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Sample records for states army medical

  1. Army medical imaging system: ARMIS

    International Nuclear Information System (INIS)

    Siedband, M.P.; Kramp, D.C.

    1987-01-01

    Recent advances of stimulable phosphor screens, data cards using optical storage means, and new personal computers with image processing capability have made possible the design of economical filmless medical imaging systems. The addition of communication links means that remote interpretation of images is also possible. The Army Medical Imaging System uses stimulable phosphor screens, digital readout, a small computer, an optical digital data card device, and a DIN/PACS link. Up to 200 images can be stored in the computer hard disk for rapid recall and reading by the radiologist. The computer permits image processing, annotation, insertion of text, and control of the system. Each device contains an image storage RAM and communicates with the computer via the small computer systems interface. Data compression is used to reduce the required storage capacity and transmission times of the 1-mB images. The credit card-size optical data cards replace film and can store 12 or more images. The data cards can be read on an independent viewer. The research is supported by the U.S. Army Biomedical Research and Development Laboratory

  2. The United States Army Medical Department Journal, April - June 2008

    Science.gov (United States)

    2008-06-01

    Amazon community at Iquitos, Stancil42 (Naval Medical Research Center Detachment, Peru ) received a grant to optimize strategies for preventing the breeding...Detachment, Lima, Peru ; Naval Medical Research Unit-2, Jakarta, Indonesia; and the Naval Medical Research Unit 3, Cairo, Egypt. These resources...the soil beneath tents and camps. In an effort to prevent sand flies breeding in rodent burrows, the Genesis Company (Wellington, Colorado) won an

  3. The United States Army Medical Department Journal. January-March 2013

    Science.gov (United States)

    2013-01-01

    HEATSTROKE IN A MILITARY WORKING DOG January – March 2013 37 THE ARMY MEDICAL DEPARTMENT JOURNAL Respiratory alkalosis can develop as a result of...dropped to 99.1ºF within 35 minutes after presentation, and the pulse and respiratory rate normalized. The mu- cous membranes were pink, but tacky. The MWD...throughout the body, including blood cells, myocardium, skeletal muscle, soft tissues, and cells of the respiratory and nervous systems.5 Venom

  4. Medical Diplomacy in the United States Army: A Concept Whose Time Has Come

    National Research Council Canada - National Science Library

    Krueger, Mary V

    2008-01-01

    ... to the terrorists who wish to defeat US troops, as well as the Western way of life. Medical diplomacy is a nonlethal tool used in combination with economic and diplomatic efforts to achieve this end...

  5. Medical Department, United States Army. Surgery in World War II. Neurosurgery. Volume 1

    Science.gov (United States)

    1958-01-01

    116 Photomicrograph showing petechial hemorrhages in cortex ------------------- 378 117 Photomicrograph showing nerve cell changes in caudate nucleus...headache unrelieved by ordinary medication or when there were signs of increasing intracranial hypertension; and (4) diagnosis of persistent fever ...hemorrhage at various points along the track of the bullet, was almost. invariably present for some days, or even for weeks, after injury. Fever was also

  6. The United States Army Medical Department Journal. July-September 2010

    Science.gov (United States)

    2010-09-01

    wide range of dedicated healthcare professionals who collaborate time and again to advance the state-of-the- art of care for our Warriors who...2010. 5. Bsisu MS. The Arab Table. New York, NY: HarperCollins; 2005. 6. Zubaida S, Tapper R, eds. A Taste of Thyme: Culinary Cultures of the

  7. The United States Army Medical Department Journal. April-June 2010

    Science.gov (United States)

    2010-06-01

    against civilians residing in the United States). On the other hand, it is evident that terrorists are willing to both kill their countrymen and to...would have killed most men. By 1836 he was clearly in decline, but his reputation and force of personality were still such that most of the Alamo’s...War. New York, NY: Putnam; 1971:131-170. 26. James M. The Raven. Atlanta, GA: Mockingbird Books, Inc;1977:31. 27. Prucha FP. The Sword of the

  8. Army Medical Support for Peace Operations and Humanitarian Assistance,

    Science.gov (United States)

    1996-01-01

    or contractors. Some coalition troops may uti - lize the theater medical system in ways it was not intended. Coalition partners’ own medical assets...agencies, and the State Depart- ment often urge the Army to expand medical services and to uti - lize any excess capacity for purposes other than the...Psychologists (new 67D). Similar concerns involved comptrollers and preventive medicine officers, field medical pharmacists , and personnel managers

  9. US Army Medical Research and Development Report.

    Science.gov (United States)

    1979-10-01

    RI) US ARMY MEDICAL RESEARCH AND DEVELOPMENT REPORT. Colonel/John Jr DTIC JUL 1 5 1980; A USL &MY MEDICAL BIOENGINEERING RESEARCH AND DEVELOPMENT...pollutants in water or soil . Pollutant by-products and breakdown products in water, air or soil will be isolated, characterized, and quantified. Where...determination of selected low-level pollutants io soil and water. Degradation products and secondary pollutants arising from munitions manufacture or pest

  10. Brigadier General James Stevens Simmons (1890-1954), Medical Corps, United States Army: a career in preventive medicine.

    Science.gov (United States)

    Marble, Sanders

    2012-02-01

    James Simmons began his career in the US Army as a laboratory officer and his assignments progressed into tropical medicine research. His interests and work evolved into preventive medicine (PM, as the Army termed public health), and he took both a PhD and a Doctorate in Public Health. As the Army's leading PM officer he was appointed head of PM in 1940 and guided the Army's PM effort through World War II. His responsibility ran from gas masks through healthy nutrition and occupational health to an enormous variety of diseases; by the war's end, the breadth and importance of PM was reflected in the Preventive Medicine Division, having fully one-sixth of all military personnel at the Surgeon General's Office. Simmons used his strong professional credentials to tap into civilian medicine for expertise the Army lacked and he established organizations that survive to this day. After retirement, he sought to expand the field of public health and raise another generation of public health physicians.

  11. [Andrologic disease detected during army medical visit].

    Science.gov (United States)

    Campodonico, Fabio; Michelazzi, Alberto; Capurro, Anna; Carmignani, Giorgio

    2003-12-01

    Aim of this study is to investigate the prevalence of andrologic diseases in young men (age 18 years) recruited for conscription in a north-western Italian region. A random sample of 1993 young men was evaluated at the Army Medical Visit Center of the Military District of Genoa. The visits were performed by the same doctor. An examination of external genitalia and secondary sex characters was made and the medical history of each conscript was recorded. Investigation procedures were standardized according to the guidelines of the WHO for the diagnosis and management of the infertile male. Andrologic disorders were found in 547 subjects (27.5%) and first diagnosed in 412 (20.7%). Specific acquired or congenital disorders are discussed. Some patients with most significant diseases were referred to the Urologic Department for second level diagnostic exams. This study underlines the role of the army medical visit as a tool for andrologic screening in young males. The military health service may be a relevant institution for postpuberal control and it could be useful to prevent future sexual and fertility problems in adult males.

  12. The United States Army Medical Department Journal, April - June 2011. Prehospital combat casualty care; The starting point of battlefield survival

    Science.gov (United States)

    2011-04-01

    from a porcine model of acute respiratory diseases secondary to pulmonary contusion. TRANSCUTANEOUS CO2 Are more accurate methods of estimating...combat medic diagnoses a tension pneumothorax from observing the patient and, if feasible, by auscultation with a stethoscope . Dyspnea, distended...Jugular veins, hypotension, and decreased unilateral breath sounds are the major findings for the diagnosis. The stethoscope was invented in 1816 by

  13. Army Medical Department Leaders in Military Operations Other Than War

    National Research Council Canada - National Science Library

    Sadlon, Gary

    2000-01-01

    .... Likewise, the Army Medical Department (AMEDD) must insure its leaders, specifically those selected to deploy world-wide, have a more diverse skill set that enables them to fully operate within the full spectrum of scenarios...

  14. African-American Medical Personnel in the US Army in the First World War.

    Science.gov (United States)

    Marble, Sanders

    2018-02-01

    In WWI, the United States was segregated by custom and law, and the Army obeyed the laws, reducing opportunities for Black medical professionals to serve their country in uniform. This article surveys African-American medical personnel serving in the US Army in World War I. It includes physicians, dentists, veterinarians, and other commissioned officers, as well as medical enlisted men. Overall, despite segregation and associated professional limitations, determined individuals still served with distinction in a variety of roles, opening doors for future advances. Published by Elsevier Inc.

  15. United States Army Weapon Systems 2010

    Science.gov (United States)

    2009-09-18

    equipment, tractor, van, wrecker, 8.8-ton Load Handling System (LHS), 8.8-ton LHS trailer, and 10-ton dump truck models). Three truck variants and...NJ) hydraulic pump and motor: Vickers (Jackson, MS) 131 UnIteD StAteS Army ACqUISItIon phASe InveStment Component High Mobility Engineer Excavator...MEDEVAC and hoist configuration, the UH-72A is also being fielded in a VIP, National Guard Homeland Security (HLS) and a Combined Training Center

  16. [On the role of army physicians in the creation of Ukrainian medical terminology].

    Science.gov (United States)

    Radysh, Ia F; Holyk, L A

    2002-01-01

    Tha article is devoted to the analysis of the role army surgeons had in creation of Ukrainean medical terminology. In the article, medical dictionaries are briefly analyzed, of which Ukrainean army surgeons are authors or co-authors.

  17. The United States Army 1996 Modernization Plan.

    Science.gov (United States)

    1996-03-08

    time and with less risk. IMA technology improvements are leveraged and inserted into the Army’s information architectures as the competitive market place...to procure a family of complementary, interoperable systems. At the end of the near-term, "Active Defense RD&A Startegy Army will begin fielding...Haul and Engineer tractors were fielded that brought modern technologies from the commercial market to the Army. However, adequate quantities were

  18. Implementation of the Asthma Practice Guideline in the Army Medical Department: Evaluation of Process and Effects

    National Research Council Canada - National Science Library

    Farley, Donna O; Cretin, Shan; Vernez, Georges; Pieklik, Suzanne; Quiter, Elaine; Ashwood, J. S; Tu, Wenli

    2005-01-01

    .... The Quality Management Directorate of the Army Medical Command (MEDCOM) contracted with RAND to work as a partner in the development and testing of guideline implementation methods for ultimate application to an Army-wide guideline program...

  19. Army Combat Medic Resilience: The Process of Forging Loyalty.

    Science.gov (United States)

    Abraham, Preetha A; Russell, Dale W; Huffman, Sarah; Deuster, Patricia; Gibbons, Susanne W

    2018-03-01

    This study presents a grounded theory analysis of in-depth interviews of United States Army Combat Medics (CMs) who had served in Iraq and/or Afghanistan. The study explores how 17 CMs nominated by their peers as resilient cope with military stressors in order to identify the factors that enable them to thrive amidst harsh conditions. Four distinct categories of characteristics unique to this group emerged: (1) social bonding, (2) readiness, (3) dual loyalty as performance, and (4) leader by example. Forging loyalty underpins these characteristics and represents the main process used by resilient CMs and comprised three behavior patterns: (1) commitment to the family, (2) commitment to the military mission, and (3) commitment to their guiding religious and spiritual beliefs. Prominent behavioral tendencies of forging loyalty likely developed during childhood and re-enforced by families, friends, and other role models. Based on the findings, new training and education efforts should focus on developing positive emotional, environmental, and social resources to enhance the health and well-being of service members and their families.

  20. Physician Retention in the Army Medical Department

    Science.gov (United States)

    2009-03-16

    Fifteen years ago, these jobs were filled by General Medical Officers ( GMO ) -- graduates of internships who spent some time “muddying their boots” in the...field while waiting a year or two for the residency position of their choice. Today, the GMO is an endangered species. In an effort to provide the best

  1. Weapons Systems, United States Army 1997.

    Science.gov (United States)

    1997-01-01

    Mexico, Morocco , Philippines, Turkey Co-Production: Korea The Army began fielding the UH-60 in 1978. Between 1978 and 1989 the Army procured UH-60A...Improvement Program ( CSR TEP) to all Area Common User System (ACUS) switch users (except AN/TTC-39-A(V)l). Incorporate Enhanced Switch Operation Program...Finland, Greece, Italy, Kuwait, Morocco , Saudi Arabia National Guard, SHAPE Tech Ctr (NATO), Spain, Special Def Acq Fund (pre-purchased export

  2. Clinical Investigation Program (Tripler Army Medical Center)

    Science.gov (United States)

    1991-10-01

    8217 I have learned an immense amount during this last year. Clinicians have no idea of the real world of medical research, finance, and politics. We (I...91. 10 Pfanner TP, Person DA, Berenberg JL, Lockett LJ: Eosinophilia Myalgia Syndrome: A Case Report and One Year Follow-Up. American College of ...protocol as yet. This is a non therapeutic study designed to gather epidemiologic and late effects data on long term (>Syrs) survivors of Wilms’ tumor

  3. Department of the Army Supply Bulletin, Army Medical Department Supply Information, SB8-75-S7

    National Research Council Canada - National Science Library

    2002-01-01

    .... Army Medical Materiel Agency (USAMMA), Fort Detrick, Maryland This edition focuses on the mission and functions of the SCMD and its capability to support the "Warfighter" during a full range of contingency operations While all of...

  4. The United States Army Comprehensive Soldier Fitness: A Critical Look

    Science.gov (United States)

    2013-03-01

    Psychoanalysis Professor Stephen Soldz, stated “ the problems identified with CSF are legion. It is time for the Army to step back from uncritically...Frederick J. Gellert Department of Command, Leadership and Management Project Adviser This manuscript is submitted in partial fulfillment of the ...organization and at every level within the Army, MRTs serve as the principal advisor to the leadership regarding CSF and as a resource for Soldiers

  5. The Mobile Modular Surgical Hospital: the Army Medical Department’s Future Unit of Action

    Science.gov (United States)

    2005-06-17

    requirements. Paula C. Lodi in her monogram “The Army Medical Department and Full Spectrum Operations” written for the School of Advanced Military...Center, 2004), 2.1-2.10. 14Paula C. Lodi, The Army Medical Department and Full Spectrum Operations, ( Monogram , School of Advanced Military Studies...paper in the past ten years on the level III hospital. Paula C. Lodi in her monogram “The Army Medical Department and Full Spectrum Operations” written

  6. U.S. Army Medical Department Journal (July-September 1998)

    National Research Council Canada - National Science Library

    Peake, James B; Goodman, Robert L; Hillhouse, Roger H; Newsome, Steve; Reed, Lester H; Hume, Jr., Carroll R. Dotson ;Roderick F; Gussenhoven, Elisabeth; Garland, Frederick N; Still, Ron; Campbell, Kyle D; Austerman, Wayne R

    1998-01-01

    .... The "MAMC Improvement Award Program" describes the Madigan Army Medical Center's incentive program to reward organizational groups within a military hospital for improving efficiency, quality of care...

  7. The Deployed Warfighter Protection Research Program: Finding New Methods to Vanquish Old Foes (The United States Army Medical Department Journal, April-June 2008)

    Science.gov (United States)

    2008-06-01

    pyriproxyfen, the most powerful insect growth regulator (IGR), against dengue vector mosquitoes. In the Peruvian Amazon community at Iquitos, Stancil42 (Naval...Medical Research Center Detachment, Peru ) received a grant to optimize strategies for preventing the breeding of Aedes aegypti mosquitoes in...effort to prevent sand flies breeding in rodent burrows, the Genesis Company (Wellington, Colorado) won an award for producing insecticidal baits that

  8. Diversity Issues in the Army as Perceived by Army Students at the United States Army War College

    National Research Council Canada - National Science Library

    Webster, Cecil

    1997-01-01

    ..., welfare, and other related programs. In recognizing this diversity, this paper identifies some diversity issues within the Army, analyzes the perception of those diversity issues by the resident Army students in the USAWC Class of 1997...

  9. United States Army Medical Materiel Development Activity

    Science.gov (United States)

    1989-03-10

    and BPL were provided by the contractor to USAMMDA personnel as required. 3 ,I SAutomatic Data Processing Support: During 1988, USAMI.DA procured...PABO, and WRAIR cooperated to immunize 40,000 volunteers in a double blind study of 0. neningitidis Vaccine. Controls received a licensed Group C

  10. Unwarranted Variation in the Medical Management of Injured Civilian Workers in the U.S. Army Medical Command

    National Research Council Canada - National Science Library

    Rice, William A

    2005-01-01

    ... submitted from each Army medical treatment facility (MTF). Using hierarchical multiple linear regression, these variables were tested as potential predictors of the average total cost per case of an injured civilian employee in each MTF...

  11. Measuring US Army medical evacuation: Metrics for performance improvement.

    Science.gov (United States)

    Galvagno, Samuel M; Mabry, Robert L; Maddry, Joseph; Kharod, Chetan U; Walrath, Benjamin D; Powell, Elizabeth; Shackelford, Stacy

    2018-01-01

    The US Army medical evacuation (MEDEVAC) community has maintained a reputation for high levels of success in transporting casualties from the point of injury to definitive care. This work served as a demonstration project to advance a model of quality assurance surveillance and medical direction for prehospital MEDEVAC providers within the Joint Trauma System. A retrospective interrupted time series analysis using prospectively collected data was performed as a process improvement project. Records were reviewed during two distinct periods: 2009 and 2014 to 2015. MEDEVAC records were matched to outcomes data available in the Department of Defense Trauma Registry. Abstracted deidentified data were reviewed for specific outcomes, procedures, and processes of care. Descriptive statistics were applied as appropriate. A total of 1,008 patients were included in this study. Nine quality assurance metrics were assessed. These metrics were: airway management, management of hypoxemia, compliance with a blood transfusion protocol, interventions for hypotensive patients, quality of battlefield analgesia, temperature measurement and interventions, proportion of traumatic brain injury (TBI) patients with hypoxemia and/or hypotension, proportion of traumatic brain injury patients with an appropriate assessment, and proportion of missing data. Overall survival in the subset of patients with outcomes data available in the Department of Defense Trauma Registry was 97.5%. The data analyzed for this study suggest overall high compliance with established tactical combat casualty care guidelines. In the present study, nearly 7% of patients had at least one documented oxygen saturation of less than 90%, and 13% of these patients had no documentation of any intervention for hypoxemia, indicating a need for training focus on airway management for hypoxemia. Advances in battlefield analgesia continued to evolve over the period when data for this study was collected. Given the inherent high

  12. Cost-Benefit Analysis of Radiation Therapy Services at Tripler Army Medical Center

    National Research Council Canada - National Science Library

    Diehl, Diane S

    2004-01-01

    The purpose of this analysis was to examine the costs and benefits associated with continuance of "in-house" radiation therapy services to eligible beneficiaries at Tripler Army Medical Center (TAMC...

  13. U.S. Army Medical Department Journal (January-March 2000)

    National Research Council Canada - National Science Library

    Peake, James B; Goodman, Petra; De Lorenzo, Robert A; LaRavia, Dennis; Thomas, Timothy L; O'Hara, Charles P; Goodman, Robert L

    2000-01-01

    This issue of the AMEDD Journal contains several articles of interest. "Proceedings of the 1999 Madigan Research Day" identifies the award-winning research abstracts of this annual Madigan Army Medical Center event...

  14. U.S. Army Medical Department Journal (April-June 2006)

    Science.gov (United States)

    2006-06-01

    basic laboratory equipment and techniques acquired at the AMS, demonstrated that Puerto Rican anemia was due to the hookworm, Necator americanus.* In...Sciences, Bangkok, Thailand; US Army Medical Research Unit-Kenya, Nairobi; Naval Medical Research Center Detachment, Lima, Peru ; Naval Medical Research...2006 131 Colombia, Ecuador, El Salvador, Netherland Antilles, Antigua, Belize, Bolivia, Costa Rica, Guatemala, Nicaragua, Panama, Peru (air, water

  15. Crucible of fire: the Boer War and the birth of the Canadian Army Medical Corps.

    Science.gov (United States)

    McCulloch, I

    1995-01-01

    Although Canada's military physicians didn't come to prominence until WW I and WW II, the Canadian Army Medical Corps (CAMC), the forerunner of the Royal Canadian Army Medical Corps and the current Canadian Forces Medical Service, actually had its origins in the Boer War. During that turn-of-the-century conflict, field hospitals accompanied Canadian troops to South Africa. Ian McCulloch discusses that early type of medical service and the steps that led to the creation of the CAMC. Images p1495-a p1496-a PMID:7585380

  16. [Formation and development of military-medical service of Terek Cossak Army in XIX--beginning XX c].

    Science.gov (United States)

    Akhmadov, T Z

    2012-10-01

    The article is dedicated to one nor enough investigated question of medical supplement of irregular Cossak army in North Caucasus in XIX--beginning XX c. The role of the government and cossaks in formation and development of medical service in Terek Cossak Army is showed. Characteristic pecularities of health care of mountain population after administrative development of the district by Tsar Russia. The author underlined that despite the disadvantages, medical service of Terek Cossak Army and Terek district in described period was right developing system of medical care for irregular army and population.

  17. Charges Assessed the Army by the Defense Logistics Agency for Deployable Medical Systems

    National Research Council Canada - National Science Library

    1995-01-01

    .... Deployable medical systems are standardized modular field hospitals that can be prepositioned in the event of a contingency, national emergency, or war operations. In FY 1994, the Defense Personnel Support Center billed the Army $25 million for acquiring and assembling deployable medical systems.

  18. Equal Opportunity Program Management for the Army Medical Department

    Science.gov (United States)

    2008-04-09

    applies to someone who has the physical, cultural, or linguistic characteristics of a national group. Personal Racism , Sexism , or Bigotry: The ...Management and Army Demographics and Statistics Departments. LTC Horrell arranged my VIP trip to the Defense Equal Opportunity Management Institute (DEOMI...harassment in the organization. Organizational productivity is maximized when illegal discrimination is eradicated. One theory of why discrimination

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

    Science.gov (United States)

    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. )

  20. Medical students' unique experience of army leadership training: a qualitative study.

    Science.gov (United States)

    Earis, John; Garner, J; Haddock, D; Jenkins, J; Jha, V

    2017-10-01

    To assess the interactive experience of first year medical students attending the leadership and management course hosted by a British Army Reserve Field Hospital developed in partnership with Liverpool University. 244 students submitted a 1000-word structured reflective learning assignment about their reaction to, learning from and any behaviour and attitude changes as a result of, the training. The assignments were thematically analysed to identify how aspects of the training had impacted upon the students' understanding of leadership and teamwork. Their comments relating to the army were analysed to gain insight into their views and experience of the training. Students were surprised at how enjoyable and useful they found the course. Initially they expressed scepticism about what they could learn in an army-based environment. However, the training, particularly command and planning tasks, helped them appreciate and understand the different skills individuals can bring to a team environment, and the importance of everyone contributing. While some students were challenged by aspects of the course, with support and encouragement from team-mates and the army personnel, they learned they could achieve more together. Teaching leadership and management skills to medical students is a challenge which can be effectively addressed by adapting and developing army training resources. Students overcame initial scepticism about participating, and learned a lot about themselves and each other. In addition, the army developed a better understanding of the doctors of the future. The expertise of the army in delivering this training was crucial to its success as the medical school could not have provided this experience unsupported. 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/.

  1. Review of U.S. Army Aviation Accident Reports: Prevalence of Environmental Stressors and Medical Conditions

    Science.gov (United States)

    2017-10-18

    terminology related to an aforementioned stressor or medical condition. Table 1 presents the identified operational stressor with the keywords extracted...USAARL Report No. 2018-02 Review of U.S. Army Aviation Accident Reports: Prevalence of Environmental Stressors and Medical Conditions By Kathryn...Environmental Stressors and Medical Conditions N/A N/A N/A N/A N/A N/A Feltman, Kathryn A. Kelley, Amanda M. Curry, Ian P. Boudreaux, David A. Milam

  2. Changes in Temporary Disability Reporting Following the Implementation of the Army Medical Readiness Transformation.

    Science.gov (United States)

    Sapp, Jason E; Cody, Matthew J; Douglas, Kevin M

    2018-02-07

    , 2016, 936 soldiers were placed on temporary disability. The majority was for orthopedic-related conditions (68.6%). Lower extremity (18.3%) and knee (17.5%) conditions were the two most common orthopedic issues. Behavioral health-related conditions (6.9%) and postoperative recovery (5.6%) were the next two most common categories. Implementation of the Army Medical Readiness Transformation resulted in a statistically significant increase in reported "non-deployable" MRC 3 soldiers compared with the previous "non-available" MRC 3A/3B population. One possible reason for this relates to how temporary disability is reported under each system, especially for those soldiers with only mild limitations. Under the new system, musculoskeletal conditions accounted for the majority of disability. Important limitations include small sample sizes, a fluctuating denominator representing authorized unit strength, and that the study did not take into account seasonal variation and the operational cycle for the unit. Future studies should look at those conditions or soldier characteristics that can help guide commanders as they make deployability decisions and how to address wellness and injury prevention to mitigate the risk of soldiers going on temporary disability. Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2018. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  3. Legacy in the Sand: The United States Army Armament, Munitions and Chemical Command in Operations Desert Shield and Desert Storm

    Science.gov (United States)

    1992-12-21

    States Army Medical Department, over 1.5 million British-designed Small Box Respirator ( SBR ) masks, utilizing activated coconut charcoal as a filter, had...conflicts this nation will tfce-short in rjuration but of high intensity. In such a war, relance must bpp oaced upon the established stockpile and the...Supply System SAW squad automatic weapon SBA Small Business Administration SBR small box respirator SCR senior command representati’e SCRAM self-contained

  4. Business Case Analysis of the Walter Reed Army Medical Center Medical/Surgical Prime Vendor Generation III Service Level Electron Program

    National Research Council Canada - National Science Library

    Markot, Peter B

    2007-01-01

    ...) staffing and medical/surgical services offered under the Prime Vendor (PV) Generation III contract would provide the best supply chain management solution for Walter Reed Army Medical Center (WRAMC...

  5. Analysis of the experience in participation of army medical service in medical arrangement in case of radiation accident

    International Nuclear Information System (INIS)

    Zhilyaev, E.G.; Goncharov, S.F.; Vorontsov, I.V.; Legeza, V.I.; Berzin, I.A.

    1995-01-01

    The paper presented calculations of manpower and money funds for rendering aid to the injured persons in case of radiation accident. The authors offered a scheme of using medical anti-radial aids on various stages of radiation accident; immediately after the accident in case of non-predicted and controlled radiation exposure. Army Medical Service is capable of solving promptly the tasks of medical aid with the help of highly mobile specialized medical units, the use of which is stipulated in the system of the Russian Service of disaster medicine. 10 refs.; 1 tab

  6. Quantitative Analysis of Contributing Factors Affecting Patient Satisfaction in Family Medicine Service Clinics at Brooke Army Medical Center

    Science.gov (United States)

    2008-06-06

    Predictors of patient satisfaction for Brooke Army Medical Center Family Medicine Service primary care clinics was performed. Data was obtained from...Factors Affecting Patient Satisfaction in Family Medicine Service Clinics at Brooke Army Medical Center Presented to MAJ Eric Schmacker, Ph.D. In...study. All patients ’ medical information was protected at all times and under no circumstances will be discussed or released to any outside agency

  7. Child Abuse and Neglect United States Army U.S. Army Central Registry (1989-1996)

    Science.gov (United States)

    1998-03-31

    This report is an analysis of the child abuse and neglect cases that have been recorded in the Army Central Registry between 1989-1996. The following...were 30,551 initial substantiated cases of child abuse and neglect, or an average of about 3,80 cases per year. There were 2,336 subsequent incidents

  8. The evolution of dependent medical care in the U.S. Army.

    Science.gov (United States)

    Herold, Thomas J S

    2011-10-01

    There is great focus within the military medical community regarding the ever growing cost of medical care overall and dependent care specifically. A great deal of discussion relates to the delivery of care through a growing military-civilian partnership, where an increased amount of health care will be referred to an ever growing network of civilian providers. The U.S. military establishment now stands at an important crossroad leading into the future of dependent care. However, the special concerns, which arise from the responsibility of caring for military dependents, are not a solely recent phenomenon. Ever since the establishment of a permanent standing U.S. Army in the late 1700s, there have been families in need of medical treatment. Although changes occurred continuously, the development and evolution of policies regulating the delivery of medical care to dependants can be divided into three periods. The first is the longest and ranges from the establishment of the Army until the year 1900. The second period spans from 1900 to the post-Korean War year of 1956. The third and final period is from 1956 to 1975. Special changes and advances in each of these periods have served to shape the face of dependent care in today's Army Medical Department.

  9. Optimizing the Distribution of United States Army Officers

    National Research Council Canada - National Science Library

    McElroy, Jeremy S

    2005-01-01

    .... The Army responds to imbalances by redistributing officers to provide each location with the minimum required officers while minimizing the number of unfilled targets and excess officers at each location...

  10. Chemical Weapons: FEMA and Army Must Be Proactive in Preparing States for Emergencies

    National Research Council Canada - National Science Library

    2001-01-01

    .... Such an accident could affect people in 10 different states. The Army plans to destroy its entire chemical weapons stockpile by 2007 and is taking measures to protect the public before and during the demilitarization process...

  11. Social Media Misuse in the United States Army

    Science.gov (United States)

    2016-06-10

    phenomenon for the Army and it will increase as more Soldiers in the millennial generation communicate through social media as well as use numerous...social media . Soldiers and leaders must also understand the punitive actions that could result from not upholding the Army values and ethics resulting...browsing a social media network’s community page in 2014 when she came upon a video that she found offensive and sexist. In one scene of the video

  12. Erica Marat, The Military and the State in Central Asia: From Red Army to Independence

    Directory of Open Access Journals (Sweden)

    Boris Petric

    2011-03-01

    Full Text Available Erica Marat is a one of the United States’ most brilliant Central Asian political scientists. She has offered numerous analyses of political transformations as presented by different think tanks and American foundations. In this book, Marat focuses on the role of the army in building state processes in contemporary Central Asian states. The book offers a wide panorama of Central Asian armies, compiling sources already published (books, reports in Russian and English etc. and some original da...

  13. A Study of Civilian Registered Nurse Recruitment at Madigan Army Medical Center, Tacoma, Washington.

    Science.gov (United States)

    1982-06-01

    34 May, 1981, "Nurse, Where Are You?" Judy Armstrong . 5 1nitial Report and Preliminary Recommendations, National Commission on Nursing (September 1981...Interview with Ms. R. Marsh, Staffing Specialist, Force Develop- ment Division, Madigan Army Medical Center, Tacoma, WA (Dec 81) 20Philip Kotler ...Marketing Management. Boston: Allyn and Bacon, Inc., 1980. Kotler , Philip. Marketing for Nonprofit Institutions. Englewood Cliffs, N.D.: Prentice-Hall

  14. Organizational Analysis of the United States Army Evaluation Center

    Science.gov (United States)

    2014-12-01

    customer at Redstone Arsenal, Alabama. Figure 14 shows the placement of the AEC APG directorates and was derived from Google Maps. Figure 14...Information (PII)  Portable Electronic Devices & Removable Storage Media  Phishing Awareness  Army G3 Computer Security Training In addition to the

  15. United States Army Medical Department Journal. Leadership in the Army Medical Department, October - December 2009

    Science.gov (United States)

    2009-12-01

    growth following the gap is the grandchildren of the baby boomers known as generation Y , or millennial . The rise in the birth rate is noticeable in...M. Healthy design. Lancet. 2004;364:405-406. 13. Urich RS, Zimring CM, Zhu X, Dubose J, Seo H, Choi Y , et al. A review of the literature on...origin or background, from Latin ethnicus (nation, people). Religion \\ri-’li-J3n\\ a personal set or institutionalized system of attitudes, beliefs, and

  16. Walter Reed Army Medical Center's Internet-based electronic health portal.

    Science.gov (United States)

    Abbott, Kevin C; Boocks, Carl E; Sun, Zhengyi; Boal, Thomas R; Poropatich, Ronald K

    2003-12-01

    Use of the World Wide Web (WWW) and electronic media to facilitate medical care has been the subject of many reports in the popular press. However, few reports have documented the results of implementing electronic health portals for essential medical tasks, such as prescription refills and appointments. At Walter Reed Army Medical Center, "Search & Learn" medical information, Internet-based prescription refills and patient appointments were established in January 2001. A multiphase retrospective analysis was conducted to determine the use of the "Search & Learn" medical information and the relative number of prescription refills and appointments conducted via the WWW compared with conventional methods. From January 2001 to May 2002, there were 34,741 refills and 819 appointments made over the Internet compared with 2,275,112 refills and approximately 500,000 appointments made conventionally. WWW activity accounted for 1.52% of refills and 0.16% of appointments. There was a steady increase in this percentage over the time of the analysis. In April of 2002, the monthly average of online refills had risen to 4.57% and online appointments were at 0.27%. Online refills were projected to account for 10% of all prescriptions in 2 years. The "Search & Learn" medical information portion of our web site received 147,429 unique visits during this same time frame, which was an average of 326 visitors per day. WWW-based methods of conducting essential medical tasks accounted for a small but rapidly increasing percentage of total activity at Walter Reed Army Medical Center. Subsequent phases of analysis will assess demographic and geographic factors and aid in the design of future systems to increase use of the Internet-based systems.

  17. The United States Army Operating Concept, 2016-2028

    Science.gov (United States)

    2010-08-19

    NationalDefenseStrategy.pdf Biddle , T. D. (2010, April). Educating Senior Military Officers: Observations from the Carlisle Parapet. [Unpublished...node/4077 National Intelligence Council Global Trends 2025: A Transformed World. (2008, November). Retrieved from http://www.dni.gov/ nic ...author. 118 Dr. Tami Davis Biddle , “Educating Senior Military Officers: Observations from the Carlisle Parapet,” US Army War College, Carlisle

  18. Combating Tobacco Use in the United States Army

    Science.gov (United States)

    2010-04-01

    videogame , tobacco use, military. 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME OF RESPONSIBLE... videogame is theory-guided and uses animations, videos and interactive activities to provide facts about smoking and tobacco use, as well as provides...prevention and cessation interactive multimedia tool ( videogame ) among active Army personnel stationed at Fort Hood, Texas. Body Throughout the

  19. The health of the American slave examined by means of Union Army medical statistics.

    Science.gov (United States)

    Freemon, F R

    1985-01-01

    The health status of the American slave in the 19th century remains unclear despite extensive historical research. Better knowledge of slave health would provide a clearer picture of the life of the slave, a better understanding of the 19th-century medicine, and possibly even clues to the health problems of modern blacks. This article hopes to contribute to the literature by examining another source of data. Slaves entering the Union Army joined an organization with standardized medical care that generated extensive statistical information. Review of these statistics answers questions about the health of young male blacks at the time American slavery ended.

  20. US Army Medical Bioengineering Research and Development Laboratory Annual Progress Report for FY 84. Volume 1

    Science.gov (United States)

    1984-10-01

    guanidIne nitrate, is biodegraded slowly in surface waters alone and relatively rapidly if present with metabolizable carbon, in which case the compound...Operation." AORN Journal 40 (1984):330. Goethals, Gerald B. "So, You Want to be in Movies ?" Today’s OR Nurse 6 (1984):36-37. Goyal, Sagar M., S.A. Schaub...Development Laboratory MR 8-84 (May 1984). Mitchell, Wayne R. Preliminarx Results of Biodegradation Studies for Guanidine Nitrate. US Army Medical

  1. Role of State Medical Boards in Continuing Medical Education

    Science.gov (United States)

    Johnson, David A.; Austin, Dale L.; Thompson, James N.

    2005-01-01

    The evaluation of physician competency prior to issuing an initial medical license has been a fundamental responsibility of medical boards. Growing public expectation holds that medical boards will ensure competency throughout a physician's career. The Federation of State Medical Boards (FSMB) strongly supports the right of state medical boards to…

  2. Pathology and Laboratory Medicine Support for the American Expeditionary Forces by the US Army Medical Corps During World War I.

    Science.gov (United States)

    Wright, James R; Baskin, Leland B

    2015-09-01

    Historical research on pathology and laboratory medicine services in World War I has been limited. In the Spanish American War, these efforts were primarily focused on tropical diseases. World War I problems that could be addressed by pathology and laboratory medicine were strikingly different because of the new field of clinical pathology. Geographic differences, changing war tactics, and trench warfare created new issues. To describe the scope of pathology and laboratory medicine services in World War I and the value these services brought to the war effort. Available primary and secondary sources related to American Expeditionary Forces' laboratory services were analyzed and contrasted with the British and German approaches. The United States entered the war in April 1917. Colonel Joseph Siler, MD, a career medical officer, was the director, and Colonel Louis B. Wilson, MD, head of pathology at the Mayo Clinic, was appointed assistant director of the US Army Medical Corps Division of Laboratories and Infectious Disease, based in Dijon, France. During the next year, they organized 300 efficient laboratories to support the American Expeditionary Forces. Autopsies were performed to better understand treatment of battlefield injuries, effects of chemical warfare agents, and the influenza pandemic; autopsies also generated teaching specimens for the US Army Medical Museum. Bacteriology services focused on communicable diseases. Laboratory testing for social diseases was very aggressive. Significant advances in blood transfusion techniques, which allowed brief blood storage, occurred during the war but were not primarily overseen by laboratory services. Both Siler and Wilson received Distinguished Service Medals. Wilson's vision for military pathology services helped transform American civilian laboratory services in the 1920s.

  3. Annihilating time and space: The electrification of the United States Army, 1875--1920

    Science.gov (United States)

    Brown, Shannon Allen

    2000-10-01

    The United States Army embraced electrical technology in the 1870s as part of a wider initiative to meet the challenge of the coastal defense mission. As commercial power storage, generation, and transmission technology improved and the army came to recognize the value of the energy source as a means and method of improving command and control, localized electrical networks were integrated into the active service of the military. New vulnerabilities emerged as the army became ever more reliant upon electric power, however, and electrification---the institutional adoption and adaptation of electrical technologies---emerged as a very expensive and contentious process guided by technical, political, and economic pressures, and influenced by conflicting personalities within the service. This study considers the institutional evolution of the U.S. Army before and during World War I with respect to the adoption and application of electrical technology. The changing relationships between the military and electrical manufacturing and utilities industries during the period 1875--1920 are also explored. Using a combination of military archival sources and published primary materials, this study traces the effects of electrification on the army. In the end, this study proves that electrification was, at first, a symptom of, and later, a partial solution to the army's struggle to modernize and centralize during the period under consideration. Electrification produced a set of conditions that encouraged a new maturity within the ranks of the army, in technical, doctrinal, and administrative terms. This growth eventually led to the development of new capabilities, new forms of military organization, new missions, and new approaches to warfare.

  4. PACS and its hospital-wide implementation: A case study at the Madigan Army Medical Center

    International Nuclear Information System (INIS)

    Choi, Hyung Sik; Kim, Yong Min; Smith, Donald V.; Bender, Gregory N.

    1993-01-01

    PACS represents the future of radiology in modern hospitals. Workstations and databases can be developed to substantially increase clinician's productivity, improve diagnostic accuracy, and make a large amount of knowledge and patient information available on-line to the physician. Currently, there are several hospitals in the process of implementing a total PACS system. They include Madigan Army Medical Center (Tacoma, Washington), VA Hospital in Baltimore, and Hammersmith Hospital in London (1). In order to provide the radiologist, the clinicians, and other health personnel in Korea with the general concept of PACS and its up-to-date status report, we describe the MDIS system being implemented in MAMC (Madigan Army Medical Center) which is the first hospital-wide large-scale PACS in the world. The major PACS components in MAMC have been installed since March 1992 and the full system implementation will be completed by summer 1993. The goal of the MDIS system in MAMC is to increase to more than 90% filmless by the end of 1993. In this paper, we discuss the introduction and background of PACS and its potential benefits, the current status of PACS installation in MAMC and the future plan, and the flow of image data and text information in MAMC

  5. The Need for the United States Army to Possess a Landing Craft with Maneuver Capabilities

    Science.gov (United States)

    2015-06-12

    landing craft after the 2004 Indian Ocean tsunami and the 2009 Myanmar cyclone.9 The landing craft enabled the relief effort to bypass partially...requirements for Army aviation . The Need for America’s Amphibious Capability In his thesis, “The Need for the United States of America’s Amphibious

  6. A Study to Evaluate the Organization and the Operating Procedures of the Patient Assistance Function at Brooke Army Medical Center, Fort Sam Houston, Texas

    Science.gov (United States)

    1979-08-01

    15 March 1979. 59Interview with Wendy L. Farace , Head Nurse, Obstetrics/Gynecology Clinic, Brooke Army Medical Center, Fort Sam Houston, Texas, 8...6 February 1979. Farace , Wendy L. Head Nurse, Obstetrica/Gynecology Clinic, Brooke Army Medical Center, Fort Sam Houston, Texas. Interview, 8 January

  7. Evaluating the Coding and Workload Accounting Improvement Initiative of Madigan Army Medical Center

    National Research Council Canada - National Science Library

    Bewley, Lee W; Bender, Brian J

    2007-01-01

    ... documentation, provider coding accuracy and education, and clinic electronic medical record (AHLTA) usage. The desired end state of the CWAI is improved medical documentation and coding accuracy at MAMC...

  8. Motivational Profiles of Medical Students of Nepalese Army Institute of Health Sciences.

    Science.gov (United States)

    Shrestha, Lochana; Pant, Shambhu Nath

    2018-01-01

    Students enter the medical study with different types of motives. Given the importance of academic motivation for good academic achievement of the students, the present study was designed to reveal the possible relationship between academic motivation and achievement in medical students. In this cross-sectional study medical students (N=364) of Nepalese Army institute of Health Sciences were participated and classified to different subgroups using intrinsic and controlled motivation scores. Cluster membership was used as an independent variable to assess differences in study strategies and academic performance. Four clusters were obtained: High Intrinsic High Controlled, Low Intrinsic High Controlled, High Intrinsic Low Controlled, and Low Intrinsic Low Controlled. High Intrinsic High Controlled and High Intrinsic Low Controlled profile students constituted 36.1%, 22.6% of the population, respectively. No significant differences were observed as regards to deep strategy and surface strategy between high interest status motivated and high interest-motivated students. However, both of the clusters had significantly deeper, surface strategy and better academic performance than status-motivated and low-motivation clusters (p motivated and interest-motivated medical students were associated with good deep and surface study strategy and good academic performance. Low-motivation and status-motivated students were associated with the least academic performance with less interest learning behaviors. This reflected that motivation is important required component for good learning outcomes for medical students Keywords: Academic performance; controlled motivation; clusters; intrinsic motivation; motivation.

  9. A Study to Determine if Ethics Committees Should be a Decision-Making and Review Mechanism for Matters Relating to No-Code Orders in the Continental United States Army Medical Department Hospitals with over One Hundred Total Operating Beds

    Science.gov (United States)

    1984-08-01

    their role in the hospital. The book Megatrends points out that there are six States which set the pace for national trends. One of these is California...care hospitals but two. Again, one must recall what the book Megatrends says about California and national trends. Another key according to this study...Catholic Hospitals," Ethics Committees Newsletter, Vol 1, No. 2, November 1983, p. 2. 7. R. Veatch, Death, PyiLn and the Biological Revolution, New Haven

  10. Fiscal Year 2011 United States Army Annual Financial Report. America’s Army: At a Strategic Crossroads

    Science.gov (United States)

    2011-01-01

    successful in any operational scenario. In FY 2011, the Army updated the Cost of the Doctrinal Army Model using improved and refined methods and the...General Fund uses engineering estimates and independently validated models to estimate environmental cleanup liabilities. The Remedial Action Cost ...Standard Price LCM = Lower of Cost or Market AC = Actual Cost O = Other MAC = Moving Average Cost Abnormal Balance The Revaluation Allowance for

  11. Army dreamers.

    Science.gov (United States)

    1988-05-14

    The birth of the Army Nursing Service took place in 1854, when Florence Nightingale, at the request of the Secretary of State for War, recruited and took to Scutari Hospital 38 women to tend the wounded of the Crimean war.

  12. Radiology in World War II (Medical Department, United States Army)

    Science.gov (United States)

    1966-01-01

    efornied each wvorkinog dav. bv a roil utie dlevelopied lo1 expiediite till(- elir . t8 ii~ap .11id ~iieiui’iie~hiiloi’ij~i were. facil itated by thle...ETOUSA. The officer sent to the European theater as Chief of Redeployment, a pharmacist by training, made arbitrary decisions on matters in which he was...lgt44 f.4t. wL*r ithi1l14’iI that lo4,keli tiks, pilorlen e-xuldite bill thant wals found14 ote il411’ uti r After f1’,lebidelo’ilt. I cavit v 1II4

  13. United States Army Medical Department Journal, January-March 2010

    Science.gov (United States)

    2010-03-01

    uti - lization of government-owned inventions by licensing inventions to the private sector. Licensing of federally owned inventions and other...physical therapists, podiatrists, optometrists, clinical dieticians, social workers, clinical pharmacists , clinical psychologists, occupational

  14. The United States Army Medical Department Journal. October - December 2010

    Science.gov (United States)

    2010-12-01

    sciences and biomedical information. As such, the Journal’s articles are readily accessible to researchers and scholars throughout the global ...and training.” However, realizing this vision in today’s highly interactive, information- saturated, and global environment is tougher than ever...assignment reminders, and learning aids. According to the eLearning Guild, over 30 percent of organizations surveyed currently deliver some amount of

  15. The United States Army Medical Department Journal, January - March 2009

    Science.gov (United States)

    2009-03-01

    discovered while an assessor is in the food establishment, so the assessor should remain flexible, observant, and receptive . While assessing a food...space. Kuwait had an acceptable facility which included a designated veterinary trailer with a storage area, as well as a treatment room/laboratory...Veterinary Corps officer.7ŕ𔃽" Although historically inaccurate, the 1963 movie entitled "Miracle of the White Stallions" was loosely based on

  16. The United States Army Medical Department Journal. October - December 2012

    Science.gov (United States)

    2012-12-01

    designer drugs.4 Spice is used as an alternative to marijuana because of the similarity of their “high” effects. Depending on the synthetic compound in...Poison Control Centers (bath salts data, synthetic marijuana data); http://www.aapcc.org/dnn/NewsandEvents/NewsMediaResources.aspx, accessed June 11...A review of herbal marijuana 1. alternatives (K2, spice), synthetic cathinones (bath salts), kratom, Salvia divinorum, methoxetamine, and pipera

  17. The United States Army Medical Department Journal. July - September 2011

    Science.gov (United States)

    2011-09-01

    wide.3 Ships of the US Maritime Prepositioning Force regularly anchor at Saipan,4 and there are US military training sites on the island. It is a... ankle sprains) and overuse (eg, anterior knee pain, medial tibial stress syndrome, and plantar fasciitis), accounted for over 4.8 million of the...patients with PFPS. Gastrocnemius and soleus muscle flexibility are important to ankle joint range of motion. Using ankle dorsiflexion as a measure for

  18. Establishing a clinical pharmacy technician at a United States Army military treatment facility.

    Science.gov (United States)

    Evans, Jennifer L; Gladd, Ellen M; Gonzalez, Alicia C; Tranam, Salman; Larrabee, Joni M; Lipphardt, Sarah E; Chen, Tina T; Ronn, Michael D; Spain, John

    2016-01-01

    To describe the creation of a clinical pharmacy technician position within the U.S. Army and to identify the personal skills and characteristics required to meet the demands of this role. An outpatient military treatment facility located in Maryland. The clinical pharmacy technician position was designed to support clinical pharmacy services within a patient-centered medical home. Funding and a position description were established to hire a clinical pharmacy technician. Expected duties included administrative (45%), patient education (30%), and dispensing (25%). Local policy, in accordance with federal law and U.S. Army regulations, was developed to define the expanded technician responsibility to deliver patient medication education. In the initial 3 months, the clinical pharmacy technician spent 24 hours per week on clinical activities, affording an additional 10-15 hours per week for clinical pharmacists to provide patient care. Completed consults increased from 41% to 56%, and patient-pharmacist encounters increased from 240 to 290 per month. The technician, acting as a clinical pharmacist extender, also completed an average of 90 patient encounters independently each month. As a result of these improvements, the decision was made to hire a second technician. Currently, the technicians spend 28-40 hours per week on clinical activities, offsetting an average of 26 hours per week for the clinical pharmacists. A patient-centered medical home clinical pharmacy technician can reduce the administrative workload for clinical pharmacists, improve their efficiency, and enhance the use of clinical pharmacy services. Several characteristics, particularly medication knowledge, make pharmacy technicians particularly suited for this role. The results from the implementation of a clinical pharmacy technician at this military treatment facility resulted in an Army-wide expansion of the position and suggested applicability in other practice sites, particularly in federal

  19. Graphical User Interface for a Remote Medical Monitoring System: U.S. Army Medic Recommendations

    Science.gov (United States)

    2009-11-01

    screens. The majority of medics (70%) also wanted a name lis! screen that, when tapped , would go to an individual patient screen. In the name list...button has been pushed. Tapping on thaI button would prompt the user to enter the password. Tapping on the light button would illuminate the screen...a summary of current local weather conditions would be dis- played in the lower ! eft of the screen. In the lower right of this map screen is

  20. A Statistical Analysis of the Relationship of Distance and Mode of Transportation on Length of Stay at Brooke Army Medical Center

    National Research Council Canada - National Science Library

    Hagen, John

    1997-01-01

    .... Transportation Command's (TRANSCOM) aeromedical evacuation system, to determine their influence on length of hospital stay at Brooke Army Medical Center in FY 1996 in order to better understand the irnpact these patients have on utilization management...

  1. Army Healthcare Enterprise Management System

    National Research Council Canada - National Science Library

    2001-01-01

    ... to buy the Enterprise Management System. The Information Technology Business Center provides information technology services to Fort Sam Houston tenants which include the Army Medical Command and the Army Medical Department Center and School...

  2. The Central Simulation Committee (CSC): a model for centralization and standardization of simulation-based medical education in the U.S. Army healthcare system.

    Science.gov (United States)

    Deering, Shad; Sawyer, Taylor; Mikita, Jeffrey; Maurer, Douglas; Roth, Bernard J

    2012-07-01

    In this report, we describe the organizational framework, operations and current status of the Central Simulation Committee (CSC). The CSC was established in 2007 with the goals of standardizing simulation-based training in Army graduate medical education programs, assisting in redeployment training of physicians returning from war, and improving patient safety within the Army Medical Department. Presently, the CSC oversees 10 Simulation Centers, controls over 21,000 sq ft of simulation center space, and provides specialty-specific training in 14 medical specialties. In the past 2 years, CSC Simulation Centers have trained over 50,000 Army medical students, residents, physician assistants, nurses, Soldiers and DoD civilian medical personnel. We hope this report provides simulation educators within the military, and our civilian simulation colleagues, with insight into the workings of our organization and provides an example of centralized support and oversight of simulation-based medical education.

