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Trench foot--a study in military-medical responsiveness in the Great War, 1914-1918.

Haller, J. S.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /06/1990 EN
Relevância na Pesquisa
26.09%
Along the nearly 15,000 miles of trenches on the western front in the Great War of 1914-1918, a condition known as "trench foot" caused serious attrition among the fighting troops and resulted in swollen limbs, impaired sensory nerves, inflammation, and even loss of tissue through gangrene. Physicians, sanitarians, and military officers explored numerous theories regarding etiology and treatment before focusing on a combined regimen of common-sense hygiene and strict military discipline.

Posttraumatic Stress Disorder in Male Military Veterans With Comorbid Overweight and Obesity: Psychotropic, Antihypertensive, and Metabolic Medications

Vieweg, W. Victor R.; Julius, Demetrios A.; Fernandez, Antony; Tassone, Daniel M.; Narla, Shireesha N.; Pandurangi, Anand K.
Fonte: Physicians Postgraduate Press, Inc. Publicador: Physicians Postgraduate Press, Inc.
Tipo: Artigo de Revista Científica
Publicado em //2006 EN
Relevância na Pesquisa
36.15%
Posttraumatic stress disorder (PTSD) is an important syndrome among military veterans. Little has been written about comorbid medical conditions of PTSD, particularly overweight and obesity. We focus on psychotropic and non-psychotropic drugs, their interactions, and metabolic issues most relevant to primary care physicians.

Utilization of former military medical corpsmen in the provision of jail health services.

King, L; Reynolds, A; Young, Q
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /08/1977 EN
Relevância na Pesquisa
26%
In an effort to improve the quality of health services within a large urban jail, former military medical corpsmen have been employed as an integral component of a jail health service. Medical corpsmen are responsible for the performance of intake medical evaluations, delivery of prescription medications, triage for physician sick call, and provision of elementary health services on the jail tiers. Utilization of medical corpsmen has been associated with improved rates of medication delivery as well as beneficial effects in relation to tuberculosis and venereal disease control, and a more appropriate utilization of physician services. Effective utilization of medical corpsmen requires cooperation from the correctional staff as well as consistent supervision and support by qualified physicians.

Closed and restricted practices.

Woodward, C. A.; Williams, A. P.; Cohen, M.; Ferrier, B.
Fonte: College of Family Physicians of Canada Publicador: College of Family Physicians of Canada
Tipo: Artigo de Revista Científica
Publicado em /09/1997 EN
Relevância na Pesquisa
36.23%
OBJECTIVE: To determine the proportion of recently certificated Ontario family physicians who have closed their practices to new patients or restricted their services. DESIGN: Cross-sectional survey mailed between September 1993 and January 1994. SETTING: Ontario family practices. PARTICIPANTS: All family medicine residency-trained certificants of the College of Family Physicians of Canada from 1989 to 1991 currently practising in Ontario. Response rate was 70% (395 of 564 eligible physicians). Otherwise eligible physicians practising as locums, emergency room physicians, or military physicians were excluded. MAIN OUTCOME MEASURES: Self-report of practices being closed to new patients and of various restrictions placed on practices. RESULTS: Nearly one third of respondents had closed their practices to new patients. Although the decision to close a practice correlated with length of time in practice, physicians in metropolitan Toronto were significantly less likely to report closed practices than physicians practising in other regions of Ontario. Restrictions reported related to patients and problems, geographic area, and type of setting(s) serviced. About 45% of respondents did not provide one or more of a defined set of five services. CONCLUSIONS: Results of this study suggest that family physicians restrict their practices in various ways within the first 5 years after certification.

Multidrug-resistant Organisms in Military Wounds from Iraq and Afghanistan

Calhoun, Jason H.; Murray, Clinton K.; Manring, M. M.
Fonte: Springer-Verlag Publicador: Springer-Verlag
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
36.09%
Mortality from battlefield wounds has historically declined, thanks to better surgical management, faster transport of casualties, and improved antibiotics. Today, one of the major challenges facing U.S. military caregivers is the presence of multidrug-resistant organisms in orthopaedic extremity wounds. The most frequently identified resistant strains of bacteria are Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter calcoaceticus-baumannii complex. Overuse of broad-spectrum antibiotics may be an important factor in building resistant strains. Acinetobacter infections appear to hospital-acquired and not from an initial colonization of the injury. More research is required to give military physicians the tools they require to reduce the infection rate and defeat multidrug-resistant organisms.

