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"Medical Readiness"

Justin M Curley, Coleen Crouch, Joshua E Wilk
Introduction: Medical readiness for deployment is arguably the most important component of personnel readiness in the U.S. Army. Administrative documents called profiles provide individualized medical recommendations to the commander regarding how to best provide for a soldier's health and welfare, and contribute to an aggregated enumeration of a unit's overall readiness to deploy. Profiles that convey behavioral health (BH) limitations thus reflect what can be called the "behavioral health readiness" of the force...
March 14, 2018: Military Medicine
Jason E Sapp, Matthew J Cody, Kevin M Douglas
Introduction: In November 2014, the U.S. Army held a readiness summit to address concerns about the accuracy of medical reporting systems. At the time, soldiers on temporary disability were tracked as a medical readiness classification (MRC) 3A or 3B. MRC 3A soldiers had a medical condition with recovery expected within 30 d and MRC 3B soldiers were expected to take longer than 30 d to recover. Both groups were considered "non-available" and presumably non-deployable. Starting June 1, 2016, with the implementation of the Army Medical Readiness Transformation, soldiers on temporary disability longer than 14 d began to be reported as MRC 3s and are considered "non-deployable...
February 7, 2018: Military Medicine
Ronald P Hudak, Rebecca Russell, P Paul Toland
Background: The evolution of governance models for the Military Health System's (MHS) large hospitals, called medical treatment facilities (MTFs), has culminated with the effort to implement Enhanced Multi-Service Markets (eMSM). The term eMSM refers to two separate concepts. First, MSM refers to those geographic areas, that is, markets, which have the following characteristics: they have MTFs that are operated by two or more Department of Defense (DoD) Services, that is, Army, Navy, or Air Force; there is a large beneficiary population; there is a substantial amount of direct care (i...
February 6, 2018: Military Medicine
Amber S Linde, Jona Caridha, Kevin J Kunkler
Background: In fiscal year 2012, the Medical Simulation and Information Sciences Research Program released two Skills Decay (SD) research program announcements (PAs) under the Medical Readiness Initiative entitled "Medical Practice Initiative Breadth of Medical Practice & Disease Frequency Exposure (MPI-BMP)" and the "Medical Practice Initiative Procedural Skill Decay and Maintenance (MPI-PSD)." The Office of Naval Research also released a PA entitled "Medical Modeling and Simulation (MM&S) for Military Training and Education...
January 1, 2018: Military Medicine
Claire S Waddington, Charlie McLeod, Peter Morris, Asha Bowen, Mark Naunton, Jonathan Carapetis, Keith Grimwood, Roy Robins-Browne, Carl D Kirkwood, Robert Baird, David Green, Ross Andrews, Deborah Fearon, Joshua Francis, Julie A Marsh, Thomas Snelling
INTRODUCTION: Diarrhoeal disease is the second leading cause of death in children under 5 years globally, killing 525 000 annually. Australian Aboriginal and Torres Strait Islander (hereafter Aboriginal) children suffer a high burden of disease. Randomised trials in other populations suggest nitazoxanide accelerates recovery for children with Giardia, amoebiasis, Cryptosporidium, Rotavirus and Norovirus gastroenteritis, as well as in cases where no enteropathogens are found. METHODS AND ANALYSIS: This double blind, 1:1 randomised, placebo controlled trial is investigating the impact of oral nitazoxanide on acute gastroenteritis in hospitalised Australian Aboriginal children aged 3 months to <5 years...
February 1, 2018: BMJ Open
Joseph LaGrew, Cameron Hightower, Terrie Vasilopoulos
INTRODUCTION: Naval Surface Forces provide care in austere environments with unique facility, personnel, and material limitations that can put the patient at risk without proper consideration of these circumstances. Tailored shipboard education currently exists but is greatly dependent on the time, preferences, expertise, and ability of a single teaching officer, allowing for significant variability in the level of training. MATERIALS AND METHODS: One hundred and twenty-two individuals were trained in 19 topics presented over 12 months through the Naval Surface Forces Pacific Command Medical Readiness Division to all surface providers on Naval Base San Diego...
