Park, the Borough of Gettysburg, and surrounding townships. The report concludes that public transit would...

U.S. Military Nation-Building Peru - A Question of National Interests

DTIC Science & Technology

1989-06-02

time, the Country Team left the possibility of hosting the exercise open after the elections. 11lbid. Also, En rque Gegos Yenero, "Success in Peru ... en Peru ." Diario de las Americas 36/150 (30 Dec 1988). "Nos dejan solos frente a Sendero." Diario La Republica (19 March 1989). "On Peru’s Future...U.S. MILITARY NATION-BUILDING IN PERU A QUESTION OF NATIONAL INTERESTS A thesis presented to the Faculty of the U.S. Army Command and General Staff

Challenges of self-reported medical conditions and electronic medical records among members of a large military cohort

PubMed Central

Smith, Besa; Chu, Laura K; Smith, Tyler C; Amoroso, Paul J; Boyko, Edward J; Hooper, Tomoko I; Gackstetter, Gary D; Ryan, Margaret AK

2008-01-01

Background Self-reported medical history data are frequently used in epidemiological studies. Self-reported diagnoses may differ from medical record diagnoses due to poor patient-clinician communication, self-diagnosis in the absence of a satisfactory explanation for symptoms, or the "health literacy" of the patient. Methods The US Department of Defense military health system offers a unique opportunity to evaluate electronic medical records with near complete ascertainment while on active duty. This study compared 38 self-reported medical conditions to electronic medical record data in a large population-based US military cohort. The objective of this study was to better understand challenges and strengths in self-reporting of medical conditions. Results Using positive and negative agreement statistics for less-prevalent conditions, near-perfect negative agreement and moderate positive agreement were found for the 38 diagnoses. Conclusion This report highlights the challenges of using self-reported medical data and electronic medical records data, but illustrates that agreement between the two data sources increases with increased surveillance period of medical records. Self-reported medical data may be sufficient for ruling out history of a particular condition whereas prevalence studies may be best served by using an objective measure of medical conditions found in electronic healthcare records. Defining medical conditions from multiple sources in large, long-term prospective cohorts will reinforce the value of the study, particularly during the initial years when prevalence for many conditions may still be low. PMID:18644098

A comparative cost analysis of an integrated military telemental health-care service.

PubMed

Grady, Brian J

2002-01-01

The National Naval Medical Center, Bethesda, Maryland, integrated telemental health care into its primary behavioral health-care outreach service in 1998. To date, there have been over 1,800 telemental health visits, and the service encounters approximately 100 visits per month at this time. The objective of this study was to compare and contrast the costs to the beneficiary, the medical system, and the military organization as a whole via one of the four methods currently employed to access mental health care from remotely located military medical clinics. The four methods include local access via the military's civilian health maintenance organization (HMO) network, patient travel to the military treatment facility, military mental health specialists' travel to the remote clinic (circuit riding) and TeleMental Healthcare (TMH). Interactive video conferencing, phone, electronic mail, and facsimile were used to provide telemental health care from a military treatment facility to a remote military medical clinic. The costs of health-care services, equipment, patient travel, lost work time, and communications were tabulated and evaluated. While the purpose of providing telemental healthcare services was to improve access to mental health care for our beneficiaries at remote military medical clinics, it became apparent that this could be done at comparable or reduced costs.

[Character of refractive errors in population study performed by the Area Military Medical Commission in Lodz].

PubMed

Nowak, Michał S; Goś, Roman; Smigielski, Janusz

2008-01-01

To determine the prevalence of refractive errors in population. A retrospective review of medical examinations for entry to the military service from The Area Military Medical Commission in Lodz. Ophthalmic examinations were performed. We used statistic analysis to review the results. Statistic analysis revealed that refractive errors occurred in 21.68% of the population. The most commen refractive error was myopia. 1) The most commen ocular diseases are refractive errors, especially myopia (21.68% in total). 2) Refractive surgery and contact lenses should be allowed as the possible correction of refractive errors for military service.

Triage in military settings.

PubMed

Falzone, E; Pasquier, P; Hoffmann, C; Barbier, O; Boutonnet, M; Salvadori, A; Jarrassier, A; Renner, J; Malgras, B; Mérat, S

2017-02-01

Triage, a medical term derived from the French word "trier", is the practical process of sorting casualties to rationally allocate limited resources. In combat settings with limited medical resources and long transportation times, triage is challenging since the objectives are to avoid overcrowding medical treatment facilities while saving a maximum of soldiers and to get as many of them back into action as possible. The new face of modern warfare, asymmetric and non-conventional, has led to the integrative evolution of triage into the theatre of operations. This article defines different triage scores and algorithms currently implemented in military settings. The discrepancies associated with these military triage systems are highlighted. The assessment of combat casualty severity requires several scores and each nation adopts different systems for triage on the battlefield with the same aim of quickly identifying those combat casualties requiring lifesaving and damage control resuscitation procedures. Other areas of interest for triage in military settings are discussed, including predicting the need for massive transfusion, haemodynamic parameters and ultrasound exploration. Copyright © 2016 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

[Organization of anesthesia management and advanced life support at military medical evacuation levels].

PubMed

Shchegolev, A V; Petrakov, V A; Savchenko, I F

2014-07-01

Anesthesia management and advanced life support for the severely wounded personnel at military medical evacuation levels in armed conflict (local war) is time-consuming and resource-requiring task. One of the mathematical modeling methods was used to evaluate capabilities of anesthesia and intensive care units at tactical level. Obtained result allows us to tell that there is a need to make several system changes of the existing system of anesthesia management and advanced life support for the severely wounded personnel at military medical evacuation levels. In addition to increasing number of staff of anesthesiology-critical care during the given period of time another solution should be the creation of an early evacuation to a specialized medical care level by special means while conducting intensive monitoring and treatment.

Chickamauga National Military Park Tour Roads, Gordon's Slough Bridge, At ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Chickamauga National Military Park Tour Roads, Gordon's Slough Bridge, At the confluence of Alexander's Bridge Road and Gordon's Slough, southeast of Alexander's Bridge, Fort Oglethorpe, Catoosa County, GA

Construction of an evaluation index system for determining the academic impact of military medical scholars.

PubMed

Li, Xuan; Hao, J Y

2018-01-13

Academic papers are an essential manner for describing new ideas and consolidating existing concepts in the field of military medicine. The academic impact of military medical publications reflects the extent and depth of recognition, acceptance and utilisation of the concepts transmitted in these publications. The aim of this research was to construct an evaluation index system suitable for evaluating the academic influence of scholars in the field of military medicine. Using the Delphi consensus methodology, 30 experts from the field of military medicine, military medical information and library and information science were asked during three rounds of questioning to score the feasibility and importance of indicators that could be used to determine academic impact. An analytic hierarchy process method was used to calculate the relative weighting of each indicator in determining the final level of academic impact. Eight evaluation indicators were agreed on to potentially determine academic impact. These comprised: 'Web of Science documents', 'Citation impact', 'h-index', 'Percentage of international collaborations', 'Percentage of the top 10% of the cited frequency', 'Category normalised citation impact', 'Percentage of documents cited' and 'The number of F1000 Recommended papers'. The evaluation index system determined from this study combines the advantages of both qualitative and quantitative recognised evaluation indicators, which are subsequently weighted according to their importance in the field of military medicine. It is hoped that this framework will provide a manner in the future for comparing the potential academic impact of military medical scholars. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Ethical challenges experienced by UK military medical personnel deployed to Sierra Leone (operation GRITROCK) during the 2014-2015 Ebola outbreak: a qualitative study.

PubMed

Draper, Heather; Jenkins, Simon

2017-12-19

As part of its response to the 2014 Ebola outbreak in west Africa, the United Kingdom (UK) government established an Ebola treatment unit in Sierra Leone, staffed by military personnel. Little is known about the ethical challenges experienced by military medical staff on humanitarian deployment. We designed a qualitative study to explore this further with those who worked in the treatment unit. Semi-structured, face-to-face and telephone interviews were conducted with 20 UK military personnel deployed between October 2014 and April 2015 in one of three roles in the Ebola treatment unit: clinician; nursing and nursing assistant; and other medical support work, including infection control and laboratory and mortuary services. Many participants reported feeling ethically motivated to volunteer for deployment, but for some personal interests were also a consideration. A small minority had negative feelings towards the deployment, others felt that this deployment like any other was part of military service. Almost all had initial concerns about personal safety but were reassured by their pre-deployment 'drills and skills', and personal protective equipment. Risk perceptions were related to perceptions about military service. Efforts to minimise infection risk were perceived to have made good patient care more difficult. Significantly, some thought the humanitarian nature of the mission justified tolerating greater risks to staff. Trust in the military institution and colleagues was expressed; many participants referred to the ethical obligation within the chain of command to protect those under their command. Participants expected resources to be overwhelmed and 'empty beds' presented a significant and pervasive ethical challenge. Most thought more patients could and should have been treated. Points of reference for participants' ethical values were: previous deployment experience; previous UK/National Health Service experience; professional ethics; and, distinctly

Perspectives from Ethiopia regarding U.S. military humanitarian assistance: how to build a better medical civil action project (MEDCAP).

PubMed

Miles, Shana; Malone, Joseph L

2013-12-01

Assuming that budgetary constraints continue over the next several years, the U.S. military's overseas medical activities including medical civic action projects (MEDCAPs) and humanitarian assistance projects could comprise an increasing proportion of the contributions of U.S. government (USG) to improving global health. We have identified several issues with MEDCAPs in Ethiopia since 2009 that resulted in delays or project cancellations. These were mostly related to lack of a plan to develop sustainable capacities. Although there are many obvious medical needs for civilian populations in Ethiopia, the provision of sustainable development assistance involving these Ethiopian populations on behalf of the USG is a complex undertaking involving coordination with many partners and coordination with several other USG agencies. Military medical professionals planning MEDCAPs and other cooperative global health projects would benefit from consultation and close coordination with U.S. Centers for Disease Control and Prevention (CDC) and U.S. Agency of International Development (USAID) experts who are involved in supporting medium- and long-term health projects in Ethiopia. The establishment of durable military medical academic relationships and involvement of overseas military medical research units could also help promote sustainable projects and build robust professional relationships in global health. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

[Scientific heritage of N.I.Pirogov in "Military-Medical Magazine"].

PubMed

Galin, L L

2010-12-01

The article is concerned with 8 publications of N. I. Pirogov, printed in "Military-Medical magazine", including the publication about the first usage of ether anesthesia on the battlefield. The articles hold timeliness not only as works which are rich in matter, but also as examples of scientific statement.

Medical support to military airborne training and operations.

PubMed

Starkey, Kerry J; Lyon, J; Sigman, E; Pynn, H J; Nordmann, G

2018-05-01

Airborne operations enable large numbers of military forces to deploy on the ground in the shortest possible time. This however must be balanced by an increased risk of injury. The aim of this paper is to review the current UK military drop zone medical estimate process, which may help to predict the risk of potential injury and assist in planning appropriate levels of medical support. In spring 2015, a British Airborne Battlegroup (UKBG) deployed on a 7-week overseas interoperability training exercise in the USA with their American counterparts (USBG). This culminated in a 7-day Combined Joint Operations Access Exercise, which began with an airborne Joint Forcible Entry (JFE) of approximately 2100 paratroopers.The predicted number of jump-related injuries was estimated using Parachute Order Number 8 (PO No 8). Such injuries were defined as injuries occurring from the time the paratrooper exited the aircraft until they released their parachute harness on the ground. Overall, a total of 53 (2.5%) casualties occurred in the JFE phase of the exercise, lower than the predicted number of 168 (8%) using the PO No 8 tool. There was a higher incidence of back (30% actual vs 20% estimated) and head injuries (21% actual vs 5% estimated) than predicted with PO No 8. The current method for predicting the incidence of medical injuries after a parachute drop using the PO No 8 tool is potentially not accurate enough for current requirements. Further research into injury rate, influencing factors and injury type are urgently required in order to provide an evidence base to ensure optimal medical logistical and clinical planning for airborne training and operations in the future. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Medical supply on contingency military operations: experience from Operation GRITROCK.

PubMed

Robinson, J P; Reeves, P

2015-01-01

Medical supply during military operations has the ability to affect the efficacy of the operation being undertaken, either negatively or positively. An appropriately-managed maritime platform with a robust medical supply chain during transit and on arrival in theatre is the main aim. A secure supply chain will reduce any implications that logistics may have with regard to capability, and negate the effects of deficiencies of short shelf life items occurring over time and during use in high tempo operations.

32 CFR 728.82 - Individuals whose military records are being considered for correction.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 5 2013-07-01 2013-07-01 false Individuals whose military records are being considered for correction. 728.82 Section 728.82 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT...

32 CFR 728.82 - Individuals whose military records are being considered for correction.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 5 2011-07-01 2011-07-01 false Individuals whose military records are being considered for correction. 728.82 Section 728.82 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT...

32 CFR 728.82 - Individuals whose military records are being considered for correction.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 5 2012-07-01 2012-07-01 false Individuals whose military records are being considered for correction. 728.82 Section 728.82 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT...

32 CFR 728.82 - Individuals whose military records are being considered for correction.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 5 2010-07-01 2010-07-01 false Individuals whose military records are being considered for correction. 728.82 Section 728.82 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT...

High intensity scenario training of military medical students to increase learning capacity and management of stress response.

PubMed

Mueller, Genevieve R; Moloff, Alan L; Wedmore, Ian S; Schoeff, Jonathan E; Laporta, Anthony J

2012-01-01

A delicate balance exists between a beneficial stress response that enhances memory and recall performance and a detrimental high stress response that impairs memory and learning. Repetitive training in stressful situations enables people to lower their stress levels from the detrimental range to a more beneficial one.1 This is particularly true for physicians in training as they seek to achieve advanced skills and knowledge in the fields of triage, emergency medicine, and surgery prior to graduation. This need is significant for medical students entering military service after graduation. We theorize that military medical students can advance their proficiencies through an Intensive Skills Week (ISW) prior to entering their third and forth year rotations. To test this theory, Rocky Vista University will hold a week long high-intensity first-responder, emergency medicine and surgical training course, facilitated by military medical physicians, to further students? skills and maximize training using the Human Worn Partial Surgical Task Simulator (Cut Suit). We also see the possible benefit to physician and non-physician military personnel, especially Special Operations Forces (SOF) medical personnel, from developing and implementing similar training programs when live tissue or cadaver models are unavailable or not feasible. Stress, cortisol, medical student, enhanced learning, scenario, high intensity. 2012.

America's medical school: 5,000 graduates since the "first class".

PubMed

Artino, Anthony R; Gilliland, William R; Cruess, David F; Durning, Steven J

2015-04-01

In 1980, the Uniformed Services University of the Health Sciences (USU) graduated its first class of medical students. As a national university intended to produce "career-committed" military officers and future leaders of the Military Health System, USU functions as the service academy for military medicine and public health. More than 40 years after the school's charter and 5,000 graduates since the first class, we describe the original purpose of USU and provide an update on its achievements. In particular, we address the question of the "staying power" of the University's alumni-the degree to which graduation from the nation's military medical school is associated with long years of devoted service to military medicine. At a time when the MHS is confronting the challenge of extended deployments, rising health care costs, and a growing array of threats to our nation's health, we suggest that America needs USU now more than ever. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

English Learning Strategies of Various Nations: A Study in Military Context

ERIC Educational Resources Information Center

Solak, Ekrem

2014-01-01

How successful learners learn English has been one of the primary interest of scientists and researchers in recent years. Therefore, this study aimed to determine what language learning strategies the military personnel from different nations used while learning English. 56 subjects from 14 different nations deployed in three different military…

Medical ethics surveillance in the Armed Forces.

PubMed

Pearn, J

2000-05-01

Modern defense services depend on a policy of the vigorous promotion of research to ensure that they retain an advantage in any future operational context. Research involving personnel within the armed forces, however, has certain constraints with respect to contemporary, best-practice medical ethics. Service members are one example of a class of "captive subjects" who require special protection in the context of medical research. (Prisoners, students, children, and the intellectually disabled are other such examples.) The majority of national defense forces now have ethical watchdog groups--institutional ethics committees--that oversee research involving service members. Such groups monitor the special considerations and constraints under which subjects in uniform can volunteer for biological research. These committees audit particularly the ethical themes of confidentiality, equality, and justice. Themes inherent in medical research in the military include the standard Beauchamp-Childress paradigm of autonomy, beneficence, nonmaleficence, and justice, to which are added the traditional military values of loyalty, respect, courtesy, and chivalry. Contemporary thinking is that the general principle of affording service members the opportunity to volunteer for research should be maintained within the constraints of compromised training time, national security, and operational necessity. Most biological research (and its outcome) does not in practice compromise confidentiality or military security. This paper presents an audit of the functioning of one national military medical ethics committee, the Australian Defence Medical Ethics Committee, and presents a discussion of its philosophies and influence within the broader military context. The Australian Defence Medical Ethics Committee believes that most research should, as an a priori condition of approval, be intended for open publication in peer-reviewed journals.

Performance of cardiopulmonary resuscitation during prolonged basic life support in military medical university students: A manikin study.

PubMed

Wang, Juan; Zhuo, Chao-Nan; Zhang, Lei; Gong, Yu-Shun; Yin, Chang-Lin; Li, Yong-Qin

2015-01-01

The quality of chest compressions can be significantly improved after training of rescuers according to the latest national guidelines of China. However, rescuers may be unable to maintain adequate compression or ventilation throughout a response of average emergency medical services because of increased rescuer fatigue. In the present study, we evaluated the performance of cardiopulmonary resuscitation (CPR) in training of military medical university students during a prolonged basic life support (BLS). A 3-hour BLS training was given to 120 military medical university students. Six months after the training, 115 students performed single rescuer BLS on a manikin for 8 minutes. The qualities of chest compressions as well as ventilations were assessed. The average compression depth and rate were 53.7±5.3 mm and 135.1±15.7 compressions per minute respectively. The proportion of chest compressions with appropriate depth was 71.7%±28.4%. The average ventilation volume was 847.2±260.4 mL and the proportion of students with adequate ventilation was 63.5%. Compared with male students, significantly lower compression depth (46.7±4.8 vs. 54.6±4.8 mm, P<0.001) and adequate compression rate (35.5%±26.5% vs. 76.1%±25.1%, P<0.001) were observed in female students. CPR was found to be related to gender, body weight, and body mass index of students in this study. The quality of chest compressions was well maintained in male students during 8 minutes of conventional CPR but declined rapidly in female students after 2 minutes according to the latest national guidelines. Physical fitness and rescuer fatigue did not affect the quality of ventilation.

Performance of cardiopulmonary resuscitation during prolonged basic life support in military medical university students: A manikin study

PubMed Central

Wang, Juan; Zhuo, Chao-nan; Zhang, Lei; Gong, Yu-shun; Yin, Chang-lin; Li, Yong-qin

2015-01-01

BACKGROUND: The quality of chest compressions can be significantly improved after training of rescuers according to the latest national guidelines of China. However, rescuers may be unable to maintain adequate compression or ventilation throughout a response of average emergency medical services because of increased rescuer fatigue. In the present study, we evaluated the performance of cardiopulmonary resuscitation (CPR) in training of military medical university students during a prolonged basic life support (BLS). METHODS: A 3-hour BLS training was given to 120 military medical university students. Six months after the training, 115 students performed single rescuer BLS on a manikin for 8 minutes. The qualities of chest compressions as well as ventilations were assessed. RESULTS: The average compression depth and rate were 53.7±5.3 mm and 135.1±15.7 compressions per minute respectively. The proportion of chest compressions with appropriate depth was 71.7%±28.4%. The average ventilation volume was 847.2±260.4 mL and the proportion of students with adequate ventilation was 63.5%. Compared with male students, significantly lower compression depth (46.7±4.8 vs. 54.6±4.8 mm, P<0.001) and adequate compression rate (35.5%±26.5% vs. 76.1%±25.1%, P<0.001) were observed in female students. CONCLUSIONS: CPR was found to be related to gender, body weight, and body mass index of students in this study. The quality of chest compressions was well maintained in male students during 8 minutes of conventional CPR but declined rapidly in female students after 2 minutes according to the latest national guidelines. Physical fitness and rescuer fatigue did not affect the quality of ventilation. PMID:26401177

Delivering biodefense continuing education to military medical providers by allowing a biodefense educational curriculum to unfold in practice.

PubMed

D'Alessandro, Donna M; D'Alessandro, Michael P

2007-12-01

A challenge today is how to deliver initial and continuing education on biodefense to military medical providers in a manner that can be integrated into their workflow and lifestyle. A summative evaluation of a prototypical biodefense digital library (BDL) and learning collaboratory was performed. The BDL posted daily links to biodefense news stories from January 2004 to December 2005. Four evaluations were completed, that is, content evaluation, curriculum comparison with a biodefense graduate program, usage evaluation, and impact factor analysis. News stories (N = 678) came from a broad range of authoritative national and international news sources (N = 178). News stories covered all of the categories in the required and elective formal biodefense graduate program courses. The BDL was consistently displayed on the first page of the top three Internet search engines, meaning that it was among the top 10 authoritative Internet sites on biodefense. Presenting biodefense news stories to busy military medical providers in an organized chronological fashion produces an unstructured biodefense educational curriculum that unfolds in practice and becomes an educational resource that is ultimately well regarded and may be efficient to use.

The Joint Military Medical Executive Skills initiative: an impressive response to changing human resource management rules of engagement.

PubMed

Kerr, Bernard J

2007-01-01

Confronted with a sudden and substantial change in the rules regarding who could command a military medical treatment facility (MTF), the Military Health System (MHS) responded to the challenge with an impressive human resource management solution-the Joint Medical Executive Skills Program. The history, emergence, and continuing role of this initiative exemplifies the MHS's capacity to fulfill the spirit and intent of an arduous Congressional mandate while enhancing professional development and sustaining the career opportunities of medical officers. The MHS response to the Congressional requirement that candidates for MTF command demonstrate professional administrative skills was decisive, creative, and consistent with the basic principles of human resource management. The Joint Medical Executive Skills Program is a management success story that demonstrates how strategic planning, well-defined skills requirements, and structured training can assure a ready supply of qualified commanders for the military's MTFs.

Prevalence and correlates of cigarette smoking among operation Iraqi freedom-era and operation enduring freedom-era women from the Active Component military and Reserve/National Guard.

PubMed

Vander Weg, Mark W; Mengeling, Michelle A; Booth, Brenda M; Torner, James C; Sadler, Anne G

2015-04-01

Tobacco use adversely affects the health and readiness of military personnel. Although rates of cigarette smoking have historically been elevated among men serving in the military, less is known about tobacco use in servicewomen. To examine the prevalence and correlates of tobacco use among women serving in the Active Component (AC) and Reserve/National Guard (RNG) as well as factors associated with starting to smoke during military service. Cross-sectional surveys of 1320 women serving in the AC or RNG were used to examine cigarette use in servicewomen. Associations between self-reported tobacco use history, sociodemographics, military service, and psychosocial factors were investigated using logistic regression analyses. Thirty-six percent of servicewomen had a lifetime history of cigarette use, with 18% reporting current smoking. Thirty-one percent of lifetime smokers initiated smoking during military service. Factors associated with current smoking included pay grade, marital status, use of psychotropic medications, past-year alcohol use, and lifetime illicit drug or illegal prescription medication use. An enlisted pay grade, being white, and a history of deployment were all associated with starting to smoke during military service. Although progress has been made in reducing the gap in tobacco use between military and civilian populations, nearly 1 in 5 servicewomen in our sample smoked cigarettes. Further efforts are needed to address tobacco use in this population. In addition to providing resources to assist smokers with quitting, additional attention should be given to preventing smoking initiation, particularly among deployed female personnel.

Intentions of Women (18-25 Years Old) to Join the Military: Results of a National Survey.

ERIC Educational Resources Information Center

Borack, Jules I.

In anticipation of the projected decline in the national population of young men and of expanding the role of women in the military, the Navy conducted a national telephone survey to gauge the interest of women and men in joining the military under present conditions and under three alternative options. The options related to expanding the role of…

Assessment of Chiropractic Treatment for Low Back Pain, Military Readiness and Smoking Cessation in Military Active Duty Personnel

DTIC Science & Technology

2016-03-01

personnel as a special service of the Physical Therapy Department. Chiropractic services have been available at NMCSD since 2003. A single DC provides...man- agement. Physical therapy and referral to a pain clinic may also be prescribed as a component of UMC. UMC providers report prescription medication...Reed National Military Medical Center. www.wrnmmc. capmed.mil/SitePages/home.aspxl. Accessed 18 Jun 2015. 33. An American Physical Therapy

Collaboration between civilian and military healthcare professionals: a better way for planning, preparing, and responding to all hazard domestic events.

PubMed

Marklund, LeRoy A; Graham, Adrienne M; Morton, Patricia G; Hurst, Charles G; Motola, Ivette; Robinson, Donald W; Kelley, Vivian A; Elenberg, Kimberly J; Russler, Michael F; Boehm, Daniel E; Higgins, Dawn M; McAndrew, Patrick E; Williamson, Hope M; Atwood, Rodney D; Huebner, Kermit D; Brotons, Angel A; Miller, Geoffrey T; Rimpel, Laukton Y; Harris, Larry L; Santiago, Manuel; Cantrell, LeRoy

2010-01-01

Collaboration is used by the US National Security Council as a means to integrate inter-federal government agencies during planning and execution of common goals towards unified, national security. The concept of collaboration has benefits in the healthcare system by building trust, sharing resources, and reducing costs. The current terrorist threats have made collaborative medical training between military and civilian agencies crucial. This review summarizes the long and rich history of collaboration between civilians and the military in various countries and provides support for the continuation and improvement of collaborative efforts. Through collaboration, advances in the treatment of injuries have been realized, deaths have been reduced, and significant strides in the betterment of the Emergency Medical System have been achieved. This review promotes collaborative medical training between military and civilian medical professionals and provides recommendations for the future based on medical collaboration.

[Military medicine in Mexico in 1915].

PubMed

Moreno-Guzmán, Antonio

2016-01-01

As a part of the symposium titled “Mexico in 1915, Epidemics, Hunger, and Medical Assistance”, presented at the National Academy of Medicine on August 5, 2015, this section will underscore the most important and transcendent facts inherent tot he military medicine and surgery that happened during the turmoil of the year 1915.

Incidence of Norovirus-Associated Medical Encounters among Active Duty United States Military Personnel and Their Dependents.

PubMed

Rha, Brian; Lopman, Benjamin A; Alcala, Ashley N; Riddle, Mark S; Porter, Chad K

2016-01-01

Norovirus is a leading cause of gastroenteritis episodes and outbreaks in US military deployments, but estimates of endemic disease burden among military personnel in garrison are lacking. Diagnostic codes from gastroenteritis-associated medical encounters of active duty military personnel and their beneficiaries from July 1998-June 2011 were obtained from the Armed Forces Health Surveillance Center. Using time-series regression models, cause-unspecified encounters were modeled as a function of encounters for specific enteropathogens. Model residuals (representing unexplained encounters) were used to estimate norovirus-attributable medical encounters. Incidence rates were calculated using population data for both active duty and beneficiary populations. The estimated annual mean rate of norovirus-associated medically-attended visits among active duty personnel and their beneficiaries was 292 (95% CI: 258 to 326) and 93 (95% CI: 80 to 105) encounters per 10,000 persons, respectively. Rates were highest among beneficiaries <5 years of age with a median annual rate of 435 (range: 318 to 646) encounters per 10,000 children. Norovirus was estimated to cause 31% and 27% of all-cause gastroenteritis encounters in the active duty and beneficiary populations, respectively, with over 60% occurring between November and April. There was no evidence of any lag effect where norovirus disease occurred in one population before the other, or in one beneficiary age group before the others. Norovirus is a major cause of medically-attended gastroenteritis among non-deployed US military active duty members as well as in their beneficiaries.

Developing regeneration in woodlots at Gettysburg National Military Park

Treesearch

Todd W. Bowersox; Gerald L. Storm; Walter M. Tzilkowski

1993-01-01

Woodlots are significant features of the historic scene at Gettysburg National Military Park, Pennsylvania. Recent inventories of these historic woodlots indicated a general lack of seedling recruitment in the uneven-aged stands with a mature mixed oak overstory and a midstory of ash-cherry-dogwood-hickory. Seedling-sized stems of shrub and tree species were abundant,...

Fresh whole blood transfusions in coalition military, foreign national, and enemy combatant patients during Operation Iraqi Freedom at a U.S. combat support hospital.

PubMed

Spinella, Philip C; Perkins, Jeremy G; Grathwohl, Kurt W; Repine, Thomas; Beekley, Alec C; Sebesta, James; Jenkins, Donald; Azarow, Kenneth; Holcomb, John B

2008-01-01

United States military doctrine permits the use of fresh whole blood (FWB), donated by U.S. military personnel on site, for casualties with life-threatening injuries at combat support hospitals. U.S. Military Medical Department policy dictates that all patients treated at military facilities during combat (coalition military personnel, foreign nationals, and enemy combatants) are to be treated equally. The objectives of this study were to describe admission vital signs and laboratory values and injury location for patients transfused with FWB, and to determine if FWB was employed equally among all patient personnel categories at a combat support hospital. This retrospective cohort study evaluated admission vital signs and laboratory values, injury location, and personnel category for all patients receiving FWB at a U.S. Army combat support hospital in Baghdad, Iraq, between January and December 2004. Eighty-seven patients received 545 units of FWB. Upon admission, the average (+/-S.D.) heart rate was 144 bpm (+/-25); systolic blood pressure, 106 mmHg (+/-33); base deficit, 9 (+/-6.5); hemoglobin, 9.0 g/dl (+/-2.6); platelet concentration, 81.9 x 10(3)/mm(3) (+/-81); international normalized ratio (INR), 2.0 (+/-1.1); and temperature 95.7 degrees F (+/-2.6). The percentages of intensive care patients who received FWB by personnel category were as follows: coalition soldiers, 51/592 (8.6%); foreign nationals, 25/347 (7.2%); and enemy combatants, 11/128 (8.5% (p = 0.38). The amount of FWB transfused by personnel category was as follows: coalition soldier, 4 units (1-35); foreign national, 4 units (1-36); and enemy combatant, 4 units (1-11) (p = 0.9). Fresh whole blood was used for anemic, acidemic, hypothermic, coagulopathic patients with life-threatening traumatic injuries in hemorrhagic shock, and it was transfused in equal percentages and amounts for coalition soldiers, foreign nationals, and enemy combatants.

The challenges of military medical education and training for physicians and nurses in the Nordic countries - an interview study.

PubMed

Sonesson, Linda; Boffard, Kenneth; Lundberg, Lars; Rydmark, Martin; Karlgren, Klas

2017-04-11

Development and use of e-learning has not taken place to the same extent in military medicine in the Nordic countries. The aim was to explore the similarities and differences in education and training in military medicine for health professionals in the Nordic countries, and more specifically to identify the specific challenges regarding education and training of military medicine, and how e-learning is used at present and the opportunities for the future. Key educators within military medicine in the Nordic countries, as approved by the respective Surgeons General, were interviewed and the interviews were analyzed using content analysis. The data showed that all Nordic countries cooperate in the field of military medical training to some extent. The models of recruitment and employment of health professionals differed as well as the degree of political support. These differences affected the ability for health professionals to gain actual experience from the military environment. To improve the quality of medical education and training, attempts were made to recruit physicians. The recruitment of physicians was considered a challenge which had resulted in disruptions of courses, training programs and maintenance of accreditation. The Nordic countries were described as having commonalities in the military medical systems and common needs for international collaboration within training, but differing in the range of education and training. Gaps were identified in methods for transferring outcomes from education into practice, as well as regarding evaluation and feedback of outcomes to military medicine. The educational tradition was described as oriented towards practical skills training without requirements on pedagogical education of educators. The results confirmed previous studies showing that e-learning was underutilized. Contextual understanding and experience of healthcare were seen as crucial factors for successful e-learning development. Extended Nordic

[Evaluation of organization of the military medical support in the peace time].

PubMed

Korshever, N G

2001-09-01

The work is devoted to investigation of some theoretical and practical aspects of organizational diagnosis of troops medical support during the peace-time. The analysis of literature, the materials obtained during the practical training of the students of Saratov Military Medical Institute, the expert questioning of the teaching stuff (14 persons) allowed to characterize the difficulties in diagnosis of different objects as well as the qualities necessary for the diagnostician. It also permitted to determine the functions, methods, classification and stages of organizational diagnosis, to substantiate the requirements necessary for evaluation of troops medical support.

Cross-cultural communication capabilities of U.S. military trainers: host nation perspective.

PubMed

Mahmood, Maysaa; Alameri, Ali; Jawad, Shakir; Alani, Yasir; Zuerlein, Scott; Nakano, Gregg; Anderson, Warner; Beadling, Charles

2013-06-01

A survey was conducted to assess trainee perception of the cross-cultural communication competency of U.S. military trainers and their satisfaction with the training they received. Findings from the survey show that U.S. military trainers rely significantly on local interpreters. This indicates variability in the ability of the trainers to communicate effectively with host nation partners, the variability being dependent on the capabilities of the individual interpreter. The findings illustrate the importance of providing military health personnel with training on how to work effectively with interpreters. The use of supplementary resources such as electronic translation devises when the interpreter is not capable of conveying health-related training information with the desired level of accuracy is recommended. Expanding the availability of general cultural training, which provides baseline information on local values, traditions, and customs in addition to health-specific cultural orientation, is also recommended to help military health trainers customize their training content and methods to fit the local environment. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

Professional Stress and Burnout in U.S. Military Medical Personnel Deployed to Afghanistan.