  3. Evaluation of the Low Back Pain Practice Guideline Implementation in the Army Medical Department

    National Research Council Canada - National Science Library

    Farley, Donna

    2004-01-01

    ... clinical care practices across the Army health system. This report presents the final results of the evaluation that RAND conducted as part of the demonstration for the low back practice guideline, which was conducted in 1999 and 2000...

  4. Median and ulnar neuropathies in U.S. Army Medical Command Band members.

    Science.gov (United States)

    Shaffer, Scott W; Koreerat, Nicholas R; Gordon, Lindsay B; Santillo, Douglas R; Moore, Josef H; Greathouse, David G

    2013-12-01

    Musicians have been reported as having a high prevalence of upper-extremity musculoskeletal disorders, including carpal tunnel syndrome. The purpose of this study was to determine the presence of median and ulnar neuropathies in U.S. Army Medical Command (MEDCOM) Band members at Fort Sam Houston, Texas. Thirty-five MEDCOM Band members (30 males, 5 females) volunteered to participate. There were 33 right-handed musicians, and the mean length of time in the MEDCOM Band was 12.2 yrs (range, 1-30 yrs). Subjects completed a history form, were interviewed, and underwent a physical examination of the cervical spine and bilateral upper extremities. Nerve conduction studies of the bilateral median and ulnar nerves were performed. Electrophysiological variables served as the reference standard for median and ulnar neuropathy and included distal sensory latencies, distal motor latencies, amplitudes, conduction velocities, and comparison study latencies. Ten of the 35 subjects (29%) presented with abnormal electrophysiologic values suggestive of an upper extremity mononeuropathy. Nine of the subjects had abnormal median nerve electrophysiologic values at or distal to the wrist; 2 had bilateral abnormal values. One had an abnormal ulnar nerve electrophysiologic assessment at the elbow. Nine of these 10 subjects had clinical examination findings consistent with the electrophysiological findings. The prevalence of mononeuropathies in this sample of band members is similar to that found in previous research involving civilian musicians (20-36%) and far exceeds that reported in the general population. Prospective research investigating screening, examination items, and injury prevention measures in musicians appears to be warranted.

  5. [Medical service of Russian Army in the First World War 1914-1918 (to the 95th anniversary of the beginning of war)].

    Science.gov (United States)

    Korniushko, I G; Gladkikh, P F; Loktev, A E

    2009-08-01

    During the First World War 1914-1918 Russian Army hadn't a united medical service, military-medical affair was diluted in multiple governances. Evacuation of wounded and ill persons was an affair of Evacuation Governance of Main Governance the General Staff. Process of treatment in field and stationary medical formations was administered by sanitarium chiefs of armies and theaters of operation, bureaucrats of Russian Red Cross Society, Russian Union of Cities and Territorial Union. Supply by medical property, accounting and arrangement of medical staff was administered by Main Military-Sanitarium Governance, supply by sanitarium-household property--by Main Indent Governance, health resort affair--by Governance of Supreme chief of sanitarium and evacuation part in Empire of prince Ol'denburgskiy P.A. On the base of different sources were characterized casualty of Russian Army during the war.

  6. Missing in Action: African American Combat Arms Officers in the United States Army

    National Research Council Canada - National Science Library

    Doward, Jr, Oscar W

    2008-01-01

    .... The monograph examines the African American Army officer's service during each period of major conflict over the last 100 years to explain why modern-day African American Army officers are prone...

  7. 75 FR 22756 - Federal Advisory Committee; United States Army Science Board; Charter Renewal

    Science.gov (United States)

    2010-04-30

    ... relating to the Army's scientific, technical, manufacturing, acquisition, logistics, and business... the following disciplines: Science, technology, manufacturing, acquisition, logistics, business...; the Assistant Secretary of the Army for Acquisition, Logistics and Technology; and as requested, other...

  8. U.S. Army Medical Department Journal (January-March 2004)

    Science.gov (United States)

    2004-03-01

    the Center’s workforce emphasizes flexibility, adaptability, and a multi- disciplined approach in providing technical products to its Army...grant award to Slab DSP to develop new integrated circuit. Press release. Auckland , New Zealand: PHITEK Systems; June 4, 2002. 11. Sharp B

  9. Response to work transitions by United States Army personnel: effects of self-esteem, self-efficacy, and career resilience.

    Science.gov (United States)

    Gowan, M A; Craft, S L; Zimmermann, R A

    2000-06-01

    This paper examined association of self-esteem, self-efficacy, and career resilience with the responses of 171 United States Army personnel making the transition to civilian jobs. Specifically, the study addresses whether personality traits are related to the appraisal of the transition from Army to civilian life and to how individuals plan to manage the transition to yield employment success. Self-esteem, self-efficacy, and career resilience were the personality variables examined. Only self-esteem and career resilience were related to harm appraisals of the transition. None of the personality variables were related to use of coping strategies. Limitations of the study and suggestions for research are provided.

  10. 75 FR 2463 - Continuing Contract for Civil Works Project Managed by the United States Army Corps of Engineers...

    Science.gov (United States)

    2010-01-15

    ... be considered a breach of contract and shall not entitle the Contractor to a price adjustment under... constitute a breach of this contract and shall not entitle the Contractor to any price adjustment under the... Continuing Contract for Civil Works Project Managed by the United States Army Corps of Engineers Clauses...

  11. Determining Market Categorization of United States Zip Codes for Purposes of Army Recruiting

    Science.gov (United States)

    2016-06-01

    Army uses commercial market segmentation data to analyze markets and past accessions to assign recruiters and quotas to maximize production. We use...Army Recruiting Command to rely on proprietary data with 66 market segments per ZIP code for market analysis and predicting recruiting potential...have different densities of potential recruits; the Army uses commercial market segmentation data to analyze markets and past accessions to assign

  12. U.S. Army Medical Command Injury Summary, Active Duty Personnel, 2014

    Science.gov (United States)

    2016-07-01

    Michelle Canham-Chervak 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Army...Public Health Center (Provisional), Aberdeen Proving Ground, Maryland 21010-5403 8. PERFORMING ORGANIZATION REPORT NUMBER S.0023116-16 9. SPONSORING... softball bases (Pollack et al., 2005) • Mouthguards for football, basketball (Knapik et al., 2007) • Protective eyewear (Cass, 2012; Goldstein and Wee

  13. U.S. Army Medical Department Journal, January-March 2007

    Science.gov (United States)

    2007-03-01

    events thundered onward. The term “Reconstruction Aides” was changed in 1926 to “ physiotherapy ” and “occupational therapy.”6 Only a few years later...The training of occupational therapists witnessed a similar buildup with the start of a student occupational therapy program in 1962.7 The decade...Soldiers was paramount.15 POST-VIETNAM In the year after the fall of Saigon, the Army Student Occupational Therapy program also ended due to the need

  14. 32 CFR 621.1 - Loan of Army/Defense Logistics Agency (DLA) owned property for use at national and State...

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Loan of Army/Defense Logistics Agency (DLA) owned... of Army/Defense Logistics Agency (DLA) owned property for use at national and State conventions. (a... and facilities on loan. (iv) Costs of packaging, packing, transportation and handling from source of...

  15. The United States Army Medical Department Journal. The United States Army Dental Corps: A Century of Commitment, Service, and Care

    Science.gov (United States)

    2011-03-01

    previously treated 888 18.27 Necrotic pulp 618 12.72 Periaradicular abscess 578 11.89 Anatomic space infection 558 11.48 Other 505 10.39...Bleeding 931 42.92 Other 747 34.44 Necrotizing Ulcerative Gingivitis 420 19.36 Ailing/Failing Implant 36 1.66 Periodontal Abscess 25 1.15 Anatomic...increased risk of coronary heart disease, stroke, pulmonary embolism, and breast cancer.15 Postmenopausal women with history of hysterectomy taking

  16. United States Army Officer Development And Procurement During World War I and II: How The Army Grew Its Officer Corps

    Science.gov (United States)

    2016-05-26

    rifle marksmanship, the use of artillery, cavalry, medical, and signal. The camp’s series of challenges culminated with a sixty- five mile hike . Upon...camps. I believe the students attending will derive not only a great deal of physical benefit from the healthful, open-air life, but also they will... benefit from discipline, habits of regularity and the knowledge of personal and camp sanitation which the experience in camp will give them. The camps

  17. Organizational Analysis of the United States Army Contracting Command-Kuwait

    National Research Council Canada - National Science Library

    Orr, Kristine R

    2008-01-01

    This study of the U.S. Army Contracting Command - Kuwait (USACC-KU) used an organizational systems framework to analyze factors related to strategy structure, processes and results experienced at USACC-KU during 2006-2008...

  18. 2005 United States Army Corps of Engineers (USACE) Post-Hurricane Katrina Levee Surveys

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — These topographic data were collected for the U.S. Army Corps of Engineers by a helicopter-mounted LiDAR sensor over the New Orleans Hurricane Protection Levee...

  19. The United States Army’s Full-Spectrum Training Strategy Challenge

    Science.gov (United States)

    2012-05-17

    48 Ibid; Jeremy Pressman , “The Second Intifada: Background and Causes of Israeli-Palestinian...2007. Odierno, Raymond, “Initial Thoughts”, www.us.army.ml, 8 Sep 2011, (accessed 8 September, 2011). Pressman , Jeremy, The Second Intifada

  20. POLLUTION PREVENTION OPPORTUNITY ASSESSMENT UNITED STATES ARMY CORPS OF ENGINEERS PITTSBURGH ENGINEER WAREHOUSE AND REPAIR STATION AND EMSWORTH LOCKS AND DAMS PITTSBURGH, PENNSYLVANIA

    Science.gov (United States)

    This report summarizes work conducted at the United States Army Corps of Engineers (USACE) Pittsburgh Engineering Warehouse and Repair Station (PEWARS) and Emsworth Locks and Dams in Pittsburgh, Pennsylvania under the U.S. Environmental Protection Agency's (EPA's) Waste Reduction...

  1. A Content Analysis of Army Newspapers Based in the Continental United States (CONUS) to Determine Editorial Differences Between Military and Civilian Editors

    National Research Council Canada - National Science Library

    Swiergosz, Paul

    1998-01-01

    A content analysis of four civilian enterprise Army newspapers published in the United States was conducted to determine if editorial differences in content and tone existed between military and civilian editors...

  2. A History of the Louisville District, Corps of Engineers United States Army, 1970-1983

    Science.gov (United States)

    1984-01-01

    on the project in 1954, and in 1962 Secretary of Army Elvis Stahr, Jr., recom- mended the project to Congress. Mter Con- gress approved the project...their opinions on the merits of the gorge and the project. One was former Secretary of the Army Elvis Stahr, who had become president of the National...Rick Garmom , Bob Weido, Frank DeGott, Kenny Hudston. Top pict.ure from left, front row: Eugene Presley , Bill Kreisle, Herschel St. Ledger, Farrel

  3. Analysis of publications in Medical Journal of Chinese People’s Liberation Army during 2006 to 2010

    Directory of Open Access Journals (Sweden)

    Dong-ping ZHU

    2011-07-01

    Full Text Available Objective To analyze the characteristics of articles published in the Medical Journal of Chinese People’s Liberation Army(MJCPLA from year 2006 to 2010,so as to provide some beneficial references for further advance of the journal.Methods Each bibliometrics index of MJCPLA during 2006 to 2010 was analyzed with literature metrology.Results A total of 2442 articles were published in 60 issues over 5 years characterizing reasonable column setting,a high proportion,accounting for 43.5%,of fund-supported researches,with coauthor paper accounting for 95.6% and coauthor degree at 5.20.The articles were provided by authors widely distributed from 31 provinces,autonomous regions,mulicipality,and Macao Special Administrative Region,America,Ukraine,German and other overseas areas,implying the author ranks are of tremendous strength,and the readers group is of steady.Conclusion For the high quality of materials being published,the MJCPLA has a claim to one of the most important military medical information sources and an important core journal in medical field.

  4. U.S. Army Medical Department Journal, April-June 2008

    Science.gov (United States)

    2008-06-01

    IGR), against dengue vector mosquitoes. In the Peruvian Amazon community at Iquitos, Stancil42 (Naval Medical Research Center Detachment, Peru ...Research Unit- Kenya, Nairobi; Naval Medical Research Center Detachment, Lima, Peru ; Naval Medical Research Unit-2, Jakarta, Indonesia; and the Naval...These projects have revealed that sand flies often emerge from the soil beneath tents and camps. In an effort to prevent sand flies breeding in rodent

  5. Medical Statistics in World War II (Medical Department, United States Army)

    Science.gov (United States)

    1975-01-01

    Glaucoma -.----------------------- .............------------- 1,198 140 438 800 R99 09 Ophthalmoplegls -------------------------.----------------- It0...03111 1.’,a .g. 0." ’.u11 O.121 11.10 (1.21 0.131 5 A.M3i 5.41 6.71 7.46 7.117 Ahm 4,111 11.54 C .31 l .... (i0.111 1.311 -0 1O.O 917 0.04 0.03 11.111...27 lalahmanlumi hkalmmmar) ............................ . . . .24 IIIM ~ ahM *Mnlt.IM &SR OuV. l L

  6. Integrating Medical Supply as Part of the Army's Single Integrated Materiel Manager Concept--Why or why Not?

    National Research Council Canada - National Science Library

    Baxter, Shelia

    1998-01-01

    .... To achieve the goal of seamless logistics integration capabilities, one concept is to establish a Single Integrated Materiel Manager for the Army which envisions integrating all such functions...

  7. Energy Survey of Eisenhower Army Medical Center, Fort Gordon, Augusta, Georgia. Volume 2. Appendices

    National Research Council Canada - National Science Library

    1996-01-01

    ...) including low cost/no cost ECO's and perform complete evaluations of each. Energy equipment replacement projects already underway, approved, or planned by the Medical Center staff will be factored into the evaluations...

  8. U.S. Army Medical Department Journal (January-March 2003)

    National Research Council Canada - National Science Library

    Porr, Darrel R; Melanson, Mark A; Winstead, , Alison D; Zolman, Ryan P; Moore, Christopher J; Gbur, Jr., Lester W. Grau ;Charles J; Yarvis, Clint Schreckhise ;Jeffrey; Bordnick, Patrick; Jones, Timothy K; Austerman, Wayne R

    2003-01-01

    .... "Ground Evacuation in the Republic of Korea," by CPT Christopher J. Moore, MS, USA, outlines the medical evacuation system in South Korea and the difficulties that terrain, weather, and overcrowded highways may pose in the event of hostilities...

  9. "An army of reformed drunkards and clergymen": the medicalization of habitual drunkenness, 1857-1910.

    Science.gov (United States)

    Chavigny, Katherine A

    2014-07-01

    Historians have recognized that men with drinking problems were not simply the passive subjects of medical reform and urban social control in Gilded Age and Progressive Era America but also actively shaped the partial medicalization of habitual drunkenness. The role played by evangelical religion in constituting their agency and in the historical process of medicalization has not been adequately explored, however. A post-Civil War evangelical reform culture supported institutions that treated inebriates along voluntary, religious lines and lionized former drunkards who publicly promoted a spiritual cure for habitual drunkenness. This article documents the historical development and characteristic practices of this reform culture, the voluntarist treatment institutions associated with it, and the hostile reaction that developed among medical reformers who sought to treat intemperance as a disease called inebriety. Those physicians' attempts to promote therapeutic coercion for inebriates as medical orthodoxy and to deprive voluntarist institutions of public recognition failed, as did their efforts to characterize reformed drunkards who endorsed voluntary cures as suffering from delusions arising from their disease. Instead, evangelical traditions continued to empower reformed drunkards to publicize their own views on their malady which laid the groundwork for continued public interest in alcoholics' personal narratives in the twentieth century. Meanwhile, institutions that accommodated inebriates' voluntarist preferences proliferated after 1890, marginalizing the medical inebriety movement and its coercive therapeutics. © The Author 2013. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  10. Futures Seminar: The United States Army in 2025 and Beyond. A Compendium of U.S. Army War College Student Papers. Volume 1

    Science.gov (United States)

    2014-06-01

    Beyond.A Compendium of U.S. Army War College Student Papers. Volume 1 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d...is expected to result in considerable cost savings due to use of existing 31. Edward C. Cardon , “Moving to the Future,” Army Technology 1, iss. 2

  11. Air Weather Service Support to the United States Army Tet and the Decade After

    Science.gov (United States)

    1979-08-01

    Emdo API Scott API Virginia Gem’Jew Alke ltnl Provide or Provides or himods or Ftevides or Provde o oranges for anugu for eworgss for elsgsfor oerr’s...confessed that it was a rein- carnation , really, a realization among Army commanders reborn with each war but buried during peace- Cot Edwin E. Carnel time

  12. Pornography and the United States Army: Ethical Considerations and Policy Implications

    Science.gov (United States)

    1991-07-12

    21bid, 9. 2 ethical concepts can helpfully inform Army ethics, values, and practices . Nevertheless, potent non-theological arguments against...prostitutes may, in fact, be pornographic, but the term applies to a wider spectrum of sexual description, explicitness, and practice . Depending on...may depict heterosexual activity, homosexual activity, child/adult sexual activity, bestiality, masturbation , sado-masochism, or other sexual

  13. 76 FR 66282 - Army Educational Advisory Committee

    Science.gov (United States)

    2011-10-26

    ... Committee: U.S. Army War College Subcommittee of the Army Education Advisory Committee. Dates of Meeting: November 15, 2011. Place of Meeting: U.S. Army War College, 122 Forbes Avenue, Carlisle, PA, Command... issues and matters related to the continued growth and development of the United States Army War College...

  14. 76 FR 72914 - Army Educational Advisory Committee

    Science.gov (United States)

    2011-11-28

    ...: U.S. Army War College Subcommittee of the Army Education Advisory Committee. Dates of Meeting: December 14, 2011. Place of Meeting: U.S. Army War College, 122 Forbes Avenue, Carlisle, PA, Command... issues and matters related to the continued growth and development of the United States Army War College...

  15. A Policy Analysis of U.S. Army Professional Filler System (PROFIS) Sourcing Management at the Regional Medical Command Level in Support of an Expeditionary Army at War

    Science.gov (United States)

    2005-04-29

    many personnel had little knowledge or understanding of their wartime units and jobs and met for the very first time when they arrived at the...this handbook useful in teaching an undergraduate introduction to public policy and for executive education groups" (Bardach, 1996, Foreword,). The...FY04 Budget ($M) (includes $76.8 GWOT) D...cM F F A 47% Percent Residency wf, 9.. Ft . TX Ci 0 Programs of Army Total El P-.TX GPk * ft C.- Cb, X PROFIS

  16. Battlefield Tourniquets: Lessons Learned in Moving Current Care Toward Best Care in an Army Medical Department at War.

    Science.gov (United States)

    Kragh, John F; Dubick, Michael A

    2016-01-01

    Bleeding prevention and control by tourniquet use by out-of-hospital caregivers is a major breakthrough in military medicine of current wars. The present review documents developments in tourniquet practices since 2001 among the US military services for aid in improving doctrine, policy, and especially care in wars to come. Tourniquets are an adjunct for resuscitation in self-care and buddy aid and today are issued to all military servicepersons who deploy into a combat zone. In the US Army, virtually every Soldier is trained in first aid tourniquet use; since 2009 they are instructed early and often to use them early and often. Despite substantial knowledge gains among the services in tourniquet use and resulting improvements in casualty survival, current evidence shows persistent difficulties in achieving best care with tourniquet use for individual trauma patients. Nevertheless, contemporary tourniquet use incorporates key lessons learned over the last 14 years of war that include: (1) tourniquet use reliably stops bleeding from limb wounds and prevents mortality in prehospital settings; and (2) brief tourniquet use appears to be safe. These 2 lessons have become so evident that civilian emergency medical systems have begun using them, albeit unevenly. Collection and interpretation of data of casualties with tourniquet use have showed that such intervention has lifesaving benefit through 2 mechanisms: control of both ongoing hemorrhage and shock severity. The next generation of interventions in bleeding control involves developing the skill sets, education, and standards of tourniquet users which may improve hemorrhage control in wars to come.

  17. A 12-month descriptive analysis of emergency intubations at Brooke Army Medical Center: a National Emergency Airway Registry study.

    Science.gov (United States)

    April, Michael D; Schauer, Steven G; Brown Rd, Calvin A; Ng, Patrick C; Fernandez, Jessie; Fantegrossi, Andrea E; Maddry, Joseph K; Summers, Shane; Sessions, Daniel J; Barnwell, Robert M; Antonacci, Mark

    2017-01-01

    Emergency airway management is a critical skill for military healthcare providers. Our goal was to describe the Emergency Department (ED) intubations at Brooke Army Medical Center (BAMC) over a 12-month period. Physicians performing endotracheal intubations in the BAMC ED complete data collection forms for each intubation event as part of the National Emergency Airway Registry, including patient demographics, intubation techniques, success and failure rates, adverse events, and patient disposition. We cross-referenced these forms against the numbers of intubation events reported in the ED nursing daily reports to ensure capture of all intubations. Providers completed forms for every intubation within 6 weeks of the procedure. We analyzed data from March 28, 2016, to March 27, 2017. During the study period, providers performed 259 intubations in the BAMC ED. Reasons for intubation were related to trauma for 184 patients (71.0%) and medical conditions for 75 patients (29.0%). Overall, first-attempt success was 83.0%. Emergency medicine residents performed a majority of first attempts (95.0%). Most common devices chosen on first attempt were a video laryngoscope for 143 patients (55.2%) and a direct laryngoscope for 115 patients (44.4%). One patient underwent cricothyrotomy. The 2 most common induction agents were ketamine (59.8%; 95% CI, 55.2%-67.4%) and etomidate (19.3%; 95% CI, 14.7%-24.7%). The most common neuromuscular blocking agents were rocuronium (62.9%; 95% CI, 56.7%-68.8%) and succinylcholine (18.9%; 95% CI, 14.3%-24.2%). In the BAMC ED, emergency intubation most commonly occurred for trauma indications using video laryngoscopy with a high first-pass success.

  18. US Army Medical Materiel development activity, 1987 annual report. Progress report, 1 January-31 December 1987

    Energy Technology Data Exchange (ETDEWEB)

    Pedersen, C.E.

    1988-05-06

    Information relating to accomplishments in military medicine in three areas is presented. The Project Management Support Division (PMSD) provides centralized administrative, financial management, contracting, and logistical support to the Project Managers and staff. The Biological Systems Project Management Division manages the development and acquisition of biological products to prevent casualties or loss of soldier effectiveness due to disease. These diseases may be naturally acquired (close contact, unsanitary conditions, contaminated environment, biting insects), or delivered deliberately (aerosols). Product Officers exploit domestic and foreign medical technology to remedy deficiencies identified by the Combat Developer and monitor research projects for their application to disease protective measures. The Pharmaceutical Systems Project Management Division centrally manages the development and the initial production of pharmaceutical products (antidotes and drugs), related drug delivery systems (autoinjectors and transdermal patches), and decontamination products. These products are fielded as preventive, protective, and therapeutic modalities for use against chemical and biological warfare threats, certain endemic diseases, and the treatment of combat casualties. The Applied Medical Systems Project Management Division is a multidisciplinary team with broad mission responsibilities to centrally manage the development and initial production of applied medical products, related diagnostic equipment, optical corrective devices for protective masks, and pesticide delivery systems.

  19. Practice on medical support in dealing with abandoned chemical weapons by Japanese army in China

    Directory of Open Access Journals (Sweden)

    Liu LIU

    2013-04-01

    Full Text Available Japanese abandoned chemical weapons (JACWs are a momentous and eventful historical issue for both China and Japan. Large quantities of chemical weapons abandoned by the Japanese invaders still remain on Chinese soil after 1945 when Japanese invaders were defeated and surrendered. Up to date, JACWs have been found in 19 provinces (cities or districts of mainland China. The types of JACWs include chemical bombs, chemical aerial bombs, gas cylinders and loose packed barrels. The types of toxic agents include mustard gas, irritant agents, choking agents, systemic poisoning agents and etc. In order to eliminate JACWs to reduce injuries produced by toxic agents, Chinese government, in cooperation with Japanese government, organized a special troop to search, excavate, retrieve, and destroy JACWs. Up to date, about 50,000 pieces of poisonous chemical had retrieved and destroyed. The first operation was officially begun in Nanjing in October 2010. The main points of medical support on the operation of destroying JACWs include proper treatment of the newly discovered patients caused by JACWs, preparedness for handling the emergency medical rescue, and to actively provide routine medical support for JACWs operation field.

  20. History of the United States Army Engineer District Far East 1957 to 1975

    Science.gov (United States)

    1976-01-01

    property to the Ministry of De- fense was growing among Korean land owners for several reasons. Compensation monies from the ROK were usu- ally tardy or...work in Japan, Korea, Taiwan, the Ryukyu Islands and the Marshall Islands to the Army Corps of Engineers, and that in the Philippine Islands... tardiness in ordering materials from the US, Mitsubishi finished the center in December 1967 in- stead of September as planned. The US Government

  1. Boards Versus Bureaucracies: Field Grade Officer Education in the United States Army, 1946-1985

    Science.gov (United States)

    2013-05-24

    Army Officer Corps. iii ACKNOWLEDGMENTS I would like to thank my wife Amanda and kids Sidney Ruth, Edward Elijah, Kendall Leanne, and Gage...days a week, in order to coincide with basic pedagogical principles.31 This recommendation was a realization by the board, after consulting...4–5. While the board does site “basic pedagogical principles” and “Education specialists” in discussing the need to take class length and duration

  2. Satellite and Ground Communication Systems: Space and Electronic Warfare Threats to the United States Army

    Science.gov (United States)

    2017-02-01

    as if SATCOM is guaranteed. This complacency is accompanied by the procurement of high-data communication and mission command systems that deny...threat. To overcome these significant vulnerabilities, the US Army must procure communications systems that maintain the information high ground, but...precious gift of our freedom.”1 A key element of remaining strong on the ground is maintaining the capability to effectively communicate on the ground. If

  3. Megacities and the United States Army: Preparing for a Complex and Uncertain Future

    Science.gov (United States)

    2014-06-01

    fighting is not, in itself, a new challenge for the Army. From the streets of Aachen to the markets of Baghdad, Soldiers have de- feated enemies who...which if allowed to fester, may build over time, mobilize segments of the popula- tion, and erupt as triggers of instability. ENVIRONMENTAL...cultural institutions, as well as over 51 million do- mestic and foreign tourists each year, agencies that provide services and security within the

  4. Fiscal Year 2014 United States Army Annual Financial Report: Maintaining Readiness Through Fiscal Responsibility

    Science.gov (United States)

    2014-01-01

    citizens at home, to combating insurgents abroad. Providing Advanced Technologies The Army’s Science and Technology (S&T) investments support Army...Construction 29,892,790 33,309,504 (Less: Earned Revenue) $ (14,868,782) $ (14,584,858) Net Cost before Losses/(Gains) from Actuarial Assumption Changes for...Benefits consist of various employee actuarial liabilities not due and payable during the current fiscal year. These liabilities consist primarily

  5. Preparing General Purpose Forces in the United States and British Armies for Counterinsurgent Operations

    Science.gov (United States)

    2010-12-10

    Operations In Iraq: Planning, Combat, And Occupation,” Thomas Ricks’ Fiasco, and reports by Army historian Major Isaiah Wilson, and former CENCTOM J-4...established Multi-National Forces-Iraq, and Lieutenant General Thomas Metz, commander of the Army’s III Corps, assumed the mantle of Multi-National Corps...Donald P. Wright and Colonel Timothy R. Reese or Thomas Ricks’ Fiasco among other books. 18Dr. Carter Malkasian, “Counterinsurgency in Iraq: May 2003

  6. Combat Operations in Mountainous Terrain: Are United States Army Light Infantry Divisions Preparing Properly?

    Science.gov (United States)

    1987-06-05

    Mountain Division, Charles Hauptman, Comeany I. 97th Mountain Infantry Regiment by CPT George Earle, and PFC Hugh Graves (1945), and 10th Mountain...training in this country is believed to depend primarily ’Albert H. Jackman , "The Tenth Mountain Division, A Successful Experiment," The Algine Journal...44-48. Houston, Charles S., Dr. "Altitude Sickness and the Army," 112zard. 2d Qtr 1986: n.p. Jackman , Albert H. "The Tenth Mountain Division, A

  7. Closing the Door Behind You: How the United States Army Conducts Logistical Withdrawals after Lengthy Operations

    Science.gov (United States)

    2013-05-23

    great and MACV decided not to implement the program in total. 13 Lieutenant General Joseph M Heiser , Jr. served as the commander of the 1 st...13 Jeffery Clarke, Advice and Support: The Final Years 1965-1973 (Washington: Department of the Army, 1988), 427-429. 14 Joseph M. Heiser , Vietnam...focused on a redistribution of weapon systems. According to Heiser , The phasedown of U.S. operations in Southeast Asia permitted an accelerated delivery

  8. United States Army Officer Personnel Reforms and the Decline of Rank Flexibility, 1890s-1920s

    Science.gov (United States)

    2014-12-04

    like that displayed by Emory Upton. The system has adopted a bureaucratic comic -point is that despite a vast education , his reliance on rote...Management Policies, 84-85. 41 Todd R. Brereton, Educating the U.S. Army: Arthur Wagner and Reform, 1875-1905 (Lincoln, NE: University of Nebraska...interwa r debate on military reform to efficiency, professionalism, and education .47 The further removed the traditional system

  9. Insider Threat: Preventing Direct Action Attacks Within the United States Army

    Science.gov (United States)

    2017-06-09

    Intelligence Agency, 2012. Joint Chiefs of Staff. Joint Publication (JP) 3-07.2, Antiterrorism. Washington, DC: Government Printing Office, 2010. 81...Federal Bureau of Investigation GEN General (Army rank, O-10) HIPAA Health Insurance Portability and Accountability Act of 1996 INSCOM Intelligence and...commanders, and the intelligence community to prevent insider threats from developing into direct action attacks, this study sought to answer the

  10. Army Technology

    Science.gov (United States)

    2015-02-01

    that allows them to perform applied research under the Institute for Biotechnology research team 1 2 3 20 | ARMY TECHNOLOGY MAGAZINE ...DASA(R&T) Deputy Assistant Secretary of the Army for Research and Technology Download the magazine , view online or read each individual story with...Army photo by Conrad Johnson) Front and back cover designs by Joe Stephens EXECUTIVE DEPUTY TO THE COMMANDING GENERAL Army Technology Magazine is an

  11. U.S. Army Medical Bioengineering Research and Development Laboratory Annual Progress Report FY 1985. Volume 1

    Science.gov (United States)

    1985-10-01

    Dental Corps, Malaysian Armed Forces; MAJ Johan van Geyzel, Malaysian Embassy, Washington, DC 7 March - BG Dato Chen Kwee Fong, Chief of Engineers... Malaysian Armed Forces; MAJ Johan van Geyzel, Malaysian Embassy, MAJ Tairobi bin Abdul Razak, Malaysian Army 2 July - BG William 0. Rodgers, Australian Army...and Diets for Culturing and Testing with Daphnia magna." Paper presented at the Ninth Symposium of Aquatic Toxicology and Environmental Fate sponsored

  12. The Variance between Recommended and Nursing Staff Levels at Womack Army Medical Center

    Science.gov (United States)

    2007-06-07

    undergone multiple advances that WMSN may fail to capture as workload. Beglinger (2006) stated, "Over the course of the past decade, the intensity of... advancement of the nursing profession by promoting high standards of nursing practice, promoting the welfare of nurses in the workplace, and by lobbying...shifts. At the opposite end of the spectrum, the neonatal intensive care unit ( NICU ) operated with 111.5 fewer RNs than was recommended for the

  13. Secular Trends in the Physical Fitness of United States Army Recruits on Entry to Service, 1975-2013.

    Science.gov (United States)

    Knapik, Joseph J; Sharp, Marilyn A; Steelman, Ryan A

    2017-07-01

    Knapik, JJ, Sharp, MA, and Steelman, RA. Secular trends in the physical fitness of United States Army recruits on entry to service, 1975-2013. J Strength Cond Res 31(7): 2030-2052, 2017-A systematic literature search was conducted to identify and analyze articles that reported on physical fitness of new US Army recruits. The National Library of Medicine's PubMed and the Defense Technical Information Center were searched using the keywords (military personnel OR trainee OR recruit OR soldier) AND (physical fitness OR strength OR endurance OR flexibility OR balance OR coordination OR muscle contraction OR running OR exercise OR physical conditioning). Reference lists of obtained articles and contact with authors enhanced the search. Studies were selected if they involved recruits in Basic Combat Training or One-Station Unit Training, provided a quantitative assessment of at least one fitness measure, and the fitness measure(s) were obtained early in training. Average values for each fitness measure were obtained, plotted by the year of data collection, and fitted to linear regression models (fitness measure × year). Fifty-three articles met the review criteria. Regression analysis indicated little temporal change in height, but body weight, body mass index, body fat, and fat-free mass increased over time. Limited V[Combining Dot Above]O2max data suggested no temporal change in male recruits, but those in female recruits V[Combining Dot Above]O2max seem to have slightly improved. Apparently contradicting the V[Combining Dot Above]O2max findings, performance on endurance runs (1- and 2-mile) declined, possibly because of the increase in body weight. Muscular endurance (push-ups, sit-ups) demonstrated little systematic change over time. Limited but multiple measures of muscular strength suggest a temporal increase in strength. Specific components of US Army recruit fitness seem to have changed over time.

  14. Pediatric care as part of the US Army medical mission in the global war on terrorism in Afghanistan and Iraq, December 2001 to December 2004.

    Science.gov (United States)

    Burnett, Mark W; Spinella, Philip C; Azarow, Kenneth S; Callahan, Charles W

    2008-02-01

    Our objective in this report was to describe the epidemiologic features of and workload associated with pediatric admissions to 12 US Army military hospitals deployed to Iraq and Afghanistan. The Patient Administration Systems and Biostatistics Activity database was queried for all local national patients Afghanistan and Iraq between December 2001 and December 2004. Pediatric admissions during the study period were 1012 (4.2%) of 24,227 admissions, occupying 10% of all bed-days. The median length of stay was 4 days (interquartile range: 1-8 days). The largest proportion of children were 11 to 17 years of age (332 of 757 children; 44%), although 45 (6%) of 757 children hospitalized were Afghanistan and Iraq. Military medical planners must continue to improve pediatric medical support, including personnel, equipment, and medications that are necessary to treat children injured during combat operations, as well as those for whom the existing host nation medical infrastructure is unable to provide care.

  15. The United States Army and the Sergeant Problem: The Army’s Systemic Inability to Produce Enough Sergeants and a Proposal to Fix it

    Science.gov (United States)

    2014-04-23

    Intelligence Agency https://www.cia.gov/ library / publications/the-world-factbook/index.html (accessed November 24, 2013); John Pike, "Royal Thai Army" http...accessed November 24, 2013); Barbara LePoer, Thailand: A Country Study, Area Handbook Series (Washington, DC: Library of Congress, 1989), 246, 259...accessed December 22, 2013); "Professional Leadership Programs: Apprenticeship, Internship, and Multicultural Fellowship", http

  16. AMEDD Clinical Psychology Short Course Held in Letterman Army Medical Center, San Francisco, California on 5-9 February 1990

    Science.gov (United States)

    1990-02-02

    hypochondriasis about AIDS (62-67). The medical consequenLes of irrational fears and erroneous beliefs about HIV transmission include (a) shortages of...report emotional or somatic symptoms through cognitive or somatic complaints. The BASIC-BIS approach recommends that psychosomatic states be assessed...via somatic parameters (physical complaints/symptoms, galvanic skin response, skin temperature, heart rate, and electromyogram, etc.) and cognitive

  17. United States Army physical readiness training: rationale and evaluation of the physical training doctrine.

    Science.gov (United States)

    Knapik, Joseph J; Rieger, William; Palkoska, Frank; Van Camp, Steven; Darakjy, Salima

    2009-07-01

    This paper reviews the rationale and evaluations of Physical Readiness Training (PRT), the new U.S. Army physical training doctrine designed to improve soldiers' physical capability for military operations. The purposes of PRT are to improve physical fitness, prevent injuries, progressively train soldiers, and develop soldiers' self-confidence and discipline. The PRT follows the principles of progressive overload, regularity, specificity, precision, variety, and balance. Specificity was achieved by examining the standard list of military (warrior) tasks and determining 1) the physical requirements, 2) the fitness components involved, and 3) the training activities that most likely could improve the military tasks. Injury-prevention features include reduced running mileage, exercise variety (cross-training), and gradual, progressive training. In 3 military field studies, the overall adjusted risk of injury was 1.5-1.8 times higher in groups of soldiers performing traditional military physical training programs when compared with groups using a PRT program. Scores on the Army Physical Fitness Test were similar or higher in groups using PRT programs. In an 8-week laboratory study comparing PRT with a weightlifting/running program, both programs resulted in major improvements in militarily relevant tasks (e.g., 3.2-km walk/run with 32-kg load, 400-m run with 18-kg load, 5- to 30-second rushes to and from prone position, 80-kg casualty drag, obstacle course). When compared with traditional military physical training programs, PRT consistently resulted in fewer injuries and in equal or greater improvements in fitness and military task performance.

  18. The Evolution of Army Leader Development

    Science.gov (United States)

    2013-03-01

    Human Resources Command, OPMD- MFE -I. 4 U.S. Army General Officer Management Office, Army General Officer Roster (Washington, DC, U.S. Department of the...Human Resources Command, Command Management Branch post board data analysis. 15 Data from the United States Army Human Resources Command, OPMD- MFE -A...May 1, 2008), D-1. 25 19 Data from the United States Army Human Resources Command, OPMD- MFE -A, 01 February, 2013. 20 U.S. Joint Chiefs of

  19. The United States Army Battalion Surgeon: Frontline Requirement or Relic of a Bygone Era?

    Science.gov (United States)

    2009-12-11

    Battalion Aid Station BN Battalion BS Battalion Surgeon CBMM Core Battalion Medical Mission DOW Died of Wounds FSO Full Spectrum Operations GMO ...General Medical Officers or GMOs . Young, motivated, and greedy for knowledge, GMOs propelled the field of military medicine forward during...peacetime through analysis, research, and innovation. Their treated populations were small and exceedingly healthy. GMOs had no mission to treat dependents

  20. Medical marijuana: the state of the research.

    Science.gov (United States)

    Mirken, B

    1996-10-18

    Recent raids on buyers' clubs in San Francisco have focused attention on medicinal uses of marijuana. The Clinton administration's policy is that there is no scientific evidence that smoked marijuana is useful in treating pain and nausea in AIDS and cancer patients. However, mainstream medical literature has supported the use of cannabis in managing symptoms of diseases such as glaucoma and multiple sclerosis. Well designed, controlled studies of marijuana are needed to determine the effective medical uses of the drug and break the political stalemate on this issue.

  1. Born Lucky: The Institutional Sources behind the Third United States Army Headquarters’ Procedures in Northwest Europe, 1944-45

    Science.gov (United States)

    2014-05-22

    Engineer Bn., Co. B, 942nd Engineer Avn . Bn., Third US Army, 1 August 1944- 9 May 1945: Vol. I, The Operations, After Action Report (Germany...practitioners are willing to investigate the possibilities. 69 BIBLIOGRAPHY 652nd Engineer Bn., Co. B, 942nd Engineer Avn . Bn. Third US Army, 1 August

  2. Non-medical use of methylphenidate among medical students of the University of the Free State

    OpenAIRE

    Jain, Roshini; Chang, Chiech; Koto, Mpho; Geldenhuys, Alden; Nichol, Richard; Joubert, Gina

    2017-01-01

    Background: Faced with demanding training programmes, medical students may be more prone to use methylphenidate for non-medical purposes in order to improve concentration, alertness and academic performance. Aim: The study aimed to investigate the prevalence of the non-medical use of methylphenidate and knowledge of this drug among undergraduate medical students of the University of the Free State. Methods: This was a cross-sectional study. A self-administered, anonymous questionnaire...

  3. 2007 Army Modernization Plan

    Science.gov (United States)

    2007-03-01

    Additional confi gurations include two NATO li ers with patients and one medical a endant. The aircra has a hoist for use in emergency...including airframes, wiring bundles and hydraulic systems on the remanufactured CH-47Fs are new. Program Status. The Army received its fi rst fully...Expansible Van and the 10T Dump Truck. Another new variant, the FMTV-Load Handling System, is expected to be fi elded in late-2007, initially to medical

  4. Army Hearing Program Status Report Quarter 2 Fiscal Year 2017

    Science.gov (United States)

    2017-07-01

    U.S. Army Publ ic Heal th Center Army Hearing Program Status Report Q2 FY17 Clinical Public Health and Epidemiology Directorate Army... Hearing Division General Medical: 500A July 2017 Approved for public release; distribution unlimited Army Hearing Program Status Report, Q2FY17...56               INTRODUCTION The Army Hearing Program Status Report (AHPSR) is a component of the Public Health

  5. Unprofessional behavior in medical school is associated with subsequent disciplinary action by a state medical board.

    Science.gov (United States)

    Papadakis, Maxine A; Hodgson, Carol S; Teherani, Arianne; Kohatsu, Neal D

    2004-03-01

    To determine if medical students who demonstrate unprofessional behavior in medical school are more likely to have subsequent state board disciplinary action. A case-control study was conducted of all University of California, San Francisco, School of Medicine graduates disciplined by the Medical Board of California from 1990-2000 (68). Control graduates (196) were matched by medical school graduation year and specialty choice. Predictor variables were male gender, undergraduate grade point average, Medical College Admission Test scores, medical school grades, National Board of Medical Examiner Part 1 scores, and negative excerpts describing unprofessional behavior from course evaluation forms, dean's letter of recommendation for residencies, and administrative correspondence. Negative excerpts were scored for severity (Good/Trace versus Concern/Problem/Extreme). The outcome variable was state board disciplinary action. The alumni graduated between 1943 and 1989. Ninety-five percent of the disciplinary actions were for deficiencies in professionalism. The prevalence of Concern/Problem/Extreme excerpts in the cases was 38% and 19% in controls. Logistic regression analysis showed that disciplined physicians were more likely to have Concern/Problem/Extreme excerpts in their medical school file (odds ratio, 2.15; 95% confidence interval, 1.15-4.02; p =.02). The remaining variables were not associated with disciplinary action. Problematic behavior in medical school is associated with subsequent disciplinary action by a state medical board. Professionalism is an essential competency that must be demonstrated for a student to graduate from medical school.

  6. Training programs in medical physics in the United States

    International Nuclear Information System (INIS)

    Lanzl, L.H.

    1977-01-01

    The history of the field of medical physics in the United States is reviewed; the importance of the development of the nuclear reactor and particle accelerators to medical physics is pointed out. Conclusions and recommendations of an IAEA/WHO seminar on the training of medical physicists (in 1972) are given and compared with existing programs in the US. It is concluded that the recommendations of the IAEA are, for the most part, followed. 1 table

  7. Prevalence of Medical Disorders in Pregnancy in Ebonyi State ...

    African Journals Online (AJOL)

    Background: Pregnancy is a physiological state, but when associated with an underlying medical disorder, it has a large ..... bacteriuria in pregnant women versus inpatient treatment ... implication of routine screen for asymptomatic bacteria.

  8. Historical Review: The U.S. Army Medical Belt for Front Line First Aid: A Well-Considered Design That Failed the Medical Department During the First World War.

    Science.gov (United States)

    Wever, Peter C; Korst, Mike B J M; Otte, Maarten

    2016-10-01

    In December 1913, a board of medical officers was appointed to adapt new U.S. Army equipment to the needs of the Hospital Corps. One of the improvements concerned substitution of the satchel-like Hospital Corps pouch used to carry first aid equipment. A waist belt with 10 pockets, known as the medical belt, was devised, and supplied with a tourniquet, adhesive plaster, safety pins, iodine swabs, sublimated gauze, individual dressing packets, gauze bandages, aromatic spirit of ammonia, and common pins. In addition, an ax carrier accommodating a hand ax, a canteen hanger, and a pouch to carry diagnosis tags and instruments were attached to the medical belt. In 1916, the medical belt was incorporated in the field supply tables in the Manual for the Medical Department. The next year, on April 6, 1917, the U.S. Congress declared war on Germany in reaction to sinking of American ships by German submarines. Although the medical belt had given satisfaction in preliminary trials, it did not withstand the test of war. In practice, the medical belt proved a source of dissatisfaction both as to the methods of packing and its contents, which were considered useless in modern warfare. Subsequently, discontinuance of the medical belt was recommended. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  9. Information as Power: An Anthology of Selected United States Army War College Student Papers. Volume 3

    Science.gov (United States)

    2009-01-01

    some efforts along this path recently when it worked with the Walt Disney Company to produce a seven minute film and hundreds of still images... Disney Parks and Resorts Partners with Departments 53. of State and Homeland Security to Welcome International Visitors to the United States

  10. The Lessons of Experience; How Strategic Leaders in the United States Army Develop and Their Lessons Learned

    National Research Council Canada - National Science Library

    Hampson, Michael

    1997-01-01

    ...". The Chief of Staff of the Army has indicated that a "Revolution in Military Affairs" will not occur until we first have a "Revolution in Military Logistics" with involved leadership of all senior commanders...

  11. The Impact of Training and Culture on Leadership Values and Perceptions at the United States Army Engineer School

    National Research Council Canada - National Science Library

    Thomas, Ted

    1998-01-01

    .... The EOBC students are training to assume leadership positions which the EOAC students were in. A random sample of business leaders values were then compared to the Army engineers values to draw cultural leadership...

  12. United States Army Aeromedical Support to African Fliers, 1941 - 1949: The Tuskegee Flight Suregons

    Science.gov (United States)

    2007-04-01

    infectious diseases: upper respiratory infections (URIs), measles, mumps, chicken pox and other contagious diseases, malaria and venereal diseases...as campaigns in Cuba, the Philippines, Mexico and Nicaragua. However, neither the Air Corps nor its Medical Corps officers had much experience in...with live chickens , rabbits, steers and beef cattle from natives. One physician commented that the locals would rather trade for coffee, tea or

  13. Medical Student Education in State Psychiatric Hospitals: A Survey of US State Hospitals.

    Science.gov (United States)

    Nurenberg, Jeffry R; Schleifer, Steven J; Kennedy, Cheryl; Walker, Mary O; Mayerhoff, David

    2016-04-01

    State hospitals may be underutilized in medical education. US state psychiatric hospitals were surveyed on current and potential psychiatry medical student education. A 10-item questionnaire, with multiple response formats, was sent to identified hospitals in late 2012. Ninety-seven of 221 hospitals contacted responded. Fifty-three (55%) reported current medical student education programs, including 27 clinical clerkship rotations. Education and training in other disciplines was prevalent in hospitals both with and without medical students. The large majority of responders expressed enthusiasm about medical education. The most frequent reported barrier to new programs was geographic distance from the school. Limited resources were limiting factors for hospitals with and without current programs. Only a minority of US state hospitals may be involved in medical student education. While barriers such as geographic distance may be difficult to overcome, responses suggest opportunities for expanding medical education in the state psychiatric hospitals.

  14. Nanotechnology Laboratory Collaborates with Army to Develop Botulism Vaccine | FNLCR

    Science.gov (United States)

    The Nanotechnology Characterization Laboratory (NCL) is collaborating with the Army to develop a candidate vaccine against botulism. Under a collaboration agreement between the National Cancer Institute and the U.S. Army Medical Research Institute of

  15. United States Army Rangers in Somalia: An Analysis of Combat Casualties on an Urban Battlefield

    National Research Council Canada - National Science Library

    Mabry, Robert L; Holcomb, John B; Baker, Andrew M; Cloonan, Clifford C; Uhorchak, John M; Perkins, Denver E; Canfield, Anthony J; Hagmann, John H

    2000-01-01

    .... From July 1998 to March 1999 data were collected for a retrospective analysis of all combat casualties sustained by United States military forces in Mogadishu, Somalia, on October 3 and 4, 1993...

  16. [When state authorisation was introduced for medical doctors in Norway].

    Science.gov (United States)

    Haave, Per

    2007-12-13

    In 1927, a law was implemented in Norway that for the first time required medical students to be state authorised before they could practice medicine and use the title medical doctor. The question of authorisation split the professional elite, both the Norwegian Medical Association and the Medical Faculty at the University of Oslo. Those very few members of the professional elite that advocated authorisation did, however, convince the government as well as the parliament that authorisation should be given and recalled by the state. State authorisation was first of all aimed at protecting the medical profession against "unfit" members; it was not a question of monopolising medical work or preventing other groups from working within the healthcare services. To put this into context, one should know that there had been a transition from a bureaucratic to a free labour market and most doctors were no longer engaged by the State, but had to practise in a private market. One feared that this would undermine the doctors' authority and status. In this situation, authorisation by the state was considered necessary to safeguard the public's confidence in doctors and their work.

