USN, D.A. Amundson, MC,;USN, K.D. Gubler, MC,;USN, J.S. Parrish, MC,
doi: 10.1093/milmed/164.12.iipmid: N/A
This content is only available as a PDF. Reprint & Copyright © by Association of Military Surgeons of U.S., 1999
MT(ASCP)SBB, Ellis M. Frohman, MA,
doi: 10.1093/milmed/164.12.iiapmid: N/A
This content is only available as a PDF. Reprint & Copyright © by Association of Military Surgeons of U.S., 1999
doi: 10.1093/milmed/164.12.xiiapmid: N/A
This content is only available as a PDF. Reprint & Copyright © by Association of Military Surgeons of U.S., 1999
doi: 10.1093/milmed/164.12.xiipmid: N/A
This content is only available as a PDF. Reprint & Copyright © by Association of Military Surgeons of U.S., 1999
USA, Alec S. Hail, VC;MS, Cynthia A. Rossi,;PhD, George V. Ludwig,;PhD, Bruce E. Ivins,;MS, Ralph F. Tammariello,;USA, LTC Erik A. Henchal, MS
doi: 10.1093/milmed/164.12.833pmid: N/A
Abstract Bacillus anthracis, a spore-forming bacterium, is the etiologic agent of anthrax. B. anthracis spores can be aerosolized, are relatively easy to produce, and are capable of producing high mortality when inhaled. The prompt use of postexposure antibiotics combined with vaccination greatly increases the survival rate. Rapid detection of exposure is critical to effective case management. Using common collection swabs, culture medium, and culturing equipment, we compared six different noninvasive sampling sites to determine which might best be used to rapidly detect the presence of B. anthracis spores on rhesus monkeys after aerosolization. The results indicate that the greatest number of spores were deposited in the nares, on the face, and on the haired portions of the head, suggesting that these locations are the most effective sampling sites when attempting to detect B. anthracis aerosol exposure. Reprint & Copyright © by Association of Military Surgeons of U.S., 1999
USA, Philip Lewis, MC;USA, David Gaule, MS
doi: 10.1093/milmed/164.12.838pmid: N/A
Abstract Patients who exhibit drug-seeking behavior are a chronic problem in most health care delivery settings. In June 1996, Tripler Army Medical Center, a tertiary care hospital serving approximately 300,000 beneficiaries, implemented a sole provider program to identify and help such patients. A multidisciplinary sole provider team assigns a sole provider to identified drug seekers. Twice a year, the team scans a printout of all prescriptions for controlled substances to identify suspicious drug usage patterns. The team also accepts referrals from health care providers. This article describes the program and reports on results, problems encountered, and steps taken to improve its efficacy. Reprint & Copyright © by Association of Military Surgeons of U.S., 1999
MC, Dennis Drehner, USAF;BSC, Katerina M. Neuhauser, USAF;MC, Thomas S. Neuhauser, USAF;MC, Dennis Drehner, USAF;MC, George V. Blackwood, USAF
doi: 10.1093/milmed/164.12.841pmid: N/A
Abstract Background: Basic military training in the U.S. Air Force exposes recruits to multiple environmental and psychological stressors. Deaths often prompt examination of the training process. Methods: This retrospective case study evaluates recruit deaths at Lackland Air Force Base between 1956 and 1996 in terms of demographic, clinical, and environmental variables. Results: Eighty-five deaths occurred, with 81% being natural, 13% suicide, 4% accidental, and 2% not classified. Ninety-four percent of recruits who died were male, and 60% were 17 to 19 years of age. The average death rate was 2.8/ 100,000 recruits. Seven recruits were sickle cell trait (SCT)-positive. The relative risk for nontraumatic deaths between expected SCT-positive and non-SCT-positive populations was 23.53 (confidence interval, 19.55–30.01). Thirty-five percent (30 recruits) died from cardiac causes, resulting in a death rate of 1.0/100,000 trainees. Thirty-three percent (28 recruits) died primarily from infections. Six deaths were due to heat stroke, 11 to suicide, and 3 to accidents. Conclusion: As a result of improvements in immunizations, changes in hydration and exercise policies, limited access to vehicles, close supervision, the “buddy system,” and the institution of the Navy-Air Force Medical Evaluation Test, only a few deaths occurred in any given year. Reprint & Copyright © by Association of Military Surgeons of U.S., 1999
USA, John J. Ciesla, MSC;USA, Kenneth J. Tannen, MSC;USA, John J. Ciesla, MSC;USA, Mustapha Debboun, MSC
doi: 10.1093/milmed/164.12.848pmid: N/A
Abstract Preventive medicine (PVNTMED) support to deployed forces is as varied as the circumstances for force deployment. The Bosnia-Herzegovina deployment of the 1st Armored Division as part of the Dayton Peace Accords Implementation Forces proved to be no exception to this premise. PVNTMED units, both in the field and at the U.S. Army-Europe support base, were challenged to provide mission support under significant mobility restrictions and in arenas of public health practice not previously thought to be of tactical significance, specifically environmental pollution. New to this operation was the deployment of a Theater Army Medical Laboratory with a mission to assist deployed PVNTMED units with the capability to rapidly diagnose infectious disease agents and provide an expanded array of environmental monitoring support. Vector-borne diseases were also a threat to health, and an innovative base camp sanitation assessment and reporting system was created to alert leaders to the risk of disease transmission to soldiers. Reprint & Copyright © by Association of Military Surgeons of U.S., 1999
doi: 10.1093/milmed/164.12.857pmid: N/A
Abstract The evolution of the Military Health System (MHS) from a traditional model to a system of managed care precipitated a fundamental shift in the design and delivery of health care. This paper will propose the elements of a health system that delivers health promotion and preventive medicine as a focal point, describe the transition of the MHS to a prevention model, and discuss the work that needs to be done to achieve an accountable, comprehensive prevention-oriented system. The MHS has the opportunity to emerge as a model health care delivery system. Reprint & Copyright © by Association of Military Surgeons of U.S., 1999
NC, Diep Duong, USAF;ARNP, Alice Szymanski Bohannon, PhD;NC, M. Candice Ross, USAFR
doi: 10.1093/milmed/164.12.863pmid: N/A
Abstract The clinical nurse researcher (CNR) is emerging as an integral part of every major medical center. The CNR has six basic roles: facilitate the conduct of research projects; stimulate staff to conduct research; upgrade the research skills of the staff; participate on committees related to research; conduct and disseminate research; and obtain funding for research studies. Readiness issues for military missions, health promotion, and disease management and prevention are consistently of interest. The CNR should be an active participant on the institutional review board and should conduct primary studies that further the reputation of the facility. The viability of any military research program today is contingent on procurement of funding; therefore, the CNR must refine skills in grantsmanship. The demands of the medical facility and the needs of the staff must be a prime consideration in the development of the role of the CNR. Reprint & Copyright © by Association of Military Surgeons of U.S., 1999
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