PubMed

Adler, Amy B; Adrian, Amanda L; Hemphill, Marla; Scaro, Nicole H; Sipos, Maurice L; Thomas, Jeffrey L

2017-03-01

Studies of medical staff members have consistently documented high levels of burnout compared to those in other professions. Although there are studies of burnout in military medical staff, there are gaps in understanding the experience of medical staff while they are deployed and few occupationally-related factors associated with decreased burnout have been identified in this population. To assess work-related variables accounting for burnout over and above rank, post-traumatic stress disorder (PTSD) symptoms, and professional stressors in the deployed environment. U.S. military medical staff members were surveyed in Afghanistan. The survey assessed burnout (emotional exhaustion and depersonalization), PTSD symptoms, perception of professional stressors, self-care behaviors, taking care of team members (team care), general leadership, and health-promoting leadership. Participants provided informed consent under a protocol approved by the institutional review board at Walter Reed Army Institute of Research, and coordinated through the Washington Headquarters Service and the Joint Casualty Care Research Team located in Afghanistan. A total of 344 individuals provided their consent (83.3%) and completed the survey. Correlations found significant positive relationships between perception of professional stressors and levels of burnout. Significant negative correlations were found between burnout and self-care, team care, general leadership, and health-promoting leadership. Regression analyses found self-care and team care accounted for less burnout even after controlling for rank, PTSD symptoms, and professional stressors. Health-promoting leadership accounted for less burnout even after controlling for these same covariates and general leadership as well. Although a cross-sectional survey, results provide three specific directions for reducing burnout in deployed medical staff. By emphasizing self-care, team care, and health-promoting leadership, policy makers

Incidence of Norovirus-Associated Medical Encounters among Active Duty United States Military Personnel and Their Dependents

PubMed Central

Rha, Brian; Lopman, Benjamin A.; Alcala, Ashley N.; Riddle, Mark S.; Porter, Chad K.

2016-01-01

Background Norovirus is a leading cause of gastroenteritis episodes and outbreaks in US military deployments, but estimates of endemic disease burden among military personnel in garrison are lacking. Methods Diagnostic codes from gastroenteritis-associated medical encounters of active duty military personnel and their beneficiaries from July 1998–June 2011 were obtained from the Armed Forces Health Surveillance Center. Using time-series regression models, cause-unspecified encounters were modeled as a function of encounters for specific enteropathogens. Model residuals (representing unexplained encounters) were used to estimate norovirus-attributable medical encounters. Incidence rates were calculated using population data for both active duty and beneficiary populations. Results The estimated annual mean rate of norovirus-associated medically-attended visits among active duty personnel and their beneficiaries was 292 (95% CI: 258 to 326) and 93 (95% CI: 80 to 105) encounters per 10,000 persons, respectively. Rates were highest among beneficiaries <5 years of age with a median annual rate of 435 (range: 318 to 646) encounters per 10,000 children. Norovirus was estimated to cause 31% and 27% of all-cause gastroenteritis encounters in the active duty and beneficiary populations, respectively, with over 60% occurring between November and April. There was no evidence of any lag effect where norovirus disease occurred in one population before the other, or in one beneficiary age group before the others. Conclusions Norovirus is a major cause of medically-attended gastroenteritis among non-deployed US military active duty members as well as in their beneficiaries. PMID:27115602

Body composition and physical fitness in a cohort of US military medical students.

PubMed

Mitchell, Sarah D; Eide, Richard; Olsen, Cara H; Stephens, Mark B

2008-01-01

Medical school requires that students balance academic schedules with other lifestyle demands, including nutrition, physical fitness, and wellness. We retrospectively reviewed trends in body composition and physical fitness of a cohort of military medical students attending the Uniformed Services University. Although students were able to maintain muscular endurance and body composition, cardiorespiratory endurance, as measured by a timed 1.5-mile run, declined significantly over a 2-yr period.

Medical specialty selection criteria of Israeli medical students early in their clinical experience: subgroups.

PubMed

Avidan, Alexander; Weissman, Charles; Elchalal, Uriel; Tandeter, Howard; Zisk-Rony, Rachel Yaffa

2018-04-18

Israeli medical school classes include a number of student subgroups. Therefore, interventions aimed at recruiting medical students to the various specialties should to be tailored to each subgroup. Questionnaires, distributed to 6 consecutive 5th-year classes of the Hebrew University - Hadassah School of Medicine, elicited information on criteria for choosing a career specialty, criteria for choosing a residency program and the importance of finding a specialty interesting and challenging when choosing a residency. Completed questionnaires were returned by 540 of 769 (70%) students. The decision processes for choosing a medical specialty and choosing a residency program were different. Family and colleagues had minimal influence on choosing a specialty, while family and their residential locality had much influence on choosing a residency, especially among women. Older age, marriage, and spousal influence were positively associated with choice of a specialty. Two-thirds of the students had completed military service, 20% were attending medical school prior to military service, 5% had completed national service and 9% had entered medical school without serving. Despite the pre-military subgroup being younger and having another 7 years of medical school, internship and military service before residency, they had begun thinking about which specialty to choose, just like the post-military students. When choosing a residency program, post-military women were more influenced by their families and family residential locality than their pre-military counterparts; differences ascribed to the older and often married post-military women having or wanting to begin families. This difference was reinforced by fewer post- than pre-military women willing to wait 2-3 years for a residency in the specialty that interested them most and were willing to begin residency immediately after internship in a specialty that interested them less. Medical school classes are composed of

Infection prevention and control in deployed military medical treatment facilities.

PubMed

Hospenthal, Duane R; Green, Andrew D; Crouch, Helen K; English, Judith F; Pool, Jane; Yun, Heather C; Murray, Clinton K

2011-08-01

Infections have complicated the care of combat casualties throughout history and were at one time considered part of the natural history of combat trauma. Personnel who survived to reach medical care were expected to develop and possibly succumb to infections during their care in military hospitals. Initial care of war wounds continues to focus on rapid surgical care with debridement and irrigation, aimed at preventing local infection and sepsis with bacteria from the environment (e.g., clostridial gangrene) or the casualty's own flora. Over the past 150 years, with the revelation that pathogens can be spread from patient to patient and from healthcare providers to patients (including via unwashed hands of healthcare workers, the hospital environment and fomites), a focus on infection prevention and control aimed at decreasing transmission of pathogens and prevention of these infections has developed. Infections associated with combat-related injuries in the recent operations in Iraq and Afghanistan have predominantly been secondary to multidrug-resistant pathogens, likely acquired within the military healthcare system. These healthcare-associated infections seem to originate throughout the system, from deployed medical treatment facilities through the chain of care outside of the combat zone. Emphasis on infection prevention and control, including hand hygiene, isolation, cohorting, and antibiotic control measures, in deployed medical treatment facilities is essential to reducing these healthcare-associated infections. This review was produced to support the Guidelines for the Prevention of Infections Associated With Combat-Related Injuries: 2011 Update contained in this supplement of Journal of Trauma.

[The Military Medical Academy during the Great Patriotic War].

PubMed

Elizarev, S V; Lemeshkin, R N; Klyuchnkov, P B

2015-05-01

The article is devoted to the 70th anniversary of Victory in the Great Patriotic War of 1941-1945. Presented the contribution of the"Military Medical Academy. Examined the activities of the academy and the fulfillment of its employees on the eve of the war, the conditions under which employees had to work in the first months of the war in Leningrad. Described the evacuation of the Academy to the rear of the' country and especially educational, scientific and practical activities of employees Academy in Samarkand; activities clinics Academy remaining in the besieged Leningrad; radical reorganization of the Academy during the war. Presented briefly the history of creation of command and the Medical Faculty. Paying tribute to the faculty of the Academy in the field of research, teaching activities and practical work in the army.

Technology complementing military psychology programs and services in the Pacific Regional Medical Command.

PubMed

Stetz, Melba C; Folen, Raymond A; Van Horn, Sandra; Ruseborn, Daniel; Samuel, Kevin M

2013-08-01

The Tripler Army Medical Center is the only federal tertiary care hospital serving the Pacific Regional Medical Command. Due to Tripler's large area of responsibility, many behavioral health professionals are starting to employ more technology during their sessions. As explained in this article, virtual reality and telepsychology efforts are proving to benefit military service members and their families in the Pacific Rim. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Psychohistory before Hitler: early military analyses of German national psychology.

PubMed

Bendersky, J W

1988-04-01

As part of a grandiose post-World War I psychological project to predict the behavior of nations, the U.S. Military Intelligence Division (MID) utilized racial and social psychological theories to explain an alleged problematic German national character. Though unsuccessful, this project has major significance in the history of psychohistory. For the newly discovered MID files reveal that ideas, attitudes, and biases many psychohistorians subsequently identified as manifestations of a peculiar German national character had previously been held by American officers and reputable psychologists. What American analysts would, in 1940, view as symptoms of a maladjusted German mind, their predecessors had, in 1920, considered valid scientific concepts.

How will military/civilian coordination work for reception of mass casualties from overseas?

PubMed

Mackenzie, Colin; Donohue, John; Wasylina, Philip; Cullum, Woodrow; Hu, Peter; Lam, David M

2009-01-01

In Maryland, there have been no military/civilian training exercises of the Medical Mutual Aid Agreement for >20 years. The aims of this paper are to describe the National Disaster Medical System (NDMS), to coordinate military and civilian medical mutual aid in response to arrival of overseas mass casualties, and to evaluate the mass-casualty reception and bed "surge" capacity of Maryland NDMS Hospitals. Three tabletop exercises and a functional exercise were performed using a simulated, overseas, military mass-casualty event. The first tabletop exercise was with military and civilian NMDS partners. The second tested the revised NDMS activation plan. The third exercised the Authorities of State Emergency Medical System and Walter Reed Army Medical Center Directors of Emergency Medicine over Maryland NDMS hospitals, and their Medical Mutual Aid Agreement. The functional exercise used Homeland Security Exercise Evaluation Program tools to evaluate reception, triage, staging, and transportation of 160 notional patients (including 20 live, moulaged "patients") and one canine. The first tabletop exercise identified deficiencies in operational protocols for military/civilian mass-casualty reception, triage, treatment, and problems with sharing a Unified Command. The second found improvements in the revised NDMS activation plan. The third informed expectations for NDMS hospitals. In the functional exercise, all notional patients were received, triaged, dispatched, and accounted in military and five civilian hospitals within two hours. The canine revealed deficiencies in companion/military animal reception, holding, treatment, and evacuation. Three working groups were suggested: (1) to ensure 100% compliance with triage tags, patient accountability, and return of equipment used in mass casualty events and exercises; (2) to investigate making information technology and imaging networks available for Emergency Operation Centers and Incident Command; and (3) to establish NDMS

Narrative approach in understanding the drivers for resilience of military combat medics.

PubMed

Russell, Cristel Antonia; Gibbons, S W; Abraham, P A; Howe, E R; Deuster, P; Russell, D W

2017-12-10

Qualitative insights may demonstrate how combat medics (CM) deal with stressors and identify how resilience can potentially develop. Yet, qualitative research is scant in comparison to the many quantitative studies of health outcomes associated with military service. Semistructured qualitative interviews were used to collect personal narratives of US Army CMs who had previously served in Iraq or Afghanistan. Thematic analysis revealed three key driving forces for how resilience develops in the context of combat and war. The first was patriotism, which captures loyalty and full commitment to the military and its missions. The second was commitment to their family, reflecting the balance of responsibility to family of origin with the obligation one feels towards their military family. The last driving force was faith, or the drive to reach towards the transcendent to provide a moral compass and develop empathy in the face of difficult situations. An individual's commitment to country, military family and faith strengthens their resilience, and this can be used to inform future research efforts as well as current clinical practice. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

[Ocular findings in Polish Armed Forces in Iraq and Afghanistan, a review of medical examinations by The Military Medical Commission in Łodz].

PubMed

Pastuszka, Mirosław; Goś, Roman; Jurowski, Piotr; Chrzaszcz, Agnieszka; Smigielski, Janusz; Nowak, Michał S

2013-01-01

To determine the prevalence of ocular disorders among Polish soldiers returning from Iraq and Afghanistan military campaigns. A retrospective review of medical records of the Military Medical Commission of Lodz, Poland was performed. Records of 296 randomly selected soldiers, including 98 who returned from Iraq in 2004 and in 198 who returned from Afghanistan in 2012, were assessed. All subjects underwent comprehensive ocular examinations according to the military regulations. We used statistical analysis to review the results. The incidence of ocular disorders in Iraq and Afghanistan groups was 17.3% and 15.1%, respectively. The study revealed that the most common disorders among soldiers were refractive errors affecting 6.8% subjects, followed by defective color vision (4.7%) and solar retinopathy (3.0%). Combat injuries were diagnosed in 3 subjects, including 2 cases of corneal injury and 1 case of retinal detachment due to blast exposure. Combat injuries occurred in 1% of soldiers returning from Iraq and Afghanistan military campaigns. There were no statistically significant differences between Iraq and Afghanistan groups in the incidence of ocular disorders. Solar retinopathy was the most common problem related to the long-term exposure to rough climate conditions in both groups. ocular findings, Iraq, Afghanistan.

Simulation and the future of military medicine.

PubMed

Leitch, Robert A; Moses, Gerald R; Magee, Harvey

2002-04-01

The U.S. military currently faces serious difficulties in training medical personnel in peacetime for the tasks of war. The military beneficiary population comprises fit young service men and women, their dependents, and retirees. Their peacetime care, although vital, does little to prepare military medical personnel for war. Medical commanders have instituted an array of training programs to compensate for this shortfall, but there remains a large gap between operational medical needs and training opportunities in peacetime. The military has begun to examine whether simulation can fill this gap. An array of commercial, off-the-shelf technologies are already being used with varying degrees of success, and major initiatives are under way in both academia and industry, supported by the military, to develop virtual reality products for combat medical training. Even as the military exploits emerging technology and begins to articulate a simulation strategy, there is a growing interest in civilian medicine in the potential for simulation to affect patient safety--how medical simulation might mitigate the injuries and deaths caused by medical errors--and how it might also improve the quality of medical education and training.

Factors influencing humanitarian care and the treatment of local patients within the deployed military medical system: casualty referral limitations.

PubMed

Causey, Marlin; Rush, Robert M; Kjorstad, Randy J; Sebesta, James A

2012-05-01

Humanitarian medical care is an essential task of the deployed military health care system. The purpose of this study was to analyze referral acceptance in treating injured local national patients during Operation Enduring Freedom. A prospective observation study of local nationals who were referred for humanitarian trauma care in Afghanistan from March through August 2009. Sixty-six patients were referred for evacuation for suspected non-coalition-caused injuries. The bed status at the receiving hospital was defined as green (able to accept patients), amber (nearing capacity), and red (at capacity). The only factor associated with acceptance was the accepting hospital bed status (odds ratio = 1.57%, 95% confidence interval, 1.11-2.22; P = .009). Factors not significant were age, the province of origin, the type of referring facility, a prior operation before the request, patient status/affiliation, or the mechanism of injury. Humanitarian medical care is directly related to the capacity for high-acuity care because bed availability is the predominate reason for acceptance or rejection. Published by Elsevier Inc.

Blood donors’ positivity for transfusion-transmissible infections: the Serbian Military Medical Academy experience

PubMed Central

Vučetić, Dušan; Kecman, Gorica; Ilić, Vesna; Balint, Bela

2015-01-01

Background Members of armed forces worldwide are considered to be very susceptible to sexually transmitted infections, thus falling into a high-risk group of blood donors regarding transfusion-transmissible infections. In the Serbian Military Medical Academy a significant number (44% for the period 2005–2013) of blood donations were from members of the Serbian Army. The aim of this study was to determine the significance of military blood donors for the safety of blood transfusion. Material and methods Between January 2005 and December 2013, a total of 155,479 blood donations were tested for hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV) and syphilis using serological assays (enzyme immunoassays, chemiluminescent microparticle immunoassay and western blot) and molecular testing (polymerase chain reaction analysis). Results The percentage of blood donations positive for transfusion-transmissible infections in the estimated period was 0.38%, and the percentage of HBV, HCV, HIV and syphilis positive blood donations was 0.20%, 0.12%, 0.005% and 0.06%, respectively. During that period, the percentage of all transfusion-transmissible infections, and in particular of HBV and HCV, declined significantly. In contrast, the percentage of HIV and syphilis positive blood donations remained unchanged. Higher rates of positivity for transfusion-transmissible infections in blood donations from members of the Serbian Army were not found, especially after mandatory military service was abolished in 2009. Discussion The reported rate of positivity for transfusion-transmissible infections in blood donations from the Military Medical Academy was considered low. This information is of great significance for further implementation of public health measures. PMID:26057495

Medical waivers for atopic conditions did not affect attrition among U.S. military academy cadets.

PubMed

Teague, Nathan; Wiesen, Andrew

2011-01-01

Atopic conditions account for approximately 35% of medical disqualifications among West Point applicants each year. There are limited outcome data concerning the utility of the atopic disqualification standards in predicting military success. Cadets entering the United States Military Academy (USMA) from 2001-2004 were selected as the cohort for this study. They were classified as exposed (medical waiver for an atopic condition) and unexposed (no medical waiver) and followed throughout their enrollment at the USMA. The outcome measures were attrition from school and frequency of clinic visits. After adjusting for gender and age, waiver status was not associated with attrition (OR = 1.02) but was associated with an increased odds of being a high clinic user (OR = 1.37). Time-to-event analysis found an equal risk of attrition between the groups over time (HR = 1.03). Relaxing atopic disqualification standards will not increase the drop-out rate from the USMA, but may increase clinic utilization.

Military and mental health correlates of unemployment in a national sample of women veterans.

PubMed

Hamilton, Alison B; Williams, Lindsay; Washington, Donna L

2015-04-01

The unemployment rate is currently higher among women Veterans than among male Veterans and civilian women. Employment is a key social determinant of health, with unemployment being strongly associated with adverse health. To identify military-related and health-related characteristics associated with unemployment in women Veterans. Secondary analysis of workforce participants (n=1605) in the National Survey of Women Veterans telephone survey. Demographics, mental health conditions, health care utilization, and military experiences and effects. Unemployment was defined as being in the labor force but unemployed and looking for work. The χ analyses to identify characteristics of unemployed women Veterans; logistic regression to identify independent factors associated with unemployment. Ten percent of women Veterans were unemployed. Independent correlates of unemployment were screening positive for depression [odds ratio (OR)=4.7; 95% confidence interval [CI], 1.8-12.4], military service during wartime (OR=2.9; 95%, CI 1.1-7.3), and service in the regular military (vs. in the National Guards/Reserves only) (OR=6.8; 95% CI, 2.2-20.5). Two postactive duty perceptions related to not being respected and understood as a Veteran were each independently associated with unemployment. Whether depression underlies unemployment, is exacerbated by unemployment, or both, it is critical to identify and treat depression among women Veterans, and also to investigate women Veterans' experiences and identities in civilian life. Community-based employers may need education regarding women Veterans' unique histories and strengths. Women who served in the regular military and during wartime may benefit from job assistance before and after they leave the military. Gender-specific adaptation of employment services may be warranted.

[Economic problems in military public health].

PubMed

Petrov, G M; Moretskiĭ, A A

2000-03-01

There are discussed the problems of military treatment and prophylactic institution (TPI) functioning under conditions of market reform of Russian public health. Main marketing concepts in military health are determined and some recommendations on work improvement in TPI of the Armed Forces in the system of obligatory medical insurance are presented, granting population paid medical services. It is necessary to form a new type of director--military and medical manager.

The National Disaster Medical System

NASA Technical Reports Server (NTRS)

Reutershan, Thomas P.

1991-01-01

The Emergency Mobilization Preparedness Board developed plans for improved national preparedness in case of major catastrophic domestic disaster or the possibility of an overseas conventional conflict. Within the health and medical arena, the working group on health developed the concept and system design for the National Disaster Medical System (NDMS). A description of NDMS is presented including the purpose, key components, medical response, patient evacuation, definitive medical care, NDMS activation and operations, and summary and benefits.

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

New York Chapter History of Military Medicine Award. U.S. Army medical helicopters in the Korean War.

PubMed

Driscoll, R S

2001-04-01

Medical evacuation helicopters are taken for granted in today's military. However, the first use of helicopters for this purpose in the Korean War was not done intentionally but as a result of the necessity of moving patients rapidly over difficult Korean terrain and of the early ebbing of the main battle line. The objective of this essay is to increase the historical awareness of military medical evacuation helicopters in the Korean War during this 50th anniversary year. By describing the many challenges and experiences encountered in implementing the use of helicopters for evacuation, the reader will appreciate how a technology developed for another use helped in the success of evacuating nearly 22,000 patients while contributing to establishing a mortality rate of wounded of 2.4%. The preparation to write this essay included archival research of historical reports, records, and oral histories from the archives of the U.S. Army Center for Military History. Additionally, a search of journal articles written during and after the Korean War was conducted. The result is a comprehensive description of the use of medical evacuation helicopters in the Korean War.

Adaptive Virtual Reality Training to Optimize Military Medical Skills Acquisition and Retention.

PubMed

Siu, Ka-Chun; Best, Bradley J; Kim, Jong Wook; Oleynikov, Dmitry; Ritter, Frank E

2016-05-01

The Department of Defense has pursued the integration of virtual reality simulation into medical training and applications to fulfill the need to train 100,000 military health care personnel annually. Medical personnel transitions, both when entering an operational area and returning to the civilian theater, are characterized by the need to rapidly reacquire skills that are essential but have decayed through disuse or infrequent use. Improved efficiency in reacquiring such skills is critical to avoid the likelihood of mistakes that may result in mortality and morbidity. We focus here on a study testing a theory of how the skills required for minimally invasive surgery for military surgeons are learned and retained. Our adaptive virtual reality surgical training system will incorporate an intelligent mechanism for tracking performance that will recognize skill deficiencies and generate an optimal adaptive training schedule. Our design is modeling skill acquisition based on a skill retention theory. The complexity of appropriate training tasks is adjusted according to the level of retention and/or surgical experience. Based on preliminary work, our system will improve the capability to interactively assess the level of skills learning and decay, optimizes skill relearning across levels of surgical experience, and positively impact skill maintenance. Our system could eventually reduce mortality and morbidity by providing trainees with the reexperience they need to help make a transition between operating theaters. This article reports some data that will support adaptive tutoring of minimally invasive surgery and similar surgical skills. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

The U.S. Army Person-Event Data Environment: A Military-Civilian Big Data Enterprise.

PubMed

Vie, Loryana L; Scheier, Lawrence M; Lester, Paul B; Ho, Tiffany E; Labarthe, Darwin R; Seligman, Martin E P

2015-06-01

This report describes a groundbreaking military-civilian collaboration that benefits from an Army and Department of Defense (DoD) big data business intelligence platform called the Person-Event Data Environment (PDE). The PDE is a consolidated data repository that contains unclassified but sensitive manpower, training, financial, health, and medical records covering U.S. Army personnel (Active Duty, Reserve, and National Guard), civilian contractors, and military dependents. These unique data assets provide a veridical timeline capturing each soldier's military experience from entry to separation from the armed forces. The PDE was designed to afford unprecedented cost-efficiencies by bringing researchers and military scientists to a single computerized repository rather than porting vast data resources to individual laboratories. With funding from the Robert Wood Johnson Foundation, researchers from the University of Pennsylvania Positive Psychology Center joined forces with the U.S. Army Research Facilitation Laboratory, forming the scientific backbone of the military-civilian collaboration. This unparalleled opportunity was necessitated by a growing need to learn more about relations between psychological and health assets and health outcomes, including healthcare utilization and costs-issues of major importance for both military and civilian population health. The PDE represents more than 100 times the population size and many times the number of linked variables covered by the nation's leading sources of population health data (e.g., the National Health and Nutrition Examination Survey). Following extensive Army vetting procedures, civilian researchers can mine the PDE's trove of information using a suite of statistical packages made available in a Citrix Virtual Desktop. A SharePoint collaboration and governance management environment ensures user compliance with federal and DoD regulations concerning human subjects' protections and also provides a secure

Health Care Provider Burnout in a United States Military Medical Center During a Period of War.

PubMed

Sargent, Paul; Millegan, Jeffrey; Delaney, Eileen; Roesch, Scott; Sanders, Martha; Mak, Heather; Mallahan, Leonard; Raducha, Stephanie; Webb-Murphy, Jennifer

2016-02-01

Provider burnout can impact efficiency, empathy, and medical errors. Our study examines burnout in a military medical center during a period of war. A survey including the Maslach Burnout Inventory (MBI), deployment history, and work variables was distributed to health care providers. MBI subscale means were calculated and associations between variables were analyzed. Approximately 60% of 523 respondents were active duty and 34% had deployed. MBI subscale means were 19.99 emotional exhaustion, 4.84 depersonalization, and 40.56 personal accomplishment. Frustration over administrative support was associated with high emotional exhaustion and depersonalization; frustration over life/work balance was associated with high emotional exhaustion. Levels of burnout in our sample were similar to civilian medical centers. Sources of frustration were related to administrative support and life/work balance. Deployment had no effect on burnout levels. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

State institutions and social identity: National representation in soldiers' and civilians' interview talk concerning military service.

PubMed

Gibson, Stephen; Condor, Susan

2009-06-01

Theory and research deriving from social identity or self-categorization perspectives often starts out with the presumption that social actors necessarily view societal objects such as nations or states as human categories. However, recent work suggests that this may be only one of a number of forms that societal representation may take. For example, nations may be understood variously as peoples, places, or institutions. This paper presents findings from a qualitative interview study conducted in England, in which soldiers and civilians talked about nationhood in relation to military service. Analysis indicated that, in this context, speakers were often inclined to use the terms 'Britain', 'nation', and 'country' as references to a political institution as opposed to a category of people. In addition, there were systematic differences between the ways in which the two samples construed their nation in institutional terms. The civilians were inclined to treat military service as a matter of obedience to the dictates of the Government of the day. In contrast, the soldiers were more inclined to frame military service as a matter of loyalty to state as symbolically instantiated in the body of the sovereign. Implications for work adopting a social identity perspective are discussed.

32 CFR 1602.17 - Military service.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 6 2010-07-01 2010-07-01 false Military service. 1602.17 Section 1602.17 National Defense Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM DEFINITIONS § 1602.17 Military service. The term military service includes service in the Army, the Navy, the Air Force...

Current directions in military health-care provider resilience.

PubMed

Lester, Paul B; Taylor, Lauren C; Hawkins, Stacy Ann; Landry, Lisa

2015-02-01

After more than a decade of war, the US military continues to place significant emphasis on psychological health and resilience. While research and programs that focus on the broader military community's resilience continue to emerge, less is known about and until recently little focus has been placed on military medical provider resilience. In this article, we review the literature on military medical provider resilience, provide an overview of the programmatic and technological advances designed to sustain and develop military medical provider resilience, and finally offer recommendations for future research.

Educating medical professionals about suicide prevention among military veterans.

PubMed

Ganz, Debora; Sher, Leo

2013-01-01

The aim of this paper was to discuss the results of a review of literature related to suicide in military veteran populations. Suicide in veteran populations has been increasing in recent years, and continues to be a medical and social problem across the globe. For medical health professionals, knowledge of the risk factors for suicide, careful assessment, and appropriate interventions are key to suicide prevention. The main aim of this review is to better understand the risk factors present in veteran suicide and find ways by which to educate medical professionals in suicide prevention. Key suicide risk factors found in veteran populations include posttraumatic stress disorder, major depressive disorder, physical injuries, substance use disorders, traumatic brain injury, combat-related guilt, access to firearms, and insufficient social support. Some psychosocial difficulties are unique to veteran populations, and medical professionals should be culturally sensitive to these factors. Psychosocial changes upon discharge from active duty, as well as stigma against mental health disorders and treatment, should also be considered and assessed. Given that general practitioners may be the first line of defense for these veterans, they should be educated in risk factors for veteran suicide and proper assessment techniques. Any suicide risk in a veteran population should be taken very seriously, and responded to appropriately.

The C.L.E.A.R. Score: a new comprehensive assessment method for academic physicians in military medical centers.

PubMed

Buller, Jerome L; Tetteh, Hassan A

2012-07-01

Evaluation of medical officer performance is a critical leadership role. This study offers a comprehensive evaluation system for military physicians. The Comprehensive Assessment equation (COMPASS equation), a modified Cobb-Douglas equation, was developed to evaluate academic physicians. The COMPASS equation assesses military physicians within five comprehensive dimensions: (1) Clinical (2) Leadership, (3) Educational (4) Administrative, and (5) Research productivity excellence to yield a composite "C.L.E.A.R. Score." The COMPASS equation's fidelity was tested with a cohort of military physicians within the department of Obstetrics and Gynecology in the Capital District Region and a C.L.E.A.R. score was calculated for individual physicians. Mean C.L.E.A.R score was 53.6 +/- 28.8 (range 10.1-98.5). The responsiveness of the model was tested using two hypothetical physician models: "low-performing-faculty" and "super-faculty," and calculated C.L.E.A.R. scores were 6.3 and 153.4, respectively. The C.L.E.A.R. score appears to recognize and assess the performance excellence of military physicians. Weighting measured characteristics of the COMPASS equation can be used to promote organizational priorities. Thus, leaders of military medicine can communicate institutional priorities and inculcate them through use of the COMPASS equation to reward and recognize the activities of military medical officers that are commensurate with institutional goals.

Intensive skills week for military medical students increases technical proficiency, confidence, and skills to minimize negative stress.

PubMed

Mueller, Genevieve; Hunt, Bonnie; Wall, Van; Rush, Robert; Molof, Alan; Schoeff, Jonathan; Wedmore, Ian; Schmid, James; Laporta, Anthony

2012-01-01

The effects of stress induced cortisol on learning and memory is well documented in the literature.1-3 Memory and learning are enhanced at low levels while high levels are detrimental. Repetitive training in stressful situations enables management of the stress response4 as demonstrated by the high intensity training military members undergo to prepare for tactical situations. Appropriate management of one?s stress response is critical in the medical field, as the negative effects of stress can potentially hinder life-saving procedures and treatments. This also applies to physicians-in-training as they learn and practice triage, emergency medicine, and surgical skills prior to graduation. Rocky Vista University?s Military Medicine Honor?s Track (MMHT) held a week long high-intensity emergency medicine and surgical Intensive Skills Week (ISW), facilitated by military and university physicians, to advance students? skills and maximize training using the Human Worn Partial Surgical Task Simulator (Cut Suit). The short-term goal of the ISW was to overcome negative stress responses to increase confidence, technical and non-technical knowledge, and skill in surgery and emergency medicine in an effort to improve performance as third-year medical students. The long-term goal was to enhance performance and proficiency in residency and future medical practice. The metrics for the short-term goals were the focus of this pilot study. Results show an increase in confidence and decrease in perceived stress as well as statistically significant improvements in technical and non-technical skills and surgical instrumentation knowledge throughout the week. There is a correlative benefit to physician and non-physician military personnel, especially Special Operations Forces (SOF) medical personnel, from developing and implementing similar training programs when live tissue or cadaver models are unavailable or unfeasible. 2012.

Psychological Type and Undergraduate Student Achievement in Pharmacy Course in Military Medical University

ERIC Educational Resources Information Center

Shi, Ru; Shan, Shou-qin; Tian, Jian-quan

2007-01-01

The Myers-Briggs Type Indicator (MBTI) was given to 264 students in an undergraduate Pharmacy course at a military medical university. Selected MBTI personality types were compared for achievement in the course using a t-test to compare total points earned. High grades were earned by students stronger in the traits of introversion (I) and judgment…

Cross-Sectional Analysis of Commonly Prescribed Medications in Military Aviation.

PubMed

Ropp, Lincoln G; Haight, Sean P; Prudhomme, Michael B; Ropp, Elizabeth L

2017-12-01

Medication use by naval aviators, either prescription or over-the-counter, is not always relayed to the flight surgeon, resulting in unsafe flying environments. Many medications have debilitating effects that prohibit their use during aviation. Education and availability of resources on approved medications for flight status personnel is lacking. A retrospective search of the Department of Defense Composite Health Care System (DoD CHCS) was conducted from five geographic locations. Basic epidemiological information was obtained to determine the most common medications (N = 70) prescribed to active-duty flight status personnel. Analysis determined their medication category, flight status designation, and a generalized location comparison. A similar control medication list for nonflight status personnel was generated from one location. Analysis found that many medications prescribed to aviators are not approved for use in aviation and are similar to those of nonflight status personnel. There were 8 of the top 15 (53%) and 40 of the 70 (57%) most commonly prescribed medications of flight status personnel which were not approved. Similarly, 49% of total prescriptions (N = 15,652) were not approved. Little difference was found in medications among nonflight and flight status personnel, as 11 of the top 15 prescription medications (73%) were identical. This research demonstrates the need for education regarding certain medications and their prohibited use during flight. Results will provide the Flight Surgeon common medications prescribed to aviators to aid them in providing a safer flying environment.Ropp LG, Haight SP, Prudhomme MB, Ropp EL. Cross-sectional analysis of commonly prescribed medications in military aviation. Aerosp Med Hum Perform. 2017; 88(12):1129-1133.

Prototype Military Message Form (P772) and Mail List Agent (MLA) for National MMHS

DTIC Science & Technology

2006-12-01

Bakanliklar Ankara TURKEY murat.ucuncu@tr.net A. Betul SASIOGLU National Research Institute of Electronics and Cryptology ( TUBITAK – UEKAE) PK.74...Electronics and Cryptology ( TUBITAK – UEKAE) was used in the system. 3. THE PROTOTYPE NATIONAL MAMF ARCHITECTURE The new national military message...System” [2] ACP 123, "Common Messaging Strategy and Procedures” [3] MA3 ASYA, “PKI Software Developed by Turkish TUBITAK UEKAE” [4] ITU-T X.500

LGBT in the Military: Policy Development in Sweden 1944-2014.

PubMed

Sundevall, Fia; Persson, Alma

This article contributes to the growing field of research on military LGBT policy development by exploring the case of Sweden, a non-NATO-member nation regarded as one of the most progressive in terms of the inclusion of LGBT personnel. Drawing on extensive archival work, the article shows that the story of LGBT policy development in the Swedish Armed Forces from 1944 to 2014 is one of long periods of status quo and relative silence, interrupted by leaps of rapid change, occasionally followed by the re-appearance of discriminatory policy. The analysis brings out two periods of significant change, 1971-1979 and 2000-2009, here described as turns in LGBT policy. During the first turn, the military medical regulation protocol's recommendation to exempt gay men from military service was the key issue. During these years, homosexuality was classified as mental illness, but in the military context it was largely framed in terms of security threats, both on a national level (due to the risk of blackmail) and for the individual homosexual (due to the homophobic military environment). In the second turn, the focus was increasingly shifted from the LGBT individual to the structures, targeting the military organization itself. Furthermore, the analysis shows that there was no ban against LGBT people serving in the Swedish Armed Forces, but that ways of understanding and regulating sexual orientation and gender identity have nonetheless shaped the military organization in fundamental ways, and continue to do so.

