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Featured Articles

Winter 2011

Increasing Security through Public Health: A Practical Model

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Parker RD. 11(1). 4 - 8. (Journal Article)

Abstract

As political and social changes swee p the globe, there are opportunities to increase national security through innovative approaches. While traditional security methods such as defense forces and homeland security provide both pre-emptive and defensive protection, new methods could meet emerging challenges by responding to the political, financial, and social trends. One method is the integration of defense, medicine and public health. By assisting a nation by providing basic services, such as healthcare, collaborative efforts can increase stabilization in areas of unrest. Improved health outcomes leads to increased domestic security, which can create a ripple effect across a region. Assessment, uptake and sustainability by the host nation are critical for program success. The proposed methodology focuses on the use of primarily extant resources, such as programs used by Special Operations Forces and other health and defense programs. Additional components include evaluation, set objectives and mission collaborations. As the nexus between foreign affairs, security, and public heal th is in crea s ing ly valida ted thr ough research and prac tice, stand ard ized i nt erv entions should b e developed to minimize overlapping expenditures, promote security and strengthen international relations.

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Effective Monitoring and Evaluation of Military Humanitarian Medical Operations

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Waller SG, Powell C, Ward JB, Riley K. 11(1). 9 - 14. (Journal Article)

Abstract

Non-military government agencies and non-governmental organizations (NGOs) have made great strides in the evaluation of humanitarian medical work, and have learned valuable lessons regarding monitoring and evaluation (M&E) that may be equally as valuable to military medical personnel. We reviewed the recent literature by the worldwide humanitarian community regarding the art and science of M&E, with focus toward military applications. The successes and failures of past humanitarian efforts have resulted in prolific analyses. Alliances of NGOs set the standard for humanitarian quality and M&E standards. Military medical personnel can apply some of these standards to military humanitarian M&E in complex and stability operations. The authors believe that the NGO community's M&E standards should be applied to improve evaluation of U.S. military medical humanitarian operations.

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Global Medical Mission Training: The Department of Defense is Making Headway in Training for Global Medical Missions

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Pueschel M. 11(1). 15 - 20. (Journal Article)

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No Shit, There I Was: The Case for Narrative-Based Clinical Knowledge

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Froede K. 11(1). 21 - 24. (Journal Article)

Abstract

Relevant literature demonstrates the absolute necessity of Special Operations Forces (SOF) clinical narratives to the medics they teach and care they deliver, and discusses the concept of narrative pedagogy via review of extant literature and also SOF-specific clinical literature. SOF clinicians (medics, physicians' assistants, physicians, etc.) provide advanced trauma, clinical, and preventive care in the most austere of combat environments. SOF clinicians have adopted specific paradigms for schooling, teaching, learning, and practice. An overarching theme within SOF-generated clinical literature is that of hermeneutics and the narrative pedagogy; SOF clinicians generate their evidence from experience and frequently tell stories to educate their peers, colleagues, and student medics to increase the knowledge of the entire community.

Keywords: Special Forces; medics; narrative pedagogy; hermeneutics; clinical evidence

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Management of the Mangled Face by a Forward Surgical Team

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Brisson P, Woll M, Welden B. 11(1). 25 - 27. (Case Reports)

Abstract

A mangled face is an uncommon injury that can occur in a combat zone as a result of blunt trauma, penetrating trauma or explosion injury. Despite the patient's dramatic disfigurement, attention needs to focus on the basic ABC's of initial trauma management. We present an injured Afghan civilian with a severe facial injury. Our approach to airway management, breathing evaluation and hemorrhage control are described. In addition we utilized two emergency hemorrhage control modalities that are usually associated with other areas of the body, a circumferential compression sling and a laparotomy sponge packing.

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Beyond Tears: The Potential Hazards Of The O-Chlorobenzylidene-Malononitrile (Cs) Gas Under Scrutiny

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Asuku ME, Milner SM, Gerold KB. 11(1). 28 - 30. (Journal Article)

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The Supply of Pharmaceuticals in Humanitarian Assistance Missions: Implications for Military Operations

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Mahmood M, Riley K, Bennett D, Anderson W. 11(1). 37 - 42. (Previously Published)

Previously published in Military Medicine, 176, 8:852, 2011

Abstract

In this article, we provide an overview of key international guidelines governing the supply of pharmaceuticals during disasters and complex emergencies. We review the World Health Organization's guidelines on pharmaceutical supply chain management and highlight their relevance for military humanitarian assistance missions. Given the important role of pharmaceuticals in addressing population health needs during humanitarian emergencies, a good understanding of how pharmaceuticals are supplied at the local level in different countries can help military health personnel identify the most appropriate supply options. Familiarity with international guidelines involved in cross-border movement of pharmaceuticals can improve the ability of military personnel to communicate more effectively with other actors involved in humanitarian and development spheres. Enhancing the knowledge base available to military personnel in terms of existing supply models and funding procedures can improve the effectiveness of humanitarian military operations and invite policy changes necessary to establish more flexible acquisition and funding regulations.

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Tactical Evacuation: Extending Critical Care on Rotary Wing Platforms to Forward Surgical Facilities

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Tobin JM, Via DK, Carter T. 11(1). 43 - 44. (Journal Article)

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