The Hospital for the Ruptured and Crippled Moves East on 42nd Street 1912 to 1925

Levine, D. B.
Fonte: Springer-Verlag Publicador: Springer-Verlag
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
26%
In 1912, the Hospital for the Ruptured and Crippled (R & C) moved to its third location since its founding in 1863. It was a newly constructed six-story building on 42nd Street between Second Avenue and First Avenue. At the time Dr. Virgil Gibney, the second Surgeon-in-Chief, was 65 years of age and had already served 25 years in that position. The building housed a New York City public school since the length of stay of the children, many afflicted with tuberculosis and poliomyelitis, might be over 1–2 years. The large number of immigrants in the city led to very challenging social conditions that saw changes made in the first two decades of the twentieth century. When this country entered World War I in 1917, the physician staff was significantly affected as many volunteered for military service. Soldiers, sailors, and marines were treated at R & C, and military physicians were educated in orthopedics and hernia care on the wards and in the outpatient department. Because of declining health in 1924, Dr. Gibney retired and was replaced as Surgeon-in-Chief by his long-term friend and colleague, Dr. William B. Coley in January 1925.

Battlefield brain: Unexplained symptoms and blast-related mild traumatic brain injury

Thompson, James M.; Scott, Kenneth C.; Dubinsky, Leslie
Fonte: College of Family Physicians of Canada Publicador: College of Family Physicians of Canada
Tipo: Artigo de Revista Científica
Publicado em /11/2008 EN
Relevância na Pesquisa
26.18%
A 40-year-old male military Veteran* presents to a family physician with chronic symptoms that include recurrent headaches, dizziness, depression, memory problems, difficulty sleeping, and relationship troubles. He has not had a family physician since leaving the military 2 years ago. His Military Occupation Classification had been infantry. He explains that he had been deployed to war zones and that during a firefight several years earlier an enemy weapon exploded nearby, killing a fellow soldier and wounding others. He does not recall being injured, but remembers feeling a thump and that his “computer had to reboot.” This was followed by headaches and a few days of ringing in his ears. He also suffered a concussion during a military hockey game. He was assessed and treated for persistent headaches in the service and recalls that results of a head computed tomography scan were negative. Veterans Affairs Canada (VAC) granted him a disability award for posttraumatic headache and provided certain treatment benefits. He took medication for the headaches. Following transition to civilian life he had difficulty holding jobs, but had been reluctant to seek help. He saw stories on television about blast-induced minor traumatic brain injury in Iraq and Afghanistan...

Dual Loyalty of Physicians in the Military and in Civilian Life

Benatar, Solomon R.; Upshur, Ross E. G.
Fonte: American Public Health Association Publicador: American Public Health Association
Tipo: Artigo de Revista Científica
Publicado em /12/2008 EN
Relevância na Pesquisa
36.23%
The concept of the dual loyalty physicians may have to both a patient and a third party is important in elucidating the obligations of physicians. The extent to which loyalty may be deflected from a patient to a third party (e.g., an insurance company or a prison commander) is greatly underestimated and has not attracted significant scholarly analysis.

"Can Breast Feeding Help You in Later Life? Evidence from German Military Heights in the Early 20th Century"*

Haines, Michael R.; Kintner, Hallie J.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
26.09%
Considerable literature exists on the benefits of breast feeding on the health and survival of infants and young children, but there is less on the effects on later life outcomes. One such measure of health and well-being that has received attention in the historical literature is terminal adult stature. Information on height is rather widely available; however, it is much more difficult to obtain data on breast feeding. One country that does have such information is Imperial Germany (1871–1919). A number of physicians and local health officials collected information on the incidence and duration of breast feeding early in the 20th century, particularly because of concern about the unusually high infant mortality rates in parts of Germany. Hallie Kintner has surveyed the published results of these studies. The information on the prevalence of breast feeding for the period 1903/10 has been inputed into a database of demographic and economic variables for the counties (Regierungsbezirke) of Germany (1850–1939) There are also published data on heights of military recruits from the Imperial German military forces in 1906. These can be linked to areas in the database and related to breast feeding practices and infant mortality both contemporaneously and approximately 20 years previous to 1906. Results indicate a significant effect of infant feeding practices on later life outcomes operating through infant health conditions...

Dermatology in the military field: What physicians should know?