The impact of military service and traumatic brain injury on the substance use norms of Army Reserve and National Guard Soldiers and their spouses.

PubMed

Devonish, J A; Homish, D L; Vest, B M; Daws, R C; Hoopsick, R A; Homish, G G

2017-09-01

Traumatic brain injury (TBI) and substance use are highly prevalent conditions among military populations. There is a significant body of evidence that suggests greater approval of substance use (i.e., norms) is related to increased substance use. The objective of this work is to understand the impact of TBI and military service on substance use norms of soldiers and their partners. Data are from the baseline assessment of Operation: SAFETY, an ongoing, longitudinal study of US Army Reserve/National Guard (USAR/NG) soldiers and their partners. Multiple regression models examined associations between alcohol, tobacco, illicit drug use, and non-medical use of prescription drug (NMUPD) norms within and across partners based on current military status (CMS) and TBI. Male USAR/NG soldiers disapproved of NMUPD, illicit drug use and tobacco use. There was no relation between military status and alcohol use. Among females, there was no relation between CMS and norms. The NMUPD norms of wives were more likely to be approving if their husbands reported TBI symptoms and had separated from the military. Husbands of soldiers who separated from the military with TBI had greater approval of the use of tobacco, NMUPD, and illicit drugs. Overall, there is evidence to suggest that, while generally disapproving of substance use, soldiers and partners become more accepting of use if they also experience TBI and separate from the military. Future research should examine the longitudinal influence of TBI on substance use norms and subsequent changes in substance use over time. Copyright © 2017. Published by Elsevier Ltd.

Saving Life, Limb, and Eyesight: Assessing the Medical Rules of Eligibility During Armed Conflict.

PubMed

Gross, Michael L

2017-10-01

Medical rules of eligibility permit severely injured Iraqi and Afghan nationals to receive care in Coalition medical facilities only if bed space is available and their injuries result directly from Coalition fire. The first rule favors Coalition soldiers over host-nation nationals and contradicts the principle of impartial, needs-based medical care. To justify preferential care for compatriots, wartime medicine invokes associative obligations of care that favor friends, family, and comrades-in-arms. Associative obligations have little place in peacetime medical care but significantly affect wartime medicine. The second rule suggests liability for collateral harm that is unsupported by international law and military ethics. Absent liability, there are pragmatic reasons to offer medical care to injured local civilians if it quells resentment and cements support for Coalition forces. In contrast to peacetime medicine, military necessity and associative obligations outweigh distributive principles based on medical need during war.

Skills Decay in Military Medical Training: A Meta-synthesis of Research Outcomes.

PubMed

Linde, Amber S; Caridha, Jona; Kunkler, Kevin J

2018-01-01

In fiscal year 2012, the Medical Simulation and Information Sciences Research Program released two Skills Decay (SD) research program announcements (PAs) under the Medical Readiness Initiative entitled "Medical Practice Initiative Breadth of Medical Practice & Disease Frequency Exposure (MPI-BMP)" and the "Medical Practice Initiative Procedural Skill Decay and Maintenance (MPI-PSD)." The Office of Naval Research also released a PA entitled "Medical Modeling and Simulation (MM&S) for Military Training and Education." A total investment of $12 M was made. This article provides a meta-synthesis of the Skills Decay research conducted under these efforts. The MSIRRP Medical Simulation Portfolio collected, reviewed, and analyzed the final reports of the Skills Decay research efforts from the three PAs. This paper provides a meta-synthesis of the outcomes of those studies. Focus of this study was to determine if the anticipated goals of the Skills Decay PAs were met as well as to provide a summary of lessons learned to the research community. Fourteen research questions posed by the PAs were structured into four main goals: (1) Skills Decay identification, (2) creation/validity of Skills Decay tools and feasibility and viability of data extraction project, (3) refreshment training to prevent or alleviate Skills Decay project, and (4) Skills Decay education content. Using a combination of training styles, choosing variables known to have Skills Decay predication value, and developing better ways of mining available data that can, in turn, provide feedback to training needs, it is possible for accurate Skills Decay models to be developed. These technologies have the ability not only capture the learner's reaction during the simulation, but to capture the simulation outcomes to predict a medical professional's level of experience and background. Lessons learned from the investments made by the government are extremely important in order to ensure that the outcomes of the

Military Retirement Benefits.

DTIC Science & Technology

1984-05-17

RD-fi49 439 MILITARY RETIREMENT BENEFITS (U) ARMY WAR COLL CARLISLE i/i 7" BARRACKS PA J D MEDLIN V MAY 84UNCLASSIFIED F/6 5/9 NL E=hhhhIhh SENSEhhhhh...appropriate military service or government agency. MILITARY RETIREMENT BENEFITS BY COLONEL JACK D. MEDLIN MEDICAL SERVICE cl- " JAN25 C r- Y4 . S17 MY...PERIOD COVERED Military Retirement Benefits S 6. PERFORMING ORG. REPORT NUMBER 7. AUTHOR(e) 6. CONTRACT OR GRANT NUMBER() Colonel Jack D. Medlin

Prevalence of high body mass index among children and adolescents at a US military treatment facility, 2008-2009.

PubMed

Choi, Y Sammy; Berry-Caban, Cristobal; Stratman, Rachel; Fleming, Jill H

2012-01-01

We assessed the prevalence of high body mass index (BMI) in a large cohort of military children. We compared BMI data from electronic medical records of military children aged 2 to 18 years with BMI data from the National Health and Nutrition Examination Survey (NHANES). The 23,778 military children studied were significantly less likely than the NHANES children to be overweight (27.1% vs 31.8%) or obese (11.9% vs 16.9%). Even though military parents are required to maintain fitness and weight standards, the absolute difference between military and civilian children was small.

32 CFR 724.215 - Military representation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 5 2010-07-01 2010-07-01 false Military representation. 724.215 Section 724.215 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL NAVAL DISCHARGE REVIEW BOARD Authority/Policy for Departmental Discharge Review § 724.215 Military representation. Military...

Medical Laboratory Technician--Microbiology, 10-3. 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 course, the second of three courses in the medical laboratory technician field adapted from military curriculum materials for use in vocational and technical education, was designed as a refresher course for student self-study and evaluation. It is suitable for use by advanced students or beginning students participating in a supervised…

Supporting deployed operations: are military nurses gaining the relevant experience from MDHUs to be competent in deployed operations?

PubMed

Beaumont, Steven P; Allan, Helen T

2014-01-01

To explore how peacetime employment of military nurses in the UK National Health Service Medical Defence Hospital Units prepares them to be competent to practise in their role on deployment. Military secondary care nurses are employed within UK National Health Service Trusts to gain clinical experience that will be relevant to their military nursing role. A two-stage grounded theory study using mixed methods: postal questionnaire survey and in-depth interviews. In stage one a postal questionnaire was distributed to all serving military nurses. Stage two involved 12 semi-structured interviews. The data from both parts of the study were analysed using grounded theory. Four categories and one core category were identified, which suggested that participants did not feel fully prepared for deployment. Their feelings of preparedness increased with deployment experience and decreased when the nature of injuries seen on deployment changed. Respondents argued that even when unprepared, they did not feel incompetent. The findings suggest that the peacetime clinical experience gained in the National Health Service did not always develop the necessary competencies to carry out roles as military nurses on deployment. This study highlights the unique role of military nurses. We discuss these findings in the light of the literature on competency and expertise. The military nurses in this study did not feel fully prepared for deployed operations. We propose a new model for how military nurses could gain relevant experience from their National Health Service placements. National Health Service clinical placements need to be reassessed regularly to ensure that they are meeting military nurses' clinical requirements. Experiences of nurses returning from deployment could be shared and used as a basis for reflection and learning within National Health Service Trusts and also inform decisions regarding the appropriateness of clinical placements for qualified military nurses. © 2012

Coordination and Integration of Military Education with National Career Education. Phase I: Career Development in Selected Occupations.

ERIC Educational Resources Information Center

Brown, Michael W.; And Others

The report describes the initial phase of a study of coordination and integration of career education in the military with the national career education effort. The study was undertaken in recognition of the potential significance of the military as a career education resource in society, and in recognition of the need to develop a concept of…

The Future of Military Graduate Medical Education

DTIC Science & Technology

1992-01-08

Army alone is the country’s largest comprehensive Health Maintenance Organization(HMO). Over the past 45 years, this work force, balancing the competing...that have to be balanced to protect national priorities. As always, costs and budgets will play a major role in determining what is maintained and...a slightly different way. For instance, the Navy generally requires all its medical officers to do some general medical officer work before going on

Soviet Military Power

DTIC Science & Technology

1984-04-01

The Soviet build-up is made possible by a national policy that has con - sistently made military materiel production its highest economic priority...classes of consumable supplies and war reserve equipment available in the USSR, as well as transport, repair and con - struction units. It includes a...the Soviet military establishment r and to the continuing growth and moderniza-tion of Soviet military power. The CPSU con .-..•_"" trols military

Clonal distribution and associated characteristics of Escherichia coli clinical and surveillance isolates from a military medical center.

PubMed

Manges, Amee R; Mende, Katrin; Murray, Clinton K; Johnston, Brian D; Sokurenko, Evgeni V; Tchesnokova, Veronika; Johnson, James R

2017-04-01

Antimicrobial-resistant Escherichia coli are a concern for military health services. We studied 100 extended-spectrum beta-lactamase (ESBL)-producing and non-producing E. coli clinical and surveillance isolates from military personnel and civilians at Brooke Army Medical Center (2007-2011). Major E. coli lineages, most prominently ST10 (24%), ST131 (16%), and ST648 (8%), were distributed much as reported for other North American populations. ST131, represented mainly by its resistance-associated ST131-H30 clonal subset, was uniquely associated with a clinical origin, regardless of ESBL status. Thus, clonal background predicted resistance phenotype and clinical versus surveillance origin, and these findings could assist military clinicians and epidemiologists. Published by Elsevier Inc.

Select clinical recommendations for military medical practitioners conducting humanitarian and civic assistance activities.

PubMed

Hollon, Justin R; Hickey, Patrick W

2010-09-01

Training and planning for stability, security, transition, and reconstruction, to include humanitarian and civic assistance activities, has taken on new importance for today's military forces. Deployed medical forces providing medical care to local populations are presented with the challenge of limited resources, complex public health needs, and complex cultural and linguistic barriers to care. In this article, we review some of the clinical situations commonly encountered during these operations and provide an evidence-based rationale for proposed courses of action. This report is timely given expanding operations in Afghanistan and the stand-up of the U.S. African Command (AFRICOM).

Military Internal Medicine Resident Decision to Apply to Fellowship and Extend Military Commitment.

PubMed

Barsoumian, Alice E; Hartzell, Joshua D; Bonura, Erin M; Ressner, Roseanne A; Whitman, Timothy J; Yun, Heather C

2018-02-06

Nationally, the number of internal medicine physicians practicing in primary care has decreased amidst increasing interest in hospitalist medicine. Current priorities in the Military Health System include access to primary care and retention of trained personnel. Recently, we have conducted a study of military internal medicine residents' decision to enter infectious disease. As part of our larger effort, we saw an opportunity to characterize factors impacting decision making of internal medicine residents' desire to apply for subspecialty training and to extend active duty service obligations. Questions were developed after discussion with various military graduate medical education and internal medicine leaders, underwent external review, and were added to a larger question set. The survey link was distributed electronically to all U.S. military affiliated residencies' graduating internal medicine residents in December 2016-January 2017. Data were analyzed by decision to apply to fellowship and decision to extend military obligation using Fisher's exact test or Pearon's chi-square test. Sixty-eight residents from 10 of 11 military residency programs responded, for a response rate of 51%. The majority (62%) applied to fellowship to start after residency completion. Reasons cited for applying to fellowship included wanting to become a specialist as soon as possible (74%), wishing to avoid being a general internist (57%), and because they are unable to practice as a hospitalist in the military (52%). Fellowship applicants were more likely to plan to extend their military obligation than non-applicants, as did those with longer duration of military commitments. No other factors, including Uniformed Services University attendance or participation in undergraduate military experiences, were found to impact plan to extend active duty service commitment. The majority of graduating internal medicine residents apply for fellowship and report a desire to avoid being a

Operation United Assistance: infectious disease threats to deployed military personnel.

PubMed

Murray, Clinton K; Yun, Heather C; Markelz, Ana Elizabeth; Okulicz, Jason F; Vento, Todd J; Burgess, Timothy H; Cardile, Anthony P; Miller, R Scott

2015-06-01

As part of the international response to control the recent Ebola outbreak in West Africa, the Department of Defense has deployed military personnel to train Liberians to manage the disease and build treatment units and a hospital for health care volunteers. These steps have assisted in providing a robust medical system and augment Ebola diagnostic capability within the affected nations. In order to prepare for the deployment of U.S. military personnel, the infectious disease risks of the regions must be determined. This evaluation allows for the establishment of appropriate force health protection posture for personnel while deployed, as well as management plans for illnesses presenting after redeployment. Our objective was to detail the epidemiology and infectious disease risks for military personnel in West Africa, particularly for Liberia, along with lessons learned from prior deployments. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Ethical standards for medical research in the Israeli military - review of the changes in the last decade.

PubMed

Hassidim, Ayal; Kayouf, Raeed; Yavnai, Nirit; Panush, Naomi; Dagan, David; Bader, Tarif; Hartal, Michael

2016-01-01

The Israel Defense Forces Medical Corps (IDF MC) institutional review board (IRB) is one of approximately 50 IRBs active in Israel. In addition to routine IRB considerations it must also address in its deliberations specific safeguards in place in the IDF to protect research volunteers in the military environment. In this report, we present the characteristics of the IDF IRB, including the unique circumstances that led to a 2008 change in the pre-IRB advisory and preparatory process (APP). We also present quantitative data on the IRB's throughput and outcomes, in order to provide a benchmark for other IRBs. We reviewed all relevant IDF regulations, both historical and current, pertaining to the structure, activity and oversight of the IRB and of medical research conducted in the IDF. Additionally, we analyzed the ethical review process for all research proposals submitted to the IDF APP between January 1, 2013 and December 31, 2015. In 2008 the IDF implemented several major changes which have had a substantial impact on the ethical regulation of military medical research. The period following these changes has seen a rise in the number of research proposals submitted to the IDF IRB annually. During the years 2013-2015, 377 research proposals entered the APP, of which 329 were deemed appropriate for IRB deliberation. Eight study protocols were granted waivers, 19 were rejected, and the remaining 302 were authorized. Overall, 345 of the 377 research proposals submitted (92 %) were ultimately cleared for execution; 310 of 329 proposals (94 %) deliberated by the IRB were authorized. The IRB required protocol revisions for 47 % of the research proposals, one-third of which were revisions directly associated with military-specific ethical precautions. Guided by the principles of protecting personal autonomy in the complex military setting, the IDF has implemented several unique measures aimed at maintaining the highest ethical standards in medical research. By sharing

Economic analysis of the military health professions scholarship program for neurosurgeons.

PubMed

Ragel, Brian T; Klimo, Paul; Grant, Gerald A; Taggard, Derek A; Nute, David; McCafferty, Randall R; Ellenbogen, Richard G

2011-09-01

The 4-year military Health Professions Scholarship Program (HPSP) provides funds for medical school tuition, books, and a monthly stipend in exchange for a 4-year military commitment (to receive all physician bonuses, an additional 3 months must be served). To analyze the economics of the HPSP for students with an interest in neurosurgery by comparing medical school debt and salaries of military, academic, and private practice neurosurgeons. Salary and medical school debt values from the American Association of Medical Colleges, salary data from the Medical Group Management Association, and 2009 military pay tables were obtained. Annual cash flow diagrams were created to encompass 14.25 years that spanned 4 years (medical school), 6 years (neurosurgical residency), and the first 4.25 years of practice for military, academic, and private practice neurosurgeons. A present value economic model was applied. Mean medical school loan debt was $154,607. Mean military (adjusted for tax-free portions), academic, and private practice salaries were $160,318, $451,068, and $721,458, respectively. After 14.25 years, the cumulative present value cash flow for military, academic, and private practice neurosurgeons was $1 193 323, $2 372 582, and $3 639 276, respectively. After 14.25 years, surgeons with medical student loans still owed $208 761. The difference in cumulative annual present value cash flow between military and academic and between military and private practice neurosurgeons was $1,179,259 and $2,445,953, respectively. The military neurosurgeon will have little to no medical school debt, whereas the calculated medical school debt of a nonmilitary surgeon was approximately $208,000.

Strategies for optimizing military physical readiness and preventing musculoskeletal injuries in the 21st century.

PubMed

Nindl, Bradley C; Williams, Thomas J; Deuster, Patricia A; Butler, Nikki L; Jones, Bruce H

2013-01-01

With downsizing of the military services and significant budget cuts, it will be more important than ever to optimize the health and performance of individual service members. Musculoskeletal injuries (MSIs) represent a major threat to the health and fitness of Soldiers and other service members that degrade our nation's ability to project military power. This affects both financial (such as the economic burden from medical, healthcare, and disability costs) and human manpower resources (Soldiers medically unable to optimally perform their duties and to deploy). For example, in 2012, MSIs represented the leading cause of medical care visits across the military services resulting in almost 2,200,000 medical encounters. They also result in more disability discharges than any other health condition. Nonbattle injuries (NBIs) have caused more medical evacuations (34%) from recent theaters of operation than any other cause including combat injuries. Physical training and sports are the main cause of these NBIs. The majority (56%) of these injuries are the direct result of physical training. Higher levels of physical fitness protect against such injuries; however, more physical training to improve fitness also causes higher injury rates. Thus, military physical training programs must balance the need for fitness with the risks of injuries. The Army has launched several initiatives that may potentially improve military physical readiness and reduce injuries. These include the US Army Training and Doctrine Command's Baseline Soldier Physical Readiness Requirements and Gender Neutral Physical Performance Standards studies, as well as the reimplementation of the Master Fitness Trainer program and the Army Medical Command's Soldier Medical Readiness and Performance Triad Campaigns. It is imperative for military leaders to understand that military physical readiness can be enhanced at the same time that MSIs are prevented. A strategic paradigm shift in the military's approach

European military mental health research: benefits of collaboration.

PubMed

Himmerich, Hubertus; Willmund, G D; Wesemann, U; Jones, N; Fear, N T

2017-06-01

Despite joint participation in international military operations, few collaborative military mental health research projects have been undertaken by European countries. From a common perspective of military mental health researchers from Germany and the UK, the lack of shared research might be related not only to the use of different languages but also the different ways in which the two militaries provide mental health and medical support to operations and differences in military institutions. One area that is suitable for military health research collaboration within UK and German forces is mental health and well-being among military personnel. This could include the study of resilience factors, the prevention of mental disorder, mental health awareness, stigma reduction and the treatment of mental disorder. Military mental health research topics, interests and the studies that have been conducted to date in the UK and Germany have considerable overlap and commonality of purpose. To undertake the investigation of the long-term consequences of operational deployment, the specific burdens placed on military families and to further the understanding of the role of factors such as biomarkers for use in military mental health research, it seems advisable to forge international research alliances across European nations, which would allow for researchers to draw transcultural and generalisable conclusions from their work. Such an enterprise is probably worthwhile given the shared research interests of Germany and the UK and the common perspectives on military mental health in particular. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The Intentions of Men 23 to 29 Years Old to Join the Military: Results of a National Survey.

ERIC Educational Resources Information Center

Borack, Jules I.

Since the population of 17-to-21-year-old males, the traditional source for military recruitment, will decline sharply during the 1980s, consideration is being given to recruiting males aged 23-29. A national survey was conducted to assess the interest of 23-to-29-year-old men in joining the military under present conditions and with monetary…

Executive Summary From the National Strength and Conditioning Association's Second Blue Ribbon Panel on Military Physical Readiness: Military Physical Performance Testing.

PubMed

Nindl, Bradley C; Alvar, Brent A; R Dudley, Jason; Favre, Mike W; Martin, Gerard J; Sharp, Marilyn A; Warr, Brad J; Stephenson, Mark D; Kraemer, William J

2015-11-01

The National Strength and Conditioning Association's tactical strength and conditioning program sponsored the second Blue Ribbon Panel on military physical readiness: military physical performance testing, April 18-19, 2013, Norfolk, VA. This meeting brought together a total of 20 subject matter experts (SMEs) from the U.S. Air Force, Army, Marine Corps, Navy, and academia representing practitioners, operators, researchers, and policy advisors to discuss the current state of physical performance testing across the Armed Services. The SME panel initially rated 9 common military tasks (jumping over obstacles, moving with agility, carrying heavy loads, dragging heavy loads, running long distances, moving quickly over short distances, climbing over obstacles, lifting heavy objects, loading equipment) by the degree to which health-related fitness components (e.g., aerobic fitness, muscular strength, muscular endurance, flexibility, and body composition) and skill-related fitness components (e.g., muscular power, agility, balance, coordination, speed, and reaction time) were required to accomplish these tasks. A scale from 1 to 10 (10 being highest) was used. Muscular strength, power, and endurance received the highest rating scores. Panel consensus concluded that (a) selected fitness components (particularly for skill-related fitness components) are currently not being assessed by the military; (b) field-expedient options to measure both health-based and skill-based fitness components are currently available; and (c) 95% of the panel concurred that all services should consider a tier II test focused on both health-related and skill-related fitness components based on occupational, functional, and tactical military performance requirements.

Restructuring Military Medical Care

DTIC Science & Technology

1995-07-01

providers, perhaps under an approach such as the Federal Employees Health Benefits (FEHB) program , discussed later in this chapter. Effects on DoD’s...CARE July 1995 Military Family Association, would give beneficiaries access to care through the Federal Employees Health Benefits program as well as...enrollment levels and BOX 6. THE FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM The Federal Employees Health Benefits (FEHB) program is the source of health

32 CFR 245.15 - Appropriate military authority.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 2 2010-07-01 2010-07-01 false Appropriate military authority. 245.15 Section 245.15 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE... Implementation of ESCAT § 245.15 Appropriate military authority. Appropriate military authority will take the...

[Criteria for determining the category of readiness for military service].

PubMed

Kulikov, V V; Liufing, A A; Panteleev, A Ia; Koval'skiĭ, O N

1997-12-01

In connection with professionalization of the Armed Forces of Russian Federation there was the necessity of deep study of laws and theoretical bases of the estimation criterion of readiness to the military service of various quota of military personnel. In this article the approaches to the given problem decision are reflected. The authors consider, that the military-medical examination represents complex process of study and estimation of the biomedical and social status of the person, definition of his conformity to conditions of the military service, the correlation of diseases and injuries with military service, but also sanction of other questions with removal of the written conclusion. The scientific development of the methodical approaches to definition of estimation of criteria of readiness category to the military service on the basis of priority of medical criteria over social in peace time becomes now one of the major problem of the military-medical examination. The authors discussed the methodological and theory questions of military-medical examination. These disputable questions require further discussion and scientific substantiation.

45 CFR 303.32 - National Medical Support Notice.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 2 2014-10-01 2012-10-01 true National Medical Support Notice. 303.32 Section 303... SERVICES STANDARDS FOR PROGRAM OPERATIONS § 303.32 National Medical Support Notice. (a) Mandatory State... specified under paragraph (c) of this section for the use, where appropriate, of the National Medical...

An Overview of National Transonic Facility Investigations for High Performance Military Aerodynamics (Invited)

NASA Technical Reports Server (NTRS)

Luckring, J. M.

2001-01-01

A review of National Transonic Facility (NTF) investigations for high-performance military aerodynamics has been completed. The review spans the entire operational period of the tunnel, and includes configurations ranging from full aircraft to basic research geometries. The intent for this document is to establish a comprehensive summary of these experiments with selected technical results

Military Medical Care: Questions and Answers

DTIC Science & Technology

2009-05-14

framework including GWOT, counterterrorism, counterinsurgency, and military support for stabilization and reconstruction efforts. With respect to the... microsurgery (rodents); and combat trauma training (goats and swine

Estimating White-tailed Deer abundance at Gettysburg National Military Park and Eisenhower National Historic Site

USGS Publications Warehouse

Stainbrook, David P.; Diefenbach, Duane R.

2012-01-01

The mission at Gettysburg National Military Park and Eisenhower National Historic Site (GNMP-ENHS) is to preserve the historic character of the parks to enable current and future generations to understand and interpret the events that took place at each park. Management objectives include maintaining the landscape as it existed during the historic 1863 Civil War battle (e.g., dense understory in woodlots) in GNMP and as it existed during Eisenhower’s occupancy (e.g., patchwork of cropfields) in ENHS. Browsing by white-tailed deer (Odocoileus virginianus) diminished regeneration of native trees in woodlots and prevented crops from reaching maturity. Thus, to increase regeneration in woodlots and reduce crop damage, the National Park Service (NPS) began culling deer in 1995 to reach a density goal of 10 deer/km2 of forest. However, park managers were interested in an accurate population estimate to determine if their management goal has been met and possible methods to monitor future abundance.

Roman Military Medicine and Croatian Archaeological Perspectives.

PubMed

Cesarik, Marijan; Cesarik, Nikola; Duplančić, Darko; Štrmelj, David

2016-09-01

This article offers a general examination of the sources responsible for understanding Roman military medicine, starting with literal and epigraphical sources all the way to archaeological remains consisting of hospitals, the infrastructure of military garrisons and small medical tools. Given that not one of the literary sources does not directly mention the medical personnel within the various military units, epigraphical discoveries widely represent the main source of our knowledge on the subject. On the other hand, the archaeological exploration of military garrisons offers proof of the medical care of Roman soldiers. If at first it appears that Roman military medicine is perfectly obvious and clear, actually this is not the case as many questions remain to be answered and debated. In all this, Croatia has its own archaeological perspective, where notably, one site stands out, which could hold a key role according to the layout of buildings within the garrison including its hospital.

Military medical advances resulting from the conflict in Korea, Part I: Systems advances that enhanced patient survival.

PubMed

Baker, Michael S

2012-04-01

The Korean War started several years after the World War II had ended and no recognition of the threat or preparation was made for this possibility. The military and its medical service had been downsized after World War II and had to quickly ramp up to meet the surprise attack. The war provided the laboratory for trials and experimentation with the new technological developments of the era. The Korean conflict led to numerous advances in medical systems and patient care. The Mobile Army Surgical Hospital came of age, and was instrumental in saving many lives. Helicopters saw their first regular use as flying ambulances to take the injured to definitive care in a timely fashion. The national blood banking program was rapidly geared up and new techniques such as plastic bags for collection and delivery resulted. Body armor was developed that would allow mobility while offering protection and was widely used for the first time. Each of these systems improvements saved the lives of soldiers in combat and were soon to be used in the civilian sector to save and improve lives around the world.

76 FR 54071 - Noncompetitive Appointment of Certain Military Spouses

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-31

... Certain Military Spouses AGENCY: U.S. Office of Personnel Management. ACTION: Final rule. SUMMARY: The U.S... to further facilitate the entry of these military spouses into the Federal civil service. DATES: This... Federal agency, and three from national military associations. Six individuals, two national military...

Sino-American Military Relations: Determinants of Policy and Corresponding Military Responsiveness

DTIC Science & Technology

2007-03-01

military medicine, administration, and a host of non -combat related areas10 Similar priorities and methods can be seen in official documents such as the...with the national foreign policy, the PLA conducts military cooperation that is non -aligned, non -confrontational and not directed against any third...benefit. It takes part in bilateral or multilateral joint military exercises in non -traditional security fields so as to enhance the joint

NATO Special Operations Forces Medical Engagements and Partnering Course: Initial Curriculum Recommendations from the NSHQ SOFMEP Committee.

PubMed

Alderman, Shawn M; Arvidsson, C Jimmy; Boedecker, Ben H; Durck, Craig H; Ferguson, Jason L; Harreld, Chad E; House, John H; Irizarry, Daniel J; Oshiki, Michael S; Sanchack, Kristian E; Torres, John E

2012-01-01

Military partnering operations and military engagements with host nation civil infrastructure are fundamental missions for NATO Special Operations Forces (SOF) conducting military assistance operations. Unit medical advisors are frequently called upon to support partnering operations and execute medical engagements with host nation health systems. As a primary point of NATO SOF medical capability development and coordination, the NATO Special Operations Headquarters (NSHQ) sought to create a practical training opportunity in which medical advisors are taught how to prepare for, plan, and execute these complex military assistance operations. An international committee of SOF medical advisors, planners and teachers was assembled to research and develop the curriculum for the first NSHQ SOF Medical Engagement and Partnering (SOFMEP) course. The committee found no other venues offering the necessary training. Furthermore, a lack of a common operating language and inadequate outcome metrics were identified as sources of knowledge deficits that create confusion and inhibit process improvement. These findings provided the foundation of this committee?s curricular recommendations. The committee constructed operational definitions to improve understanding and promote dialogue between medical advisors and commanders. Active learning principles were used to construct a curriculum that engages learners and enhances retention of new material. This article presents the initial curriculum recommendations for the SOFMEP course, which is currently scheduled for October 2012. 2012.

[The standardization of medical care and the training of medical personnel].

PubMed

Korbut, V B; Tyts, V V; Boĭshenko, V A

1997-09-01

The medical specialist training at all levels (medical orderly, doctor's assistant, general practitioner, doctors) should be based on the medical care standards. Preliminary studies in the field of military medicine standards have demonstrated that the medical service of the Armed Forces of Russia needs medical resources' standards, structure and organization standards, technology standards. Military medical service resources' standards should reflect the requisitions for: all medical specialists' qualification, equipment and material for medical set-ups, field medical systems, drugs, etc. Standards for structures and organization should include requisitions for: command and control systems in military formations' and task forces' medical services and their information support; health-care and evacuation functions, sanitary control and anti-epidemic measures and personnel health protection. Technology standards development could improve and regulate the health care procedures in the process of evacuation. Standards' development will help to solve the problem of the data-base for the military medicine education system and medical research.

[Conviction, pragmatism, research enthusiasm--mechanisms of conformity. The Medical Faculty of Giessen during National Socialism].

PubMed

Oehler-Klein, Sigrid

2007-01-01

In the course of its history the University of Giessen was threatened several times by closure, due to the University's geographical location, size, or a relative lack of reputation. This paper deals with the policy of the University's Medical Faculty during the Nazi period, when it faced specific demands and opportunities. While the University's restructuring had been initiated by some active National Socialists, this process was pragmatically supported by the Medical Faculty as a whole in order to gain advantages from its location. In particular, the Faculty (1.) institutionalized racial hygiene--a chair for one of the most radical representatives of this subject in Germany was requested--and (2.) established collaboration with the "Wehrmacht". The newly opened up perspectives for research were seen as an opportunity. In fact, from 1940 the University of Giessen was frequented again by many medical students; in 1943, the Berlin Academy for Military Medicine relocated some institutes and scientists to the University of Giessen, as the capital had become too unsafe for them because of increasing air raids.

Pain complaints and psychological distress among soldiers in specialty military medical clinics.

PubMed

Feldman, D; Rabinowitz, J

1995-05-01

This paper explores: (1) the relationship of pain complaints and psychological distress among orthopedic, dermatology, ophthalmology, and neurology outpatients, (2) the ability of patients with pain complaints and their physicians to detect patients' psychological distress, and (3) the connection between type of pain, prognosis as rated by physician, and patient's use of military primary health care and mental health treatment. Five hundred fifty-six soldiers in compulsory service in the Israel Defence Forces, ages 18 to 21, responded to the PERI-D (Psychiatric Epidemiological Research Interview Demoralization Scale), a measure of psychological distress, and questions about presenting medical complaint and use of mental health and primary health services. Military specialist physicians, who were blind to patients' responses, were asked the extent to which they thought that the cause of the patients' complaints were physical or psychological and to prognosticate. Almost 47% of soldiers attended clinics due to pain. In descending order were limb pain (42.5%), headache (29.1%), lower-back pain (24.5%), and right arm pain (3.8%). Right arm complainers were the most distressed and the heaviest users of primary health care and got the lowest prognosis, yet the physicians did not detect any psychological distress in this group. The least distressed and lowest users of medical services were patients with limb pain. There was a positive linear relationship between psychological distress and use of primary health care. There was a negative linear relationship between distress and prognosis. The patients' ability to detect psychological distress was better than that of the physicians. Physicians tended to find more cases of psychological distress than did the PERI-D in lower-back pain and limb pain patients. Psychologically distressed headache and limb pain patients reported using significantly more primary health care than non-distressed patients with similar pain complaints

[Current state and prospects of military personnel health monitoring].

PubMed

Rezvantsev, M V; Kuznetsov, S M; Ivanov, V V; Zakurdaev, V V

2014-01-01

The current article is dedicated to some features of the Russian Federation Armed Forces military personnel health monitoring such as legal and informational provision, methodological basis of functioning, historical aspect of formation and development of the social and hygienic monitoring in the Russian Federation Armed Forces. The term "military personnel health monitoring" is defined as an analytical system of constant and long-term observation, analysis, assessment, studying of factors determined the military personnel health, these factors correlations, health risk factors management in order to minimize them. The current state of the military personnel health monitoring allows coming to the conclusion that the military health system does have forces and resources for state policy of establishing the population health monitoring system implementation. The following directions of the militarily personnel health monitoring improvement are proposed: the Russian Federation Armed Forces medical service record and report system reorganization bringing it closer to the civilian one, implementation of the integrated approach to the medical service informatisation, namely, military personnel health status and medical service resources monitoring. The leading means in this direction are development and introduction of a military serviceman individual health status monitoring system on the basis of a serviceman electronic medical record card. Also it is proposed the current Russian Federation Armed Forces social and hygienic monitoring improvement at the expense of informational interaction between the two subsystems on the basis of unified military medical service space.

29 CFR 2590.609-2 - National Medical Support Notice.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 9 2014-07-01 2014-07-01 false National Medical Support Notice. 2590.609-2 Section 2590..., Qualified Medical Child Support Orders, Coverage for Adopted Children § 2590.609-2 National Medical Support Notice. (a) This section promulgates the National Medical Support Notice (the Notice), as mandated by...

29 CFR 2590.609-2 - National Medical Support Notice.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 9 2013-07-01 2013-07-01 false National Medical Support Notice. 2590.609-2 Section 2590..., Qualified Medical Child Support Orders, Coverage for Adopted Children § 2590.609-2 National Medical Support Notice. (a) This section promulgates the National Medical Support Notice (the Notice), as mandated by...