  17. The United States Army Medical Department Journal. October-December 2007

    Science.gov (United States)

    2007-12-01

    understanding of the concepts of emotional intelligence researched and championed by Daniel Goleman and his associates for the past several decades hold...Agincourt EMOTIONAL INTELLIGENCE – INTRODUCTION READING: Goleman D. What makes a leader? Harv Bus Rev. 2004;82(1):82-91. VIDEO: Gettysburg, Scenes: 8...10; Prisoner delivery/Used by idiots/What we’re fighting for (New Line Cinema, 1993). EMOTIONAL INTELLIGENCE – STYLES OF LEADERSHIP I READING: Goleman

  18. Hand Surgery In World War II. Medical Department, United States Army,

    Science.gov (United States)

    1955-09-01

    Few of these patients presented deep cicatrices , latent infection was minimal, and as a rule the position of function was maintained. DEBARKATION...HOSPITAL 217 Many patients were received with large dorsal cicatrices which, although healed, were unstable. Joints and tendons not directly injured by...burns were frequently damaged by constriction and immobility because of superimposed cicatrices . Joint stiffness was likely to be even more pronounced

  19. Blood Program in World War II. Medical Department, United States Army

    Science.gov (United States)

    1964-01-01

    phase of which was the supply of p asma for the Armed Forces. At the suggestion of Col. (later Brig. Gen.) Charles C. Hillman, MC, Chief, Professional...American Red Cross and the National Foundation for Infantile Paralysis at the cost of processing. THE KOREAN WAR 785 RED BLOOD CELLS During the Korean...after, 725 262-263 National Formulary, 377 Multiple injections of- National Foundation for Infantile Paralysis, blood substitutes, 373 784 bovine

  20. The United States Army Medical Department Journal, July-September 2009

    Science.gov (United States)

    2009-09-01

    including Escherichia coli O157:H7, Salmonella enteritidis, Yersinia pseudotuberculosis, Helicobactor pylori, Vibrio cholerae , and rotavirus,3-11 as shown...of houseflies (Musca domestica) in the transmission of Vibrio cholerae in India. Acta Tropica. 2001;78:31-34. 11. Tan SW, Yap KL, Lee HL. Mechanical...northeastern Mexico . J Am Mosq Control Assoc. 2001;17(2):93-97. 22. Cohnstaedt LW, Gillen JI, Munstermann LE. Light- emitting diode technology improves

  1. Medical Department, United States Army. Wound Ballistics for World War II.

    Science.gov (United States)

    1962-01-01

    Similarly, there were elliptic entry wounds, a result of the " keyholing " effect of bullets hitting with their sides. Table 2 gives a description of small...interlocked welded steel, and their turrets were constructed in one piece in order to give sufficient rigidity. The King Tiger was virtually invulnerable...Reed N. Fitch, T4g. Charles J. Berzenyi, and TIg . Charles R. Restife. The team was organized to participate in the contemplated New Ireland operation

  2. Medical Department, United States Army. Surgery in World War 2. Neurosurgery. Volume 2

    Science.gov (United States)

    1959-01-01

    extension, without respect for such anatonlic barriers as fascia , peri- osteuni, or the serosal mnenmbranes or the capsules of viscera. T[ie appearance...NEUROSURGERY a bilateral atypical plantar response was obtained in complete lesions, in the form of a delayed, weak, slow, vermicular type of plantar ...wound after closure of the dura, and closure was effected in layers. Because this was a re- opened wound, a slip drain was left beneath the fascia for

  3. The United States Army Medical Department Journal. October-December 2011

    Science.gov (United States)

    2011-12-01

    left side of the shield are the 13 stripes of the American Flag. The green staff is the staff of Asclepius (according to Greek mythology , the first...endures but change. When the Greek philosopher Heraclitus penned that contemplation some 2,500 years ago, he undoubtedly had no concept of its

  4. The United States Army Medical Department Journal. July-September 2012

    Science.gov (United States)

    2012-01-01

    efforts have been conducted in endemic countries (Mexico, Guatemala, Brazil, and Peru ) in Central and South America. Surveillance techniques in...Parsippany, NJ Simple Green Concentrate, Sunshine Makers Inc,  Huntington Beach , CA Pine Sol Concentrate (active ingredient 8.7% pine  oil), The...High levels of ambient particulate matter and burn pit smoke can irritate the eyes and respiratory passages at the time of exposure. Air pollution

  5. A Study to Identify the Transitional Training Needs for United States Army Medical Residents

    Science.gov (United States)

    1988-07-29

    Books Kotler , Philip, and Roberta Clarke. Marketing for Health Care Organizations. Englewood Cliffs: Prentice Hall, 1987. Runyon, Richard P., and...8217 and most can benefit from instruction in administrative principles and practices during residency" (444). A focus began to turn toward residency...leadership development, office communi-ations, professional and legal obligations, Rawls 8 and practice marketing . Because these newly trained physicians

  6. The United States Army Medical Department Journal. Force Health Protection April - June 2009

    Science.gov (United States)

    2009-06-01

    that may significantly increase long-term health risks (eg cancer ) through appropriate command channels.I<p6) Likewise, Joint Chiefs of Staff...Control with Glyphosate . Dover, DE: Delaware Division of Fish and Wildlife; 1984. AUTHORS CPT Rufolo is a project officer, Environmental Health

  7. A State Cinematographic Practice in Wartime. The Belgian Army Film Unit 1916-1922

    NARCIS (Netherlands)

    Rochet, Bénédicte

    2016-01-01

    abstractMass media widely disseminated iconographic representations of the war. In this profusion of images, the behaviour of state authorities changed, while they had previously looked down on these two types of media. The alleged power of images led belligerents to take control of war pictures

  8. 15 CFR Notes Applicable to State... - Notes applicable to State of Understanding related to Medical Equipment:

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Notes applicable to State of Understanding related to Medical Equipment: applicable Notes applicable to State of Understanding related to Medical Equipment: Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) BUREAU OF INDUSTRY AND SECURITY,...

  9. Building on a Foundation of Strength: Fiscal Year 2012 United States Army Annual Financial Report

    Science.gov (United States)

    2012-01-01

    Soldiers, and their families, regardless of component or geographic location. The Family Covenant is twofold in purpose: It recognizes the strength...than 103,000 geographically - dispersed AC and RC children, in 40 states who participated in youth outreach activities, camps, and workshops offered...Italy to replace the U.S. Patriot air defense systems, Patriot and Hawk systems in Germany, and Nike Hercules systems in Italy. The North Atlantic

  10. Mass Atrocities Prevention: The Role and Performance of the United States Army

    Science.gov (United States)

    2015-06-12

    advertise the progress made toward our national atrocity prevention strategy, highlights achievements made by the various departments within the...Atrocities, stated specifically “The faculty from the service academies will meet at the U.S. Holocaust Memorial Museum at the end of May 2012 to discuss how...a close working relationship with the US Holocaust Memorial Museum in Washington D.C., and provides educational opportunities for many Cadets to

  11. Army Support to the United States Border Patrol in the 21st Century

    Science.gov (United States)

    2011-05-19

    and Lieutenant Colonel (Promotable) Clifford J. Weinstein (United States Marine Corps). Thank you for letting me travel this important journey and...Operating Bases in Deming and Playas , New Mexico. The 4-14 CAV was preparing for its deployment to the Joint Readiness Training Center (JRTC) at Fort Polk...write strategic policy. Once a suitable bench of key planners comes back to USBP, they can travel throughout the UCs and train other agents across the

  12. EPA and the Army Corps’ Rule to Define Waters of the United States

    Science.gov (United States)

    2017-01-05

    ponds as defined in 40 C.F.R. 423.11(m) which also meet the criteria of this definition) are not waters of the United States.d (1) Waste ...treatment systems, including treatment ponds or lagoons, designed to meet the requirements of the Clean Water Act. (1) Waste treatment systems, including...4) Floodplain: The term floodplain means an area bordering inland or coastal waters that was formed by sediment deposition from such water under

  13. The Ukrainian Crisis and European Security: Implications for the United States and U.S. Army

    Science.gov (United States)

    2015-01-01

    14 Chris Giles and Stefan Wagstyl, “IMF Warns of Third Eurozone Recession Since Finan- cial Crisis,” Financial Times, October 8, 2014. 15 Ulrich...Jones, and Kathrin Hille, “Russian Air Incursions Rattle Baltic States,” Financial Times, September 25, 2014. 25 Andrew Higgins , “Tensions Surge in...Opening of the Munich Security Conference, January 31, 2014. Giles, Chris , and Stefan Wagstyl, “IMF Warns of Third Eurozone Recession Since Financial

  14. 2013 CENTER FOR ARMY LEADERSHIP ANNUAL SURVEY OF ARMY LEADERSHIP (CASAL): MAIN FINDINGS

    Science.gov (United States)

    2014-04-30

    The Center for Army Profession and Ethic (CAPE) has fielded education and training materials (including doctrine, pamphlets , videos, brochures , and...Army Pamphlet (DA PAM) 600-3, Commissioned Officer Development and Career Management, states that a goal of warrant officer training and education... Pamphlet 600-25, U.S. Army noncommissioned officer professional development and career management. Washington, D.C.: Headquarters, Department of the Army

  15. Curb your premium! evaluating state intervention in medical malpractice insurance

    OpenAIRE

    Sofia, AmaralGarcia; Veronica, Grembi

    2011-01-01

    Using data of Italian public healthcare providers over years 2001 through 2008, we evaluate the impact of two policies adopted by Italian Regions (i.e., States) to cope with increasing medical malpractice costs using a Difference-in-Difference specification. We assess the impact of the policies on premiums paid and legal expenditures. The first policy consisted in collecting information and monitoring both compensation requests and any legal action related to a medical malpractice claim again...

  16. Medical tourism services available to residents of the United States.

    Science.gov (United States)

    Alleman, Brandon W; Luger, Tana; Reisinger, Heather Schacht; Martin, Rene; Horowitz, Michael D; Cram, Peter

    2011-05-01

    There are growing reports of United States (US) residents traveling overseas for medical care, but empirical data about medical tourism are limited. To characterize the businesses and business practices of entities promoting medical tourism and the types and costs of procedures being offered. DESIGN, PARTICIPANTS, AND OUTCOMES: Between June and August 2008, we conducted a telephone survey of all businesses engaged in facilitating overseas medical travel for US residents. We collected information from each company including: the number of employees; number of patients referred overseas; medical records security processes; destinations to which patients were referred; treatments offered; treatment costs; and whether patient outcomes were collected. We identified 63 medical tourism companies and 45 completed our survey (71%). Companies had a mean of 9.8 employees and had referred an average of 285 patients overseas (a total of approximately 13,500 patients). 35 (79%) companies reported requiring accreditation of foreign providers, 22 (50%) collected patient outcome data, but only 17 (39%) described formal medical records security policies. The most common destinations were India (23 companies, 55%), Costa Rica (14, 33%), and Thailand (12, 29%). The most common types of care included orthopedics (32 companies, 73%), cardiac care (23, 52%), and cosmetic surgery (29, 66%). 20 companies (44%) offered treatments not approved for use in the US--most commonly stem cell therapy. Average costs for common procedures, CABG ($18,600) and knee arthroplasty ($10,800), were similar to previous reports. The number of Americans traveling overseas for medical care with assistance from medical tourism companies is relatively small. Attention to medical records security and patient outcomes is variable and cost-savings are dependent on US prices. That said, overseas medical care can be a reasonable alternative for price sensitive patients in need of relatively common, elective medical

  17. The Center for the Army Profession and Ethic (CAPE) Annual Survey of the Army Profession (CASAP FY16)

    Science.gov (United States)

    2016-12-30

    incredibly fatiguing which cuts into my personal time to include mental health, physical health, and emotional well-being.” Understand this...April 2016. Its findings contribute to shared understanding of the State of the Army Profession within the Army Culture of Trust -- informing senior...Army leaders regarding the effectiveness of policies and practices intended to inspire and motivate Army professionals to “live by and uphold the Army

  18. Army Solid State Laser Program: Design, Operation, and Mission Analysis for a Heat-Capacity Laser

    International Nuclear Information System (INIS)

    Dane, C B; Flath, L; Rotter, M; Fochs, S; Brase, J; Bretney, K

    2001-01-01

    Solid-state lasers have held great promise for the generation of high-average-power, high-quality output beams for a number of decades. However, the inherent difficulty of scaling the active solid-state gain media while continuing to provide efficient cooling has limited demonstrated powers to 10X the diffraction limit. Challenges posed by optical distortions and depolarization arising from internal temperature gradients in the gain medium of a continuously cooled system are only increased for laser designs that would attempt to deliver the high average power in the form of high energy pulses (>25J) from a single coherent optical aperture. Although demonstrated phase-locking of multiple laser apertures may hold significant promise for the future scaling of solid-state laser systems,1 the continuing need for additional technical development and innovation coupled with the anticipated complexity of these systems effectively limits this approach for near-term multi-kW laser operation outside of a laboratory setting. We have developed and demonstrated a new operational mode for solid-state laser systems in which the cooling of the gain medium is separated in time from the lasing cycle. In ''heat-capacity'' operation, no cooling takes place during lasing. The gain medium is pumped very uniformly and the waste heat from the excitation process is stored in the solid-state gain medium. By depositing the heat on time scales that are short compared to thermal diffusion across the optical aperture, very high average power operation is possible while maintaining low optical distortions. After a lasing cycle, aggressive cooling can then take place in the absence of lasing, limited only by the fracture limit of the solid-state medium. This mode of operation is ideally suited for applications that require 1-30s engagements at very high average power. If necessary, multiple laser apertures can provide continuous operation. Land Combat mission analysis of a stressing air defense

  19. Operationalizing Army Cyber

    Science.gov (United States)

    2013-03-01

    killed just under 3,000 people and cost the U.S. economy somewhere between three and five trillion dollars. The Japanese attacked with a state... economy , and military readiness. The challenge is to design an Army Cyber force that can support the United States Cyber Command (USCYBERCOM) national...still keeps the intelligence and signal functions separate in most units today from battalion to echelon above Corps ( EAC ). There are many past reasons

  20. Variability in United States Allopathic Medical School Tuition.

    Science.gov (United States)

    Gil, Joseph A; Park, Sarah H; Daniels, Alan H

    2015-11-01

    Over the course of the last generation, the cost of medical school attendance and medical student debt has increased drastically. Medical student debt has been reported as high as $350,000, and the Association of American Medical Colleges (AAMC) reports that medical school tuition continues to increase annually. The increasing cost of medical education and associated financial burden is now beginning to deter potential applicants from pursuing a career in medicine. In this study we aimed to assess medical school tuition across the US. We hypothesized that the cost of medical school attendance is variable across all regions of the US, and as a result, the financial burden on medical students is inconsistent. All 123 allopathic medical schools accredited by the AAMC were assessed in this investigation. In-state and out-of-state tuitions for the year 2016 were obtained from U.S. News and World Report. Additionally, medical school size was collected. Regions were defined according to the US Census Bureau definition, with the US being divided into 4 regions: Northeast, Midwest, South, and West. There was no difference in average medical school size among the 4 regions (P > .05). Average in-state tuition was $38,291.56 ± $9801.38 (95% confidence interval [CI], $34,658.07-$41,513.46) in the Midwest, $45,923.04 ± $9178.87 (95% CI, $42,566.28-$49,216.78) in the Northeast, $32,287.78 ± $12,277.53 (95% CI, $28,581.90-$35,378.68) in the South, and $37,745.40 ± $11,414.37 (95% CI, $30,063.28-$40,458.99) in the West. In-state tuition in the South was significantly lower than in the Northeast, West, and Midwest (P tuition in the Northeast was significantly higher than in the South, West, and Midwest (P tuition is $54,104.04 ± $8227.65 (95% CI, $51,207.6-$57,000.39) in the Midwest, $53,180.10 ± $3963.71 (95% CI, $51,761.71-$54,598.50) in the Northeast, $48,191.86 ± $12,578.13 (95% CI, $44,595.84-$51,787.89) in the South, and $52,920.47 ± $7400.83 (95% CI, $49

  1. POLLUTION PREVENTION OPPORTUNITY ASSESSMENT OF THE UNITED STATES ARMY CORPS OF ENGINEERS GARRISON DAM HYDRO- ELECTRIC POWERPLANT - RIVERDALE, NORTH DAKOTA

    Science.gov (United States)

    The report describes the results of pollution prevention opportunity assessments conducted at a representative U.S. Army Corps of Engineers civil works dam and hydroelectric power plant. ecommended methods for reducing pollution resulting primarily from the operation of these fac...

  2. International medical cooperation project for State of Libya using international medical tourism system in Thailand

    OpenAIRE

    奥寺, 敬; 坂本, 美重

    2013-01-01

    International medical cooperation project for State of Libya is reported. The concept of this project is to treat Libyan injured people using international medical tourism system in Thailand. Management of patient, including evaluation, domestic and international transportation arrangement of hospital, is supported by Normeca International Co., Ltd, (Pattaya, Thailand). Treatment of Libyan patient in two international hospitals (Bangpakok 9 Hospital and Navamin 9 Hopsital) in Bangkok was succ...

  3. Medical tourism today: what is the state of existing knowledge?

    Science.gov (United States)

    Hopkins, Laura; Labonté, Ronald; Runnels, Vivien; Packer, Corinne

    2010-07-01

    One manifestation of globalization is medical tourism. As its implications remain largely unknown, we reviewed claimed benefits and risks. Driven by high health-care costs, long waiting periods, or lack of access to new therapies in developed countries, most medical tourists (largely from the United States, Canada, and Western Europe) seek care in Asia and Latin America. Although individual patient risks may be offset by credentialing and sophistication in (some) destination country facilities, lack of benefits to poorer citizens in developing countries offering medical tourism remains a generic equity issue. Data collection, measures, and studies of medical tourism all need to be greatly improved if countries are to assess better both the magnitude and potential health implications of this trade.

  4. Pattern of Medical Admissions at Enugu State University of Science ...

    African Journals Online (AJOL)

    Technology Teaching Hospital, Parklane, Enugu, 2Department of Community Medicine, University of Nigeria Teaching. Hospital, Ituku/Ozalla ... A review of medical admissions into the Enugu State University of Science and Technology. Teaching .... Cord lesions, rabies, Guilliane Barré syndrome, motor neuron disease and ...

  5. Pattern of medical admissions at Enugu state university of science ...

    African Journals Online (AJOL)

    Pattern of medical admissions at Enugu state university of science and technology teaching hospital: a 5 year review. ... The diseases encountered most were diabetes mellitus‑735/3,865 (19.1%), hypertension/congestive cardiac failure‑703/3,865 (18.2%), strokes‑614/3,865 (15.9%) and human immunodeficiency virus ...

  6. Graphical User Interface (GUI) for the Warfighter Physiological Status Monitoring (WPSM) System - U.S. Army Medic Recommendations

    National Research Council Canada - National Science Library

    Tharion, William J; Kaushik, Sangeeta

    2006-01-01

    .... This information is sent wirelessly to a personal digital assistant (PDA) held by the medic. The primary purpose of this study was to determine what features should be included in the graphical user interface (GUI...

  7. An introduction to medical malpractice in the United States.

    Science.gov (United States)

    Bal, B Sonny

    2009-02-01

    Medical malpractice law in the United States is derived from English common law, and was developed by rulings in various state courts. Medical malpractice lawsuits are a relatively common occurrence in the United States. The legal system is designed to encourage extensive discovery and negotiations between adversarial parties with the goal of resolving the dispute without going to jury trial. The injured patient must show that the physician acted negligently in rendering care, and that such negligence resulted in injury. To do so, four legal elements must be proven: (1) a professional duty owed to the patient; (2) breach of such duty; (3) injury caused by the breach; and (4) resulting damages. Money damages, if awarded, typically take into account both actual economic loss and noneconomic loss, such as pain and suffering.

  8. Non-medical use of methylphenidate among medical students of the University of the Free State

    Directory of Open Access Journals (Sweden)

    Roshini Jain

    2017-01-01

    Full Text Available Background: Faced with demanding training programmes, medical students may be more prone to use methylphenidate for non-medical purposes in order to improve concentration, alertness and academic performance. Aim: The study aimed to investigate the prevalence of the non-medical use of methylphenidate and knowledge of this drug among undergraduate medical students of the University of the Free State. Methods: This was a cross-sectional study. A self-administered, anonymous questionnaire was distributed during lectures to all students in the five year groups of the undergraduate medical programme. Results: Of the 643 undergraduate medical students, 541 completed the questionnaire (response rate: 84.1%. Approximately 11.0% of surveyed students were using methylphenidate at the time of the study, of which the majority (67.9% used it for academic purposes and 70.6% received it from a medical health professional. Less than a third of users had been diagnosed with Attention-Deficit/Hyperactivity Disorder. Methylphenidate users’ median knowledge was greater than non-users, and methylphenidate knowledge increased from first-year and second-year students to third-year to fifth-year students. Median knowledge scores per year group ranged from 52.0% to 60.0%. Conclusion: Methylphenidate is mainly used for non-medical purposes by medical students. Students generally have a low level of knowledge on methylphenidate. Specific information on methylphenidate should be included in lectures on stress management and study methods during the course of the medical curriculum.

  9. Army TLS

    Science.gov (United States)

    2014-12-10

    Fast Deflation Device Tether marking Pennants Balloon / Tether marking LED Flashing light Loading Ramps Customized Trailer for transportation and Field...amount of xtra lift that permits the ballon to rise (if Res_Lift = 0, balloon is at equilibrium) RL = NL – Payload – Tether Payload: the weight of...Army TLS The TLS uses tethered aerodynamic blimps and precision-powered winches to loft one or more specialty-designed meteorological payloads that

  10. Development of diode-pumped medical solid-state lasers

    International Nuclear Information System (INIS)

    Kim, Cheol Jung; Kim, Min Suk

    2000-09-01

    Two thirds of human body consists of water and the absorption of laser by water is an important factor in medical laser treatment. Er medical lasers have been used in the dermatology, ophthalmology and dental treatments due to its highest absorption by water. However, 2.9 um Er laser can not be transmitted through an optical fiber. On the other hand, Tm laser can be transmitted through an fiber and also has very high absorption by water. Therefore, Tm lasers are used in ophthalmology and heart treatment wherein the fiber delivery is very important for the treatment. Until now, mainly lamp-pumped solid-state lasers have been used in medical treatments, but the lamp-pumped solid-state lasers are being replaced with the diode-pumped solid-state lasers because the diode-pumped solid-state lasers are more compact and much easier to maintain. Following this trend, end-pumped Er and side-pumped Tm lasers have been developed and the output power of 1 W was obtained for Er and Tm respectively

  11. Development of diode-pumped medical solid-state lasers

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Cheol Jung; Kim, Min Suk

    2000-09-01

    Two thirds of human body consists of water and the absorption of laser by water is an important factor in medical laser treatment. Er medical lasers have been used in the dermatology, ophthalmology and dental treatments due to its highest absorption by water. However, 2.9 um Er laser can not be transmitted through an optical fiber. On the other hand, Tm laser can be transmitted through an fiber and also has very high absorption by water. Therefore, Tm lasers are used in ophthalmology and heart treatment wherein the fiber delivery is very important for the treatment. Until now, mainly lamp-pumped solid-state lasers have been used in medical treatments, but the lamp-pumped solid-state lasers are being replaced with the diode-pumped solid-state lasers because the diode-pumped solid-state lasers are more compact and much easier to maintain. Following this trend, end-pumped Er and side-pumped Tm lasers have been developed and the output power of 1 W was obtained for Er and Tm respectively.

  12. Service to the Nation, Strength for the Future. Fiscal Year 2013 United States Army Annual Financial Report

    Science.gov (United States)

    2013-01-01

    September 25, 2013. Forward-stationed Army forces in the Republic of Korea, Japan, Europe, and elsewhere provide Geographic Combatant Commands with...designs more easily tailored to meet the varied demands of the geographic combatant commanders and reduce the complexities of joint planning and... Nike Hercules systems in Italy. The North Atlantic Treaty Organization (NATO) MEADS Management Agency (NAMEADSMA) is the NATO contracting authority

  13. Could the United States Army Have a Positive Impact on the Insurgency and Counterdrug Problems in Peru

    Science.gov (United States)

    1994-06-03

    CGSC, Fort Leavenworth, KS, Dec. 1990 LAS FUERZAS ARMADAS DEL PERU Y LOS DERECHOS HUMANOS EN LA LUCHA CONTRA EL TERRORISMO (Not Dated), A Booklet...op- erations were countered by the DINCOTE (Direccion Nacional Contra el Terrorismo ), a special antiterrorist branch of the national police. They...branches of our Army could contribute to a joint and combined operation in Peru to defeat Shining Path ele - ments. In addition to this, the reader may

  14. Predicting risk for disciplinary action by a state medical board.

    Science.gov (United States)

    Cardarelli, Roberto; Licciardone, John C; Ramirez, Gilbert

    2004-01-01

    Disciplinary actions taken against physicians in the United States have been increasing over the last decade, yet the factors that place physicians at risk have not been well identified. The objective of this study is to identify predictors of physician disciplinary action. This case-control study used data from the Texas State Board of Medical Examiners from January 1989 through December 1998. Characteristics of disciplined physicians and predictors of disciplinary action for all violations and by type of violation were the main outcome descriptors. Years in practice, black physicians, and osteopathic graduates were positive predictors for disciplinary action. In contrast, female physicians, international medical graduates, and Hispanic and Asian physicians were less likely to receive disciplinary action compared with male, US allopathic, and white physicians, respectively. Most specialists, except psychiatrists and obstetrician-gynecologists, were less likely to be disciplined than were family practitioners, whereas general practitioners were more likely to be disciplined. More studies are needed to corroborate these findings.

  15. Annual Research Progress Report Fiscal Year 1990. Volume 1. Department of Clinical Investigation (Brooke Army Medical Center)

    Science.gov (United States)

    1990-10-01

    granulomE , Arch. Dermatol., (in press). Low, G. J. Ionizing radiation-induced pemphigus. Arch. Dermatol., (in press). McCollough, M. L. Dominant...the severity of their headache on a linear pain scale as well as a verbal scale. Patients were questioned as to whether they had received medications...occurred either by phone or in the Neurologist’s office, using the same verbal and linear scales. Progress: In all, six patients were entered into the

  16. The current state of basic medical education in Israel: implications for a new medical school.

    Science.gov (United States)

    Reis, Shmuel; Borkan, Jeffrey M; Weingarten, Michael

    2009-11-01

    The recent government decision to establish a new medical school, the fifth in Israel, is an opportune moment to reflect on the state of Basic Medical Education (BME) in the country and globally. It provides a rare opportunity for planning an educational agenda tailored to local needs. This article moves from a description of the context of Israeli health care and the medical education system to a short overview of two existing Israeli medical schools where reforms have recently taken place. This is followed by an assessment of Israeli BME and an effort to use the insights from this assessment to inform the fifth medical school blueprint. The fifth medical school presents an opportunity for further curricular reforms and educational innovations. Reforms and innovations include: fostering self-directed professional development methods; emphasis on teaching in the community; use of appropriate educational technology; an emphasis on patient safety and simulation training; promoting the humanities in medicine; and finally the accountability to the community that the graduates will serve.

  17. A Study to Restructure the Marketing Plan at Dwight David Eisenhower Army Medical Center, Fort Gordon, Georgia

    Science.gov (United States)

    1993-02-01

    term plan. The components are the audit, market segmentation, marketing mix , implementation, evaluation and control. Dienemann and Wintz (1992) state...discuss the marketing mix as a separate element in their marketing plan and also use different terminology for two of the P’s. 17 They use in lieu of...definition of the marketing mix under the component of StrateQies does much to explain the four separate elements of the mix but does not state the

  18. State-level medical and absenteeism cost of asthma in the United States.

    Science.gov (United States)

    Nurmagambetov, Tursynbek; Khavjou, Olga; Murphy, Louise; Orenstein, Diane

    2017-05-01

    For medically treated asthma, we estimated prevalence, medical and absenteeism costs, and projected medical costs from 2015 to 2020 for the entire population and separately for children in the 50 US states and District of Columbia (DC) using the most recently available data. We used multiple data sources, including the Medical Expenditure Panel Survey, U.S. Census Bureau, Kaiser Family Foundation, Medical Statistical Information System, and Current Population Survey. We used a two-part regression model to estimate annual medical costs of asthma and a negative binomial model to estimate annual school and work days missed due to asthma. Per capita medical costs of asthma ranged from $1,860 (Mississippi) to $2,514 (Michigan). Total medical costs of asthma ranged from $60.7 million (Wyoming) to $3.4 billion (California). Medicaid costs ranged from $4.1 million (Wyoming) to $566.8 million (California), Medicare from $5.9 million (DC) to $446.6 million (California), and costs paid by private insurers ranged from $27.2 million (DC) to $1.4 billion (California). Total annual school and work days lost due to asthma ranged from 22.4 thousand (Wyoming) to 1.5 million days (California) and absenteeism costs ranged from $4.4 million (Wyoming) to $345 million (California). Projected increase in medical costs from 2015 to 2020 ranged from 9% (DC) to 34% (Arizona). Medical and absenteeism costs of asthma represent a significant economic burden for states and these costs are expected to rise. Our study results emphasize the urgency for strategies to strengthen state level efforts to prevent and control asthma attacks.

  19. Pediatric Care as Part of the US Army Medical Mission in the Global War on Terrorism in Afghanistan and Iraq, December 2001 to December 2004

    National Research Council Canada - National Science Library

    Burnett, Mark W; Spinella, Philip C; Azarow, Kenneth S; Callahan, Charles W

    2008-01-01

    OBJECTIVE. Our objective in this report was to describe the epidemiologic features of and workload associated with pediatric admissions to 12 US Army military hospitals deployed to Iraq and Afghanistan. METHODS...

  20. The Woman's Land Army: 1918-1920.

    Science.gov (United States)

    Laughlin, Margaret

    1994-01-01

    Describes the origins and work of the Women's Land Army, a World War I British volunteer agricultural production unit. Details similar program in the United States. Identifies the impact of the Women's Land Army including enhanced political, economic, and physical freedom for the participants and future generations of women. (CFR)

  1. Administration: Army Congressional Fellowship Program

    National Research Council Canada - National Science Library

    2000-01-01

    This printing publishes a new Army Regulation. This regulation presents the policies and procedures under which the Army manages the Army Congressional Fellowship Program and supplements applicable Department...

  2. A state-level analysis of the economic impacts of medical tourism in Malaysia

    OpenAIRE

    Klijs, J.; Ormond, M.E.; Mainil, T.; Peerlings, J.H.M.; Heijman, W.J.M.

    2016-01-01

    In Malaysia, a country that ranks among the world's most recognised medical tourism destinations, medical tourism is identified as a potential economic growth engine for both medical and non-medical sectors. A state-level analysis of economic impacts is important, given differences between states in economic profiles and numbers, origins, and expenditure of medical tourists. We applied input–output (I–O) analysis, based on state-specific I–O data and disaggregated foreign patient data. The an...

  3. THE BAND OF ABDUL QAHHAR MUDZAKKAR: Biographical Sketch of Rebelious Leaders of Islamic State-Indonesian Islamic Army (DI/TII of Sulawesi

    Directory of Open Access Journals (Sweden)

    Muhammad Hasbi

    2014-12-01

    Full Text Available The rebellious movement of Islamic State-Indonesian Islamic Army (DI/TII began from dissa­tis­faction towards the secular state of newly indepen­dent Indonesia. Abd. Qahhar Mudzakkar, the leader of DI/TII in Sulawesi and his followers revolted against the govern­ment, and subsequently formed their own Islamic government. Since Qahhar graduated from Muhammadiyah school, his theological basis in his cause to establishing an Islamc state is very prevalent. He believed that his Islamic state is to uphold the truth and to defend the religion of Allah. Thus whoever opposed his DI/TII movement would be considered infidel simply because of favoring or supporting the Indonesian government they considered secular and communist. His followers and supporters were preachers and clerics, who helped Qahhar by carrying out specific functions and positions in his Islamic state. In addition, those people played an important role in getting recognition and acceptance of Sulawesi muslim society for Islamic state campaign launched by Abdul Qahhar Mudzak­kar. Without their involvement, DI/TII would never had been so popular among muslim community in Sulawesi.

  4. Pediatric marijuana exposures in a medical marijuana state.

    Science.gov (United States)

    Wang, George Sam; Roosevelt, Genie; Heard, Kennon

    2013-07-01

    An increasing number of states are decriminalizing the use of medical marijuana, and the effect on the pediatric population has not been evaluated. To compare the proportion of marijuana ingestions by young children who sought care at a children's hospital in Colorado before and after modification of drug enforcement laws in October 2009 regarding medical marijuana possession. Retrospective cohort study from January 1, 2005, through December 31, 2011. Tertiary-care children's hospital emergency department in Colorado. A total of 1378 patients younger than 12 years evaluated for unintentional ingestions: 790 patients before September 30, 2009, and 588 patients after October 1, 2009. Marijuana ingestion. Marijuana exposure visits, marijuana source, symptoms, and patient disposition. The proportion of ingestion visits in patients younger than 12 years (age range, 8 months to 12 years)that were related to marijuana exposure increased after September 30, 2009, from 0 of 790 (0%; 95% CI, 0%-0.6%) to 14 of 588 (2.4%; 95% CI, 1.4%-4.0%) (P patients had lethargy, 1 had ataxia, and 1 had respiratory insufficiency. Eight patients were admitted, 2 to the intensive care unit. Eight of the 14 cases involved medical marijuana, and 7 of these exposures were from food products. We found a new appearance of unintentional marijuana ingestions by young children after modification of drug enforcement laws for marijuana possession in Colorado. The consequences of unintentional marijuana exposure in children should be part of the ongoing debate on legalizing marijuana.

  5. A state-level analysis of the economic impacts of medical tourism in Malaysia

    NARCIS (Netherlands)

    Klijs, J.; Ormond, M.E.; Mainil, T.; Peerlings, J.H.M.; Heijman, W.J.M.

    2016-01-01

    In Malaysia, a country that ranks among the world's most recognised medical tourism destinations, medical tourism is identified as a potential economic growth engine for both medical and non-medical sectors. A state-level analysis of economic impacts is important, given differences between states in

  6. Observations of the role of science in the United States medical cannabis state policies: Lessons learnt.

    Science.gov (United States)

    Grbic, Jelica; Goddard, Perilou; Ryder, David

    2017-04-01

    Clinical trials have shown cannabis to be effective in the treatment of some medical conditions and there is mounting public and political pressure to enact laws enabling the use of cannabis for medicinal purposes. To date, 28 United States (U.S.) states and the District of Columbia have enacted medical cannabis laws. This study sought to identify the main issues pertaining to the development of medical cannabis laws in the U.S, including the role of scientific evidence. Data were collected from three groups of participants: government officials, lobbyists and medical professionals involved in the medical cannabis debate in five selected states in the U.S.; researchers from the same five states conducting funded research in the alcohol and other drugs field; and members of the International Society for the Study of Drug Policy. The data were analysed using thematic analysis. Six major themes emerged in relation to the factors influencing policy: scientific evidence plays a limited role in the development of policy; the available research is limited and mixed; there is a need for clearer communication and active dissemination of evidence to policy makers; researchers need to consider what research is likely to impact on policy; scientific evidence is not a major factor in policy development; and there is a need to consider evidence within a political context. Researchers need to be aware of the political context in which medical cannabis laws are or are not enacted and consider ways in which research findings can achieve a higher profile within this context. Copyright © 2016. Published by Elsevier B.V.

  7. Qualification Requirement Perceptions of the United States Army Acquisition Workforce Since Implementation of the Defense Acquisition Workforce Improvement Act (DAWIA)

    Science.gov (United States)

    2013-11-09

    certificate, teaching /lecturing, and symposium/conference attendance [points vary]). A two-year CLP cycle is standard for every Army acquisition workforce...School of Business and Public Policy who teach defense acquisition–related courses to take our survey. Our intent was to gain their professional...pertic:ipetion) 0 Rotational Assiglments 0 011\\ efl -1 ____ _J ^Åèìáëáíáçå=oÉëÉ~êÅÜ=mêçÖê~ã= dê~Çì~íÉ=pÅÜççä=çÑ=_ìëáåÉëë=C=mìÄäáÅ=mçäáÅó= - 85 - k~î~ä=mçëíÖê

  8. The State of Emergency Medical Services (EMS) Systems in Africa.

    Science.gov (United States)

    Mould-Millman, Nee-Kofi; Dixon, Julia M; Sefa, Nana; Yancey, Arthur; Hollong, Bonaventure G; Hagahmed, Mohamed; Ginde, Adit A; Wallis, Lee A

    2017-06-01

    Introduction Little is known about the existence, distribution, and characteristics of Emergency Medical Services (EMS) systems in Africa, or the corresponding epidemiology of prehospital illness and injury. A survey was conducted between 2013 and 2014 by distributing a detailed EMS system questionnaire to experts in paper and electronic versions. The questionnaire ascertained EMS systems' jurisdiction, operations, finance, clinical care, resources, and regulatory environment. The discovery of respondents with requisite expertise occurred in multiple phases, including snowball sampling, a review of published scientific literature, and a rigorous search of the Internet. The survey response rate was 46%, and data represented 49 of 54 (91%) African countries. Twenty-five EMS systems were identified and distributed among 16 countries (30% of African countries). There was no evidence of EMS systems in 33 (61%) countries. A total of 98,574,731 (8.7%) of the African population were serviced by at least one EMS system in 2012. The leading causes of EMS transport were (in order of decreasing frequency): injury, obstetric, respiratory, cardiovascular, and gastrointestinal complaints. Nineteen percent of African countries had government-financed EMS systems and 26% had a toll-free public access telephone number. Basic emergency medical technicians (EMTs) and Basic Life Support (BLS)-equipped ambulances were the most common cadre of provider and ambulance level, respectively (84% each). Emergency Medical Services systems exist in one-third of African countries. Injury and obstetric complaints are the leading African prehospital conditions. Only a minority (<9.0%) of Africans have coverage by an EMS system. Most systems were predominantly BLS, government operated, and fee-for-service. Mould-Millman NK , Dixon JM , Sefa N , Yancey A , Hollong BG , Hagahmed M , Ginde AA , Wallis LA . The state of Emergency Medical Services (EMS) systems in Africa. Prehosp Disaster Med. 2017;32(3):273-283.

  9. Self-medication of mood and anxiety disorders with marijuana: Higher in states with medical marijuana laws.

    Science.gov (United States)

    Sarvet, Aaron L; Wall, Melanie M; Keyes, Katherine M; Olfson, Mark; Cerdá, Magdalena; Hasin, Deborah S

    2018-05-01

    Self-medication with drugs or alcohol is commonly reported among adults with mood or anxiety disorders, and increases the risk of developing substance use disorders. Medical marijuana laws (MML) may be associated with greater acceptance of the therapeutic value of marijuana, leading individuals to self-medicate. The study utilized data from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (2004-2005). Participants were sampled from households in the general population and included adults with a mood or anxiety disorder in the past 12 months (n = 7418), and the subset of those who used marijuana and no other drug (n = 314). Weighted logistic regression models predicted the prevalence of self-medication with drugs in U.S. states with and without MML, adjusting for individual and state-level covariates. As a negative control, analyses were repeated for self-medication with alcohol. Overall, self-medication with drugs was 3.73 percentage points higher (95% confidence interval [CI]: 0.93-6.53) among those living in MML states (p = 0.01). For the subpopulation that only used marijuana, self-medication with drugs was 21.22 percentage points higher (95% CI: 3.91-38.53) among those living in MML states (p = 0.02). In contrast, self-medication with alcohol had nearly identical prevalence in MML and non-MML states, overall and for drinkers. Among adults with mood or anxiety disorders, living in a medical marijuana law state is associated with self-medication with marijuana. While additional research is needed to determine the reasons for this association, clinical screening for self-medication with marijuana may be particularly important in states with medical marijuana laws. Copyright © 2018 Elsevier B.V. All rights reserved.

  10. Contending medical ideologies and state formation: the nineteenth-century origins of medical pluralism in contemporary Colombia.

    Science.gov (United States)

    Sowell, David

    2003-01-01

    This article addresses the encounter between contending medical ideologies in nineteenth-century Colombia. The first era of medical pluralism, in colonial Latin America, developed from the imposition of Hispanic medicine on existing indigenous medical systems through an imperial structure. This produced a "colonial medical spectrum" incorporating various medical ideologies that came under attack by practitioners of scientific medicine in the 1800s. As scientific physicians gained privileged access to state resources, they undertook partially successful campaigns to deny Hispanic, homeopathic, and other medical systems the right to be practiced. As the state authorized scientific medicine, other practices became "popularized," thereby laying the foundation for the medical pluralism of contemporary Colombia that juxtaposes "academic" and "traditional" medicines.

  11. MEDICAL ETHICS EDUCATION IN TURKEY; STATE OF PLAY AND CHALLENGES.

    Science.gov (United States)

    Ekmekçi, Perihan Elif

    Medical ethics can be traced back to Hippocratic Oath in antiquity. Last decade witnessed improvements in science and technology which attracted attention to the ethical impacts of the innovations in medicine. The need to combine medical innovations with a preservation of human values and to cultivate ethical competencies required by professionalism conceived medical ethics education in various levels in medical schools. Despite the diversities regarding teaching hours, methodology and content of the courses, medical ethics became a fundamental part of medical education around the world. In Turkey medical ethics education is given both in undergraduate and postgraduate levels. The high increase in the number of medical schools and shortfall of instructors who have medical ethics as their primary academic focus creates a big challenge in medical ethics education in both levels. Currently there are 89 medical schools in Turkey and only six medical schools are giving postgraduate medical ethics education. In 2010 only 33 of all medical schools could establish a separate department dedicated to medical ethics. There are no medical ethics courses embedded in residency programs. The quality and standardization of undergraduate medical ethics education has started but there are no initiatives to do so in postgraduate level.

  12. A Pilotless Army in the Megalopolis

    National Research Council Canada - National Science Library

    Wegner, Robert

    2004-01-01

    This monograph answers the question, "Can unmanned aerial vehicles (UAVs) supplant manned United States Army attack and reconnaissance helicopters in the conduct of future urban operations" and the answer is, "not completely...

  13. Prevention of suicidal behaviour among army personnel: a qualitative study.

    Science.gov (United States)

    Crawford, M J; Sharpe, D; Rutter, D; Weaver, T

    2009-09-01

    To examine the context of suicidal behaviour among soldiers in the United Kingdom and identify factors that could reduce the risk of such behaviour. A series of in-depth interviews with service providers involved in treating soldiers following deliberate self harm. Their responses were compared with those of a small sub-sample of soldiers who presented to Army medical services following self harm. We interviewed 21 service providers with a range of experience and professional backgrounds and 10 soldiers. Service providers told us that the rarity of suicide among soldiers together with lower levels of mental illness amongst those who end their lives made suicide prevention in the Army a difficult task. However they highlighted concerns about recruitment and retention of young soldiers, and stated that stigmatisation of mental illness in the Army sometimes prevented those with suicidal ideation seeking help. They also highlighted the role of alcohol use in precipitating self-harm. Soldiers who had self-harmed told us that they struggled to balance the demands of work and family life and described harming themselves impulsively often while intoxicated with alcohol. Soldiers look to sources of support outside the Army, and see commanding officers, rather than healthcare professionals, as helping resolve their problems. Neither service providers nor soldiers mentioned helplines and other 'independent' sources of confidential advice and support which are available to soldiers serving with the British Army. Our findings highlight problems associated with efforts to reduce suicide among soldiers but suggest that these should focus continuing to try to reduce stigmatisation of mental distress and specifically on the role of commanding officers. Greater efforts should also be made to publicise existing sources of help and reduce levels of alcohol misuse.

  14. 2009 Center for Army Leadership Annual Survey of Army Leadership (CASAL): Army Education

    Science.gov (United States)

    2010-06-11

    right time, handling pre- education attitudes, and tracking performance gains and career advantages related to academics.  Developing current, relevant...Army Leadership Technical Report 2010-2 2009 CENTER FOR ARMY LEADERSHIP ANNUAL SURVEY OF ARMY LEADERSHIP (CASAL): ARMY EDUCATION ...Joshua Hatfield ICF International John P. Steele Center for Army Leadership June 2010 The Center for Army Leadership An

  15. We Want You: It Takes a Village To Market the Army

    Science.gov (United States)

    2013-03-01

    controls over its marketing activities. While policy governs Army behavior, principles of marketing shape it as well. In marketing , the brand...18. 92 Ibid., 18. 93 Head, 4. 94 Kotler and Lee, 239. 95 Ibid., 209. 96 Ibid., 218. 97 U.S. Army Marketing and Research Group, “Army...We Want You: It Takes a Village To Market the Army by Lieutenant Colonel Daniel C. Hodne United States Army

  16. Cultural Changes Required in the Army to Truly Achieve a Total Force

    Science.gov (United States)

    2016-02-16

    tailored to achieve anticipated objectives.”1 Honorable John M. McHugh , Secretary of the Army Army Directive 2012-08 (Army Total Force Policy...United States Soldier. 16 End Notes 1 McHugh , John M. “Army Directive 2012-08 (Army Total Force Policy).” Secretary of the Army, September 4...1 (February 2006): 40–42. McCullough, Amy. “Out of Reserve (Air Force Reserve Command)” 94, no. 12 (2011): 40. McHugh , John M. “Army Directive 2012

  17. South African medical schools: Current state of selection criteria and ...

    African Journals Online (AJOL)

    Selection of medical students at South African (SA) medical schools must promote ... groups, while ensuring optimal student throughput and success, and training future ... In keeping = with international practices, a variety of academic and ...

  18. Weekend Warriors for Water: Combating Water Scarcity in West Africa with United States Army National Guard and Reserve Forces

    Science.gov (United States)

    2017-06-09

    vulnerable to “conflict and instability from political, social, economic , and environmental challenges” (United States Africa Command 2017). The...improve regional stability , which in turn increases economic , political, and social development. RC deployments to support water scarcity missions can...Capacity DOD Department of Defense DOS Department of State ECOWAS Economic Community of West African States FHA Foreign Humanitarian Assistance

  19. Medical review practices for driver licensing volume 3: guidelines and processes in the United States.

    Science.gov (United States)

    2017-04-01

    This is the third of three reports examining driver medical review practices in the United States and how : they fulfill the basic functions of identifying, assessing, and rendering licensing decisions on medically or : functionally at-risk drivers. ...

  20. Medical aspects of quality assurance in the United States

    International Nuclear Information System (INIS)

    Hanks, G.E.

    1997-01-01

    Three powerful national programs have been developed, and their acceptance and utilization in the United States have been accelerated by the recent development of managed competition. The first program was a model quality assurance program for day to day use in an individual radiation oncology facility. In addition to maintaining the physical aspects of the department, the medical side includes indicator items in patient evaluation and treatment and other measures that are periodically monitored. The entire process is comprehensive and is accepted by the Joint Commission on Hospital Accreditation as being satisfactory evidence of ongoing quality assurance and quality improvement. The second program was the development of a set of standards for radiation oncology in the United States. These standards were developed in the past and have recently been expanded into a more comprehensive document that describes the appropriate performance by this specialty. The third program was a Practice Accreditation program. The Practice Accreditation program is an on-site review of structure and processes of patient care by a radiation oncologist and data manager. This intense on-site review generated data that is then compared to similar facilities and to national averages to judge the adequacy of patient management in the facility. We have observed recently that various managed care programs require this practice accreditation before their patients can be treated in contracting facilities. Lastly, the Council of the American College of Radiology has made some extremely positive statements in support of improving radiation oncology practice, and the positive effects of these council resolutions can be clearly shown on the practice

  1. Profesional medical library education in the United States in relation to the qualifications of medical library manpower in Ohio.

    Science.gov (United States)

    Rees, A M; Rothenberg, L; Denison, B

    1968-10-01

    THE PRESENT SYSTEM OF EDUCATION FOR MEDICAL LIBRARY PRACTICE IN THE UNITED STATES CONSISTS OF FOUR MAJOR COMPONENTS: graduate degree programs in library science with specialization in medical librarianship; graduate degree programs in library science with no such specialization; postgraduate internships in medical libraries; continuing education programs. Data are presented illustrating the flow of graduates along these several educational pathways into medical library practice.The relevance of these educational components to the current medical library work force is discussed with reference to manpower data compiled for Ohio. The total number of medical library personnel in Ohio in 1968 is 316. Of this total, only forty-two (approximately 14 percent) have received any formal library training. Seventy persons have only a high school education. From these figures, it is concluded that there is no standard or essential qualification which is universally accepted as educational preparation for work in medical libraries; that the comparative sophistication of the educational programs in medical librarianship has yet to be reflected widely in general medical library practice; that an increasingly large number of non-professional or ancillary personnel are being, and will continue to be, utilized in medical libraries; that large numbers of untrained persons have sole responsibility for medical libraries; and that appropriate educational programs will have to be designed specifically for this type of personnel.

  2. Baseline Marine Biological Survey ROI-NAMUR Outfall United States Army Kwajalein Atoll, Republic of the Marshall Islands, 1997(NODC Accession 0000630)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Roi-Namur is located at the northernmost tip of Kwajalein Atoll, approximately 64 kilometers north of the U.S. Army Kwajalein Atoll(USAKA) central command post on...

  3. Baseline marine biological survey at Roi-Namur sewage outfall, United States Army Kwajalein Atoll, Republic of the Marshall Islands, 1997 (NODC Accession 0000630)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Roi-Namur is located at the northernmost tip of Kwajalein Atoll, approximately 64 kilometers north of the U.S. Army Kwajalein Atoll (USAKA) central command post on...

  4. Marine biological survey of ROI-NAMUR outfall at the United States Army Kwajalein Atoll, Republic of the Marshall Islands, May 2000 (NODC Accession 0000653)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Roi-Namur is located at the northernmost tip of Kwajalein Atoll, approximately 64 kilometers north of the U.S. Army Kwajalein Atoll (USAKA) central command post on...

  5. A history of US Army PAs.

    Science.gov (United States)

    Chalupa, Robyn L; Marble, W Sanders

    2017-11-01

    The US military has a long tradition of using physician assistants (PAs). The Army began using PAs in 1971 in an effort to supplement the physicians and surgeons in the medical corps. As their numbers grew, PAs gradually replaced general medical officers assigned to battalions. Later, specialty positions developed in aviation medicine, orthopedics, and emergency medicine. The need for a PA serving as an adviser in the major commands slowly developed at all levels of leadership. In 2015, the Army removed limitations on female PAs assigned to combat units. PAs lead in tactical and clinical settings, filling command roles, senior clinical positions, and administrative leadership roles.

  6. Survey of United States Army Physician Opinion: The Issue of Written ’Do Not Resuscitate’ Orders

    Science.gov (United States)

    1984-08-01

    Westminister Press, 1975), p. 176-7. 71Cushing, p. 29. 72Alexander, p. 26. 73Kevin M. McIntyre, "Mediolegal Aspects of Decision Making in Resuscitation and Life...34Physicians Opinions Toward Legislation Defining Death and Withholding Life Support," Southern Medical Journal 74 (February 1981): 215-18. 82Norman K...Louis S. Let the Patient Decide. Philadelphia: The Westminister Press, 1978. Browning, Mary H. and Lewis, Edith P. comps. The Dying Patient: A Nursing

  7. Association Between State Medical Malpractice Environment and Postoperative Outcomes in the United States.

    Science.gov (United States)

    Minami, Christina A; Sheils, Catherine R; Pavey, Emily; Chung, Jeanette W; Stulberg, Jonah J; Odell, David D; Yang, Anthony D; Bentrem, David J; Bilimoria, Karl Y

    2017-03-01

    The US medical malpractice system assumes that the threat of liability should deter negligence, but it is unclear whether malpractice environment affects health care quality. We sought to explore the association between state malpractice environment and postoperative complication rates. This observational study included Medicare fee-for-service beneficiaries undergoing one of the following operations in 2010: colorectal, lung, esophageal, or pancreatic resection, total knee arthroplasty, craniotomy, gastric bypass, abdominal aortic aneurysm repair, coronary artery bypass grafting, or cystectomy. The state-specific malpractice environment was measured by 2010 medical malpractice insurance premiums, state average award size, paid malpractice claims/100 physicians, and a composite malpractice measure. Outcomes of interest included 30-day readmission, mortality, and postoperative complications (eg sepsis, myocardial infarction [MI], pneumonia). Using Medicare administrative claims data, associations between malpractice environment and postoperative outcomes were estimated using hierarchical logistic regression models with hospital random-intercepts. Measures of malpractice environment did not have significant, consistent associations with postoperative outcomes. No individual tort reform law was consistently associated with improved postoperative outcomes. Higher-risk state malpractice environment, based on the composite measure, was associated with higher likelihood of sepsis (odds ratio [OR] 1.22; 95% CI 1.07 to 1.39), MI (OR 1.14; 95% CI 1.06 to 1.23), pneumonia (OR 1.09; 95% CI 1.03 to 1.16), acute renal failure (OR 1.15; 95% CI 1.08 to 1.22), deep vein thrombosis/pulmonary embolism (OR 1.22; 95% CI 1.13 to 1.32), and gastrointestinal bleed (OR 1.18; 95% CI 1.08 to 1.30). Higher risk malpractice environments were not consistently associated with a lower likelihood of surgical postoperative complications, bringing into question the ability of malpractice lawsuits to

  8. Self-medication in three Orange Free State communities

    African Journals Online (AJOL)

    lates of non-compliance were explored, but self- medication was not found to be a substitute for formal medical care. S Air Med J 1993; 83: 345·346. Medicines. None. 1-3 types ... availability and accessibility of professional health care;. (iv) the perceived health .... tent manner in which cultural differences, education, health ...

