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[PMID]:28554194
[Au] Autor:McLellan AT
[Ad] Endereço:From Treatment Research Institute, Philadelphia, Pennsylvania.
[Ti] Título:New Department of Veterans Affairs and Department of Defense Guidelines on Pain Management With Opioids: Comment and Concern.
[So] Source:Ann Intern Med;167(1):50-51, 2017 07 04.
[Is] ISSN:1539-3704
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Analgésicos Opioides/uso terapêutico
Dor Crônica/tratamento farmacológico
Manejo da Dor
Guias de Prática Clínica como Assunto
United States Department of Defense
United States Department of Veterans Affairs
[Mh] Termos MeSH secundário: Analgésicos Opioides/efeitos adversos
Seres Humanos
Transtornos Relacionados ao Uso de Opioides/epidemiologia
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170726
[Lr] Data última revisão:
170726
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170530
[St] Status:MEDLINE
[do] DOI:10.7326/M17-0814


  2 / 256 MEDLINE  
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[PMID]:28388218
[Au] Autor:Roos J; Chue C; DiEuliis D; Emanuel P
[Ti] Título:The Department of Defense Chemical and Biological Defense Program: An Enabler of the Third Offset Strategy.
[So] Source:Health Secur;15(2):207-214, 2017 Mar/Apr.
[Is] ISSN:2326-5108
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The US Department of Defense (DOD) established programs to defend against chemical and biological weapons 100 years ago because military leaders understood that the operational capability of the US military is diminished when service member health is compromised. These threats to operational readiness can be from an overt attack using chemical and biological threats but may also arise from natural exposures. In the current era of rapidly emerging technologies, adversaries are not only rediscovering chemical and biological weapons; they are also displaying an increased propensity to employ them to cause strategic instability among deployed forces or nations undergoing conflict. The United States's investments in its Chemical and Biological Defense Program (CBDP) can be a critical enabler of the third offset strategy, which is a DOD initiative that seeks to maximize force capability to offset emerging threats. To realize this vision, the CBDP must make fundamental changes in acquiring and employing effective technologies so that enemy use of chemical and biological agents against US assets is no longer a viable option. Maximization of US force health status will provide a strategic advantage over theater opponents more vulnerable to operational degradation from chemical and biological threats.
[Mh] Termos MeSH primário: Armas Biológicas
Defesa Civil/métodos
Planejamento Estratégico
United States Department of Defense
[Mh] Termos MeSH secundário: Seres Humanos
Invenções/utilização
Ciência Militar/métodos
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biological Warfare Agents)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170408
[St] Status:MEDLINE
[do] DOI:10.1089/hs.2017.0008


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[PMID]:28376996
[Au] Autor:VanVactor JD
[Ti] Título:Healthcare logistics in disaster planning and emergency management: A perspective.
[So] Source:J Bus Contin Emer Plan;10(2):157-176, 2017 Dec 01.
[Is] ISSN:1749-9216
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:This paper discusses the role of healthcare supply chain management in disaster mitigation and management. While there is an abundance of literature examining emergency management and disaster preparedness efforts across an array of industries, little information has been directed specifically toward the emergency interface, interoperability and unconventional relationships among civilian institutions and the US Department of Defense (US DoD) or supply chain operations involved therein. To address this imbalance, this paper provides US DoD healthcare supply chain managers with concepts related to communicating and planning more effectively. It is worth remembering, however, that all disasters are local - under the auspice of tiered response involving federal agencies, the principal responsibility for responding to domestic disasters and emergencies rests with the lowest level of government equipped and able to deal with the incident effectively. As such, the findings are equally applicable to institutions outside the military. It also bears repeating that every crisis is unique: there is no such thing as a uniform response for every incident. The role of the US DoD in emergency preparedness and disaster planning is changing and will continue to do so as the need for roles in support of a larger effort also continues to change.
[Mh] Termos MeSH primário: Planejamento em Desastres/organização & administração
Emergências
Gestão de Riscos/organização & administração
United States Department of Defense
[Mh] Termos MeSH secundário: Comportamento Cooperativo
Eficiência Organizacional
Órgãos Governamentais
Regulamentação Governamental
Seres Humanos
Inovação Organizacional
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170615
[Lr] Data última revisão:
170615
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170406
[St] Status:MEDLINE


