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Unbound Medicine.
(Civilian Health and Medical Program of the Uniformed Services)
187 results
  • A Primer on the Military Health System's Approach to Medical Research and Development. [Journal Article]
    Acad Med. 2020 Feb 11 [Online ahead of print]Rasmussen TE, Kellermann AL, Rauch T
  • The Military Health System (MHS) has a medical research program aimed at a wide range of health-, disease-, and injury-related topic areas that works with civilian academic institutions and the biomedical industry to accomplish its goals. There are many opportunities for civilian academic institutions and the biomedical industry to engage with this program, but its unique features are important t…
  • Biomedical Response to Neisseria gonorrhoeae and Other Sexually Transmitted Infections in the US Military. [Journal Article]
    Mil Med. 2019 11 01; 184(Suppl 2):51-58.Garges E, Early J, … Jerse A
  • CONCLUSIONS: Continued monitoring of circulating resistance patterns on a global scale is critical for ensuring appropriate treatments are prescribed for service members that may be infected in the U.S. or while deployed. Domestic surveillance for gonococcal AMR within the Military Health System has indicated that resistance patterns, while variable, are not dramatically different from what is seen in U.S. civilian data. Global patterns of gonococcal AMR have been described through the establishment of a central DoD gonococcal reference laboratory and repository. This repository of global isolates provides a platform for further research and development into biomedical countermeasures against gonococcal infections.
  • Does Universal Insurance and Access to Care Influence Disparities in Outcomes for Pediatric Patients with Osteomyelitis? [Journal Article]
    Clin Orthop Relat Res. 2019 Oct 15 [Online ahead of print]Young JD, Dee EC, … Schoenfeld AJ
  • CONCLUSIONS: We found that for pediatric patients with osteomyelitis in the universally insured TRICARE system, many of the historically reported disparities in care were absent, suggesting these patients benefitted from improved access to healthcare. However, despite universal coverage, racial disparities persisted in the civilian care environment, suggesting that no single intervention such as universal insurance sufficiently addresses differences in racial disparities in care. Future studies can address the pervasiveness of these disparities in other patient populations and the various mechanisms through which they exert their effects, as well as potential interventions to mitigate these disparities.
  • Uniformed Medical Students and Residents in Emergency Medicine. [Journal Article]
    J Emerg Med. 2019 Nov 09 [Online ahead of print]Macian D, Schofer JM, … Kazzi A
  • "Uniformed medical students and residents" refers to medical school enrollees and physicians in training who are obligated to serve in the military after graduation or training completion. This is in exchange for 2 forms of financial support that are provided by the military for individuals interested in pursuing a career in medicine. These programs are offered namely through the Uniformed Servic…
  • Attrition Rate in Military General Surgery GME and Effect on Quality of Military Programs. [Journal Article]
    J Surg Educ. 2019 Nov - Dec; 76(6):e49-e55.Rolland G, Ahnfeldt EP, … Ritter EM
  • CONCLUSIONS: Previous used methodology over estimates the attrition rate in MGS GME. The lower rate in MGS programs results in a high level of graduate performance as measured by ABS pass rates. Interruption in training and especially marital status and age ≥ 35 appear to be potential predictors of attrition. Components of MGS GME training and selection processes might inform efforts to reduce attrition and improve performance in civilian surgical GME.
  • Contribution Of Care Source To Cancer Treatment Cost Variation In The US Military Health System. [Journal Article]
    Health Aff (Millwood). 2019 08; 38(8):1335-1342.Eaglehouse YL, Aljehani M, … Zhu K
  • The US Military Health System (MHS) provides universal access to health care for more than nine million eligible beneficiaries through direct care in military treatment facilities or purchased care in civilian facilities. Using information from linked cancer registry and administrative databases, we examined how care source contributed to cancer treatment cost variation in the MHS for patients ag…
  • Assessing Low-Value Health Care Services In The Military Health System. [Journal Article]
    Health Aff (Millwood). 2019 08; 38(8):1351-1357.Koehlmoos TP, Madsen CK, … Weissman JS
  • Low-value care is the provision of procedures and treatments that provide little or no benefit to patients while increasing the cost of health care. This study examined the provision of low-value care in the Military Heath System (MHS), comparing care delivered in civilian health care facilities (purchased care) to care delivered in Department of Defense-controlled health care facilities (direct …
  • The impact of the reserve military neurosurgeon: practice, community, and service. [Journal Article]
    Neurosurg Focus. 2018 12 01; 45(6):E14.Menger R, Mundell BF, … in conjunction with Council of State Neurosurgical Societies and AANS/CNS Joint Committee of Military Neurosurgeons
  • CONCLUSIONS: Reserve neurosurgeons are satisfied with their military service while making substantial contributions to the military's neurosurgical capabilities, with the overwhelming majority of current military reservists having been deployed or mobilized during their reserve commitments. Through the authors' modeling, the impact of deployment on the military neurosurgeon, neurosurgeon's practice, and the local community can be significantly mitigated by a larger practice environment.