Chong, Wei-Sheng
Fonte: Baishideng Publishing Group Co., Limited Publicador: Baishideng Publishing Group Co., Limited
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
26.4%
In the civilian dermatological setting, the top 5 skin diseases usually seen are eczema/dermatitis, acne, benign skin tumors, viral infections and pigmentary disorders. In comparison, the top 5 skin conditions encountered in the military sector are usually fungal infections, eczema/dermatitis, insect bite reactions, bacterial infections and acne. This is not surprising as military personnel, due to the special environment and vocations they are in, are prone to getting eczema as heat, sweating and wearing of the military uniform aggravate the condition. Fungal infections are common in those who wear the army boots. Insect bite reactions are not an uncommon sight among those who have to go to the jungle regularly for outfield training. Grass allergy or intolerance, contact dermatitis or acneiform eruption due to the application of military camouflage cream on the face, contact dermatitis to insect repellents, and military uniform allergy and intolerance are amongst the commonest dermatological problems encountered in the military field, and physicians should recognize them, investigate and manage these problems accordingly. Lastly, a diagnosis not to be missed in the military field is cutaneous melioidosis, especially when a military personnel presents with a non-healing ulcer.

Demobilization and Reintegration Programs : Addressing Gender Issues

Nathalie de Watteville
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Relevância na Pesquisa
26%
Women have always participated to some extent in combat, but several recent wars have seen them fighting on the front lines. And while the roles of female excombatants vary widely, the women seem to share one unfortunate characteristic: limited access to benefits when peace and demobilization come. This is also true for girls abducted for sexual services and the families of ex-combatants in the receiving community. These groups are often neglected during demobilization and reintegration; or at best, women, men, boys, and girls may receive equal benefits but are treated as a homogenous group, which prevents their specific needs from being addressed. Some think that the first objective of a DRP (Demobilization and Reintegration Program) is to have a positive impact on the peace dividend. Another goal often mentioned is the reduction of military expenditures for budgetary reasons. However, others argue that the DRP objectives should be to assist vulnerable excombatans.

Integration of Personal Digital Assistant (PDA) devices into the Military Healthcare Clinic Environment

Miller, Paul C.
Fonte: Monterey, California. Naval Postgraduate School Publicador: Monterey, California. Naval Postgraduate School
Tipo: Tese de Doutorado
Relevância na Pesquisa
26.14%
The business drivers within managed care are mandating that physicians have point-of-care access to medical reference data, patient specific data, formularies, treatment protocols, and billing/coding information. One emerging technology that has the potential to provide this access with little economic investment is the mobile Personal Digital Assistant. The authors address a variety of wireless technologies and security concerns regarding real-time access to patient data. The family practice staff at the Naval Hospital Lemoore explored and contrasted the capabilities of commercially available PDAs, wireless interfaces, and medical software applications to ascertain their value within the Military Health System. A production-ready interface between the Composite Health Care System and the Nutrition Management Information Server demonstrates the potential for eliminating the difficulties associated with documenting patient encounters and capturing charges. Survey tools generate a requirements standard for deployment of this technology within the Military Health System on an enterprise-wide scale with a hybrid approach to packaging based on functionality. The authors recommend the Military Health System embrace this technology as a means to realize its vision of best value health services.

A turnover analysis for Department of Defense physicians

Gaffney, James K.
Fonte: Monterey, California. Naval Postgraduate School Publicador: Monterey, California. Naval Postgraduate School
Tipo: Tese de Doutorado
EN_US
Relevância na Pesquisa
36.36%
This thesis analyzes the career orientation of military physicians. Career orientation is analyzed using a logistic regression (logit) model with a dichotomous dependent variable career intention (short-term/long-term). The model is used to analyze the career intentions of four cohorts: all physicians, single physicians, married physicians, and couples (married physicians plus their spouses). The relative importance of various demographic and cognitive/perceptual factors to the career orientation decision is assessed. The results highlight potential policy variables which can be impacted by manpower policy planners to manage the career orientation of military physicians. Keywords: Physician turnover, DOD Retention, All volunteers, Theses. (sdw)

La bioéthique et les conflits armés : la réflexion éthique des médecins militaires