September 2017: Military Medicine
Kelly C Mead, David J Tennent, Daniel J Stinner
INTRODUCTION: Ringed external fixation has demonstrated promising results in the management of severe combat-related extremity injuries. The purpose of this study was to identify and compare rates of wartime-related surgical cases at times of high and low casualty time periods, and then compare these case numbers with those performed during a 2-week Medical Readiness Training Exercise (MEDRETE) in Honduras. MATERIALS AND METHODS: A retrospective review was performed of patients treated at a single Military Treatment Facility with definitive ringed external fixators during a 2-year period of high-volume combat casualty flow (January 2009-December 2010) and a subsequent 2-year period of low-volume combat casualty flow (January 2013-December 2014)...
July 2017: Military Medicine
Katherine E Little, Katie M Martinez, Jessica L Forman, Jason P Richter, Michael L Wade
The variable costs of providing surgical procedures for military beneficiaries are greater when care is rendered in the civilian purchased care network than when provided at a direct care military treatment facility (MTF). To reduce healthcare-related costs, retaining surgical services is a priority at MTFs across the U.S. Army Medical Command. This study is the first to identify factors significantly associated with outpatient surgical service site selection in the military health system (MHS). We analyzed 1,000,305 patient encounters in fiscal year 2014, of which 970,367 were direct care encounters and 29,938 were purchased care encounters...
July 2017: Journal of Healthcare Management / American College of Healthcare Executives
Khalid Alansari, Rafah Sayyed, Bruce L Davidson, Shahaza Al Jawala, Mohamed Ghadier
BACKGROUND: The goal of this study was to determine if IV magnesium, useful for severe pediatric asthma, reduces time to medical readiness for discharge in patients with bronchiolitis when added to supportive care. METHODS: We compared a single dose of 100 mg/kg of IV magnesium sulfate vs placebo for acute bronchiolitis. Patients received bronchodilator therapy, nebulized hypertonic saline, and 5 days of dexamethasone if there was eczema and/or a family history of asthma...
July 2017: Chest
Andrew L Smith, Ashish Kulhari, Julie A Wolfram, Anthony Furlan
BACKGROUND AND PURPOSE: The purpose of this study is to determine if the common insurance practice of requiring precertification before a medically ready stroke patient can be discharged to a skilled nursing facility (SNF) or inpatient rehabilitation facility (IRF) causes a delay in discharge. Eliminating delays in discharge of stroke patients is important given the increasing demands for health-care efficiency after the passage of the Affordable Health Care Act. METHODS: A retrospective chart review of 1007 patients who were admitted to our comprehensive stroke center with the primary diagnosis of stroke over a 12-month period was performed...
April 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Cheryl Hoying, Sharon Farra, Rosalie Mainous, Rebecca Baute, Matthew Gneuhs
An innovative interprofessional disaster preparedness program was designed and implemented through an academic-practice partnership between a large midwestern children's hospital and a community-based state university. This course was part of a constellation of courses developed in response to Presidential Directive (HSPD) 8, a mandate to standardize disaster response training that was issued after the inefficiencies following Hurricane Katrina. A hybrid immersive and didactic approach was used to train senior leadership and frontline clinicians...
February 2017: Journal of Nursing Administration
R Bapat, R McClead, E Shepherd, G Ryshen, T Bartman
AIM: To evaluate readmission data in a level IV neonatal intensive care unit (NICU) to identify patient characteristics and process failures which serve as drivers for readmission. METHODS: Our center is a primary referral center in Central and Southeast Ohio, providing us a unique opportunity to evaluate readmissions. We studied our current discharge process, caregiver perception of discharge readiness, parental comfort and the pre-discharge and post-discharge characteristics of infants...
2016: Journal of Neonatal-perinatal Medicine
Joshua Radi, Michael Brisson, Michael Line
The US Army aeromedical physician assistant (PA) serves aviation units in regards to crewmember medical readiness. All PAs are graduates of a 6-week flight surgeon course. They are responsible for conducting nearly 40% of the annual US Army flight physicals. This unique training and deployment illustrates the growing adaptability of PAs to assume a greater role in military medicine.