UK role 4 military infection services: past, present and future.

PubMed

Dufty, Ngozi E; Bailey, M S

2013-09-01

NATO describes 'Role 4' military medical services as those provided for the definitive care of patients who cannot be treated within a theatre of operations and these are usually located in a military force's country of origin and may include the involvement of civilian medical services. The UK Defence Medical Services have a proud history of developing and providing clinical services in infectious diseases and tropical medicine, sexual health and HIV medicine, and medical microbiology and virology. These UK Role 4 Military Infection Services have adapted well to recent overseas deployments, but new challenges will arise due to current military cutbacks and a greater diversity of contingency operations in the future. Further evidence-based development of these services will require leadership by military clinicians and improved communication and support for 'reach-back' services.

The Promise ... The Reality: Military Health Care Management Revisited

DTIC Science & Technology

2000-02-01

using the Military Health Care System and published these monthly for use by hospitals/clinics and senior commanders. Patient satisfaction is among the...quickly. Americans , in and out of uniform, are interested in health care. America�s soldiers expect that our nation will provide health care for them...medical needs for their families and has highlighted inequities among health care options for active and reserve component personnel, retirees and family

Urologic Diseases in Korean Military Population: a 6-year Epidemiological Review of Medical Records

PubMed Central

2017-01-01

We sought to describe the incidence rate of the urologic disease in the Korean military by reviewing diagnoses made in active duty soldiers from 2008 to 2013. A total of 72,248 first visits were generated in the Defense Medical Statistics Information System (DMSIS) with its gradually increasing trend over 6 years. A sharp increase of first visit was observed after implementation of the regular health check-up for all conscripted soldiers since 2013. Urolithiasis, prostatitis, epididymoorchitis, urethritis, and varicocele were prevalent. Prostatitis was the highest diagnosis made in the outpatient service, while varicocele was ranked the highest in the inpatient service. The incidence rates of urologic disease varied from 12.3 to 34.2 cases per 1,000 person-years. The urologic disease in conscripted men showed different distribution when we separated the population into conscripted and professional soldiers. Epididymoorchitis was the highest disease followed by urolithiasis, dysuresia, and balanoposthitis in 2013. This study underscores that the urologic disease has spent significant amount of health care resources in the Korean military. This calls for further study to find any significant difference and contributing factors of the urologic disease in the military and the civilian population. PMID:27914143

Leadership lessons from military education for postgraduate medical curricular improvement.

PubMed

Edler, Alice; Adamshick, Mark; Fanning, Ruth; Piro, Nancy

2010-03-01

quality medical education includes both teaching and learning of data-driven knowledge, and appropriate technical skills and tacit behaviours, such as effective communication and professional leadership. But these implicit behaviours are not readily adaptable to traditional medical curriculum models. This manuscript explores a medical leadership curriculum informed by military education. our paediatric anaesthesia residents expressed a strong desire for more leadership opportunity within the training programme. Upon exploration, current health care models for leadership training were limited to short didactic presentations or lengthy certificate programmes. We could not find an appropriate model for our 1-year fellowship. in collaboration with the US Naval Academy, we modified the 'Leadership Education and Development Program' curriculum to introduce daily and graduated leadership opportunities: starting with low-risk decision-making tasks and progressing to independent professional decision making and leadership. Each resident who opted into the programme had a 3-month role as team leader and spent 9 months as a team member. At the end of the first year of this curriculum both quantitative assessment and qualitative reflection from residents and faculty members noted significantly improved clinical and administrative decision making. The second-year residents' performance showed further improvement. medical education has long emphasised subject-matter knowledge as a prime focus. However, in competency-based medical education, new curriculum models are needed. Many helpful models can be found in other professional fields. Collaborations between professional educators benefit the students, who are learning these new skills, the medical educators, who work jointly with other professionals, and the original curriculum designer, who has an opportunity to reflect on the strengths and weaknesses of his or her model. Blackwell Publishing Ltd 2010.

JEDI - an executive dashboard and decision support system for lean global military medical resource and logistics management.

PubMed

Sloane, Elliot B; Rosow, Eric; Adam, Joe; Shine, Dave

2006-01-01

Each individual U.S. Air Force, Army, and Navy Surgeon General has integrated oversight of global medical supplies and resources using the Joint Medical Asset Repository (JMAR). A Business Intelligence system called the JMAR Executive Dashboard Initiative (JEDI) was developed over a three-year period to add real-time interactive data-mining tools and executive dashboards. Medical resources can now be efficiently reallocated to military, veteran, family, or civilian purposes and inventories can be maintained at lean levels with peaks managed by interactive dashboards that reduce workload and errors.

32 CFR 644.326 - Army military real property.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Army military real property. 644.326 Section 644.326 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) REAL... military real property. Military real property, including industrial real property, under the control of...

Risky Business: Challenges and Successes in Military Radiation Risk Communication

DTIC Science & Technology

2012-01-01

looted by local Iraqis. The decision was quickly made to assemble a special scientifi c team from within USACHPPM and expedite its dispatch to Iraq ...Military Police (MP) Company, New York Army National Guard, redeployed from Iraq and were inappropriately denied routine postdeployment bioassay...the medical specimens to a nonaccred- ited geology laboratory, depleted uranium was detected (though no amounts reported) and the story immediately

How to turn a team of experts into an expert medical team: guidance from the aviation and military communities

PubMed Central

Burke, C; Salas, E; Wilson-Donnelly, K; Priest, H

2004-01-01

There is no question that interdisciplinary teams are becoming ubiquitous in healthcare. It is also true that experts do not necessarily combine to make an expert team. However when teams work well they can serve as adaptive systems that allow organisations to mitigate errors within complex domains, thereby increasing safety. The medical community has begun to recognise the importance of teams and as such has begun to implement team training interventions. Over the past 20 years the military and aviation communities have made a large investment in understanding teams and their requisite training requirements. There are many lessons that can be learned from these communities to accelerate the impact of team training within the medical community. Therefore, the purpose of the current paper is to begin to translate some of the lessons learned from the military and aviation communities into practical guidance that can be used by the medical community. PMID:15465963

Training Australian Defence Force Medical Officers to civilian general practice training standards--reflections on military medicine and its links to general practice education and training.

PubMed

Kitchener, Scott J; Rushbrook, Elizabeth; Brennan, Leonard; Davis, Stephen

2011-06-06

This article examines military medicine and its links to civilian general practice education and training, drawing attention to the variations and difficulties in, and successful approaches for, training Australian Defence Force (ADF) Medical Officers. Military medicine has been an area of change over the 10 years of the Australian General Practice Training (AGPT) program. Crisis situations like those in Timor Leste and Afghanistan have focused attention and recognition on the importance of primary health care in the work of the ADF. To train doctors in military medicine, there are several different models at different locations around Australia, as well as large variations in military course and experience recognition and approvals between AGPT regional training providers. At times, the lack of standardisation in training delays the progress of ADF registrars moving through the AGPT program and becoming independently deployable Medical Officers.

32 CFR 9.2 - Establishment of Military Commissions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 1 2010-07-01 2010-07-01 false Establishment of Military Commissions. 9.2 Section 9.2 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE MILITARY COMMISSIONS PROCEDURES FOR TRIALS BY MILITARY COMMISSIONS OF CERTAIN NON-UNITED STATES CITIZENS IN THE WAR AGAINST...

Medical Laboratory Technician--Chemical Chemistry & Urinalysis, 10-2. 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 publication, the last of three course materials in the medical laboratory technician field adapted from the Military Curriculum Materials for Use in Technical and Vocational Education series, was designed as a refresher course for student self-study and evaluation. It can be used by advanced students or beginning students participating in a…

The use of animals in live-tissue trauma training and military medical research.

PubMed

Martinic, Gary

2011-09-21

Uncontrolled hemorrhage is the most common preventable cause of death for soldiers wounded in combat. In live-tissue trauma training (LTTT), animals (mostly goats and pigs) are used to train physicians and paramedical personnel in how to treat severe traumatic injuries, including severe blood loss. Military personnel insist that such realistic training is necessary and has to date saved countless lives of soldiers. Animal rights groups, however, argue that the practice is inhumane and should be replaced with alternative methods. In this essay, the author explains how and why animals are used for LTTT and in military medical research (MMR), as well as why he feels that the continued use of animals for LTTT and MMR is justified. The author hopes to encourage wider discussion of this topic within the scientific, defense and animal welfare circles, leading to further refinements in the welfare and protection of animals used for these important, though often controversial, purposes.

76 FR 28403 - National Registry of Certified Medical Examiners

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-17

... [Docket No. FMCSA-2008-0363] RIN 2126-AA97 National Registry of Certified Medical Examiners ACTION: Notice... by training providers in implementing the National Registry of Certified Medical Examiners (National... included minimum training requirements for medical examiners. The draft guidance announced by this notice...

[The results of delivering surgical care to the wounded and sick in military medical establishments and impending tasks].

PubMed

Briusov, P G; Efimenko, N A

1997-07-01

In article results of activity of the military surgeons on rendering of the surgical care to wounded and sick in 1996 are analyzed. During combat actions in Chechnya despite of severe forms of wounds and significant increase of combined battle traumas lethality among heavy wounded was reduced in 2 times. At common lethality rate in 1.3%, in hospitals from wounds 1.5% of wounded died, from traumas--0.7%, burns--2.9%, frostbitten--0.5%. As to peace time surgery, the analysis of main parameters of surgical work in military medical establishments, structure of diseases of servicemen, surgical activity, average terms of treatment, lethality after operations, defects in rendering of the surgical care is given. In conclusions the authors say about problems, that the military surgeons have today.

Increasing educational indebtedness influences medical students to pursue specialization: a military recruitment potential?

PubMed

Bale, Asha G; Coutinho, Karl; Swan, Kenneth G; Heinrich, George F

2013-02-01

Cost of medical education and student indebtedness has increased dramatically. This study surveyed medical students on educational debt, educational costs, and whether indebtedness influenced career choice. Responses should impact (1) Department of Defense (DoD) recruitment of physicians and (2) future of primary care. The authors surveyed 188 incoming medical students (University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Class of 2012) concerning educational indebtedness, perceptions about educational costs, and plans regarding loan repayment. Data were analyzed and expressed as mean +/- standard error. Students with loans anticipated their medical educational costs to be $155,993. 62% felt costs were "exorbitant," and 28% "appropriate." 64% planned to specialize, whereas only 9% chose primary care. 28% of students planning specialization said income potential influenced their decision. 70% of students said cost was a factor in choosing New Jersey Medical School over a more expensive school. Students anticipated taking about 10 years to repay loans. As medical educational costs and student indebtedness rise, students are choosing less costly education and career paths with higher potential future earnings. These trends will negatively impact health care availability, accessibility, and cost. DoD programs to provide financial assistance in exchange for military service are not well publicized. These findings should increase DoD recruitment opportunities.

Medical Service Specialist, Blocks I & II, 10-10. 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 first course of a two-course, postsecondary-level series for medical service specialists is one of a number of military-developed curriculum packages selected for adaptation to vocational instruction and curriculum development in a civilian setting. The purpose stated for the 50-hour course is to provide training in the basic theory and…

45 CFR 303.32 - National Medical Support Notice.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 2 2011-10-01 2011-10-01 false National Medical Support Notice. 303.32 Section... HUMAN SERVICES STANDARDS FOR PROGRAM OPERATIONS § 303.32 National Medical Support Notice. (a) Mandatory... Medical Support Notice (NMSN), to enforce the provision of health care coverage for children of...

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

PubMed

Lv, Yipeng; Xue, Chen; Ge, Yang; Ye, Feng; Liu, Xu; Liu, Yuan; Zhang, Lulu

2016-01-01

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 health system. 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. 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' satisfaction included staff categories, satisfaction with environment, and satisfaction with medical quality. 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.

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. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Caring sexual assault patients in the military: past, present, and future.

PubMed

Ferguson, Cynthia T

2008-01-01

Recently instituted sexual assault prevention and response policies and programs within the Department of Defense (DoD) have paved the way for significant improvements in the medical care of sexual assault patients in the military services. Military personnel who suffer assault are now able to choose a method of reporting that either immediately triggers an investigation or allows the incident to remain confidential. This process allows for the development of an enhanced trust in the system and allows military personnel to receive medical and forensic care on the level of their choice. Military medical professionals are continually striving to provide the highest standard of care for military personnel, DoD employees, and beneficiaries. The new policies and programs are continually taking shape; however, there are barriers to education and understanding of the sexual assault prevention and response processes that require increased coordination between military and civilian personnel and their medical services in order to provide optimum care for all patients involved.

Committee on Military Nutrition Research

DTIC Science & Technology

2007-01-01

AD_________________ Award Number: DAMD17-99-1-9478 TITLE: COMMITTEE ON MILITARY NUTRITION ...COVERED (From - To) 01 Jun 99 – 31 Dec 06 4. TITLE AND SUBTITLE COMMITTEE ON MILITARY NUTRITION RESEARCH 5a. CONTRACT NUMBER...report presents the activities of the National Academy of Sciences/Institute of Medicine’s Committee on Military Nutrition Research (CMNR) for the

32 CFR 538.4 - Convertibility of military payment certificates.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 3 2014-07-01 2014-07-01 false Convertibility of military payment certificates. 538.4 Section 538.4 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS MILITARY PAYMENT CERTIFICATES § 538.4 Convertibility of military payment certificates. (a...

Russian military in the year 2000. Master's thesis

DOE Office of Scientific and Technical Information (OSTI.GOV)

McIlmail, J.F.; Jaworski, J.L.

Through the use of content analysis, this paper attempts to paint a picture of the Russian military in the year 2000 and its impact on the US national security strategy. The research begins by defining the origin of Russian national security policy and how that translates into military policy and doctrine. A framework for evaluating Russian military doctrines is provided with a chronology of the military reform process and the related doctrinal reforms that has its birth in the 1987 announcement of a defensive-defense. Following from the doctrinal variant framework the new strategic missions of the 1992 draft military doctrinemore » are presented with an analysis that shows they are a clear departure from the past and truly represent a defensive-defense type doctrine. Additionally, a comparison is made with the current military reform ongoing in Russia with the historical precedent of the Russian military reform of 1924-25. A rough outline of the separate branches of the Russian military both present and future is provided based on the ongoing trends in the reform process. This thumbnail sketch of the Russian military then assists in the analysis and conclusion that even after a possible 50% cutback in US military spending, in the year 2000 the Russian military will not pose a threat to US national security. The major caveat to this conclusion is in the realm of nuclear weapons and this issue is therefore discussed in some length....Former Soviet Union, Russia, Commonwealth of Independent States (CIS), Conventional Forces in Europe treaty (CFE), European Security, New National Security Strategy, Nuclear Weapons, Nuclear Strategy.« less

Visualizing Patterns of Drug Prescriptions with EventFlow: A Pilot Study of Asthma Medications in the Military Health System

DTIC Science & Technology

2013-06-01

1 Visualizing Patterns of Drug Prescriptions with EventFlow: A Pilot Study of Asthma Medications in the...asthmatics within the Military Health System (MHS). Visualizing the patterns of asthma medication use surrounding a LABA prescription is a quick way to...random sample of 100 asthma patients under age 65 with a new LABA prescription from January 1, 2006-March 1, 2010 in MHS healthcare claims. Analysis was

[The contribution of the department of childhood diseases of the S.M.Kirov Military-medical academy to the medical support of students of educational organizations of general education of the Ministry of Defence].

PubMed

Shabalov, N P; Arsentev, V G; Mikheev, A V; Tsiteladze, A A

2015-10-01

The article is devoted to the 150th anniversary of the department of childhood diseases of the S.M.Kirov Military Medical Academy and reflects on important activity of the department - creation of the system of medical support for students of general education institutions of the Ministry of Defense. The authors emphasize the role of professor M.S.Maslov, as well as other members of the department, in the development of manuals for health maintenance organization of first Suvorov military schools (1944, 1947). The authors also summarize results of the methodological and scientific work, training and improvement of professional skills of medical staff for educational institutions, including the heads of medical service of schools. The role of the department in improving the medical support for educational institutions of secondary education institutions f'the Ministry of Defence of the Russian Federation at the present stage of development of the Armed Forces is described in the given article.

Coordinating Military Response to Disasters

DTIC Science & Technology

2016-01-22

of two noted natural disasters . Section four analyzes the two options of the affected area National Guard forces and the tailored regional located...recommendations and conclusions. Title Coordinating Military Response to Disasters Thesis Military response to natural disasters is a critical aspect...National Guard forces in response to natural disasters and man-made emergencies such as riots or terrorist attacks.13 The third role is federal

National military strategy in the post cold war era: Nuclear deterrence or an alternative. Study project

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pooley, G.R.

In the aftermath of the Cold War it becomes necessary to explore the validity of nuclear deterrence as the cornerstone of the United States National Military Strategy for the upcoming period of transition in international relations. Using the current world situation as a starting point, the evolving trends in international relations, arms control and nuclear proliferation, the strategic threat and the evolution of technology will be analyzed in an effort to forecast the complexion of international relations twenty years hence. Then, within this context, nuclear deterrence and a non nuclear alternative nonoffensive defense, proposed by the Danish political scientist, Bjornmore » Moller, will be examined. In the final analysis, this project will suggest an appropriate direction for the evolution of the United States' National Military Strategy which, in the opinion of the author, provides the best probability for long term world peace.« less

Exploring the impact of a pedometer on body composition and physical fitness in a cohort of U.S. military medical students: a pilot study.

PubMed

Lystrup, Robert; West, Gordon F; Ward, Matthew; Hall, Jennifer; Stephens, Mark

2015-01-01

Military medical professionals play a central role in preventing and treating obesity among America's warriors through training, medical care, and their personal example. Unfortunately, medical students in both undergraduate and graduate settings often experience declines in physical fitness. Pedometry has been demonstrated as one means of promoting fitness with 10,000 steps/day generally accepted as a key benchmark. With this in mind, we used pedometry as an incentive during the preclinical years to encourage students to adopt a more active lifestyle. Findings suggest that participants that consistently report meeting the 10,000 steps/day maintained or improved their aerobic fitness. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Diagnoses and factors associated with medical evacuation and return to duty among nonmilitary personnel participating in military operations in Iraq and Afghanistan

PubMed Central

Cohen, Steven P.; Brown, Charlie; Kurihara, Connie; Plunkett, Anthony; Nguyen, Conner; Strassels, Scott A.

2011-01-01

Background Nonmilitary personnel play an increasingly critical role in modern wars. Stark differences exist between the demographic characteristics, training and missions of military and nonmilitary members. We examined the differences in types of injury and rates of returning to duty among nonmilitary and military personnel participating in military operations in Iraq and Afghanistan. Methods We collected data for nonmilitary personnel medically evacuated from military operations in Iraq and Afghanistan between 2004 and 2007. We compared injury categories and return-to-duty rates in this group with previously published data for military personnel and identified factors associated with return to duty. Results Of the 2155 medically evacuated nonmilitary personnel, 74.7% did not return to duty. War-related injuries in this group accounted for 25.6% of the evacuations, the most common causes being combat-related injuries (55.4%) and musculoskeletal/spinal injuries (22.9%). Among individuals with non–war-related injuries, musculoskeletal injuries accounted for 17.8% of evacuations. Diagnoses associated with the highest return-to-duty rates in the group of nonmilitary personnel were psychiatric diagnoses (15.6%) among those with war-related injuries and noncardiac chest or abdominal pain (44.0%) among those with non–war-related injuries. Compared with military personnel, nonmilitary personnel with war-related injuries were less likely to return to duty (4.4% v. 5.9%, p = 0.001) but more likely to return to duty after non–war-related injuries (32.5% v. 30.7%, p = 0.001). Interpretation Compared with military personnel, nonmilitary personnel were more likely to be evacuated with non–war-related injuries but more likely to return to duty after such injuries. For evacuations because of war-related injuries, this trend was reversed. PMID:21324873

76 FR 68609 - Military Family Month, 2011

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-04

... troops embody the courage and character that make America's military the finest in the world, their... Vol. 76 Friday, No. 214 November 4, 2011 Part III The President Proclamation 8743--Military Family Month, 2011 Proclamation 8744--National Adoption Month, 2011 Proclamation 8745--National Alzheimer's...

Development and Implementation of the DHAPP Military eHealth Information Network System.

PubMed

Kratz, Mary; Thomas, Anne; Hora, Ricardo; Vera, Delphis; Lutz, Mickey; Johnson, Mark D

2017-01-01

As the Joint United Nations Programme on HIV/AIDS, the Global Fund, and the US President's Emergency Plan for AIDS Relief focus on reaching 90-90-90 goals, military health systems are scaling up to meet the data demands of these ambitious objectives. Since 2008, the US Department of Defense HIV/AIDS Prevention Program (DHAPP) has been working with military partners in 14 countries on implementation and adoption of a Military eHealth Information Network (MeHIN). Each country implementation plan followed a structured process using international eHealth standards. DHAPP worked with the private sector to develop a commercial-off-the-shelf (COTS) electronic medical record (EMR) for the collection of data, including patient demographic information, clinical notes for general medical care, HIV encounters, voluntary medical male circumcision, and tuberculosis screening information. The COTS software approach provided a zero-dollar software license and focused on sharing a single version of the EMR across countries, so that all countries could benefit from software enhancements and new features over time. DHAPP also worked with the public sector to modify open source disease surveillance tools and open access of HIV training materials. Important lessons highlight challenges to eHealth implementation, including a paucity of technology infrastructure, military leadership rotations, and the need for basic computer skills building. While not simple, eHealth systems can be built and maintained with requisite security, flexibility, and reporting capabilities that provide critical information to improve the health of individuals and organizations. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

[The role of the N. N. Burdenko Main Military Clinical Hospital in the development of specialized medical care in the Armed Forces of the Russian Federation].

PubMed

1997-11-01

The article give the characteristic of the specialized medical care as the highest form of the medical care, enabling to use more effectively the most advanced achievements of all fields of the clinical medicine and appropriate categories of the experts with the purposes of the successful treatment of the injured and patients. A role of V. A. Oppel', N. N. Burdenko, E. I. Smirnov in origin and development of the specialized medical help in military-field conditions is marked. On example of Burdenko Main Military Clinical Hospital achievement and problems of the specialized medical help at the present stage are shown, prospects and ways of its further development and perfection are planned.

Risk factors associated with suicide in current and former US military personnel.

PubMed

LeardMann, Cynthia A; Powell, Teresa M; Smith, Tyler C; Bell, Michael R; Smith, Besa; Boyko, Edward J; Hooper, Tomoko I; Gackstetter, Gary D; Ghamsary, Mark; Hoge, Charles W

2013-08-07

Beginning in 2005, the incidence of suicide deaths in the US military began to sharply increase. Unique stressors, such as combat deployments, have been assumed to underlie the increasing incidence. Previous military suicide studies, however, have relied on case series and cross-sectional investigations and have not linked data during service with postservice periods. To prospectively identify and quantify risk factors associated with suicide in current and former US military personnel including demographic, military, mental health, behavioral, and deployment characteristics. Prospective longitudinal study with accrual and assessment of participants in 2001, 2004, and 2007. Questionnaire data were linked with the National Death Index and the Department of Defense Medical Mortality Registry through December 31, 2008. Participants were current and former US military personnel from all service branches, including active and Reserve/National Guard, who were included in the Millennium Cohort Study (N = 151,560). Death by suicide captured by the National Death Index and the Department of Defense Medical Mortality Registry. Through the end of 2008, findings were 83 suicides in 707,493 person-years of follow-up (11.73/100,000 person-years [95% CI, 9.21-14.26]). In Cox models adjusted for age and sex, factors significantly associated with increased risk of suicide included male sex, depression, manic-depressive disorder, heavy or binge drinking, and alcohol-related problems. None of the deployment-related factors (combat experience, cumulative days deployed, or number of deployments) were associated with increased suicide risk in any of the models. In multivariable Cox models, individuals with increased risk for suicide were men (hazard ratio [HR], 2.14; 95% CI, 1.17-3.92; P = .01; attributable risk [AR], 3.5 cases/10,000 persons), and those with depression (HR, 1.96; 95% CI, 1.05-3.64; P = .03; AR, 6.9/10,000 persons), manic-depressive disorder (HR, 4.35; 95% CI, 1

Joint and National Intelligence Support to Military Operations

DTIC Science & Technology

2004-10-07

missions. The goal is to maximize the impact of intelligence on military operations by increasing the efficiency of the intelligence process and the...intelligence support to military operations will be affected by non-threat-related environmental factors such as requisite changes in sources and...tailored and highly detailed intelligence analyses of a wide variety of human and information environmental factors, such as public attitudes and

Medical Service Specialist, Blocks III, V, VI, 10-11. 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 second course of a two-course, postsecondary-level series for medical service specialist is one of a number of military-developed curriculum packages selected for adaptation to vocational instruction and curriculum development in a civilian setting. The purpose stated for the 89-hour course is to provide training in the basic theory and…

Determining the dimensions of essential medical coverage required by military body armour plates utilising Computed Tomography.

PubMed

Breeze, J; Lewis, E A; Fryer, R

2016-09-01

Military body armour is designed to prevent the penetration of ballistic projectiles into the most vulnerable structures within the thorax and abdomen. Currently the OSPREY and VIRTUS body armour systems issued to United Kingdom (UK) Armed Forces personnel are provided with a single size front and rear ceramic plate regardless of the individual's body dimensions. Currently limited information exists to determine whether these plates overprotect some members of the military population, and no method exists to accurately size plates to an individual. Computed Tomography (CT) scans of 120 male Caucasian UK Armed Forces personnel were analysed to measure the dimensions of internal thoraco-abdominal anatomical structures that had been defined as requiring essential medical coverage. The boundaries of these structures were related to three potential anthropometric landmarks on the skin surface and statistical analysis was undertaken to validate the results. The range of heights of each individual used in this study was comparable to previous anthropometric surveys, confirming that a representative sample had been used. The vertical dimension of essential medical coverage demonstrated good correlation to torso height (suprasternal notch to iliac crest) but not to stature (r(2)=0.53 versus 0.04). Horizontal coverage did not correlate to either measure of height. Surface landmarks utilised in this study were proven to be reliable surrogate markers for the boundaries of the underlying anatomical structures potentially requiring essential protection by a plate. Providing a range of plate sizes, particularly multiple heights, should optimise the medical coverage and thus effectiveness of body armour for UK Armed Forces personnel. The results of this work provide evidence that a single width of plate if chosen correctly will provide the essential medical coverage for the entire military population, whilst recognising that it still could overprotect the smallest individuals

Edward D. Churchill as a combat consultant: lessons for the senior visiting surgeons and today's military medical corps.

PubMed

Cannon, Jeremy W; Fischer, Josef E

2010-03-01

In World War II, Edward D. Churchill volunteered as a combat consultant. In this role, he mentored many junior surgeons and challenged the Army leadership to treat hemorrhagic shock with blood rather than plasma. These lessons have continued relevance for today's Senior Visiting Surgeons and our military medical corps.

The doctrinal basis for medical stability operations.

PubMed

Baker, Jay B

2010-01-01

This article describes possible roles for the military in the health sector during stability operations, which exist primarily when security conditions do not permit the free movement of civilian actors. This article reviews the new U.S. Army Field Manuals (FMs) 3-24, Counterinsurgency and FM 3-07, Stability Operations, in the context of the health sector. Essential tasks in medical stability operations are identified for various logical lines of operation including information operations, civil security, civil control, support to governance, support to economic development, and restoration of essential services. Restoring essential services is addressed in detail including coordination, assessment, actions, and metrics in the health sector. Coordination by the military with other actors in the health sector including host nation medical officials, other United States governmental agencies, international governmental organizations (IGOs), and nongovernment organizations (NGOs) is key to success in medical stability operations.

Worldwide Survey of Substance Abuse and Health Behaviors among Military Personnel (1988)

DTIC Science & Technology

1989-01-25

military medical per- sonnel. * Almost 40 percent of military personnel report having changed their sexual behavior because of concern about getting...through a comprehensive system of medical care. A concen- trated health promotion program, however, has been a fairly recent phenome- non. In 1986, the...the prevalence of substance use (alcohol use, non- medical drug use, tobacco use) among military personnel, " identify the physical, social and work

Multinational medical support to operations: challenges, benefits and recommendations for the future.

PubMed

Cordell, R F

2012-03-01

This paper considers the strategic aspects of medical support to military operations as delivered through multi-national collaboration. The military medical services are in essence a people organisation; the purpose of the organisation is primarily to support the people engaged in military operations, and also the people providing healthcare to them. Increasingly, supporting the latter also includes preparation for the ethical dilemmas that they will face. Providing health advice and healthcare on operations is now usually undertaken on a multinational basis, in order to generate sufficient medical capacity to meet the requirement with assets of the appropriate (and NATO mandated) capability. This will be an enduring feature, particularly in light of increasing costs of providing high quality healthcare and the operational and logistic challenges of delivering this capability in adverse environments, and in the context of medical personnel being a limited resource. The key to overcoming the challenges, often the result of the "people issues" such as cultural differences, is to recognise the value that the inherent diversity of multinational healthcare provision brings. The benefit is realised through sharing best practice, and the lessons from challenges met, as well as through burden sharing, and to understand that challenges are most commonly the result of misunderstandings, such as those inherent in language differences. The advice for those bringing a multinational team together includes considering the implications of culture (noting differences in national and military perspectives, and in medical processes such as clinical governance), to ensure effective communication, and to utilise feedback to confirm understanding. It is important not to prejudge or denigrate others. Share information and knowledge, provide positive reinforcement when things go well, and recognise that there will inevitably be challenges and use these as an opportunity to learn. Above

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…

[Military insurance. Military insurance regulations and the handling of diseases/injuries among draftees].

PubMed

Dobloug, I

1989-01-30

This article discusses civilian and military insurance regulations, including social support in case of illness or injury during compulsory military service. The procedure is exemplified by the treatment of conscripts who are diagnosed as having cancer testis while doing their compulsory service. It is essential that civilian medical practitioners are familiar with this procedure, so that they can advise any conscripts who consult them.

Tropical skin diseases in British military personnel.

PubMed

Bailey, Mark S

2013-09-01

Skin complaints are common in travellers to foreign countries and are responsible for up to 25% of medical consultations by military personnel during deployments in the tropics. They also have relatively high rates of field hospital admission, medical evacuation and referral to UK Role 4 healthcare facilities. Non-infectious tropical skin diseases include sunburn, heat rash, arthropod bites, venomous bites, contact dermatitis and phytophotodermatitis. During tropical deployments skin infections that commonly occur in military personnel may become more frequent, severe and difficult to treat. Several systemic tropical infections have cutaneous features that can be useful in making early diagnoses. Tropical skin infections such as cutaneous larva migrans, cutaneous myiasis, cutaneous leishmaniasis and leprosy do occur in British troops and require specialist clinical management. This illustrated review focuses on the most significant tropical skin diseases that have occurred in British military personnel in recent years. Clinical management of these conditions on deployments would be improved and medical evacuations could be reduced if a military dermatology 'reach-back' service (including a telemedicine facility) was available.

Mesenchymal stem cell therapy for acute radiation syndrome: innovative medical approaches in military medicine.

PubMed

Eaton, Erik B; Varney, Timothy R

2015-01-01

After a radiological or nuclear event, acute radiation syndrome (ARS) will present complex medical challenges that could involve the treatment of hundreds to thousands of patients. Current medical doctrine is based on limited clinical data and remains inadequate. Efforts to develop medical innovations that address ARS complications are unlikely to be generated by industry because of market uncertainties specific to this type of injury. A prospective strategy could be the integration of cellular therapy to meet the medical demands of ARS. The most clinically advanced cellular therapy to date is the administration of mesenchymal stem cells (MSCs). Results of currently published investigations describing MSC safety and efficacy in a variety of injury and disease models demonstrate the unique qualities of this reparative cell population in adapting to the specific requirements of the damaged tissue in which the cells integrate. This report puts forward a rationale for the further evaluation of MSC therapy to address the current unmet medical needs of ARS. We propose that the exploration of this novel therapy for the treatment of the multivariate complications of ARS could be of invaluable benefit to military medicine.

Advances in damage control resuscitation and surgery: implications on the organization of future military field forces

PubMed Central

Tien, Col Homer; Beckett, Maj Andrew; Garraway, LCol Naisan; Talbot, LCol Max; Pannell, Capt Dylan; Alabbasi, Thamer

2015-01-01

Medical support to deployed field forces is increasingly becoming a shared responsibility among allied nations. National military medical planners face several key challenges, including fiscal restraints, raised expectations of standards of care in the field and a shortage of appropriately trained specialists. Even so, medical services are now in high demand, and the availability of medical support may become the limiting factor that determines how and where combat units can deploy. The influence of medical factors on operational decisions is therefore leading to an increasing requirement for multinational medical solutions. Nations must agree on the common standards that govern the care of the wounded. These standards will always need to take into account increased public expectations regarding the quality of care. The purpose of this article is to both review North Atlantic Treaty Organization (NATO) policies that govern multinational medical missions and to discuss how recent scientific advances in prehospital battlefield care, damage control resuscitation and damage control surgery may inform how countries within NATO choose to organize and deploy their field forces in the future. PMID:26100784

Civil-Military Integration: The Politics of Outsourcing National Security

ERIC Educational Resources Information Center

Lavallee, Tara M.

2010-01-01

The post 9/11 environment has been characterized by domestic policy actors being incorporated into a globalizing defense industrial sector through the concept of civil-military integration. From administration to administration, the push for increased civil-military integration has spread beyond its original boundaries and has reached the…

Poison exposures in young Israeli military personnel: a National Poison Center Data analysis.