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[PMID]:28329509
[Au] Autor:Rosenbaum BE; Campion CH; Cohen JM; Latkowski JA
[Ad] Endereço:Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York. Rosenbaum@med.nyu.edu.
[Ti] Título:The Department of Defense: pioneers of early teledermatology.
[So] Source:Dermatol Online J;23(2), 2017 Feb 15.
[Is] ISSN:1087-2108
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The United States (US) Department of Defense(DoD) has been a leader in using telecommunicationstechnology to provide remote medical care. The DoDhas been using telemedicine for more than twentyyears to provide medical services to military personneldeployed throughout the world, and has largelyinfluenced the development of teledermatology. Theexperiences of early military teledermatology serviceshave yielded valuable lessons that have been essentialto the creation of successful civilian programs.
[Mh] Termos MeSH primário: Dermatologia/história
Medicina Militar/história
Telemedicina/história
[Mh] Termos MeSH secundário: História do Século XX
História do Século XXI
Seres Humanos
Estados Unidos
United States Department of Defense
United States Department of Veterans Affairs
[Pt] Tipo de publicação:HISTORICAL ARTICLE; LETTER
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170323
[St] Status:MEDLINE


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[PMID]:28187513
[Au] Autor:Fiore LD; Rodriguez H; Shriver CD
[Ad] Endereço:Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), Veterans Affairs Boston Healthcare System, Department of Veterans Affairs Office of Research and Development-Cooperative Studies Program, Washington, DC, USA.
[Ti] Título:Collaboration to Accelerate Proteogenomics Cancer Care: The Department of Veterans Affairs, Department of Defense, and the National Cancer Institute's Applied Proteogenomics OrganizationaL Learning and Outcomes (APOLLO) Network.
[So] Source:Clin Pharmacol Ther;101(5):619-621, 2017 May.
[Is] ISSN:1532-6535
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:A tri-federal initiative arising out of the Cancer Moonshot has resulted in the formation of a program to utilize advanced genomic and proteomic expression platforms on high-quality human biospecimens in near-real-time in order to identify potentially actionable therapeutic molecular targets, study the relationship of molecular findings to cancer treatment outcomes, and accelerate novel clinical trials with biomarkers of prognostic and predictive value.
[Mh] Termos MeSH primário: Oncologia
National Cancer Institute (U.S.)
Proteogenômica
United States Department of Defense
United States Department of Veterans Affairs
[Mh] Termos MeSH secundário: Sistemas de Liberação de Medicamentos
Seres Humanos
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170425
[Lr] Data última revisão:
170425
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170211
[St] Status:MEDLINE
[do] DOI:10.1002/cpt.658