  9. The Current Status of Medical Marijuana in the United States

    OpenAIRE

    McKenna, Gerald J

    2014-01-01

    Medical marijuana is currently a controversial issue in medicine. There are strong pro and con opinions but relatively little scientific data on which to base medical decisions. The unfortunate scheduling of marijuana in class I has limited research and only serves to fuel the controversy.

  10. A Peer Sharing Approach to Mission Planning and Development in US Army Tactical Environments

    National Research Council Canada - National Science Library

    Lundy, Jacques

    2002-01-01

    This thesis analyzes the technical and information management environment that United States Army heavy combat tactical units operate in and provides a solution for how the Army's software development...

  11. The Role of the Army Reserve in the Weapons of Mass Destruction/Homeland Defense Program

    National Research Council Canada - National Science Library

    Smith, Joseph

    2000-01-01

    ... attack. Given these increasing threats to the territory, population, and infrastructure of the United States, the Army Reserve should have an expanded role in providing homeland defense capabilities. The Army Reserve is well suited to homeland defense missions.

  12. Discovering the Army's Core Competencies

    National Research Council Canada - National Science Library

    Rudesheim, Frederick

    2001-01-01

    This paper seeks to answer the question, "Has the Army correctly identified its core competencies to ensure the Army can adequately respond to the national military strategy?" FM 1, The Army (Prototype Draft...

  13. Maternal Mortality at Federal Medical Centre Yola, Adamawa State ...

    African Journals Online (AJOL)

    the management of the Federal Medical centre Yola before the .... response to emergencies may help reduce deaths from obstetric ... HIV, anesthetic deaths and Diabetic ketoacidosis (DKA) were the indirect causes of maternal mortality.

  14. Women in the Army

    Science.gov (United States)

    1980-06-06

    Army womenpower re- quirements with no apparent end in sight. No country, not even Russia or Israel, has ever made a conscious decision to include...provide a basis for decision making. iiI CHAPTER ONE AN HISTORICAL OVERVIEW Few books have been written which outline the history of military women...with a bill introducing the Women’s Army Auxillary Corps (WAAC). In order 7 that the Army could maintain control over this sensitive issue, General

  15. Army Sustainment. Volume 44, Issue 5. September-October 2012

    Science.gov (United States)

    2012-10-01

    Department of Defense or any of its agencies, and do not change or supersede official Army publications. The masculine pro - noun may refer to either gender...the Army Test and Evaluation Command (ATEC), AMC, and the Army staff, who con - stitute the candidate selection panel. CASCOM provides the TRADOC...improper use of these items that causes the fires. The Occupational Safety and Health Administration ( OSHA ) states that equipment needs to be used

  16. Army Maintenance System Transformation

    National Research Council Canada - National Science Library

    Gilbertson, Frank V

    2006-01-01

    .... Used in conjunction with pertinent historical data and developed with Army transformation goals in mind, General Systems thinking can provide the framework for guiding maintenance transformation...

  17. The Effect of Medical Marijuana Laws on Crime: Evidence from State Panel Data, 1990-2006

    OpenAIRE

    Morris, Robert G.; TenEyck, Michael; Barnes, J. C.; Kovandzic, Tomislav V.

    2014-01-01

    Background Debate has surrounded the legalization of marijuana for medical purposes for decades. Some have argued medical marijuana legalization (MML) poses a threat to public health and safety, perhaps also affecting crime rates. In recent years, some U.S. states have legalized marijuana for medical purposes, reigniting political and public interest in the impact of marijuana legalization on a range of outcomes. Methods Relying on U.S. state panel data, we analyzed the association between st...

  18. Residency training in the United States: What foreign medical ...

    African Journals Online (AJOL)

    FMGs) planning to pursue post-graduate residency training in the United States of America (USA). While the number of residency training positions is shrinking, and the number of United States graduates has steadily declined over the past ...

  19. South African medical schools: Current state of selection criteria and medical students' demographic profile.

    Science.gov (United States)

    van der Merwe, L J; van Zyl, G J; St Clair Gibson, A; Viljoen, M; Iputo, J E; Mammen, M; Chitha, W; Perez, A M; Hartman, N; Fonn, S; Green-Thompson, L; Ayo-Ysuf, O A; Botha, G C; Manning, D; Botha, S J; Hift, R; Retief, P; van Heerden, B B; Volmink, J

    2015-12-16

    Selection of medical students at South African (SA) medical schools must promote equitable and fair access to students from all population groups, while ensuring optimal student throughput and success, and training future healthcare practitioners who will fulfil the needs of the local society. In keeping with international practices, a variety of academic and non-academic measures are used to select applicants for medical training programmes in SA medical schools. To provide an overview of the selection procedures used by all eight medical schools in SA, and the student demographics (race and gender) at these medical schools, and to determine to what extent collective practices are achieving the goals of student diversity and inclusivity. A retrospective, quantitative, descriptive study design was used. All eight medical schools in SA provided information regarding selection criteria, selection procedures, and student demographics (race and gender). Descriptive analysis of data was done by calculating frequencies and percentages of the variables measured. Medical schools in SA make use of academic and non-academic criteria in their selection processes. The latter include indices of socioeconomic disadvantage. Most undergraduate medical students in SA are black (38.7%), followed by white (33.0%), coloured (13.4%) and Indian/Asian (13.6%). The majority of students are female (62.2%). The number of black students is still proportionately lower than in the general population, while other groups are overrepresented. Selection policies for undergraduate medical programmes aimed at redress should be continued and further refined, along with the provision of support to ensure student success.

  20. ARMY CYBER STRUCTURE ALIGNMENT

    Science.gov (United States)

    2016-02-16

    content/?q=historic-cyber-unit-begins- daily-action . 14 John M. McHugh , Secretary of the Army, HQDA General Order 2014-02, Affirmation of Secretary of...support-plays-role-in-tactical-operations/75545442/. McHugh , John M., Secretary of the Army, HQDA General Order 2014-02, Affirmation of Secretary of

  1. Battling Bullying in the British Army 1987 – 2004

    Directory of Open Access Journals (Sweden)

    James K. Wither

    2004-09-01

    Full Text Available This article explores the attempts by the UK MOD to eradicate bullying in the British Army. Although British recruits are not confronted by mistreatment that compares with the phenomenon of dedovshchina, the Army has struggled to eliminate incidents of bullying from the ranks, which have tarnished the image of the British Army. The article examines the nature and extent of the problem, the efficacy of official policy to combat it, and suggests reasons why bullying persists even in a long- standing professional army. It also seeks to provide instructive insights for those militaries of the successor states of the Soviet Union that are currently blighted by dedovshchina.

  2. Medical marijuana laws in 50 states: investigating the relationship between state legalization of medical marijuana and marijuana use, abuse and dependence.

    Science.gov (United States)

    Cerdá, Magdalena; Wall, Melanie; Keyes, Katherine M; Galea, Sandro; Hasin, Deborah

    2012-01-01

    Marijuana is the most frequently used illicit substance in the United States. Little is known of the role that macro-level factors, including community norms and laws related to substance use, play in determining marijuana use, abuse and dependence. We tested the relationship between state-level legalization of medical marijuana and marijuana use, abuse, and dependence. We used the second wave of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a national survey of adults aged 18+ (n=34,653). Selected analyses were replicated using the National Survey on Drug Use and Health (NSDUH), a yearly survey of ∼68,000 individuals aged 12+. We measured past-year cannabis use and DSM-IV abuse/dependence. In NESARC, residents of states with medical marijuana laws had higher odds of marijuana use (OR: 1.92; 95% CI: 1.49-2.47) and marijuana abuse/dependence (OR: 1.81; 95% CI: 1.22-2.67) than residents of states without such laws. Marijuana abuse/dependence was not more prevalent among marijuana users in these states (OR: 1.03; 95% CI: 0.67-1.60), suggesting that the higher risk for marijuana abuse/dependence in these states was accounted for by higher rates of use. In NSDUH, states that legalized medical marijuana also had higher rates of marijuana use. States that legalized medical marijuana had higher rates of marijuana use. Future research needs to examine whether the association is causal, or is due to an underlying common cause, such as community norms supportive of the legalization of medical marijuana and of marijuana use. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  3. Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States, 1999–2010

    Science.gov (United States)

    Bachhuber, Marcus A.; Saloner, Brendan; Cunningham, Chinazo O.; Barry, Colleen L.

    2015-01-01

    IMPORTANCE Opioid analgesic overdose mortality continues to rise in the United States, driven by increases in prescribing for chronic pain. Because chronic pain is a major indication for medical cannabis, laws that establish access to medical cannabis may change overdose mortality related to opioid analgesics in states that have enacted them. OBJECTIVE To determine the association between the presence of state medical cannabis laws and opioid analgesic overdose mortality. DESIGN, SETTING, AND PARTICIPANTS A time-series analysis was conducted of medical cannabis laws and state-level death certificate data in the United States from 1999 to 2010; all 50 states were included. EXPOSURES Presence of a law establishing a medical cannabis program in the state. MAIN OUTCOMES AND MEASURES Age-adjusted opioid analgesic overdose death rate per 100 000 population in each state. Regression models were developed including state and year fixed effects, the presence of 3 different policies regarding opioid analgesics, and the state-specific unemployment rate. RESULTS Three states (California, Oregon, and Washington) had medical cannabis laws effective prior to 1999. Ten states (Alaska, Colorado, Hawaii, Maine, Michigan, Montana, Nevada, New Mexico, Rhode Island, and Vermont) enacted medical cannabis laws between 1999 and 2010. States with medical cannabis laws had a 24.8% lower mean annual opioid overdose mortality rate (95% CI, −37.5% to −9.5%; P = .003) compared with states without medical cannabis laws. Examination of the association between medical cannabis laws and opioid analgesic overdose mortality in each year after implementation of the law showed that such laws were associated with a lower rate of overdose mortality that generally strengthened over time: year 1 (−19.9%; 95% CI, −30.6% to −7.7%; P = .002), year 2 (−25.2%; 95% CI, −40.6% to −5.9%; P = .01), year 3 (−23.6%; 95% CI, −41.1% to −1.0%; P = .04), year 4 (−20.2%; 95% CI, −33.6% to −4

  4. Medical cannabis laws and opioid analgesic overdose mortality in the United States, 1999-2010.

    Science.gov (United States)

    Bachhuber, Marcus A; Saloner, Brendan; Cunningham, Chinazo O; Barry, Colleen L

    2014-10-01

    Opioid analgesic overdose mortality continues to rise in the United States, driven by increases in prescribing for chronic pain. Because chronic pain is a major indication for medical cannabis, laws that establish access to medical cannabis may change overdose mortality related to opioid analgesics in states that have enacted them. To determine the association between the presence of state medical cannabis laws and opioid analgesic overdose mortality. A time-series analysis was conducted of medical cannabis laws and state-level death certificate data in the United States from 1999 to 2010; all 50 states were included. Presence of a law establishing a medical cannabis program in the state. Age-adjusted opioid analgesic overdose death rate per 100 000 population in each state. Regression models were developed including state and year fixed effects, the presence of 3 different policies regarding opioid analgesics, and the state-specific unemployment rate. Three states (California, Oregon, and Washington) had medical cannabis laws effective prior to 1999. Ten states (Alaska, Colorado, Hawaii, Maine, Michigan, Montana, Nevada, New Mexico, Rhode Island, and Vermont) enacted medical cannabis laws between 1999 and 2010. States with medical cannabis laws had a 24.8% lower mean annual opioid overdose mortality rate (95% CI, -37.5% to -9.5%; P = .003) compared with states without medical cannabis laws. Examination of the association between medical cannabis laws and opioid analgesic overdose mortality in each year after implementation of the law showed that such laws were associated with a lower rate of overdose mortality that generally strengthened over time: year 1 (-19.9%; 95% CI, -30.6% to -7.7%; P = .002), year 2 (-25.2%; 95% CI, -40.6% to -5.9%; P = .01), year 3 (-23.6%; 95% CI, -41.1% to -1.0%; P = .04), year 4 (-20.2%; 95% CI, -33.6% to -4.0%; P = .02), year 5 (-33.7%; 95% CI, -50.9% to -10.4%; P = .008), and year 6 (-33.3%; 95% CI, -44.7% to

  5. The State of Disability Awareness in American Medical Schools.

    Science.gov (United States)

    Seidel, Erica; Crowe, Scott

    2017-09-01

    This study was designed to: (1) determine how many American medical schools include disability awareness in their curriculum, (2) explore the format of disability awareness programs in existence, and (3) understand why some schools do not include disability awareness in their curriculum. An online survey was sent to deans of medical education (or equivalent positions) at accredited allopathic and osteopathic American medical schools (N = 167) in 2015. Seventy-five schools (45%) completed surveys. Fifty-two percent (39/75) reported having a disability awareness program. The most common format was people with disabilities or caregivers speaking in a large group setting. Programs were most likely to focus on adults with physical disabilities. Among schools without a program, the top barriers were no one advocating for inclusion in the curriculum and time constraints. Nearly half of schools without a program expressed interest in adopting an awareness curriculum if one was made available. Such results indicate that efforts should be made to increase the number of schools that provide disability awareness education through increased advocacy and providing additional resources to schools without a curriculum.

  6. Improvement of the training system of medical and pharmaceutical specialists at medical college of Saratov State Medical University

    Directory of Open Access Journals (Sweden)

    Popkov V.M.

    2015-06-01

    Full Text Available The development of high-technological medical care in Russia has improved the quality of rendering of medical aid to the population, but at the same time the lack of efficient, qualified specialists has been revealed. Today graduates of professional educational institution are characterized by the knowledge in theory and inefficient practical experience, while the employer is interested in the optimal combination of these qualities. All of these facts lead to the necessity of introducing into the educational process technologies of dual training as a tool of approximation theory to practice Saratov. Medical University may share the experience of introduction and organization of elements of the complex educational system in the process of realization of the programs of secondary professional education through the creation of educational-productive cluster on the bases of clinics.

  7. The effect of medical marijuana laws on crime: evidence from state panel data, 1990-2006.

    Directory of Open Access Journals (Sweden)

    Robert G Morris

    Full Text Available Debate has surrounded the legalization of marijuana for medical purposes for decades. Some have argued medical marijuana legalization (MML poses a threat to public health and safety, perhaps also affecting crime rates. In recent years, some U.S. states have legalized marijuana for medical purposes, reigniting political and public interest in the impact of marijuana legalization on a range of outcomes.Relying on U.S. state panel data, we analyzed the association between state MML and state crime rates for all Part I offenses collected by the FBI.Results did not indicate a crime exacerbating effect of MML on any of the Part I offenses. Alternatively, state MML may be correlated with a reduction in homicide and assault rates, net of other covariates.These findings run counter to arguments suggesting the legalization of marijuana for medical purposes poses a danger to public health in terms of exposure to violent crime and property crimes.

  8. Evaluating Mobile Device Ownership and Usage in the U.S. Army: Implications for Army Training

    Science.gov (United States)

    2014-07-01

    Mercado University of Central Florida Randall D. Spain U.S. Army Research Institute July 2014 United States Army...NUMBER 633007 6. AUTHOR(S) Joseph E. Mercado ; Randall D. Spain 5c. PROJECT NUMBER A792 5d. TASK NUMBER 5e...13. SUPPLEMENTARY NOTES Subject Matter POC and Subject Matter Expert: Joseph E. Mercado 14. ABSTRACT (Maximum 200 words): As the U.S

  9. Psychotropic Medication Use among Adolescents: United States, 2005-2010

    Science.gov (United States)

    ... no. 12–3929. 2010. Pratt LA, Brody DJ. Depression in the United States household population, 2005–2006. NCHS data brief, no 7. Hyattsville, MD: National Center for Health Statistics. 2008. Akinbami LJ, Liu X, Pastor PN, Reuben ...

  10. Characterization and analysis of medical solid waste in Osun State ...

    African Journals Online (AJOL)

    use

    1Department of Civil Engineering, Osun State College of Technology, ... achieve waste segregation, packaging in colour-coded and labeled bags, safe ...... J. Air. Waste Manage. Assoc., 48: 516–526. Martin J, Nakayama T, Flores L (2002).

  11. If We Don’t, Who Will? The Employment of the United States Army to Combat Potential Pandemic Outbreaks in West Africa

    Science.gov (United States)

    2015-06-12

    question focus on the Army primarily because of the recent deployment to Liberia to combat the Ebola outbreak. 4 Certainly, the results of this study... Ebola virus had infected over 5,500 people, killed 2,800 and was projected to infect approximately 550,000 citizens of Liberia and neighboring Sierra

  12. Creativity and Strategic Vision: The Key to the Army’s Future

    Science.gov (United States)

    1993-04-21

    future strategic leadership . 22 ENDNOTES 1. U.S. Army War College, Army Command. Leadership , and Management : Theory and Practice ([Carlisle Barracks...referring to a strategic leader, the Army War College reference text on command, leadership and management quoted earlier states. "he develops and...strategic leadership , are still applicable. He suggests that the Army should identify and track creative Individuals at the accession point, managing

  13. An Analysis of Primary Care Provider Productivity in the Department of Family and Community Medicine at Carl R. Darnall Army Medical Center

    Science.gov (United States)

    2007-06-08

    are the Weekend Acute Care Clinic ( WACC ), After Hours Clinic (AHC), Troop Medical Clinic 10 (TMC 10), Troop Medical Clinic 12 (TMC 12), and Troop...and expense data. WACC Weekend Acute Care Clinic is staffed on a rotational basis by DFCM core assets; 0800-1700 on Saturdays & Sundays, by walk-in and

  14. Accession Medical Standards Analysis and Research Activity (AMSARA) 2014, Annual Report, and four Supplemental Applicants and Accessions Tables for: Army, Air Force, Marine, and Navy

    Science.gov (United States)

    2016-02-02

    active component accessions, between 2008 and 2013, 13% were accessed with a history of medical disqualification that was either remediated prior to...between 2008 and 2013, 15% accessed with a history of previous medical disqualification and 1% were hospitalized in the first year of service. About...include achievement, adjustment, attention-seeking, cooperation, dominance, even- temperedness, generosity, intellectual efficiency, non- delinquency

  15. Slaves of the statemedical internship and community service in ...

    African Journals Online (AJOL)

    Owing to a chronic shortage of medical staff in South Africa, sleep-deprived medical interns and community service doctors work up to 200 hours of overtime per month under the state's commuted overtime policy. Nurses moonlight in circumvention of the Basic Conditions of Employment Act. For trainee doctors, overtime ...

  16. Medical abortion practices : a survey of National Abortion Federation members in the United States

    NARCIS (Netherlands)

    Wiegerinck, Melanie M. J.; Jones, Heidi E.; O'Connell, Katharine; Lichtenberg, E. Steve; Paul, Maureen; Westhoff, Carolyn L.

    2008-01-01

    Background: Little is known about clinical implementation of medical abortion in the United States following approval of mifepristone as an abortifacient by the Food and Drug Administration (FDA) in 2000. We collected information regarding medical abortion practices of National Abortion Federation

  17. Medical abortion practices: a survey of National Abortion Federation members in the United States

    NARCIS (Netherlands)

    Wiegerinck, Melanie M. J.; Jones, Heidi E.; O'Connell, Katharine; Lichtenberg, E. Steve; Paul, Maureen; Westhoff, Carolyn L.

    2008-01-01

    Little is known about clinical implementation of medical abortion in the United States following approval of mifepristone as an abortifacient by the Food and Drug Administration (FDA) in 2000. We collected information regarding medical abortion practices of National Abortion Federation (NAF) members

  18. Type 2 diabetes in 'the young' | Iro | Abia State University Medical ...

    African Journals Online (AJOL)

    Abia State University Medical Students' Association Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 2, No 1 (2000) >. Log in or Register to get access to full text downloads.

  19. [Department of Otorhinolaryngology of the I.P. Pavlov Saint-Peterburg First State Medical University].

    Science.gov (United States)

    Karpishchenko, S A

    This article is designed to report the results of the analysis ofacademic, scientific, and clinical activities of the Department of Otorhinolaryngology of the I.P. Pavlov Saint-Peterburg First State Medical University.

  20. Characterization and analysis of medical solid waste in Osun State ...

    African Journals Online (AJOL)

    This paper reports the study of quantum and characterization of medica solid wastes generated by healthcare facilities in Osun State. The work involved administration of a questionnaire and detailed studies conducted on facilities selected on the basis of a combination of purposive and random sampling methods.

  1. Clinical neuro-oncology formal education opportunities for medical students in the United States and Canada.

    Science.gov (United States)

    Dixit, Karan S; Nicholas, Martin Kelly; Lukas, Rimas V

    2014-12-01

    To develop an understanding of the availability of the formal clinical neuro-oncology educational opportunities for medical students. The curriculum websites of all medical schools accredited by the Liaison Committee on Medical Education were reviewed for the presence of clinical neuro-oncology electives as well as other relevant data. Ten (6.8%) of medical schools accredited by the Liaison Committee on Medical Education offer formal neuro-oncology electives. Half are clustered in the Midwest. Forty percent are at institutions with neuro-oncology fellowships. All are at institutions with neurosurgery and neurology residency programs. Formal clinical neuro-oncology elective opportunities for medical students in the United States and Canada are limited. Additional such opportunities may be of value in the education of medical students. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Grace Under Fire: The Army Nurses of Pearl Harbor, 1941.

    Science.gov (United States)

    Milbrath, Gwyneth R

    2016-01-01

    Much has been written about the military events of December 7, 1941; however, little has been documented about the nurses' work and experience at Pearl Harbor, Hawaii. The aerial assault on Pearl Harbor was the first time in US history that Army nurses had been on the front line of battle. Nurses quickly triaged and stabilized those who could be saved, and provided compassion and comfort to those who were dying, in an environment where the nurses were unsure of their own survival. Traditional historical methods and a social history framework were used in this investigation. Primary sources included oral histories from the US Army Medical Department Center of History and Heritage and the State of Hawaii's website, Hawaii Aviation. Secondary sources included published books, newspaper articles, military websites, and history texts. Due to the limited bed capacity, Hickam Field Hospital converted to an evacuation hospital. Nurses, physicians, and medical corpsman triaged, stabilized, and transported those likely to survive, while staging the dead behind the building. The emergency room at Tripler Hospital was quickly flooded with patients from the battlefield, but the staff was able to sort patients appropriately to the wards, to the operating room, or provide comfort care as they died. At Schofield Hospital, collaboration between tireless doctors, nurses, and corpsmen was key to providing life-saving surgery and care.

  3. ‘Close enough’ – The link between the Syrian Electronic Army and the Bashar al-Assad regime, and implications for the future development of nation-state cyber counter-insurgency strategies

    Directory of Open Access Journals (Sweden)

    Stewart Kenton Bertram

    2017-02-01

    Full Text Available The case of the Syrian Electronic Army (SEA offers the chance to study a counter response to the cyber activism of the Arab Spring. Research methods featured an adapted method of snowball sampling. The main technical finding of the study placed the SEA within two degrees of separation from a senior politician within the Assad regime. The core conclusion of the paper is the definition of a ‘close enough’ relationship between the SEA and the Assad regime, defined as distant enough to preserve plausible deniability but close enough to ensure the strategic alignment of the SEA to state policy goals.

  4. Diversity of United States medical students by region compared to US census data

    Directory of Open Access Journals (Sweden)

    Smith MM

    2015-05-01

    Full Text Available Mark M Smith,1 Steven H Rose,1 Darrell R Schroeder,2 Timothy R Long1 1Department of Anesthesiology, Mayo Clinic College of Medicine, Rochester, MN, USA; 2Division of Biomedical Statistics and Informatics, Mayo Clinic College of Medicine, Rochester, MN, USA Purpose: Increasing the diversity of the United States (US physician workforce to better represent the general population has received considerable attention. The purpose of this study was to compare medical student race data to that of the US general population. We hypothesized that race demographics of medical school matriculants would reflect that of the general population. Patients and methods: Published race data from the United States Census Bureau (USCB 2010 census and the 2011 Association of American Medical Colleges (AAMC allopathic medical school application and enrollment by race and ethnicity survey were analyzed and compared. Race data of enrolled medical students was compared to race data of the general population within geographic regions and subregions. Additionally, race data of medical school applicants and matriculants were compared to race data of the overall general population. Results: Race distribution within US medical schools was significantly different than race distribution for the overall, regional, and subregional populations of the US (P<0.001. Additionally, the overall race distribution of medical school applicants differed significantly to the race distribution of the general population (P<0.001. Conclusion: This study demonstrated that race demographics of US medical school applicants and matriculants are significantly different from that of the general population, and may be resultant of societal quandaries present early in formal education. Initiatives targeting underrepresented minorities at an early stage to enhance health care career interest and provide academic support and mentorship will be required to address the racial disparity that exists in US

  5. What the Army Needs to Know to Align Its Operational and Institutional Activities

    Science.gov (United States)

    2007-01-01

    responsibilities of the Army leadership. In their roles as stakeholders in short-term acquisition, the Army leaders named here bring to bear the...required immunizations, be medically healthy, and have dental readiness classification of 1 or 2. Personal medical equipment (e.g., earplugs, eyeglasses

  6. Factors associated with high-severity disciplinary action by a state medical board: a Texas study of medical license revocation.

    Science.gov (United States)

    Cardarelli, Roberto; Licciardone, John C

    2006-03-01

    There has been an increase in research evaluating factors associated with disciplinary action of physicians by state medical boards. However, factors related to the severity of disciplinary action are lacking. By investigating these factors while controlling for the type of violation, the authors sought to determine whether physician characteristics influenced the process of disciplinary action by state medical boards. Physicians disciplined by the Texas Medical Board between January 1, 1989, and December 31, 1998, were included in this case-controlled study (N=1129). Multivariate logistic regression analysis was used to compute odds ratios (ORs) and 95% confidence intervals (CIs) for factors associated with license revocation, the most severe disciplinary action, compared with all other forms of disciplinary action combined. Anesthesiologists (OR, 2.45; 95% CI, 1.05-5.74), general practitioners (OR, 1.80; 95% CI, 1.01-3.19), and psychiatrists (OR, 2.68; 95% CI, 1.41-5.13), as well as those with multiple disciplinary actions (OR, 1.91; 95% CI, 1.29-2.83) were most susceptible to license revocation. The more years a disciplined physician was in practice, the greater risk he or she had of license revocation (OR, 1.05; 95% CI, 1.04-1.07). Factors associated with a greater likelihood of license revocation for physicians are: primary medical specialty, number of years in practice, and a history of multiple disciplinary actions.

  7. Affective computing and medical informatics: state of the art in emotion-aware medical applications.

    Science.gov (United States)

    Luneski, Andrej; Bamidis, Panagiotis D; Hitoglou-Antoniadou, Madga

    2008-01-01

    The area of affective computing has received significant attention by the research community over the last few years. In this paper we review the underlying principles in the field, in an effort to draw threads for possible future development within medical informatics. The approach is lead by considering the three main affective channels, namely, visual, audio/speech, and physiological in relation to e-health, emotional intelligence and e-learning. A discussion on the importance of past and present applications together with a prediction on future literature output is also provided.

  8. The Role of FORSCOM (United States Army Forces Command) in the Reception and Care of Refugees from Cuba in the Continental United States

    Science.gov (United States)

    1984-11-01

    attempted to move with them. Civil Affairs personnel finally ruled that only maternal or imme- diate members of a family would be relocated into the...some responsibility, and avoid further criminal acts, it would have to move expeditiously, authoritatively , and compre- hensively. The commiase.on...number of authoritarian heads of state throughout the world, it was probable that such a phenomenon would occur again. Thus, the Task Force Commander’s

  9. Army's drinking water surveillance program

    International Nuclear Information System (INIS)

    Sneeringer, P.V.; Belkin, F.; Straffon, N.; Costick, S.A.

    1977-01-01

    In 1976 a total of 827 water sources from Army installations throughout the world were sampled and analyzed for 53 chemical constituents and physical parameters. Medically significant contaminants included radiation measurements, heavy metals, fluoride, nitrate, and pesticides. Radiological activity appeared to vary with geographic location; a majority being from water sources in the western part of the U.S. No results for tritium were found to exceed the health-reference limit. Confirmatory analyses for radium-226 identified 3 groundwater sources as exceeding the limit; one was attributed to natural activity and the other sources are currently being investigated. Of the metals considered to be medically significant, mercury, chromium, lead, cadmium, silver, barium and arsenic were found in amounts within health level limits. Nitrate levels exceeding the health limit were confirmed for 2 drinking water sources

  10. The Army Ethic

    Science.gov (United States)

    2015-06-12

    The Constitution and Declaration of Independence simultaneously hold two different views of human nature, an individualist and a collectivist view...Profession, defines the Army Ethic as “the evolving set of laws, values, and beliefs, deeply embedded within the core of the Army culture and...incorporate other viewpoints or respond to shifts in morality, religion, economics, and other socio- cultural factors. This thesis will use the term

  11. The Total Army

    Science.gov (United States)

    2016-01-01

    http://thediplomat.com/2015/04/chinas-growing-cyberwar-capabilities/ (accessed April 25, 2016); Nicolas Giacometti, “China’s Nuclear Modernization and...link between the operational and tactical levels of war.48 47. Michelle Tan , “US Army Generals Criticize Outdated Deployment Model: ‘We’ve Gotten...unveils-its-big-8-initiatives/81882852/ (accessed March 16, 2016). 58. Michelle Tan , “US Army Generals Criticize Outdated Deployment Model: ‘We’ve

  12. Army Leader Transitions Handbook

    Science.gov (United States)

    2008-01-01

    The courseware allows users to tailor training materials to specific needs. Users access this at the CAL AKO website or Army eLearning https...usarmy.skillport.com/ skillportfe/login/usarmylogin.cfm. New users must register with eLearning . Then login, select “Army Custom Curricula” and scroll to...challenges of your transition. Patience, flexibility and a good understanding of influence techniques on your part will help make any needed realignment a

  13. Energy and Resource Recovery from Wastewater Treatment: State of the Art and Potential Application for the Army and the DoD

    Science.gov (United States)

    2015-06-01

    animals, as opposed to using it directly for human consumption. Biosolids derived from sludge Sludges are generated as a by-product of conventional...deodorants, and in odor-resistant clothing. Zeolitic sieves can be used to recover specific metals, and electrical methods, such as electrokinetics...Richard J. Scholze, Scott A. Waisner, and Chris S. Griggs June 2015 Approved for public release; distribution is unlimited. The US Army

  14. State and Federal Regulatory measurement responsibilities around medical facilities

    International Nuclear Information System (INIS)

    Lanzl, L.H.

    1976-01-01

    Radiation exposure to man is due chiefly to diagnostic x-ray procedures, in which radiation is intentionally directed toward a patient. Radiation therapy presents a lesser problem because a smaller percentage of the population is subjected to such treatment. Recently, some innovative steps were taken in the State of Illinois to reduce patient exposure in four diagnostic procedures without reducing the benefits derived therefrom. However, if these procedures are to be carried out properly, it is necessary to increase the precision and accuracy of radiation exposure measurements to the order of +-2 percent. The usual accuracy and precision of radiation protection measurements are of the order of +- 20 percent. Thus, should the Illinois radiation protection rules become widely adopted, the national dosimetry network will need to upgrade exposure measurement techniques

  15. The U.S. Army War College - An Analysis of Class and Seminar Composition and the Impacts of OPMS III

    National Research Council Canada - National Science Library

    Boltz, Cliff

    2003-01-01

    As the U.S. Army transforms, the United States Army War College (USAWC) endeavors to determine whether the right officers are attending the USAWC and what defines the experience base of arriving students...

  16. United States Department of Health and Human Services Biodosimetry and radiological/nuclear medical countermeasure programs

    International Nuclear Information System (INIS)

    Homer, Mary J.; Raulli, Robert; Esker, John; Moyer, Brian; Wathen, Lynne; DiCarlo-Cohen, Andrea L.; Maidment, Bert W.; Rios, Carmen; Macchiarini, Francesca; Hrdina, Chad; Prasanna, Pataje G.

    2016-01-01

    The United States Department of Health and Human Services (HHS) is fully committed to the development of medical countermeasures to address national security threats from chemical, biological, radiological, and nuclear agents. Through the Public Health Emergency Medical Countermeasures Enterprise, HHS has launched and managed a multi-agency, comprehensive effort to develop and operationalize medical countermeasures. Within HHS, development of medical countermeasures includes the National Institutes of Health (NIH), (led by the National Institute of Allergy and Infectious Diseases), the Office of the Assistant Secretary of Preparedness and Response/Biomedical Advanced Research and Development Authority (BARDA); with the Division of Medical Countermeasure Strategy and Requirements, the Centers for Disease Control and Prevention, and the Food and Drug Administration as primary partners in this endeavor. This paper describes various programs and coordinating efforts of BARDA and NIH for the development of medical countermeasures for radiological and nuclear threats. (authors)

  17. Annual Progress Report on the Research Program of the United States Army Medical Research Institute of Infectious Diseases on Medical Defense against Biological Agents for Fiscal Year 1981

    Science.gov (United States)

    1981-10-01

    drug analogues against 5 viruses in tissue culture; 38 were tested in rodents with RVF; 24 drugs had antiviral activity. lPreclinical toxicological... analogues of diphtheria toxin were tested for toxicity, ADP-ribo- ylation capability and WAD hy’drolysis activity. Toxin analogues deficient in each of hese...of drug control. Certain amines known to protect from diphtheria toxin (NH4CI, methylamine, and chloroquine ) were tested with reticulocytes and

  18. Mapping medical marijuana: state laws regulating patients, product safety, supply chains and dispensaries, 2017.

    Science.gov (United States)

    Klieger, Sarah B; Gutman, Abraham; Allen, Leslie; Pacula, Rosalie Liccardo; Ibrahim, Jennifer K; Burris, Scott

    2017-12-01

    (1) To describe open source legal data sets, created for research use, that capture the key provisions of US state medical marijuana laws. The data document how state lawmakers have regulated a medicine that remains, under federal law, a Schedule I illegal drug with no legitimate medical use. (2) To demonstrate the variability that exists across states in rules governing patient access, product safety and dispensary practice. Two legal researchers collected and coded state laws governing marijuana patients, product safety and dispensaries in effect on 1 February 2017, creating three empirical legal data sets. We used summary tables to identify the variation in specific statutory provisions specified in each state's medical marijuana law as it existed on 1 February 2017. We compared aspects of these laws to the traditional Federal approach to regulating medicine. Full data sets, codebooks and protocols are available through the Prescription Drug Abuse Policy System (http://www.pdaps.org/; Archived at http://www.webcitation.org/6qv5CZNaZ on 2 June 2017). Twenty-eight states (including the District of Columbia) have authorized medical marijuana. Twenty-seven specify qualifying diseases, which differ across states. All states protect patient privacy; only 14 protect patients against discrimination. Eighteen states have mandatory product safety testing before any sale. While the majority have package/label regulations, states have a wide range of specific requirements. Most regulate dispensaries (25 states), with considerable variation in specific provisions such as permitted product supply sources number of dispensaries per state and restricting proximity to various types of location. The federal ban in the United States on marijuana has resulted in a patchwork of regulatory strategies that are not uniformly consistent with the approach usually taken by the Federal government and whose effectiveness remains unknown. © 2017 Society for the Study of Addiction.

  19. Assisting IAEA Member States to Strengthen Regulatory Control, Particularly in the Medical Area

    International Nuclear Information System (INIS)

    Johnston, P.

    2016-01-01

    As per its Statue and Mandate, IAEA is developing Safety Standards and is also providing assistance for their application in Member States. One target and very large audience of this programme is the community of national regulatory bodies for radiation safety, expected to be established in all 168 Member States. Ionizing radiation is being used throughout the world in medical practices and medical exposure is the most significant manmade source of exposure to the population from ionizing radiation. Radiation accidents involving medical uses have accounted for more injuries and early acute health effects than any other type of radiation accident, including accidents at nuclear facilities. With the constant emerging of new technologies using ionizing radiation for medical diagnostic and treatment, there are on-going challenges for Regulatory bodies. The presentation will highlight some figures related to the medical exposure worldwide, and then it will introduce the main safety standards and other publications developed specifically for Regulatory Bodies and focusing on medical practices. It will also highlight the most important and recent mechanisms (tools, peer reviews and advisory services, training courses, networks) that the Agency is offering to its Member States in order to cope with the main challenges worldwide, contributing thus to the efficiency and effectiveness of the regulatory oversight of medical facilities and activities. (author)

  20. The state of radiologic teaching practice in preclinical medical education: survey of American medical, osteopathic, and podiatric schools.

    Science.gov (United States)

    Rubin, Zachary; Blackham, Kristine

    2015-04-01

    This study describes the state of preclinical radiology curricula in North American allopathic, osteopathic, and podiatric medical schools. An online survey of teaching methods, radiology topics, and future plans was developed. The Associations of American Medical Colleges, Colleges of Osteopathic Medicine, and Colleges of Podiatric Medicine listing for all US, Canadian, and Puerto Rican schools was used for contact information for directors of anatomy and/or radiology courses. Letters were sent via e-mail to 198 schools, with a link to the anonymous survey. Of 198 schools, 98 completed the survey (48%). Radiology curricula were integrated with other topics (91%), and taught by anatomists (42%) and radiologists (43%). The majority of time was spent on the topic of anatomy correlation (35%). Time spent teaching general radiology topics in the curriculum, such as physics (3%), modality differences (6%), radiation safety (2%), and contrast use (2%) was limited. Most schools had plans to implement an innovative teaching method in the near future (62%). The major challenges included limits on: time in the curriculum (73%); resources (32%); and radiology faculty participation (30%). A total of 82% reported that their curriculum did not model the suggestions made by the Alliance of Medical Student Educators in Radiology. This survey describes the current state of preclinical radiology teaching: curricula were nonstandard, integrated into other courses, and predominantly used for anatomy correlation. Other important contextual principles of the practice of radiology were seldom taught. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  1. Online nutrition and T2DM continuing medical education course launched on state-level medical association.

    Science.gov (United States)

    Hicks, Kristen K; Murano, Peter S

    2017-01-01

    The purpose of this research study was to determine whether a 1-hour online continuing medical education (CME) course focused on nutrition for type 2 diabetes would result in a gain in nutrition knowledge by practicing physicians. A practicing physician and dietitian collaborated to develop an online CME course (both webinar and self-study versions) on type 2 diabetes. This 1-hour accredited course was launched through the state-level medical association's education library, available to all physicians. Physicians (n=43) registered for the course, and of those, 31 completed the course in its entirety. A gain in knowledge was found when comparing pre- versus post-test scores related to the online nutrition CME ( P Online CME courses launched via state-level medical associations offer convenient continuing education to assist practicing physicians in addressing patient nutrition and lifestyle concerns related to chronic disease. The present diabetes CME one-credit course allowed physicians to develop basic nutrition care concepts on this topic to assist patients in a better way.

  2. Human Resource Automation Architecture Validation for a Transforming Army

    National Research Council Canada - National Science Library

    Devine, Patrick

    2005-01-01

    .... These steps if taken will result in better support to United States Army members while expediting access to commander's key information requirements and decreasing the workload of service providers...

  3. Hazardous Waste Surveys of Two Army Installations and an Army Hospital.

    Science.gov (United States)

    1980-08-01

    232 Nickel-63 Uranium-238 Plutonium-239 Polonium - 210 6 Army Medical Treatment Facilities: General Administration Army Regulation (AR) 40-2, 42A peren...Adhesive BN R 0x AU DOI545AO GI. 312 F 44 0,3 27)d17 N6341( 2 14,5 0 6 Adhesive 81 A XY AO D041419A0 PI 210 82140 O0 5824596 RO.34 140376139 Adhesi E ON...conform to clean air pollutant standards. 46 4 Noninfectious Solid Waste. Most wastes in this category are: (1) food waste from the military mess and

  4. The risk of disciplinary action by state medical boards against physicians prescribing opioids.

    Science.gov (United States)

    Richard, Jack; Reidenberg, Marcus M

    2005-02-01

    Concern of physicians about being disciplined for prescribing opioids for patients in pain is one cause for undertreatment of pain. This study was done to assess the actual risk of being disciplined by state medical boards. A review of records of actions by the New York State Board for Professional Medical Misconduct for 3 years and of all medical boards in the United States for 9 months was done to determine this risk. New York State, with 7.8% of U.S. physicians, had 10 physicians disciplined annually related to overprescribing opioids, while the total for the entire U.S. was 120 physicians annually. Most physicians disciplined had multiple violations in addition to overprescribing controlled substances. In the national sample, 43% were prescribing for themselves or for nonpatients, 12% prescribed for addicts without addressing the patients' problems of addiction, 42% had inadequate records, 19% prescribed without indication for opioids, 13% were incompetent in additional ways, and 8% were having sexual activity with patients. Not a single physician, for whom information was available, was disciplined solely for overprescribing opioids. The actual risk of an American physician being disciplined by a state medical board for treating a real patient with opioids for a painful medical condition is virtually nonexistent.

  5. Which US States Pose the Greatest Threats to Military Readiness and Public Health? Public Health Policy Implications for a Cross-sectional Investigation of Cardiorespiratory Fitness, Body Mass Index, and Injuries Among US Army Recruits.

    Science.gov (United States)

    Bornstein, Daniel B; Grieve, George L; Clennin, Morgan N; McLain, Alexander C; Whitsel, Laurie P; Beets, Michael W; Hauret, Keith G; Jones, Bruce H; Sarzynski, Mark A

    2018-01-09

    Many states in the southern region of the United States are recognized for higher rates of obesity, physical inactivity, and chronic disease. These states are therefore recognized for their disproportionate public health burden. The purpose of this study was to investigate state-level distributions of cardiorespiratory fitness, body mass index (BMI), and injuries among US Army recruits in order to determine whether or not certain states may also pose disproportionate threats to military readiness and national security. Sex-specific state-level values for injuries and fitness among 165 584 Army recruits were determined. Next, the relationship between median cardiorespiratory fitness and injury incidence at the state level was examined using Spearman correlations. Finally, multivariable Poisson regression models stratified by sex examined state-level associations between fitness and injury incidence, while controlling for BMI, and other covariates. Cardiorespiratory fitness and training-related injury incidence. A cluster of 10 states from the south and southeastern regions (Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, and Texas) produced male or female recruits who were significantly less fit and/or more likely to become injured than recruits from other US states. Compared with the "most fit states," the incidence of injuries increased by 22% (95% CI, 17-28; P < .001) and 28% (95% CI, 19-36; P < .001) in male and female recruits from the "least fit states," respectively. The impact of policies, systems, and environments on physical activity behavior, and subsequently fitness and health, has been clearly established. Advocacy efforts aimed at active living policies, systems, and environmental changes to improve population health often fail. However, advocating for active living policies to improve national security may prove more promising, particularly with legislators. Results from this study demonstrate

  6. Army Business Transformation - Next Steps

    National Research Council Canada - National Science Library

    2006-01-01

    As a follow-on to the Army Science Board 2005 Summer Study on Best Practices, the Army Science Board was tasked to identify areas where alternative approaches and application of transforming practices...

  7. ISD Designed Medical Specialist Training.

    Science.gov (United States)

    Rock, Samuel K., Jr.; Chagalis, George P.

    The Basic Medical Specialist course has one of the largest enrollments of the U.S. Army's Academy of Health Sciences; 11,000 soldiers were trained in this course in 1977 and 1978. Training encompasses both emergency first aid (for field medics) and basic nursing skills. A task force working to improve Army training developed this course, in…

  8. Periodic medical check-up among residents of three Nigerian South-western States

    Directory of Open Access Journals (Sweden)

    Saheed Opeyemi Usman

    2016-09-01

    Full Text Available Objectives: General medical examination is a common form of preventive medicine. Periodic medical check-up generally involves thorough history, physical examination and screening of asymptomatic persons by physicians on a regular basis as part of a routine health care process. Periodic medical check-up is considered effective in preventing illness and promoting health and reducing morbidity and mortality. This study is therefore designed to determine the knowledge, attitude and practice of periodic medical check-up among residents of Osun, Ondo and Ekiti States of Nigeria. It is also to determine the influence of educational status on its practice and compare the outcomes in the three states. Materials and Methods: The cross-sectional survey study utilizing both qualitative and quantitative method of data collection was conducted at various locations across the three states. The locations included those of public servants, private sector workers, artisans, traders, business men/women, farmers, among others. Results: 1200 consenting residents participated in the study in each of the three states. 518 (43.2% of the respondents in Ondo State are males while 682 (57.8% are females. 465 (38.8% of the respondents in Ekiti State are males while 735 (61.2% are females. 494 (41.2% of the respondents in Osun State are males while 706 (59.8% are females. The mean age in Ondo, Ekiti and Osun were 43.8 +/- 10.7 years, 44.6 +/- 11.5 years and 41.7 +/- 10.1 years respectively. 89.2%, 88.3% and 87.4% of the respondents are aware of periodic medical check-up in Ondo, Ekiti and Osun states respectively. Conclusion: There is high level of awareness of periodic medical check-up in all three states but the level of practice of routine medical check-up is low. The majority of the respondents probably don't practice it because their health insurance plan does not cover the medical check-up or due to individual/organizational financial constraints. [J Contemp Med 2016

  9. Military Medical Revolution: Military Trauma System

    Science.gov (United States)

    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

  10. A Comparative Analysis of Patient Access Modes at Wilford Hall United States Air Force Medical Center and Selected Civilian Medical Centers

    Science.gov (United States)

    1983-12-01

    In A COMPARATIVE ANALYSIS OF PATIENT ACCESS MODES AT WILFORD HALL UNITED STATES AIR FORCE MEDICAL CENTER N AND SELECTED CIVILIAN MEDICAL CENTERS0 N...current patient access modes at WHMC and several civilian medical centers of comparable size. This project has pursued the subject of patient access in...selected civilian medical centers which are comparable to WHMC in size, specialty mix, workload, and mission, providing responsive and efficient patient

  11. Should the United States Army Adapt New Conditions in Its HIV Policy to Allow Eligible HIV Positive Soldiers the Ability to Serve Overseas

    Science.gov (United States)

    2017-06-09

    2017b). HIV: Either of two retroviruses that infect and destroy helper T-cells of the immune system causing the marked reduction in their numbers that...2014a, 36). Since HIV-positive Soldiers do not pose a risk in non-combat locations and these HIV-positive Soldiers may have specific skill sets and...guidance to inform leadership will help mitigate this risk. Finally, the U.S. Army has made an investment in training its personnel and these skills

  12. Slaves of the state - medical internship and community service in South Africa.

    Science.gov (United States)

    Erasmus, Nicolette

    2012-06-05

    Owing to a chronic shortage of medical staff in South Africa, sleep-deprived medical interns and community service doctors work up to 200 hours of overtime per month under the state's commuted overtime policy. Nurses moonlight in circumvention of the Basic Conditions of Employment Act. For trainee doctors, overtime over 80 hours is unpaid, and rendered involuntarily under threat of not qualifying to practise medicine in South Africa. As forced labour, and sleep deprivation amounting to cruel and degrading treatment, it is outlawed in international law. No other professional group in the country is subjected to such levels of exploitation and discrimination by the state. These abuses should be challenged under the Constitution. Solutions include the installation of electronic time-recording in state hospitals, cessation of unpaid overtime, limits on medical intern shifts to a maximum of 16 hours, and an investigation by the Human Rights Commission of South Africa.

  13. Gifts and influence: Conflict of interest policies and prescribing of psychotropic medications in the United States.

    Science.gov (United States)

    King, Marissa; Bearman, Peter S

    2017-01-01

    The pharmaceutical industry spends roughly 15 billion dollars annually on detailing - providing gifts, information, samples, trips, honoraria and other inducements - to physicians in order to encourage them to prescribe their drugs. In response, several states in the United States adopted policies that restrict detailing. Some states banned gifts from pharmaceutical companies to doctors, other states simply required physicians to disclose the gifts they receive, while most states allowed unrestricted detailing. We exploit this geographic variation to examine the relationship between gift regulation and the diffusion of four newly marketed medications. Using a dataset that captures 189 million psychotropic prescriptions written between 2005 and 2009, we find that uptake of new costly medications was significantly lower in states with marketing regulation than in areas that allowed unrestricted pharmaceutical marketing. In states with gift bans, we observed reductions in market shares ranging from 39% to 83%. Policies banning or restricting gifts were associated with the largest reductions in uptake. Disclosure policies were associated with a significantly smaller reduction in prescribing than gift bans and gift restrictions. In states that ban gift-giving, peer influence substituted for pharmaceutical detailing when a relatively beneficial drug came to market and provided a less biased channel for physicians to learn about new medications. Our work suggests that policies banning or limiting gifts from pharmaceutical representatives to doctors are likely to be more effective than disclosure policies alone. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Medical devices and the Middle East: market, regulation, and reimbursement in Gulf Cooperation Council states

    Directory of Open Access Journals (Sweden)

    Howard JJ

    2014-11-01

    Full Text Available Jason J Howard Division of Paediatric Orthopaedics, Department of Surgery, Sidra Medical and Research Center, Doha, Qatar Abstract: With some of the richest economies in the world, the Gulf Cooperation Council (GCC is undergoing rapid growth not only in its population but also in health care expenditure. Despite the GCC's abundance of hydrocarbon-based wealth, the drivers of the medical device industry in the GCC are still in flux, with gains yet to be made in areas of infrastructure, regulation, and reimbursement. However, the regional disease burden, expanding health insurance penetration, increasing privatization, and a desire to attract skilled expatriate health care providers have led to favorable conditions for the medical device market in the GCC. The purpose of this article is to investigate the current state of the GCC medical device industry, with respect to market, regulation, and reimbursement, paying special attention to the three largest medical device markets: Saudi Arabia, the United Arab Emirates, and Qatar. The GCC would seem to represent fertile ground for the development of medical technologies, especially those in line with the regional health priorities of the respective member states. Keywords: medical devices, regulation, reimbursement, Middle East 

  15. Army Contract Writing System (ACWS)

    Science.gov (United States)

    2016-03-01

    2016 Major Automated Information System Annual Report Army Contract Writing System (ACWS) Defense Acquisition Management Information Retrieval...Information 4 Responsible Office 4 References 4 Program Description 5 Business Case 5 Program Status 6 Schedule 7 Performance...Program Information Program Name Army Contract Writing System (ACWS) DoD Component Army Responsible Office Program Manager References MAIS

  16. State Variation in Medical Imaging: Despite Great Variation, the Medicare Spending Decline Continues.

    Science.gov (United States)

    Rosenkrantz, Andrew B; Hughes, Danny R; Duszak, Richard

    2015-10-01

    The purpose of this study was to assess state-level trends in per beneficiary Medicare spending on medical imaging. Medicare part B 5% research identifiable files from 2004 through 2012 were used to compute national and state-by-state annual average per beneficiary spending on imaging. State-to-state geographic variation and temporal trends were analyzed. National average per beneficiary Medicare part B spending on imaging increased 7.8% annually between 2004 ($350.54) and its peak in 2006 ($405.41) then decreased 4.4% annually between 2006 and 2012 ($298.63). In 2012, annual per beneficiary spending was highest in Florida ($367.25) and New York ($355.67) and lowest in Ohio ($67.08) and Vermont ($72.78). Maximum state-to-state geographic variation increased over time, with the ratio of highest-spending state to lowest-spending state increasing from 4.0 in 2004 to 5.5 in 2012. Spending in nearly all states decreased since peaks in 2005 (six states) or 2006 (43 states). The average annual decrease among states was 5.1% ± 1.8% (range, 1.2-12.2%) The largest decrease was in Ohio. In only two states did per beneficiary spending increase (Maryland, 12.5% average annual increase since 2005; Oregon, 4.8% average annual increase since 2008). Medicare part B average per beneficiary spending on medical imaging declined in nearly every state since 2005 and 2006 peaks, abruptly reversing previously reported trends. Spending continued to increase, however, in Maryland and Oregon. Identification of state-level variation may facilitate future investigation of the potential effect of specific and regional changes in spending on patient access and outcomes.

