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https://www.readbyqxmd.com/read/28422894/impact-of-telephone-based-problem-solving-treatment-on-the-use-of-medical-and-psychological-services-in-the-military
#1
John S Richardson, Jesse R Fann, Kathleen R Bell, Nancy Temkin
OBJECTIVE: To explore the impact of problem-solving treatment (PST) for mild traumatic brain injury in active duty service members on the use of medical and psychological services. PARTICIPANTS: Service members who had a mild traumatic brain injury during their last deployment and enrolled in the CONcussion Treatment After Combat Trauma (CONTACT) study. DESIGN: Secondary analysis of a randomized clinical trial. Participants were assigned to telephone-based PST, or e-mailed or mailed education only over the course of 6 months...
April 18, 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/28396477/command-and-control-of-sierra-leone-s-ebola-outbreak-response-evolution-of-the-response-architecture
#2
Emma Ross
Management, coordination and logistics were critical for responding effectively to the Ebola outbreak in Sierra Leone, and the duration of the epidemic provided a rare opportunity to study the management of an outbreak that endured long enough for the response to mature. This qualitative study examines the structures and systems used to manage the response, and how and why they changed and evolved. It also discusses the quality of relationships between key responders and their impact. Early coordination mechanisms failed and the President took operational control away from the Ministry of Health and Sanitation and established a National Ebola Response Centre, headed by the Minister of Defence, and District Ebola Response Centres...
May 26, 2017: Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences
https://www.readbyqxmd.com/read/28388218/the-department-of-defense-chemical-and-biological-defense-program-an-enabler-of-the-third-offset-strategy
#3
Jason Roos, Calvin Chue, Diane DiEuliis, Peter Emanuel
The US Department of Defense (DOD) established programs to defend against chemical and biological weapons 100 years ago because military leaders understood that the operational capability of the US military is diminished when service member health is compromised. These threats to operational readiness can be from an overt attack using chemical and biological threats but may also arise from natural exposures. In the current era of rapidly emerging technologies, adversaries are not only rediscovering chemical and biological weapons; they are also displaying an increased propensity to employ them to cause strategic instability among deployed forces or nations undergoing conflict...
March 2017: Health Security
https://www.readbyqxmd.com/read/28376996/healthcare-logistics-in-disaster-planning-and-emergency-management-a-perspective
#4
Jerry D VanVactor
This paper discusses the role of healthcare supply chain management in disaster mitigation and management. While there is an abundance of literature examining emergency management and disaster preparedness efforts across an array of industries, little information has been directed specifically toward the emergency interface, interoperability and unconventional relationships among civilian institutions and the US Department of Defense (US DoD) or supply chain operations involved therein. To address this imbalance, this paper provides US DoD healthcare supply chain managers with concepts related to communicating and planning more effectively...
December 1, 2017: Journal of Business Continuity & Emergency Planning
https://www.readbyqxmd.com/read/28372033/behavioral-emergency-response-team-implementation-improves-patient-safety-staff-safety-and-staff-collaboration
#5
Cdr Jennifer M Zicko, Lcdr Rebecca A Schroeder, Cdr William S Byers, Lt Adam M Taylor, Cdr Dennis L Spence
BACKGROUND: Staff members working on our nonmental health (non-MH) units (i.e., medical-surgical [MS] units) were not educated in recognizing or deescalating behavioral emergencies. Published evidence suggests a behavioral emergency response team (BERT) composed of MH experts who assist with deescalating behavioral emergencies may be beneficial in these situations. Therefore, we sought to implement a BERT on the inpatient non-MH units at our military treatment facility. AIMS: The objectives of this evidence-based practice process improvement project were to determine how implementation of a BERT affects staff and patient safety and to examine nursing staffs' level of knowledge, confidence, and support in caring for psychiatric patients and patients exhibiting behavioral emergencies...
April 3, 2017: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/28363389/joining-forces-the-status-of-military-and-veteran-health-care-in-nursing-curricula
#6
Brenda Elliott, Barbara Patterson
According to the Department of Veterans Affairs, there are approximately 23 million veterans living in the United States. In 2012, the Joining Forces initiative highlighted the need to enhance nursing education for the military and veteran population. With the drawdown of 2 long, large-scale conflicts, a young cohort of veterans presented new challenges in health care. Although not necessarily a traditional vulnerable population, given their emergent health care needs, they are vulnerable. Purnell's Model for Cultural Competence provided a framework for this exploratory descriptive study...
