Glucose-6-Phosphate Dehydrogenase Deficiency is Associated with Cardiovascular Disease in U.S. Military Centers.

Glucose-6-phosphate dehydrogenase (G6PD) protects erythrocytes from oxidative stress and hemolysis; G6PD deficiency is the most prevalent enzymopathy. The United States military routinely performs tests to prevent exposing G6PD-deficient personnel to antimalarial drugs that might cause life-threatening hemolytic reactions. In addition, G6PD is a key determinant of vascular function, and its deficiency can lead to impaired nitric oxide production and greater vascular oxidant stress-precursors to atherosclerosis and cardiovascular disease.

Patient-centered medical home implementation effects on emergency room utilization: a case study.

The Patient-Centered Medical Home (PCMH) concept has been commended for its potential to increase access to primary care while improving quality and health outcomes. Numerous studies have documented the benefits of the PCMH healthcare delivery modality inclusive of decreased emergency room (ER) visits among PCMH enrollees. Yet a debate wages on whether PCMHs are conceptually sound and clinically effective with few empirical studies dedicated to the study of this relatively new care delivery model (Friedberg et al.

Patient satisfaction in military medicine: model refinement and assessment of continuity of care effects.

The Military Health System (MHS) identified patient-centered care and satisfied beneficiaries as main objectives in their 2006 Strategic Plan. The objective of this study was to expand upon the previous MHS model to determine predictors of patient satisfaction behaviors based upon associated attitudes and beliefs in addition to determining the predictive qualities presented by continuity of care. A sample of 90,318 patient responses from 2002 to 2004 was drawn from the Customer Satisfaction Survey database.

Building from within: identifying leadership competencies for future navy nurse executives.

The purpose of this research is to forecast the relevant competencies and important skills, knowledge, and abilities (SKAs) for Navy nurse executives in the next 5 to 10 years. Using 2 iterations, Wave I and Wave II, of the Delphi technique, 6 competency domains emerged: business management, executive leadership, professional development, global awareness and interoperability, communications, and personnel management. For Wave I, 38 (19%) of 200 nurses identified what they considered to be the 5 most relevant competencies and skills, knowledge, and abilities.

Using Anscombe's quartet plus one to illustrate data set matching, proper model specification, and relationships between inferential tests.

In 1854, London experienced an epidemic of cholera that took more than 500 lives. In September of that year, Dr. John Snow plotted the locations of cases and of water pumps throughout the city.

The development of a conceptual model for evaluating dental patient satisfaction.

The purpose of this study was to identify levels and predictors of patient satisfaction and develop a conceptual model for dental patient satisfaction in military treatment facilities. Respondents completed 658,443 surveys during 17 fiscal quarters, beginning with the fourth quarter of 2000. The final data set contained 309,261 surveys, with no missing data.

Executive competencies of nurses in the Veterans Health Administration.

This study identifies competencies and accompanying skills, knowledge, and abilities (SKAs) required by the Veterans Health Administration (VHA) nurse executives. Using the Delphi decision-making method, 144 VHA directors of nursing identified five top competencies necessary for nurse executives. An expert panel sorted competencies into the eight core domains of the VHA high-performance development model.

Patient satisfaction with dental hygiene providers in US military clinics.

Purpose: Military service members receive their dental care from military dental clinics. The purposes of this study were to assess satisfaction and to identify predictors of patient satisfaction with the hygiene provider in military dental treatment facilities.

Methods: Standardized surveys were administered from 2000 through 2004 by the Tri-Service Center for Oral Health Studies.

Executive competencies in healthcare administration: preceptors of the Army-Baylor University Graduate Program.

The purpose of this research was to identify the mentoring and executive competencies required among preceptors of the Army-Baylor University Graduate Program in Health and Business Administration, and to specify the requisite skills, knowledge, and abilities (SKAs) needed to achieve those competencies. In the first wave of inquiry, a list of 123 competencies and associated SKAs was elicited from a network of 80 current and past preceptor executives employing a Delphi methodology using e-mail. An expert panel, which consisted of seven past program directors, examined and sorted the list into four preceptor content domains, viz.

Patient satisfaction in military medicine: model refinement and assessment of Department of Defense effects.

A sample of 154,893 patient responses from the Customer Satisfaction Survey database was drawn for 1999 to 2000. Average patient satisfaction levels consistently appeared to be high (between 6, very satisfied, and 7, completely satisfied, on the 7-point rating scale). Hierarchical regression results essentially replicated all three major constructs of an earlier theoretical attitude model.

Army junior dental officer retention.

Objectives: The objectives of the survey were to quantify the extent of indebtedness of junior dental officers and to determine the impact of a loan repayment program on career decisions.

Methods: We designed a customized survey instrument because no preexisting, validated, survey instrument was available. A query was performed in the Medical Operations Data System to identify all captains (0-3) currently on active duty in the Army (N = 348).