  17. The current format and ongoing advances of medical education in the United States.

    Science.gov (United States)

    Gishen, Kriya; Ovadia, Steven; Arzillo, Samantha; Avashia, Yash; Thaller, Seth R

    2014-01-01

    The objective of this study was to examine the current system of medical education along with the advances that are being made to support the demands of a changing health care system. American medical education must reform to anticipate the future needs of a changing health care system. Since the dramatic transformations to medical education that followed the publication of the Flexner report in 1910, medical education in the United States has largely remained unaltered. Today, the education of future physicians is undergoing modifications at all levels: premedical education, medical school, and residency training. Advances are being made with respect to curriculum design and content, standardized testing, and accreditation milestones. Fields such as plastic surgery are taking strides toward improving resident training as the next accreditation system is established. To promote more efficacious medical education, the American Medical Association has provided grants for innovations in education. Likewise, the Accreditation Council for Graduate Medical Education outlined 6 core competencies to standardize the educational goals of residency training. Such efforts are likely to improve the education of future physicians so that they are able to meet the future needs of American health care.

  18. Otolaryngology in the medical school curriculum: Current trends in the United States.

    Science.gov (United States)

    Boscoe, Elizabeth F; Cabrera-Muffly, Cristina

    2017-02-01

    To identify trends in medical school otolaryngology curriculum requirements. Survey of United States allopathic medical schools. A survey was sent to deans of curriculum at allopathic medical schools. We identified opportunities for medical students to learn basic concepts in otolaryngology during their undergraduate medical training. The opportunities were classified into preclinical and clinical as well as elective and mandatory rotations. Of the schools surveyed, 60% responded. Mean class size was 149 students. Sixty-eight percent of surveyed schools noted that 75% to 100% of their students participated in preclinical otolaryngology experiences, with 59% reporting a mandatory preclinical otolaryngology module for all students. Eighty-nine percent of schools offered otolaryngology as a clinical elective rotation, with a mean of 12 students participating yearly. Only 7% of schools required a mandatory otolaryngology clinical rotation. Our data suggest that medical students do not receive sufficient exposure to otolaryngology during medical school. Increased requirements for otolaryngology curriculum may be beneficial to all medical students, regardless of their specialty choice. NA. Laryngoscope, 00:000-000, 2016 127:346-348, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  19. Pharmacist prescriptive authority for smoking cessation medications in the United States.

    Science.gov (United States)

    Adams, Alex J; Hudmon, Karen Suchanek

    2018-02-06

    To characterize the status of state laws regarding the expansion of pharmacists' prescriptive authority for smoking cessation medications and to summarize frequently asked questions and answers that arose during the associated legislative debates. Legislative language was reviewed and summarized for all states with expanded authority, and literature supporting the pharmacist's capacity for an expanded role in smoking cessation is described. The core elements of autonomous tobacco cessation prescribing models for pharmacists vary across states. Of 7 states that currently have fully or partially delineated protocols, 4 states (Colorado, Idaho, Indiana, New Mexico) include all medications approved by the U.S. Food and Drug Administration for smoking cessation, and 3 (Arizona, California, Maine) include nicotine replacement therapy products only. The state protocol in Oregon is under development. Most states specify minimum cessation education requirements and define specific elements (e.g., patient screening, cessation intervention components, and documentation requirements) for the autonomous prescribing models. Through expanded authority and national efforts to advance the tobacco cessation knowledge and skills of pharmacy students and licensed pharmacists, the profession's role in tobacco cessation has evolved substantially in recent years. Eight states have created, or are in the process of creating, pathways for autonomous pharmacist prescriptive authority. States aiming to advance tobacco control strategies to help patients quit smoking might consider approaches like those undertaken in 8 states. Copyright © 2018 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  20. Polyester Culture: The U.S. Army’s Aversion to Broadening Assignments

    Science.gov (United States)

    2012-04-18

    United States Army Human Resources Command, OPMD- MFE - I. 17 United States Code, Title X, Section 661, Office of the Law Revision Counsel. Web...Command, OPMD- MFE -Joint Policy Desk. 19 Data from the United States Army Human Resources Command, OPMD- MFE - I. 20 Ibid. 21 Max Webber, “Essays in

  1. Medical and Nonmedical Use of Prescription Opioids among High School Seniors in the United States

    Science.gov (United States)

    McCabe, Sean Esteban; West, Brady T.; Teter, Christian J.; Boyd, Carol J.

    2012-01-01

    Objective To determine the prevalence of medical and nonmedical use of prescription opioids among high school seniors in the United States, and to assess substance use behaviors based on medical and nonmedical use of prescription opioids. Design Nationally representative samples of high school seniors (modal age 18) were surveyed during the spring of their senior year via self-administered questionnaires. Setting Data were collected in public and private high schools. Participants The sample consisted of 7,374 students from three independent cohorts (2007-09). Main Outcome Measures Self-reports of medical and nonmedical use of prescription opioids and other substance use. Results An estimated 17.6% of high school seniors reported lifetime medical use of prescription opioids, while 12.9% reported nonmedical use of prescription opioids. Gender differences in the medical and nonmedical use were minimal, while racial/ethnic differences were extensive. Over 37% of nonmedical users reported intranasal administration of prescription opioids. An estimated 80% of nonmedical users with an earlier history of medical use had obtained prescription opioids from a prescription they had previously. The odds of substance use behaviors were greater among individuals who reported any history of nonmedical use of prescription opioids relative to those who reported medical use only. Conclusions Nearly one in every four high school seniors in the United States has ever had some exposure to prescription opioids either medically or nonmedically. The quantity of prescription opioids and number of refills prescribed to adolescents should be carefully considered and closely monitored to reduce subsequent nonmedical use of leftover medication. PMID:22566521

  2. Distinguishing medication-free subjects with unipolar disorder from subjects with bipolar disorder: state matters.

    Science.gov (United States)

    Rive, Maria M; Redlich, Ronny; Schmaal, Lianne; Marquand, André F; Dannlowski, Udo; Grotegerd, Dominik; Veltman, Dick J; Schene, Aart H; Ruhé, Henricus G

    2016-11-01

    Recent studies have indicated that pattern recognition techniques of functional magnetic resonance imaging (fMRI) data for individual classification may be valuable for distinguishing between major depressive disorder (MDD) and bipolar disorder (BD). Importantly, medication may have affected previous classification results as subjects with MDD and BD use different classes of medication. Furthermore, almost all studies have investigated only depressed subjects. Therefore, we focused on medication-free subjects. We additionally investigated whether classification would be mood state independent by including depressed and remitted subjects alike. We applied Gaussian process classifiers to investigate the discriminatory power of structural MRI (gray matter volumes of emotion regulation areas) and resting-state fMRI (resting-state networks implicated in mood disorders: default mode network [DMN], salience network [SN], and lateralized frontoparietal networks [FPNs]) in depressed (n=42) and remitted (n=49) medication-free subjects with MDD and BD. Depressed subjects with MDD and BD could be classified based on the gray matter volumes of emotion regulation areas as well as DMN functional connectivity with 69.1% prediction accuracy. Prediction accuracy using the FPNs and SN did not exceed chance level. It was not possible to discriminate between remitted subjects with MDD and BD. For the first time, we showed that medication-free subjects with MDD and BD can be differentiated based on structural MRI as well as resting-state functional connectivity. Importantly, the results indicated that research concerning diagnostic neuroimaging tools distinguishing between MDD and BD should consider mood state as only depressed subjects with MDD and BD could be correctly classified. Future studies, in larger samples are needed to investigate whether the results can be generalized to medication-naïve or first-episode subjects. © 2016 John Wiley & Sons A/S. Published by John Wiley

  3. Exchange sex among people receiving medical care for HIV in the United States - medical monitoring project 2009-2013.

    Science.gov (United States)

    Olaiya, Oluwatosin; Nerlander, Lina; Mattson, Christine L; Beer, Linda

    2018-04-20

    Many studies of persons who exchange sex for money or drugs have focused on their HIV acquisition risk, and are often limited to select populations and/or geographical locations. National estimates of exchange sex among people living with HIV (PLWH) who are in medical care, and its correlates, are lacking. To address these gaps, we analyzed data from the Medical Monitoring Project, a surveillance system that produces nationally representative estimates of behavioral and clinical characteristics of PLWH receiving medical care in the United States, to estimate the weighted prevalence of exchange sex overall, and by selected socio-demographic, behavioral and clinical characteristics. We found 3.6% of sexually active adults reported exchange sex in the past 12 months. We found a higher prevalence of exchange sex among transgender persons, those who experienced homelessness, and those with unmet needs for social and medical services. Persons who exchanged sex were more likely to report depression and substance use than those who did not exchange sex. We found a higher prevalence of sexual behaviors that increase the risk of HIV transmission and lower viral suppression among persons who exchanged sex. PLWH who exchanged sex had a higher prevalence of not being prescribed ART, and not being ART adherent than those who did not exchange sex. We identify several areas for intervention, including: provision of or referral to services for unmet needs (such as housing or shelter), enhanced delivery of mental health and substance abuse screening and treatment, risk-reduction counseling, and ART prescription and adherence support services.

  4. Variations by state in physician disciplinary actions by US medical licensure boards.

    Science.gov (United States)

    Harris, John Alexander; Byhoff, Elena

    2017-03-01

    To investigate the variation in the rate of state medical board physician disciplinary actions between US states. Longitudinal study of state medical board physician disciplinary action rates using the US National Practitioner Data Bank and American Medical Association estimates of physician demographics across all 50 states and the District of Columbia from 2010 to 2014. Results were reliability adjusted using a multilevel logistic model controlling for year of disciplinary action, physicians per capita in each state and the rate of malpractice claims per physician in each state. From 2010 to 2014, there were a total of 5046 506 physician licensure years present. Medical boards reported a total of 21 647 disciplinary actions, of which 5137 (23.7%) were major disciplinary actions involving revocation, suspension or surrender of licence. The mean, reliability-adjusted rate of all disciplinary actions was 3.76 (95% CI 3.21 to 4.42) with a significant variation between states. State rates ranged from 2.13 (95% CI 1.86 to 2.45) to 7.93 (95% CI 6.33 to 9.93) actions per 1000 physicians. The mean rate of major disciplinary actions was 2.71 (95% CI 1.93 to 3.82), ranging from 0.64 (95% CI 0.53 to 0.76) to 2.71 (95% CI 1.93 to 3.82) actions per 1000 physicians. The correlation between the rate of major disciplinary action and minor disciplinary actions was 0.34. There is a significant, fourfold variation in the annual rate of medical board physician disciplinary action by state in the USA. When indicated, state medical boards should consider policies aimed at improving standardisation and coordination to provide consistent supervision to physicians and ensure public safety. 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/.

  5. Psychotropic Medication Use Among Adults With Schizophrenia and Schizoaffective Disorder in the United States.

    Science.gov (United States)

    Stroup, T Scott; Gerhard, Tobias; Crystal, Stephen; Huang, Cecilia; Tan, Zhiqiang; Wall, Melanie M; Mathai, Chacku M; Olfson, Mark

    2018-05-01

    The authors examined the use of different classes of psychotropic medication in outpatient treatment of schizophrenia and schizoaffective disorder. Data from the United States Medicaid program were used to examine psychotropic medication use in a cohort of patients who had a diagnosis of schizophrenia or schizoaffective disorder in the calendar year 2010. The cohort of Medicaid recipients who filled one or more prescriptions for a psychotropic medication in 2010 included 116,249 patients classified as having schizophrenia and 84,537 classified as having schizoaffective disorder. During 2010, 86.1% of patients with schizoaffective disorder and 70.1% with schizophrenia were treated with two or more different classes of psychotropic. Psychotropic medications other than antipsychotics were commonly prescribed for individuals with a diagnosis of schizophrenia or schizoaffective disorder. Their widespread use and uncertainty about their net benefits signal a need for research on their efficacy, safety, and appropriate use in these conditions.

  6. 42 CFR 456.6 - Review by State medical agency of appropriateness and quality of services.

    Science.gov (United States)

    2010-10-01

    ... and quality of services. 456.6 Section 456.6 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Provisions § 456.6 Review by State medical agency of appropriateness and quality of services. (a) The... professional health personnel of the appropriateness and quality of Medicaid services. (b) The purpose of this...

  7. [State policy at the end of life. The transformation of medical deontology].

    Science.gov (United States)

    Serrano Ruiz-Calderón, José Miguel

    2012-01-01

    The contemporary state invades privacy in ways that affect even the end of life process. It develops public policies that can affect medical ethics. This limitation of power leaves the doctor's attention to the profession and may become a convenient code.

  8. An Update on the Status of Anatomical Sciences Education in United States Medical Schools

    Science.gov (United States)

    Drake, Richard L.; McBride, Jennifer M.; Pawlina, Wojciech

    2014-01-01

    Curricular changes continue at United States medical schools and directors of gross anatomy, microscopic anatomy, neuroscience/neuroanatomy, and embryology courses continue to adjust and modify their offerings. Developing and supplying data related to current trends in anatomical sciences education is important if informed decisions are going to…

  9. Advances in solid state laser technology for space and medical applications

    Science.gov (United States)

    Byvik, C. E.; Buoncristiani, A. M.

    1988-01-01

    Recent developments in laser technology and their potential for medical applications are discussed. Gas discharge lasers, dye lasers, excimer lasers, Nd:YAG lasers, HF and DF lasers, and other commonly used lasers are briefly addressed. Emerging laser technology is examined, including diode-pumped lasers and other solid state lasers.

  10. The Army Lawyer

    Science.gov (United States)

    2007-07-01

    authors in the articles do not necessarily reflect the view of The Judge Advocate General or the Department of the Army. Masculine or feminine...for the hegemonic power (read ‘United States’) and its followers to determine international public enemy on a case-by-case basis. A legal

  11. Army Sustainability Report 2010

    Science.gov (United States)

    2011-09-01

    the Fairfax Village Neighborhood Center’s native plant and butterfly garden. The center is the first LEED platinum military project (photo: US Army... Bush in 2007. 11 Statement of Deputy Under Secretary of Defense for Strategy, Plans, and Forces, Kathleen Hicks before the Senate Environment and

  12. Perceptions of the state policy environment and adoption of medications in the treatment of substance use disorders.

    Science.gov (United States)

    Knudsen, Hannah K; Abraham, Amanda J

    2012-01-01

    Despite growing interest in the use of evidence-based treatment practices for treating substance use disorders, adoption of medications by treatment programs remains modest. Drawing on resource dependence and institutional theory, this study examined the relationships between adoption of medications by treatment programs and their perceptions about the state policy environment. Data were collected through mailed surveys and telephone interviews with 250 administrators of publicly funded substance abuse treatment programs in the United States between 2009 and 2010. Multiple imputation and multivariate logistic regression were used to estimate the associations between perceptions of the state policy environment and the odds of adopting at least one medication for the treatment of substance use disorders. A total of 91 (37%) programs reported having prescribed any medication for treatment of a substance use disorder. Programs were significantly more likely to have adopted at least one medication if they perceived greater support for medications by the Single State Agency. The odds of adoption were significantly greater if the program was aware that at least one medication was included on their state's Medicaid formulary and that state-contract funding permitted the purchase of medications. States may play significant roles in promoting the adoption of medications, but adequate dissemination of information about state policies and priorities may be vital to further adoption. Future research should continue to study the relationships between the adoption of medications for treating substance use disorders and the evolving policy environment.

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

    Science.gov (United States)

    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.

  14. Educational gradients in psychotropic medication use among older adults in Costa Rica and the United States.

    Science.gov (United States)

    Domino, Marisa Elena; Dow, William H; Coto-Yglesias, Fernando

    2014-10-01

    The relationship of education, psychiatric diagnoses, and use of psychotropic medication has been explored in the United States, but little is known about this relationship in poorer countries, despite the high burden of mental illness in these countries. This study estimated educational gradients in diagnosis and psychotropic drug use in the United States and Costa Rica, a middle-income country with universal health insurance. Analyses were conducted by using data of older adults (≥60) from the 2005 U.S. Medical Expenditure Panel Survey (N=4,788) and the 2005 Costa Rican Longevity and Healthy Aging Study (N=2,827). Logistic regressions examined the effect of education level (low, medium, or high) and urban residence on the rates of self-reported mental health diagnoses, screening diagnosis, and psychotropic medication use with and without an associated psychiatric diagnosis. Rates of self-reported diagnoses were lower in the United States (12%) than in Costa Rica (20%), possibly reflecting differences in survey wording. In both countries, the odds of having depression were significantly lower among persons with high education. In Costa Rica, use of psychotropic medication among persons with self-reported diagnoses increased by education level. The educational gradients in medication use were different in the United States and Costa Rica, and stigma and access to care in these countries may play an important role in these differences, although type of insurance did not affect educational gradients in the United States. These analyses increase the evidence of the role of education in use of the health care system.

  15. Who killed Rambhor?: The state of emergency medical services in India

    Directory of Open Access Journals (Sweden)

    Rajesh H Garg

    2012-01-01

    Full Text Available In India, the healthcare delivery system starts up from the sub-center at the village level and reaches up to super specialty medical centers providing state of the art emergency medical services (EMS. These highest centers, located in big cities, are considered the last referral points for the patients from nearby cities and states. As the incidents of rail and road accidents have increased in recent years, the role of EMS becomes critical in saving precious lives. But when the facilities and management of these emergency centers succumbs before the patient, then the question arises regarding the adequate availability and quality of EMS. The death of an unknown common man, Rambhor, for want of EMS in three big hospitals in the national capital of India put a big question on the "health" of the emergency health services in India. The emergency services infrastructure seems inadequate and quality and timely provision of EMS to critical patients appears unsatisfactory. There is lack of emergency medicine (EM specialists in India and also the postgraduation courses in EM have not gained foot in our medical education system. Creation of a Centralized Medical Emergency Body, implementation of management techniques, modification of medical curriculum, and fixing accountability are some of the few steps which are required to improve the EMS in India.

  16. Medical devices and the Middle East: market, regulation, and reimbursement in Gulf Cooperation Council states.

    Science.gov (United States)

    Howard, Jason J

    2014-01-01

    With some of the richest economies in the world, the Gulf Cooperation Council (GCC) is undergoing rapid growth not only in its population but also in health care expenditure. Despite the GCC's abundance of hydrocarbon-based wealth, the drivers of the medical device industry in the GCC are still in flux, with gains yet to be made in areas of infrastructure, regulation, and reimbursement. However, the regional disease burden, expanding health insurance penetration, increasing privatization, and a desire to attract skilled expatriate health care providers have led to favorable conditions for the medical device market in the GCC. The purpose of this article is to investigate the current state of the GCC medical device industry, with respect to market, regulation, and reimbursement, paying special attention to the three largest medical device markets: Saudi Arabia, the United Arab Emirates, and Qatar. The GCC would seem to represent fertile ground for the development of medical technologies, especially those in line with the regional health priorities of the respective member states.

  17. United States academic medical centers: priorities and challenges amid market transformation.

    Science.gov (United States)

    Thompson, Irene M; Anason, Barbara

    2012-01-01

    United States academic medical centers (AMCs) have upheld their long-standing reputation for excellence by teaching and training the next generation of physicians, supporting medical research, providing world-class medical care, and offering breakthrough treatments for highly complex medical cases. In recent years, the pace and direction of change reshaping the American health care industry has created a set of new and profound challenges that AMC leaders must address in order to sustain their institutions. University HealthSystem Consortium (UHC) is an alliance of 116 leading nonprofit academic medical centers and 276 of their affiliated hospitals, all of which are focused on delivering world-class patient care. Formed in 1984, UHC fosters collaboration with and among its members through its renowned programs and services in the areas of comparative data and analytics, performance improvement, supply chain management, strategic research, and public policy. Each year, UHC surveys the executives of its member institutions to understand the issues they view as most critical to sustaining the viability and success of their organizations. The results of UHC's most recent 2011 member survey, coupled with a 2012 Strategic Health Perspectives Harris Interactive presentation, based in parton surveys of major health care industry stakeholders reveal the most important and relevant issues and opportunities that hospital leaders face today, as the United States health care delivery system undergoes a period of unprecedented transformation.

  18. Characteristics of HIV-Positive Transgender Men Receiving Medical Care: United States, 2009-2014.

    Science.gov (United States)

    Lemons, Ansley; Beer, Linda; Finlayson, Teresa; McCree, Donna Hubbard; Lentine, Daniel; Shouse, R Luke

    2018-01-01

    To present the first national estimate of the sociodemographic, clinical, and behavioral characteristics of HIV-positive transgender men receiving medical care in the United States. This analysis included pooled interview and medical record data from the 2009 to 2014 cycles of the Medical Monitoring Project, which used a 3-stage, probability-proportional-to-size sampling methodology. Transgender men accounted for 0.16% of all adults and 11% of all transgender adults receiving HIV medical care in the United States from 2009 to 2014. Of these HIV-positive transgender men receiving medical care, approximately 47% lived in poverty, 69% had at least 1 unmet ancillary service need, 23% met criteria for depression, 69% were virally suppressed at their last test, and 60% had sustained viral suppression over the previous 12 months. Although they constitute a small proportion of all HIV-positive patients, more than 1 in 10 transgender HIV-positive patients were transgender men. Many experienced socioeconomic challenges, unmet needs for ancillary services, and suboptimal health outcomes. Attention to the challenges facing HIV-positive transgender men may be necessary to achieve the National HIV/AIDS Strategy goals of decreasing disparities and improving health outcomes among transgender persons.

  19. Library instruction in medical education: a survey of current practices in the United States and Canada.

    Science.gov (United States)

    Nevius, Amanda M; Ettien, A'Llyn; Link, Alissa P; Sobel, Laura Y

    2018-01-01

    The most recent survey on instruction practices in libraries affiliated with accredited medical institutions in the United States was conducted in 1996. The present study sought to update these data, while expanding to include Canadian libraries. Additional analysis was undertaken to test for statistically significant differences between library instruction in the United States and Canada and between libraries affiliated with highly ranked and unranked institutions. A twenty-eight-question survey was distributed to libraries affiliated with accredited US and Canadian medical schools to assess what and how often librarians teach, as well as how librarians are involved in the curriculum committee and if they are satisfied with their contact with students and faculty. Quantitative data were analyzed with SAS, R, and MedCalc. Most of the seventy-three responding libraries provided instruction, both asynchronously and synchronously. Library instruction was most likely to be offered in two years of medical school, with year one seeing the most activity. Database use was the most frequently taught topic, and libraries reported a median of five librarians providing instruction, with larger staffs offering slightly more education sessions per year. Libraries associated with highly ranked schools were slightly more likely to offer sessions that were integrated into the medical school curriculum in year four and to offer sessions in more years overall. In US and Canadian libraries, regardless of the rank of the affiliated medical school, librarians' provision of instruction in multiple formats on multiple topics is increasingly common.

  20. Current disparities in the prices of medical materials between Japan and the United States: further investigation of cardiovascular medical devices.

    Science.gov (United States)

    Yasunaga, Hideo; Ide, Hiroo; Imamura, Tomoaki

    2007-02-01

    Prices of medical devices in Japan were previously reported to be 2 to 4 times higher than those in the United States in 1996 and 1997. However, such data are out of date. We previously compared the market prices in early 2005 between Japan and the US for 16 items in 10 categories of medical materials, and showed that price differences still existed for all these items. However, the number of items investigated was small for each category, and generalization of the results might have been limited. The present study conducted a further investigation into price information for multiple items for each category, focusing on 5 cardiovascular devices. The US market price information was obtained from interviews of a healthcare provider network and 2 different group-purchasing organizations. We could obtain price information on 19 items in 5 categories. We substituted the Japanese reimbursement prices for the Japanese market prices. The price ratio (Japanese reimbursement price / US market price)was 2.0-3.5 for coronary stents, 5.9-6.8 for percutaneous transluminal coronary angioplasty catheters, 2.2-3.5 for pacemakers, 1.6-2.5 for mechanical valves, and 3.4-4.7 for oxygenators. The price disparities for cardiovascular devices between Japan and the US were reconfirmed. Japan's healthcare system should establish group-purchasing organizations, promote centers of clinical excellence, and abolish regulation of parallel imports and protectionism under the Japanese Pharmaceutical Affairs Law.

  1. Army Logistician. Volume 41, Issue 1, January-February 2009

    Science.gov (United States)

    2009-02-01

    metrics and academic discipline. ARMy LOGISTICIAN PROFESSIONAL BULLETIN OF UNITED STATES ARMY LOGISTICS 47 According to Miles and Huberman , “when...transformation efforts from an NCW 8 Matthew B. Miles and A. Michael Huberman , Qualitative Data Analysis, Sage, Thousand Oaks, California, 1994. 9 Department of...their first 5 months in Iraq, the 426th BSB “Taskmasters” drove more than 89,000 miles on perilous roads to deliver their essential cargo—a feat

  2. Culture and medical decision making: Healthcare consumer perspectives in Japan and the United States.

    Science.gov (United States)

    Alden, Dana L; Friend, John M; Lee, Angela Y; de Vries, Marieke; Osawa, Ryosuke; Chen, Qimei

    2015-12-01

    Two studies identified core value influences on medical decision-making processes across and within cultures. In Study 1, Japanese and American adults reported desired levels of medical decision-making influence across conditions that varied in seriousness. Cultural antecedents (interdependence, independence, and power distance) were also measured. In Study 2, American adults reviewed a colorectal cancer screening decision aid. Decision preparedness was measured along with interdependence, independence, and desire for medical information. In Study 1, higher interdependence predicted stronger desire for decision-making information in both countries, but was significantly stronger in Japan. The path from information desire to decision-making influence desire was significant only in Japan. The independence path to desire for decision-making influence was significant only in the United States. Power distance effects negatively predicted desire for decision-making influence only in the United States. For Study 2, high (low) interdependents and women (men) in the United States felt that a colorectal cancer screening decision aid helped prepare them more (less) for a medical consultation. Low interdependent men were at significantly higher risk for low decision preparedness. Study 1 suggests that Japanese participants may tend to view medical decision-making influence as an interdependent, information sharing exchange, whereas American respondents may be more interested in power sharing that emphasizes greater independence. Study 2 demonstrates the need to assess value influences on medical decision-making processes within and across cultures and suggests that individually tailored versions of decision aids may optimize decision preparedness. (c) 2015 APA, all rights reserved).

  3. Department of the Army - The Fiscal Year 2008 Military Personnel, Army Appropriation and the Antideficiency Act

    Science.gov (United States)

    2010-06-22

    of the Army, U.S. Army Audit Agency, Budgeting for the Military Personnel, Army Appropriation, Report No. A-2010-0028- FFM (Jan. 6, 2010); Department...of the Army, U.S. Army Audit Agency, Military Personnel, Army FY 05 Subsistence Charges, Report No. A-2008-0037- FFM (Feb. 12, 2008); Department of

  4. [Medical doctors as the state presidents and prime ministers--a biographical analysis].

    Science.gov (United States)

    Lass, Piotr; Szarszewski, Adam; Gaworska-Krzemińska, Aleksandra; Sławek, Jarosław

    2012-01-01

    The authors overviewed the biographies of 29 medical doctors who became the heads of the state or the prime ministers of their countries. Most of them ruled in a countries of fresh or unstable democracies, most often in Asia, Africa and Latin America, three of them were bloody dictators. With the exemptions of Georges Clemenceau and Sun-Yat-Sen they were not famous as historical figures, although some were good administrators like the prime minister of Norway, Gro Harlem Brundtland, Malayan prime minister Mahatir bin Mohamad, Brasilian and Chilean presidents, Juscelino Kubitschek and Veronica Bachelet. Regarding specialisation was mostly general medics or they specialised in public health.

  5. The workplace satisfaction of Romania’s medical personnel in state and public institutions

    Directory of Open Access Journals (Sweden)

    Ghenu Cristina

    2017-07-01

    Full Text Available Nowadays the Romanian medical system is facing changes in terms of qualified personnel. Each year a great number of doctors decide to leave Romania in order to conduct practice in other countries with better working conditions. In this situation where doctors are no longer pleased to work in Romanian institutions, can we question the quality of their working environment? This study aims to determine the workplace satisfaction of Romania’s medical personnel currently working in private as well as state healthcare institutions. In this process, the study also discloses the inside image of Romanian medical units concerning the quality of the working environment, the quality of communications between subordinates belonging to the same section as well as their relations with their „direct superior”, „hierarchic superior” and „senior management”. To construct the current research, Romanian medical personnel completed a survey in order to determine their knowledge and judgment regarding their working environment. The research implied two phases: the first phase lasted one month and a half during which 100 medical personnel from a public hospital were selected to answer a survey; the second phase followed and it targeted the application of the same questions on 100 medical personnel working in a private institution. The survey comprised situations of everyday life in which any employee can be found. The results reveal the present situation of Romanian medical personnel, how often, despite of their unpleasant working conditions, they are forced to give their best in order to provide the quality medical treatment that any patient is entitled to. Therefore, the findings (1 reveal the inside image of Romanian hospital’s system and (2 offer an empirical foundation for subsequent research and improvement of working environments in Romanian hospitals.

  6. Exposure and Knowledge of Sharps Injuries among Medical Students in Seven States of Mexico

    Directory of Open Access Journals (Sweden)

    Adrián Camacho-Ortiz

    2015-03-01

    Full Text Available Background: Medical students are vulnerable to accidental exposure to blood-borne pathogens when performing clinical activities. Knowle­dge of both the prevalence of exposure and necessary reporting procedures is important to minimize the risk of harm to medical students. Methods: A cross-sectional online survey of medical students from 19 universities from seven states in Mexico was utilized to determine the prevalence of needle stick injuries amongst medical students and the associated reporting procedures. Results: We included 312 res­pondents; of these, 52.24% were men and 47.76% were women, with a mean age of 23.19 years (SD ± 2.11 years. Nearly all of them (94.23% were medical students doing clerkships in public hospitals. Mean knowledge score of blood-borne pathogens was 3.6 (SD ± 1.16 on a scale of 0-10 designed specifically for this study. Thirty-five per cent of the respondents had sustained a needle stick injury at some point during their medical school training, and 33.97% reported some type of mucocutaneous exposure. Overall, the non-reporting rate of needle stick injury was 48.34%. Approximately 25% of the respondents were not familiar with reporting procedures in the event of a needle stick injury or mucocutaneous exposure; 61.50% had received information from their hospital about the standard protocol to follow after a blood or body fluid exposure. Conclusion: In this Mexican population of medical students, there is a high risk of suffering needle stick injuries during medical training. Furthermore, knowledge regarding prevention, evaluation, and reporting of needle stick injuries is suboptimal.

  7. Predicting Falls in Parkinson Disease: What Is the Value of Instrumented Testing in OFF Medication State?

    Directory of Open Access Journals (Sweden)

    Martina Hoskovcová

    Full Text Available Falls are a common complication of advancing Parkinson's disease (PD. Although numerous risk factors are known, reliable predictors of future falls are still lacking. The objective of this prospective study was to investigate clinical and instrumented tests of balance and gait in both OFF and ON medication states and to verify their utility in the prediction of future falls in PD patients.Forty-five patients with idiopathic PD were examined in defined OFF and ON medication states within one examination day including PD-specific clinical tests, instrumented Timed Up and Go test (iTUG and computerized dynamic posturography. The same gait and balance tests were performed in 22 control subjects of comparable age and sex. Participants were then followed-up for 6 months using monthly fall diaries and phone calls.During the follow-up period, 27/45 PD patients and 4/22 control subjects fell one or more times. Previous falls, fear of falling, more severe motor impairment in the OFF state, higher PD stage, more pronounced depressive symptoms, higher daily levodopa dose and stride time variability in the OFF state were significant risk factors for future falls in PD patients. Increased stride time variability in the OFF state in combination with faster walking cadence appears to be the most significant predictor of future falls, superior to clinical predictors.Incorporating instrumented gait measures into the baseline assessment battery as well as accounting for both OFF and ON medication states might improve future fall prediction in PD patients. However, instrumented testing in the OFF state is not routinely performed in clinical practice and has not been used in the development of fall prevention programs in PD. New assessment methods for daylong monitoring of gait, balance and falls are thus required to more effectively address the risk of falling in PD patients.

  8. Impact оf the First World War оn the Transformation of German Army

    Directory of Open Access Journals (Sweden)

    Evdokimova Tatyana

    2014-11-01

    Full Text Available Germany’s defeat in World War I and proclamation of the first German republic significantly influenced the change of the role of the army in the German state. At the stage of reorganization of the Kaiser’s army into the Reichswehr (1918–1921 the main result of this transformation became the creation of a new model of the German Army in which the principle of “distancing” the army from politics was replaced by new legislative and political realities that raised the question of inevitability of relationship between the army and the state. The Versailles Treaty and the Weimar constitution put forward the task of turning the German army into integral part of the state apparatus which led to losing its apoliticality. They also contributed to the emergence of Reich Ministry and the post of Reich Minister combined in one person the representative of the army and the state power. Besides, they helped to form a united German professional army and provided joint search of allies in the field of armaments by politicians and military men. The army tried to defend the old Prussian military traditions in terms of the German State called itself the Reich, and Weimar politicians sought to put the army under a parliamentary-presidential control. At the later stage of the Weimar Republic political generals will appear in the army, and important government positions will be taken by the representatives of the Generalitat. But the outcome of the force balance already at the stage of development of the temporary Reichswehr, when the real power in the army was in hands of the commander of the ground forces, and not of the Reich President and Reich Minister largely predetermined the strength of the conservative military elite in the future.

  9. Army Programs: Army Finance and Accounting Quality Assurance Program

    National Research Council Canada - National Science Library

    1988-01-01

    This regulation discusses the primary responsibilities of commanders and staff officers at installation and higher levels for execution of the Army Finance and Accounting Quality Assurance (QA) Program...

  10. The U.S. Army's Initial Impressions of Operations Enduring Freedom and Noble Eagle. Center for Strategic Leadership. October 2002. Issue Paper 10-02

    National Research Council Canada - National Science Library

    Thompson, Eugene

    2002-01-01

    .... During a 26-29 August 2002 conference conducted at the Collins Center for Strategic Leadership of the United States Army War College, a group of 51 representatives, from throughout the Army gathered...

  11. Retrospective on the construction and practice of a state-level emergency medical rescue team.

    Science.gov (United States)

    Lei, Zhang; Haitao, Guo; Xin, Wang; Yundou, Wang

    2014-10-01

    For the past few years, disasters like earthquakes, landslides, mudslides, tsunamis, and traffic accidents have occurred with an ever-growing frequency, coverage, and intensity greatly beyond the expectation of the public. In order to respond effectively to disasters and to reduce casualties and property damage, countries around the world have invested more efforts in the theoretical study of emergency medicine and the construction of emergency medical rescue forces. Consequently, emergency medical rescue teams of all scales and types have come into being and have played significant roles in disaster response work. As the only state-level emergency medical rescue force from the Chinese People's Armed Police Forces, the force described here has developed, through continuous learning and practice, a characteristic mode in terms of grouping methods, equipment system construction, and training.

  12. Cross-cultural medical education in the United States: key principles and experiences.

    Science.gov (United States)

    Betancourt, Joseph R; Cervantes, Marina C

    2009-09-01

    The field of cross-cultural care focuses on the ability to communicate effectively and provide quality health care to patients from diverse sociocultural backgrounds. In recent years, medical schools in the United States have increasingly recognized the growing importance of incorporating cross-cultural curricula into medical education. Cross-cultural medical education in the United States has emerged for four reasons: (1) the need for providers to have the skills to care for a diverse patient population; (2) the link between effective communication and health outcomes; (3) the presence of racial/ethnic disparities that are, in part, due to poor communication across cultures; and (4) medical school accreditation requirements. There are three major approaches to cross-cultural education: (1) the cultural sensitivity/awareness approach that focuses on attitudes; (2) the multicultural/categorical approach that focuses on knowledge; and (3) the cross-cultural approach that focuses on skills. The patient-based approach to cross-cultural care combines these three concepts into a framework that can be used to care for any patient, anytime, anywhere. Ultimately, if cross-cultural medical education is to evolve, students must believe it is important and understand that the categorical approach can lead to stereotyping; it should be taught using patient cases and highlighting clinical applications; it should be embedded in a longitudinal, developmentally appropriate fashion; and it should be integrated into the larger curriculum whenever possible. At the Harvard Medical School, we have tried to apply all of these lessons to our work, and we have started to develop a strategic integration process where we try to raise awareness, impart knowledge, and teach cross-cultural skills over the 4 years of schooling.

  13. Do medical French students know how to properly score a mini mental state examination?

    Science.gov (United States)

    Hernandorena, Intza; Chauvelier, Sophie; Vidal, Jean-Sébastien; Piccoli, Matthieu; Coulon, Joséphine; Hugonot-Diener, Laurence; Rigaud, Anne-Sophie; Hanon, Olivier; Duron, Emmanuelle

    2017-06-01

    The mini mental state examination (MMSE) is a validated tool to assess global cognitive function. Training is required before scoring. Inaccurate scoring can lead to inappropriate medical decisions. In France, MMSE is usually scored by medical students. To assess if medical French students know how to properly score a mini mental state examination. Two « physician-patient » role playings performed by 2 specialized physicians, were performed in front of University Paris V medical students. Role playing A: Scoring of a MMSE according to a script containing five tricks; Role playing B: Find the 5 errors committed in a pre-filled MMSE form, according to the second script. One hundred and five students (64.4% of women, 49.5% in fifth medical school year) anonymously participated. Eighty percent of students had already scored a MMSE and 40% had been previously trained to MMSE scoring. Forty five percent of students previously scored an MMSE, without previously being trained. In test A, 16% of students did not commit any errors, 45.7% one error and 38.1% two errors. In test B, the proportion of students who provided 0, 1, 2, 3, 4 and 5 good answers was 3.3%, 29.7%, 29.7%, 25.3%, 7.7% and 4.4% respectively. No association between medical school year, previous training to MMSE scoring and performances at both tests were found. French students do not properly score MMSE. MMSE scoring is not enough or accurately taught (by specialists). The university will provide on line the tests and a short filmed teaching course performed by neuropsychological specialists.

  14. The Impact of State Medical Malpractice Reform on Individual-Level Health Care Expenditures.

    Science.gov (United States)

    Yu, Hao; Greenberg, Michael; Haviland, Amelia

    2017-12-01

    Past studies of the impact of state-level medical malpractice reforms on health spending produced mixed findings. Particularly salient is the evidence gap concerning the effect of different types of malpractice reform. This study aims to fill the gap. It extends the literature by examining the general population, not a subgroup or a specific health condition, and controlling for individual-level sociodemographic and health status. We merged the Database of State Tort Law Reforms with the Medical Expenditure Panel Survey between 1996 and 2012. We took a difference-in-differences approach to specify a two-part model for analyzing individual-level health spending. We applied the recycled prediction method and the bootstrapping technique to examining the difference in health spending growth between states with and without a reform. All expenditures were converted to 2010 U.S. dollars. Only two of the 10 major state-level malpractice reforms had significant impacts on the growth of individual-level health expenditures. The average annual expenditures in states with caps on attorney contingency fees increased less than that in states without the reform (p negligence rule, the average annual expenditures increased more in both states with a pure comparative fault reform (p < .05) and states with a comparative fault reform that barred recovery if the plaintiff's fault was equal to or greater than the defendant's (p < .05). A few state-level malpractice reforms had significantly affected the growth of individual-level health spending, and the direction and magnitude of the effects differed by type of reform. © Health Research and Educational Trust.

  15. Union Directions - Army Response.

    Science.gov (United States)

    1985-12-06

    reflects the long-held belief in the Army that employee participation in decisions that affect their worklife is healthy and desirable. Although some...pluralistic society, checks and balances are as important for the economy as for the government. Business executives who salivate at the thought of vanishing...Unions. Reading, MA: Addison-Wesley, 1976. 37. National Federation of Federal Employees. NFFE’s Guide to Quality of Worklife Programs. No. G-21

  16. 1998 Army Modernization Plan

    Science.gov (United States)

    1998-01-01

    Biological (CB) Protective Duty Uniform (STO) • Biometrics (SRO) • Nanoscience (SRO) • Millimeter Wave Material and Dissemination Technology... Biometrics and Nanoscience SROs will enable the development of advanced NBC detection and characterization systems, including the exploitation of biologically...Requirements Trailers • Procure HEMAT Trailers Figure K-23 K-19 //;<?. U.S. Army 1997Modernization Plan This final fleet assessment, made against the

  17. Colonial army recruitment patterns and post-colonial Military Coups ...

    African Journals Online (AJOL)

    Since time immemorial, societies, states and state builders have been challenged and transformed by the need and quest for military manpower. European states relied on conscript armies to 'pacify' and retain colonies in parts of the non-European world. These facts underscore the meticulous attention paid by the British to ...

  18. Nostalgia in the Army (17th-19th Centuries).

    Science.gov (United States)

    Battesti, Michèle

    2016-01-01

    People died from nostalgia in the army in the 17th-19th centuries. The term 'nostalgia', created by the doctor Johannes Hofer (1669-1752), from Mulhouse, came from the Germanic Heimweh, or 'homesickness'. It affected the young people enrolled in the army, such as Swiss mercenaries. Longing for their native land, they were consumed by an ongoing desire to return home. If it was impossible to do so, they sank into 'a sadness accompanied with insomnia, anorexia and other unpleasant symptoms' that could lead to death. Nostalgia became classified as a disease during the last quarter of the 18th century and ravaged the French army during the Revolution and the Napoleonic wars. However, as soon as the wars ended, it ceased to exist in the army (except the colonial army). It was removed from the nosology in the first half of the 19th century. Rapidly explained as an example of a misdiagnosis or a confusion between 'connection and cause', nostalgia needs to be assessed in regard to the medical debate between 'alienists' and 'organicists'. Creating much concern, nostalgia needs to be considered in the historical context of a society destabilized by modernity, with some individuals uprooted by the sudden transition from civil society to military life. It raises questions about the role that the army played in the creation of the French national union. Nostalgia may have also covered psychic traumatisms later designated as combat fatigue, war neurosis, or post-traumatic stress disorder. © 2016 S. Karger AG, Basel.

  19. Army Transformation and the Future Combat System

    Science.gov (United States)

    2008-03-01

    Christina Fishback. “U.S. Army’s Reaction to FM 100-5.” Master’s Thesis Draft. (Manhattan: Kansas State University, 2008). Introduction . 12 U.S. Army...Military Revolution, 1300-2050. Ed. Macgregor Knox and Williamson Murray. ( Cambridge and New York: Cambridge University Press, 2001); Even with the...Ibid. This evident by his saying that "glory is fleeting, but obscurity is forever." 131 In an abstract manner, Shakespeare observes the similar

  20. Cohesion assessment of student groups from the faculty of dentistry at Burdenko Voronezh State Medical University

    Directory of Open Access Journals (Sweden)

    Pashkov A. N.

    2017-10-01

    Full Text Available the article presents data on the study of the cohesion of 115 students from the faculty of dentistry at Burdenko Voronezh State Medical University. The study revealed that students have high and medium favorable psychological climate. 99 of them have the average level of group cohesion, and 16 revealed a low level of this indicator. To improve the educational process and interpersonal relations, these results must be taken into account when forming groups.

  1. Return of TRIGA fuel from the Medical University of Hanover (MHH) to the United States

    International Nuclear Information System (INIS)

    Hampel, Gabriele; Klaus, Uwe; Schmidt, Thomas

    1999-01-01

    The Medical University of Hanover (MHH) returned its TRIGA fuel to the United States in the summer of 1999. This paper deals with the procedure for handling the fuel elements within and outside the reactor facility. It describes the dry loading technology, taking into account the special conditions relevant to the MHH. It also includes the time scale for both the various steps of the procedure and the entire process, as well as the main results of the radiological surveys. (author)

  2. Access to healthcare for undocumented migrants in France: a critical examination of State Medical Assistance.

    Science.gov (United States)

    André, Jean-Marie; Azzedine, Fabienne

    2016-01-01

    In France in 2012, of the total population of 65.2 million, 8.7 % were migrants. After being the third principal host country, France is now the 6th highest host country in the OECD. Since the 1980's numerous Acts have been passed by parliament on immigration issues. In 2000 the Universal Health Cover (Couverture Maladie Universelle) was created as health coverage for all residents of France. At the same time the State Medical Assistance (Aide Médicale de l'Etat) was created as health protection for undocumented migrants. Since the creation of this scheme, it has been the object of many political debates which call it into question, on account of its cost, perceived fraud, and the legitimacy of a social protection for undocumented migrants. Recently, access to State Medical Assistance has been made difficult by introducing conditions of residence and financial contributions. After a reports' analysis on institutional, associative, research studies and European recommendations, we note that all reports converge on the necessity of health protection for undocumented migrants. The major reasons are humanitarian, respect of European and International conventions, for public health, and financial. Moreover, fraud allegations have proved to be unfounded. Finally, State Medical Assistance is underused: in 2014 data from Médecins du Monde shows that only 10.2 % of undocumented migrant patients in their health facilities have access to this scheme. We conclude that the political debate concerning the State Medical Assistance should be about its under-utilisation, its improvement, its merger with the Universal Health Cover, and not its elimination. Moreover, the current debates regarding this scheme stigmatize this population, which is already precarious, making it more difficult for migrants to access healthcare, and generally, weaken national social cohesion.

  3. New medical schools in the United States: forces of change past and present.

    Science.gov (United States)

    Smith, Lawrence

    2009-01-01

    The new millennium has ushered in a growth phase in the number of American medical schools. Historically the United States has built schools during bursts of activity with relative quiescence in between these periods. We had a twenty-two year period with no growth in medical school size or number. During that time there were significant changes in patient characteristics, student culture, financial reimbursement, quality, and manpower needs that have put stress on medical schools, hospitals, clinical practice and healthcare systems. In addition, there have been remarkable new opportunities in the way we teach, including changes in teaching methodology, educational technology, and a better understanding of how students actually learn. All of these advances have taken place during a period of enormous pressure to change residency programs, reorganize medical and clinical science, and question the very need for traditional departmental structures. It is likely that the new medical schools will emerge looking different from the older schools and they are likely to catalyze a period of curricular change.

  4. Army Healthcare Enterprise Management System

    National Research Council Canada - National Science Library

    2001-01-01

    .... The complaint alleged that the Army Healthcare Enterprise Management System was not properly competed, potential conflicts of interest existed, and possible contract performance problems existed...

  5. Impact of Medical Tourism on Cosmetic Surgery in the United States

    Science.gov (United States)

    Franzblau, Lauren E.

    2013-01-01

    Summary: Developing countries have been attracting more international patients by building state-of-the-art facilities and offering sought-after healthcare services at a fraction of the cost of the US healthcare system. These price differentials matter most for elective procedures, including cosmetic surgeries, which are paid for out of pocket. It is unclear how this rise in medical tourism will affect the practice of plastic surgery, which encompasses a uniquely large number of elective procedures. By examining trends in the globalization of the cosmetic surgery market, we can better understand the current situation and what plastic surgeons in the United States can expect. In this article, we explore both domestic and foreign factors that affect surgical tourism and the current state of this industry. We also discuss how it may affect the practice of cosmetic surgery within the United States. PMID:25289258

  6. Impact of Medical Tourism on Cosmetic Surgery in the United States

    Directory of Open Access Journals (Sweden)

    Lauren E. Franzblau, BS

    2013-10-01

    Full Text Available Summary: Developing countries have been attracting more international patients by building state-of-the-art facilities and offering sought-after healthcare services at a fraction of the cost of the US healthcare system. These price differentials matter most for elective procedures, including cosmetic surgeries, which are paid for out of pocket. It is unclear how this rise in medical tourism will affect the practice of plastic surgery, which encompasses a uniquely large number of elective procedures. By examining trends in the globalization of the cosmetic surgery market, we can better understand the current situation and what plastic surgeons in the United States can expect. In this article, we explore both domestic and foreign factors that affect surgical tourism and the current state of this industry. We also discuss how it may affect the practice of cosmetic surgery within the United States.

  7. Impact of medical tourism on cosmetic surgery in the United States.

    Science.gov (United States)

    Franzblau, Lauren E; Chung, Kevin C

    2013-10-01

    Developing countries have been attracting more international patients by building state-of-the-art facilities and offering sought-after healthcare services at a fraction of the cost of the US healthcare system. These price differentials matter most for elective procedures, including cosmetic surgeries, which are paid for out of pocket. It is unclear how this rise in medical tourism will affect the practice of plastic surgery, which encompasses a uniquely large number of elective procedures. By examining trends in the globalization of the cosmetic surgery market, we can better understand the current situation and what plastic surgeons in the United States can expect. In this article, we explore both domestic and foreign factors that affect surgical tourism and the current state of this industry. We also discuss how it may affect the practice of cosmetic surgery within the United States.

  8. Medical police and the nanny state: public health versus private autonomy.

    Science.gov (United States)

    Baron, Jeremy Hugh

    2006-07-01

    Rome tried to increase both the numbers of its people and their well-being, and hence their wealth, but it was not until the 16th century that European rulers were urged to achieve these aims by the power of the state to enforce public health. By the 17th century, absolutist states such as France, Austria and especially Germany had created an administrative profession of enlightened despotism, with medical police to encourage healthy and thus wealth-producing citizens. Johann Peter Frank (1745-1821) was the profession's exemplar with his 6,262 page System einer vollstländigen medischiner Polizey, leading to comprehensive public health legislation in German-speaking states, followed by more libertarian countries such as Britain and the United States. However, controversy continues on the role of government in trying to save its citizens, and especially their children, from harming themselves and/or others by their actions and omissions.

  9. Pre-Medical Preparation in Microbiology among Applicants and Matriculants in Osteopathic Medical School in the United States.