  • A Review of Scrub Typhus (Orientia tsutsugamushi and Related Organisms): Then, Now, and Tomorrow. [Review]
    Trop Med Infect Dis. 2018 Jan 17; 3(1)Luce-Fedrow A, Lehman ML, … Richards AL
  • Scrub typhus and the rickettsial diseases represent some of the oldest recognized vector-transmitted diseases, fraught with a rich historical aspect, particularly as applied to military/wartime situations. The vectors of Orientia tsutsugamushi were once thought to be confined to an area designated as the Tsutsugamushi Triangle. However, recent reports of scrub typhus caused by Orientia species ot…
  • I Serve 2: Identifying and caring for military-connected children in civilian primary care settings. [Journal Article]
    J Am Assoc Nurse Pract. 2018 Nov; 30(11):614-618.Rossiter AG, Patrician PA, … Wilmoth MC
  • Military children make tremendous sacrifices in support of a parent(s) military service. More than two million children have a parent who is serving or has served in the Armed Forces. Research shows that military-connected children are at higher risk of physical, psychological, and behavioral health issues. While "resilient" is the word used to describe most military children, it is important to …
  • Acute and long-term consequences of exposure to organophosphate nerve agents in humans. [Review]
    Epilepsia. 2018 10; 59 Suppl 2:92-99.Figueiredo TH, Apland JP, … Marini AM
  • Nerve agents are organophosphate (OP) compounds and among the most powerful poisons known to man. A terrorist attack on civilian or military populations causing mass casualties is a real threat. The OP nerve agents include soman, sarin, cyclosarin, tabun, and VX. The major mechanism of acute toxicity is the irreversible inhibition of acetylcholinesterase. Acetylcholinesterase inhibition results i…
  • Factors Influencing Selection of Infectious Diseases Training for Military Internal Medicine Residents. [Journal Article]
    Clin Infect Dis. 2018 10 30; 67(10):1582-1587.Barsoumian AE, Hartzell JD, … Yun HC
  • CONCLUSIONS: Despite differences in the context of training and practice among military trainees compared with civilian colleagues, residents cited similar factors affecting career choice. Interest in global health was higher in this cohort. Salary continues to be identified as a deterrent to choosing ID. Differences between military and civilian residents' desire to pursue ID fellowship are likely explained by additional unmeasured factors deserving further study.
  • Gender Disparities Within US Army Orthopedic Surgery: A Preliminary Report. [Journal Article]
    Mil Med. 2018 01 01; 183(1-2):e162-e166.Daniels CM, Dworak TC, … Gwinn DE
  • CONCLUSIONS: There exists a gender disparity among US Army orthopedic surgeons, similar to that seen in civilian orthopedics. Gender equity is also lacking among medical students who feed into Army graduate medical education programs. The gender profile of our patient population is not reflected by that of providers. Because patients prefer providers of the same gender, this is a limitation to patient satisfaction and access to care for musculoskeletal injuries. Further study is underway to identify perceptions and potential causes of these disparities, including the critical perspective of our patients. In addition to the inherent benefits offered by diversity (e.g., expanding the talent pool and more perspectives for decision-making), ultimately it affords a greater ability to maintain a fit and ready force.
  • A pilot registry of trauma surgeons willing and ready to respond to disasters. [Journal Article]
    J Trauma Acute Care Surg. 2018 02; 84(2):393-396.Grabo D, Strumwasser A, … Briggs S
  • CONCLUSIONS: This initiative complements efforts to organize a registry of trauma surgeons who are qualified and willing to respond in all aspects of disaster response. While trauma surgeons are optimally positioned to provide a wide range of surgical expertise in a disaster, this study further demonstrated the lack of a universally accepted disaster training program for surgeons willing to respond to mass casualty incidents. Standardized disaster response training for surgeons remains a challenge for the future.
  • Being Prepared for the Next Conflict: A Case Analysis of a Military Level I Trauma Center. [Journal Article]
    Mil Med. 2017 05; 182(5):e1681-e1687.Roberts H, Osborn P, … Stinner DJ
  • As we transition to an interwar period, combat-related injuries are at their lowest levels in over a decade, yet we must continue to maintain our surgical skills and train new surgeons. During the recent wars, the importance of the treatment and care for amputations and complex extremity injuries became apparent. This study compares the number of these procedures performed during the treatment of…
  • Battlefield Trauma-Induced Hypothermia: Transitioning the Preferred Method of Casualty Rewarming. [Review]
    Wilderness Environ Med. 2017 Jun; 28(2S):S82-S89.Bennett BL, Holcomb JB
  • For centuries, cold and wet weather has affected military combat operations leading to tremendous loss of manpower caused by cold-weather-related injuries including trench foot, frostbite, and hypothermia. The initial battlefield management of hypothermia in military personnel had not advanced significantly following many wars and conflicts until 2006. The aim of this review is to: 1) provide an …
  • Bleeding Control Using Hemostatic Dressings: Lessons Learned. [Review]
    Wilderness Environ Med. 2017 Jun; 28(2S):S39-S49.Bennett BL
  • Based on lessons learned, many military battlefield trauma advances ultimately transition to enhance civilian trauma care. However, even with major strides to enhance battlefield hemorrhage control, it is unclear how effectively these techniques and products are being translated to civilian trauma. The purpose of this brief review is to present the evidence of current hemostatic product effective…
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