Abstract:
:The challenges of managing military medicine over the last three decades have been complicated by rapidly changing priorities and redirections. Inspired by Kuhn's theory of "paradigm shifts," we can identify five distinct paradigms and four paradigm shifts that have dominated military medicine over the last 25 years. These shifts began in the early 1970s when military medicine was forced to make a transition from a focus on combat casualty care to the problems of becoming an all-volunteer force. These paradigm shifts continue in the form of the current challenges of simultaneously embracing new cost-conscious forms of health care delivery while downsizing the force. Each of the shifts has been characterized by a lack of anticipation and the onset of crisis. The present challenges faced by military medical leadership are not necessarily unprecedented; prescience in regard to inevitable future shifts could reduce turmoil and enhance adaptation.
journal_name
Mil Medjournal_title
Military medicineauthors
Brown FWsubject
Has Abstractpub_date
1994-09-01 00:00:00pages
622-6issue
9eissn
0026-4075issn
1930-613Xjournal_volume
159pub_type
杂志文章abstract::A retrospective study was performed to evaluate breast imaging in the Wilford Hall Medical Center, the largest medical facility in the U.S. Air Force, from the time period of October 1997 to October 2000, in comparison with its civilian counterparts. The results demonstrate that although Wilford Hall Medical Center br...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/milmed.169.5.361
更新日期:2004-05-01 00:00:00
abstract::A 22-year-old active duty E1 Nepalese male who recently emigrated from Nepal suddenly exhibited strange behaviors and mutism during Advanced Individual Training. After receiving care from a hospital near his unit, he was transferred to Walter Reed Army Medical Center Inpatient Psychiatry for further evaluation and tre...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/milmed.172.11.1213
更新日期:2007-11-01 00:00:00
abstract:OBJECTIVE:Problematic anger is a significant clinical issue in military personnel, and is further complicated by comorbid post-traumatic stress disorder (PTSD). Despite increasing numbers of military personnel returning from deployment with anger and aggression difficulties, the treatment of problematic anger has recei...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usx115
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:In 2014, the U.S. Public Health Service (USPHS) Commissioned Corps deployed to Monrovia, Liberia, to operate a 25-bed Ebola treatment unit (ETU) constructed by the U.S. Military. The ETU was named the Monrovia Medical Unit (MMU) and was constructed from an U.S. Air Force Expeditionary Medical Support (EMEDS)...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-17-00010
更新日期:2017-09-01 00:00:00
abstract::Military personnel deployed to Iraq and Afghanistan often develop mental health difficulties, which may manifest as problematic driving behavior. Veterans may be more likely to engage in risky driving and to subsequently be involved in motor vehicle accidents and fatalities. This article reviews literature on driving ...
journal_title:Military medicine
pub_type: 杂志文章,评审
doi:10.7205/MILMED-D-13-00327
更新日期:2014-06-01 00:00:00
abstract::The impact of a pharmacy officer on patient compliance and blood pressure control on a deployed nuclear-powered aircraft carrier for a 2-week at-sea period was evaluated. Before any counseling by a pharmacy officer, 43 crewmembers on chronic medications anonymously completed a compliance questionnaire. The pharmacy of...
journal_title:Military medicine
pub_type: 临床试验,杂志文章
doi:
更新日期:2000-02-01 00:00:00
abstract::Fixed wing aircraft are the primary means of deployment for designated U.S. contingency forces. The majority of logistical constraints medical units encounter during deployment (in support of contingency forces) are a direct result of limited airframes dedicated to their movement into an area of operations. The compet...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1991-05-01 00:00:00
abstract:OBJECTIVES:We aimed to describe differences in combat experience for male and female veterans and characterize differential effects on postdeployment physical and mental health symptoms, including aggression. METHODS:Retrospective cross-sectional health screening data from 554 Operation Enduring Freedom and Operation ...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-14-00255
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVES:Military personnel risk injury due to accidents, disasters, and military threats during Phase Zero "shaping" operations. Medical facilities must be poised to respond. METHODS:The U.S. Pacific Command (PACOM) Area of Responsibility (AOR) covers more than 50% of the earth's surface; relevant Clinical Practice...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-16-00167
更新日期:2017-03-01 00:00:00
abstract::Among Army aviators, the incidence of total hip arthroplasty (THA) is unknown. This study analyzes the incidence and aeromedical disposition of THA among Army aviators. The U.S. Army Epidemiology Data Register was queried for a 10-year period from calendar year 1987 to 1996. The aviators selected for this study cohort...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:2001-02-01 00:00:00
abstract::Military free fall or HALO (high altitude-low opening) is a distinct form of tactical parachuting used by the elite forces of the U.S. military. This study was undertaken to examine the type, location, and mechanism of injuries sustained by the military HALO parachutist during training. A retrospective study identifie...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1999-07-01 00:00:00
abstract:OBJECTIVE:To compare the influence of various statistical analysis approaches while assessing the marginal effect of polypharmacy (prescription of multiple psychotropics including a first-line antidepressant) on all-cause hospital admission among veterans diagnosed with post-traumatic stress disorder. METHODS:Data wer...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-15-00327
更新日期:2016-10-01 00:00:00
abstract::In the easily surveyable and rather homogeneous military population of the Norwegian Armed Forces, a group of 112 male suicide-attempting conscripts was studied retrospectively. Compared to a normal conscript population, suicide attempters more often had troublesome backgrounds, had experienced psychiatric problems an...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1990-12-01 00:00:00
abstract::The purpose of this study was to evaluate the effects of the M17 and M43 protective masks on stereoacuity. Twelve subjects were tested on the Keystone diagnostic series stereopsis test at nearpoint and the Howard-Dolman apparatus at 40 cm and 6 m. Stereopsis was evaluated without a mask and with the M43 and M17 masks....