March 2017: Journal of Professional Nursing: Official Journal of the American Association of Colleges of Nursing
https://www.readbyqxmd.com/read/28350782/acknowledging-the-risk-for-traumatic-brain-injury-in-women-veterans
#7
Timothy Amoroso, Katherine M Iverson
Since the Iraq and Afghanistan wars began, an unprecedented number of women have been engaging in combat operations. Likewise, the number of women using Department of Veterans Affairs (VA) services has doubled since 2001. Military service, and deployment to combat in particular, poses certain risks for traumatic brain injury (TBI)-for all service members. However, women may have additional military and nondeployment risk factors such as intimate partner violence (IPV). We briefly review the definition and classification issues related to TBI, as well as common acute and chronic health symptoms after TBI...
April 2017: Journal of Nervous and Mental Disease
https://www.readbyqxmd.com/read/28328683/surgical-support-during-the-terrorist-attacks-in-paris-13-november-2015-experience-at-b%C3%A3-gin-military-teaching-hospital
#8
Olivier Barbier, Brice Malgras, Camille Choufani, Antoine Bouchard, Didier Ollat, Gilbert Versier
BACKGROUND: Recent conflicts have allowed the French Army Health Service to improve management quality for wartime-injured people during military operations. On 13 November 2015, it was in Paris that France was directly attacked and Bégin Military Teaching Hospital, like several hospitals in Paris, had to face a large number of gunshot victims. Thanks to our operational experience, injured people hospitalized in military hospitals benefited from a management based on triage and damage control (DC) principles...
March 21, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28324673/a-framework-to-guide-the-assessment-of-human-machine-systems
#9
Kimberly Stowers, James Oglesby, Shirley Sonesh, Kevin Leyva, Chelsea Iwig, Eduardo Salas
OBJECTIVE: We have developed a framework for guiding measurement in human-machine systems. BACKGROUND: The assessment of safety and performance in human-machine systems often relies on direct measurement, such as tracking reaction time and accidents. However, safety and performance emerge from the combination of several variables. The assessment of precursors to safety and performance are thus an important part of predicting and improving outcomes in human-machine systems...
March 2017: Human Factors
https://www.readbyqxmd.com/read/28320917/predictors-of-massive-blood-transfusion-a-delphi-study-to-examine-the-views-of-experts
#10
Jacqueline V Mclennan, K C Mackway-Jones, S T Horne, R Body
BACKGROUND: Trauma patients requiring massive blood transfusion (MBT) have high morbidity and mortality: early and aggressive use of blood products during immediate resuscitation may improve survival. There is currently a lack of evidence to guide initial identification of these patients which is especially important in areas where plasma may need to be thawed. In the absence of this evidence, this study aimed to robustly evaluate expert opinion by using a Delphi process to identify predictors of massive transfusion...
March 20, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28318990/junctional-hemorrhage-control-for-tactical-combat-casualty-care
#11
REVIEW
Russ S Kotwal, Frank K Butler
During historic, as well as more recent, conflicts, most combat casualties who die from their injuries do so in the prehospital setting. Although many of the injuries incurred by these casualties are nonsurvivable, a number of injuries are still potentially survivable. Of those injuries that are potentially survivable, the majority are truncal, junctional, and extremity hemorrhage. Novel and effective approaches directed toward prehospital hemorrhage control have emerged in recent years, some of which can prove useful in the management of junctional hemorrhage whether in a military or civilian setting...
March 16, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28301394/effects-on-the-anti-abo-titers-of-military-blood-donors-from-a-predeployment-vaccination-program
#12
Olle Berséus
BACKGROUND: The use of blood group O as "universal blood" for emergency whole blood transfusions carries the risk for a hemolytic transfusion reaction mediated by incompatible A-/B-antibodies. This risk can be minimized by assuring that the donor has a low titer of anti-A and anti-B. The level of these naturally occurring antibodies have been shown to be increased by vaccination with most biologically derived vaccines. This boostering effect has been investigated for the new generation of vaccines...