PubMed

Lavon, Ophir; Bentur, Yedidia

2017-06-01

To characterize poison exposures in young Israeli military personnel as reported to the national poison center. Retrospective poison center chart review over a 14-year period. Cases included were Israeli soldiers aged 18-21 years, the compulsory military service age required by the Israeli law. 1770 records of poison exposures in young military personnel were identified. Most exposed individuals involved males (n = 1268, 71.6%). Main routes of exposure were ingestion (n = 854, 48.3%), inhalation (n = 328, 18.6%) and ocular (n = 211, 11.9%). Accidents or misuse (n = 712, 40.2%) were the most frequently reported circumstances, followed by suicide attempts (370, 20.9%), and bites and stings (161, 9.1%). More than half of the cases involved chemicals (n = 939, 53.1%); hydrocarbons, gases and corrosives were the main causative agents. Pharmaceuticals (mainly analgesics) were involved in 519 (29.3%) cases, venomous animals (mainly scorpions, centipedes, and snakes) in 79 (4.5%). Clinical manifestations were reported in 666 (37.6%) cases, mostly gastrointestinal, neurologic, and respiratory. The vast majority of cases (1634, 92.3%) were asymptomatic or mildly affected; no fatalities were recorded. In 831 (46.9%) cases the clinical toxicologist recommended referral to an emergency department; ambulatory observation was recommended in 563 (31.8%) cases, and hospitalization in 86 (4.9%). Our data show that poison exposures among young soldiers involve mainly males, accidents, misuse and suicides, oral route and chemicals; most exposures were asymptomatic or with mild severity. Repeated evaluations of poison center data pertaining to military personnel is advised for identifying trends in poison exposure and characteristics in this particular population.

Preventing heat injury: military versus civilian perspective.

PubMed

Cooper, J K

1997-01-01

Guidelines for preventing heat injury (HI) among military personnel are not directly applicable to civilian personnel. Military guidelines call for relatively large volumes of prophylactic water consumption and physical activity limitations depending on the wet bulb globe temperature. However, in civilian populations, there is an increased prevalence of HI risk factors: older age, medication use, especially anticholinergic and psychotropic medications, obesity, previous HI, and skin disorders. Although dehydration is a major contributor to HI in military situations, it is unlikely in classical heat stroke among civilians. Civilian guidelines are based on the heat index. Activity levels must be restricted more for civilians, and prophylactic water consumption (beyond replacing loss from sweat) is not necessary. This review discusses the pathophysiology of heat injury, contrasts the military and civilian approach to prevention of HI, and describes appropriate field intervention for HI.

Medical Laboratory Technician--Hematology, Serology, Blood Banking & Immunohematology, 10-4. Military Curriculum Materials for Vocational and Technical Education.

ERIC Educational Resources Information Center

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

This course, the third of three courses in the medical laboratory technician field adapted from military curriculum materials for use in vocational and technical education, was designed as a refresher course for student self-study and evaluation. It is suitable for use by advanced students or beginning students participating in a supervised…

Bureaucratization and medical professionals' values: A cross-national analysis.

PubMed

Racko, Girts

2017-05-01

Understanding the impact of the bureaucratization of governance systems on the occupational values of medical professionals is a fundamental concern of the sociological research of healthcare professions. While previous studies have examined the impact of bureaucratized management, organizations, and healthcare fields on medical professionals' values, there is a lack of cross-national research on the normative impact of the bureaucratized systems of national governance. Using the European Social Survey data for 29 countries, this study examines the impact of the bureaucratization of national governance systems on the occupational values of medical professionals. The findings indicate that medical professionals who are employed in countries with the more bureaucratized systems of national governance are less concerned with openness to change values, that emphasize autonomy and creativity, and self-transcendence values, that emphasize common good. The findings also indicate that the negative effect of the bureaucratization of national governance on the openness to change values is stronger for medical professionals in more bureaucratized organizations with more rationalized administration systems. Copyright © 2017 Elsevier Ltd. All rights reserved.

Compliance with Antimalarial Chemoprophylaxis Recommendations for Wounded United States Military Personnel Admitted to a Military Treatment Facility

PubMed Central

Rini, Elizabeth A.; Weintrob, Amy C.; Tribble, David R.; Lloyd, Bradley A.; Warkentien, Tyler E.; Shaikh, Faraz; Li, Ping; Aggarwal, Deepak; Carson, M. Leigh; Murray, Clinton K.

2014-01-01

Malaria chemoprophylaxis is used as a preventive measure in military personnel deployed to malaria-endemic countries. However, limited information is available on compliance with chemoprophylaxis among trauma patients during hospitalization and after discharge. Therefore, we assessed antimalarial primary chemoprophylaxis and presumptive antirelapse therapy (primaquine) compliance among wounded United States military personnel after medical evacuation from Afghanistan (June 2009–August 2011) to Landstuhl Regional Medical Center in Landstuhl, Germany, and then to three U.S. military hospitals. Among admissions at Landstuhl Regional Medical Center, 74% of 2,540 patients were prescribed primary chemoprophylaxis and < 1% were prescribed primaquine. After transfer of 1,331 patients to U.S. hospitals, 93% received primary chemoprophylaxis and 33% received primaquine. Of 751 trauma patients with available post-admission data, 42% received primary chemoprophylaxis for four weeks, 33% received primaquine for 14 days, and 17% received both. These antimalarial chemoprophylaxis prescription rates suggest that improved protocols to continue malaria chemoprophylaxis in accordance with force protection guidelines are needed. PMID:24732457

The fishes of Pea Ridge National Military Park, Arkansas, 2003

USGS Publications Warehouse

Justus, B.G.; Petersen, James C.

2005-01-01

A fish inventory was conducted at Pea Ridge National Military Park, Arkansas, during base-flow conditions in September 2003. Six sites including four streams and two ponds were sampled using conventional electrofishing equipment (a seine also was used at one site). There were 653 individuals collected comprising 18 species (plus 1 hybrid) and 15 genera. The number of species collected at the four stream sites ranged from 1 16. Most fish species collected generally are associated with small streams in the Ozark Plateaus. The two most common species were the banded sculpin and the southern redbelly dace. Three species and a sunfish hybrid were collected from the quarry pond. No fish were collected from the unnamed pond. A preliminary expected species list incorrectly listed 42 species because of incorrect species range or habitat requirements. One species not on the original list was added to the revised list. Upon revising this list, the inventory yielded 18 the 40 species (45 percent) and 1 hybrid. No previous fish inventories have been completed for park but some observations can be made relative to species distributions. There were only five fish species collected in three headwater streams, and it is unlikely that many other species would occur in these three streams because of constraints imposed on the fish community by stream size. Little Sugar Creek, a medium-sized stream, had the most species collected, and it is likely that additional species would be collected from this stream if additional sampling were to occur. Distribution records indicate that all 18 species occur in the general area. Although no species collected in this study are federallylisted threatened or endangered species, three species collected at Pea Ridge National Military Park may be of some special interest to National Park Service managers and others. Two the species collected (cardinal shiner and stippled darter) are endemic to the Ozark Plateaus; both are rather common in certain

Military health system efficiency: a review of history and recommendations for the future.

PubMed

Coppola, Nicholas; Satterwhite, Robin; Fulton, Lawrence V; Shanderson, Laurie L; Pasupathy, Rubini

2012-06-01

This article reviews the history of measuring military medical health care efficiency. No single approved definition or uniform framework has ever been offered or suggested defining military medical treatment facility efficiency over the last 225 years within the Department of Defense. The purpose of this article is to consolidate much of the existing research on the latent variable of military medical efficiency over the last two centuries, and to provide health care leaders a framework for understanding past and current practices in measuring efficiency in the military health care setting.

Counseling and Connecting with the Military Undergraduate: The Intersection of Military Service and University Life

ERIC Educational Resources Information Center

Bonar, Ted C.; Domenici, Paula L.

2011-01-01

The majority of military undergraduates at universities are National Guard and Reserve personnel and prior-service military veterans, all difficult to identify on campus. These students face unique cultural challenges. Though the academic literature primarily addresses disability services and administrative programs often focus on "wounded…

Return with Honor: Code of Conduct Training in the National Military Strategy Security Environment

DTIC Science & Technology

2004-09-01

maximize the number of deaths and injuries among the most vulnerable civilians, such as children, women and the elderly… The terrorist leaders - who do...Return with Honor: Code of Conduct Training in the National Military Strategy Security Environment 6. AUTHOR(S) Major Laura M. Ryan 5. FUNDING NUMBERS ...7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Naval Postgraduate School Monterey, CA 93943-5000 8. PERFORMING ORGANIZATION REPORT NUMBER

Unified Medical Command and Control in the Department of Defense

DTIC Science & Technology

2012-03-22

This is the Joint Task Force – Capital Medical (JTF CAPMED ) model, in which organizations, resources, and personnel are aligned under a single...This was demonstrated in the formation of the JTF- CAPMED , designed as a 3-star level command controlling military medical activities in the National...used ground vehicles, helicopters and fixed wing aircraft for strategic casualty evacuation (CASEVAC). Enroute care is standard and critical in

Emergency medical dispatch : national standard curriculum ready

DOT National Transportation Integrated Search

1996-05-01

This Traffic Tech describes the recently updated "Emergency Medical Dispatch: National Standard Curriculum," which was developed in 1972. Emergency service providers use these uniform standards to develop or select an emergency medical dispatch progr...

Two-year survival and growth of artificial northern red oak regeneration at Gettysburg National Military Park

Treesearch

David S. Larrick; Todd W. Bowersox; Gerald L. Storm; Walter M. Tzilkowski

1997-01-01

Overstory competition and foraging by white-tailed deer (Odocoileus virginianus) and small mammals are cited as reasons for regeneration failure in mixed-oak stands of Pennsylvania. At Gettysburg National Military Park, deer densities are high (>0.6 deer/ha), and the mixed-oak woodlots were lacking in seedling- and sapling-sized natural oak...

Military Government

DTIC Science & Technology

1949-07-01

The water supply may be disrupted or poluted . ( 4) Hospital facilities and medical supplies may be extremely scarce. Dead may be found unburied and...insurance unit may supervise all insurance companies, or an income tax unit may audit internal revenue offices. (2) Other military government units carry

Training military surgeons: a challenge for the future.

PubMed

MacFarlane, Campbell; Ryan, James

2002-03-01

The last 10 years has seen a reduction in defense spending and a contraction in military force size in all NATO countries. This has had a direct effect on military medical capability. In some allied countries, this reduction has extended to the virtual disappearance of independent military hospitals. Military surgeons are now few in number, and fewer still have had recent operational experience. This article addresses the problem and offers some solutions.

The military health system: a community of solutions for medical education, health care delivery, and public health.

PubMed

Lennon, Robert P; Saguil, Aaron; Seehusen, Dean A; Reamy, Brian V; Stephens, Mark B

2013-01-01

Multiple strategies have been proposed to improve health care in the United States. These include the development of communities of solution (COSs), implementation of patient-centered medical homes (PCMHs), and lengthening family medicine residency training. There is scant literature on how to build and integrate these ideal models of care, and no literature about how to build a model of care integrating all 3 strategies is available. The Military Health System has adopted the PCMH model and will offer some 4-year family medicine residency positions starting in 2013. Lengthening residency training to 4 years represents an unprecedented opportunity to weave experiential COS instruction throughout a family physician's graduate medical education, providing future family physicians the skills needed to foster a COS in their future practice. This article describes our COS effort to synergize 3 aspects of modern military medicine: self-defined community populations, the transition to the PCMH model, and the initiation of the 4-year length of training pilot program in family medicine residency training. In this way we provide a starting point and general how-to guide that can be used to create a COS integrated with other current concepts in medicine.

Risk of Suicide Among US Military Service Members Following Operation Enduring Freedom or Operation Iraqi Freedom Deployment and Separation From the US Military.

PubMed

Reger, Mark A; Smolenski, Derek J; Skopp, Nancy A; Metzger-Abamukang, Melinda J; Kang, Han K; Bullman, Tim A; Perdue, Sondra; Gahm, Gregory A

2015-06-01

A pressing question in military suicide prevention research is whether deployment in support of Operation Enduring Freedom or Operation Iraqi Freedom relates to suicide risk. Prior smaller studies report differing results and often have not included suicides that occurred after separation from military service. To examine the association between deployment and suicide among all 3.9 million US military personnel who served during Operation Enduring Freedom or Operation Iraqi Freedom, including suicides that occurred after separation. This retrospective cohort design used administrative data to identify dates of deployment for all service members (October 7, 2001, to December 31, 2007) and suicide data (October 7, 2001, to December 31, 2009) to estimate rates of suicide-specific mortality. Hazard ratios were estimated from time-dependent Cox proportional hazards regression models to compare deployed service members with those who did not deploy. Suicide mortality from the Department of Defense Medical Mortality Registry and the National Death Index. Deployment was not associated with the rate of suicide (hazard ratio, 0.96; 99% CI, 0.87-1.05). There was an increased rate of suicide associated with separation from military service (hazard ratio, 1.63; 99% CI, 1.50-1.77), regardless of whether service members had deployed or not. Rates of suicide were also elevated for service members who separated with less than 4 years of military service or who did not separate with an honorable discharge. Findings do not support an association between deployment and suicide mortality in this cohort. Early military separation (<4 years) and discharge that is not honorable were suicide risk factors.

Dual-Military Couples, Child Care and Retention

DTIC Science & Technology

2016-04-01

military child care provided in child development centers (CDCs) are subsidized by the government. In national surveys of state oversight and...Retain Dual-Military Members The Honorable Carter is already on a promising path with his assurance that the DoD would develop a plan to expand child ...Jowers, Karen, “Military Leaders Promise to Extend Child Care Hours, Shorten Wait Lists at Child Development Centers,” Military Times, http

Medical management of radiation accidents: capabilities and deployment principles of the Bundeswehr Institute of Radiobiology.

PubMed

Dörr, Harald; Meineke, Viktor

2012-10-01

Radiation accidents are fortunately infrequent occurrences, but since their consequences can be very serious as in the Chernobyl and the Fukushima nuclear accidents, medical management of radiation accidents is of great importance. Besides several other tasks, medical management of radiation accidents is one of the key tasks of the Bundeswehr Institute of Radiobiology. Within a Task Force Unit for medical chemical, biological, radiological, and nuclear (CBRN) Defense, the institute provides designated personnel who will perform clinical investigations on the scene and will liaise with the institute, where different methods for biological dosimetry and dose reconstruction will be performed. The most important aspects of efficient medical management of radiation accidents are diagnosis of radiation-induced health damage, determination of the cause, dealing with contamination/incorporation, pathophysiological and therapeutic principles, preparatory planning, national and international cooperation and training. Military and non-military institutions have to work closely together when it comes to radiation accidents and since national resources are limited and could be exhausted, international networks can help to ensure medical treatment for radiation accident victims.

32 CFR 575.6 - Catalogue, United States Military Academy.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 3 2013-07-01 2013-07-01 false Catalogue, United States Military Academy. 575.6... ADMISSION TO THE UNITED STATES MILITARY ACADEMY § 575.6 Catalogue, United States Military Academy. The latest edition of the catalogue, United States Military Academy, contains additional information...

32 CFR 575.6 - Catalogue, United States Military Academy.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 3 2011-07-01 2009-07-01 true Catalogue, United States Military Academy. 575.6... ADMISSION TO THE UNITED STATES MILITARY ACADEMY § 575.6 Catalogue, United States Military Academy. The latest edition of the catalogue, United States Military Academy, contains additional information...

32 CFR 575.6 - Catalogue, United States Military Academy.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 3 2010-07-01 2010-07-01 true Catalogue, United States Military Academy. 575.6... ADMISSION TO THE UNITED STATES MILITARY ACADEMY § 575.6 Catalogue, United States Military Academy. The latest edition of the catalogue, United States Military Academy, contains additional information...

32 CFR 644.328 - Army military leased property.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Army military leased property. 644.328 Section 644.328 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) REAL... military leased property. (a) Department of the Army command installations or parts thereof held by lease...

75 FR 26055 - Military Spouse Appreciation Day, 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-11

... uniform and their families. They are America's greatest military asset, and my Administration is committed... Nation's servicemembers. At the heart of our Armed Forces, servicemembers' spouses keep our military... families, often celebrating their children's life milestones while the other parent is away. Military...

Applications of Transductive Spectral Clustering Methods in a Military Medical Concussion Database.

PubMed

Walker, Peter B; Norris, Jacob N; Tschiffely, Anna E; Mehalick, Melissa L; Cunningham, Craig A; Davidson, Ian N

2017-01-01

Traumatic brain injury (TBI) is one of the most common forms of neurotrauma that has affected more than 250,000 military service members over the last decade alone. While in battle, service members who experience TBI are at significant risk for the development of normal TBI symptoms, as well as risk for the development of psychological disorders such as Post-Traumatic Stress Disorder (PTSD). As such, these service members often require intense bouts of medication and therapy in order to resume full return-to-duty status. The primary aim of this study is to identify the relationship between the administration of specific medications and reductions in symptomology such as headaches, dizziness, or light-headedness. Service members diagnosed with mTBI and seen at the Concussion Restoration Care Center (CRCC) in Afghanistan were analyzed according to prescribed medications and symptomology. Here, we demonstrate that in such situations with sparse labels and small feature sets, classic analytic techniques such as logistic regression, support vector machines, naïve Bayes, random forest, decision trees, and k-nearest neighbor are not well suited for the prediction of outcomes. We attribute our findings to several issues inherent to this problem setting and discuss several advantages of spectral graph methods.

32 CFR 637.4 - Military Police and the USACIDC.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Military Police and the USACIDC. 637.4 Section... ENFORCEMENT AND CRIMINAL INVESTIGATIONS MILITARY POLICE INVESTIGATION Investigations § 637.4 Military Police and the USACIDC. (a) The military police or the USACIDC are authorized to investigate allegations of...

Medicine and the Holocaust: a visit to the Nazi death camps as a means of teaching medical ethics in the Israel Defense Forces Medical Corps.

PubMed

Oberman, Anthony S; Brosh-Nissimov, Tal; Ash, Nachman

2010-12-01

A novel method of teaching military medical ethics, medical ethics and military ethics in the Israel Defense Force (IDF) Medical Corps, essential topics for all military medical personnel, is discussed. Very little time is devoted to medical ethics in medical curricula, and even less to military medical ethics. Ninety-five per cent of American students in eight medical schools had less than 1 h of military medical ethics teaching and few knew the basic tenets of the Geneva Convention. Medical ethics differs from military medical ethics: the former deals with the relationship between medical professional and patient, while in the latter military physicians have to balance between military necessity and their traditional priorities to their patients. The underlying principles, however, are the same in both: the right to life, autonomy, dignity and utility. The IDF maintains high moral and ethical standards. This stems from the preciousness of human life in Jewish history, tradition and religious law. Emphasis is placed on these qualities within the Israeli education system; the IDF teaches and enforces moral and ethical standards in all of its training programmes and units. One such programme is 'Witnesses in Uniform' in which the IDF takes groups of officers to visit Holocaust memorial sites and Nazi death camps. During these visits daily discussions touch on intricate medical and military ethical issues, and contemporary ethical dilemmas relevant to IDF officers during active missions.

Civil-Military Relations: A Selected Bibliography

DTIC Science & Technology

2011-05-01

no. 4 (July 2007): 612- 637. Sage Filho, Joao R. Martins , and Daniel Zirker. "Nationalism, National Security, and Amazonia: Military Perceptions and...411-428. Wiley McGregor, Petra . "The Role of Innere Fuehrung in German Civil-Military Relations." Strategic Insights 5, no. 4 (April 2006). http...Relations during World War I. Westport: Praeger, 2008. 191pp. (D570 .A1F56 2008) Praeger Security International Goedde, Petra . GIs and Germans

Interventions for Sustainable Weight Loss in Military Families

DTIC Science & Technology

through connections made at the 2017 IPR meeting, we participated in discussions with LTC McKnight (Principle Advisor and Military Attach Environmental...Science Engineering Officer Military Operational Medicine Research Program) and Joyce Wessel Raezer (Executive Director, National Military Family... Association ). To combat the recruitment challenges being faced, the idea of including family members of Military Reservists was discussed, but was later

[Civilian-military coordination].

PubMed

de Montravel, G

2002-01-01

Current humanitarian emergencies create complex, mutidimensional situations that stimulate simultaneous responses from a wide variety of sources including governments, non-governmental organizations (NGO), United Nations agencies, and private individuals. As a result, it has become essential to establish a coherent framework in which each actor can contribute promptly and effectively to the overall effort. This is the role of the United Nations Office for the Coordination of Humanitarian Affairs. Regardless of the circumstances and level of coordination, cooperation and collaboration between humanitarian and military personnel, it is necessary to bear in mind their objectives. The purpose of humanitarian action is to reduce human suffering. The purpose of military intervention is to stop warfare. The author of this article will discuss the three major obstacles to civilian-military coordination (strategic, tactical, and operational). Operations cannot be conducted smoothly and differences cannot be ironed out without mutual respect between the two parties, an explicit definition of their respective duties and responsibilities, a clear understanding of their cultural differences, and the presence of an organization and facilities for coordination and arbitrage by a neutral referee.

32 CFR 538.2 - Use of military payment certificates.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 3 2010-07-01 2010-07-01 true Use of military payment certificates. 538.2... ACCOUNTS MILITARY PAYMENT CERTIFICATES § 538.2 Use of military payment certificates. (a) Areas in which used. Military payment certificates are to be used only in the Department of Defense by authorized...

Improving Military Educational Benefits

DTIC Science & Technology

1983-03-16

military to take advantage of their educational benefits . o Adding recruiters or increasing bonuses are less costly ways to increase the number of...as members left to take advantage of their benefits --poorer retention would cancel out five percentage points of that gain. The overall cost of our...IMPROVING MILITARY EDUCATIONAL BENEFITS Statement of Robert F. Hale Assistant Director for National Security and International Affairs

76 FR 27217 - Military Spouse Appreciation Day, 2011

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-11

..., Strengthening our Military Families: Meeting America's Commitment, which marshaled resources from across our... of America A Proclamation Military spouses serve as steady and supportive partners to the heroes in uniform who protect and defend our great Nation every day. Across America and around the world, military...

Military Veterans' Midlife Career Transition and Life Satisfaction

ERIC Educational Resources Information Center

Robertson, Heather C.; Brott, Pamelia E.

2014-01-01

Many military veterans face the challenging transition to civilian employment. Military veteran members of a national program, Troops to Teachers, were surveyed regarding life satisfaction and related internal/external career transition variables. Participants included military veterans who were currently or had previously transitioned to K-12…

Military nephrology—what a civilian doctor should know

PubMed Central

2011-01-01

This article provides some background on military nephrology in the UK. The primary objective of the Defence Medical Services is the maintenance of operational capability of military personnel. This includes exclusion of nephrological diseases that might reduce renal reserve to a critical level under field conditions, increasing susceptibility to trauma, burns, infection and adverse environmental conditions and increasing the need for renal support. Renal failure potentially compromises not only the patient but also his comrades through reduced staffing and inability to execute the military mission. Safety of weapon systems for which the patient is responsible may be reduced. At forward locations, need for evacuation may put aircraft or vehicles and their crew with medical attendants at unnecessary risk. Regular follow-up and continuity of care are difficult owing to the demands of military life that include frequent postings and deployments. PMID:25984145

[Loyalty to professional and military duty].

PubMed

Chizh, I M

1995-01-01

The author of this article--Chief of the Russian Armed Forces Medical Service--analyses the trends of optimization of medical support of the Army and Navy, taking into account the experience of combat casualty care during Chechen crisis. In order to enhance the efficiency of medical support during combat activities all the personnel is supplied with first-aid kits. Each company is reinforced with a medical assistant or army physician; battalion medical posts--with physicians, medical assistants, aidmen, mobile dressing room and ambulances; regiment medical posts--with two surgeons, an anaesthesiologist, an instrument nurse and nurse-anaesthetist. The primary medical care is provided at the battalion medical post; qualified (secondary) surgical care--at regiment medical posts, and specialized (tertiary) medical care--at special medical detachments (SMD) and military hospitals. The wounded are evacuated from the zone of combat actions by APC or MICV, and then by helicopters. The further evacuation of wounded is realized by transport or medical aircraft, including "Skalpel" flight surgery plane. The experience of army physicians has proved the necessity of multilateral development of Mobile Forces Medical Service and the formation of aeromobile hospitals. An airborne infantry battalion must have a medical company in its organic structure, and respectively a separate medical battalion must have an aeromobile medical company. The SMD which are assigned to act in the emergency situations of peaceful time also can be effective in providing medical care (including specialized care) during local military conflicts. Thinking over the further development of medical support in the Armed Forces the author assigns a number of tasks throughout all the chain of medical command, including medical establishments, medical examination boards, the Corps of Senior medical specialists (in surgery, internal medicine, pathologicoanatomy, sanitary supervision, etc). A special attention is

Compliance with antimalarial chemoprophylaxis recommendations for wounded United States military personnel admitted to a military treatment facility.

PubMed

Rini, Elizabeth A; Weintrob, Amy C; Tribble, David R; Lloyd, Bradley A; Warkentien, Tyler E; Shaikh, Faraz; Li, Ping; Aggarwal, Deepak; Carson, M Leigh; Murray, Clinton K

2014-06-01

Malaria chemoprophylaxis is used as a preventive measure in military personnel deployed to malaria-endemic countries. However, limited information is available on compliance with chemoprophylaxis among trauma patients during hospitalization and after discharge. Therefore, we assessed antimalarial primary chemoprophylaxis and presumptive antirelapse therapy (primaquine) compliance among wounded United States military personnel after medical evacuation from Afghanistan (June 2009-August 2011) to Landstuhl Regional Medical Center in Landstuhl, Germany, and then to three U.S. military hospitals. Among admissions at Landstuhl Regional Medical Center, 74% of 2,540 patients were prescribed primary chemoprophylaxis and < 1% were prescribed primaquine. After transfer of 1,331 patients to U.S. hospitals, 93% received primary chemoprophylaxis and 33% received primaquine. Of 751 trauma patients with available post-admission data, 42% received primary chemoprophylaxis for four weeks, 33% received primaquine for 14 days, and 17% received both. These antimalarial chemoprophylaxis prescription rates suggest that improved protocols to continue malaria chemoprophylaxis in accordance with force protection guidelines are needed. © The American Society of Tropical Medicine and Hygiene.

Can dimensions of national culture predict cross-national differences in medical communication?

PubMed

Meeuwesen, Ludwien; van den Brink-Muinen, Atie; Hofstede, Geert

2009-04-01

This study investigated at a country level how cross-national differences in medical communication can be understood from the first four of Hofstede's cultural dimensions, i.e. power distance, uncertainty avoidance, individualism/collectivism and masculinity/femininity, together with national wealth. A total of 307 general practitioners (GPs) and 5820 patients from Belgium, Estonia, Germany, Great Britain, the Netherlands, Poland, Romania, Spain, Sweden and Switzerland participated in the study. Medical communication was videotaped and assessed using Roter's interaction analysis system (RIAS). Additional context information of physicians (gender, job satisfaction, risk-taking and belief of psychological influence on diseases) and patients (gender, health condition, diagnosis and medical encounter expectations) was gathered by using questionnaires. Countries differ considerably form each other in terms of culture dimensions. The larger a nation's power distance, the less room there is for unexpected information exchange and the shorter the consultations are. Roles are clearly described and fixed. The higher the level of uncertainty avoidance, the less attention is given to rapport building, e.g. less eye contact. In 'masculine' countries there is less instrumental communication in the medical interaction, which was contrary to expectations. In wealthy countries, more attention is given to psychosocial communication. The four culture dimensions, together with countries' wealth, contribute importantly to the understanding of differences in European countries' styles of medical communication. Their predictive power reaches much further than explanations along the north/south or east/west division of Europe. The understanding of these cross-national differences is a precondition for the prevention of intercultural miscommunication. Improved understanding may occur at microlevel in the medical encounter, as well as on macrolevel in pursuing more effective cooperation and

Nationally representative prevalence estimates of gay, bisexual, and other men who have sex with men who have served in the U.S. military.

PubMed

Hoover, Karen W; Tao, Kevin L; Peters, Philip J

2017-01-01

To estimate the number of men in the U.S. military who are gay, bisexual, or other men who have sex with men (MSM) to inform the development of military and other federal policies. We analyzed data from the National Surveys of Family Growth to estimate the number of U.S. men who were gay, bisexual, or MSM, and who had served in the military, compared to those who did not serve. We stratified using hierarchical categories of gay, bisexual, and other MSM to compare proportions in the military and general population. We found that 4.23% of men self-reported as gay, bisexual, or other MSM among men who served in the military, compared to 4.14% among men who had not served (p = 0.93). When stratified, we found that 0.78% self-reported as gay among men who served in the military, compared to 2.12% among men who had not served (p<0.001). The proportion of men who identified as a gay was lower in the military than in the general population. This finding might have been influenced by historical military policies related to sexual orientation.

Knowledge mapping visualization analysis of the military health and medicine papers published in the web of science over the past 10 years.

PubMed

Zhang, Xuan-Ming; Zhang, Xuan; Luo, Xu; Guo, Hai-Tao; Zhang, Li-Qun; Guo, Ji-Wei

2017-01-01

Military medicine is a research field that seeks to solve the medical problems that occur in modern war conditions based on public medicine theory. We explore the main research topics of military health and medical research in the web of science™ core collection (WoSCC) from 2007 to 2016, and the goal of this work is to serve as a reference for orientation and development in military health and medicine. Based on CiteSpace III, a reference co-citation analysis is performed for 7921 papers published in the WoSCC from 2007 to 2016. In addition, a cluster analysis of research topics is performed with a comprehensive analysis of high-yield authors, outstanding research institutions and their cooperative networks. Currently, the research topics in military health and medicine mainly focus on the following seven aspects: mental health diagnoses and interventions, an army study to assess risk and resilience in service members (STARRS), large-scale military action, brain science, veterans, soldier parents and children of wartime, and wound infection. We also observed that the annual publication rate increased with time. Wessely S, Greenberg N, Fear NT, Smith TC, Smith B, Jones N, Ryan MAK, Boyko EJ, Hull L, and Rona RJ were the top 10 authors in military health and medicine research. The top 10 institutes were the Uniformed Services University of the Health Sciences, the United States Army, the United States Navy, Kings College London, Walter Reed National Military Medical Center, Boston University, Walter Reed Army Institute of Research, Walter Reed Army Medical Center, Naval Health Research Center, and the VA Boston Healthcare System. We are able to perform a comprehensive analysis of studies in military health and medicine research and summarize the current research climate and the developmental trends in the WoSCC. However, further studies and collaborations are needed worldwide. Overall, our findings provide valuable information and new perspectives and shape

Militares medici in nummis repraesentati: the heritage of military medicine in coins and medals.

PubMed

Pearn, John

2002-01-01

Coins and commemorative medals constitute one special repository of the history of military medicine. The numismatic record has proven to be the most enduring, albeit one of the most selective, records of the progress of history. Matters of health, and especially of military medicine, have been central to the endeavors and indeed the survival of many cultures and societies. Many such themes in the national and international history of military medicine are preserved in the medallic record. Coins and medallions thus constitute one record of the chronology of this profession, one parallel to that of the more traditional history to be found in oral and written records. This account presents a four-part classification of medical coins and medals of military interest. These examples include (1) medals that portray military surgeons and physicians; (2) medals that commemorate special events of military medicine: (3) coins that portray the themes of the discipline of military medicine and health; and (4) a miscellaneous group that includes such examples as disease "touch pieces" and the militarily worn medals of such bodies as the International Red Cross and the Order of St. John, the latter of which are awarded inter alia for contributions to prehospital care in the field. A representative photo archive of such exemplars is included in this account.

Sociometric approaches for managing military units and predicting of behavior of military personnel

NASA Astrophysics Data System (ADS)

Kudro, Nataliya M.; Puzikova, Svetlana M.

2017-09-01

In the Republic of Kazakhstan military service becomes attractive primarily for that category of people who have no opportunity to acquire high quality vocational or higher education, decent income by the speciality available, or those who have not yet identified themselves professionally and socially. Its a serious problem how to ensure ability of military units to execute their service duties in conditions of more and more increasing requirements for professional competences of military personnel, increased intellectualization of military service when the quality of "human material" often is not corresponding to the required standards. This problem in the national and foreign science is still being developed and has no final solutions accessible for the scientific society. This article presents an effort to offer specialists in the military administration area one of probable tools to forecast successfulness of execution of professional tasks by military units based on results of sociometric studies and algorithms of plotting Bayesian networks. Using these tools a military leader will be able to evaluate effectiveness of his managerial activity, correct mechanisms of individual and mentoring activity with regard to individual servicemen, provide an opportunity to eliminate risks of failing to fulfill professional tasks on time and failing to ensure combat readiness of entrusted military team.

32 CFR 169a.14 - Military personnel commercial activity.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 1 2011-07-01 2011-07-01 false Military personnel commercial activity. 169a.14 Section 169a.14 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE DEFENSE CONTRACTING COMMERCIAL ACTIVITIES PROGRAM PROCEDURES Procedures § 169a.14 Military personnel commercial...

32 CFR 169a.14 - Military personnel commercial activity.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 1 2013-07-01 2013-07-01 false Military personnel commercial activity. 169a.14 Section 169a.14 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE DEFENSE CONTRACTING COMMERCIAL ACTIVITIES PROGRAM PROCEDURES Procedures § 169a.14 Military personnel commercial...

32 CFR 169a.14 - Military personnel commercial activity.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 1 2010-07-01 2010-07-01 false Military personnel commercial activity. 169a.14 Section 169a.14 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE DEFENSE CONTRACTING COMMERCIAL ACTIVITIES PROGRAM PROCEDURES Procedures § 169a.14 Military personnel commercial...

Proposal of a framework for evaluating military surveillance systems for early detection of outbreaks on duty areas

PubMed Central

Meynard, Jean-Baptiste; Chaudet, Herve; Green, Andrew D; Jefferson, Henry L; Texier, Gaetan; Webber, Daniel; Dupuy, Bruce; Boutin, Jean-Paul

2008-01-01

Background In recent years a wide variety of epidemiological surveillance systems have been developed to provide early identification of outbreaks of infectious disease. Each system has had its own strengths and weaknesses. In 2002 a Working Group of the Centers for Disease Control and Prevention (CDC) produced a framework for evaluation, which proved suitable for many public health surveillance systems. However this did not easily adapt to the military setting, where by necessity a variety of different parameters are assessed, different constraints placed on the systems, and different objectives required. This paper describes a proposed framework for evaluation of military syndromic surveillance systems designed to detect outbreaks of disease on operational deployments. Methods The new framework described in this paper was developed from the cumulative experience of British and French military syndromic surveillance systems. The methods included a general assessment framework (CDC), followed by more specific methods of conducting evaluation. These included Knowledge/Attitude/Practice surveys (KAP surveys), technical audits, ergonomic studies, simulations and multi-national exercises. A variety of military constraints required integration into the evaluation. Examples of these include the variability of geographical conditions in the field, deployment to areas without prior knowledge of naturally-occurring disease patterns, the differences in field sanitation between locations and over the length of deployment, the mobility of military forces, turnover of personnel, continuity of surveillance across different locations, integration with surveillance systems from other nations working alongside each other, compatibility with non-medical information systems, and security. Results A framework for evaluation has been developed that can be used for military surveillance systems in a staged manner consisting of initial, intermediate and final evaluations. For each stage

Military-Induced Family Separation: A Stress Reduction Intervention.

