Letters to the EditorGreen, Johnny, B.;French, Thomas, N.;Kragh, John, F.;Farr, Warner, D.;Kragh, John, F.
doi: 10.1093/milmed/158.2.A3pmid: N/A
Article PDF first page preview Close This content is only available as a PDF. Reprint & Copyright © by Association of Military Surgeons of U.S., 1993
Against Medical Advice: Part I, A Review of the LiteratureJeffer, Edward, K.
doi: 10.1093/milmed/158.2.69pmid: N/A
Abstract As a preliminary step to studying the Army's experience with against medical advice (AMA) discharges, the literature was reviewed. Fifty-one articles were found through a computer program search. These articles reported widely varying rates depending upon the type of patient, primary diagnosis, and type of setting. Patients with drug and/or alcohol abuse problems are at significantly higher risk for AMA. No civilian studies have been identified which evaluate long-term trends. This content is only available as a PDF. Reprint & Copyright © by Association of Military Surgeons of U.S., 1993
Against Medical Advice: Part II, The Army Experience 1971–1988Jeffer, Edward, K.
doi: 10.1093/milmed/158.2.73pmid: N/A
Abstract The Army experience with discharges against medical advice (AMA) from 1971 to 1988 is analyzed. AMA discharges have declined in a statistically significant manner in both medical centers and community hospitals. Discharges have decreased among men but increased among women. AMA discharges have decreased for both blacks and whites. Among clinical services, only obstetrics and gynecology demonstrated statistically significant increases. Among patient categories, only family members showed an increase. The possible sources of these various changes are discussed. This content is only available as a PDF. Reprint & Copyright © by Association of Military Surgeons of U.S., 1993
Variables Related to the Psychological Well Being of Army Wives during the Stress of an Extended Military SeparationKnapp, Tamara, S.;Newman, Shana, J.
doi: 10.1093/milmed/158.2.77pmid: N/A
Abstract Past research has indicated that extended military separations have a profound impact on military wives. The present study examines the relationship between self-esteem, locus of control, accumulated stressors, perceived military stress, and the psychological well-being of 74 Army wives whose husbands were stationed in the Persian Gulf. Accumulated stressors and perceived military stress were able to account for a significant portion of the variance in psychological well-being. This suggests that during an extended separation, the lower the accumulation of stressors and perceived military stress, the greater the psychological well-being of Army wives. Clinical implications of these findings are discussed. This content is only available as a PDF. Author notes 1 The opinions and assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense. Reprint & Copyright © by Association of Military Surgeons of U.S., 1993
The Role of Hyperbaric Oxygenation in the Treatment of Clostridial MyonecrosisRudge, Frederick, W.
doi: 10.1093/milmed/158.2.80pmid: N/A
Abstract Hyperbaric oxygenation as an adjunct in the treatment of clostridial myonecrosis (gas gangrene) has been used extensively in facilities with hyperbaric chambers. The United States Air Force has had extensive experience in the treatment of clostridial myonecrosis, treating 77 patients since 1965. This study reviews the experience in the treatment of this disease process in military multiplace hyperbaric chambers and provides an in-depth analysis of factors affecting patient survival. A comprehensive review of the literature on the treatment of clostridial myonecrosis with hyperbaric oxygenation is presented in this paper. This content is only available as a PDF. Reprint & Copyright © by Association of Military Surgeons of U.S., 1993
Preparing for the Downsizing and Closure of Letterman Army Medical Center: A Case StudyBales, Joel, D.
doi: 10.1093/milmed/158.2.84pmid: N/A
Abstract Letterman Army Medical Center (LAMC) began a phased downsizing in July 1991 which will lead to closure by June 30,1994. An analysis of the downsizing and closure process has yielded information which can be valuable to medical treatment facility managers faced with similar challenges in the future. By review and analysis of documentation, this case study extracted and interpreted pertinent information from historical records and from personnel involved in planning for the downsizing and closure of LAMC. This study provides managers of military hospitals that are downsizing or closing with a summary of issues for planning, compiled by their relative importance, and a description of methods employed by LAMC fomanaging these issues. This content is only available as a PDF. Author notes * Research performed while Administrative Resident at Letterman Army Medical Center, Presidio of San Francisco, CA 94129 Reprint & Copyright © by Association of Military Surgeons of U.S., 1993