March 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28291501/lateral-flow-rapid-test-for-accurate-and-early-diagnosis-of-scrub-typhus-a-febrile-illness-of-historically-military-importance-in-the-pacific-rim
#13
Chien-Chung Chao, Zhiwen Zhangm, Giulia Weissenberger, Hua-Wei Chen, Wei-Mei Ching
Scrub typhus (ST) is an infection caused by Orientia tsutsugamushi. Historically, ST was ranked as the second most important arthropod-borne medical problem only behind malaria during World War II and the Vietnam War. The disease occurs mainly in Southeast Asia and has been shown to emerge and reemerge in new areas, implying the increased risk for U.S. military and civilian personnel deployed to these regions. ST can effectively be treated by doxycycline provided the diagnosis is made early, before the development of severe complications...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291498/emergency-department-wounds-managed-by-combat-medics-a-case-series
#14
Steven G Schauer, James A Pfaff
BACKGROUND: Combat medics are an integral part of their unit helping to conserve the fighting strength. Minor wounds are a common problem in the deployed settings that affect a soldier's ability to partake in operations. While the medics often manage wound care, there is very little data on the outcomes. METHODS: Cases were acquired as part of a quality assurance project providing training feedback to medics on wound management. Laceration management is delegated to the medic at the direction of the provider...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291495/an-assessment-of-national-emt-certification-among-enlisted-military-medics
#15
Stephen Harper, Remle Crowe, Melissa Bentley, Chetan Kharod, Benjamin Walrath
BACKGROUND: Navy Hospital Corpsmen (HMs) are the Navy equivalent to Emergency Medical Technicians (EMTs) both in-garrison and on the battlefield. In 2000, the Emergency Medical Services (EMS) Education Agenda for the Future highlighted the need for a single certification agency to provide consistent evaluation of entry level competence for each nationally recognized EMS provider level. Administered by the National Registry of EMTs (NREMT), National EMT Certification is currently utilized by 46 states, the District of Columbia, four territories, and six federal organizations as part of their processes for granting licensure...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291494/military-emergency-medical-service-system-assessment-application-of-the-national-park-service-needs-assessment-and-program-audit-to-objectively-evaluate-the-military-ems-system-of-okinawa-japan
#16
Elliot M Ross, Stephen A Harper, Cord Cunningham, Benjamin D Walrath, Gerard DeMers, Chetan U Kharod
INTRODUCTION: As part of a Military Emergency Medical Services (EMS) system process improvement initiative, the authors sought to objectively evaluate the U.S. military EMS system for the island of Okinawa. They applied a program evaluation tool currently utilized by the U.S. National Park Service (NPS). METHODS: A comprehensive needs assessment was conducted to evaluate the current Military EMS system in Okinawa, Japan. The NPS EMS Program Audit Worksheet was used to get an overall "score" of our assessment...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291221/-a-new-concept-of-organization-and-scope-of-neurosurgical-care-in-the-us-army-during-armed-conflicts-in-the-early-2000s
#17
Yu V Khrapov, D E Alekseev, D V Svistov
Military operations in various parts of the world in the early 2000s are becoming more regionalized; new warfare tactics emerge, which makes it necessary to review and modify the neurosurgical care system. The article reviews the results of original studies on this issue and summarizes the experience of the US Army medical service in Afghanistan and Iraq. The article discusses the structure of sanitary losses, organization and scope of medical and evacuation neurosurgical measures, types and techniques of surgical interventions, and the rate of complications...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28290979/orbital-cellulitis-in-a-psoriatic-patient-treated-with-adalimumab
#18
Vienna G Katana, Robert J Carpenter, John P Trafeli, Julia M Kwan
INTRODUCTION: Psoriatic patients on tumor necrosis factor alpha inhibitors (TNFi) may be at increased risk for upper respiratory tract infections, including chronic rhino-sinusitis (CRS). Rarely, CRS can progress to orbital cellulitis (OC), an emergent ophthalmic complication wherein respiratory flora from paranasal sinus disease intrude the retro-orbital space. MATERIALS AND METHODS: Single case report. RESULTS: We report the first case, to our knowledge, of an invasive sinusitis that rapidly evolved into OC in a patient receiving adalimumab treatment for plaque psoriasis and psoriatic arthritis...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290966/ultrasound-detection-of-soft-tissue-abscesses-performed-by-non-physician-u-s-army-medical-providers-na%C3%A3-ve-to-diagnostic-sonography
#19
Mike LaDuke, Jon Monti, Aaron Cronin, Bart Gillum
BACKGROUND: Patients commonly present to emergency rooms and primary care clinics with cellulitic skin infections with or without abscess formation. In military operational units, non-physician medical personnel provide most primary and initial emergency medical care. The objective of this study was to determine if, after minimal training, Army physician assistants and medics could use portable ultrasound (US) machines to detect superficial soft tissue abscesses. METHODS: This was a single-blinded, randomized, prospective observational study conducted over the course of 2 days at a military installation...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290958/comparative-assessment-of-three-approaches-of-teaching-nonmedically-trained-persons-in-the-handling-of-supraglottic-airways-a-randomized-controlled-trial
#20
Mario Hensel, Willi Schmidbauer, Michael Benker, Paula Schmieder, Thoralf Kerner
BACKGROUND: The use of supraglottic airways has been recommended in combat trauma airway management. To ensure an adequate airway management on the battlefield, suitable training concepts are sought to efficiently teach as many soldiers as possible. Our aim was to compare three approaches of teaching laypersons in the handling of supraglottic airways in a mannequin model. METHODS: In this prospective randomized blinded study, 285 military service men without any medical background were divided into three groups and trained in the use of the Laryngeal Mask Airway Supreme (LMA) and the Laryngeal Tube Disposable (LT-D)...
March 2017: Military Medicine
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