Personality testing: enhancing in-service selection of mid-career soldiers.

Noncognitive attributes - notably personality - consistently predict important job-related outcomes for the Army (e.g., attrition, performance, disciplinary incidents) during Soldiers' first term of enlistment.

Implications of True and Perceived Treatment Burden on Cardiovascular Medication Use.

Unlabelled: Clinical decisions require weighing possible risks and benefits, which are often based on the provider's sense of treatment burden. Patients often have a different view of how heavily treatment burden should be weighted. To examine how much small variations in patient treatment burden would influence optimal use of antihypertensive medications and how much over- and undertreatment can result from clinicians misunderstanding their patients' values.

Embedded Mental Health: Promotion of Psychological Hygiene Within a Submarine Squadron.

Introduction: Psychological fitness is an important component to operational unit readiness and success. Embedding behavioral health providers can reduce unplanned personnel losses (UPL) as a result of psychological stress. The U.

Data-Driven Markov Decision Process Approximations for Personalized Hypertension Treatment Planning.

Markov decision process (MDP) models are powerful tools. They enable the derivation of optimal treatment policies but may incur long computational times and generate decision rules that are challenging to interpret by physicians. In an effort to improve usability and interpretability, we examined whether Poisson regression can approximate optimal hypertension treatment policies derived by an MDP for maximizing a patient's expected discounted quality-adjusted life years.

Strategic modeling of the neonatal nurse practitioner workforce.

Background: Neonatal nurse practitioners (NNPs) play a vital role in the medical care of newborns and infants. There is expected to be a shortage of NNPs in the near future.

Purpose: To assess the present NNP workforce and study the impact of potential policy changes to alleviate forecasted shortages.

Impact of a patient-centered medical home on access, quality, and cost.

Context: Patient-centered medical homes (PCMHs) are intended to actively provide effective care by physician-led teams, where patients take a leading role and responsibility.

Objective: To determine whether the Walter Reed PCMH has reduced costs while at least maintaining if not improving access to and quality of care, and to determine whether access, quality, and cost impacts differ by chronic condition status.

Design, Setting, And Patients: This study conducted a retrospective analysis using a patient-level utilization database to determine the impact of the Walter Reed PCMH on utilization and cost metrics, and a survey of enrollees in the Walter Reed PCMH to address access to care and quality of care.

Lessons learned from smallpox vaccination of U.S. Navy forces before Operation Iraqi Freedom.

Our objectives were to document and to analyze the U.S. Navy's smallpox vaccination program before Operation Iraqi Freedom, discerning lessons for future mass vaccination programs.

Promoting health and improving health care in a cost-effective manner through a military digital library.

Objective: The Virtual Naval Hospital (VNH) is a digital library designed to meet the information needs of U.S. Navy medical professionals.

Modeling the consequences of bioterrorism response.

Military medicine is playing important roles in preparing for the possibility of a covert biological attack on the United States. The objective of this work was to develop a spreadsheet tool that allows planners to compare the consequences of different speeds of response to a covert bioterrorist attack using the metric of preventable deaths. Our model simulates the number of patients to be treated and the number of deaths by day.

Is there a link between pharmaceutical consumption and improved health in OECD countries?

Objective: The objective of this study was to determine whether there is a measurable health return associated with high pharmaceutical consumption in a sample of developed countries.

Design And Setting: The study focused on the production of health, disaggregating healthcare into pharmaceuticals and other healthcare. We controlled for wealth and lifestyle factors.

A cost-effectiveness analysis of shipboard telemedicine.

Background: The U.S. Navy is considering the installation of telemedicine equipment on more than 300 ships.

Information technologies for Marine Corps combat medicine.

Future Marine Corps warfighting concepts will make it more difficult to locate casualties, which will complicate casualty evacuation, lengthen casualty wait times, and require infantrymen or corpsmen to provide more extensive treatment. In these future scenarios, information flow and communications will be critical to medical functions. We asked, for Navy medical support to the Marines, what information will future combat medicine require and what technologies should supply those information needs? Based on analyses of patient data streams, focus groups of Navy medical personnel, and our estimates of the cost and feasibility of communications systems, we recommend the following: (1) increase medical training for some fraction of Marines, especially in hemorrhage control; (2) augment corpsmen's training; (3) furnish data systems for evacuation and supply that would provide in-transit visibility and simplify requests; (4) provide all ground medical personnel with access to treatment information systems and limited voice communications; and (5) exploit e-mail systems to reduce reliance on voice communications.