Rochon, Christiane
Fonte: Université de Montréal Publicador: Université de Montréal
Tipo: Thèse ou Mémoire numérique / Electronic Thesis or Dissertation
FR
Relevância na Pesquisa
46.69%
Le but de la recherche est d’étudier les tensions éthiques que peuvent vivre les médecins militaires, qui doivent agir à la fois comme soignants, militaires (même s’ils sont non combattants) et parfois comme acteurs humanitaires. Parmi la littérature sur l’éthique de la médecine militaire, les dilemmes la concernant sont souvent présentés comme le fruit de pressions réelles ou perçues provenant de l’institution militaire, des règles, codes, lois ou de politiques, ceci afin de détourner le médecin de son but premier, soit l’intérêt du patient. Pour mieux comprendre les défis éthiques auxquels sont confrontés les médecins militaires canadiens et comment ceux-ci les traitent, la recherche utilise une approche de bioéthique empirique. À partir d’une analyse de la littérature, nous examinons les dilemmes éthiques des médecins militaires, le concept de profession, ainsi que les codes d’éthique (médicaux et militaires) canadiens. L’expérience éthique est ensuite explorée à partir d’entrevues semi-directives effectuées auprès de quatorze médecins militaires ayant participé à des missions opérationnelles, notamment à Kandahar en Afghanistan, entre 2006 et 2010. Les résultats, tant conceptuels qu’empiriques...

Military health care system and Tricare: an economic analysis indicates the occurrence of self-selection

Ryan, John W.; Wise, Christopher M.
Fonte: Monterey California. Naval Postgraduate School Publicador: Monterey California. Naval Postgraduate School
Formato: xiv, 73 p. : ill. ; 28 cm.
Relevância na Pesquisa
36.2%
MBA Professional Report; The military health care system has been plagued by increasing health care costs for the past few decades. The military has implemented a couple of programs in an effort to control costs while maintaining quality health care for beneficiaries. The CHAMPUS program was DoD's first attempt to allow beneficiaries to receive care from civilian physicians for a small fee. This program was replaced with the Tricare program which offered a three option health plan and provided easy access to medical care for beneficiaries, but it failed to control costs. This project initially attempted to demonstrate that by increasing cost shares to beneficiaries associated with the Tricare program, greater efficiency and cost savings in the military health care system could be achieved. While unable to prove this, we found evidence of self-selection occurring among Tricare Standard enrollees. Standard enrollees are using inpatient and outpatient care at higher rates than their Prime counterparts. Analysis of this self-selection could have implications for future policy decisions concerning the military health care system.

Cost-benefit analysis of Obstetrical/Gynecological physicians who accept active duty patients on the Monterey Peninsula

Butterfield, Tracy L.
Fonte: Monterey, California. Naval Postgraduate School Publicador: Monterey, California. Naval Postgraduate School
Tipo: Tese de Doutorado Formato: 53 p.
EN_US
Relevância na Pesquisa
26.32%
Approved for public release; distribution is unlimited.; With amjor shifts in military health care, more active duty members are being seen by civilian physicians. This thesis examines Obstetrical care for active duty servicemembers on the Monterey Peninsula. The central objectives of this study was to analyze incentives for civilian Obstetrical/Gynecological physicians to accept active duty patients. To address this issue, interview were conducted of contracted and non-contracted Obstetrical/Gynecological phyisicians on the Monterey Peninsula. The interviews obtained information about the physician's costs and beenfits for accepting active duty patients. Additionally, with the payment for an active duty member's medical treatment care being closely liked to Medicare rates, the interview data was copared to studies on barriers to prenatal care for low-income patients. The major findings were that the major disadvantage to accepting active duty patients is not that the military pays for health care at a discounted rate. The major disadvantage for physicians to accept active duty patients is the volume of paperwork and claims filing associated with being a contracted physician. The primary benefit the physicians receive by accepting active duty patients is tha additional volume of patients.; http://www.archive.org/details/costbenefitanaly00butt; Lieutenant...

A comprehensive study of factors impacting the future size and scope of military graduate medical education

Spencer, Jason E
Fonte: Monterey, California. Naval Postgraduate School Publicador: Monterey, California. Naval Postgraduate School
ENG
Relevância na Pesquisa
26.44%
Approved for public release; distribution is unlimited; Graduate medical education (GME) is the postgraduate medical education required for all medical school graduates pursuing licensure. Since World War II, the military medical services have undertaken full time inservice GME missions to ensure a supply of quality physicians and surgeons for both the military's wartime readiness and peacetime health benefit missions. However, determining the number of active duty physicians and surgeons, and the specialties which they practice, has been a complex and controversial issue within military medicine, particularly since the end of the Cold War. This thesis examines the factors impacting the future size and scope of military GME. A comprehensive history of military GME is provide Detailed events and issues impacting GME which surfaced following the Cold War are also discussed. The current Department of Defense GME policy and funding issues are examined, as well as the operational GME implementation model developed by the United States Navy. This thesis found that GME has historically been a valuable tool for recruiting, training, and retaining quality physicians and surgeons. Post Cold War budget constraints and readiness policies and private sector changes in GME are likely to force changes in military GME programs...