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[PMID]:28074438
[Au] Autor:Schoenfeld AJ; Makanji H; Jiang W; Koehlmoos T; Bono CM; Haider AH
[Ad] Endereço:Center for Surgery and Public Health, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA. ajschoen@neomed.edu.
[Ti] Título:Is There Variation in Procedural Utilization for Lumbar Spine Disorders Between a Fee-for-Service and Salaried Healthcare System?
[So] Source:Clin Orthop Relat Res;475(12):2838-2844, 2017 Dec.
[Is] ISSN:1528-1132
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Whether compensation for professional services drives the use of those services is an important question that has not been answered in a robust manner. Specifically, there is a growing concern that spine care practitioners may preferentially choose more costly or invasive procedures in a fee-for-service system, irrespective of the underlying lumbar disorder being treated. QUESTIONS/PURPOSES: (1) Were proportions of interbody fusions higher in the fee-for-service setting as opposed to the salaried Department of Defense setting? (2) Were the odds of interbody fusion increased in a fee-for-service setting after controlling for indications for surgery? METHODS: Patients surgically treated for lumbar disc herniation, spinal stenosis, and spondylolisthesis (2006-2014) were identified. Patients were divided into two groups based on whether the surgery was performed in the fee-for-service setting (beneficiaries receive care at a civilian facility with expenses covered by TRICARE insurance) or at a Department of Defense facility (direct care). There were 28,344 patients in the entire study, 21,290 treated in fee-for-service and 7054 treated in Department of Defense facilities. Differences in the rates of fusion-based procedures, discectomy, and decompression between both healthcare settings were assessed using multinomial logistic regression to adjust for differences in case-mix and surgical indication. RESULTS: TRICARE beneficiaries treated for lumbar spinal disorders in the fee-for-service setting had higher odds of receiving interbody fusions (fee-for-service: 7267 of 21,290 [34%], direct care: 1539 of 7054 [22%], odds ratio [OR]: 1.25 [95% confidence interval 1.20-1.30], p < 0.001). Purchased care patients were more likely to receive interbody fusions for a diagnosis of disc herniation (adjusted OR 2.61 [2.36-2.89], p < 0.001) and for spinal stenosis (adjusted OR 1.39 [1.15-1.69], p < 0.001); however, there was no difference for patients with spondylolisthesis (adjusted OR 0.99 [0.84-1.16], p = 0.86). CONCLUSIONS: The preferential use of interbody fusion procedures was higher in the fee-for-service setting irrespective of the underlying diagnosis. These results speak to the existence of provider inducement within the field of spine surgery. This reality portends poor performance for surgical practices and hospitals in Accountable Care Organizations and bundled payment programs in which provider inducement is allowed to persist. LEVEL OF EVIDENCE: Level III, economic and decision analysis.
[Mh] Termos MeSH primário: Planos de Pagamento por Serviço Prestado/economia
Custos de Cuidados de Saúde
Recursos em Saúde/economia
Seguro Saúde/economia
Vértebras Lombares/cirurgia
Padrões de Prática Médica/economia
Avaliação de Processos (Cuidados de Saúde)/economia
Salários e Benefícios
Doenças da Coluna Vertebral/economia
Doenças da Coluna Vertebral/cirurgia
Fusão Vertebral/economia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Feminino
Gastos em Saúde
Recursos em Saúde/utilização
Seres Humanos
Modelos Logísticos
Masculino
Meia-Idade
Modelos Econômicos
Análise Multivariada
Razão de Chances
Estudos Retrospectivos
Doenças da Coluna Vertebral/diagnóstico
Fusão Vertebral/utilização
Resultado do Tratamento
Estados Unidos
United States Department of Defense/economia
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171117
[Lr] Data última revisão:
171117
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170112
[St] Status:MEDLINE
[do] DOI:10.1007/s11999-017-5229-5


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[PMID]:28055222
[Au] Autor:Shoubaki LA
[Ti] Título:Surveillance snapshot: Findings from the Department of Defense Global, Laboratory-based, Influenza Surveillance Program, 2015-2016 influenza season.
[So] Source:MSMR;23(12):12, 2016 Dec.
[Is] ISSN:2152-8217
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Influenza Humana/epidemiologia
Militares/estatística & dados numéricos
[Mh] Termos MeSH secundário: Seres Humanos
Influenza Humana/virologia
Vigilância da População
Estados Unidos/epidemiologia
United States Department of Defense
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170613
[Lr] Data última revisão:
170613
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170106
[St] Status:MEDLINE


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[PMID]:28055221
[Au] Autor:Poss DE; Writer JV; Harris S
[Ti] Título:Zika virus infections in Military Health System beneficiaries since the introduction of the virus in the Western Hemisphere, 1 January 2016 through 30 November 2016.
[So] Source:MSMR;23(12):7-11, 2016 Dec.
[Is] ISSN:2152-8217
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The introduction and rapid spread of Zika virus (ZIKV) across the Western Hemisphere have posed a risk of infection to Military Health System (MHS) beneficiaries. The associated consequences of infection and the dynamics of transmission may place a unique burden on military personnel, their dependents, and the MHS. This article summarizes the impact of ZIKV transmission on MHS beneficiaries between 1 January and 30 November 2016. Cases were identified from a variety of sources, including direct reporting from the services, extraction of laboratory data, and data from the Defense Medical Surveillance System (DMSS) Reportable Medical Events database. There have been 156 confirmed cases of Zika in MHS beneficiaries, including five Zika cases in pregnant beneficiaries and 110 cases in service members. A majority of cases reported exposure in Puerto Rico (n=91, 58.3%). Although most ZIKV infections are asymptomatic or have a relatively mild illness, the gravity of pregnancy and neurologic issues linked to infection remains a significant impetus for the continued surveillance of ZIKV in the MHS population.
[Mh] Termos MeSH primário: Benefícios do Seguro/estatística & dados numéricos
Militares/estatística & dados numéricos
Infecção pelo Zika virus/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Criança
Pré-Escolar
Feminino
Programas Governamentais
Seres Humanos
Lactente
Recém-Nascido
Masculino
Meia-Idade
Vigilância da População
Gravidez
Porto Rico/epidemiologia
Estados Unidos/epidemiologia
United States Department of Defense
Adulto Jovem
Zika virus
Infecção pelo Zika virus/transmissão
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170613
[Lr] Data última revisão:
170613
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170106
[St] Status:MEDLINE