    Science.gov (United States)

    Ramos, Raddy L; Guercio, Erik; Martinez, Luis R

    2017-01-01

    It is recognized that medical school curricula contain significant microbiology-related content as part of the training of future physicians who will be responsible stewards of antimicrobials. Surprisingly, osteopathic and allopathic medical schools do not require pre-medical microbiology coursework, and the extent to which medical students have completed microbiology coursework remains poorly understood. In this report, we show that fewer than 3% of applicants and matriculants to osteopathic medical school (OMS) have completed an undergraduate major or minor in microbiology, and fewer than 17% of applicants and matriculants to OMS have completed one or more microbiology-related courses. These data demonstrate limited pre-medical microbiology-related knowledge among osteopathic medical students, which may be associated with an increase in perceived stress when learning this content or during clinical rotations as well as a potential lack of interest in pursuing a career in infectious diseases.

  10. Modified Diet Recipes for Army Medical Facilities

    Science.gov (United States)

    1983-10-20

    meatballs , Eggs , whole slightly 1 egg 45 weighing 33 grams each. beaten 3. Place on sheet pan and bake Water 1/3 cup 1/3 cup 10 minutes, or until... egg , water, and rolled oats. Shape into 30 meatballs , weighing 45 grams each. Place on sheet pan and bake 20 minutes or until done* Drain well... egg , water, and rolled oats. Shape into 30 meatballs , weighing 45 grams each. Place on sheet pan and bake 20 minutes or until done. Drain well

  11. Flexitime in an Army Medical Center.

    Science.gov (United States)

    1981-04-01

    and Costigan (1973) conducted a longitudinal study of employee responses to the four day week in a medium-sized pharmaceutical company. The patterns...New York, New York, 1979. Nord, W.R. and Costigan, R. Worker adjustment to the four - day week : a longitudinal study. Journal of Applied Psychology, 58

  12. Accommodating the medical use of marijuana: surveying the differing legal approaches in Australia, the United States and Canada.

    Science.gov (United States)

    Bogdanoski, Tony

    2010-02-01

    While the scientific and medical communities continue to be divided on the therapeutic benefits and risks of cannabis use, anecdotal evidence from medical users themselves suggests that using cannabis is indeed improving their quality of life by alleviating their pain and discomfort. Notwithstanding the benefits anecdotally claimed by these medical users and the existence of some scientific studies confirming their claims, criminal drug laws in all Australian and most United States jurisdictions continue to prohibit the possession, cultivation and supply of cannabis even for medical purposes. However, in contrast to Australia and most parts of the United States, the medical use of cannabis has been legal in Canada for about a decade. This article reviews these differing legal and regulatory approaches to accommodating the medical use of cannabis (namely, marijuana) as well as some of the challenges involved in legalising it for medical purposes.

  13. Medical research in emergency research in the European Union member states: tensions between theory and practice.

    Science.gov (United States)

    Kompanje, Erwin J O; Maas, Andrew I R; Menon, David K; Kesecioglu, Jozef

    2014-04-01

    In almost all of the European Union member states, prior consent by a legal representative is used as a substitute for informed patient consent for non-urgent medical research. Deferred (patient and/or proxy) consent is accepted as a substitute in acute emergency research in approximately half of the member states. In 12 European Union member states emergency research is not mentioned in national law. Medical research in the European Union is covered by the Clinical Trial Directive 2001/20/EC. A proposal for a regulation by the European Commission is currently being examined by the European Parliament and the Council and will replace Directive 2001/20/EC. Deferred patient and/or proxy consent is allowed in the proposed regulation, but does not fit completely in the practice of emergency research. For example, deferred consent is only possible when legal representatives are not available. This criterion will delay inclusion of patients in acute life-threatening conditions in short time frames. As the regulation shall be binding in its entirety in all member states, emergency research in acute situations is still not possible as it should be.

  14. Medical Device Regulation: A Comparison of the United States and the European Union.

    Science.gov (United States)

    Maak, Travis G; Wylie, James D

    2016-08-01

    Medical device regulation is a controversial topic in both the United States and the European Union. Many physicians and innovators in the United States cite a restrictive US FDA regulatory process as the reason for earlier and more rapid clinical advances in Europe. The FDA approval process mandates that a device be proved efficacious compared with a control or be substantially equivalent to a predicate device, whereas the European Union approval process mandates that the device perform its intended function. Stringent, peer-reviewed safety data have not been reported. However, after recent high-profile device failures, political pressure in both the United States and the European Union has favored more restrictive approval processes. Substantial reforms of the European Union process within the next 5 to 10 years will result in a more stringent approach to device regulation, similar to that of the FDA. Changes in the FDA regulatory process have been suggested but are not imminent.

  15. Spanish adaptation of The Penn State College of Medicine Scale to assess professionalism in medical students.

    Science.gov (United States)

    Bustamante, Eliseo; Sanabria, Álvaro

    2014-01-01

    Professionalism is a subject of interest in medical schools around the world. The use of a questionnaire could be useful to assess professionalism in Colombia. To adapt The Penn State University College of Medicine Professionalism Questionnaire as a culturally valid instrument in the Spanish language. We followed recommendations from the IQOLA project and used forward and back translation with four independent translations, as well as a pilot evaluation and an evaluation of psychometric features with 250 students. We evaluated item-scale correlations and internal consistency with Chronbach's alpha test and conducted a principal components factor analysis. Global Cronbach's alpha was 0.86, the Kaiser-Meyer-Olkin measure of sampling adequacy was 0.83, and Bartlett's test of sphericity had a p >0.00001. We found six factors that explained 93% of the total variance and four new factors emerged in the factor analysis, while eight items had high uniqueness. The Penn State University College of Medicine Scale measures professionalism attitudes in medical students with good reliability. However, the structure of the scale demonstrated differences when used in the Latin American medical student population.

  16. United States Army, Seventh Army Field Order No. 1 (ANVIL)

    Science.gov (United States)

    1944-07-29

    sites in the ARGENS’Valley (See Operat Lone Instruc- tions No.1), bobwcon FREJUS and LE L,U~.. fr.o’! ground-observed enen:y Artillery fire. ,(8) Protcct...1� pcroonncl will be cautioned thnt ,ll:-:criccm and British porn - o chute nnd glider troops will be opcr at tng inland fro,:: the ben ch ea , A...defended. At immediate site there is a light 3-gun battery and a 4-gun c/d battery. 915918 map XXXIII-46 586. Radar coast-watcher. Position: Details

  17. Medicalization and morality in a weak state: health, hygiene and water in Dar Es Salaam, Tanzania.

    Science.gov (United States)

    Obrist, Brigit

    2004-04-01

    Inspired by Foucault, many studies have examined the medicalization of everyday life in Western societies. This paper reconsiders potentials and limitations of this concept in an African city. Grounded in ethnographic research in Dar es Salaam, Tanzania, it concentrates on cleanliness, health and water in a lower middle-class neighbourhood. The findings show that women are familiar with professional health development discourses emphasizing cleanliness as a high value linked to bodily and domestic health. These discourses have been diffused in schools, clinics and other institutions during the colonial and socialist period. Women not only refer to these discourses, they try to reproduce them in daily practice and even demand them. This coercive yet voluntary nature of institutionalized discourses points to 'paradoxes of medicalization' also found in Western societies. It acquires, however, different meanings in a weak state like contemporary Tanzania which hardly manages to institutionalize medicalization through professional practice. Under such conditions, women who choose to follow health development discourses suffer a heavier practical, intellectual and emotional burden than those who are less committed. This may at least partly explain why many women assume a pragmatic stance towards the medicalization of everyday life.

  18. Army Blast Claims Evaluation Procedures

    Science.gov (United States)

    1994-03-01

    ATIN: AFZX-JA Building 4551 Fort Polk, LA 71459-5000 Commander U.S. Army Engineer Center and Fort Leonard Wood ATIN: AlZT-JA Building 1706 East...U.S. Armed Forces Claims Service, Korea APO AP 96205-0084 No. of Copies Organization 1 Commander U.S. Army South ATI’N: SOJA Building 154 APO

  19. The 1991 Department of the Army Service Response Force exercise: Procedural Guide SRFX-91

    Energy Technology Data Exchange (ETDEWEB)

    Madore, M.A.; Thomson, R.S.; Haffenden, R.A.; Baldwin, T.E.; Meleski, S.A.

    1991-09-01

    This procedural guide was written to assist the US Army in planning for a chemical emergency exercise at Tooele Army Depot in Utah. The roles of various members of the emergency response community are described for various accident scenarios, and the relationships between the various responders are identified. For the June 1991 exercise at Tooele, the emergency response community includes the command structure at Tooele Army Depot; the US Army Service Response Force and other Department of Defense agencies; emergency response personnel from Tooele, Salt Lake, and Utah counties and municipal governments; the Utah Comprehensive Emergency Management Agency and other state agencies; and various federal agencies.

  20. Pain clinic definitions in the medical literature and U.S. state laws: an integrative systematic review and comparison.

    Science.gov (United States)

    Andraka-Christou, Barbara; Rager, Joshua B; Brown-Podgorski, Brittany; Silverman, Ross D; Watson, Dennis P

    2018-05-22

    In response to widespread opioid misuse, ten U.S. states have implemented regulations for facilities that primarily manage and treat chronic pain, called "pain clinics." Whether a clinic falls into a state's pain clinic definition determines the extent to which it is subject to oversight. It is unclear whether state pain clinic definitions model those found in the medical literature, and potential differences lead to discrepancies between scientific and professionally guided advice found in the medical literature and actual pain clinic practice. Identifying discrepancies could assist states to design laws that are more compatible with best practices suggested in the medical literature. We conducted an integrative systematic review to create a taxonomy of pain clinic definitions using academic medical literature. We then identified existing U.S. state pain clinic statutes and regulations and compared the developed taxonomy using a content analysis approach to understand the extent to which medical literature definitions are reflected in state policy. In the medical literature, we identified eight categories of pain clinic definitions: 1) patient case mix; 2) single-modality treatment; 3) multidisciplinary treatment; 4) interdisciplinary treatment; 5) provider supervision; 6) provider composition; 7) marketing; and 8) outcome. We identified ten states with pain clinic laws. State laws primarily include the following definitional categories: patient case mix; single-modality treatment, and marketing. Some definitional categories commonly found in the medical literature, such as multidisciplinary treatment and interdisciplinary treatment, rarely appear in state law definitions. This is the first study to our knowledge to develop a taxonomy of pain clinic definitions and to identify differences between pain clinic definitions in U.S. state law and medical literature. Future work should explore the impact of different legal pain clinic definitions on provider decision

  1. A renewed Medication Adherence Alliance call to action: harnessing momentum to address medication nonadherence in the United States

    Directory of Open Access Journals (Sweden)

    Zullig LL

    2016-07-01

    Full Text Available Leah L Zullig,1,2 Bradi B Granger,3 Hayden B Bosworth,1–4 On behalf of the Medication Adherence Alliance 1Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, 2Division of General Internal Medicine, Department of Medicine, Duke University, 3Duke Heart Center Nursing Research Program, School of Nursing, Duke University, 4Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA The problem: Nonadherence to prescription medications is a common and costly problem with multiple contributing factors, spanning the dimensions of individual behavior change, psychology, medicine, and health policy, among others. Addressing the problem of medication nonadherence requires strategic input from key experts in a number of fields.Meeting of experts: The Medication Adherence Alliance is a group of key experts, predominately from the US, in the field of medication nonadherence. Members include representatives from consumer advocacy groups, community health providers, nonprofit groups, the academic community, decision-making government officials, and industry. In 2015, the Medication Adherence Alliance convened to review the current landscape of medication adherence. The group then established three working groups that will develop recommendations for shifting toward solutions-oriented science.Commentary of expert opinion: From the perspective of the Medication Adherence Alliance, the objective of this commentary is to describe changes in the US landscape of medication adherence, framing the evolving field in the context of a recent think tank meeting of experts in the field of medication adherence. Keywords: medication adherence, health planning recommendations, chronic disease

  2. The Army Study Program.

    Science.gov (United States)

    1980-10-09

    STUDDIES BY CATEGORY STUDY TITLE SPONSOR NMtTHOO PPA ADM RE:MOTE LINK PRUG DARCOM CONTRACT ADV TECH MODEL FULL DARCON CONTRACT ARMY COMMAND ANDi CONTROL...HOUUSE NUN -RLCURRIN 1 LMANUS DARCON I"-HUSL FF-TH-hLLI TM~k ECUNLNI(. ANALYSIS DARCOM CUNTRALT FOR SFELTKUM ANALYZERS UPLRA1IUN&L FLt)AI/EKPSL TKADL...TECHNULOGY A5 AESM:NT TRADOC bUTH *TEN YEAR INSTRUMENTATIOft ANALYSkIS OCSA ot" PHASE I TERRAIN MODELS DARCOM bUTH lEST CRITLRIA FUOR NUN -IIILLL-K WEAPUN

  3. A renewed Medication Adherence Alliance call to action: harnessing momentum to address medication nonadherence in the United States.

    Science.gov (United States)

    Zullig, Leah L; Granger, Bradi B; Bosworth, Hayden B

    2016-01-01

    Nonadherence to prescription medications is a common and costly problem with multiple contributing factors, spanning the dimensions of individual behavior change, psychology, medicine, and health policy, among others. Addressing the problem of medication nonadherence requires strategic input from key experts in a number of fields. The Medication Adherence Alliance is a group of key experts, predominately from the US, in the field of medication nonadherence. Members include representatives from consumer advocacy groups, community health providers, nonprofit groups, the academic community, decision-making government officials, and industry. In 2015, the Medication Adherence Alliance convened to review the current landscape of medication adherence. The group then established three working groups that will develop recommendations for shifting toward solutions-oriented science. From the perspective of the Medication Adherence Alliance, the objective of this commentary is to describe changes in the US landscape of medication adherence, framing the evolving field in the context of a recent think tank meeting of experts in the field of medication adherence.

  4. Advanced robotics for medical rehabilitation current state of the art and recent advances

    CERN Document Server

    Xie, Shane

    2016-01-01

    Focussing on the key technologies in developing robots for a wide range of medical rehabilitation activities – which will include robotics basics, modelling and control, biomechanics modelling, rehabilitation strategies, robot assistance, clinical setup/implementation as well as neural and muscular interfaces for rehabilitation robot control – this book is split into two parts; a review of the current state of the art, and recent advances in robotics for medical rehabilitation. Both parts will include five sections for the five key areas in rehabilitation robotics: (i) the upper limb; (ii) lower limb for gait rehabilitation (iii) hand, finger and wrist; (iv) ankle for strains and sprains; and (v) the use of EEG and EMG to create interfaces between the neurological and muscular functions of the patients and the rehabilitation robots. Each chapter provides a description of the design of the device, the control system used, and the implementation and testing to show how it fulfils the needs of that specific ...

  5. State-of-the-art radiation detectors for medical imaging: Demands and trends

    Energy Technology Data Exchange (ETDEWEB)

    Darambara, Dimitra G. [Joint Department of Physics, Royal Marsden Foundation Trust and Institute of Cancer Research, Fulham Road, London SW3 6JJ (United Kingdom)]. E-mail: dimitra.darambara@icr.ac.uk

    2006-12-20

    Over the last half-century a variety of significant technical advances in several scientific fields has been pointing to an exploding growth in the field of medical imaging leading to a better interpretation of more specific anatomical, biochemical and molecular pathways. In particular, the development of novel imaging detectors and readout electronics has been critical to the advancement of medical imaging allowing the invention of breakthrough platforms for simultaneous acquisition of multi-modality images at molecular level. The present paper presents a review of the challenges, demands and constraints on radiation imaging detectors imposed by the nature of the modality and the physics of the imaging source. This is followed by a concise review and perspective on various types of state-of-the-art detector technologies that have been developed to meet these requirements. Trends, prospects and new concepts for future imaging detectors are also highlighted.

  6. State-of-the-art radiation detectors for medical imaging: Demands and trends

    International Nuclear Information System (INIS)

    Darambara, Dimitra G.

    2006-01-01

    Over the last half-century a variety of significant technical advances in several scientific fields has been pointing to an exploding growth in the field of medical imaging leading to a better interpretation of more specific anatomical, biochemical and molecular pathways. In particular, the development of novel imaging detectors and readout electronics has been critical to the advancement of medical imaging allowing the invention of breakthrough platforms for simultaneous acquisition of multi-modality images at molecular level. The present paper presents a review of the challenges, demands and constraints on radiation imaging detectors imposed by the nature of the modality and the physics of the imaging source. This is followed by a concise review and perspective on various types of state-of-the-art detector technologies that have been developed to meet these requirements. Trends, prospects and new concepts for future imaging detectors are also highlighted

  7. First trimester medication abortion practice in the United States and Canada.

    Directory of Open Access Journals (Sweden)

    Heidi E Jones

    Full Text Available We conducted a cross-sectional survey of abortion facilities from professional networks in the United States (US, n = 703 and Canada (n = 94 to estimate the prevalence of medication abortion practices in these settings and to look at regional differences. Administrators responded to questions on gestational limits, while up to five clinicians per facility reported on 2012 medication abortion practice. At the time of fielding, mifepristone was not approved in Canada. 383 (54.5% US and 78 (83.0% Canadian facilities participated. In the US, 95.3% offered first trimester medication abortion compared to 25.6% in Canada. While 100% of providers were physicians in Canada, just under half (49.4% were advanced practice clinicians in the US, which was more common in Eastern and Western states. All Canadian providers used misoprostol; 85.3% with methotrexate. 91.4% of US providers used 200 mg of mifepristone and 800 mcg of misoprostol, with 96.7% reporting home misoprostol administration. More than three-quarters of providers in both countries required an in-person follow-up visit, generally with ultrasound. 87.7% of US providers routinely prescribed antibiotics compared to 26.2% in Canada. Nonsteroidal anti-inflammatory drugs were the most commonly reported analgesic, with regional variation in opioid narcotic prescription. In conclusion, medication abortion practice follows evidence-based guidelines in the US and Canada. Efforts to update practice based on the latest evidence for reducing in-person visits and increasing provision by advanced practice clinicians could strengthen these services and reduce barriers to access. Research is needed on optimal antibiotic and analgesic use.

  8. Evaluation of a pilot medication therapy management project within the North Carolina State Health Plan.

    Science.gov (United States)

    Christensen, Dale B; Roth, Mary; Trygstad, Troy; Byrd, John

    2007-01-01

    To assess the feasibility of a pharmacist-based medication therapy management (MTM) service for North Carolina State Health Plan enrollees. Before/after design with two control groups. Community pharmacies and an ambulatory care clinic in North Carolina serving patients from October 2004 to March 2005. 67 patients who used a large number of prescription drugs, 10 community/ambulatory care pharmacists, and more than 600 participants from two control groups. Pharmacist-conducted MTM reviews for volunteering patients. Process measures (type and frequency of drug therapy problems detected and services performed), economic measures (number and cost of medications dispensed), and humanistic measures (patient satisfaction with services). Pharmacists identified an average of 3.6 potential drug therapy problems (PDTPs) per patient at the first visit. The most common PDTP categories were "potential underuse" and "more cost-effective drug available." Pharmacist actions were divided nearly equally between activities that would result in increased and decreased drug use. Pharmacists recommended a drug therapy change in about 50% of patients and contacted the prescriber more than 85% of the time. About 50% of patients with PDTPs had a change in drug therapy. Prescription use during the postintervention period decreased in both the study and control groups but was statistically significant only among the control groups. No significant differences were observed in patient co-payment or insurer prescription costs. Pharmacists provided the following educational services: medication use (90%), disease management (88%), adherence, and self-care (60%). Survey results indicated that patients highly valued the service. A voluntary MTM program targeted at ambulatory patients using a large number of medications reduced the number of PDTPs but did not necessarily result in reductions in prescription drug use or cost. Nearly all patients received some form of medication adherence or disease

  9. Integration of Educational and Research Activities of Medical Students (Experience of the Medical Faculty of Saint Petersburg State University).

    Science.gov (United States)

    Balakhonov, Aleksei V; Churilov, Leonid P; Erman, Mikhail V; Shishkin, Aleksandr N; Slepykh, Lyudmila A; Stroev, Yuri I; Utekhin, Vladimir J; Basantsova, Natalia Y

    2017-12-01

    The article is devoted to the role of research activity of the medical students in higher education of physicians. The teaching of physicians in classical universities and specialized medical schools is compared. The history of physicians' training in Russia in imperial, Soviet and post-Soviet periods is reviewed and compared to development of higher medical education in other countries. Article gives the the description of all failed attempts to establish a Medical Faculty within oldest classical university of Russia, crowned by history of last and successful attempt of its establishment. Authors' experience of adjoining education and research in curriculum and extra-curricular life of this Medical Faculty is discussed. The problems of specialization and fundamentalization of medical education are subjected to analysis. Clinical reasoning and reasoning of scholar-experimentalist are compared. The article reviews the role of term and course papers and significance of self-studies and graduation thesis in education of a physician. The paper gives original definition of interactive learning, and discusses the methods and pathways of intermingling the fundamental science and clinical medicine in medical teaching for achievement of admixed competencies of medical doctor and biomedical researcher.

  10. U.S. Army Officer Perceptions of the New OER (DA Form 67-8).

    Science.gov (United States)

    1982-12-01

    67-8. B. BACKGROUND The U.S. Army Officer Evaluation Reporting System (OERS) is the product of many years’of research and development. It is part of...Professional Study, Air War College, Maxwell AFB, AL, April 1975. Currey, Cecil B., Self-Destruction The Disintergration and Decay of the United States Army

  11. The Challenges of Adopting a Culture of Mission Command in the US Army

    Science.gov (United States)

    2015-05-23

    attributes of organizations. Culture includes core values and shared interpretations about how things are; climate includes individualistic ...attractive when compared to the changing organizational culture of business – which was moving to flatter organizations, with more individual autonomy ...The Challenges of Adopting a Culture of Mission Command in the US Army A Monograph by LTC James W. Wright United States Army School of

  12. Orthopedic board certification and physician performance: an analysis of medical malpractice, hospital disciplinary action, and state medical board disciplinary action rates.

    Science.gov (United States)

    Kocher, Mininder S; Dichtel, Laura; Kasser, James R; Gebhardt, Mark C; Katz, Jeffery N

    2008-02-01

    Specialty board certification status has become the de facto standard of competency by which the profession and the public recognize physician specialists. However, the relationship between orthopedic board certification and physician performance has not been established. Rates of medical malpractice claims, hospital disciplinary actions, and state medical board disciplinary actions were compared between 1309 board-certified (BC) and 154 non-board-certified (NBC) orthopedic surgeons in 3 states. There was no significant difference between BC and NBC surgeons in medical malpractice claim proportions (BC, 19.1% NBC, 16.9% P = .586) or in hospital disciplinary action proportions (BC, 0.9% NBC, 0.8% P = 1.000). There was a significantly higher proportion of state medical board disciplinary action for NBC surgeons (BC, 7.6% NBC, 13.0% P = .028). An association between board certification status and physician performance is necessary to validate its status as the de facto standard of competency. In this study, BC surgeons had lower rates of state medical board disciplinary action.

  13. Teaching psychosomatic (biopsychosocial) medicine in United States medical schools: survey findings.

    Science.gov (United States)

    Waldstein, S R; Neumann, S A; Drossman, D A; Novack, D H

    2001-01-01

    A survey of US medical schools regarding the incorporation of psychosomatic (biopsychosocial) medicine topics into medical school curriculum was conducted. The perceived importance and success of this curriculum, barriers to teaching psychosomatic medicine, and curricular needs were also assessed. From August 1997 to August 1999, representatives of US medical schools were contacted to complete a survey instrument either by telephone interview or by written questionnaire. Survey responses were received from 54 of the 118 US medical schools contacted (46%). Responses were obtained from representatives of both public (57%) and private (43%) institutions. Only 20% of respondents indicated that their schools used the term "psychosomatic medicine"; the terms "behavioral medicine" (63%) and "biopsychosocial medicine" (41%) were used more frequently. Coverage of various health habits (eg, substance use and exercise) ranged from 52% to 96%. The conceptualization and/or measurement of psychosocial factors (eg, stress and social support) was taught by 80% to 93% of schools. Teaching about the role of psychosocial factors in specific disease states or syndromes ranged from 33% (renal disease) to 83% (cardiovascular disease). Coverage of treatment-related issues ranged from 44% (relaxation/biofeedback) to 98% (doctor-patient communication). Topics in psychosomatic medicine were estimated to comprise approximately 10% (median response) of the medical school curriculum. On a scale of 1 (lowest) to 10 (highest), ratings of the relative importance of this curriculum averaged 7 (SD = 2.5; range = 2-10). Student response to the curriculum varied from positive to mixed to negative. Perceived barriers to teaching psychosomatic medicine included limited resources (eg, time, money, and faculty), student and faculty resistance, and a lack of continuity among courses. Sixty-three percent of respondents expressed an interest in receiving information about further incorporation of topics in

  14. Devolution's policy impact on non-emergency medical transportation in State Children's Health Insurance Programs.

    Science.gov (United States)

    Borders, Stephen; Blakely, Craig; Ponder, Linda; Raphael, David

    2011-01-01

    Proponents of devolution often maintain that the transfer of power and authority of programs enables local officials to craft policy solutions that better align with the needs of their constituents. This article provides one of the first empirical evaluations of this assumption as it relates to non-emergency medical transportation (NEMT) in the State Children's Health Insurance Program (SCHIP). NEMT programs meet a critical need in the areas in which they serve, directly targeting this single key access barrier to care. Yet states have great latitude in making such services available. The authors utilize data from 32 states to provide a preliminary assessment of devolution's consequences and policy impact on transportation-related access to care. Their findings provide mixed evidence on devolution's impact on policy outcomes. Proponents of devolution can find solace in the fact that several states have gone beyond federally mandated minimum requirements to offer innovative programs to remove transportation barriers to care. Detractors of devolution will find continued pause on several key issues, as a number of states do not offer NEMT to their SCHIP populations while cutting services and leaving over $7 billion in federal matching funding unspent.

  15. ER-E4 regulation. Transitional arrangement to implement the rules for evaluating and state control of medical equipment

    International Nuclear Information System (INIS)

    2015-01-01

    Establish a regulatory document where the validity and status of the documents contained in the Regulatory Legal Base Technical Program of medical equipment is exposed, given the scope thereof to comply with the provisions of the Regulation. This regulation is aimed at all subjects (manufacturers or producers, suppliers or distributors, importers, users, medical equipment, as well as health institutions SNS) involved in activities related to the evaluation and control of the State Medical equipment and make use of complementary technical legal documents.

  16. National Systematic Legal Review of State Policies on Emergency Medical Services Licensure Levels' Authority to Administer Opioid Antagonists.

    Science.gov (United States)

    Kinsman, Jeremiah M; Robinson, Kathy

    2018-02-27

    Previous research conducted in November 2013 found there were a limited number of states and territories in the United States (US) that authorize emergency medical technicians (EMTs) and emergency medical responders (EMRs) to administer opioid antagonists. Given the continued increase in the number of opioid-related overdoses and deaths, many states have changed their policies to authorize EMTs and EMRs to administer opioid antagonists. The goal of this study is to provide an updated description of policy on EMS licensure levels' authority to administer opioid antagonists for all 50 US states, the District of Columbia (DC), and the Commonwealth of Puerto Rico (PR). State law and scopes of practice were systematically reviewed using a multi-tiered approach to determine each state's legally-defined EMS licensure levels and their authority to administer an opioid antagonist. State law, state EMS websites, and state EMS scope of practice documents were identified and searched using Google Advanced Search with Boolean Search Strings. Initial results of the review were sent to each state office of EMS for review and comment. As of September 1, 2017, 49 states and DC authorize EMTs to administer an opioid antagonist. Among the 40 US jurisdictions (39 states and DC) that define the EMR or a comparable first responder licensure level in state law, 37 states and DC authorize their EMRs to administer an opioid antagonist. Paramedics are authorized to administer opioid antagonists in all 50 states, DC, and PR. All 49 of the US jurisdictions (48 states and DC) that define the advanced emergency medical technician (AEMT) or a comparable intermediate EMS licensure level in state law authorize their AEMTs to administer an opioid antagonist. 49 out of 52 US jurisdictions (50 states, DC, and PR) authorize all existing levels of EMS licensure levels to administer an opioid antagonist. Expanding access to this medication can save lives, especially in communities that have limited

  17. A comparison of medical education in Germany and the United States: from applying to medical school to the beginnings of residency.

    Science.gov (United States)

    Zavlin, Dmitry; Jubbal, Kevin T; Noé, Jonas G; Gansbacher, Bernd

    2017-01-01

    Both Germany and the United States of America have a long tradition of science and medical excellence reaching back as far as the nineteenth century. The same tribute must be paid to the medical educational system in both countries. Despite significant initial similarities and cross-inspiration, the paths from enrolling in a medical university to graduating as a medical doctor in Germany and the US seem to have become much different. To fill a void in literature, the authors' objective therefore is to delineate both structures of medical education in an up-to-date review and examine their current differences and similarities. Recent medical publications, legal guidelines of governmental or official organizations, articles in media, as well as the authors' personal experiences are used as sources of this report. Tuition loans of over $200,000 are not uncommon for students in the US after graduating from medical schools, which are often private institutions. In Germany, however, the vast majority of medical universities are tax-funded and, for this reason, free of tuition. Significant differences and surprisingly multiple similarities exist between these two systems, despite one depending on government and the other on private organizations. Germany currently employs an integrated medical curriculum that typically begins right after high school and consists of a 2-year long pre-clinical segment teaching basic sciences and a 4-year clinical segment leading medical students to the practical aspects of medicine. On the other hand, the US education is a two-stage process. After successful completion of a Bachelor's degree in college, an American student goes through a 4-year medical program encompassing 2 years of basic science and 2 years of clinical training. In this review, we will address some of these similarities and major differences.

  18. Radiation monitoring and dose distribution of medical workers in A.P. state 1999-2000

    International Nuclear Information System (INIS)

    Singh, D.R.; Reddy, K.S.; Kamble, M.K.; Roy, Madhumita

    2001-01-01

    Individual monitoring for external ionizing radiation is being conducted for all radiation workers in Andhra Pradesh State by TLD Unit located in Nuclear Fuel Complex, Hyderabad.The Unit comes under Personnel Monitoring Section of Bhabha Atomic Research Center, Mumbai. The aim of monitoring is to confirm that the radiation safety standards are strictly adhered in the institutions and also to investigate excessive exposures, if any. Personnel monitoring also provides data for epidemiological studies. In view of ICRP/AERB recommendations of 100 mSv dose limit for the five years block of 1994-98, the dose distribution among radiation workers in Andhra Pradesh State is analyzed for the period 1994-98. In continuation of above work, we have analyzed the data for the year 1999-2000 for various medical diagnostic procedures and these are presented

  19. University of the Witwatersrand physiotherapy undergraduate curriculum alignment to medical conditions of patients within Gauteng state health facilities

    Directory of Open Access Journals (Sweden)

    Mokgobadibe V. Ntsiea

    2017-06-01

    Conclusion: The Wits physiotherapy curriculum covers all medical conditions treated by physiotherapists within the Gauteng state health facilities, and overall, the curriculum prepares the students to practise in a variety of situations.

  20. Alfred Russel Wallace's medical libertarianism: state medicine, human progress, and evolutionary purpose.

    Science.gov (United States)

    Flannery, Michael A

    2015-01-01

    Alfred Russel Wallace (1823-1913), naturalist and explorer of South America and the Malay Archipelago, secured his place in history by independently discovering the theory of natural selection. His letter outlining the theory was sent from Ternate in eastern Indonesia and received at Down House, according to Charles Darwin (1809-82), on June 18, 1858, prompting the now-famed evolutionist to rush his languishing manuscript to press. Wallace's contributions to evolutionary biology, biogeography, and anthropology are well known, but his medical views have received far less attention. Within the context of a strident populist antivaccination movement and an ominous elitist eugenics campaign, Wallace took his stand, which revealed itself in a libertarianism that defended traditional socialist constituencies (the working poor, the lumpenproletariat, and feminist reformers) against state-mandated medical interventions. Rather than viewing Wallace as a heterodox contrarian, this article argues that his positions were logical outgrowths of his medical libertarianism and evolutionary and social theories. © The Author 2013. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  1. The Army rolls through Indianapolis: Fieldwork at the Virtual Army Experience

    Directory of Open Access Journals (Sweden)

    Robertson Allen

    2009-03-01

    Full Text Available This essay takes an ethnographic look at the individuals and institutions associated with the development, production, and implementation of the Virtual Army Experience (VAE, a mobile mission simulator that travels across the United States to venues such as state fairs and air shows. As an explicit aid to Army recruitment and interaction with the public, the VAE is an interesting nexus point that often channels public anxieties surrounding the medium of the video game and its role in the militarization of society. Here, I present my own experience of doing ethnography at this site, describing how it is received by visitors and interpreted by its employees. By means of the example of the VAE, I argue that polarizing media reports and academic criticisms that pit the processes of militarization against critical reflection of those processes are counterproductive and result in silencing more nuanced and thoughtful critical reflection that is already present at sites such as the VAE.

  2. The evaluation of psycho-emotional state in junior students of medical university

    Directory of Open Access Journals (Sweden)

    Tetiana Pavliuk

    2017-06-01

    Full Text Available Currently, psychosocial factors, stress and mental exhaustion are considered by WHO experts and the International Labour Organization as an important new factor affecting the health, working capacity, training and career. Young generation, especially students, who are an industrial and intellectual potential of the country can be attributed to the risk group because of the extremely high burden of adaptation. The intensity and tension of modern life at a psychological level preceding the occurrence of negative emotional experiences and stress reactions that, accumulating, cause the formation of depressions. The aim of the study was to examine the level of psycho-emotional stress in the junior students of medical university. The observations of the medical students of the second year of study were performed. To determine the psycho-emotional stress we have used adaptive varint of H.Ayzenko method that include an anxiety, frustration, aggressiveness and rigidity, through questionnaires. According to a survey results of the state of psycho-emotional state low levels of stress resistance were found in students in learning activities, indicating that students are exposed to the negative impact of the environment. It should also be noted that the level of emotional condition of students depends on the personal experience of stressful situations that arise in students’ lives.

  3. Transforming the Primary Care Training Clinic: New York State's Hospital Medical Home Demonstration Pilot.

    Science.gov (United States)

    Angelotti, Marietta; Bliss, Kathryn; Schiffman, Dana; Weaver, Erin; Graham, Laura; Lemme, Thomas; Pryor, Veronica; Gesten, Foster C

    2015-06-01

    Training in patient-centered medical home (PCMH) settings may prepare new physicians to measure quality of care, manage the health of populations, work in teams, and include cost information in decision making. Transforming resident clinics to PCMHs requires funding for additional staff, electronic health records, training, and other resources not typically available to residency programs. Describe how a 1115 Medicaid waiver was used to transform the majority of primary care training sites in New York State to the PCMH model and improve the quality of care provided. The 2013-2014 Hospital Medical Home Program provided awards to 60 hospitals and 118 affiliated residency programs (training more than 5000 residents) to transform outpatient sites into PCMHs and provide high-quality, coordinated care. Site visits, coaching calls, resident surveys, data reporting, and feedback were used to promote and monitor change in resident continuity and quality of care. Descriptive analyses measured improvements in these areas. A total of 156 participating outpatient sites (100%) received PCMH recognition. All sites enhanced resident education using PCMH principles through patient empanelment, development of quality dashboards, and transforming resident scheduling and training. Clinical quality outcomes showed improvement across the demonstration, including better performance on colorectal and breast cancer screening rates (rate increases of 13%, P≤.001, and 11%, P=.011, respectively). A 1115 Medicaid waiver is a viable mechanism for states to transform residency clinics to reflect new primary care models. The PCMH transformation of 156 sites led to improvements in resident continuity and clinical outcomes.

  4. Predicting United States Medical Licensure Examination Step 2 clinical knowledge scores from previous academic indicators

    Directory of Open Access Journals (Sweden)

    Monteiro KA

    2017-06-01

    Full Text Available Kristina A Monteiro, Paul George, Richard Dollase, Luba Dumenco Office of Medical Education, The Warren Alpert Medical School of Brown University, Providence, RI, USA Abstract: The use of multiple academic indicators to identify students at risk of experiencing difficulty completing licensure requirements provides an opportunity to increase support services prior to high-stakes licensure examinations, including the United States Medical Licensure Examination (USMLE Step 2 clinical knowledge (CK. Step 2 CK is becoming increasingly important in decision-making by residency directors because of increasing undergraduate medical enrollment and limited available residency vacancies. We created and validated a regression equation to predict students’ Step 2 CK scores from previous academic indicators to identify students at risk, with sufficient time to intervene with additional support services as necessary. Data from three cohorts of students (N=218 with preclinical mean course exam score, National Board of Medical Examination subject examinations, and USMLE Step 1 and Step 2 CK between 2011 and 2013 were used in analyses. The authors created models capable of predicting Step 2 CK scores from academic indicators to identify at-risk students. In model 1, preclinical mean course exam score and Step 1 score accounted for 56% of the variance in Step 2 CK score. The second series of models included mean preclinical course exam score, Step 1 score, and scores on three NBME subject exams, and accounted for 67%–69% of the variance in Step 2 CK score. The authors validated the findings on the most recent cohort of graduating students (N=89 and predicted Step 2 CK score within a mean of four points (SD=8. The authors suggest using the first model as a needs assessment to gauge the level of future support required after completion of preclinical course requirements, and rescreening after three of six clerkships to identify students who might benefit from

  5. Portraying the Army Reserve Components in Army War Games and Exercises

    National Research Council Canada - National Science Library

    Dillon, Dick

    2002-01-01

    .... Ensuring that accuracy and realism was the primary purpose of the Role of the Army National Guard and Army Reserve in Army Exercises workshop conducted at the Collins Center for Strategic Leadership from 23-26 September 2002.

  6. Elder Abuse Identification in the Prehospital Setting: An Examination of State Emergency Medical Services Protocols.

    Science.gov (United States)

    Namboodri, Brooke L; Rosen, Tony; Dayaa, Joseph A; Bischof, Jason J; Ramadan, Nadeem; Patel, Mehul D; Grover, Joseph; Brice, Jane H; Platts-Mills, Timothy F

    2018-03-22

    To describe statewide emergency medical service (EMS) protocols relating to identification, management, and reporting of elder abuse in the prehospital setting. Cross-sectional analysis. Statewide EMS protocols in the United States. Publicly available statewide EMS protocols identified from published literature, http://EMSprotocols.org, and each state's public health website. Protocols were reviewed to determine whether elder abuse was mentioned, elder abuse was defined, potential indicators of elder abuse were listed, management of older adults experiencing abuse was described, and instructions regarding reporting were provided. EMS protocols for child abuse were reviewed in the same manner for the purpose of comparison. Of the 35 publicly available statewide EMS protocols, only 14 (40.0%) mention elder abuse. Of protocols that mention elder abuse, 6 (42.9%) define elder abuse, 10 (71.4%) describe indicators of elder abuse, 8 (57.1%) provide instruction regarding management, and 12 (85.7%) provide instruction regarding reporting. Almost twice as many states met each of these metrics for child abuse. Statewide EMS protocols for elder abuse vary in regard to identification, management, and reporting, with the majority of states having no content on this subject. Expansion and standardization of protocols may increase the identification of elder abuse. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

  7. Effects of disease severity and medication state on postural control asymmetry during challenging postural tasks in individuals with Parkinson's disease.

    Science.gov (United States)

    Barbieri, Fabio A; Polastri, Paula F; Baptista, André M; Lirani-Silva, Ellen; Simieli, Lucas; Orcioli-Silva, Diego; Beretta, Victor S; Gobbi, Lilian T B

    2016-04-01

    The aim of this study was to investigate the effects of disease severity and medication state on postural control asymmetry during challenging tasks in individuals with Parkinson's disease (PD). Nineteen people with PD and 11 neurologically healthy individuals performed three standing task conditions: bipedal standing, tandem and unipedal adapted standing; the individuals with PD performed the tasks in ON and OFF medication state. The participants with PD were distributed into 2 groups according to disease severity: unilateral group (n=8) and bilateral group (n=11). The two PD groups performed the evaluations both under and without the medication. Two force plates were used to analyze the posture. The symmetric index was calculated for various of center of pressure. ANOVA one-way (groups) and two-way (PD groups×medication), with repeated measures for medication, were calculated. For main effects of group, the bilateral group was more asymmetric than CG. For main effects of medication, only unipedal adapted standing presented effects of PD medication. There was PD groups×medication interaction. Under the effects of medication, the unilateral group presented lower asymmetry of RMS in anterior-posterior direction and area than the bilateral group in unipedal adapted standing. In addition, the unilateral group presented lower asymmetry of mean velocity, RMS in anterior-posterior direction and area in unipedal standing and area in tandem adapted standing after a medication dose. Postural control asymmetry during challenging postural tasks was dependent on disease severity and medication state in people with PD. The bilateral group presented higher postural control asymmetry than the control and unilateral groups in challenging postural tasks. Finally, the medication dose was able to reduce postural control asymmetry in the unilateral group during challenging postural tasks. Copyright © 2015 Elsevier B.V. All rights reserved.

  8. Increasing Army Retention Through Incentives

    National Research Council Canada - National Science Library

    Beerman, Kevin

    2006-01-01

    .... If the Army fails to address the enlisted retention issue in the near future departures of experienced NCOs will have a detrimental impact our military's ability to provide for our nation's security...

  9. Christian Contributions to Army Values

    National Research Council Canada - National Science Library

    D'Emma, Gregory

    2000-01-01

    .... The Army builds the soldier's heart, spirit, and soul by the values we instill. Over the years these values of loyalty, duty, respect, selfless service, honor, integrity, and personal courage have been trained and reinforced...

  10. Racial Extremism in the Army

    National Research Council Canada - National Science Library

    Hudson, Walter M

    1998-01-01

    ... modem phenomenon of "skinheads." I then discuss the history of white supremacist extremism in the Army, culminating in the December, 1995 murders of two black civilians by soldiers assigned to the 82d Airborne Division at Fort Bragg, North Carolina...

  11. Mobile medical and health apps: state of the art, concerns, regulatory control and certification

    Science.gov (United States)

    Boulos, Maged N. Kamel; Brewer, Ann C.; Karimkhani, Chante; Buller, David B.; Dellavalle, Robert P.

    2014-01-01

    This paper examines the state of the art in mobile clinical and health-related apps. A 2012 estimate puts the number of health-related apps at no fewer than 40,000, as healthcare professionals and consumers continue to express concerns about the quality of many apps, calling for some form of app regulatory control or certification to be put in place. We describe the range of apps on offer as of 2013, and then present a brief survey of evaluation studies of medical and health-related apps that have been conducted to date, covering a range of clinical disciplines and topics. Our survey includes studies that highlighted risks, negative issues and worrying deficiencies in existing apps. We discuss the concept of ‘apps as a medical device’ and the relevant regulatory controls that apply in USA and Europe, offering examples of apps that have been formally approved using these mechanisms. We describe the online Health Apps Library run by the National Health Service in England and the calls for a vetted medical and health app store. We discuss the ingredients for successful apps beyond the rather narrow definition of ‘apps as a medical device’. These ingredients cover app content quality, usability, the need to match apps to consumers’ general and health literacy levels, device connectivity standards (for apps that connect to glucometers, blood pressure monitors, etc.), as well as app security and user privacy. ‘Happtique Health App Certification Program’ (HACP), a voluntary app certification scheme, successfully captures most of these desiderata, but is solely focused on apps targeting the US market. HACP, while very welcome, is in ways reminiscent of the early days of the Web, when many “similar” quality benchmarking tools and codes of conduct for information publishers were proposed to appraise and rate online medical and health information. It is probably impossible to rate and police every app on offer today, much like in those early days of the Web

  12. State-Targeted Funding and Technical Assistance to Increase Access to Medication Treatment for Opioid Use Disorder.

    Science.gov (United States)

    Abraham, Amanda J; Andrews, Christina M; Grogan, Colleen M; Pollack, Harold A; D'Aunno, Thomas; Humphreys, Keith; Friedmann, Peter D

    2018-04-01

    As the United States grapples with an opioid epidemic, expanding access to effective treatment for opioid use disorder is a major public health priority. Identifying effective policy tools that can be used to expand access to care is critically important. This article examines the relationship between state-targeted funding and technical assistance and adoption of three medications for treating opioid use disorder: oral naltrexone, injectable naltrexone, and buprenorphine. This study draws from the 2013-2014 wave of the National Drug Abuse Treatment System Survey, a nationally representative, longitudinal study of substance use disorder treatment programs. The sample includes data from 695 treatment programs (85.5% response rate) and representatives from single-state agencies in 49 states and Washington, D.C. (98% response rate). Logistic regression was used to examine the relationships of single-state agency targeted funding and technical assistance to availability of opioid use disorder medications among treatment programs. State-targeted funding was associated with increased program-level adoption of oral naltrexone (adjusted odds ratio [AOR]=3.14, 95% confidence interval [CI]=1.49-6.60, p=.004) and buprenorphine (AOR=2.47, 95% CI=1.31-4.67, p=.006). Buprenorphine adoption was also correlated with state technical assistance to support medication provision (AOR=1.18, 95% CI=1.00-1.39, p=.049). State-targeted funding for medications may be a viable policy lever for increasing access to opioid use disorder medications. Given the historically low rates of opioid use disorder medication adoption in treatment programs, single-state agency targeted funding is a potentially important tool to reduce mortality and morbidity associated with opioid disorders and misuse.

  13. Robotics In Manufacturing: Army View

    Science.gov (United States)

    Michel, F. J.

    1983-05-01

    (Figure 1) This is an outline of my presentation today. The U. S. Army has a dual interest in the use of robots, namely: 1. As a substitute for or an extension of the soldier in the battlefield, and 2. in the factories that make Army materiel, or - as we call it -the the production base. The Production Base can again be divided into three separate segments, i.e., the Army owned and operated facilities or GOG6s, such as Rock Island and Watervliet arsenals, and not to be overlooked, the depot operations. There the Army manufactures gun tubes and other related parts for artillery weapons and repairs and overhauls them. A second category is the Army owned and contractor operated facilities or GOCOs,such as the ammunition plants, the tank plants at Lima, Ohio and Warren, Michigan and the Stratford Engine Plant in Connecticut where gas turbines for helicopter and the Abrams tank are manufactured. The last category covers the industrial base, that is those factories which are not only operated but also owned by the contractor himself also referred to as COCOs. You can see from this description that the Army is supported by a base which produces a diversified line of products. Therefore, the task of technology development and technology insertion is considerably more complex than what one encounters in the average U. S. Manufacturing organization.

  14. Variation in cash price of the generic medications most prescribed by dermatologists in pharmacies across the United States.

    Science.gov (United States)

    Alghanem, Noor; Abokwidir, Manal; Fleischer, Alan B; Feldman, Steven R; Alghanem, Ward

    2017-03-01

    The United States has the highest drug costs in the world. Consumers complain about large price differences at pharmacies on generic drugs. To evaluate variation in cash prices of generic medications most prescribed in dermatology across different drugstores and states in United States. The 11 generic drugs most prescribed by dermatologists according to National Ambulatory Medical Care Survey were assessed. By using Google, the most common used pharmacies in United States were listed, which are located at a random selection of six states. By calling the first available number of each pharmacy in the six states and asking about the generic cash price of the smallest stock size and the most prescribed type, the data were collected. Drug prices varied; the median cumulative price of the 11 medications was highest at Rite Aid ($1226) and lowest at Walmart ($795.34) with 35% difference. The prices at CVS differed by 20% across different states; however, the prices at Walmart, Rite Aid and Walgreens were consistent. New York has the highest and Iowa the lowest prices, especially at CVS, ($1160.79) versus ($931.32). There are varieties in the prices for the generic medications in different pharmacies and States.

  15. [The state's physics examinations for medical students and the construction of a natural science basis for academic medical training between 1865-1880].

    Science.gov (United States)

    Van Lieburg, M J

    1995-01-01

    Betweem 1865, when the new Dutch Health Acts introduced the legal monopoly of the academic medical profession, and 1879, when a new law for higher education provided the basis for the integration of the non-academic teaching of medicine within the universities, non-academic students could pass state medical examinations in order to become a physician. In this article I studied in detail the first phase of this examination route, when students were questioned about their knowledge of mathematics, physics, chemistry and the life sciences. The state commissions responsible for taking these examinations have certainly played an important role in the process of the introduction of scientific medicine into the universities as well as the introduction of the sciences into secondary schools, preparing scholars for academic medical training. Moreover, because scientists, physicians and secondary school teachers participated together in these commissions, the science examination boards linked the several educational echelons and divisions in science and medicine concerned with this process of transformation of the medical professions and medical science in the 1860s and 1870s.