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1994-12-01 00:00:00
abstract::The Israel Defense Forces (IDF) Medical Corps provides medical services-routine and emergency--to all IDF personnel (conscripts, career personnel, and reservists). Despite the fact that there are no differences in prevalence of disease in the IDF compared with the civil sector, health consumer appraisal, in the milita...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/milmed.169.4.282
更新日期:2004-04-01 00:00:00
abstract:INTRODUCTION:Chronic insomnia is a common and debilitating disease that increases risk for significant morbidity and workplace difficulties. Cognitive behavioral therapy for insomnia (CBT-I) is the first-line treatment, but there is a critical lack of behavioral health providers trained in CBT-I because, in part, of a ...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usaa359
更新日期:2021-01-25 00:00:00
abstract::Over 20 yr have elapsed since the end of the First Gulf War, yet approximately one-third of the veterans exhibit Gulf War Illness (GWI) symptoms, particularly depression and memory impairments. Exposure to organophosphate (OP) compounds is implicated for GWI development. The role of calcium (Ca2+) signaling in learnin...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usx148
更新日期:2018-03-01 00:00:00
abstract::The Department of Defense Familial Breast/Ovarian Cancer Research Project has offered genetic counseling and testing for BRCA1 and BRCA2 on a research basis to patients meeting specific diagnostic criteria, with risk for BRCA1 and BRCA2 mutations calculated based on the Couch model. In 2.5 years, 250 patients were eva...
journal_title:Military medicine
pub_type: 杂志文章,多中心研究
doi:
更新日期:2002-02-01 00:00:00
abstract::This article provides a synopsis of the limited investigations examining the impact of external load (EL) on performance of high-intensity tasks under load (HITL), EL training intervention effects on HITL performance, and injuries from EL training. Repetitive lifting tasks and initiation of locomotion, such as rapidly...
journal_title:Military medicine
pub_type: 杂志文章,评审
doi:10.7205/MILMED-D-14-00079
更新日期:2014-09-01 00:00:00
abstract::A case series of 417 consecutive ward admissions onboard the USS Forrestal (CV59) is presented. During the 1-year study period, the inpatient ward was open for 260 days while the ship was underway, including workups and extended Mediterranean deployment. The case series displays the variety of clinical inpatient care ...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1995-06-01 00:00:00
abstract::We report on a 22-year-old infantryman who sustained a right frontal wound to his head. He was treated and returned to duty immediately. During a computed tomography scan, 38 years after the incident, a metallic foreign body and disruption of the brain consistent with a projectile track were discovered in his brain. I...
journal_title:Military medicine
pub_type: 杂志文章,评审
doi:10.7205/milmed-d-10-00323
更新日期:2011-02-01 00:00:00
abstract:INTRODUCTION:Department of Defense (DoD) has identified problem-solving training (PST) as a promising prevention/early intervention for mental health disorders. PST is a four-session group intervention that emphasizes building problem-solving and coping skills to mitigate emotional dysregulation and the adverse effects...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usy229
更新日期:2019-05-01 00:00:00
abstract::In this article, the authors discuss some of the hard realities of chemical and biological warfare defense in terms of the medical and medical logistics implications. In the opinion of the authors, there are no adequate defensive measures at present which would protect troops and sailors from the effects of either che...
journal_title:Military medicine
pub_type: 杂志文章,评审
doi:
更新日期:1991-07-01 00:00:00
abstract::The regulatory aspects of generic drug substitution and the scientific concepts that serve as the basis for generic drug approval are discussed, with emphasis on the source of therapeutic equivalence information compiled by the Food and Drug Administration in Approved Drug Products with Therapeutic Equivalence Evaluat...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1998-04-01 00:00:00
abstract:INTRODUCTION:Firearm-related injuries account for 20% of all injury-related deaths and are responsible for 105,000 injuries annually. The occurrence of bullet emboli to the heart is exceedingly rare. Given the rarity of emboli, controversy exists over management. The primary endpoint of this study is to establish a man...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usx191
更新日期:2018-09-01 00:00:00
abstract:UNLABELLED:Complementary and alternative medicine (CAM) is a growing component of medicine within the U.S. civilian and military populations. Tripler Army Medical Center (TAMC) Family Medicine Clinic represents an overseas medical facility stationed among a diverse ethnic population. The impact that local cultures have...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/milmed-d-09-00077
更新日期:2010-07-01 00:00:00
abstract::To maintain operational readiness, military personnel engage in vigorous physical and training activities that carry risk for injury. A 1-year prospective cohort study, starting April 1996, was conducted at Fort Bragg, North Carolina among 1,965 members of the 82nd Airborne Division to quantify musculoskeletal injurie...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:2002-12-01 00:00:00
abstract:INTRODUCTION:The development of methods that generate individualized assessments of the procoagulant potential of burn patients could improve their treatment. Beyond its role as an essential intermediate in the formation of thrombin, factor (F)Xa has systemic effects as an agonist to inflammatory processes. In this stu...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usy397
更新日期:2019-03-01 00:00:00
abstract::The difficulty and importance of developing and implementing a definition of quality in health care is discussed. Some current definitions are considered, and a recommended definition of quality health care is presented. ...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1992-05-01 00:00:00
abstract:INTRODUCTION:Hypersensitivity reactions to natural rubber latex are well-characterized occupational concerns for health care personnel. Health care providers are at increased risk for exposure and possibly transmission of vaccine preventable diseases. Therefore, many health care facilities require providers to be vacci...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usz376
更新日期:2020-03-02 00:00:00