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[PMID]:27726318
[Au] Autor:Department of Defense
[Ti] Título:Sexual Assault Prevention and Response (SAPR) Program. Interim final rule; amendment.
[So] Source:Fed Regist;81(187):66185-9, 2016 Sep 27.
[Is] ISSN:0097-6326
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This rule amends as a final rule published on April 5, 2013 to implement Department of Defense's SAPR Program. The Department seeks to establish a culture free of sexual assault through prevention, education and training, response capability, victim support, reporting procedures, and accountability to enhance the safety and well-being of all persons covered by this regulation.
[Mh] Termos MeSH primário: Programas Governamentais/organização & administração
Militares/legislação & jurisprudência
Delitos Sexuais/prevenção & controle
United States Department of Defense/organização & administração
[Mh] Termos MeSH secundário: Seres Humanos
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1611
[Cu] Atualização por classe:170109
[Lr] Data última revisão:
170109
[Sb] Subgrupo de revista:T
[Da] Data de entrada para processamento:161012
[St] Status:MEDLINE


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[PMID]:27661797
[Au] Autor:Diehl G; Bradstreet N; Monahan F
[Ad] Endereço:Capt. Glendon Diehl, MSC, USN, PhD, is Director; Nicole Bradstreet, MPP, is Global Health Analyst; and Felicia Monahan, MPH, is Division Manager, Assessment, Monitoring, and Evaluation; all at the Center for Global Health Engagement; Uniformed Services University of the Health Sciences , Bethesda, Maryland.
[Ti] Título:The Department of Defense at the Forefront of a Global Health Emergency Response: Lessons Learned from the Ebola Outbreak.
[So] Source:Health Secur;14(5):366-74, 2016 Sep-Oct.
[Is] ISSN:2326-5108
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Tasked with analyzing the effectiveness of the Department of Defense's (DoD's) global health engagements, the Uniformed Services University of the Health Sciences (USU) used the Measures Of Effectiveness in Defense Engagement and Learning (MODEL) study to conduct a qualitative analysis of the DoD's response efforts to the Ebola pandemic in West Africa. The research aims to summarize the findings of studies that monitor and evaluate the DoD's response to the Ebola pandemic or compare the effectiveness of different DoD response activities; it further aims to identify common themes around positive and negative lessons learned and recommendations that can be applied to future DoD humanitarian assistance and disaster response efforts. The search included documents and observations from PubMed, Disaster Lit: Resource Guide for Disaster Medicine and Public Health, the Joint Lessons Learned Information System, the DoD and US Africa Command websites, and Google Scholar. The records selected from the search were analyzed to provide insights on the DoD's humanitarian assistance and disaster response engagements that could be employed to inform future operations and policy. Furthermore, the research identifies strengths and gaps in military capabilities to respond to disasters, which can be used to inform future training and education courses. Overall, the findings demonstrate the importance of monitoring, evaluating, and assessing disaster response activities and provide new evidence to support the implementation of activities, in accordance with the Global Health Security Agenda, to strengthen all-threat prevention, detection, and response capabilities worldwide.
[Mh] Termos MeSH primário: Controle de Doenças Transmissíveis/organização & administração
Surtos de Doenças/prevenção & controle
Política de Saúde
Doença pelo Vírus Ebola/prevenção & controle
Vigilância em Saúde Pública
Socorro em Desastres/organização & administração
United States Department of Defense/organização & administração
[Mh] Termos MeSH secundário: África Ocidental/epidemiologia
Controle de Doenças Transmissíveis/métodos
Planejamento em Desastres/organização & administração
Saúde Global
Doença pelo Vírus Ebola/epidemiologia
Seres Humanos
Cooperação Internacional
Vigilância em Saúde Pública/métodos
Pesquisa Qualitativa
Garantia da Qualidade dos Cuidados de Saúde
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170510
[Lr] Data última revisão:
170510
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160924
[St] Status:MEDLINE
[do] DOI:10.1089/hs.2016.0022



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