  16. The Cost of Sustaining a Patient-Centered Medical Home: Experience From 2 States

    Science.gov (United States)

    Magill, Michael K.; Ehrenberger, David; Scammon, Debra L.; Day, Julie; Allen, Tatiana; Reall, Andreu J.; Sides, Rhonda W.; Kim, Jaewhan

    2015-01-01

    PURPOSE As medical practices transform to patient-centered medical homes (PCMHs), it is important to identify the ongoing costs of maintaining these “advanced primary care” functions. A key required input is personnel effort. This study’s objective was to assess direct personnel costs to practices associated with the staffing necessary to deliver PCMH functions as outlined in the National Committee for Quality Assurance Standards. METHODS We developed a PCMH cost dimensions tool to assess costs associated with activities uniquely required to maintain PCMH functions. We interviewed practice managers, nurse supervisors, and medical directors in 20 varied primary care practices in 2 states, guided by the tool. Outcome measures included categories of staff used to perform various PCMH functions, time and personnel costs, and whether practices were delivering PCMH functions. RESULTS Costs per full-time equivalent primary care clinician associated with PCMH functions varied across practices with an average of $7,691 per month in Utah practices and $9,658 in Colorado practices. PCMH incremental costs per encounter were $32.71 in Utah and $36.68 in Colorado. The average estimated cost per member per month for an assumed panel of 2,000 patients was $3.85 in Utah and $4.83 in Colorado. CONCLUSIONS Identifying costs of maintaining PCMH functions will contribute to effective payment reform and to sustainability of transformation. Maintenance and ongoing support of PCMH functions require additional time and new skills, which may be provided by existing staff, additional staff, or both. Adequate compensation for ongoing and substantial incremental costs is critical for practices to sustain PCMH functions. PMID:26371263

  17. Medical rehabilitation of leprosy patients discharged home in abia and ebonyi States of Nigeria.

    Science.gov (United States)

    Enwereji, Ezinne Ezinna; Ahuizi, Eke Reginald; Iheanocho, Okereke Chukwunenye; Enwereji, Kelechi Okechukwu

    2011-11-01

    To examine the extent to which medical coverage is available to discharged leprosy patients in communities. Evidence has shown that after care services, follow-up visits and national disease prevention programs are important components of medical rehabilitation to leprosy patients discharged home after treatment. Denying them accessibility to these services could expose them to multiple disabilities as well as several disease conditions including HIV/AIDS. These adverse health conditions could be averted if health workers extend healthcare services to discharged leprosy patients. This study was conducted to examine the extent to which discharged leprosy patients have access to healthcare services in the communities. All 33 leprosy patients who were fully treated with multi-drug therapy (MDT) and discharged home in the two leprosy settlements in Abia and Ebonyi States of Nigeria were included in this study. The list of discharged leprosy patients studied and their addresses were provided by the leprosy settlements where they were treated. Also, snowball-sampling method was used to identify some of the leprosy patients whose addresses were difficult to locate in the communities. Instruments for data collection were questionnaire, interview guide and checklist. These were administered because respondents were essentially those with no formal education. Analysis of data was done quantitatively and qualitatively. Findings showed that 20 (60.6%) of discharged patients did not receive health programs like HIV/AIDS prevention or family planning. Also, follow-up visits and after-care services were poor. About 14 (42.4%) of the patients live in dirty and overcrowded houses. On the whole, discharged patients were poorly medically rehabilitated (mean score: 4.7±1.1 out of total score of 7). Denying discharged leprosy patients opportunity of accessing health care services could increase prevalence of infectious diseases including HIV/AIDS among them. There is need to extend

  18. Globalization of health care delivery in the United States through medical tourism.

    Science.gov (United States)

    Kumar, Sameer; Breuing, Richard; Chahal, Rajneet

    2012-01-01

    This study highlights some of the inefficiencies in the U.S. health care system and determines what effect medical tourism has had on the U.S. and global health care supply chains. This study also calls attention to insufficient health communication efforts to inform uninsured or underinsured medical tourists about the benefits and risks and determines the managerial and cost implications of various surgical procedures on the global health care system into the future. This study evaluated 3 years (2005, 2007, and 2011) of actual and projected surgical cost data. The authors selected 3 countries for analysis: the United States, India, and Thailand. The surgeries chosen for evaluation were total knee replacement (knee arthroplasty), hip replacement (hip arthroplasty), and heart bypass (coronary artery bypass graft). Comparisons of costs were made using Monte Carlo simulation with variability encapsulated by triangular distributions. The results are staggering. In 2005, the amount of money lost to India and Thailand on just these 3 surgeries because of cost inefficiencies in the U.S. health care system was between 1.3 to 2 billion dollars. In 2011, because many more Americans are expected to travel overseas for health care, this amount is anticipated to rise to between 20 and 30.2 billion dollars. Therefore, more attention should be paid to health communication efforts that truly illustrate the benefits/risks of medical travel. The challenge of finding reliable data for surgeries performed and associated surgical cost estimates was mitigated by the use of a Monte Carlo simulation of triangular distributions. The implications from this study are clear: If the U.S. health care industry is unable to eliminate waste and inefficiency and thus curb rising costs, it will continue to lose surgical revenue to foreign health providers. Copyright © Taylor & Francis Group, LLC

  19. The cost of sustaining a patient-centered medical home: experience from 2 states.

    Science.gov (United States)

    Magill, Michael K; Ehrenberger, David; Scammon, Debra L; Day, Julie; Allen, Tatiana; Reall, Andreu J; Sides, Rhonda W; Kim, Jaewhan

    2015-09-01

    As medical practices transform to patient-centered medical homes (PCMHs), it is important to identify the ongoing costs of maintaining these "advanced primary care" functions. A key required input is personnel effort. This study's objective was to assess direct personnel costs to practices associated with the staffing necessary to deliver PCMH functions as outlined in the National Committee for Quality Assurance Standards. We developed a PCMH cost dimensions tool to assess costs associated with activities uniquely required to maintain PCMH functions. We interviewed practice managers, nurse supervisors, and medical directors in 20 varied primary care practices in 2 states, guided by the tool. Outcome measures included categories of staff used to perform various PCMH functions, time and personnel costs, and whether practices were delivering PCMH functions. Costs per full-time equivalent primary care clinician associated with PCMH functions varied across practices with an average of $7,691 per month in Utah practices and $9,658 in Colorado practices. PCMH incremental costs per encounter were $32.71 in Utah and $36.68 in Colorado. The average estimated cost per member per month for an assumed panel of 2,000 patients was $3.85 in Utah and $4.83 in Colorado. Identifying costs of maintaining PCMH functions will contribute to effective payment reform and to sustainability of transformation. Maintenance and ongoing support of PCMH functions require additional time and new skills, which may be provided by existing staff, additional staff, or both. Adequate compensation for ongoing and substantial incremental costs is critical for practices to sustain PCMH functions. © 2015 Annals of Family Medicine, Inc.

  20. Proceedings [of the] Second National Conference of State Medical Association Representatives on Continuing Medical Education, October 13-15, 1970.

    Science.gov (United States)

    American Medical Association, Chicago, IL.

    The responsibility of organized medicine in the area of continuing education was the focus of this conference. Papers presented at the conference and summaries of workshop discussion groups comprise this document. The papers are: The Purpose of the Conference; Maintenance of Physician Competence; Motivation for Continuing Medical Education; Peer…

  1. A flexible super-capacitive solid-state power supply for miniature implantable medical devices.

    Science.gov (United States)

    Meng, Chuizhou; Gall, Oren Z; Irazoqui, Pedro P

    2013-12-01

    We present a high-energy local power supply based on a flexible and solid-state supercapacitor for miniature wireless implantable medical devices. Wireless radio-frequency (RF) powering recharges the supercapacitor through an antenna with an RF rectifier. A power management circuit for the super-capacitive system includes a boost converter to increase the breakdown voltage required for powering device circuits, and a parallel conventional capacitor as an intermediate power source to deliver current spikes during high current transients (e.g., wireless data transmission). The supercapacitor has an extremely high area capacitance of ~1.3 mF/mm(2), and is in the novel form of a 100 μm-thick thin film with the merit of mechanical flexibility and a tailorable size down to 1 mm(2) to meet various clinical dimension requirements. We experimentally demonstrate that after fully recharging the capacitor with an external RF powering source, the supercapacitor-based local power supply runs a full system for electromyogram (EMG) recording that consumes ~670 μW with wireless-data-transmission functionality for a period of ~1 s in the absence of additional RF powering. Since the quality of wireless powering for implantable devices is sensitive to the position of those devices within the RF electromagnetic field, this high-energy local power supply plays a crucial role in providing continuous and reliable power for medical device operations.

  2. Judicial demand of medications through the Federal Justice of the State of Paraná

    Science.gov (United States)

    Nisihara, Renato Mitsunori; Possebom, Ana Carolina; Borges, Luiza de Martino Cruvinel; Shwetz, Ana Claudia Athanasio; Bettes, Fernanda Francis Benevides

    2017-01-01

    ABSTRACT Objective To describe the profile of lawsuits related to drug requests filled at the Federal Justice of the State of Paraná. Methods A cross-sectional study, and the data were obtained through consulting the lawsuits at the online system of the Federal Justice of Paraná. Results Out of 347 lawsuits included in the study, 55% of plaintiffs were women, with a median age of 56 years. Oncology was the field with more requests (23.6%), and the highest mean costs. A wide variety of diseases and broad variety of requested drugs were found in the lawsuits. Approximately two-thirds of them were requested by the brand name, and the most often requested drugs were palivizumab and tiotropium bromide. Only 14.5% of the requested medicines were registered in the National Medication Register. The Public Defender’s Office filled actions in 89.6% of cases and all lawsuits had an interim relief. The mean time for approval was 35 days and 70% of requests were granted. Conclusion Oncology was the field with the highest demand for medicines at the Federal Justice of Paraná in 2014. A great variety of medications was requested. The Public Defender´s Office represented most lawsuits. All demands had an interim relief, and the majority of requests were granted, within an average of 35 days. PMID:28444095

  3. Solid-state pulse modulator using Marx generator for a medical linac electron-gun

    Science.gov (United States)

    Lim, Heuijin; Hyeok Jeong, Dong; Lee, Manwoo; Lee, Mujin; Yi, Jungyu; Yang, Kwangmo; Ro, Sung Chae

    2016-04-01

    A medical linac is used for the cancer treatment and consists of an accelerating column, waveguide components, a magnetron, an electron-gun, a pulse modulator, and an irradiation system. The pulse modulator based on hydrogen thyratron-switched pulse-forming network is commonly used in linac. As the improvement of the high power semiconductors in switching speed, voltage rating, and current rating, an insulated gate bipolar transistor has become the more popular device used for pulsed power systems. We propose a solid-state pulse modulator to generator high voltage by multi-stacked storage-switch stages based on the Marx generator. The advantage of our modulator comes from the use of two semiconductors to control charging and discharging of the storage capacitor at each stage and it allows to generate the pulse with various amplitudes, widths, and shapes. In addition, a gate driver for two semiconductors is designed to reduce the control channels and to protect the circuits. It is developed for providing the pulsed power to a medical linac electron-gun that requires 25 kV and 1 A as the first application. In order to improve the power efficiency and achieve the compactness modulator, a capacitor charging power supply, a Marx pulse generator, and an electron-gun heater isolated transformer are constructed and integrated. This technology is also being developed to extend the high power pulsed system with > 1 MW and also other applications such as a plasma immersed ion implantation and a micro pulse electrostatic precipitator which especially require variable pulse shape and high repetition rate > 1 kHz. The paper describes the design features and the construction of this solid-state pulse modulator. Also shown are the performance results into the linac electron-gun.

  4. Characteristics of Transgender Women Living with HIV Receiving Medical Care in the United States.

    Science.gov (United States)

    Mizuno, Yuko; Frazier, Emma L; Huang, Ping; Skarbinski, Jacek

    2015-09-01

    Little has been reported from population-based surveys on the characteristics of transgender persons living with HIV. Using Medical Monitoring Project (MMP) data, we describe the characteristics of HIV-infected transgender women and examine their care and treatment needs. We used combined data from the 2009 to 2011 cycles of MMP, an HIV surveillance system designed to produce nationally representative estimates of the characteristics of HIV-infected adults receiving medical care in the United States, to compare demographic, behavioral, and clinical characteristics, and met and unmet needs for supportive services of transgender women with those of non-transgender persons using Rao-Scott chi-square tests. An estimated 1.3% of HIV-infected persons receiving care in the United States self-identified as transgender women. Transgender women were socioeconomically more marginalized than non-transgender men and women. We found no differences between transgender women and non-transgender men and women in the percentages prescribed antiretroviral therapy (ART). However, a significantly lower percentage of transgender women compared to non-transgender men had 100% ART dose adherence (78.4% vs. 87.4%) and durable viral suppression (50.8% vs. 61.4%). Higher percentages of transgender women needed supportive services. No differences were observed in receipt of most of supportive services, but transgender women had higher unmet needs than non-transgender men for basic services such as food and housing. We found little difference between transgender women and non-transgender persons in regards to receipt of care, treatment, and most of supportive services. However, the noted disparities in durable viral suppression and unmet needs for basic services should be explored further.

  5. Solid-state pulse modulator using Marx generator for a medical linac electron-gun

    International Nuclear Information System (INIS)

    Lim, Heuijin; Jeong, Dong Hyeok; Lee, Manwoo; Lee, Mujin; Yi, Jungyu; Yang, Kwangmo; Ro, Sung Chae

    2016-01-01

    A medical linac is used for the cancer treatment and consists of an accelerating column, waveguide components, a magnetron, an electron-gun, a pulse modulator, and an irradiation system. The pulse modulator based on hydrogen thyratron-switched pulse-forming network is commonly used in linac. As the improvement of the high power semiconductors in switching speed, voltage rating, and current rating, an insulated gate bipolar transistor has become the more popular device used for pulsed power systems. We propose a solid-state pulse modulator to generator high voltage by multi-stacked storage-switch stages based on the Marx generator. The advantage of our modulator comes from the use of two semiconductors to control charging and discharging of the storage capacitor at each stage and it allows to generate the pulse with various amplitudes, widths, and shapes. In addition, a gate driver for two semiconductors is designed to reduce the control channels and to protect the circuits. It is developed for providing the pulsed power to a medical linac electron-gun that requires 25 kV and 1 A as the first application. In order to improve the power efficiency and achieve the compactness modulator, a capacitor charging power supply, a Marx pulse generator, and an electron-gun heater isolated transformer are constructed and integrated. This technology is also being developed to extend the high power pulsed system with > 1 MW and also other applications such as a plasma immersed ion implantation and a micro pulse electrostatic precipitator which especially require variable pulse shape and high repetition rate > 1 kHz. The paper describes the design features and the construction of this solid-state pulse modulator. Also shown are the performance results into the linac electron-gun

  6. National Characteristics of Emergency Medical Services Responses for Older Adults in the United States.

    Science.gov (United States)

    Duong, Hieu V; Herrera, Lauren Nicholas; Moore, Justin Xavier; Donnelly, John; Jacobson, Karen E; Carlson, Jestin N; Mann, N Clay; Wang, Henry E

    2018-01-01

    Older adults, those aged 65 and older, frequently require emergency care. However, only limited national data describe the Emergency Medical Services (EMS) care provided to older adults. We sought to determine the characteristics of EMS care provided to older adults in the United States. We used data from the 2014 National Emergency Medical Services Information System (NEMSIS), encompassing EMS response data from 46 States and territories. We excluded EMS responses for children older adults as age ≥65 years. We compared patient demographics (age, sex, race, primary payer), response characteristics (dispatch time, location type, time intervals), and clinical course (clinical impression, injury, procedures, medications) between older and younger adult EMS emergency 9-1-1 responses. During the study period there were 20,212,245 EMS emergency responses. Among the 16,116,219 adult EMS responses, there were 6,569,064 (40.76%) older and 9,547,155 (59.24%) younger adults. Older EMS patients were more likely to be white and the EMS incident to be located in healthcare facilities (clinic, hospital, nursing home). Compared with younger patients, older EMS patients were more likely to present with syncope (5.68% vs. 3.40%; OR 1.71; CI: 1.71-1.72), cardiac arrest/rhythm disturbance (3.27% vs. 1.69%; OR 1.97; CI: 1.96-1.98), stroke (2.18% vs. 0.74%; OR 2.99; CI: 2.96-3.02) and shock (0.77% vs. 0.38%; OR 2.02; CI: 2.00-2.04). Common EMS interventions performed on older persons included intravenous access (32.02%), 12-lead ECG (14.37%), CPR (0.87%), and intubation (2.00%). The most common EMS drugs administered to older persons included epinephrine, atropine, furosemide, amiodarone, and albuterol or ipratropium. One of every three U.S. EMS emergency responses involves older adults. EMS personnel must be prepared to care for the older patient.

  7. To Strive, to Seek, to Find, and Not Yield: How Chiefs of Staff of the Army Lead Change

    Science.gov (United States)

    2013-05-23

    The Savage Wars of Peace: Small Wars and the Rise of American Power (New York: Basic Books, 2002) 3...34 The Leadership Quarterly 18 (2007): 411-428. Bolger, Daniel P. "An Enduring Army: Getting It Right." Army, OCT 2010: 163-166. Boot, Max. The Savage ...History of the United States Army. Bloomington: University of Indiana Press, 1984. Westmorland, William C. A Soldier Reports. Garden City, NY: Doubleday

  8. Decreasing Disability Processing Days for Soldiers in the U.S. Army Through Initiatives in Human Resource Management Support Systems: A Two-Tiered, Three Year Evaluation

    Directory of Open Access Journals (Sweden)

    Bernard Kerr, Jr.

    2005-02-01

    Full Text Available This essay highlights the findings of a two tiered, three year evaluation. The first tier studied human resource and quality management initiatives at Walter Reed Army Medical Center (WRAMC Washington, DC from 1992-1994. The second tier researched disability records through the United States Army Physical Disability Agency, Bethesda, Maryland in 1996. The first tier found that Total Quality Management reduced the average length of stay (ALOS and size of the disability population from 220 days and 240 disability cases to 65 days and 57 disability cases over 24 months. The second tier studied 8,301 soldiers whose disability records were processed in Fiscal Year 1996. The research shows only administrative variables affect ALOS. The authors recommend a program of disability case management and increasing emphasis on transition assistance programs to reduce ALOS in the PDES.

  9. Information Sharing between the U.S. Department State and the U.S. Army: Using Knowledge Management Technology and Tools to Bridge the Gap

    Science.gov (United States)

    2015-06-12

    Davenport, “Saving IT’s Soul : Human Centered Information Management,” Harvard Business Review 72, no. 2 (March-April 1994): 119-131. 30 Bryant Duhon...overall systems. Both organizations rely heavily on Microsoft Windows based clients and servers as well as email as a primary tool for knowledge...Accessed January 26, 2015. http://www.state.gov/t/pm/rls/rm/145332.htm. Davenport, Thomas H. “Saving IT’s Soul : Human Centered Information Management

  10. Overcoming movement obstacles by the religiously orthodox: the Muslim Brotherhood in Egypt, Shas in Israel, Comunione e Liberazione in Italy, and the Salvation Army in the United States.

    Science.gov (United States)

    Davis, Nancy J; Robinson, Robert V

    2009-03-01

    This article examines four movements of the religiously orthodox that should have failed according to most social movement theory and research. The movements combine (1) an extraordinarily broad agenda, (2) a strict, morally absolutist ideology, and (3) a strong proscription against compromise with other groups, each of which has been identified as a liability that can lead to movement failure. Through inductive, qualitative analyses, the authors identify four shared strategies that helped these movements overcome these obstacles: bypassing the state, building grassroots structures, providing graduated membership, and reprioritizing agendas. Analyses of these movements also suggest that particular combinations of movement "liabilities" may actually be advantageous.

  11. Company Level Commander Development In The US Army

    Science.gov (United States)

    2013-12-01

    pedagogy and andragogy in instruction can have a significant positive impact on developing combat arms officers to be successful company level commanders...Recommendations to achieve these improvements using andragogy are discussed. In the United States (US) Army, when an officer...use Malcom Knowles’ andragogy framework for understanding adults as learners in order to analyze the trainees and maximize the training outcomes for

  12. Inpatient Obstetric Care at Irwin Army Community Hospital: A Study to Determine the Most Efficient Organization

    Science.gov (United States)

    2001-03-01

    Reese’s new birthing suites may curb maternity malpractice suits. Modern Healthcare, 16 (11), 48. Clark, L., & Stewart, R. (1982). Nurse-midwifery...Davis Highway, Suite 1204, Arlington VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law , no person shall be...US Army Medical Department Center and School Bldg 2841 MCCS-HRA (US Army-Baylor Program in HCA) 3151 Scott Road, Suite 1412 Fort Sam Houston, TX 78234

  13. Application of the Taxonomy of Injuries: Analysis of Army Recruit Injuries, CY 2016

    Science.gov (United States)

    2018-01-31

    Assessing Fitness for Military Enlistment: Physical , Medical, and Mental Health Standards. Washington, DC: The National Academies Press. 13. U.S. Army...Public Health Information Paper Application of the Taxonomy of Injuries: Analysis of Army Recruit Injuries, CY 2016 PHIP No. 12-01-0118...Recruit Injuries, CY2016; Public Health Information Paper 12-01-0118 5a. CONTRACT NUMBER n/a 5b. GRANT NUMBER

  14. The Effects of a Customer Service Initiative at Moncrief Army Community Hospital

    Science.gov (United States)

    2008-04-06

    Vroom (1964) in job satisfaction , Linder-Pelz argued that expectancy (i.e., the evaluation of object attributes) was determined by the relationship...Sf. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADORESS(ES) MONCRIEF ARMY COMMUNITY HOSPITAL 4 500 STUART STREET FORT JACKSON, SC 29207...8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING / MONITORING AGENCY NAME(S) AND ADDRESS(ES) US ARMY MEDICAL DEPARTMENT CENTER AND SCHOOL

  15. Patterns of medical management of overactive bladder (OAB) and benign prostatic hyperplasia (BPH) in the United States.

    Science.gov (United States)

    Anger, Jennifer T; Goldman, Howard B; Luo, Xuemei; Carlsson, Martin O; Chapman, Douglass; Zou, Kelly H; Russell, David; Ntanios, Fady; Esinduy, Canan B; Clemens, J Quentin

    2018-01-01

    Overactive bladder (OAB) and benign prostatic hyperplasia (BPH) are highly prevalent conditions that place a large burden on the United States (US) health care system. We sought to analyze patterns of prescription medication usage for incident OAB in men and women, and for incident BPH in men using US health insurance claims data. This study used Truven Health MarketScan® Commercial and Medicare Supplemental Research databases. The data were pooled from diverse points of care. BPH subjects included men age 18+ with the first and last two diagnoses of BPH ≥30 days apart and no BPH diagnosis for 1 year prior. OAB subjects included men and women age 18+, who were diagnosed similarly with incident OAB. The type of medication, medication continuation (persistence), and switching to a different medication were analyzed through September 30, 2013. Medication persistence was much higher overall for BPH than OAB (56% vs 34%, respectively, P BPH age 65+ (62%). Patients age 18-64 were less likely to continue medication than older adults (age 65+) for both BPH and OAB. A 9.4% of patients in the OAB cohort and 6.9% of men with BPH switched from one medication to another. Persistence was higher with BPH than OAB medications overall, whereas switching rates were higher in the OAB group. The lower persistence of OAB medication may be due to less efficacy or tolerability. The possibility of under treatment of OAB also warrants future investigations. © 2017 Wiley Periodicals, Inc.

  16. Comparative analysis of field ration for military personnel of the ukrainian army and armies of other countries worldwide

    OpenAIRE

    M. Mardar; M. Hkrupalo; M. Stateva

    2017-01-01

    For the purpose of improvement of the Ukrainian nutritional standards this Article provides comparative analysis of field rations of different countries worldwide to make a proposal on improvement of food-stuff assortment in food ration for military personnel in the Armed Forces of Ukraine, Army of USA, the British Army, Army of Germany, Army of Italy, Army of Canada, Army of France, Army of Belarus, Army of Armenia. In accordance with the comparative analysis it was established that ration c...

  17. Monitoring of Federally Threatened and Endangered Species on U.S. Army Installations

    National Research Council Canada - National Science Library

    Mellon, Robert H; Balbach, Harold E; Ward, Michael

    2004-01-01

    ...) species on United States Army installations, and the results of a survey conducted to ascertain the kinds and quality of efforts being made to monitor these species in compliance with the Endangered...

  18. What the Army Needs to Know to Align Its Operational and Institutional Activities

    National Research Council Canada - National Science Library

    Camm, Frank; Cook, Cynthia R; Masi, Ralph; Wong, Anny

    2007-01-01

    ... from those mastered in years past. And a whole series of supporting organizations must adapt to the global deployments of an Army that will be based largely in the United States rather than overseas...

  19. What the Army Needs to Know to Align Its Operational and Institutional Activities: Executive Summary

    National Research Council Canada - National Science Library

    Camm, Frank; Cook, Cynthia R; Masi, Ralph; Wong, Anny

    2007-01-01

    ... from those mastered in years past. And a whole series of supporting organizations must adapt to the global deployments of an Army that will be based largely in the United States rather than overseas...

  20. Strategic Analysis and Associated Management Products Supporting the Reengineering of Bayne-Jones Army Community Hospital: Consultative Products and Findings

    National Research Council Canada - National Science Library

    Fulton, Larry

    1998-01-01

    .... ̂Product 2 - "Bayne-Jones Army Community Hospital Web Site," a strategic Internet web site for marketing health and wellness, the TRICARE medical network, the Joint Readiness Training Center Surgeon's...

  1. Answering the Hottest Question in Army Education: What Is Army University?

    Science.gov (United States)

    Kem, John S.; LeBoeuf, Eugene J.; Martin, James B.

    2016-01-01

    The most common question heard by senior members of Army University is always, "What is Army University?" The newest education institution in the U.S. Army was created to unify the training and educational institutions of the Army, making the large learning organization more effective and efficient for its soldiers, bringing together 37…

  2. US Army Weapon Systems Human-Computer Interface (WSHCI) style guide, Version 1

    Energy Technology Data Exchange (ETDEWEB)

    Avery, L.W.; O`Mara, P.A.; Shepard, A.P.

    1996-09-30

    A stated goal of the U.S. Army has been the standardization of the human computer interfaces (HCIS) of its system. Some of the tools being used to accomplish this standardization are HCI design guidelines and style guides. Currently, the Army is employing a number of style guides. While these style guides provide good guidance for the command, control, communications, computers, and intelligence (C4I) domain, they do not necessarily represent the more unique requirements of the Army`s real time and near-real time (RT/NRT) weapon systems. The Office of the Director of Information for Command, Control, Communications, and Computers (DISC4), in conjunction with the Weapon Systems Technical Architecture Working Group (WSTAWG), recognized this need as part of their activities to revise the Army Technical Architecture (ATA). To address this need, DISC4 tasked the Pacific Northwest National Laboratory (PNNL) to develop an Army weapon systems unique HCI style guide. This document, the U.S. Army Weapon Systems Human-Computer Interface (WSHCI) Style Guide, represents the first version of that style guide. The purpose of this document is to provide HCI design guidance for RT/NRT Army systems across the weapon systems domains of ground, aviation, missile, and soldier systems. Each domain should customize and extend this guidance by developing their domain-specific style guides, which will be used to guide the development of future systems within their domains.

  3. From 32 ounces to zero: a medical geographic study of dispensing a cultivated batch of "plum" cannabis flowers to medical marijuana patients in Washington State.

    Science.gov (United States)

    Aggarwal, Sunil K; Carter, Gregory T; Zumbrunnen, Craig; Morrill, Richard; Sullivan, Mark; Mayer, Jonathan D

    2013-01-01

    The medicinal use of cannabis is a growing phenomenon in the U.S. predicated on the success of overcoming specific spatial challenges and establishing particular human-environment relationships. This article takes a medical geographic "snapshot" of an urban site in Washington State where qualifying chronically ill and debilitated patients are delivered locally produced botanical cannabis for medical use. Using interview, survey, and observation, this medical geographic research project collected information on the social space of the particular delivery site and tracked the production cost, reach, and health value of a 32-ounce batch of strain-specific medical cannabis named "Plum" dispensed over a four-day period. A convenience sample of 37 qualifying patients delivered this batch of cannabis botanical medicine was recruited and prospectively studied with survey instruments. Results provide insight into patients' self-rated health, human-plant relationships, and travel-to-clinic distances. An overall systematic geographic understanding of the medical cannabis delivery system gives a grounded understanding of the lengths that patients and care providers go, despite multiple hurdles, to receive and deliver treatment with botanical cannabis that relieves diverse symptoms and improves health-related quality-of-life.

  4. Operational Reach: Is Current Army Doctrine Adequate?

    National Research Council Canada - National Science Library

    Heintzelman, Scott

    2003-01-01

    The term operational reach, an element of operational design, is new to U.S. Army doctrine. Operational reach is not found in the previous edition of the Army's basic operational doctrine, Field Manual...

  5. Analysis of injuries from the Army Ten Miler: A 6-year retrospective review.

    Science.gov (United States)

    Pasquina, Paul F; Griffin, Sarah C; Anderson-Barnes, Victoria C; Tsao, Jack W; O'Connor, Francis G

    2013-01-01

    A number of long-distance running events are held each year in the United States; the Army Ten Miler (ATM) is one such race held annually in Washington, DC. The purpose of the present study was to retrospectively analyze medical encounters for runners participating in the ATM from 1998 to 2004. Of the estimated 91,750 runners over the 6-year period, 73,100 participants finished the race and were included in the data analysis. Demographic and injury data were collected from medical records of participants who received medical care while participating in the ATM, and injury-related factors were assessed. The most common category of injury was musculoskeletal (44%), followed by medical-related problems (27%) and dermatological injuries (27%). Similar to marathon and ironman races, ATM injury rates correlate with race-day temperature and dew point. Overall, however, the injury rates observed at the ATM were relatively low compared to those reported for longer distance events. Finally, we detail the medical coverage provided at the ATM, as this coverage could be used as a guide for similarly distanced races.

  6. Engineer: The Professional Bulletin of Army Engineers, Jan-Apr 2010

    Science.gov (United States)

    2010-04-01

    Dornstadter 51 Transformation in Korea By Major Rafael Pazos and Captain Miguel Uc Headquarters, Department of the ArmyVolume 40 PB 5-10-1...States with an By Major Rafael Pazos and Captain Miguel Uc January-April 201052 Engineer initial grant of 205 acres at USAG–Humphreys, allowing the...the quality of life of our Service members. Major Pazos is the deputy commander of the United States Army Corps of Engineers (USACE), Gulf Region

  7. The effect of race on postsurgical ambulatory medical follow-up among United States Veterans.

    Science.gov (United States)

    Schonberger, Robert B; Dai, Feng; Brandt, Cynthia; Burg, Matthew M

    2017-08-01

    To investigate the association between self-identified black or African American race and the presence of ambulatory internal medicine follow-up in the year after surgery. Our hypothesis was that among US Veterans who presented for surgery, black or African American race would be associated with a decreased likelihood to receive ambulatory internal medicine follow-up in the year after surgery. Retrospective observational. All US Veterans Affairs hospitals. A total of 236,200 Veterans undergoing surgery between 2006 and 2011 who were discharged within 10 days of surgery and survived the full 1-year exposure period. None. Attendance at an internal medicine follow-up appointment within 1 year after surgery. After controlling for year of surgery, age, age ≥65 years, sex, Hispanic ethnicity, and number of inpatient days, black or African American patients were 11% more likely to lack internal medicine follow-up after surgery (adjusted odds ratio, 1.11; 95% confidence interval, 1.06-1.16). When accounting for geographic region, this difference remained significant at the Bonferoni-corrected P < .007 level only in the Midwest United States where black or African American patients were 28% more likely to lack medical follow-up in the year after surgery (odds ratio, 1.28; 95% confidence interval, 1.16-1.42; P < .0001). The disparity in ambulatory medical follow-up following surgery among black or African American vs nonblack or non-African American Veterans in the Midwest region deserves further study and may lead to important quality improvement initiatives aimed specifically at this population. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. MEDICATION SYSTEM ANALYSIS OF AN UNIVERSITY HOSPITAL IN THE STATE OF GOIÁS

    Directory of Open Access Journals (Sweden)

    Ana Elisa Bauer de Camargo Silva

    2004-04-01

    Full Text Available The medication errors can bring serious consequences to patients, professionals andhealthcare institutions, they have multiple causes, amongst them failures related to theprofessionals and related to the medication system. This study’s objective was to identify and toanalyse the medication system process, its failures in order to propose improvement actions to thehospital. This exploratory descriptive study took place in the medical clinical unit and in thepharmacy of a general and university hospital of the state of Goiás, after approval of theCommittee of the Ethics of the correspondent hospital. The sample included: (first phase apharmacist, (third phase 40 professionals divided into 12 resident physicians (30%, 20 nursingprofessionals (50%, 8 pharmacy team members (20%; 294 patient charts were also used. Thedata was collected in 2002 and consisted of an interview with the professional in charge of themedication system, and non-participant observation of the environment and actions of theprofessionals and the academic people, interviews with the professionals and patient chartanalysis. The professionals were asked to sign on the “Free Will Participation Agreement”. It waspossible based on the data collected to describe the following processes: handwriting medicationprescription using carbon paper, individually dose dispensing and that the nursing professional whoadministrates the drug is not the same that prepares it in the clinical unit. The results based on the21 days of observation of the drug prescription, dispensing and administration processes were: theenvironment is the main problem in the prescription (75% and dispensing (30,6% processes, it isa noisy place and interruptions frequently occur; safety failures during the technique and inadvancedrug preparation appeared in the top (46,8% in the preparation process. The datacollection also allowed to build a chart of the 60 steps from drug prescription to monitoring. Theresults from

  9. Trends in medical malpractice claims in patients with cleft or craniofacial abnormalities in the United States.

    Science.gov (United States)

    Rawal, Rounak B; Kilpatrick, Lauren A; Wood, Jeyhan S; Drake, Amelia F

    2016-11-01

    To describe medical malpractice trends in patients with cleft and/or craniofacial abnormalities. A modified Delphi approach was used to gather search terms. Search settings included "all jury verdicts and settlements", with jurisdiction of "all states" and "all federal courts" (by court and circuit). A retrospective review of WestLawNext legal database was conducted. Cases were excluded if they did not have a direct association from the patient's craniofacial anomaly or if they were not related to malpractice. Forty-two cases met inclusion criteria. Cases closed between 1981 and 2014 were included. The mean payment among claims with an indemnity payment was $3.9 million. Of cases brought to trial, 62% were in favor of the plaintiff. Amongst physicians named as co-defendants, pediatricians were most commonly named (24%), followed by plastic surgeons (16%), obstetricians (7.8%), and radiologists (7.8%). "Missed diagnosis" was the most common type of negligent claim (45%), followed by "surgical error" (21%), and "medication error" (17%). "Anoxic brain injury" resulted in the highest median indemnity payment for complication of patient management ($3.5 million), followed by "wrongful birth" ($1.03 million), and "minor physical injury" ($520,000). No specific type of negligent claim (p = 0.764) nor complication of patient management (p = 0.61) was associated with a greater indemnity payment. Mean indemnity payment was $920,000 prior to 2001 and $4.4 million after 2001 (p = 0.058). Mean indemnity payments were fourteen-fold greater in patients as compared to those in the overall population ($3.9 million versus $274,887) and seven-fold greater than those in the average pediatric population ($3.9 million versus $520,923). All healthcare providers should be aware of the associated medical malpractice claims that may be incurred when treating patients at risk for these conditions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. 1986 AMEDD (Army Medical Department) Clinical Psychology Short Course: Tripler Army Medical Center, Honolulu, Hawaii.

    Science.gov (United States)

    1987-09-01

    system in which it operates. Beginning with Ferdinand de Saussure (1857-1914) and his published lectures entitled, Course in General Linguistics (1915...an important contribution was made to the study of language and human communication. Saussure introduced the idea that the study of one language (alone...and by itself) without reference to other language or languages was, indeed, a worthy occupation for a language scientist. Saussure built upon the

  11. 76 FR 12087 - Army Educational Advisory Committee

    Science.gov (United States)

    2011-03-04

    ...: U.S. Army War College Subcommittee of the Army Education Advisory Committee. Dates of Meeting: March 24, 2011. Place of Meeting: U.S. Army War College, 122 Forbes Avenue, Carlisle, PA, Command... faculty; table and examine online College issues; assess resident and distance education programs, self...

  12. 75 FR 7255 - Army Educational Advisory Committee

    Science.gov (United States)

    2010-02-18

    ... Committee: U.S. Army War College Subcommittee of the Army Education Advisory Committee. Date of Meeting: March 11, 2010. Place of Meeting: U.S. Army War College, 122 Forbes Avenue, Carlisle, PA, Command...; table and examine online College issues; assess resident and distance education programs, self- study...

  13. 32 CFR 631.14 - Army policy.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Army policy. 631.14 Section 631.14 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL...-Installation Operations (Military Patrols and Investigative Activities) and Policy § 631.14 Army policy. (a...

  14. Annual Research Progress Report Letterman Army Institute of Research

    Science.gov (United States)

    1974-06-30

    occurs in the human oral cavity following trauma °r -J J« "^ an important defense mechanism in the highly infected oral environment ^d...antiseptic to temporarily reduce the bacterial population of the oral cavity . A collaborative study between Letterman Army Medical Center and...penicillin resistant strains of bacteria are frequently- observed components of the microbiota of oral and maxlllofacial in- fections surveyed at Letterman

  15. Army Hearing Program Status Report Quarter 1 Fiscal Year 2017

    Science.gov (United States)

    2017-03-27

    Occupational Health Objectives for Fiscal Year 2016, 21 October 2015. Memorandum, Office of the Surgeon General, subject: Public Health Management System ...Army’s Safety and Occupational Health objectives. U.S. Army Medical Command (MEDCOM) Chief of Staff Memorandum, dated 15 December 2016, mandates... Occupational and Environmental Health Readiness System – Hearing Conservation (DOEHRS-HC), and an average of 2 CIV and 3 MIL losses were recorded

  16. An adaptive and generalizable closed-loop system for control of medically induced coma and other states of anesthesia

    Science.gov (United States)

    Yang, Yuxiao; Shanechi, Maryam M.

    2016-12-01

    Objective. Design of closed-loop anesthetic delivery (CLAD) systems is an important topic, particularly for medically induced coma, which needs to be maintained for long periods. Current CLADs for medically induced coma require a separate offline experiment for model parameter estimation, which causes interruption in treatment and is difficult to perform. Also, CLADs may exhibit bias due to inherent time-variation and non-stationarity, and may have large infusion rate variations at steady state. Finally, current CLADs lack theoretical performance guarantees. We develop the first adaptive CLAD for medically induced coma, which addresses these limitations. Further, we extend our adaptive system to be generalizable to other states of anesthesia. Approach. We designed general parametric pharmacodynamic, pharmacokinetic and neural observation models with associated guidelines, and derived a novel adaptive controller. We further penalized large steady-state drug infusion rate variations in the controller. We derived theoretical guarantees that the adaptive system has zero steady-state bias. Using simulations that resembled real time-varying and noisy environments, we tested the closed-loop system for control of two different anesthetic states, burst suppression in medically induced coma and unconsciousness in general anesthesia. Main results. In 1200 simulations, the adaptive system achieved precise control of both anesthetic states despite non-stationarity, time-variation, noise, and no initial parameter knowledge. In both cases, the adaptive system performed close to a baseline system that knew the parameters exactly. In contrast, a non-adaptive system resulted in large steady-state bias and error. The adaptive system also resulted in significantly smaller steady-state infusion rate variations compared to prior systems. Significance. These results have significant implications for clinically viable CLAD design for a wide range of anesthetic states, with potential cost

  17. Identification of Tasks Performed by United States Army Dietitians Which are Perceived as Delegable to Enlisted Personnel Having the 94F50 or the 94F40 Military Occupational Specialty

    Science.gov (United States)

    1976-09-01

    diversification, and franchising 3. higher costs per employee and an increased need for higher productivity 4. increasiing numbers of formal in-service...Army’s New CAFe ," Cornell Hotel and Restaurant Administration Quarterly 13 (May 1972):76-81. Snyder, Oscar P., "Computer-Managed Susbistence System: A

  18. Domains of unprofessional behavior during medical school associated with future disciplinary action by a state medical board.

    Science.gov (United States)

    Teherani, Arianne; Hodgson, Carol S; Banach, Mary; Papadakis, Maxine A

    2005-10-01

    In a previous study, we showed that unprofessional behavior in medical school was associated with subsequent disciplinary action. This study expands on that work by identifying the domains of unprofessional behavior that are most problematic. In this retrospective case-control study, negative comments were extracted from student files for 68 case (disciplined) and 196 matched control (nondisciplined) physicians. Comments were analyzed qualitatively and subsequently quantified. The relationship between domains of behavior and disciplinary action was established through chi-square tests and multivariate analysis of variance. Three domains of unprofessional behavior emerged that were related significantly to later disciplinary outcome: (1) poor reliability and responsibility, (2) lack of self-improvement and adaptability, and (3) poor initiative and motivation. Three critical domains of professionalism associated with future disciplinary action have been defined. These findings could lead to focused remediation strategies and policy decisions.

  19. [Management of chemical burns and inhalation poisonings in acute medical care procedures of the State Fire Service].

    Science.gov (United States)

    Chomoncik, Mariusz; Nitecki, Jacek; Ogonowska, Dorota; Cisoń-Apanasewicz, Urszula; Potok, Halina

    2013-01-01

    Emergency Medical Services (EMS) were founded by the government to perform tasks aimed at providing people with help in life-threatening conditions. The system comprises two constituent parts. The first one is public administrative bodies which are to organise, plan, coordinate and supervise the completion of the tasks. The other constituent is EMS units which keep people, resources and units in readiness. Supportive services, which include: the State Fire Service (SFS) and the National Firefighting and Rescue System (NFRS), are of great importance for EMS because they are eligible for providing acute medical care (professional first aid). Acute medical care covers actions performed by rescue workers to help people in life-threatening conditions. Rescue workers provide acute medical care in situations when EMS are not present on the spot and the injured party can be accessed only with the use of professional equipment by trained workers of NFRS. Whenever necessary, workers of supportive services can assist paramedics' actions. Cooperation of all units of EMS and NFRS is very important for rescue operations in the integrated rescue system. Time is a key aspect in delivering first aid to a person in life-threatening conditions. Fast and efficient first aid given by the accident's witness, as well as acute medical care performed by a rescue worker can prevent death and minimise negative effects of an injury or intoxication. It is essential that people delivering first aid and acute medical care should act according to acknowledged and standardised procedures because only in this way can the process of decision making be sped up and consequently, the number of possible complications following accidents decreased. The present paper presents an analysis of legal regulations concerning the management of chemical burn and inhalant intoxication in acute medical care procedures of the State Fire Service. It was observed that the procedures for rescue workers entitled to

  20. U.S. Army Corps of Engineers Waste Experiences: More Than You May Think

    International Nuclear Information System (INIS)

    Hays, D. C.; Honerlah, H. B.

    2003-01-01

    U.S. Army Corps of Engineers (USACE) works with other federal, and state agencies through several different programs on numerous Hazardous, Toxic, and Radioactive Waste (HTRW) sites. Formerly Utilized Sites Remediation Program (FUSRAP), Formerly Used Defense Sites (FUDS), EPA Superfund, Installation Restoration, Army Deactivated Nuclear Reactor Program, and many other programs present hazardous, radioactive, and mixed waste issues. While the USACE has a reputation of excellent dirt movers, little is discussed of our other waste management experiences. This paper discusses some of the challenges facing the Health Physics (HP) staff of the USACE. The HP staff is currently organized as one team, the Radiation Safety Support Team (RSST), comprised of 15 individuals at 6 locations across the country. With typical RSST missions including HP consultation to USACE activities world wide, many waste challenges arise. These challenges have involved radioactive wastes of all classifications and stability. Sealed and unsealed sources; instruments and dials; contaminated earth and debris; liquids; lab, reactor, and medical wastes are all successfully managed by the USACE. USACE also develops, evaluates, and utilizes waste treatment Types of radioactive waste at HTRW sites include: Low Level Radioactive Wastes (LLRW) (class A, B, C, and greater than C), 11e.(2), Transuranic (TRU), Mixed, and Naturally Occurring (NORM/TENORM)

  1. Review of survey articles regarding medication therapy management (MTM) services/programs in the United States.

    Science.gov (United States)

    Oladapo, Abiola O; Rascati, Karen L

    2012-08-01

    To provide a summary of published survey articles regarding the provision of medication therapy management (MTM) services in the United States. A literature search was conducted to identify original articles on MTM-related surveys conducted in the United States, involving community and outpatient pharmacists, physicians, patients, or pharmacy students and published by the primary researchers who conducted the study. Search engines used included PubMed, Medline, and International Pharmaceutical Abstracts (IPA). If MTM was in the keyword list, mesh heading, title, or abstract, the article was reviewed. References from these articles were searched to determine whether other relevant articles were available. A total of 405 articles were initially reviewed; however, only 32 articles met the study requirements. Of the 32 articles, 17 surveyed community/outpatient pharmacists, 3 surveyed pharmacy students, 4 surveyed physicians, and 8 surveyed patients. The survey periods varied across the different studies, with the earliest survey conducted in 2004 and the most recent survey conducted in 2009. The surveys were conducted via the telephone, US mail, interoffice mail, e-mails, Internet/Web sites, hand-delivered questionnaires, and focus groups. Despite the identified barriers to the provision of MTM services, pharmacists reportedly found it professionally rewarding to provide these services. Pharmacists claimed to have adequate clinical knowledge, experience, and access to information required to provide MTM services. Pharmacy students were of the opinion that the provision of MTM services was important to the advancement of the pharmacy profession and in providing patients with a higher level of care. Physicians supported having pharmacists adjust patients’ drug therapy and educate patients on general drug information but not in selecting patients’ drug therapy. Finally, patients suggested that alternative ways need to be explored in describing and marketing MTM

  2. Correlation of United States Medical Licensing Examination and Internal Medicine In-Training Examination performance.

    Science.gov (United States)

    Perez, Jose A; Greer, Sharon

    2009-12-01

    The Internal Medicine In-Training Examination (ITE) is administered during residency training in the United States as a self-assessment and program assessment tool. Performance on this exam correlates with outcome on the American Board of Internal Medicine Certifying examination. Internal Medicine Program Directors use the United States Medical Licensing Examination (USMLE) to make decisions in recruitment of potential applicants. This study was done to determine a correlation of USMLE Steps 1, 2 and 3 results with ITE scores in each level of Internal Medicine training. A retrospective review of all residents graduating from an Internal Medicine program from 1999 to 2006 was done. Subjects included had data for all USMLE Steps and ITE during all years of training. Thirty-one subjects were included in the study. Correlations of USMLE Steps 1, 2 and 3 were done with ITE scores (percent correct) in each year of training. Pearson's correlation coefficient (r) was determined for each pairing and a t test to determine statistical significance of the correlation was done. Statistical significance was defined as P value ITE percent correct in PGY I, II and III were 0.46, 0.55 and 0.51 respectively. Corresponding r values for USMLE Step 2 and ITE percent correct were 0.79, 0.70 and 0.72; for USMLE Step 3 these values were 0.51, 0.37 and 0.51 respectively for each training year. USMLE scores are correlated with ITE scores. This correlation was strongest for USMLE Step 2.

  3. Cerebral angioplasty practice at major medical centers in the United States

    International Nuclear Information System (INIS)

    Chaturvedi, S.; St Pierre, M.E.; Bertasio, B.

    2000-01-01

    Concern has been expressed recently regarding the proliferation of angioplasty and/or stenting of cerebral vessels. However, little is known about the volume of angioplasties being performed or the number of experienced interventionalists. A questionnaire was mailed to directors of accredited radiology residency programs in the United States, to define the level of expertise available at teaching hospitals in terms of angioplasty and/or stenting. Of 200 programs surveyed, 111 responded (56 %). Of 111 program directors 47 (42 %) indicated that cerebral angioplasty was being performed at their center. The greatest experience is currently for angioplasty of post-subarachnoid hemorrhage vasospasm (mean 16 procedures performed) and the least experience for dilation of basilar artery atherosclerosis (mean five procedures performed). The reported stroke and/or death rate in centers performing angioplasty of the extracranial carotid system is 1.5 %. Comparisons with other medical specialties (e. g., cardiologists, neurologists, neurosurgeons) are necessary to determine the full scope of extracranial neurovascular procedures being performed and the corresponding complication rates. (orig.)

  4. Resting State Brain Network Disturbances Related to Hypomania and Depression in Medication-Free Bipolar Disorder.

    Science.gov (United States)

    Spielberg, Jeffrey M; Beall, Erik B; Hulvershorn, Leslie A; Altinay, Murat; Karne, Harish; Anand, Amit

    2016-12-01

    Research on resting functional brain networks in bipolar disorder (BP) has been unable to differentiate between disturbances related to mania or depression, which is necessary to understand the mechanisms leading to each state. Past research has also been unable to elucidate the impact of BP-related network disturbances on the organizational properties of the brain (eg, communication efficiency). Thus, the present work sought to isolate network disturbances related to BP, fractionate these into components associated with manic and depressive symptoms, and characterize the impact of disturbances on network function. Graph theory was used to analyze resting functional magnetic resonance imaging data from 60 medication-free patients meeting the criteria for BP and either a current hypomanic (n=30) or depressed (n=30) episode and 30 closely age/sex-matched healthy controls. Correction for multiple comparisons was carried out. Compared with controls, BP patients evidenced hyperconnectivity in a network involving right amygdala. Fractionation revealed that (hypo)manic symptoms were associated with hyperconnectivity in an overlapping network and disruptions in the brain's 'small-world' network organization. Depressive symptoms predicted hyperconnectivity in a network involving orbitofrontal cortex along with a less resilient global network organization. Findings provide deeper insight into the differential pathophysiological processes associated with hypomania and depression, along with the particular impact these differential processes have on network function.

  5. Standardization and Implementation of a Standard Emergency Code Call System within Estern Region Medical Command

    Science.gov (United States)

    2009-03-01

    ACHs) exist the same way that Kaiser has established different levels of services within a geographical region ( Hawaii : Hilo , Kona, Honolulu, Maui...California, Hawaii , etc., the Army MHS is divided into regions. Within these regions, Army Medical Centers (MEDCENSs) and Army Community Hospitals

  6. Prevalence and cost of hospital medical errors in the general and elderly United States populations.

    Science.gov (United States)

    Mallow, Peter J; Pandya, Bhavik; Horblyuk, Ruslan; Kaplan, Harold S

    2013-12-01

    The primary objective of this study was to quantify the differences in the prevalence rate and costs of hospital medical errors between the general population and an elderly population aged ≥65 years. Methods from an actuarial study of medical errors were modified to identify medical errors in the Premier Hospital Database using data from 2009. Visits with more than four medical errors were removed from the population to avoid over-estimation of cost. Prevalence rates were calculated based on the total number of inpatient visits. There were 3,466,596 total inpatient visits in 2009. Of these, 1,230,836 (36%) occurred in people aged ≥ 65. The prevalence rate was 49 medical errors per 1000 inpatient visits in the general cohort and 79 medical errors per 1000 inpatient visits for the elderly cohort. The top 10 medical errors accounted for more than 80% of the total in the general cohort and the 65+ cohort. The most costly medical error for the general population was postoperative infection ($569,287,000). Pressure ulcers were most costly ($347,166,257) in the elderly population. This study was conducted with a hospital administrative database, and assumptions were necessary to identify medical errors in the database. Further, there was no method to identify errors of omission or misdiagnoses within the database. This study indicates that prevalence of hospital medical errors for the elderly is greater than the general population and the associated cost of medical errors in the elderly population is quite substantial. Hospitals which further focus their attention on medical errors in the elderly population may see a significant reduction in costs due to medical errors as a disproportionate percentage of medical errors occur in this age group.

  7. The medical examination in United States immigration applications: the potential use of genetic testing leads to heightened privacy concerns.

    Science.gov (United States)

    Burroughs, A Maxwell

    2005-01-01

    The medical examination has been an integral part of the immigration application process since the passing of the Immigration Act of 1891. Failing the medical examination can result in denial of the application. Over the years the medical examination has been expanded to include questioning about diseases that are scientifically shown to be rooted in an individual's genetic makeup. Recent advances in the fields of genomics and bioinformatics are making accurate and precise screening for these conditions a reality. Government policymakers will soon be faced with decisions regarding whether or not to sanction the use of these newly-developed genetic tests in the immigration application procedure. The terror threat currently facing the United States may ultimately bolster the argument in favor of genetic testing and/or DNA collection of applicants. However, the possibility of a government mandate requiring genetic testing raises a host of ethical issues; including the threat of eugenics and privacy concerns. Genetic testing has the ability to uncover a wealth of sensitive medical information about an individual and currently there are no medical information privacy protections afforded to immigration applicants. This article examines the potential for genetic testing in the immigration application process and the ethical issues surrounding this testing. In particular, this article explores the existing framework of privacy protections afforded to individuals living in the United States and how this and newly-erected standards like those released by the Health and Human Services (HHS) might apply to individuals seeking to immigrate to the United States.