December 2016: JAAPA: Official Journal of the American Academy of Physician Assistants
Michelle Canham-Chervak, Ryan A Steelman, Anna Schuh, Bruce H Jones
Injuries are a barrier to military medical readiness, and overexertion has historically been a leading mechanism of injury among active duty U.S. Army soldiers. Details are needed to inform prevention planning. The Defense Medical Surveillance System (DMSS) was queried for unique medical encounters among active duty Army soldiers consistent with the military injury definition and assigned an overexertion external cause code (ICD-9: E927.0-E927.9) in 2014 (n=21,891). Most (99.7%) were outpatient visits and 60% were attributed specifically to sudden strenuous movement...
November 2016: MSMR
Derek Licina, Brad Cogswell, Richard Paz
No abstract text is available yet for this article.
November 2016: Military Medicine
James C Dunford, Karl C Kronmann, Luke R Peet, Jeffrey D Stancil
The article provides observations of multiple honey bee (Apis mellifera) swarms aboard the USNS Comfort (TAH-20) during the Continuing Promise 2015 mission. A brief overview of swarming biology is given along with control/removal recommendations to reduce sting exposures. The observations suggest that preventive medicine personnel should provide adequate risk communications about the potential occurrence of bee swarms aboard military ships, and medical department personnel should be prepared for the possibility of treating of multiple sting exposures, especially in the Southern Command Area of Operations where the Africanized genotype of A mellifera is common...
October 2016: U.S. Army Medical Department Journal
Michael W Temple, Christoph U Lehmann, Daniel Fabbri
OBJECTIVES: Discharging patients from the Neonatal Intensive Care Unit (NICU) can be delayed for non-medical reasons including the procurement of home medical equipment, parental education, and the need for children's services. We previously created a model to identify patients that will be medically ready for discharge in the subsequent 2-10 days. In this study we use Natural Language Processing to improve upon that model and discern why the model performed poorly on certain patients...
2016: Applied Clinical Informatics
Nicholas A Morris, Ayush Batra, Alessandro Biffi, Adam B Cohen
INTRODUCTION: Neurocritical care beds are a scarce, valuable resource. The purpose of this pilot study was to quantify discharge delays from the neurologic intensive care unit (NICU) at a tertiary-care teaching hospital and to examine the impact on overall hospital length of stay (LOS). Secondary goals were to evaluate (1) the effect of NICU delays on patient physical/occupational therapy services and (2) the accuracy of clinician estimates of NICU discharge date and hospital LOS. METHODS: We conducted a prospective cohort study of consecutive patients discharged over 1 month from NICU...
April 2016: Neurohospitalist
Søren Walther-Larsen, Gitte Bruun Aagaard, Susanne Molin Friis, Trine Petersen, Jørn Møller-Sonnergaard, Janne Rømsing
BACKGROUND: Ambulatory surgery forms a large part of pediatric surgical practice. Several studies indicate that postoperative pain is poorly managed with more than 30% of children having moderate to severe pain. In a busy outpatient clinic contact between healthcare professionals and the family is increasingly limited calling for a global and efficient pain management regime. OBJECTIVE: The aim of this prospective observational cohort study was to determine postoperative pain intensity following day surgery in children after our structured intervention for pain management...
February 2016: Paediatric Anaesthesia
Elisabeth Hesse, Edmond Amisi Okito, Kelly Mann, Michael McCullough, Emil Lesho
BACKGROUND: Health initiatives support regional stability and are a priority for US and African partners. We present data and experience from the Democratic Republic of Congo (DRC), a strategically and epidemiologically ideal location for collaborative medical engagement (CME). Our objectives included relationship building, exposure of US military medical personnel to uncommon tropical diseases, bolstering a referral hospital, and updating Congolese physicians on new treatment or preventive standards of care...
2015: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
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