ERIC Educational Resources Information Center

Black, William G., Jr.

1993-01-01

Notes that Persian Gulf War focused public attention on the problems military families face in coping with military-induced family separation. Highlights some of the unique stressors faced by active-duty, national guard, and reserve military families. Presents practical guidelines to assist social workers in designing interventions to help these…

Medical policy development for human spaceflight at NASA: an evolution.

PubMed

Doarn, Charles R

2011-11-01

Codification of medical policy for the National Aeronautics and Space Administration (NASA) did not occur until 1977. Policy development was based on NASA's human spaceflight efforts from 1958, and the need to support the operational aspects of the upcoming Space Shuttle Program as well as other future activities. In 1958, the Space Task Group (STG), a part of the National Advisory Committee on Aeronautics (NACA), became the focal point for astronaut selection, medical support, and instrumentation development in support of Project Mercury. NACA transitioned into NASA in 1958. The STG moved to Houston, TX, in 1961 and became the Manned Spacecraft Center. During these early years, medical support for astronaut selection and healthcare was provided through arrangements with the U.S. military, specifically the United States Air Force, which had the largest group of subject matter experts in aerospace medicine. Through most of the 1960s, the military worked very closely with NASA in developing the foundations of bioastronautics and space medicine. This work was complemented by select individuals from outside the government. From 1958 to 1977, there was no standard approach to medical policy formulation within NASA. During this time, it was individualized and subjected to political pressures. This manuscript documents the evolution of medical policy in the NASA, and provides a historical account of the individuals, processes, and needs to develop policy.

Prospective use of unmanned aerial vehicles for military medical evacuation in future conflicts.

PubMed

Handford, Charles; Reeves, F; Parker, P

2018-03-09

In order to continue to deliver outstanding medical care on the battlefield, the UK Defence Medical Services must continue to adapt, overcome and actively embrace change. One potential area is the rapid proliferation and sophistication of automated and remote systems such as unmanned aerial vehicles (UAVs). UAVs are already used to deliver blood to remote military locations in Afghanistan and defibrillators to those that need them in the USA and Sweden. An area of future opportunity would be to facilitate rapid evacuation of wounded personnel from high intensity, high threat, remote and austere areas directly to specialist care. Such a capability would reduce threat to human life while allowing rapid extraction of casualties from high risk or inaccessible environments straight back to Role 3 care, all of which in these situations is either not possible or carries too much risk using conventional aerial assets. The article aims to highlight a potential future capability, stimulate debate and reflection, all of which is essential for innovation and future organisational development. The potential uses and benefits of UAVs are highlighted including both the challenges and rewards of utilising UAVs for casualty evacuation. Key benefits are reduced risk to human life, cost, ability to insert into areas conventional aircraft cannot and the rapidity of transfer. Challenges are likely to be airspace management, decisions on appropriate level of care to deliver during transit and ultimately user acceptability. The article also highlights that in order to maximise our ability to exploit new technologies, all arms and trades within the military must be involved in collective research and development. Furthermore, sensible corroboration with private companies will further enhance our ability to acquire products that best serve our needs. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use

Risk Information Management Resource (RIMR): modeling an approach to defending against military medical information assurance brain drain

NASA Astrophysics Data System (ADS)

Wright, Willie E.

2003-05-01

As Military Medical Information Assurance organizations face off with modern pressures to downsize and outsource, they battle with losing knowledgeable people who leave and take with them what they know. This knowledge is increasingly being recognized as an important resource and organizations are now taking steps to manage it. In addition, as the pressures for globalization (Castells, 1998) increase, collaboration and cooperation are becoming more distributed and international. Knowledge sharing in a distributed international environment is becoming an essential part of Knowledge Management. This is a major shortfall in the current approach to capturing and sharing knowledge in Military Medical Information Assurance. This paper addresses this challenge by exploring Risk Information Management Resource (RIMR) as a tool for sharing knowledge using the concept of Communities of Practice. RIMR is based no the framework of sharing and using knowledge. This concept is done through three major components - people, process and technology. The people aspect enables remote collaboration, support communities of practice, reward and recognize knowledge sharing while encouraging storytelling. The process aspect enhances knowledge capture and manages information. While the technology aspect enhance system integration and data mining, it also utilizes intelligent agents and exploits expert systems. These coupled with supporting activities of education and training, technology infrastructure and information security enables effective information assurance collaboration.

32 CFR 154.15 - Military appointment, enlistment, and induction.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 1 2010-07-01 2010-07-01 false Military appointment, enlistment, and induction... Requirements § 154.15 Military appointment, enlistment, and induction. (a) General. The appointment, enlistment... tendered to immigrant alien health professionals, chaplains, and attorneys. (e) Mobilization of military...

Cultural self-awareness as a crucial component of military cross-cultural competence.

PubMed

Pappamihiel, Constantine J; Pappamihiel, Eleni

2013-01-01

The military forces in the United States represent a unique culture that includes many subcultures within their own military society. Acculturation into the military often deemphasizes the influence of personal narrative and thereby establishes the primacy of military culture over personal cultural influences. The authors make the argument that military personnel need to further develop an understanding and appreciation of personal cultural narrative as well as organizational culture. The increased integration of military personnel with interagency partners, along with cooperative efforts between relief organizations, and nongovernmental organizations in politically/economically unstable areas around the globe serves to make cross-cultural interaction unavoidable in the future. Military medical personnel are especially likely to interact with others who have culturally different values. These interactions can occur between organizations as easily as they can during patient care. They must be able to step outside of their military culture and develop cross-cultural competence that is grounded in cultural self-awareness. Without an appropriate level of cultural self-awareness, military and medical personnel run the risk of being unable to communicate across dissimilar cultures or worse, alienating key stakeholders in collaborative operations between military services, coalition partners, and nonmilitary organizations. It is the authors? contention that unless military personnel, especially those in the medical arena, are able to appropriately self-assess situations that are impacted by culture, both their own and the other personnel involved, the resulting cultural dissonance is more likely to derail any significant positive effect of such collaborations. 2013.

Nuclear Medical Science Officers: Army Health Physicists Serving and Defending Their Country Around the Globe

NASA Astrophysics Data System (ADS)

Melanson, Mark; Bosley, William; Santiago, Jodi; Hamilton, Daniel

2010-02-01

Tracing their distinguished history back to the Manhattan Project that developed the world's first atomic bomb, the Nuclear Medical Science Officers are the Army's experts on radiation and its health effects. Serving around the globe, these commissioned Army officers serve as military health physicists that ensure the protection of Soldiers and those they defend against all sources of radiation, military and civilian. This poster will highlight the various roles and responsibilities that Nuclear Medical Science Officers fill in defense of the Nation. Areas where these officers serve include medical health physics, deployment health physics, homeland defense, emergency response, radiation dosimetry, radiation research and training, along with support to the Army's corporate radiation safety program and international collaborations. The poster will also share some of the unique military sources of radiation such as depleted uranium, which is used as an anti-armor munition and in armor plating because of its unique metallurgic properties. )

Caring for Active Duty Military Personnel in the Civilian Sector

PubMed Central

Waitzkin, Howard; Noble, Marylou

2011-01-01

Due to the wars in Iraq and Afghanistan, the unmet medical and psychological needs of military personnel are creating major challenges. Increasingly, active duty military personnel are seeking physical and mental health services from civilian professionals. The Civilian Medical Resources Network attempts to address these unmet needs. Participants in the Network include primary care and mental health practitioners in all regions of the country. Network professionals provide independent assessments, clinical interventions in acute situations, and documentation that assists GIs in obtaining reassignment or discharge. Most clients who use Network services come from low-income backgrounds and manifest psychological rather than physical disorders. Qualitative themes in professional-client encounters have focused on ethical conflicts, the impact of violence without meaning (especially violence against civilians), and perceived problems in military health and mental health policies. Unmet needs of active duty military personnel deserve more concerted attention from medical professionals and policy makers. PMID:21339846

Problems of Military Cemeteries Greenery - Case Study of the Military Cemetery in Zvolen

NASA Astrophysics Data System (ADS)

Halajová, Denisa; Petreková, Denisa; Bihuňová, Mária

2017-10-01

The intention of this work is to highlight the importance of understanding military cemeteries as objects of cultural and historical heritage and as a part of garden design history. The design and maintenance of cemeteries and graves is a manifestation of the national culture. This is even more evident in military cemeteries, the maintenance of which is regulated by international agreements. Objects of military cemeteries are important places not only from the historical and architectural point of view, but also as green space. Most military cemeteries in Slovakia originated from World War I and II. In Slovakia, 160,000 soldiers were buried, 75,206 of them lost their lives in World War I and 93,000 in World War II. 32,495 war graves are registered by The Ministry of the Interior of the Slovak Republic - 23,316 war graves from World War I and 9,179 from World War II. From the period of World War II, there are 22 cemeteries and graveyards in Slovakia, established for soldiers of the Soviet, German, Romanian and Czechoslovak army. Military cemeteries and memorials are mostly high quality works of architecture and art. This paper focuses on the current situation and restoration issues of military cemeteries by examining the Military Cemetery in Zvolen. In the context of its planned reconstruction, a comprehensive tree assessment has been started in 2016. The Military Cemetery in Zvolen, being one of the largest military cemeteries in Slovakia, consists of The Cemetery of the Soviet Army with 17,628 buried soldiers and The Romanian Cemetery with 11,000 buried soldiers. The Romanian Cemetery is one of the largest cemeteries of the Romanian Army in Europe. Both cemeteries were declared national cultural monuments in 1963. In the cemetery, dendrometrical parameters and the health condition of trees were evaluated. In total, there are 825 woody plants. In both cemeteries, coniferous trees prevail, mainly individuals of the genus Thuja (49.4 %). Moreover, the maintenance of

33 CFR 334.845 - Wisconsin Air National Guard, Volk Field military exercise area located in Lake Michigan offshore...

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Wisconsin Air National Guard, Volk Field military exercise area located in Lake Michigan offshore from Manitowoc and Sheboygan..., DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE DANGER ZONE AND RESTRICTED AREA REGULATIONS § 334.845 Wisconsin...

33 CFR 334.845 - Wisconsin Air National Guard, Volk Field military exercise area located in Lake Michigan offshore...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Wisconsin Air National Guard, Volk Field military exercise area located in Lake Michigan offshore from Manitowoc and Sheboygan..., DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE DANGER ZONE AND RESTRICTED AREA REGULATIONS § 334.845 Wisconsin...

33 CFR 334.845 - Wisconsin Air National Guard, Volk Field military exercise area located in Lake Michigan offshore...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Wisconsin Air National Guard, Volk Field military exercise area located in Lake Michigan offshore from Manitowoc and Sheboygan..., DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE DANGER ZONE AND RESTRICTED AREA REGULATIONS § 334.845 Wisconsin...

33 CFR 334.845 - Wisconsin Air National Guard, Volk Field military exercise area located in Lake Michigan offshore...

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Wisconsin Air National Guard, Volk Field military exercise area located in Lake Michigan offshore from Manitowoc and Sheboygan..., DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE DANGER ZONE AND RESTRICTED AREA REGULATIONS § 334.845 Wisconsin...

33 CFR 334.845 - Wisconsin Air National Guard, Volk Field military exercise area located in Lake Michigan offshore...

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Wisconsin Air National Guard, Volk Field military exercise area located in Lake Michigan offshore from Manitowoc and Sheboygan..., DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE DANGER ZONE AND RESTRICTED AREA REGULATIONS § 334.845 Wisconsin...

Preventing Suicides in the Military | NIH MedlinePlus the Magazine

MedlinePlus

... this page please turn Javascript on. Feature: Preventing Suicides Preventing Suicides in the Military Past Issues / Winter 2010 Table ... National Institute of Mental Health aims to reduce suicides among America's military and military veterans. "The suicide ...

Rheumatoid arthritis in a military aviator.

PubMed

Moszyk, Danielle J; Sulit, Daryl J

2007-01-01

Rheumatoid arthritis is a chronic inflammatory condition whose pathogenesis is determined partially by genetic and environmental factors. Without treatment, 20 to 30% of individuals with this condition will become permanently disabled in a few years. Rheumatoid arthritis and its potential complications can cause significant disability and could seriously affect the performance of an aviator. Traditionally, disease-modifying anti-rheumatic drugs (DMARD) and biologics have not been used until disease progression occurs, but they recently have been added earlier in the course of disease for a more aggressive approach to treatment. It has been shown to significantly reduce the number of affected joints, pain, and disability. This newer treatment regimen has helped a military pilot continue his aviation career. We present the case of an experienced designated military pilot who was diagnosed with rheumatoid arthritis. He was initially treated early with a DMARD and biologic medication. He has remained in remission and currently only uses etanercept (biologic medication) and a non-steriodal anti-inflammatory drug to control his disease. He has responded favorably to therapy and has few limitations. Due to his positive response to treatment, the aviator was granted military aeromedical waivers for rheumatoid arthritis and chronic medication use.

Sleep medicine is coming of age in military medicine : Report from the Military Health System Research Symposium (2017) in Kissimmee, Florida.

PubMed

Eliasson, Arn H; Lettieri, Christopher; Netzer, Nikolaus

2018-05-01

In August 2017, the US Military Health System held its sixth annual Research Symposium for medical researchers from the US Army, Navy, Air Force, and Public Health Service. The symposium provides a collaborative environment for academia, industry, and military researchers who address advancement in areas of Combat Casualty Care, Military Operational Medicine, Clinical and Rehabilitative Medicine, and Military Infectious Diseases. This year, Sleep Medicine received substantial attention with presentations scattered throughout the program, poster presentations as well as a scheduled breakout session with podium presentations. A brief description of the breakout session follows.

Realizing Major William Borden's dream: military medicine, Walter Reed Army Medical Center, and its wounded warriors, 1909-2009: an essay review.

PubMed

Connor, J T H

2011-07-01

This essay review examines three books dealing with the founding and subsequent activities of Walter Reed Army Medical Center (WRAMC) and the evolution of military medicine from 1909 to 2009 recently published by the US Army's Borden Institute. Established by fellow army doctor William Borden to honor Walter Reed himself, WRAMC, located in Washington, DC, soon became the public and professional face of medical care for American soldiers. The discussion highlights the ongoing issue of the care and treatment of combat amputees; aspects of gender within military medicine; and WRAMC's function as an educational and research facility. Also discussed are the archival and documentary bases for these books and their utility for historians. Complimentary analysis of two of the books which are, in particular, explicitly about the history of WRAMC is contextualized within the celebration of the centennial of this army post contemporaneously with its closure, amalgamation, and relocation primarily to Maryland. © The Author 2010. Published by Oxford University Press. All rights reserved.

5 CFR 841.708 - Special provisions affecting retired military reserve technicians.

Code of Federal Regulations, 2010 CFR

2010-01-01

... military reserve technicians. 841.708 Section 841.708 Administrative Personnel OFFICE OF PERSONNEL... ADMINISTRATION Cost-of-Living Adjustments § 841.708 Special provisions affecting retired military reserve technicians. (a) Military reserve technicians who retire as a result of a medical disability are excepted from...

Coordinating an interdisciplinary disease management conference on a military installation: collaboration between military and civilian communities, lessons learned.

PubMed

Lewis-Fleming, Glenda; Knapp, Casey A

2009-08-01

The needs of individuals with chronic diseases or disabilities are similar whether within military or civilian communities. With finite resources and the continuing global war on terrorism, military treatment facilities (MTFs) may find collaborative, multidisciplinary, continuing education efforts with community agencies invaluable. Collaborative efforts that bring military and civilian communities together can result in innovative programs that offer cost-effective high-quality information to enhance the knowledge and skill level of military families, providers, and other professionals who provide services and care for military eligible beneficiaries. This article addresses the development and implementation of two major multidisciplinary disease management conferences at Naval Medical Center Portsmouth (NMCP), Virginia. It provides an overview of lessons learned in the areas of preplanning, team building, program development, implementation, and evaluation. Despite challenges, tremendous benefits may be reaped from efforts to include diverse target populations from military and civilian communities.

National Institute of General Medical Sciences

MedlinePlus

... Over Navigation Links National Institute of General Medical Sciences Site Map Staff Search My Order Search the ... NIGMS Website Research Funding Research Training News & Meetings Science Education About NIGMS Feature Slides View All Slides ...

[Improvement of medical equipment setting for the hospital link of the medical service during wartime].

PubMed

Miroshnichenko, Yu V; Goryachev, A B; Popov, A A; Rodionov, E O

2016-04-01

One of the priorities of the military health care is to improve the system of rationing medical equipment for the hospital unit of the medical service of the Armed Forces in wartime. This is determined the fact that the effectiveness of measures to provide military field hospitals with medical supplies depends on the quality of medical care for the wounded and sick, as well as the level of their return to duty. The article presents the characteristics of modern standards medical supplies procurement of military field hospitals included in the new regulatory legal act of the Russian Federation Ministry of Defence--"Standards of supplies medical supplies medical and pharmaceutical organizations (units) of the Russian Federation on the wartime armed forces", approved and put into effect in 2015 by order of the Minister of Defence of the Russian Federation.

The military veteran to physician assistant pathway: building the primary care workforce.

PubMed

Brock, Douglas; Bolon, Shannon; Wick, Keren; Harbert, Kenneth; Jacques, Paul; Evans, Timothy; Abdullah, Athena; Gianola, F J

2013-12-01

The physician assistant (PA) profession emerged to utilize the skills of returning Vietnam-era military medics and corpsmen to fortify deficits in the health care workforce. Today, the nation again faces projected health care workforce shortages and a significant armed forces drawdown. The authors describe national efforts to address both issues by facilitating veterans' entrance into civilian PA careers and leveraging their skills.More than 50,000 service personnel with military health care training were discharged between 2006 and 2010. These veterans' health care experience and maturity make them ideal candidates for civilian training as primary care providers. They trained and practiced in teams and functioned under minimal supervision to care for a broad range of patients. Military health care personnel are experienced in emergency medicine, urgent care, primary care, public health, and disaster medicine. However, the PA profession scarcely taps this valuable resource. Fewer than 4% of veterans with health care experience may ever apply for civilian PA training.The Health Resources and Services Administration (HRSA) implements two strategies to help prepare and graduate veterans from PA education programs. First, Primary Care Training and Enhancement (PCTE) grants help develop the primary care workforce. In 2012, HRSA introduced reserved review points for PCTE: Physician Assistant Training in Primary Care applicants with veteran-targeted activities, increasing their likelihood of receiving funding. Second, HRSA leads civilian and military stakeholder workgroups that are identifying recruitment and retention activities and curricula adaptations that maximize veterans' potential as PAs. Both strategies are described, and early outcomes are presented.

Veterans worry that unexplained medical problems a legacy of service during Gulf War.

PubMed Central

Robinson, A

1995-01-01

Some Canadians who served in the military in the Persian Gulf 4 years ago complain of a range of symptoms commonly described as Gulf War syndrome. Although the syndrome is not recognized as a clinical entity, symptoms include fatigue, lack of sleep, depression, cognitive problems, rashes, bone aches, lassitude, lack of motivation, forgetfulness, mood changes irritability and diarrhea. The medical branch of the Department of National Defence has established programs to inform, guide diagnosis and reach out to symptomatic veterans of the Persian Gulf conflict. Civilian physicians who provide similar care to military personnel who participated in the conflict are invited to call the medical branch (613 996-3752) for further information. Images p945-a PMID:7697587

Military anesthesia trainees in WWII at the University of Wisconsin: their training, careers, and contributions.

PubMed

Parks, Colby L; Schroeder, Mark E

2013-05-01

The emerging medical specialty of anesthesiology experienced significant advances in the decade prior to World War II but had limited numbers of formally trained practitioners. With war looming, a subcommittee of the National Research Council, chaired by Ralph M. Waters, MD., was charged with ensuring sufficient numbers of anesthesiologists for military service. A 12-week course was developed to train military physicians at academic institutions across the country, including the Wisconsin General Hospital. A total of 17 officers were trained in Madison between September 1942 and December 1943. Notably, Virgil K. Stoelting, the future chair of anesthesiology at Indiana University, was a member of this group.A rigorous schedule of study and clinical work ensured the officers learned to administer anesthesia safely while using a variety of techniques. Their leadership and contributions in the military and after the war contributed significantly to the further growth of anesthesiology.

Thyroid cancer incidence among active duty U.S. military personnel, 1990-2004

PubMed Central

Enewold, Lindsey R.; Zhou, Jing; Devesa, Susan S.; de Gonzalez, Amy Berrington; Anderson, William F.; Zahm, Shelia H.; Stojadinovic, Alexander; Peoples, George E.; Marrogi, Aizenhawar J.; Potter, John F.; McGlynn, Katherine A.; Zhu, Kangmin

2011-01-01

BACKGROUND Increases in thyroid papillary carcinoma incidence rates have largely been attributed to heightened medical surveillance and improved diagnostics. We examined papillary carcinoma incidence in an equal-access healthcare system by demographics, which are related to incidence. METHODS Incidence rates during 1990-2004 among white and black individuals aged 20-49 years in the military and the general U.S. population were compared using data from the Department of Defense’s Automated Central Tumor Registry and the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER-9) program. RESULTS Incidence was significantly higher in the military than in the general population among white women [incidence rate ratio (IRR)=1.42, 95% 95% confidence interval (CI)=1.25-1.61], black women (IRR=2.31, 95% CI=1.70-2.99), and black men (IRR=1.69, 95% CI=1.10-2.50). Among whites, differences between the two populations were confined to rates of localized tumors (women: IRR=1.73, 95% CI=1.47-2.00; men: IRR=1.51, 95% CI=1.30-1.75), which may partially be due to variation in staging classification. Among white women, rates were significantly higher in the military regardless of tumor size, and rates rose significantly over time both for tumors ≤2 cm (military: IRR=1.64, 95% CI=1.18-2.28; general population: IRR=1.55, 95% CI=1.45-1.66) and >2 cm (military: IRR=1.74, 95% CI=1.07-2.81; general population: IRR=1.48, 95% CI=1.27-1.72). Among white men, rates increased significantly only in the general population. Incidence also varied by military service branch. CONCLUSIONS Heightened medical surveillance does not appear to fully explain the differences between the two populations or the temporal increases in either population. IMPACT These findings suggest the importance of future research into thyroid cancer etiology. PMID:21914838

Alcohol and Stress in the Military

PubMed Central

Schumm, Jeremiah A.; Chard, Kathleen M.

2012-01-01

Although research has independently linked stress experienced by military personnel to both alcohol use and posttraumatic stress disorder, more recently researchers have noted that there also is a significant overlap between stress reactions and alcohol use in veterans and active-duty service members. This overlap seems to be most understood in individuals who have experienced combat or military sexual trauma. This article will provide a brief review of some potential causal mechanisms underlying this relationship, including self-medication and genetic vulnerability models. It also addresses the possible implications for assessment and treatment of military personnel with co-occurring disorders. PMID:23584106

32 CFR 644.327 - Air Force military real property.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Air Force military real property. 644.327 Section... Force military real property. Military real property under the control of the Department of the Air Force will be placed in excess status as outlined in AFR 87-4. ...

National Leadership Summit on Military Families

DTIC Science & Technology

2009-01-01

not represent immunity from distress, and resilience training cannot serve as a “ vaccination ” for distress. Rather, resilience is a set of...would develop policies, programs, and services for children with special needs, including those with autism (the autism rate among military children is...counseling, and assistance. Mrs. Goosey would also focus on children with special needs, including autism . She has a friend who is struggling to get

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.

Engaging Military Partners: Supporting Connections to Communities

ERIC Educational Resources Information Center

Edwards, Harriett C.

2009-01-01

In the current Overseas Contingency Operation (OCO), families and communities have been impacted by multiple deployments. This is particularly challenging for families that are geographically isolated from military installations and resources typically available near these facilities. Operation Military Kids (OMK) is a national partnership…

Providing care to military personnel and their families: how we can all contribute.

PubMed

Gleeson, Todd D; Hemmer, Paul A

2014-09-01

Providing medical care to members of the military and their families remains a societal duty carried out not only by military physicians but also, and in large part, by civilian providers. As many military families are geographically dispersed, it is probable that all physicians at some point in their training or careers will care for this unique patient population. Understanding the military culture can help physicians provide the best care possible to our military families, and inclusion of military cultural competency curricula in all medical schools is a first step in advancing this understanding. The authors review the knowledge, skills, and attitudes that all health professionals should acquire to be able to care for those who serve and offer recommendations for developing these among all students and trainees.

Medical care as the carrot: the Red Cross in Indonesia during the war of decolonization, 1945-1950.

PubMed

van Bergen, L

2013-01-01

During the war of decolonisation in Indonesia 1945-1950, the Dutch Red Cross and the Dutch East Indies Red Cross delivered aid to sick and wounded soldiers and civilians. This was supposed to happen in cooperation with organisations including the Indonesian Red Cross, the International Committee of the Red Cross, the military health service and civilian health services. Due to lack of resources, doctors and nurses, and due to differing interests, cooperation went anything but smoothly, severely undermining medical aid. On top of that, the aid that was given turned out be a tool of propaganda for the Dutch cause. Aid was deliberately--and with Red Cross consent--used as a political-military tool in the service of Dutch national interests. In a military strategy of carrot and stick, medical care served as the carrot.

Assessing curriculum effectiveness: a survey of Uniformed Services University medical school graduates.

PubMed

Picho, Katherine; Gilliland, William R; Artino, Anthony R; DeZee, Kent J; Dong, Ting; McManigle, John E; Cruess, David F; Durning, Steven J

2015-04-01

This study assessed alumni perceptions of their preparedness for clinical practice using the Accreditation Council for Graduate Medical Education (ACGME) competencies. We hypothesized that our alumni's perception of preparedness would be highest for military-unique practice and professionalism and lowest for system-based practice and practice-based learning and improvement. 1,189 alumni who graduated from the Uniformed Services University (USU) between 1980 and 2001 completed a survey modeled to assess the ACGME competencies on a 5-point, Likert-type scale. Specifically, self-reports of competencies related to patient care, communication and interpersonal skills, medical knowledge, professionalism, systems-based practice, practice-based learning and improvement, and military-unique practice were evaluated. Consistent with our expectations as the nation's military medical school, our graduates were most confident in their preparedness for military-unique practice, which included items assessing military leadership (M = 4.30, SD = 0.65). USU graduates also indicated being well prepared for the challenges of residency education in the domain of professionalism (M = 4.02, SD = 0.72). Self-reports were also high for competencies related to patient care (M = 3.86, SD = 0.68), communication and interpersonal skills (M = 3.88, SD = 0.66), and medical knowledge (M = 3.78, SD = 0.73). Consistent with expectations, systems-based practice (M = 3.50, SD = 0.70) and practice-based learning and improvement (M = 3.57, SD = 0.62) were the lowest rated competencies, although self-reported preparedness was still quite high. Our findings suggest that, from the perspective of our graduates, USU is providing both an effective military-unique curriculum and is preparing trainees for residency training. Further, these results support the notion that graduates are prepared to lead and to practice medicine in austere environments. Compared to other competencies that were assessed, self

Military Experience Directed into Health Careers. Final Report.

ERIC Educational Resources Information Center

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

Operation MEDIHC's (Military Experience Directed into Health Careers) final report is presented which firmly establishes the need for its purpose, which is providing a meaningful career continuation for medical personnel who were trained while serving in the military service. It is reported that the New Jersey MEDIHC Program experienced a…

Basic Military Justice Handbook. Revision

DTIC Science & Technology

1989-01-01

copies. Note: The accused will be escorted to the local medical facility for a preconfinement physical. This is a function of your master-at-arms...5004 of ref (a). a. Retrieved dependent ID cards. b. If not surrendered, notify local medical facilities and military activities. c. A terminate DD 1172...dental records, and secure physical immediately before trial (or notify medical people of need). B. POST-TRIAL MATTERS 1. Assure confinement order is

Private Military and Security Companies - Counterinsurgency and Nation Building Strategy

DTIC Science & Technology

2013-04-25

cans, and bought war bonds is long gone. One advantage that the private sector brings to public wars is capacity. Companies like Kellogg and Brown...1 Anne-Marie Buzatu, and Benjamin S . Buckland, “Private Military & Security Companies : Future Challenges in...From  -­‐  To)   September 2012 - April 2013 4.  TITLE  AND  SUBTITLE   Private Military and Security Companies - Counterinsurgency and

The Prevalence of Metabolic Syndrome Among Soldiers of the Military Police of Bahia State, Brazil.

PubMed

Filho, Romário Teixeira Braga; D'Oliveira, Argemiro

2014-07-01

The mortality rate of men is generally higher than that of women, irrespective of the age group. Currently, a key concern for health care professionals is the prevalence of risk factors associated with cardiovascular disease and metabolic syndrome. This study aimed at assessing the prevalence of individual risk factors for cardiovascular disease as well as the prevalence of metabolic syndrome among men serving in the Military Police Corps of the state of Bahia, Brazil. This service employs mostly men, and they are known to experience high levels of occupational stress and professional victimization. We conducted a cross-sectional study among military police soldiers (n = 452) who were candidates for a military police training course in Bahia, Brazil. All candidates who attended the selection process were evaluated according to the criteria of the National Cholesterol Education Program's Adult Panel III in order to assess the presence of medical disorders that could contribute to cardiovascular disease and metabolic syndrome. The authors identified a high prevalence of hypertension (55.76%), hypertriglyceridemia (50.85%), waist circumference of >102 cm (31.76%), low high-density lipoprotein cholesterol levels (30.46%), and impaired fasting glucose (28.15%) in our subjects. The overall prevalence of metabolic syndrome was 38.54%. The authors suggest that measures should be taken to ensure that military policemen receive continued medical care, both in their professional capacity and in their personal circumstances, and that attention be focused on intervention programs. © The Author(s) 2013.

29 CFR 2590.609-2 - National Medical Support Notice.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Retirement Income Security Act (ERISA), the Notice is deemed to be a qualified medical child support order....609-2 Labor Regulations Relating to Labor (Continued) EMPLOYEE BENEFITS SECURITY ADMINISTRATION..., Qualified Medical Child Support Orders, Coverage for Adopted Children § 2590.609-2 National Medical Support...

The military's approach to traumatic brain injury and post-traumatic stress disorder

NASA Astrophysics Data System (ADS)

Ling, Geoffrey S. F.; Grimes, Jamie; Ecklund, James M.

2014-06-01

Traumatic brain injury (TBI) and Post Traumatic Stress Disorder (PTSD) are common conditions. In Iraq and Afghanistan, explosive blast related TBI became prominent among US service members but the vast majority of TBI was still due to typical causes such as falls and sporting events. PTS has long been a focus of the US military mental health providers. Combat Stress Teams have been integral to forward deployed units since the beginning of the Global War on Terror. Military medical management of disease and injury follows standard of care clinical practice guidelines (CPG) established by civilian counterparts. However, when civilian CPGs do not exist or are not applicable to the military environment, new practice standards are created. Such is the case for mild TBI. In 2009, the VA-DoD CPG for management of mild TBI/concussion was published and a system-wide clinical care program for mild TBI/concussion was introduced. This was the first large scale effort on an entire medical care system to address all severities of TBI in a comprehensive organized way. In 2010, the VA-DoD CPG for management of PTSD was published. Nevertheless, both TBI and PTS are still incompletely understood. Investment in terms of money and effort has been committed by the DoD to their study. The Defense and Veterans Brain Injury Center, National Intrepid Center of Excellence and the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury are prominent examples of this effort. These are just beginnings, a work in progress ready to leverage advances made scientifically and always striving to provide the very best care to its military beneficiaries.

[Lines of research in the field of cellular technologies and its application in military medicine].

PubMed

Chepur, S V; Iudin, A B; Shperling, I A; Iurkevich, Iu V; Vengerovich, N G; Shchipanov, S G; Shulepov, A V

2015-02-01

The paper presents an overview of cellular therapy products and medical tissue engineering of the leading countries of the world (including the US) and identifies lines of research in the field of cellular technology application in the interests of national military medicine. The authors gave information concerning practical implementation of the achievements of biomedical research in the field of regenerative cellular products and technologies in Russia as different products, which may be used at the stages of medical evacuation. The authors presented results of research, which was, performed on the model of mine blast injury in accordance with principle possibility of the usage of cellular technologies products (multipotent mesenchymal stromal cells) in medical practice.

[The significance of the experience in organizing medical support for the troops during the war years for the development of the modern military medical infrastructure].

PubMed

Pogodin, Iu I; Gurov, A N

1995-05-01

In the present period when combat activities are being carried out at the territory of Russia, namely in Chechnya, it is very important to solve the problem of the improvement of the infrastructure of medical service as a basis of territorial system of medical support of troops. That's why we are looking at the experience of medical support of troops in the period of the Great Patriotic war in order to determine the basic characteristic features of military medical infrastructure (MMI) of that time. Using the experience of medical support in the period of the Great Patriotic war it is necessary to draw the main attention on studying the medico-geographical aspects of the Armed Forces deployment over the whole territory of the country, state of health service system (taking into account its reformation), influence of natural, socio-economic and ecological factors of different regions upon the health of servicemen, organization of medical support of troops, proliferation of infectious and parasitic diseases, local resources and availability of medication materials, medical supplies, equipment and technique, as well as other indices which must be taken into consideration in routine situations or during disaster relief. All this information is very valuable for the process of the formation of an adequate MMF in the zone of responsibility of medical support of troops.

32 CFR 635.14 - Accounting for military police record disclosure.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Accounting for military police record disclosure... § 635.14 Accounting for military police record disclosure. (a) AR 340-21 prescribes accounting policies and procedures concerning the disclosure of military police records. (b) Provost Marshals/Directors of...

[Medical support of Russian Armed Forces: the results and perspectives].