Comparison of Five 2nd-Generation Supraglottic Airway Devices for Airway Management Performed by Novice Military Operators

Henlin, Tomas; Sotak, Michal; Kovaricek, Petr; Tyll, Tomas; Balcarek, Lukas; Michalek, Pavel
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
26.09%
Objectives. Five different second-generation supraglottic airway devices, ProSeal LMA, Supreme LMA, i-gel, SLIPA, and Laryngeal Tube Suction-D, were studied. Operators were inexperienced users with a military background, combat lifesavers, nurses, and physicians. Methods. This was a prospective, randomized, single-blinded study. Devices were inserted in the operating room in low light conditions after induction of general anesthesia. Primary outcome was successful insertion on the first attempt while secondary aims were insertion time, number of attempts, oropharyngeal seal pressure, ease of insertion, fibre optic position of device, efficacy of ventilation, and intraoperative trauma or regurgitation of gastric contents. Results. In total, 505 patients were studied. First-attempt insertion success rate was higher in the Supreme LMA (96%), i-gel (87.9%), and ProSeal LMA (85.9%) groups than in the Laryngeal Tube Suction-D (80.6%) and SLIPA (69.4%) groups. Insertion time was shortest in the Supreme LMA (70.4 ± 32.5 s) and i-gel (74.4 ± 41.1 s) groups (p < 0.001). Oropharyngeal seal pressures were higher in the Laryngeal Tube Suction-D and ProSeal LMA groups than in other three devices. Conclusions. Most study parameters for the Supreme LMA and i-gel were found to be superior to the other three tested supraglottic airway devices when inserted by novice military operators.

Women and War: What Physicians Should Know

Murdoch, Maureen; Bradley, Arlene; Mather, Susan H; Klein, Robert E; Turner, Carole L; Yano, Elizabeth M
Fonte: Blackwell Science Inc Publicador: Blackwell Science Inc
Tipo: Artigo de Revista Científica
Publicado em /03/2006 EN
Relevância na Pesquisa
26.22%
Most of today's 1.7 million women veterans obtain all or most of their medical care outside the VA health care system, where their veteran status is rarely recognized or acknowledged. Several aspects of women's military service have been associated with adverse psychologic and physical outcomes, and failure to assess women's veteran status, their deployment status, and military trauma history could delay identifying or treating such conditions. Yet few clinicians know of women's military history—or of military service's impact on women's subsequent health and well being. Because an individual's military service may be best understood within the historical context in which it occurred, we provide a focused historical overview of women's military contributions and their steady integration into the Armed Forces since the War for Independence. We then describe some of the medical and psychiatric conditions associated with military service.

Dilemmas in Military Medical Ethics: A Call for Conceptual Clarity

Rochon, Christiane
Fonte: BioéthiqueOnline Publicador: BioéthiqueOnline
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
56.61%
Malgré l’augmentation des conflits armés et des changements qui les caractérisent, les enjeux éthiques auxquels font face les médecins militaires sont très peu traités dans la littérature en bioéthique. Les médecins militaires sont des membres du corps militaire, même s’ils sont non combattants, et ils jouent un rôle de soignant tout en pouvant être appelés à agir comme aide humanitaire. Certains auteurs se sont même interrogés sur la compatibilité morale d’être à la fois médecin et soldat. Les conflits éthiques soulevés dans la littérature sur les médecins militaires peuvent être organisés autour de trois perspectives : 1) les problèmes moraux en médecine militaire seraient particuliers compte tenu des difficultés à respecter les principes bioéthiques traditionnels; 2) les codes d’éthique médicaux et les lois internationales seraient trop restrictifs ou inadéquats pour le contexte militaire; et 3) les médecins sont des acteurs sociaux qui devraient être pacifistes, défenseurs des droits de la personne, politiquement neutres ou promoteurs de la paix. Une revue des divers dilemmes rencontrés par les médecins militaires identifiés dans la littérature nous montre que ces perspectives se situent à des niveaux d’analyse différents (micro...