  8. The Army National Guard Annual Financial Report, Fiscal Year 2010

    Science.gov (United States)

    2010-01-01

    provided supplemental security at the Kulani Prison near Hilo , Hawaii . Elements of the 93rd Civil Support Team provided immediate disaster...emergencies in CONUS (the continental United States), Hawaii , and Alaska as directed by higher headquarters. Enterprise Data Warehouse (EDW) In FY10, users...OEF-A). These two elements will redeploy and demobilize in early FY11. 43 state in Fo R M atio n su M M a R ies HAWAII In FY10, the Hawaii Army

  9. The Difference that Makes a Difference: Distinguishing between Knowledge Management and Information Management in the U.S. Army

    Science.gov (United States)

    2011-05-19

    Knowledge Management, Culture, Doctrine, 14. SUBJECT TERMS 52 15. NUMBER OF PAGES Theory of Knowledge, NUCOR Case Study, Learning Organization...27 Army Leadership Insights into Knowledge Management ............................................ 27 NUCOR Case Study...knowledge management is conducted in a Fortune 500 company, NUCOR . Additionally, interviews with active members of the United States Army provides

  10. Immigration, Statecraft and Public Health: The 1920 Aliens Order, Medical Examinations and the Limitations of the State in England

    Science.gov (United States)

    Taylor, Becky

    2016-01-01

    This article considers the medical measures of the 1920 Aliens Order barring aliens from Britain. Building on existing local and port public health inspection, the requirement for aliens to be medically inspected before landing significantly expanded the duties of these state agencies and necessitated the creation of a new level of physical infrastructure and administrative machinery. This article closely examines the workings and limitations of alien medical inspection in two of England’s major ports—Liverpool and London—and sheds light on the everyday working of the Act. In doing so it reflects on the ambitions, actions and limitations of the state and so extends research by historians of the nineteenth and early twentieth century on the disputed histories of public health and the complexities of statecraft. Overall it suggests the importance of developing nuanced understandings of the gaps and failures arising from the translation of legislation into practice. PMID:27482146

  11. More medical comorbidities in patients with bipolar disorder from the United States than from the Netherlands and Germany

    NARCIS (Netherlands)

    Post, R.M.; Altshuler, L.L.; Leverich, G.S.; Frye, M.A.; Suppes, T.; McElroy, S.L.; Keck, P.E.; Nolen, W.A.; Kupka, R.W.; Grunze, H.; Rowe, M.

    2014-01-01

    Medical comorbidities are common in patients with bipolar (BP) disorder but have not been previously examined for differences between United States and Europe. More than 900 outpatients with BP I and BP II disorder (mean age, 41 years) filled out a questionnaire including the occurrence of 30 listed

  12. More Medical Comorbidities in Patients With Bipolar Disorder From the United States Than From the Netherlands and Germany

    NARCIS (Netherlands)

    Post, Robert M.; Altshuler, Lori L.; Leverich, Gabriele S.; Frye, Mark A.; Suppes, Trish; McElroy, Susan L.; Keck, Paul E.; Nolen, Willem A.; Kupka, Ralph W.; Grunze, Heinz; Rowe, Mike

    Medical comorbidities are common in patients with bipolar (BP) disorder but have not been previously examined for differences between United States and Europe. More than 900 outpatients with BP I and BP II disorder (mean age, 41 years) filled out a questionnaire including the occurrence of 30 listed

  13. The causes of medical malpractice suits against radiologists in the United States.

    Science.gov (United States)

    Whang, Jeremy S; Baker, Stephen R; Patel, Ronak; Luk, Lyndon; Castro, Alejandro

    2013-02-01

    To determine the most frequent causes of malpractice suits as derived from credentialing data of 8401 radiologists. This study was approved by the Institutional Review Board of New Jersey Medical School. A total of 8401 radiologists in 47 states participating in the network of One-Call Medical, a broker for computed tomographic/magnetic resonance studies in workers' compensation cases, were required to provide their malpractice history as part of their credentialing application. Of these, 2624 (31%) radiologists had at least one claim in their career. In each enrollee's credentialing file, if there was a claim against the enrollee there was a narrative regarding each malpractice case from which, in most instances, a primary allegation could be discerned. Among the 4793 cases, an alleged cause could be derived from the narrative in 4043 (84%). Statistical analysis was performed with Stata 12 (2011; Stata, College Station, Tex) software. The most common general cause was error in diagnosis (14.83 claims per 1000 person-years [95% confidence interval {CI}: 14.19, 15.51]). In this category, breast cancer was the most frequently missed diagnosis (3.57 claims per 1000 person-years [95% CI: 3.26, 3.91]), followed by nonspinal fractures (2.49 claims per 1000 person-years [95% CI: 2.28, 2.72]), spinal fractures (1.32 claims per 1000 person-years [95% CI: 1.16, 1.49]), lung cancer (1.26 claims per 1000 person-years [95% CI: 1.11, 1.42]), and vascular disease (1.08 claims per 1000 person-years [95% CI: 0.93, 1.24]). The category next in frequency was procedural complications (1.76 claims per 1000 person-years [95% CI: 1.58, 1.96]), followed by inadequate communication with either patient (0.40 claim per 1000 person-years [95% CI: 0.32, 0.50]) or referrer (0.71 claim per 1000 person-years [95% CI: 0.60, 0.84]). Radiologists had only a peripheral role in 0.92 claim per 1000 person-years (95% CI: 0.77, 1.10). Failure to recommend additional testing was a rare cause (0.41 claim

  14. AACE/ACE Disease State Clinical Review: Medical Management of Cushing Disease.

    Science.gov (United States)

    Hamrahian, Amir H; Yuen, Kevin C J; Hoffman, Andrew R

    2014-07-01

    To review available medical therapies for patients with Cushing disease and to provide a roadmap for their use in clinical practice. PubMed searches were performed to identify all of the available published data on medical management of Cushing disease. Medical therapy is usually not the first-line treatment for patients with Cushing disease but may be used to improve clinical manifestations of Cushing disease in patients who are not suitable candidates for surgery, following unsuccessful surgery or recurrence, or as a "bridge therapy" in those who have undergone radiotherapy. Medical therapy may also be used in preoperative preparation of patients with severe disease. Current available medical options for patients with Cushing disease include centrally acting agents, steroidogenesis inhibitors, and a glucocorticoid receptor antagonists. At present, there are no head-to-head studies comparing the efficacy, tolerability, and safety of different U.S. Food and Drug Administration (FDA)- and non-FDA-approved drugs in patients with Cushing disease. With the initiation of new studies and the completion of ongoing clinical trials, the number of FDA-approved drugs for medical treatment of Cushing disease is expected to increase. Medical therapy has an important adjunctive role in the management of patients with Cushing disease. The decision to initiate medical treatment depends on many factors, including patient characteristics and preference. Long-term studies are needed to better define the clinical efficacy, safety, and tolerability of medical treatment of Cushing disease, including the role of combination therapies.

  15. United States Army Space Experiment 601

    Science.gov (United States)

    1992-07-29

    impossible to urinate except into a diaper . The LES is hot and humid, bulky and heavy, and is unacceptable for space flight. The risk versus comfort...that the DSP satellite solar panels -r::eived enough sunlight reflected from the Earth to completely power the spacecraft, making the CRU output voltage...that were excessively cloudy were excluded from the statistics (if > 90% of pixels in the sample had brightness values above the threshold). The solar

  16. Homosexuality, Manliness, and the United States Army

    Science.gov (United States)

    2010-05-01

    units upon completion of basic and advanced training. Nowadays, most servicemembers live in apartment style quarters, where they may share...grown up in an era where differing sexual orientation was far more acceptable than in previous generations, which subsequently leads to the second...changed over time from pre- Victorian to World War I. Focusing the majority of his research on Canadian youth in Ontario during the build-up to World

  17. Male parentage in army ants

    DEFF Research Database (Denmark)

    Kronauer, Daniel J C; Schöning, Caspar; Boomsma, Jacobus J

    2006-01-01

    of active research in insect sociobiology. Here we present microsatellite data for 176 males from eight colonies of the African army ant Dorylus (Anomma) molestus. Comparison with worker genotypes and inferred queen genotypes from the same colonies show that workers do not or at best very rarely reproduce...

  18. The Army word recognition system

    Science.gov (United States)

    Hadden, David R.; Haratz, David

    1977-01-01

    The application of speech recognition technology in the Army command and control area is presented. The problems associated with this program are described as well as as its relevance in terms of the man/machine interactions, voice inflexions, and the amount of training needed to interact with and utilize the automated system.

  19. Army Transformation to Expeditionary Formations

    National Research Council Canada - National Science Library

    Bryson, Jeff

    2008-01-01

    This thesis explores the path of transformation in the U.S. Army from its inception in the late 1990s by then Chief of Staff GEN Eric Shinseki to the Interim Brigade Combat Team and through Operations Enduring and Iraqi Freedom...

  20. Gender disparities in medical expenditures attributable to hypertension in the United States.

    Science.gov (United States)

    Basu, Rituparna; Franzini, Luisa; Krueger, Patrick M; Lairson, David R

    2010-01-01

    We sought to examine and attempt to explain gender disparities in hypertension-attributable expenditure among noninstitutionalized individuals in the United States. Using the 2001-2004 Medical Expenditure Panel Survey and the Aday and Andersen health care use model, we estimated hypertension-attributable health care expenditures for inpatient stay, outpatient visits, prescription drugs, office visits, and emergency room (ER) visits among men and women by applying the method of recycled prediction. Hypertensive individuals were identified using International Classification of Diseases, 9th edition, codes or self-report of a diagnosis of hypertension. The adjusted mean hypertension-attributable expenditure per individual was significantly higher for women than for men for prescription drugs, inpatient stays, office visits, outpatient visits and ER visits expenditures. However, as age increased, the gender difference in adjusted mean expenditures became smaller and eventually reversed. This reversal occurred at different ages for different expenditures. For prescription drugs, office visits and outpatient expenditures, the reversal in expenditures occurred around age 50 to 59. The maximum difference was observed in outpatient expenditures, where women's average expenditure was $102 more than men's below age 45 but $103 less than men's above age 75. These differences remained significant even after controlling for predisposing, enabling, and need predictors of health care use. Our findings imply that there are gender disparities in hypertension-related expenditures, but that this disparity depends on age. These findings support recent findings on gender disparities in heart diseases and raise the question of physicians' bias in their diagnostic or prognostic approaches to hypertension in men and women. Copyright 2010 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  1. Guide to preemption of state-law claims against Class III PMA medical devices.

    Science.gov (United States)

    Whitney, Daniel W

    2010-01-01

    There is a perception that the express preemption holding of the Supreme Court in Riegel v. Medtronic, 552 U.S. 312(2008), immunizes medical device manufacturers from common law personal injury actions involving Class III devices that received FDA clearance under a premarket approval application (PMA). In the aftermath of Riegel, many lawsuits involving Class III PMA devices have been dismissed by district courts applying the new heightened pleading standard of Bell Atlantic Corp. v. Twombly, 550 U.S. 544 (2007). Other lawsuits involving Class III PMA devices premised on fraud-on-FDA have been dismissed based on the implied preemption holding of the Supreme Court in Buckman v. Plaintiffs' Legal Comm., 531 U.S. 341 (2001). When these decisions are carefully analyzed together with Medtronic, Inc. v. Lohr, 518 U.S. 470 (1996), which found no preemption regarding a Class III device receiving FDA clearance through the 510(k) mechanism, it is apparent that the preemption defense does not apply universally to Class III PMA devices. The overall methodology for framing a non-preempted claim is to first identify conduct which violated the PMA or other specific requirements related to safety or efficacy. If such conduct can also be stated in terms of a breach of a parallel common law duty (e.g, failure to warn under strict liability or negligence, manufacturing defect or breach of warranty), then it would appear the claim is not preempted. Alternatively, regardless of a specific violation, common law remedies are not preempted by general CGMP requirements.

  2. Emergency Medical Services Public Health Implications and Interim Guidance for the Ebola Virus in the United States

    Directory of Open Access Journals (Sweden)

    Christopher E. McCoy

    2014-11-01

    Full Text Available The 25th known outbreak of the Ebola Virus Disease (EVD is now a global public health emergency and the World Health Organization (WHO has declared the epidemic to be a Public Health Emergency of International Concern (PHEIC. Since the first cases of the West African epidemic were reported in March 2014, there has been an increase in infection rates of over 13,000% over a 6-month period. The Ebola virus has now arrived in the United States and public health professionals, doctors, hospitals, Emergency Medial Services Administrators, Medical Directors, and policy makers have been working with haste to develop strategies to prevent the disease from reaching epidemic proportions. Prehospital care providers (emergency medical technicians and paramedics and medical first responders (including but not limited to firefighters and law enforcement are the healthcare systems front lines when it comes to first medical contact with patients outside of the hospital setting. Risk of contracting Ebola can be particularly high in this population of first responders if the appropriate precautions are not implemented. This article provides a brief clinical overview of the Ebola Virus Disease and provides a comprehensive summary of the Center for Disease Control and Prevention’s Interim Guidance for Emergency Medical Services (EMS Systems and 9-1-1 Public Safety Answering Points (PSAPS for Management of Patients with Known of Suspected Ebola Virus Disease in the United States. [West J Emerg Med. 2014;15(7:-0.

  3. Survey of pharmacy involvement in hospital medication reconciliation programs across the United States

    Directory of Open Access Journals (Sweden)

    Gregory R Stein

    2015-11-01

    Full Text Available Objective: The objective of this study is to conduct a review of pertinent literature, assess pharmacy involvement in medication reconciliation, and offer insight into best practices for hospitals to implement and enhance their medication reconciliation programs. Method: Pharmacists in hospitals nationwide were asked to complete an anonymous survey via the American College of Clinical Pharmacy online database. The multiple choice survey analyzed the roles that healthcare professionals play in medication reconciliation programs at hospitals. Results: Of the survey responses received, 32/91 (35% came from pharmacists at hospitals with a pharmacy-led medication reconciliation program. Of these pharmacy-led programs, 17/32 (53% have a dedicated pharmacist or pharmacy staff to perform medication reconciliation. Conclusion: A comprehensive review of literature suggests that pharmacy involvement has the potential to reduce medication reconciliation errors and may improve patient satisfaction. Focused, full-time medication reconciliation pharmacists can help hospitals save time and money, improve outcomes, and meet higher standards issued by the Joint Commission. Data obtained in this study show the extent to which pharmacists contribute to achieving these goals in healthcare systems nationwide. This baseline study provides a strong case for hospitals to implement a pharmacy-led medication reconciliation program.

  4. Influence of Clerkship on Attitudes of Medical Students toward Psychiatry across Cultures: United States and Qatar

    Science.gov (United States)

    Burgut, F. Tuna; Polan, H. Jonathan

    2013-01-01

    Objective: To assure adequate treatment for patients with mental illness worldwide, medical schools must impart positive attitudes toward psychiatry. The authors examined the effect of culture on changes in attitudes toward psychiatry among medical students receiving the same psychiatry clerkship curriculum in two different countries. Methods: A…

  5. University of the Free State medical students' view of at-risk drinking ...

    African Journals Online (AJOL)

    Marijuana was the most common non-alcoholic substance used by medical students (14.6%) in the preceding 3 years. Alcohol and other substances were most frequently used during social activities with friends. Conclusions. Both medical students' knowledge of levels of alcohol intake associated with increased risks and ...

  6. Race, ethnicity, and medical student well-being in the United States.

    Science.gov (United States)

    Dyrbye, Liselotte N; Thomas, Matthew R; Eacker, Anne; Harper, William; Massie, F Stanford; Power, David V; Huschka, Mashele; Novotny, Paul J; Sloan, Jeff A; Shanafelt, Tait D

    2007-10-22

    Little is known about the training experience of minority medical students. We explore differences in the prevalence of burnout, depressive symptoms, and quality of life (QOL) among minority and nonminority medical students as well as the role race/ethnicity plays in students' experiences. Medical students (N = 3080) at 5 medical schools were surveyed in 2006 using validated instruments to assess burnout, depression, and QOL. Students were also asked about the impact of race/ethnicity on their training experience. The response rate was 55%. Nearly half of students reported burnout (47%) and depressive symptoms (49%). Mental QOL scores were lower among students than among the age-matched general population (43.1 vs 47.2; P race/ethnicity had adversely affected their medical school experience (11% vs 2%; P race does contribute to the distress minority students do experience. Additional studies are needed to define the causes of these perceptions and to improve the learning climate for all students.

  7. A pilot study exploring awareness among general public toward issues related to medication safety in the state of Penang, Malaysia

    Directory of Open Access Journals (Sweden)

    Mohamed Azmi Hassali

    2012-01-01

    Full Text Available Context: A better understanding of medication safety ensures better health state among healthcare consumers. Aim: The study aims to assess general public awareness toward issues related to medication safety. Settings and Design: A cross-sectional study was conducted among general public selected conveniently in the state of Penang, Malaysia. Materials and methods: A total of 500 respondents were approached and 476 consumers participated in the survey giving a response rate of 95.2%. Statistical analysis: Data were analyzed by using SPSS version 12.0 and descriptive statistics were reported where appropriate. Results: Majority of the respondents (n=292, 61.3% stated that they were well aware of the possible side effects of their current medications. A total of 196 respondents (41.17% believed that all medicines registered in Malaysia are safe to use as these medicines have no side effects. About 40.33% (n=192 of the respondents claimed that they share their unused medicines with family and friends who are having similar illness. Majority of respondents 57.7% (n=275 were satisfied with the drug information provided by the healthcare professionals. This study also found that more than 80% of the respondents (n=409 did report that they read the labels of their medication before using. Conclusions: In this study, it was revealed that there is a moderate level of public knowledge regarding medication safety. It is evident that public underestimates the risk of their medications. There is a general lack of awareness and understanding among the public especially toward side effects.

  8. [General awareness and use of generic medication among citizens of Tubarão, state of Santa Catarina, Brazil].

    Science.gov (United States)

    Blatt, Carine Raquel; Trauthman, Silvana Cristina; Schmidt, Edegar Henrique; Marchesan, Samuel; da Silva, Luana May; Martins, João Luiz

    2012-01-01

    Although generic medication has been introduced in the country to offer an accessible alternative to brand-name medication, it represents only 14% of sales in number of units within the pharmaceutical market. The aim of this work was to research the level of awareness and the use of generic products among residents of the municipality of Tubarão, State of Santa Catarina, Brazil. A transversal study was carried out with a sample of 234 interviewees, distributed among municipal areas. With regard to use, the majority of those interviewed had used generic medication, and half of them had at least one such product in their home. To verify awareness of different types of medication, pictures with the generic, brand name and similar packaging for paracetamol and atenolol were shown and 91% were able to identify all products correctly. To be of higher economic standing, already having used generic products, believing that the generic medication has the same effect as the brand name medication, finding generic products in drugstores easily and being accustomed to buy generic products, were factors that were positively associated with the correct identification.

  9. Accreditation of undergraduate medical training programs: practices in nine developing countries as compared with the United States.

    Science.gov (United States)

    Cueto, Jose; Burch, Vanessa C; Adnan, Nor Azila Mohd; Afolabi, Bosede B; Ismail, Zalina; Jafri, Wasim; Olapade-Olaopa, E Oluwabunmi; Otieno-Nyunya, Boaz; Supe, Avinash; Togoo, Altantsetseg; Vargas, Ana Lia; Wasserman, Elizabeth; Morahan, Page S; Burdick, William; Gary, Nancy

    2006-07-01

    Undergraduate medical training program accreditation is practiced in many countries, but information from developing countries is sparse. We compared medical training program accreditation systems in nine developing countries, and compared these with accreditation practices in the United States of America (USA). Medical program accreditation practices in nine developing countries were systematically analyzed using all available published documents. Findings were compared to USA accreditation practices. Accreditation systems with explicitly defined criteria, standards and procedures exist in all nine countries studied: Argentina, India, Kenya, Malaysia, Mongolia, Nigeria, Pakistan, Philippines and South Africa. Introduction of accreditation processes is relatively recent, starting in 1957 in India to 2001 in Malaysia. Accrediting agencies were set up in these countries predominantly by their respective governments as a result of legislation and acts of Parliament, involving Ministries of Education and Health. As in the USA, accreditation: (1) serves as a quality assurance mechanism promoting professional and public confidence in the quality of medical education, (2) assists medical schools in attaining desired standards, and (3) ensures that graduates' performance complies with national norms. All nine countries follow similar accreditation procedures. Where mandatory accreditation is practiced, non-compliant institutions may be placed on probation, student enrollment suspended or accreditation withdrawn. Accreditation systems in several developing countries are similar to those in the developed world. Data suggest the trend towards instituting quality assurance mechanisms in medical education is spreading to some developing countries, although generalization to other areas of the world is difficult to ascertain.

  10. What Are Medical Students in the United States Learning About Radiation Oncology? Results of a Multi-Institutional Survey

    International Nuclear Information System (INIS)

    Zaorsky, Nicholas G.; Shaikh, Talha; Handorf, Elizabeth; Eastwick, Gary; Hesney, Adam; Scher, Eli D.; Jones, Ryan T.; Showalter, Timothy N.; Avkshtol, Vladimir; Rice, Stephanie R.; Horwitz, Eric M.; Meyer, Joshua E.

    2016-01-01

    Purpose: The purposes of this study were to assess the exposure that medical students (MSs) have to radiation oncology (RO) during the course of their medical school career, as evidenced by 2 time points in current medical training (ie, first vs fourth year; MS1s and MS4s, respectively) and to assess the knowledge of MS1s, MS4s, and primary care physicians (PCPs) about the appropriateness of RT in cancer management in comparison with RO attendings. Methods: We developed and beta tested an electronic survey divided into 3 parts: RO job descriptions, appropriateness of RT, and toxicities of RT. The surveys were distributed to 7 medical schools in the United States. A concordance of >90% (either yes or no) among RO attendings in an answer was necessary to determine the correct answer and to compare with other subgroups using a χ"2 test (P 1 of 5 respondents. Multiple nontoxicities of RT (eg, emitting low-level radiation from the treatment site) were incorrectly identified as toxicities by >1 of 5 respondents. MS4s/PCPs with an RO rotation in medical school had improved scores in all prompts. Conclusions: Although MS knowledge of general RT principles improves from the first to the fourth year, a large knowledge gap still exists between MSs, current PCPs, and ROs. Some basic misconceptions of RT persist among a minority of MSs and PCPs. We recommend implementing formal education in RO fundamentals during the core curriculum of medical school.

  11. The American Board of Internal Medicine Maintenance of Certification Examination and State Medical Board Disciplinary Actions: a Population Cohort Study.

    Science.gov (United States)

    McDonald, Furman S; Duhigg, Lauren M; Arnold, Gerald K; Hafer, Ruth M; Lipner, Rebecca S

    2018-03-07

    Some have questioned whether successful performance in the American Board of Internal Medicine (ABIM) Maintenance of Certification (MOC) program is meaningful. The association of the ABIM Internal Medicine (IM) MOC examination with state medical board disciplinary actions is unknown. To assess risk of disciplinary actions among general internists who did and did not pass the MOC examination within 10 years of initial certification. Historical population cohort study. The population of internists certified in internal medicine, but not a subspecialty, from 1990 through 2003 (n = 47,971). ABIM IM MOC examination. General internal medicine in the USA. The primary outcome measure was time to disciplinary action assessed in association with whether the physician passed the ABIM IM MOC examination within 10 years of initial certification, adjusted for training, certification, demographic, and regulatory variables including state medical board Continuing Medical Education (CME) requirements. The risk for discipline among physicians who did not pass the IM MOC examination within the 10 year requirement window was more than double than that of those who did pass the examination (adjusted HR 2.09; 95% CI, 1.83 to 2.39). Disciplinary actions did not vary by state CME requirements (adjusted HR 1.02; 95% CI, 0.94 to 1.16), but declined with increasing MOC examination scores (Kendall's tau-b coefficient = - 0.98 for trend, p actions were less severe among those passing the IM MOC examination within the 10-year requirement window than among those who did not pass the examination. Passing a periodic assessment of medical knowledge is associated with decreased state medical board disciplinary actions, an important quality outcome of relevance to patients and the profession.

  12. 2013 Center for Army Leadership Annual Survey of Army Leadership (CASAL): Army Civilian Leaders

    Science.gov (United States)

    2014-05-30

    Army civilian workforce with regard to gender and ethnic origin (Office of the Assistant G-1 for Civilian Personnel, 2013). The reported education...climates of perceived inequality . Civilian leader comments frequently referenced favoritism as reflecting cronyism, unfair personnel actions, and...interests of others, unequal enforcement of standards and discipline, and use of discretion in workplace justice. As demonstrated in previous CASAL

  13. Challenging the Sacred Assumption: A Call for a Systemic Review of Army Aviation Maintenance

    Science.gov (United States)

    2017-05-25

    much to me. You three are my heroes, and I can never repay you for your selfless sacrifice for me, our Army and our Nation. 1 Introduction...Command (AMCOM) lamented the increasing costs of sustaining aging fleets of aircraft. Major General Collyar stated, “Sustainment costs are eating away at...indicates the Army aviation is not alone . Across the Department of Defense, given the rising O&M spending, the services cannot “clearly identify the

  14. Starting Strong: Talent-based Branching of Newly Commissioned U.S. Army Officers

    Science.gov (United States)

    2016-04-01

    security policy formulation. iii v Strategic Studies Institute and U.S. Army War College Press STARTING STRONG: TALENT -BASED BRANCHING OF NEWLY...public release; distribution is unlimited. ***** This publication is subject to Title 17, United States Code , Sections 101 and 105. It is in the public...SSI website at www.StrategicStudiesInstitute.army.mil/newsletter. ***** This volume is the 9th in a series of monographs on officer talent management

  15. Getting it Right: The Endurance of Improvised Explosive Device Education in the US Army

    Science.gov (United States)

    2017-05-25

    NCO leadership and education was critical to success. This was especially true in divisional engineer units where squad operations in support of...Getting it Right: The Endurance of Improvised Explosive Device Education in the US Army A Monograph by MAJ Christian R. Johnson United States...Endurance of Improvised Explosive Device Education in the US Army 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S

  16. Federalism, intergovernmental relations, and the challenge of the medically uninsurable: a retrospective on high risk pools in the states.

    Science.gov (United States)

    Plein, L Christopher

    2010-01-01

    While relatively overlooked in health policy research and analysis, state high risk insurance pools play a notable role in contemporary health policy arrangements. Also know as State Comprehensive Health Insurance Plans, high-risk pools emerged in the late 1970s as states began to grapple with the challenges of the medically uninsured. Today, thirty-five states operate these programs. To further our understanding of health and human services administration, it is important to examine these plans, especially in context of intergovernmental health policy in the United States. This analysis provides an overview of high risk pool evolution and gives attention to forces that have shaped their development, such as model legislation, funding arrangements, and increasing federal-level interest in their use as platforms to advance national policy initiatives.

  17. 77 FR 50089 - Army Education Advisory Committee Meeting

    Science.gov (United States)

    2012-08-20

    ... DEPARTMENT OF DEFENSE Department of the Army Army Education Advisory Committee Meeting AGENCY... the Army announces the following committee meeting: Name of Committee: Army Education Advisory... learning environment. The agenda will include topics relating to Army Learning Model 2015 and support to...

  18. 77 FR 11084 - Army Education Advisory Committee Meeting

    Science.gov (United States)

    2012-02-24

    ... DEPARTMENT OF DEFENSE Department of the Army Army Education Advisory Committee Meeting AGENCY... the Army announces the following committee meeting: Name of Committee: Army Education Advisory... Army 2020 learning environment. The agenda will include topics relating Arm Learning Model 2015 and to...

  19. 75 FR 19302 - Radiation Sources on Army Land

    Science.gov (United States)

    2010-04-14

    ... possession of ionizing radiation sources by non-Army agencies (including their civilian contractors) on an... radiation sources on Army land. The Army requires Non-Army agencies (including their civilian contractors... ionizing radiation sources on an Army Installation. For the purpose of this proposed rule, ``ionizing...

  20. 78 FR 33074 - Army Science Board Summer Study Session

    Science.gov (United States)

    2013-06-03

    ...--This study evaluates what science and technology competencies the Army must maintain and/or develop as... DEPARTMENT OF DEFENSE Department of the Army Army Science Board Summer Study Session AGENCY... the Army announces the following committee meeting: 1. Name of Committee: Army Science Board (ASB). 2...

  1. Treatment of Young People With Antipsychotic Medications in the United States.

    Science.gov (United States)

    Olfson, Mark; King, Marissa; Schoenbaum, Michael

    2015-09-01

    Despite concerns about rising treatment of young people with antipsychotic medications, little is known about trends and patterns of their use in the United States. To describe antipsychotic prescription patterns among young people in the United States, focusing on age and sex. A retrospective descriptive analysis of antipsychotic prescriptions among patients aged 1 to 24 years was performed with data from calendar years 2006 (n = 765,829), 2008 (n = 858,216), and 2010 (n = 851,874), including a subset from calendar year 2009 with service claims data (n = 53,896). Data were retrieved from the IMS LifeLink LRx Longitudinal Prescription database, which includes approximately 60% of all retail pharmacies in the United States. Denominators were adjusted to generalize estimates to the US population. The percentage of young people filling 1 or more antipsychotic prescriptions during the study year by sex and age group (younger children, 1-6 years; older children, 7-12 years; adolescents, 13-18 years; and young adults, 19-24 years) was calculated. Among young people with antipsychotic use, percentages with specific clinical psychiatric diagnoses and 1 or more antipsychotic prescriptions from a psychiatrist and from a child and adolescent psychiatrist were also determined. The percentages of young people using antipsychotics in 2006 and 2010, respectively, were 0.14% and 0.11% for younger children, 0.85% and 0.80% for older children, 1.10% and 1.19% for adolescents, and 0.69% and 0.84% for young adults. In 2010, males were more likely than females to use antipsychotics, especially during childhood and adolescence: 0.16% vs 0.06% for younger children, 1.20% vs 0.44% for older children, 1.42% vs 0.95% for adolescents, and 0.88% vs 0.81% for young adults. Among young people treated with antipsychotics in 2010, receiving a prescription from a psychiatrist was less common among younger children (57.9%) than among other age groups (range, 70.4%-77.9%). Approximately 29.3% of

  2. A progressive three-phase innovation to medical education in the United States.

    Science.gov (United States)

    Pfeifer, Cory M

    2018-12-01

    The practice of medicine has changed greatly over the past 100 years, yet the structure of undergraduate medical education has evolved very little. Many schools have modified their curricula to incorporate problem-based learning and organ systems-based curricula, but few schools have adequately addressed rising tuition costs. Undergraduate medical education has become cost-prohibitive for students interested in primary care. In the meanwhile, the concept of a separate dedicated intern year is outdated and mired in waste despite remaining a requirement for several hospital-based and surgical specialties. Described here is an innovative approach to medical education which reduces tuition costs and maximizes efficiency, based on principals already employed by several schools. This integrated curriculum, first suggested by the author in 2010, keeps the current USMLE system in place, exposes medical students to patient care earlier, expands and incorporates the 'intern' year into a four-year medical training program, provides more time for students to decide on a specialty, and allows residency programs to acquire fully-licensed practitioners with greater clinical experience than the status quo. MCAT: Medical college admission test; USMLE: US medical licensing examination.

  3. Discharge against medical advice in a pediatric emergency center in the State of Qatar

    Directory of Open Access Journals (Sweden)

    Hala Abdulateef

    2012-05-01

    Full Text Available Objective: The objective of this study was to analyze cases that had left the Pediatric Emergency Center Al Sadd, Doha (PEC against medical advice, with the aim of developing policies to help reduce this occurrence. Methodology: All patients that were admitted to the main PEC observation room for treatment and/or investigation and subsequently left against medical advice from February 18, 2007 to June 18, 2007, were followed by a phone call, and a questionnaire, which was completed by the departmental patient representative. Results: 99,133 patients attended the facility during the study period. Of those, 106 left the facility against medical advice. Ninety-four guardians were successfully contacted. 90% of the cases were in children below 2 years of age. In 87% of the cases the mother was the main decision maker for leaving against medical advice. Domestic obligations were the leading cause of DAMA (discharge against medical advice, reported in 45% of the cases. Respondents reported that the consequences of DAMA were well explained by medical staff before they left the facility however, they had not met with the departmental patient representative during their stay. Conclusion:As the majority of DAMA cases occurred in infants, medical staff should address the concerns of this group early on in the course of treatment. Maintaining communication and providing support, in particular for mothers of higher risk groups may help to reduce the rate of DAMA cases.

  4. The end of medical confidentiality? Patients, physicians and the state in history.

    Science.gov (United States)

    Rieder, Philip; Louis-Courvoisier, Micheline; Huber, Philippe

    2016-09-01

    Medical confidentiality has come under attack in the public sphere. In recent disasters both journalists and politicians have questioned medical confidentiality and claimed that in specific contexts physicians should be compelled to communicate data on their patients' health. The murders of innocent individuals by a suicidal pilot and a Swiss convicted criminal have generated polemical debates on the topic. In this article, historical data on medical confidentiality is used to show that medical practices of secrecy were regularly attacked in the past, and that the nature of medical confidentiality evolved through time depending on physicians' values and judgements. Our demonstration is based on three moments in history. First, at the end of the 16th century, lay authorities put pressure on physicians to disclose the names of patients suffering from syphilis. Second, in the 18th century, physicians faced constant demands for information about patients' health from relatives and friends. Third, employers and insurance companies in the 20th century requested medical data on sick employees. In these three different situations, history reveals that the concept of medical confidentiality was plastic, modelled in the first instance to defend well-to-do patients, in the second instance it was adapted to accommodate the physician's social role and, finally, to defend universal values and public health. Medical secrecy was, and is today, a medical and societal norm that is shaped collectively. Any change in its definition and enforcement was and should be the result of negotiations with all social actors concerned. 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/

  5. Prevalence of alcohol-interactive prescription medication use among current drinkers: United States, 1999 to 2010.

    Science.gov (United States)

    Breslow, Rosalind A; Dong, Chuanhui; White, Aaron

    2015-02-01

    The majority of Americans consume alcoholic beverages. Alcohol interacts negatively with numerous commonly prescribed medications. Yet, on a population level, little is known about use of alcohol-interactive (AI) prescription medications among drinkers. The purpose of our study was to determine the prevalence of AI prescription medication use among current drinkers in the U.S. population. Data were from the National Health and Nutrition Examination Survey (NHANES 1999 to 2010); 26,657 adults aged ≥20 years had data on past year alcohol consumption and past month prescription medication use. Analyses were adjusted for covariates: age, race/ethnicity, education, marital status, and smoking. Statistical procedures accounted for survey stratification, clustering, and nonresponse. Analyses were weighted to be nationally representative. The unadjusted total prevalence of AI medication use was 42.8% (95% confidence interval [CI] 41.5 to 44.0). Among current drinkers, adjusted prevalence was 41.5% (CI 40.3 to 42.7). Among participants aged ≥65 total prevalence of AI medication use was 78.6% (CI 77.3 to 79.9) and adjusted prevalence among current drinkers was 77.8% (CI 75.7 to 79.7). The AI medications most commonly used by current drinkers were cardiovascular agents, central nervous system agents, and metabolic agents. Our results suggest that there could be substantial simultaneous exposure to alcohol and AI prescription medications in the U.S. population. Given the adverse health risks of combining alcohol with AI prescription medications, future efforts are needed to collect data to determine actual simultaneous prevalence. Copyright © 2015 by the Research Society on Alcoholism.

  6. State of the art assessment and engineering evaluation of medical waste thermal treatment

    International Nuclear Information System (INIS)

    Barton, R.G.; Hassel, G.R.; Lanier, W.S.; Seeker, W.R.

    1989-01-01

    Incineration is a method of disposing of medical waste (such as radioactive materials, toxic metals, etc.) that is increasingly utilized to reduce the wastes volume and hazard. Recent field tests indicate that medical waste incinerators may be prone to emitting high concentrations of acid gases, toxic organic compounds and other hazardous substances. This paper examines current practices in the design and operation of medical waste incinerators to identify the parameters which govern toxic emissions. A variety of design and operating parameters including chamber temperatures, gas phase mixing and waste feed rate were found to have an important impact on emissions

  7. Judicial demand of medications through the Federal Justice of the State of Paraná.

    Science.gov (United States)

    Nisihara, Renato Mitsunori; Possebom, Ana Carolina; Borges, Luiza de Martino Cruvinel; Shwetz, Ana Claudia Athanasio; Bettes, Fernanda Francis Benevides

    2017-01-01

    To describe the profile of lawsuits related to drug requests filled at the Federal Justice of the State of Paraná. A cross-sectional study, and the data were obtained through consulting the lawsuits at the online system of the Federal Justice of Paraná. Out of 347 lawsuits included in the study, 55% of plaintiffs were women, with a median age of 56 years. Oncology was the field with more requests (23.6%), and the highest mean costs. A wide variety of diseases and broad variety of requested drugs were found in the lawsuits. Approximately two-thirds of them were requested by the brand name, and the most often requested drugs were palivizumab and tiotropium bromide. Only 14.5% of the requested medicines were registered in the National Medication Register. The Public Defender's Office filled actions in 89.6% of cases and all lawsuits had an interim relief. The mean time for approval was 35 days and 70% of requests were granted. Oncology was the field with the highest demand for medicines at the Federal Justice of Paraná in 2014. A great variety of medications was requested. The Public Defender´s Office represented most lawsuits. All demands had an interim relief, and the majority of requests were granted, within an average of 35 days. Descrever o perfil das ações que solicitam medicamentos ajuizadas na Justiça Federal do Paraná. Estudo transversal descritivo, cujos dados foram obtidos por meio de consulta aos processos no sistema on-line da Justiça Federal do Paraná. Dentre os 347 processos incluídos no estudo, 55% dos autores eram mulheres, com mediana da idade de 56 anos, sendo a área mais procurada a oncologia (23,6%). A área oncológica também foi a que apresentou maiores custos médios. Foi ampla a variedade de doenças geradoras das ações e também foi consequentemente grande a variedade de medicamentos solicitados. Cerca de dois terços dos fármacos foram solicitados pelo nome comercial, e os mais requeridos foram o palivizumabe e brometo de

  8. A Surgical Business Composite Score for Army Medicine.

    Science.gov (United States)

    Stoddard, Douglas R; Robinson, Andrew B; Comer, Tracy A; Meno, Jenifer A; Welder, Matthew D

    2016-06-01

    Measuring surgical business performance for Army military treatment facilities is currently done through 6 business metrics developed by the Army Medical Command (MEDCOM) Surgical Services Service Line (3SL). Development of a composite score for business performance has the potential to simplify and synthesize measurement, improving focus for strategic goal setting and implementation. However, several considerations, ranging from data availability to submetric selection, must be addressed to ensure the score is accurate and representative. This article presents the methodology used in the composite score's creation and presents a metric based on return on investment and a measure of cases recaptured from private networks. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  9. University of the Free State medical students' view of at-risk drinking ...

    African Journals Online (AJOL)

    2009-03-01

    Mar 1, 2009 ... Medical students' view of what constitutes at-risk drinking behaviour is ... several forms of cancer.5 Individual susceptibility to alcohol-related complications .... marijuana, tranquillisers and miscellaneous substances. In each.

  10. State of the art in medical applications using non-thermal atmospheric pressure plasma

    Science.gov (United States)

    Tanaka, Hiromasa; Ishikawa, Kenji; Mizuno, Masaaki; Toyokuni, Shinya; Kajiyama, Hiroaki; Kikkawa, Fumitaka; Metelmann, Hans-Robert; Hori, Masaru

    2017-12-01

    Plasma medical science is a novel interdisciplinary field that combines studies on plasma science and medical science, with the anticipation that understanding the scientific principles governing plasma medical science will lead to innovations in the field. Non-thermal atmospheric pressure plasma has been used for medical treatments, such as for cancer, blood coagulation, and wound healing. The interactions that occur between plasma and cells/tissues have been analyzed extensively. Direct and indirect treatment of cells with plasma has broadened the applications of non-thermal atmospheric pressure plasma in medicine. Examples of indirect treatment include plasma-assisted immune-therapy and plasma-activated medium. Controlling intracellular redox balance may be key in plasma cancer treatment. Animal studies are required to test the effectiveness and safety of these treatments for future clinical applications.

  11. Library instruction in medical education: a survey of current practices in the United States and Canada

    Directory of Open Access Journals (Sweden)

    Amanda M. Nevius

    2018-01-01

    Results: Most of the seventy-three responding libraries provided instruction, both asynchronously and synchronously. Library instruction was most likely to be offered in two years of medical school, with year one seeing the most activity. Database use was the most frequently taught topic, and libraries reported a median of five librarians providing instruction, with larger staffs offering slightly more education sessions per year. Libraries associated with highly ranked schools were slightly more likely to offer sessions that were integrated into the medical school curriculum in year four and to offer sessions in more years overall. Conclusions: In US and Canadian libraries, regardless of the rank of the affiliated medical school, librarians’ provision of instruction in multiple formats on multiple topics is increasingly common.  This article has been approved for the Medical Library Association’s Independent Reading Program.

  12. Trends, Productivity Losses, and Associated Medical Conditions Among Toxoplasmosis Deaths in the United States, 2000–2010

    Science.gov (United States)

    Cummings, Patricia L.; Kuo, Tony; Javanbakht, Marjan; Sorvillo, Frank

    2014-01-01

    Few studies have quantified toxoplasmosis mortality, associated medical conditions, and productivity losses in the United States. We examined national multiple cause of death data and estimated productivity losses caused by toxoplasmosis during 2000–2010. A matched case–control analysis examined associations between comorbid medical conditions and toxoplasmosis deaths. In total, 789 toxoplasmosis deaths were identified during the 11-year study period. Blacks and Hispanics had the highest toxoplasmosis mortality compared with whites. Several medical conditions were associated with toxoplasmosis deaths, including human immunodeficiency virus (HIV), lymphoma, leukemia, and connective tissue disorders. The number of toxoplasmosis deaths with an HIV codiagnosis declined from 2000 to 2010; the numbers without such a codiagnosis remained static. Cumulative disease-related productivity losses for the 11-year period were nearly $815 million. Although toxoplasmosis mortality has declined in the last decade, the infection remains costly and is an important cause of preventable death among non-HIV subgroups. PMID:25200264

  13. The humanising power of medical history: responses to biomedicine in the 20th century United States.

    Science.gov (United States)

    Warner, John Harley

    2011-12-01

    Most American historians of medicine today would be very hesitant about any claim that medical history humanises doctors, medical students or the larger health care enterprise. Yet, the idea that history can and ought to serve modern medicine as a humanising force has been a persistent refrain in American medicine. This essay explores the emergence of this idea from the end of the 19th century, precisely the moment when modern biomedicine became ascendant. At the same institutions where the new version of scientific medicine was most energetically embraced, some professional leaders warned that the allegiance to science driving the profession's technical and cultural success was endangering humanistic values fundamental to professionalism and the art of medicine. They saw in history a means for rehumanising modern medicine and countering the risk of cultural crisis. While some iteration of this vision of history was remarkably durable, the meanings attached to 'humanism' were both multiple and changing, and the role envisioned for history in a humanistic intervention was transformed. Starting in the 1960s as part of a larger cultural critique of the putative 'dehumanisation' of the medical establishment, some advocates promoted medical history as a tool to help fashion a new kind of humanist physician and to confront social inequities in the health care system. What has persisted across time is the way that the idea of history as a humanising force has almost always functioned as a discourse of deficiency-a response to perceived shortcomings of biomedicine, medical institutions and medical professionalism.

  14. On-call duty effects on sleep-state physiological stability in male medical interns.

    Directory of Open Access Journals (Sweden)

    Yu-Hsuan Lin

    Full Text Available BACKGROUND: On-call duty among medical interns is characterized by sleep deprivation and stressful working conditions, both of which alter cardiac autonomic modulation. We hypothesized that sleep stability decreased in medical interns during on-call duty. We used cardiopulmonary-coupling (CPC analysis to test our hypothesis. METHODS: We used electrocardiogram (ECG-based CPC analysis to quantify physiological parameters of sleep stability in 13 medical interns during on-call and on-call duty-free periods. There were ten 33.5-h on-call duty shifts per month for interns, each followed by 2 on-call duty-free days, over 3 months. Measurements during sleep were collected before, during, and after an on-call shift. Measurements were repeated 3 months later during an on-call duty-free period. RESULTS: The medical interns had significantly reduced stable sleep, and displayed increased latency to the first epoch of stable sleep during the on-call night shift, compared to the pre-call and on-call duty-free nights. Interns also had significantly increased rapid-eye-movement (REM sleep during the on-call night shift, compared to the pre-call and on-call duty-free nights. CONCLUSION: Medical interns suffer disrupted sleep stability and continuity during on-call night shifts. The ECG-based CPC analysis provides a straightforward means to quantify sleep quality and stability in medical staff performing shift work under stressful conditions.

  15. [Medical supply planning : dynamic registry of physicians, sixth reform of the State and numerus clausus].

    Science.gov (United States)

    Benahmed, N; De Wever, A; Pirson, M

    2017-01-01

    The last few years have seen major changes in the Belgian medical planning. The paper aims to describe them and to assess how they will affect the medical demography. Grey literature review and federal and federated entities legislation summary. A new dynamic register allows a better knowledge of medical workforce in all sectors of labour market. Recent legislation evolutions induce fragmentation of competences related to human resource for health planning : federal authorities are responsive for the fixation of number of GP and specialists and community authorities for registration of health professionals and fixation of sub-quotas in different branches of specialised medicine. Finally, the French Community has setting up a multiple selection system of medical students that have to past an 'orientation test', a possible reorientation after January examinations and then a numerus fixus at the end of the first academic year. Dynamic register improves the knowledge of medical workforce repartition. However, the assessment of its volume shows methodological limitations. From an operational viewpoint, the fragmentation of competences will ask coordination effort from all authority levels to avoid impairment in planning process. Finally, French Community has to consider evaluation and ambitious revision of medical workforce planning in their region.

  16. Post market surveillance in the german medical device sector - current state and future perspectives.

    Science.gov (United States)

    Zippel, Claus; Bohnet-Joschko, Sabine

    2017-08-01

    Medical devices play a central role in the diagnosis and treatment of diseases but also bring the potential for adverse events, hazards or malfunction with serious consequences for patients and users. Medical device manufacturers are therefore required by law to monitor the performance of medical devices that have been approved by the competent authorities (post market surveillance). Conducting a nationwide online-survey in the German medical device sector in Q2/2014 in order to explore the current status of the use of post market instruments we obtained a total of 118 complete data sets, for a return rate of 36%. The survey included manufacturers of different sizes, producing medical devices of all risk classes. The post market instruments most frequently reported covered the fields of production monitoring and quality management as well as literature observation, regulatory vigilance systems, customer knowledge management and market observation while Post Market Clinical Follow-up and health services research were being used less for product monitoring. We found significant differences between the different risk classes of medical devices produced and the intensity of use of post market instruments. Differences between company size and the intensity of instruments used were hardly detected. Results may well contribute to the development of device monitoring which is a crucial element of the policy and regulatory system to identify device-related safety issues. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. The state of the art of medical imaging technology: from creation to archive and back.

    Science.gov (United States)

    Gao, Xiaohong W; Qian, Yu; Hui, Rui

    2011-01-01

    Medical imaging has learnt itself well into modern medicine and revolutionized medical industry in the last 30 years. Stemming from the discovery of X-ray by Nobel laureate Wilhelm Roentgen, radiology was born, leading to the creation of large quantities of digital images as opposed to film-based medium. While this rich supply of images provides immeasurable information that would otherwise not be possible to obtain, medical images pose great challenges in archiving them safe from corrupted, lost and misuse, retrievable from databases of huge sizes with varying forms of metadata, and reusable when new tools for data mining and new media for data storing become available. This paper provides a summative account on the creation of medical imaging tomography, the development of image archiving systems and the innovation from the existing acquired image data pools. The focus of this paper is on content-based image retrieval (CBIR), in particular, for 3D images, which is exemplified by our developed online e-learning system, MIRAGE, home to a repository of medical images with variety of domains and different dimensions. In terms of novelties, the facilities of CBIR for 3D images coupled with image annotation in a fully automatic fashion have been developed and implemented in the system, resonating with future versatile, flexible and sustainable medical image databases that can reap new innovations.

  18. 76 FR 56406 - Science and Technology Reinvention Laboratory Demonstration Project; Department of the Army; Army...

    Science.gov (United States)

    2011-09-13

    ... DEPARTMENT OF DEFENSE Office of the Secretary Science and Technology Reinvention Laboratory Demonstration Project; Department of the Army; Army Research, Development and Engineering Command; Tank... personnel management demonstration project for eligible TARDEC employees. Within that notice the table...

  19. U.S. Army weapon systems human-computer interface style guide. Version 2

    Energy Technology Data Exchange (ETDEWEB)

    Avery, L.W.; O`Mara, P.A.; Shepard, A.P.; Donohoo, D.T.

    1997-12-31

    A stated goal of the US Army has been the standardization of the human computer interfaces (HCIs) of its system. Some of the tools being used to accomplish this standardization are HCI design guidelines and style guides. Currently, the Army is employing a number of HCI design guidance documents. While these style guides provide good guidance for the command, control, communications, computers, and intelligence (C4I) domain, they do not necessarily represent the more unique requirements of the Army`s real time and near-real time (RT/NRT) weapon systems. The Office of the Director of Information for Command, Control, Communications, and Computers (DISC4), in conjunction with the Weapon Systems Technical Architecture Working Group (WSTAWG), recognized this need as part of their activities to revise the Army Technical Architecture (ATA), now termed the Joint Technical Architecture-Army (JTA-A). To address this need, DISC4 tasked the Pacific Northwest National Laboratory (PNNL) to develop an Army weapon systems unique HCI style guide, which resulted in the US Army Weapon Systems Human-Computer Interface (WSHCI) Style Guide Version 1. Based on feedback from the user community, DISC4 further tasked PNNL to revise Version 1 and publish Version 2. The intent was to update some of the research and incorporate some enhancements. This document provides that revision. The purpose of this document is to provide HCI design guidance for the RT/NRT Army system domain across the weapon systems subdomains of ground, aviation, missile, and soldier systems. Each subdomain should customize and extend this guidance by developing their domain-specific style guides, which will be used to guide the development of future systems within their subdomains.

  20. Narrative review of the safety and efficacy of marijuana for the treatment of commonly state-approved medical and psychiatric disorders

    OpenAIRE

    Belendiuk, Katherine A; Baldini, Lisa L; Bonn-Miller, Marcel O

    2015-01-01

    The present investigation aimed to provide an objective narrative review of the existing literature pertaining to the benefits and harms of marijuana use for the treatment of the most common medical and psychological conditions for which it has been allowed at the state level. Common medical conditions for which marijuana is allowed (i.e., those conditions shared by at least 80 percent of medical marijuana states) were identified as: Alzheimer?s disease, amyotrophic lateral sclerosis, cachexi...