U.S. Army-Baylor University Health Care Administration Program: evidenced-based outcomes in the military health system.

The purpose of this research is to assess the impact of an educational program on the Military Health System on some of the evidence-based educational outcomes for the Individual (student) and the Society (all Army Medical Treatment Facilities). The U.S.

Patient satisfaction in military medicine: status and an empirical test of a model.

The Department of Defense (DoD) is concerned about how well military medical treatment facilities in the military health system perform. Patient expectations, attitudes, and health care use have been examined in numerous studies; the results are fairly consistent. Eligible beneficiaries report moderate satisfaction with the health care received.

Reserve components' perceptions and changing roles.

This article reviews the historical background of Reserve and National Guard forces, total force policy, types of reserve personnel, perceptions and attitudes of reservists, morale and unit cohesion, perceived preparedness for mobilization, mobilizations and demobilizations, current downsizing and reorganizations, operations other than war, and readiness. The majority of the studies report reservists' perceptions and attitudes. Because the majority of the Army's war-making capability is found in the reserves, how well the reserves function has national security implications.

Senior executive behaviors for the Army Dental Care System of the 21st century.

Challenges will most likely confront the Army Dental Care System as it moves into the next century. Like any other learning organization, the Army dental care system must develop a continuous stream of dynamic leaders to direct its evolution if it wants to survive. Using the Delphi method, the investigators surveyed senior dental leaders to determine the attitudes and behaviors believed to be required to perform successfully as commanders, residency directors, and senior staff officers.

Vision 21 Delphi panel: senior Army Medical Service Corps Officers' vision of behaviors for success of future Medical Service Corps officers.

A Delphi study was conducted of Army senior Medical Service Corps leaders (O6s) to identify the expected behaviors and competencies needed to ensure that junior officers will achieve successful careers as Medical Service Corps officers in the 21st century. A Delphi mailing was conducted in two phases. In the first iteration, 41 behaviors were identified to be of importance.

Patient attitudes and utilization patterns in Army medical treatment facilities.

In Section 733 of the National Defense Authorization Act for Fiscal Years 1992 and 1993, Congress directed the Department of Defense to study the military medical care system. When the Congressionally directed study findings become available, baseline data will be needed for comparison. From 1989 to 1992, patient satisfaction surveys were conducted of eligible beneficiaries who might seek health care in Army military medical treatment facilities (MMTFs).

Screening alcohol abuse potential among Army reservists with the Short Michigan Alcoholism Screening Test.

The Short Michigan Alcoholism Screening Test was psychometrically useful in screening a sample of 560 reservists from a midwest general hospital unit. The most conservative estimate of alcohol abuse potential was 11.3%, with possibly 6.

A survey of Army medical department reserve personnel mobilized in support of Operation Desert Storm.

Surveys from 3,930 Army medical reservists mobilized in support of the Health Services Command mission during Operation Desert Shield/Storm were collected as units were demobilized from April to June, 1991. A survey questionnaire addressed questions related to factors associated with mobilization and intentions to remain in or leave reserve service after demobilization. Results were grouped according to rank, years of service, occupational specialty, and reserve category.

The prevalence of symptoms in medical outpatients and the adequacy of therapy.

Common symptoms account for substantial patient disability and health services utilization. To determine the prevalence of 15 symptoms and the adequacy of therapy, 500 medical outpatients were surveyed. The 410 respondents indicated which symptoms were "major problems" and what therapy, if any, had been helpful.

Common symptoms in ambulatory care: incidence, evaluation, therapy, and outcome.

Purpose And Patients And Methods: Many symptoms in outpatient practice are poorly understood. To determine the incidence, diagnostic findings, and outcome of 14 common symptoms, we reviewed the records of 1,000 patients followed by house staff in an internal medicine clinic over a three-year period. The following data were abstracted for each symptom: patient characteristics, symptom duration, evaluation, suspected etiology of the symptom, treatment prescribed, and outcome of the symptom.

Chronic fatigue in primary care. Prevalence, patient characteristics, and outcome.

Although fatigue is one of the most common complaints in ambulatory care, research has been minimal. Of the 1159 consecutive patients surveyed in two adult primary-care clinics, 276 (24%) indicated that fatigue was a major problem. Fatigue was more prevalent in women than in men (28% vs 19%).

Prospective randomized evaluation of antishock MAST in post-traumatic hypotension.

During an 18-month period, among 35,000 injured patients presenting to an urban trauma center, more than 3,500 were admitted, and 1,500 underwent surgery on the General Surgical Service. Three hundred fifty-two patients with prehospital systolic blood pressures of less than 90 mm Hg were randomized on an alternate day basis to receive treatment with 'MAST' (163 patients) or 'No-MAST' (189 patients). Age, mechanism of injury, prehospital management times, prehospital trauma scores, prehospital fluids administered, Injury Severity Scores, emergency center treatment, operative protocol, and calculated probability of survival were virtually identical for both groups.