PubMed

Shappo, V V

2008-01-01

The results of work of the Russian Federation Armed Forces medical service obtained in 2007 were summarized and the main problems of its activities in the current year and the very near future were determined. So the work at defining medical support as a type of Army and Navy support was began. The most important task of medical service in 2008 is realization of the Armed Forces medical support conception and goal-oriented program "The improvement of Russian Federation Armed Forces medical support in 2008-2012", the formation of two-level system of personnel's medical support. During the task realization the medical units and institutions are reorganized into federal state institutions. The RF DM Main Military Medical Headquarters works at significant improvement of war and military service veterans' medical attendance. The departmental program "Development of material and technical basis of military medical institutions for 2001-2010" is successfully realized. The measures to optimize the assignment of graduates from military medical higher schools are carried out. The tasks to improve the research work were outlined. The new principles of organization of military medical service control and work will be based on centralization of planning and decentralization of decision implementation, the possibility of military medical units to carry it out taking into account the common intention, safe feedback in order to make the work of army and navy medical specialists more effective in any conditions.

Cancer Incidence in the U.S. Military Population: Comparison with Rates from the SEER Program

PubMed Central

Zhu, Kangmin; Devesa, Susan S.; Wu, Hongyu; Zahm, Shelia H.; Jatoi, Ismail; Anderson, William F.; Peoples, George; Maxwell, Larry G.; Granger, Elder; Potter, John F.; McGlynn, Katherine A.

2009-01-01

The U.S. active-duty military population may differ from the U.S. general population in its exposure to cancer risk factors and access to medical care. Yet, it is not known if cancer incidence rates differ between these two populations. We therefore compared the incidence of four cancers common in U.S. adults (lung, colorectum, prostate, and breast cancers) and two cancers more common in U.S. young adults (testicular and cervical cancers) in the military and general populations. Data from the Department of Defense's Automated Central Tumor Registry (ACTUR) and the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) nine cancer registries for the years 1990-2004 for persons aged 20-59 years were analyzed. Incidence rates were significantly lower in the military population for colorectal cancer in white men, lung cancer in white and black men and white women, and cervical cancer in black women. In contrast, incidence rates of breast and prostate cancers were significantly higher in the military among both whites and blacks. Incidence rates of testicular cancer did not differ between ACTUR and SEER. Although the numbers of diagnoses among military personnel were relatively small for temporal trend analysis, we found a more prominent increase in prostate cancer in ACTUR than in SEER. Overall, these results suggest that cancer patterns may differ between military and non-military populations. Further studies are needed to confirm these findings and explore contributing factors. PMID:19505907

Military Versus Civilian Murder-Suicide.

PubMed

Patton, Christina L; McNally, Matthew R; Fremouw, William J

2015-07-03

Previous studies have implicated significant differences between military members and civilians with regard to violent behavior, including suicide, domestic violence, and harm to others, but none have examined military murder-suicide. This study sought to determine whether there were meaningful differences between military and civilian murder-suicide perpetrators. Using data from the Center for Disease Control's (CDC) National Violent Death Reporting System (NVDRS), military (n = 259) and civilian (n = 259) murder-suicide perpetrators were compared on a number of demographic, psychological, and contextual factors using chi-square analyses. Logistic regression was used to determine which variables predicted membership to the military or civilian perpetrator groups. Military murder-suicide perpetrators were more likely to be older, have physical health problems, be currently or formerly married, less likely to abuse substances, and to exhibit significantly different motives than civilian perpetrators. Logistic regression revealed that membership to the military, rather than the civilian, perpetrator group was predicted by age, physical health problems, and declining heath motive-reflecting the significance of a more than 15-year difference in mean age between the two groups. Findings point to the need to tailor suicide risk assessments to include questions specific to murder-suicide, to assess attitudes toward murder-suicide, and to the importance of assessing suicide and violence risk in older adult military populations. © The Author(s) 2015.

Military Review. Volume 73. June 1993, Number 6

DTIC Science & Technology

1993-06-01

1993 * MILITARY REVIEW JOINT OPERATIONS allied landing forces to Field Marshal Erwin battle and smooth linkages between the dib- Rommel’s ability to...to understand its risks and effecting synchronization. Differences in strengths. Almost every nation’s military language, technology , doctrine and... military lessons learned from the Gulf War. The perforancsie following Operation Desert future role of the RC is certainly receiving a Not sfaane ede

First psychiatric hospitalizations in the US military: the National Collaborative Study of Early Psychosis and Suicide (NCSEPS).

PubMed

Herrell, Richard; Henter, Ioline D; Mojtabai, Ramin; Bartko, John J; Venable, Diane; Susser, Ezra; Merikangas, Kathleen R; Wyatt, Richard J

2006-10-01

Military samples provide an excellent context to systematically ascertain hospitalization for severe psychiatric disorders. The National Collaborative Study of Early Psychosis and Suicide (NCSEPS), a collaborative study of psychiatric disorders in the US Armed Forces, estimated rates of first hospitalization in the military for three psychiatric disorders: bipolar disorder (BD), major depressive disorder (MDD) and schizophrenia. First hospitalizations for BD, MDD and schizophrenia were ascertained from military records for active duty personnel between 1992 and 1996. Rates were estimated as dynamic incidence (using all military personnel on active duty at the midpoint of each year as the denominator) and cohort incidence (using all military personnel aged 18-25 entering active duty between 1992 and 1996 to estimate person-years at risk). For all three disorders, 8723 hospitalizations were observed in 8,120,136 person-years for a rate of 10.7/10,000 [95% confidence interval (CI) 10.5-11.0]. The rate for BD was 2.0 (95% CI 1.9-2.1), for MDD, 7.2 (95% CI 7.0-7.3), and for schizophrenia, 1.6 (95% CI 1.5-1.7). Rates for BD and MDD were greater in females than in males [for BD, rate ratio (RR) 2.0, 95% CI 1.7-2.2; for MDD, RR 2.9, 95% CI 2.7-3.1], but no sex difference was found for schizophrenia. Blacks had lower rates than whites of BD (RR 0.8, 95% CI 0.7-0.9) and MDD (RR 0.8, 95% CI 0.8-0.9), but a higher rate of schizophrenia (RR 1.5, 95% CI 1.3-1.7). This study underscores the human and financial burden that psychiatric disorders place on the US Armed Forces.

Association of Temporal Variations in Staffing With Hospital-Acquired Pressure Injury in Military Hospitals.

PubMed

Patrician, Patricia A; McCarthy, Mary S; Swiger, Pauline; Raju, Dheeraj; Breckenridge-Sproat, Sara; Su, Xiaogang; Randall, Kelly H; Loan, Lori A

2017-04-01

To more precisely evaluate the effects of nurse staffing on hospital-acquired pressure injury (HAPI) development, data on nursing care hours per patient day (NCHPPD), nursing skill mix, patient turnover (i.e., admissions, transfers, and discharges), and patient acuity were merged with patient information from pressure injury prevalence surveys that were collected annually for the Military Nursing Outcomes Database (MilNOD) project. The MilNOD included staffing and adverse events from 56 medical-surgical, stepdown, and critical care units in 13 military hospitals over a 4-year-period. Data on 1,643 patients were analyzed with Cox proportional hazards models and generalized estimating equations. Staffing was not associated with pressure injuries in stepdown or critical care patients. However, among the 1,104 medical-surgical patients, higher licensed practical nurse (LPN) nursing care hours per patient day (NCHPPD) 3 days and 1 week prior to the HAPI discovery date were associated with fewer HAPI (HR 0.27, p < .001), after controlling for patient age, Braden mobility score, and albumin level. Neither total staff number, nor RN NCHPPD, nor the proportion of staff who were RNs (RN skill mix) were associated with HAPI. These findings suggest that on military medical-surgical units, LPNs play a major role in HAPI prevention. Although the national trend in acute care is to staff hospital units with more RNs and patient care technicians, and fewer LPNs, hospitals should reconsider LPNs as valuable members of the nursing care team. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

[Reimbursement of opiate substitution drugs to militaries in 2007].

PubMed

d'Argouges, F; Desjeux, G; Marsan, P; Thevenin-Garron, V

2012-09-01

The use of psychoactive drugs by militaries is not compatible with the analytical skills and self-control required by their jobs. Military physicians take this problem into consideration by organising systematic drugs screening in the French forces. However, for technical reasons, opiates are not concerned by this screening with the agreement of the people concerned. The estimated number of militaries who use an opiate substitute may be an approach of heroin consumption in the French forces. This study describes buprenorphine and methadone reimbursements made during 2007 by the national military healthcare centre to French militaries. Each French soldier is affiliated to a special health insurance. The national military healthcare centre has in its information system, all the data concerning drug reimbursement made to French military personnel. This is a retrospective study of buprenorphine and methadone reimbursements made during 2007 by the military healthcare centre, to militaries from the three sectors of the French forces, and from the gendarmerie and joint forces. Only one reimbursement of one of these two drugs during this period allowed the patient to be included in our study. Daily drug dose and treatment steadiness profile have been calculated according to the criteria of the French monitoring centre for drugs and drug addiction. The criteria of the National guidelines against frauds have been used to identify misuse of these drugs. Doctors' shopping behaviour has also been studied. Finally, the nature of the prescriber and the consumption of other drugs in combination with opiate substitute have been analysed. One hundred and eighty-one military consumers of opiate substitute drugs (167 men and 14 women) participated. This sample included people from the three sectors of the French forces as well as from the gendarmerie and from the joint forces. The average age of the consumers was 26.6 years (20-42 years). The average length of service was 6.1 years

The Success of a National Dialogue on Sustainable Military Range Management

ERIC Educational Resources Information Center

Siegel, Lenny

2003-01-01

Military munitions are the silent giant of hazardous waste management and cleanup in the United States. Toward the end of the first Clinton administration, the Navy and Air Force prevailed upon the Army--the armed service with the biggest ordnance problem--to consider co-sponsoring a formal dialogue on military munitions facilitated by the…

76 FR 14366 - National Registry of Certified Medical Examiners

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-16

... [Docket No. FMCSA-2008-0363] RIN 2126-AA97 National Registry of Certified Medical Examiners AGENCY... Certified Medical Examiners (NRCME) published on December 1, 2008. In the comments on the NPRM, a commenter inquired as to what a motor carrier had to do to verify that a medical examiner's certificate had been...

Introduction: military neurosurgery, past and present.

PubMed

Klimo, Paul; Ragel, Brian T

2010-05-01

For a physician has the worth of many other warriors, both for the excision of arrows and for the administration of soothing drugs. Homer, Iliad XI.514-515 Ever since armed conflict has been used as a means to settle disputes among men, there have been those who have been tasked to mend the wounds that ravage a soldier's body from the weapons of war. The Iliad portrays the pivotal 10th year of the legendary Trojan War, during which a schism in the Greek leadership prolongs the extended siege of the city of Troy. In the midst of this martial epic come the lines quoted above, quietly attesting to the value of the military physician, even under the crude conditions of the Greek Dark Age. They are uttered by Idomeneus, one of the foremost Greeks, when he is enjoining one of his comrades, Nestor, to rescue the injured Greek physician Machaon and take him back from the line to treat his wounds. He is afraid that Machaon will be captured by the Trojans, a loss far greater than that of any other single warrior. Duty to country has helped shape the careers of many neurosurgeons, including iconic US figures such as Harvey Cushing and Donald Matson. This issue of Neurosurgical Focus celebrates the rich history of military neurosurgery from the wars of yesterday to the conflicts of today. We have been humbled by the tremendous response to this topic. The 25 articles within this issue will provide the reader with both a broad and an in-depth look at the many facets of military neurosurgery. We have attempted to group articles based on their predominant topic. We also encourage our audience to read other recently published articles. The first 8 articles relate to the current conflicts in Afghanistan and Iraq. The lead article, written by Randy Bell and colleagues from the National Naval Medical Center and Walter Reed Army Medical Center, discusses what is arguably one of the most important contributions by military neurosurgeons from these 2 conflicts: the rapid and aggressive

Military chemical warfare agent human subjects testing: part 1--history of six-decades of military experiments with chemical warfare agents.

PubMed

Brown, Mark

2009-10-01

Military chemical warfare agent testing from World War I to 1975 produced thousands of veterans with concerns of possible long-term health consequences. Clinical and research evaluation of potential long-term health effects has been difficult because the exposures occurred decades ago, the identity of troops exposed and exposure magnitudes are uncertain, and acute effects during experiments poorly documented. In contrast, a companion article describes the large amount of information available about the specific agents tested and their long-term health effects. This short history describes U.S. military chemical-agent experiments with human subjects and identifies tested agents. Finally, the demonstrated need to anticipate future health concerns from military personnel involved in such military testing suggests current and future military researchers should be required, by law and regulation, to fully record the identity of those exposed, relevant exposure magnitude, and complete medical information for all subjects. New study protocols and institutional review board approvals for research involving military personnel should reflect this need.

Utilization of psychiatric services by female military personnel changes since admission of women to all German Armed Forces military careers.

PubMed

Zimmermann, Peter; Ströhle, Andreas; Langner, Franziska; Lanczik, Mario

2010-07-01

In 2001, women were admitted to all military careers in the German Armed Forces. This study examines whether the utilization of psychiatric services of female military personnel has changed since then. The central medical database of German military personnel for the years 2000 and 2006 was analyzed. Between 2000 and 2006, the percentage (based on the average totals of male and female military personnel) of consultations of primary care unit surgeons for psychiatric problems increased significantly for both male and female military personnel, this increase being more apparent for women than for men. Stress-related disorders showed the greatest rise. In 2006, as opposed to 2000, the total proportion of both outpatient and inpatient mental health treatment provided to female military personnel was significantly higher than for males, particularly regarding stress-related, affective and personality disorders. Gender-specific aspects should be considered more intensely in preventive and therapeutic psychiatric supply in the German Armed Forces.

78 FR 9899 - National Committee on Foreign Medical Education and Accreditation

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-12

... DEPARTMENT OF EDUCATION National Committee on Foreign Medical Education and Accreditation AGENCY: Office of Postsecondary Education, U.S. Department of Education, National Committee on Foreign Medical Education and Accreditation. ACTION: The purpose of this notice is to announce the upcoming meeting of the...

Evaluating the stability of DSM-5 PTSD symptom network structure in a national sample of U.S. military veterans.

PubMed

von Stockert, Sophia H H; Fried, Eiko I; Armour, Cherie; Pietrzak, Robert H

2018-03-15

Previous studies have used network models to investigate how PTSD symptoms associate with each other. However, analyses examining the degree to which these networks are stable over time, which are critical to identifying symptoms that may contribute to the chronicity of this disorder, are scarce. In the current study, we evaluated the temporal stability of DSM-5 PTSD symptom networks over a three-year period in a nationally representative sample of trauma-exposed U.S. military veterans. Data were analyzed from 611 trauma-exposed U.S. military veterans who participated in the National Health and Resilience in Veterans Study (NHRVS). We estimated regularized partial correlation networks of DSM-5 PTSD symptoms at baseline (Time 1) and at three-year follow-up (Time 2), and examined their temporal stability. Evaluation of the network structure of PTSD symptoms at Time 1 and Time 2 using a formal network comparison indicated that the Time 1 network did not differ significantly from the Time 2 network with regard to network structure (p = 0.12) or global strength (sum of all absolute associations, i.e. connectivity; p = 0.25). Centrality estimates of both networks (r = 0.86) and adjacency matrices (r = 0.69) were highly correlated. In both networks, avoidance, intrusive, and negative cognition and mood symptoms were among the more central nodes. This study is limited by the use of a self-report instrument to assess PTSD symptoms and recruitment of a relatively homogeneous sample of predominantly older, Caucasian veterans. Results of this study demonstrate the three-year stability of DSM-5 PTSD symptom network structure in a nationally representative sample of trauma-exposed U.S. military veterans. They further suggest that trauma-related avoidance, intrusive, and dysphoric symptoms may contribute to the chronicity of PTSD symptoms in this population. Published by Elsevier B.V.

32 CFR 644.550 - Sale to employees or military personnel.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Sale to employees or military personnel. 644.550... PROPERTY REAL ESTATE HANDBOOK Disposal Sale Procedure § 644.550 Sale to employees or military personnel. The sale of Government real property will not be made to civilian employees or military members of the...

Military Retirement: Background and Recent Developments

DTIC Science & Technology

2017-01-06

nonmonetary benefits including exchange and commissary privileges, medical care through TRICARE, and access to Morale , Welfare and Recreation (MWR...include exchange and commissary privileges, medical care through TRICARE, and access to Morale , Welfare and Recreation facilities and programs...over the past decade. Congress grapples with constituent concerns as well as budgetary constraints in considering military retirement issues . In the

National Costs Of The Medical Liability System

PubMed Central

Mello, Michelle M.; Chandra, Amitabh; Gawande, Atul A.; Studdert, David M.

2011-01-01

Concerns about reducing the rate of growth of health expenditures have reignited interest in medical liability reforms and their potential to save money by reducing the practice of defensive medicine. It is not easy to estimate the costs of the medical liability system, however. This article identifies the various components of liability system costs, generates national estimates for each component, and discusses the level of evidence available to support the estimates. Overall annual medical liability system costs, including defensive medicine, are estimated to be $55.6 billion in 2008 dollars, or 2.4 percent of total health care spending. PMID:20820010

Military Training Lands Historic Context: Small Arms Ranges

DTIC Science & Technology

2010-03-01

ER D C/ CE R L TR -1 0 -1 1 Military Training Lands Historic Context Small Arms Ranges Dan Archibald, Adam Smith, Sunny Adams, and...unlimited. ERDC/CERL TR-10-11 March 2010 Military Training Lands Historic Context Small Arms Ranges Dan Archibald, Adam Smith, Sunny Adams...context for military training lands, written to satisfy a part of Section 110 of the National Historic Preservation Act (NHPA) of 1966 as amended

National policy and military doctrine: development of a nuclear concept of land warfare, 1949-1964

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bockar, D.

In the thirty years that battle field nuclear weapons have been available, no one has originated an idea of how they might be used as an entirely new weapon. New weapons are routinely introduced into existing combat organizations before an appropriate tactical concept has been invented. But never before in history has a new weapon been deployed on so massive a scale without a tactical concept that exploited the radical implications of its novel technology for traditional warfare. This study is an attempt to understand the problem of developing a persuasive tactical concept for nuclear weapons. The process of assimilationmore » by which military organizations integrate new weapons with existing weapons in novel tactical and organizational concepts has an intellectual, and institutional, and a political dimension. The principle of civilian control, however, makes the process by which weapons are assimilated part of the process by which national security policies are made. In peacetime the military's formulation of doctrine is almost entirely consequent upon the world view, the methodological and managerial assumptions, and the domestic policy concerns of political authority.« less

32 CFR 634.42 - Civil-military cooperative programs.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 4 2014-07-01 2013-07-01 true Civil-military cooperative programs. 634.42... ENFORCEMENT AND CRIMINAL INVESTIGATIONS MOTOR VEHICLE TRAFFIC SUPERVISION Traffic Supervision § 634.42 Civil... organized effort to coordinate military and civil traffic safety activities throughout a State or area...

32 CFR 634.42 - Civil-military cooperative programs.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 4 2011-07-01 2011-07-01 false Civil-military cooperative programs. 634.42... ENFORCEMENT AND CRIMINAL INVESTIGATIONS MOTOR VEHICLE TRAFFIC SUPERVISION Traffic Supervision § 634.42 Civil... organized effort to coordinate military and civil traffic safety activities throughout a State or area...

32 CFR 634.42 - Civil-military cooperative programs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Civil-military cooperative programs. 634.42... ENFORCEMENT AND CRIMINAL INVESTIGATIONS MOTOR VEHICLE TRAFFIC SUPERVISION Traffic Supervision § 634.42 Civil... organized effort to coordinate military and civil traffic safety activities throughout a State or area...

32 CFR 634.42 - Civil-military cooperative programs.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 4 2012-07-01 2011-07-01 true Civil-military cooperative programs. 634.42... ENFORCEMENT AND CRIMINAL INVESTIGATIONS MOTOR VEHICLE TRAFFIC SUPERVISION Traffic Supervision § 634.42 Civil... organized effort to coordinate military and civil traffic safety activities throughout a State or area...

32 CFR 634.42 - Civil-military cooperative programs.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 4 2013-07-01 2013-07-01 false Civil-military cooperative programs. 634.42... ENFORCEMENT AND CRIMINAL INVESTIGATIONS MOTOR VEHICLE TRAFFIC SUPERVISION Traffic Supervision § 634.42 Civil... organized effort to coordinate military and civil traffic safety activities throughout a State or area...

32 CFR 196.210 - Military and merchant marine educational institutions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 2 2014-07-01 2014-07-01 false Military and merchant marine educational... OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Coverage § 196.210 Military and merchant marine... marine. ...

What Do China’s Military Reforms Mean for Taiwan

DTIC Science & Technology

2016-10-01

is a Research Fellow in the Center for the Study of Chinese Military Affairs, Institute for National Strategic Studies, at the National Defense...organizations directly under the CMC, where they can be more closely scrutinized. Another strengthens auditing and discipline inspection functions...developing doctrine and conduct- ing training and operations relevant to a Taiwan contingency. The PLA is already instituting professional military

Women veterans' healthcare delivery preferences and use by military service era: findings from the National Survey of Women Veterans.

PubMed

Washington, Donna L; Bean-Mayberry, Bevanne; Hamilton, Alison B; Cordasco, Kristina M; Yano, Elizabeth M

2013-07-01

The number of women Veterans (WVs) utilizing the Veterans Health Administration (VA) has doubled over the past decade, heightening the importance of understanding their healthcare delivery preferences and utilization patterns. Other studies have identified healthcare issues and behaviors of WVs in specific military service eras (e.g., Vietnam), but delivery preferences and utilization have not been examined within and across eras on a population basis. To identify healthcare delivery preferences and healthcare use of WVs by military service era to inform program design and patient-centeredness. Cross-sectional 2008-2009 survey of a nationally representative sample of 3,611 WVs, weighted to the population. Healthcare delivery preferences measured as importance of selected healthcare features; types of healthcare services and number of visits used; use of VA or non-VA; all by military service era. Military service era differences were present in types of healthcare used, with World War II and Korea era WVs using more specialty care, and Vietnam era-to-present WVs using more women's health and mental health care. Operations Enduring Freedom, Iraqi Freedom, New Dawn (OEF/OIF/OND) WVs made more healthcare visits than WVs of earlier military eras. The greatest healthcare delivery concerns were location convenience for Vietnam and earlier WVs, and cost for Gulf War 1 and OEF/OIF/OND WVs. Co-located gynecology with general healthcare was also rated important by a sizable proportion of WVs from all military service eras. Our findings point to the importance of ensuring access to specialty services closer to home for WVs, which may require technology-supported care. Younger WVs' higher mental health care use reinforces the need for integration and coordination of primary care, reproductive health and mental health care.

[Problems and prospects of infectious diseases and HIV-infected military personnel register organization].

PubMed

Bolekhan, V N; Zagorodnikov, G G; Gorichnyĭ, V A; Orlova, E S; Nikolaev, P G

2014-08-01

An analysis of regulatory documents of the Ministry of Healthcare and the Ministry of Defence of the Russian Federation related to HIV/AIDS prevention was carried out. The current system of HIV/AIDS detection and registration among military and civil personnel was assessed. Problems and prospects of scientific-and-research laboratory (the register of infectious disease pathology and HIV-infected military personnel) of Scientific-and-research centre at the Kirov Military medical academy were discussed. It is proposed that the main direction of the laboratory activity will be the restoration of up-to-date records of military personnel with HIV/AIDS. This activity will provide the necessary information to responsible specialists of the Main state sanitary and epidemiological surveillance centre and the Main military medical department of the Ministry of Defence of the Russian Federation for the sanitary and epidemiological surveillance for purposeful and economically feasible management decisions in the field of military personnel infection diseases prevention.

Investigating the respiratory health of deployed military personnel.

PubMed

Morris, Michael J; Zacher, Lisa L; Jackson, David A

2011-10-01

Recent news media articles have implied a direct relationship between environmental exposures such as burn pits during current deployments and the development of serious and debilitating chronic pulmonary disease. These articles suggest that the military is superficially investigating evidence that establishes a link between deployment and development of chronic lung disease. Anecdotal cases of military personnel with lung disease are detailed to suggest a systemic problem with undiagnosed and untreated pulmonary disease in deployed service members. Despite these contentions, the U.S. Army Medical Department and other agencies have been actively pursuing numerous scientific investigations into deployment-related lung disease to define the severity and prevalence of the issue. This article will review relevant research efforts by the U.S. military in the existing medical literature and address the current efforts planned by the services to systematically investigate the possibility of deployment-related pulmonary disease.

New business with the new military.

PubMed

Apgar, Mahlon; Keane, John M

2004-09-01

A $200 billion market has appeared on your business horizon, but you may not have noticed it. It's the U.S. military--the new U.S. military. Virtually all aspects of the military are changing to ensure it can fight unpredictable threats while sustaining the infrastructure needed to support and train forces. The military is turning to non-traditional business partners to meet a wide range of needs, from health care to housing to information technology. The Defense Department is yielding its monopoly on every aspect of national security and adopting a more businesslike model in which the military's warfighting capabilities are supported through outsourcing and business alliances. Civilians are replacing military personnel in many noncombat roles. Military functions with corporate equivalents are candidates for outsourcing and privatization. Market standards are replacing the heavy customization that has locked many companies out of this marketplace. The authors have participated in the transformation process from different perspectives--one civilian, the other military. Together, they highlight the prospects that transformation is creating for companies outside the traditional defense industry and reveal paths to success in this complex market. They also present six principles for doing business with the military that require persistence, integrity, and a willingness to master the intricacies of a distinctive culture. By understanding the logic of military transformation, executives can identify and create vast new business opportunities. And by mastering the six principles, they can build profitable long-term relationships.

77 FR 46802 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-06

...-0100] National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory... Transportation (DOT). ACTION: Meeting Notice--National Emergency Medical Services Advisory Council. SUMMARY: The... NEMSAC is to provide a nationally recognized council of emergency medical services representatives and...

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

77 FR 28759 - Military Spouse Appreciation Day, 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-16

... back to our country day after day. The strength and readiness of America's military depends on the well... heroes, our Nation's military spouses also offer tremendous service and make great sacrifices for our....JoiningForces.gov . America's service members represent only one percent of our population, but they...

German MedicalTeachingNetwork (MDN) implementing national standards for teacher training.

PubMed

Lammerding-Koeppel, M; Ebert, T; Goerlitz, A; Karsten, G; Nounla, C; Schmidt, S; Stosch, C; Dieter, P

2016-01-01

An increasing demand for proof of professionalism in higher education strives for quality assurance (QA) and improvement in medical education. A wide range of teacher trainings is available to medical staff in Germany. Cross-institutional approval of individual certificates is usually a difficult and time consuming task for institutions. In case of non-acceptance it may hinder medical teachers in their professional mobility. The faculties of medicine aimed to develop a comprehensive national framework, to promote standards for formal faculty development programmes across institutions and to foster professionalization of medical teaching. Addressing the above challenges in a joint approach, the faculties set up the national MedicalTeacherNetwork (MDN). Great importance is attributed to work out nationally concerted standards for faculty development and an agreed-upon quality control process across Germany. Medical teachers benefit from these advantages due to portability of faculty development credentials from one faculty of medicine to another within the MDN system. The report outlines the process of setting up the MDN and the national faculty development programme in Germany. Success factors, strengths and limitations are discussed from an institutional, individual and general perspective. Faculties engaged in similar developments might be encouraged to transfer the MDN concept to their countries.

Onward and Upward Bound: Military Veterans Charge toward Higher Education

ERIC Educational Resources Information Center

Stewart, Reginald L.

2014-01-01

In this article, Reginald L. Stewart asks: "What is the true value of higher education to military veterans?" Military veterans may be underrepresented in higher education due to life adversities including homelessness, medical disabilities, substance abuse, family hardships, and deficient academic skills, however, with the transition of…

Intentions of Women (18-25 Years Old) to Join the Military: Results of a National Survey.

DTIC Science & Technology

1978-09-01

MILITARY : RESULTS OF A NATIONAL SURVEY __________________________ S . PERFORMING ORG. N~PQRT NUMUER 7. Au fllON(.) S CONTRACT OR GRANT NUNSER(.) Jules...I. Borack S . PERFORMING ORGANI ZAtION N AME~~~~D ADDRE SS ~~~~. PRO GRAM ELEMENT. PROJECT. TaS~- AREA & WÔRK UNIT NUMSERS Navy Personnel Research and...non— Be interested in hiking. traditional women ’ s activities a- Marital status Be married . Be single. Financial Have financial responsibility Have no

Military Considerations in Transsexual Care of the Active Duty Member.

PubMed

Folaron, Irene; Lovasz, Monica

2016-10-01

Retention standards and policies applied to active duty members in the U.S. military who identify as transgender have recently been in evolution. The Secretary of Defense recently released a new directive allowing transgender members to serve openly with the option to transition gender while in active duty, abrogating the old policy disqualifying transgender members from continued service. There is a reasonable expectation that some may pursue medical and surgical options toward gender transition. The clinical pathway for gender transition relies heavily on Mental Health and Endocrinology services. This article highlights the medical aspects of gender transition and how they can affect readiness and the delivery of military health care. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Acupuncture therapy for fever induced by viral upper respiratory tract infection (URTI) in military medical service: a case series.

PubMed

Kwon, SeungWon; Shin, KyoungHo; Jung, WooSang; Moon, SangKwan; Cho, KiHo

2014-12-01

We report the cases of eight military patients with fever (≥38°C) induced by viral upper respiratory tract infection (URTI) who requested treatment with acupuncture in the military medical service room. All patients were treated immediately after diagnosis with classical acupuncture (GV14, GB20, TE8 points) and a new type of acupuncture, equilibrium acupuncture (Feibing and Ganmao points). After one treatment session (20 min), reduction of body temperature was confirmed in all patients. Accompanying symptoms such as headache, myalgia and nasal obstruction also showed a tendency to decrease. Within 3 days of treatment, six of the eight patients had recovered from the URTI. No adverse effects of acupuncture treatment were reported. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

[Trends of the scientific work development in central military-and-clinical hospitals].

PubMed

Tregubov, V N; Baranov, V V

2006-04-01

Scientific work in central military-and-clinical hospitals (CMCH) is very important since it leads to creation and application of modern medical technologies in practice of military-and-medical service, professional growth of doctors and improves the status of hospitals among other medical organizations. The analysis of CMCH under the Russian Ministry of Defense shows that the main role in the development of scientific work in central hospitals belongs to management which is the activity to perform planning, organization, coordination, motivation and control functions.

Visiting Holocaust-Related Sites with Medical Students as an Aid in Teaching Medical Ethics.

PubMed

González-López, Esteban; Ríos-Cortés, Rosa

2016-05-01

During the Nazi period numerous doctors and nurses played a nefarious role. In Germany they were responsible for the sterilization and killing of disabled persons. Furthermore, the Nazi doctors used concentration camp inmates as guinea pigs in medical experiments for military or racial purposes. A study of the collaboration of doctors with National Socialism exemplifies behavior that must be avoided. Combining medical teaching with lessons from the Holocaust could be a way to transmit Medical Ethics to doctors, nurses and students. The authors describe a study tour with medical students to Poland, to the largest Nazi extermination camp, Auschwitz, and to the city of Krakow. The tour is the final component of a formal course entitled: "The Holocaust, a Reflection from Medicine" at the Autónoma University of Madrid, Spain. Visiting sites related to the Holocaust, the killing centers and the sites where medical experiments were conducted has a singular meaning for medical students. Tolerance, non-discrimination, and the value of human life can be both learnt and taught at the very place where such values were utterly absent.

77 FR 66625 - National Institute of General Medical Sciences; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-06

...: Helen R. Sunshine, Ph.D., Chief, Office of Scientific Review, National Institute of General Medical...: Robert Horowits, Ph.D., Senior Investigator, National Institute of General Medical Sciences, National... Chemistry Research; 93.862, Genetics and [[Page 66626

Management of infants born to women infected with hepatitis B in the military healthcare system.

PubMed

Sainato, Rebecca J; Simmons, Elizabeth G; Muench, Dawn F; Burnett, Mark W; Braun, LoRanée

2013-08-28

Hepatitis B virus (HBV) is endemic worldwide. Given significant rates of infectivity, all infants born to Hepatitis B surface antigen positive mothers need to receive treatment at birth, immunization and post-vaccination serologic testing. However, not all infants complete these requirements. We performed a retrospective review of the management of infants born to Hepatitis B infected mothers at two large military hospitals in the United States that use a global electronic medical record to track patient results. We then compared these results to those recently published by the National Perinatal Hepatitis B Prevention Program (PHBPP), which does not include hospitals in the United States Military Healthcare System. Our results show that although all infants were managed appropriately at birth and immunization rates were very high, post vaccination follow-up testing rates were much lower than those seen in centers participating in the PHBPP. The rates of post vaccination serological testing were significantly higher for infants born to Hepatitis B e antigen positive mothers and those referred to a pediatric infectious disease specialist. Despite use of a global electronic medical record in the United States Military Healthcare System, management of HBV-exposed infants does not always follow recommended guidelines. These infants could benefit from a more systematic method of follow-up, similar to the PHBPP, to ensure HBV serologic testing is obtained after the vaccination series is complete.

[Political and organizational-legal frameworks for cooperation between countries of the Asia-Pacific region in the field of military medicine].

PubMed

Kholikov, I V; Dmitrakovich, D V

2014-12-01

A framework for cooperation in the field of military medicine in the Asia-Pacific region is considered. Expert Working Group on Military Medicine in cooperation with the Association of Southeast Asian dialogue partners (including Russia) was formed to discuss the most important issues in the field of military medicine, to share practical experience of military physicians, standardization and unification of medical equipment, medicines, levels and standards of medical services and other issues in order to enhance cooperation of military medical services of the participating countries. From 2014 to 2016, the Russian Federation and the Kingdom of Thailand are co-chairs of the expert group.

Military Medical Revolution: Military Trauma System

DTIC Science & Technology

2012-01-01

receive state-of-the-art physical therapy and occupational therapy , in- cluding demanding and challenging sports equipment and virtual reality systems...Knudson MM. Into the theater: perspectives from a civilian trauma sur- geon’s visit to the combat support hospital in Balad, Iraq. Bull Am Coll Surg...following type III open tibia fracture . J Orthop Trauma. 2012;26:43 47. 52. U.S Army Medical Research and Materiel Command. Armed Forces In- stitute of

32 CFR 536.73 - Statutory authority for the Military Claims Act.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 3 2010-07-01 2010-07-01 true Statutory authority for the Military Claims Act... AND ACCOUNTS CLAIMS AGAINST THE UNITED STATES Claims Cognizable Under the Military Claims Act § 536.73 Statutory authority for the Military Claims Act. The statutory authority for this subpart is contained in...

The Brief Military Career of Dr. William H. Welch.

PubMed

Gilman, James K

2017-03-01

The purpose of this article is to examine the Army service of Dr. William H. Welch during World War I. Archival research utilizing prime source documents in the William H. Welch Collection of the Alan M. Chesney Medical Archives for the Johns Hopkins Medical Institutions. Welch joined the Army at the age of 67 after serving as one of the principal transformational forces for reforming medical education in the United States and founding the first academic institution for educating public health professionals in the United States, the Johns Hopkins School of Public Health and Hygiene. His longstanding relationship with Army Surgeon General William Gorgas served as the backdrop for Welch's service. Welch served as both a staff officer and as a traveling medical inspector general, assessing the medical care of troops preparing for overseas duty. He did not adapt particularly well to military dress and decorum but his status as one of the icons of American medicine rendered these shortcomings insignificant. Welch was joined in Army service by a number of American medical luminaries-both Mayo brothers, George Crile, and Harvey Cushing among them. Although Welch remained on active duty for only 13 months, he maintained a nominal relationship with Army medicine through appointment to the Medical Officer Reserve Corps until the time of his death. 2016 marks the centennial of the establishment of the first independent academic institution in America dedicated to education and training of professionals focused on public health and hygiene issues. 2017 marks the centennial of U.S. entry into World War I. Dr. William H. Welch played an important role in both of these historic events and, although his active service was brief, the impact of his example was substantial. Analysis of his military career in its full historical context provides insight into the relationship between academic medicine and military medicine during periods of armed conflict. Reprint & Copyright © 2017

Pulse!!: a model for research and development of virtual-reality learning in military medical education and training.

PubMed

Dunne, James R; McDonald, Claudia L

2010-07-01

Pulse!! The Virtual Clinical Learning Lab at Texas A&M University-Corpus Christi, in collaboration with the United States Navy, has developed a model for research and technological development that they believe is an essential element in the future of military and civilian medical education. The Pulse!! project models a strategy for providing cross-disciplinary expertise and resources to educational, governmental, and business entities challenged with meeting looming health care crises. It includes a three-dimensional virtual learning platform that provides unlimited, repeatable, immersive clinical experiences without risk to patients, and is available anywhere there is a computer. Pulse!! utilizes expertise in the fields of medicine, medical education, computer science, software engineering, physics, computer animation, art, and architecture. Lab scientists collaborate with the commercial virtual-reality simulation industry to produce research-based learning platforms based on cutting-edge computer technology.

Cost Savings and Patient Experiences of a Clinic-Based, Wide-Awake Hand Surgery Program at a Military Medical Center: A Critical Analysis of the First 100 Procedures.

PubMed

Rhee, Peter C; Fischer, Michelle M; Rhee, Laura S; McMillan, Ha; Johnson, Anthony E

2017-03-01

Wide-awake, local anesthesia, no tourniquet (WALANT) hand surgery was developed to improve access to hand surgery care while optimizing medical resources. Hand surgery in the clinic setting may result in substantial cost savings for the United States Military Health Care System (MHS) and provide a safe alternative to performing similar procedures in the operating room. A prospective cohort study was performed on the first 100 consecutive clinic-based WALANT hand surgery procedures performed at a military medical center from January 2014 to September 2015 by a single hand surgeon. Cost savings analysis was performed by using the Medical Expense and Performance Reporting System, the standard cost accounting system for the MHS, to compare procedures performed in the clinic versus the operating room during the study period. A study specific questionnaire was obtained for 66 procedures to evaluate the patient's experience. For carpal tunnel release (n = 34) and A1 pulley release (n = 33), there were 85% and 70% cost savings by having the procedures performed in clinic under WALANT compared with the main operating room, respectively. During the study period, carpal tunnel release, A1 pulley release, and de Quervain release performed in the clinic instead of the operating room amounted to $393,100 in cost savings for the MHS. There were no adverse events during the WALANT procedure. A clinic-based WALANT hand surgery program at a military medical center results in considerable cost savings for the MHS. Economic/Decision Analysis IV. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Testing a potential national strategy for cost-effective medical technology

NASA Astrophysics Data System (ADS)

Fitch, J. Patrick

1995-10-01

The Center for Healthcare Technologies at Lawrence Livermore National Laboratory is a partnership among government, industry, and universities that focuses on improving healthcare through development of cost-effective technology. With the guidance of healthcare providers, medical institutions, and medical instrument manufacturers, technology can be harnessed to reduce healthcare costs. The partnership is a miniature test case for a potential national strategy for development and adoption of technology specifically to reduce costs.

[The role of the vaccine prophylaxis of cervical cancer among female military personnel].

PubMed

Shmidt, A A; Alieva, M T; Ivanova, L V; Molchanov, O V

2015-06-01

The authors presented results of the study concerning human papillomavirus infecting of military students of higher military educational institutions of the Ministry of Defence of the Russian Federation. In the Center for Obstetrics and Gynaecology of the Kirov Military-Medical Academy was performed a dynamic examination of 478 female cadets aged 17-25. The high level of high-risk HPV viruses was revealed during the examination what proves the necessity of prophylaxis enhancing with the aim to prevent gynecological diseases and reproductive health promotion. The main ways of cervical cancer prophylaxis are health education, in-depth medical examination of women with the aim to reveal and treat gynecological diseases (this medical examination should be carried out twice a year), primary prevention of cervical cancer by vaccination.

3 CFR 8375 - Proclamation 8375 of May 8, 2009. Military Spouse Day, 2009

Code of Federal Regulations, 2010 CFR

2010-01-01

... Proc. 8375 Military Spouse Day, 2009By the President of the United States of America A Proclamation Military spouses share the sacrifices of service with our Nation's men and women in uniform. As members of... household finances to comforting children impacted by a military parent's absence, military spouses take on...

Gender Dysphoria in the Military.

PubMed

Ford, Shannon; Schnitzlein, Carla

2017-11-07

With the announcement that members of the military who identify as transgender are allowed to serve openly, the need for Department of Defense behavioral health providers to be comfortable in the assessment, diagnosis, and treatment of this population becomes quickly evident. This population has been seeking care in the community and standards have been developed to help guide decision-making, but a comparable document does not exist for the military population. Previously published papers were written in anticipation of the policy allowing for open service. The civilian sector has treatment guidelines and evidence supporting the same for reference. There is no similar document for the military population, likely due to the recent change and ongoing development. This paper attempts to provide an overview of the recent Department of Defense policy and walks the reader through key considerations when providing care to a transgender member of the military as it relates to those who are currently serving in the military through the use of a case example. The military transgender population faces some unique challenges due to the need to balance readiness and deployability with medically necessary health care. Also complicating patient care is that policy development is ongoing-as of this publication, the decision has not yet been made regarding how people who identify as transgender will access into the military nor is there final approval regarding coverage for surgical procedures. Unique circumstances of this population are brought up to generate more discussion and encourage further evaluation and refinement of the process.

Evaluation of data obtained from military disability medical administrative databases for service members with schizophrenia or bipolar disorder.

PubMed

Millikan, Amy M; Weber, Natalya S; Niebuhr, David W; Torrey, E Fuller; Cowan, David N; Li, Yuanzhang; Kaminski, Brenda

2007-10-01

We are studying associations between selected biomarkers and schizophrenia or bipolar disorder among military personnel. To assess potential diagnostic misclassification and to estimate the date of illness onset, we reviewed medical records for a subset of cases. Two psychiatrists independently reviewed 182 service medical records retrieved from the Department of Veterans Affairs. Data were evaluated for diagnostic concordance between database diagnoses and reviewers. Interreviewer variability was measured by using proportion of agreement and the kappa statistic. Data were abstracted to estimate date of onset. High levels of agreement existed between database diagnoses and reviewers (proportion, 94.7%; kappa = 0.88) and between reviewers (proportion, 92.3%; kappa = 0.87). The median time between illness onset and initiation of medical discharge was 1.6 and 1.1 years for schizophrenia and bipolar disorder, respectively. High levels of agreement between investigators and database diagnoses indicate that diagnostic misclassification is unlikely. Discharge procedure initiation date provides a suitable surrogate for disease onset.

Food allergy guidance in the United States Military: A work group report from the AAAAI Military Allergy and Immunology Assembly (MAIA).

PubMed

Waibel, Kirk; Lee, Rachel; Coop, Christopher; Mendoza, Yun; White, Kevin

2018-05-16

A diagnosis of food allergy adversely impacts one's ability to join or remain in the military. Inadequate knowledge or misconceptions of current military-specific standards regarding food allergy and how these apply to enlistment, induction, and retention in the United States military can potentially lead to inaccurate counseling as each military service has specific regulations which impact the evaluation and decision-making process. Recognizing this knowledge gap, the American Allergy, Asthma, and Immunology (AAAAI) Military Allergy and Immunology Assembly (MAIA) established a Work Group who reviewed and summarized all aspects of military instructions, policies, and regulations regarding IgE mediated food allergy. A flowchart was developed outlining each step of the military entry process for an individual with a history of food allergy. Further, summary tables were made to provide improved "fluency" regarding each service's medical regulations while key considerations were outlined for the allergist who is evaluating an individual who is seeking military entry or retention. Both civilian and military allergists play an essential role in the evaluation, counseling, and management of patients with a food allergy history. Understanding the service-specific language and regulations regarding food allergy will improve the allergist's awareness, counseling, and management of these individuals. Copyright © 2018. Published by Elsevier Inc.

Twelve month use of mental health services in a nationally representative, active military sample.

PubMed

Fikretoglu, Deniz; Guay, Stéphane; Pedlar, David; Brunet, Alain

2008-02-01

Mental disorders constitute a significant public health problem in active military populations. However, very little is known about patterns of mental health service use in these populations. The primary objective of this study was to examine the patterns and predictors of mental health service use in active Canadian Force members. Additional objectives included identification of barriers to service use. A cross-sectional analysis was conducted using data from the Canadian Community Health Survey-Canadian Forces Supplement. Participants were assessed for mood, anxiety, and substance use disorders using the World Health Organization's Composite International Diagnostic Interview. Those who met criteria for at least 1 disorder in the past year (n = 1220) were included in the analyses. Of military members with a 12-month diagnosis, 42.6% used services in the past year. Predictors of service use included mental health indicators, gender, marital status, and military rank. Of military members who failed to use services, only a small percentage (3.5-16.0%) acknowledged a need for services. These members perceived a number of barriers to services, foremost among which was lack of trust in military health, administrative, and social services. Despite recent efforts to de-stigmatize mental health problems and treatments, unmet need for mental health services remains a significant problem in active militaries. Our findings indicate that military institutions should continue public education campaigns to de-stigmatize mental health problems and should make necessary changes in health delivery systems to gain the trust of military members.

Cohort Profile: The National Academy of Sciences-National Research Council Twin Registry (NAS-NRC Twin Registry)

PubMed Central

Gatz, Margaret; Harris, Jennifer R; Kaprio, Jaakko; McGue, Matt; Smith, Nicholas L; Snieder, Harold; Spiro, Avron; Butler, David A

2015-01-01

The National Academy of Sciences-National Research Council Twin Registry (NAS-NRC Twin Registry) is a comprehensive registry of White male twin pairs born in the USA between 1917 and 1927, both of the twins having served in the military. The purpose was medical research and ultimately improved clinical care. The cohort was assembled in the early 1960s with identification of approximately 16 000 twin pairs, review of service records, a brief mailed questionnaire assessing zygosity, and a health survey largely comparable to questionnaires used at that time with Scandinavian twin registries. Subsequent large-scale data collection occurred in 1974, 1985 and 1998, repeating the health survey and including information on education, employment history and earnings. Self-reported data have been supplemented with mortality, disability and medical data through record linkage. Potential collaborators should access the study website [http://www.iom.edu/Activities/Veterans/TwinsStudy.aspx] or e-mail the Medical Follow-up Agency at [Twins@nas.edu]. Questionnaire data are being prepared for future archiving with the National Archive of Computerized Data on Aging (NACDA) at the Inter-University Consortium for Political and Social Research (ICPSR), University of Michigan, MI. PMID:25183748

Purchased Behavioral Health Care Received by Military Health System Beneficiaries in Civilian Medical Facilities, 2000-2014.

PubMed

Wooten, Nikki R; Brittingham, Jordan A; Pitner, Ronald O; Tavakoli, Abbas S; Jeffery, Diana D; Haddock, K Sue

2018-02-06

Behavioral health conditions are a significant concern for the U.S. military and the Military Health System (MHS) because of decreased military readiness and increased health care utilization. Although MHS beneficiaries receive direct care in military treatment facilities, a disproportionate majority of behavioral health treatment is purchased care received in civilian facilities. Yet, limited evidence exists about purchased behavioral health care received by MHS beneficiaries. This longitudinal study (1) estimated the prevalence of purchased behavioral health care and (2) identified patient and visit characteristics predicting receipt of purchased behavioral health care in acute care facilities from 2000 to 2014. Medical claims with Major Diagnostic Code 19 (mental disorders/diseases) or 20 (alcohol/drug disorders) as primary diagnoses and TRICARE as the primary/secondary payer were analyzed for MHS beneficiaries (n = 17,943) receiving behavioral health care in civilian acute care facilities from January 1, 2000, to December 31, 2014. The primary dependent variable, receipt of purchased behavioral health care, was modeled for select mental health and substance use disorders from 2000 to 2014 using generalized estimating equations. Patient characteristics included time, age, sex, and race/ethnicity. Visit types included inpatient hospitalization and emergency department (ED). Time was measured in days and visits were assumed to be correlated over time. Behavioral health care was described by both frequency of patients and visit type. The University of South Carolina Institutional Review Board approved this study. From 2000 to 2014, purchased care visits increased significantly for post-traumatic stress disorder, adjustment, anxiety, mood, bipolar, tobacco use, opioid/combination opioid dependence, nondependent cocaine abuse, psychosocial problems, and suicidal ideation among MHS beneficiaries. The majority of care was received for mental health disorders (78

References from Brazilian medical journals in national publications.

PubMed

Teixeira, Renan Kleber Costa; Botelho, Nara Macedo; Petroianu, Andy

2013-01-01

To assess whether there is a preference for international journal citation to the detriment of national ones in ten Brazilian medical journals, in two different periods. All references in the articles published in Arquivos Brasileiros de Oftalmologia, Revista Brasileira de Cirurgia Cardiovascular, Revista da Associação Médica Brasileira, São Paulo Medical Journal, Arquivos Brasileiros de Endocrinologia e Metabologia, Clinics, Jornal Brasileiro de Pneumologia, Revista da Sociedade Brasileira de Medicina Tropical, Revista Brasileira de Psiquiatria e Acta Ortopédica Brasileira in the years 2011 and 2007 were analyzed, assessing the number of articles published in national and international journals. A total of 36,125 references from 1,462 articles published in the 10 aforementioned journals were analyzed. Of the total number, 4.242 (11.74%) were from Brazilian journals. There was no significant difference between the two analyzed periods. A total of 453 (30,98%) of the articles studied non-cited brazilian papers,and 81 (5.54%) articles had more Brazilian than international references. Of total references analyzed, 11.74% were related to articles published in Brazilian journals. This number, when compared to the percentage of Brazilian articles published in the medical area, demonstrates a good number of citations of national articles. Copyright © 2012 Elsevier Editora Ltda. All rights reserved.

Coastal Fortifications and National Military Policy, 1815-1835

DTIC Science & Technology

2015-05-21

my work and not spilling apple juice on my laptop. To Dr. Rick Herrera at the School for Advanced Military Studies for his support, mentorship and...and men, the amount required to protect planned fortification locations would be $16,750,000 plus the loss in labor force, versus $5,658,000

Military Preparedness

DTIC Science & Technology

2015-09-01

United States Army War College Department of Command, Leadership, and Management Carlisle Barracks, Carlisle, PA Military Preparednessa Dr...The question seems a simple one at the national level, but in defense management practice it is actually two questions rolled into one, and the...documents, readiness management processes and systems assess those capabilities and aid in remedial action to correct deficiencies. The second question is

First psychiatric hospitalizations in the US military: the National Collaborative Study of Early Psychosis and Suicide (NCSEPS)

PubMed Central

HERRELL, RICHARD; HENTER, IOLINE D.; MOJTABAI, RAMIN; BARTKO, JOHN J.; VENABLE, DIANE; SUSSER, EZRA; MERIKANGAS, KATHLEEN R.; WYATT, RICHARD J.

2015-01-01

Background Military samples provide an excellent context to systematically ascertain hospitalization for severe psychiatric disorders. The National Collaborative Study of Early Psychosis and Suicide (NCSEPS), a collaborative study of psychiatric disorders in the US Armed Forces, estimated rates of first hospitalization in the military for three psychiatric disorders : bipolar disorder (BD), major depressive disorder (MDD) and schizophrenia. Method First hospitalizations for BD, MDD and schizophrenia were ascertained from military records for active duty personnel between 1992 and 1996. Rates were estimated as dynamic incidence (using all military personnel on active duty at the midpoint of each year as the denominator) and cohort incidence (using all military personnel aged 18–25 entering active duty between 1992 and 1996 to estimate person-years at risk). Results For all three disorders, 8723 hospitalizations were observed in 8 120 136 person-years for a rate of 10·7/10 000 [95% confidence interval (CI) 10·5–11·0]. The rate for BD was 2·0 (95% CI 1·9–2·1), for MDD, 7·2 (95% CI 7·0–7·3), and for schizophrenia, 1·6 (95% CI 1·5–1·7). Rates for BD and MDD were greater in females than in males [for BD, rate ratio (RR) 2·0, 95% CI 1·7–2·2; for MDD, RR 2·9, 95% CI 2·7–3·1], but no sex difference was found for schizophrenia. Blacks had lower rates than whites of BD (RR 0·8, 95% CI 0·7–0·9) and MDD (RR 0·8, 95% CI 0·8–0·9), but a higher rate of schizophrenia (RR 1·5, 95% CI 1·3–1·7). Conclusions This study underscores the human and financial burden that psychiatric disorders place on the US Armed Forces. PMID:16879759

Metadata - National Hospital Ambulatory Medical Care Survey (NHAMCS)

EPA Pesticide Factsheets

The National Hospital Ambulatory Medical Care Survey (NHAMCS) is designed to collect information on the services provided in hospital emergency and outpatient departments and in ambulatory surgery centers.

Mental Health Medication Use Correlates with Poor Outcome After Femoroacetabular Impingement Surgery in a Military Population.

PubMed

Ernat, J J; Song, D J; Brugman, S C; Shaha, S H; Tokish, J M; Lee, G Y

2015-08-05

Femoroacetabular impingement is a common cause of hip pain in young adults. Several preoperative risk factors for poor outcomes with surgery have been identified; however, to our knowledge, no study has attempted to determine the effect of psychiatric comorbidity on outcomes with femoroacetabular impingement surgery. A retrospective review was performed on active-duty patients at one institution undergoing surgery for femoroacetabular impingement over five years. Medical records were reviewed for demographic characteristics, radiographic data, and history of mental health medication use. Return-to-duty status was considered the primary outcome measure. Outcome scores obtained included modified Harris hip scores, Single Assessment Numeric Evaluation scores, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, patient satisfaction, and Veterans RAND-12 scores. Patients taking mental health medication were compared with those who were not with regard to return to duty and validated patient-reported outcome measures. Ninety-three patients (mean age, 32.2 years) were available for follow-up at a mean duration of 3.6 years. Of the seventeen patients discharged from service postoperatively, twelve (71%) were taking mental health medications. One-third (twenty-five) of seventy-six patients who returned to duty were taking mental health medication and this difference was significant (p < 0.006). Patients taking mental health medication had significantly poorer modified Harris hip scores (p < 0.02), WOMAC scores (p < 0.0008), and Veterans RAND-12 mental scores (p < 0.001). Antidepressant, antipsychotic, and multiple mental health medication use were all predictive of medical discharge due to hip pain. Psychiatric comorbidities are an important risk factor in active-duty military personnel undergoing surgery for femoroacetabular impingement. Mental health medication use is associated with poorer outcome scores and can significantly lower the

USSR Report, Military Affairs, No. 1735, Military History Journal, No. 5, May 1982

DTIC Science & Technology

1983-01-12

National People’s Council] (KRN) issued a decree announcing formation of the Polish National Liberation Com- mittee ( PNLC ) -- the first worker-peasant...cooperation between the Soviet and Polish governments were handled through a Soviet delegation assigned to the PNLC . In particular, it was charged with...administration upon cessation of military opera- tions in that area. In the combat zone an authorized representative of the PNLC provided’liaison between the

GIS applications for military operations in coastal zones

USGS Publications Warehouse

Fleming, S.; Jordan, T.; Madden, M.; Usery, E.L.; Welch, R.

2009-01-01

In order to successfully support current and future US military operations in coastal zones, geospatial information must be rapidly integrated and analyzed to meet ongoing force structure evolution and new mission directives. Coastal zones in a military-operational environment are complex regions that include sea, land and air features that demand high-volume databases of extreme detail within relatively narrow geographic corridors. Static products in the form of analog maps at varying scales traditionally have been used by military commanders and their operational planners. The rapidly changing battlefield of 21st Century warfare, however, demands dynamic mapping solutions. Commercial geographic information system (GIS) software for military-specific applications is now being developed and employed with digital databases to provide customized digital maps of variable scale, content and symbolization tailored to unique demands of military units. Research conducted by the Center for Remote Sensing and Mapping Science at the University of Georgia demonstrated the utility of GIS-based analysis and digital map creation when developing large-scale (1:10,000) products from littoral warfare databases. The methodology employed-selection of data sources (including high resolution commercial images and Lidar), establishment of analysis/modeling parameters, conduct of vehicle mobility analysis, development of models and generation of products (such as a continuous sea-land DEM and geo-visualization of changing shorelines with tidal levels)-is discussed. Based on observations and identified needs from the National Geospatial-Intelligence Agency, formerly the National Imagery and Mapping Agency, and the Department of Defense, prototype GIS models for military operations in sea, land and air environments were created from multiple data sets of a study area at US Marine Corps Base Camp Lejeune, North Carolina. Results of these models, along with methodologies for developing large

GIS applications for military operations in coastal zones

NASA Astrophysics Data System (ADS)

Fleming, S.; Jordan, T.; Madden, M.; Usery, E. L.; Welch, R.

In order to successfully support current and future US military operations in coastal zones, geospatial information must be rapidly integrated and analyzed to meet ongoing force structure evolution and new mission directives. Coastal zones in a military-operational environment are complex regions that include sea, land and air features that demand high-volume databases of extreme detail within relatively narrow geographic corridors. Static products in the form of analog maps at varying scales traditionally have been used by military commanders and their operational planners. The rapidly changing battlefield of 21st Century warfare, however, demands dynamic mapping solutions. Commercial geographic information system (GIS) software for military-specific applications is now being developed and employed with digital databases to provide customized digital maps of variable scale, content and symbolization tailored to unique demands of military units. Research conducted by the Center for Remote Sensing and Mapping Science at the University of Georgia demonstrated the utility of GIS-based analysis and digital map creation when developing large-scale (1:10,000) products from littoral warfare databases. The methodology employed-selection of data sources (including high resolution commercial images and Lidar), establishment of analysis/modeling parameters, conduct of vehicle mobility analysis, development of models and generation of products (such as a continuous sea-land DEM and geo-visualization of changing shorelines with tidal levels)-is discussed. Based on observations and identified needs from the National Geospatial-Intelligence Agency, formerly the National Imagery and Mapping Agency, and the Department of Defense, prototype GIS models for military operations in sea, land and air environments were created from multiple data sets of a study area at US Marine Corps Base Camp Lejeune, North Carolina. Results of these models, along with methodologies for developing large

32 CFR 643.13 - Military requirement for real estate under grant.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 4 2011-07-01 2011-07-01 false Military requirement for real estate under grant... (CONTINUED) REAL PROPERTY REAL ESTATE General § 643.13 Military requirement for real estate under grant. When a military requirement arises for real estate which is being used under a grant of non-Army use, the...

32 CFR 643.13 - Military requirement for real estate under grant.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 4 2012-07-01 2011-07-01 true Military requirement for real estate under grant... (CONTINUED) REAL PROPERTY REAL ESTATE General § 643.13 Military requirement for real estate under grant. When a military requirement arises for real estate which is being used under a grant of non-Army use, the...

32 CFR 643.13 - Military requirement for real estate under grant.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 4 2013-07-01 2013-07-01 false Military requirement for real estate under grant... (CONTINUED) REAL PROPERTY REAL ESTATE General § 643.13 Military requirement for real estate under grant. When a military requirement arises for real estate which is being used under a grant of non-Army use, the...

32 CFR 643.13 - Military requirement for real estate under grant.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 4 2014-07-01 2013-07-01 true Military requirement for real estate under grant... (CONTINUED) REAL PROPERTY REAL ESTATE General § 643.13 Military requirement for real estate under grant. When a military requirement arises for real estate which is being used under a grant of non-Army use, the...

32 CFR 643.13 - Military requirement for real estate under grant.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Military requirement for real estate under grant... (CONTINUED) REAL PROPERTY REAL ESTATE General § 643.13 Military requirement for real estate under grant. When a military requirement arises for real estate which is being used under a grant of non-Army use, the...

32 CFR 538.2 - Use of military payment certificates.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Section 538.2 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND... used. Military payment certificates are to be used only in the Department of Defense by authorized... to individuals in and under the Department of Defense. (c) Facilities in which used. Military payment...

Saving tourists: the status of emergency medical services in California's National Parks.

PubMed

Heggie, Travis W; Heggie, Tracey M

2009-01-01

Providing emergency medical services (EMS) in popular tourist destinations such as National Parks requires an understanding of the availability and demand for EMS. This study examines the EMS workload, EMS transportation methods, EMS funding, and EMS provider status in California's National Park Service units. A retrospective review of data from the 2005 Annual Emergency Medical Services Report for National Park Service (NPS) units in California. Sixteen NPS units in California reported EMS activity. EMS program funding and training costs totaled USD $1,071,022. During 2005 there were 84 reported fatalities, 910 trauma incidents, 663 non-cardiac medicals, 129 cardiac incidents, and 447 first aid incidents. Sequoia and Kings Canyon National Parks, Yosemite National Park, Golden Gate National Recreation Area, and Death Valley National Park accounted for 83% of the total EMS case workload. Ground transports accounted for 85% of all EMS transports and Emergency Medical Technicians with EMT-basic (EMT-B) training made up 76% of the total 373 EMS providers. Providing EMS for tourists can be a challenging task. As tourist endeavors increase globally and move into more remote environments, the level of EMS operations in California's NPS units can serve as a model for developing EMS operations serving tourist populations.

Reaching across boundaries: a military providers and public schools partnership on behalf of children with special needs.

PubMed

Lewis-Fleming, Glenda

2014-08-01

In January 2011, Neurodevelopmental Pediatrics, a division of the Pediatric Department at Naval Medical Center Portsmouth established a collaborative effort with the local public school systems called the Community Partnership Forum. This performance improvement initiative was designed to strengthen community relationships and communication between Neurodevelopmental Pediatrics, the local public school systems, and diverse military and civilian agencies engaged in the education and care of military children with disabilities in Hampton Roads, Virginia. It was developed as a result of military families and providers voicing concerns about ongoing obstacles with special education-related services. The goal was to create a local multifaceted process to mitigate myths and promote a shared understanding of educational resources in the medical and educational systems. This article summarizes this collegial process between the medical center, the public school systems, and diverse military and community agencies. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Headache triggers in the US military.

PubMed

Theeler, Brett J; Kenney, Kimbra; Prokhorenko, Olga A; Fideli, Ulgen S; Campbell, William; Erickson, Jay C

2010-05-01

Headaches can be triggered by a variety of factors. Military service members have a high prevalence of headache but the factors triggering headaches in military troops have not been identified. The objective of this study is to determine headache triggers in soldiers and military beneficiaries seeking specialty care for headaches. A total of 172 consecutive US Army soldiers and military dependents (civilians) evaluated at the headache clinics of 2 US Army Medical Centers completed a standardized questionnaire about their headache triggers. A total of 150 (87%) patients were active-duty military members and 22 (13%) patients were civilians. In total, 77% of subjects had migraine; 89% of patients reported at least one headache trigger with a mean of 8.3 triggers per patient. A wide variety of headache triggers was seen with the most common categories being environmental factors (74%), stress (67%), consumption-related factors (60%), and fatigue-related factors (57%). The types of headache triggers identified in active-duty service members were similar to those seen in civilians. Stress-related triggers were significantly more common in soldiers. There were no significant differences in trigger types between soldiers with and without a history of head trauma. Headaches in military service members are triggered mostly by the same factors as in civilians with stress being the most common trigger. Knowledge of headache triggers may be useful for developing strategies that reduce headache occurrence in the military.

Medical ethics at Guantanamo Bay and Abu Ghraib: the problem of dual loyalty.

PubMed

Clark, Peter A

2006-01-01

Although knowledge of torture and physical and psychological abuse was widespread at both the Guantanamo Bay detention facility and Abu Ghraib prison in Iraq, and known to medical personnel, there was no official report before the January 2004 Army investigation of military health personnel reporting abuse, degradation or signs of torture. Military medical personnel are placed in a position of a "dual loyalty" conflict. They have to balance the medical needs of their patients, who happen to be detainees, with their military duty to their employer. The United States military medical system failed to protect detainee's human rights, violated the basic principles of medical ethics and ignored the basic tenets of medical professionalism.

Development of national competency-based learning objectives "Medical Informatics" for undergraduate medical education.

PubMed

Röhrig, R; Stausberg, J; Dugas, M

2013-01-01

The aim of this project is to develop a catalogue of competency-based learning objectives "Medical Informatics" for undergraduate medical education (abbreviated NKLM-MI in German). The development followed a multi-level annotation and consensus process. For each learning objective a reason why a physician needs this competence was required. In addition, each objective was categorized according to the competence context (A = covered by medical informatics, B = core subject of medical informatics, C = optional subject of medical informatics), the competence level (1 = referenced knowledge, 2 = applied knowledge, 3 = routine knowledge) and a CanMEDS competence role (medical expert, communicator, collaborator, manager, health advocate, professional, scholar). Overall 42 objectives in seven areas (medical documentation and information processing, medical classifications and terminologies, information systems in healthcare, health telematics and telemedicine, data protection and security, access to medical knowledge and medical signal-/image processing) were identified, defined and consented. With the NKLM-MI the competences in the field of medical informatics vital to a first year resident physician are identified, defined and operationalized. These competencies are consistent with the recommendations of the International Medical Informatics Association (IMIA). The NKLM-MI will be submitted to the National Competence-Based Learning Objectives for Undergraduate Medical Education. The next step is implementation of these objectives by the faculties.

Cost associated with being overweight and with obesity, high alcohol consumption, and tobacco use within the military health system's TRICARE prime-enrolled population.

PubMed

Dall, Timothy M; Zhang, Yiduo; Chen, Yaozhu J; Wagner, Rachel C Askarinam; Hogan, Paul F; Fagan, Nancy K; Olaiya, Samuel T; Tornberg, David N

2007-01-01

To estimate medical and indirect costs to the Department of Defense (DoD) that are associated with tobacco use, being overweight or obese, and high alcohol consumption. Retrospective, quantitative research. Healthcare provided in military treatment facilities and by providers participating in the military health system. The 4.3 million beneficiaries under age 65 years who were enrolled in the military TRICARE Prime health plan option in 2006. The findings come from a cost-of-disease model developed by combining information from DoD and civilian health surveys and studies; DoD healthcare encounter data for 4.1 million beneficiaries; and epidemiology literature on the increased risk of comorbidities from unhealthy behaviors. DoD spends an estimated $2.1 billion per year for medical care associated with tobacco use ($564 million), excess weight and obesity ($1.1 billion), and high alcohol consumption ($425 million). DoD incurs nonmedical costs related to tobacco use, excess weight and obesity, and high alcohol consumption in excess of $965 million per year. Unhealthy lifestyles are significant contributors to the cost of providing healthcare services to the nation's military personnel, military retirees, and their dependents. The continued rise in healthcare costs could impact other DoD programs and could potentially affect areas related to military capability and readiness. In 2006, DoD initiated Healthy Choices for Life initiatives to address the high cost of unhealthy lifestyles and behaviors, and the DoD continues to monitor lifestyle trends through the DoD Lifestyle Assessment Program.

Military Technical Revolution: A Structural Framework

DTIC Science & Technology

1993-03-01

new world situation and draw conclusions about the military forces the United States will need in the years ahead to meet its demands and challenges...collectivization of peacetime military operations. In this new world , the United States will need to rethink the nature and scope of its national interests. Those...mission will also require defense of international sea- lanes and Middle East oil, both of which remain vital to the world and U ’. S . economies. Third

Cooperative Efforts within the US Military Health Services System

DTIC Science & Technology

1985-05-01

sultation provi’dtd in the diagnosis of disease. The Center for Advanced Pathology includes such specialized areas as forensic , radiologic, dental and...medical entomology programs within the three Military Medical- Services were-reorganized into a single Department of Defense Organizational Board

The Scientific Field during Argentina's Latest Military Dictatorship (1976-1983): Contraction of Public Universities and Expansion of the National Council for Scientific and Technological Research (CONICET)

ERIC Educational Resources Information Center

Bekerman, Fabiana

2013-01-01

This study looks at some of the traits that characterized Argentina's scientific and university policies under the military regime that spanned from 1976 through 1983. To this end, it delves into a rarely explored empirical observation: financial resource transfers from national universities to the National Scientific and Technological Research…

A National Study on the Effects of Concussion in Collegiate Athletes and US Military Service Academy Members: The NCAA-DoD Concussion Assessment, Research and Education (CARE) Consortium Structure and Methods.

PubMed