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Artykuły w czasopismach na temat "Naval Training Center (San Diego, Calif.)"
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Christopher, George W. "Invasive Meningococcal Disease at Fort Ord and San Diego Naval Training Center, 1962–1964". Military Medicine 185, nr 7-8 (27.06.2020): 397–99. http://dx.doi.org/10.1093/milmed/usz389.
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Abstract Meningococcal epidemics at 2 training facilities were early examples of outbreaks fueled by military demographics and because of lethal drug-resistant bacteria for which there are no vaccines or chemoprophylaxis. Positive outcomes included the elucidation of the natural history of meningococcal colonization and disease and the initiation of vaccine development.
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Engelbert, LT Patrick R., Travis G. Deaton, Benjamin D. Walrath i Sherri L. Rudinsky. "The Joint Emergency Medicine Exercise: A Capstone Training Evolution of a Military Unique Curriculum for Emergency Medicine Residents". Military Medicine 185, Supplement_1 (styczeń 2020): 544–48. http://dx.doi.org/10.1093/milmed/usz209.
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ABSTRACT Introduction The role of the Emergency Medicine (EM) physician in the U.S. military continues to expand, and current Accreditation Council for Graduate Medical Education general training requirements do not optimally prepare military EM graduates to be successful in postresidency operational assignments. To address this gap, the Naval Medical Center San Diego EM residency program introduced a Military Unique Curriculum (MUC) culminating in a capstone event, the Joint Emergency Medicine Exercise (JEMX). Methods Part of an approved Quality Improvement project, annual survey results from 2012 to 2017 evaluated graduate opinion on the strengths and weaknesses of the MUC. We describe a pilot project conceived by tri-service EM physicians to evaluate the feasibility of the JEMX. Results Forty-eight graduate residents responded to surveys, 18 of which were administered pre-MUC implementation. With a 100% response rate from graduate residents, overall trends showed greater perceived readiness for postresidency operational assignments after MUC implementation. Written comments received cited the MUC as areas where the Naval Medical Center San Diego EM program excelled and the successful JEMX evolutions as the most valuable curricular component of the MUC. Conclusion An integrated MUC with a capstone exercise, such as our JEMX, provides a feasible and effective educational experience that improves operational readiness of graduating EM residents.
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Augustino, Leslie R., Lisa Braun, Rebecca E. Heyne, Antoinette Shinn, LeAnne Lovett-Floom, Heather King, Ceferina Brackett, Laurie Migliore i Jennifer Hatzfeld. "Implementing Evidence-Based Practice Facilitators: A Case Series". Military Medicine 185, Supplement_2 (maj 2020): 7–14. http://dx.doi.org/10.1093/milmed/usz460.
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Abstract Background In 2017, the TriService Nursing Research Program completed a strategic planning session, which identified key barriers to implementing evidence-based practice (EBP) within the U.S. Military Health System (MHS) including a focus on readiness training and deployments, frequent staff moves for military members, and relatively junior nurses in clinical roles. To facilitate EBP at individual military treatment facilities (MTFs), an EPB Facilitator role was developed using an evidence-based model and based on validated EBP competencies. Methods This new role was implemented at four MTFs in 2018: Naval Medical Center Portsmouth, 59th Medical Wing at Joint Base San Antonio Lackland, Naval Medical Center San Diego, and David Grant USAF Medical Center at Travis Air Force Base. This case series provides a description of the initial implementation of this role. Results Common enablers and challenges were identified from the experiences at all four sites. These included the importance of incorporating efforts into existing organizational efforts and infrastructure; the value of nurse leaders inviting EBP facilitators to participate and engage in scheduled meetings and committees; the significance of engaging with existing quality, process improvement, and training initiatives; and the benefit of collaborating with advanced practice nurses within the organization. The common challenges for all EBP facilitators were the frequent staff turnover at all levels and a lack of standardization to review and approve EBP initiatives, which makes it difficult to navigate the complete process of project implementation and collaboration across sites. Another challenge has been the difficulty to measure the impact of this role at the MTF and MHS levels. Conclusions As EBP efforts continue and the program matures, it is anticipated that the outcomes from the individually completed projects, to include decreases in safety events, fiscal savings, and other improvements in organizational metrics, can be compiled to demonstrate the collective impact of these roles within the MHS.
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Broyles, James W., i Michael Christie. "Usability and Performance Testing of Hand-held Data-entry Devices for Navy Shipboard Damage Control and Fire-fighting Environments". Proceedings of the Human Factors and Ergonomics Society Annual Meeting 39, nr 14 (październik 1995): 967. http://dx.doi.org/10.1177/154193129503901473.
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Portable, hand-held, data-entry devices were evaluated for intended use by shipboard engineering repair team personnel for improving on-scene casualty reporting of damage control and fire-fighting efforts. Current on-scene reporting methods use pre-formatted damage control messages, hand carried from the scene of the casualty to the repair lockers, and often rely on two-way radios for rapid transmission of critical casualty information. During the initial reporting period, this process is often confusing, time-late, and sometimes ambiguous or error-prone. Five off-the-shelf data entry devices were tested for usability and performance for data input and display of casualty information in a laboratory setting at the Naval Postgraduate School, Monterey, with follow-on field testing done by damage control and fire-fighting personnel assigned to Fleet Training Center, San Diego and Detachment Treasure Island and the Afloat Training Group, Pacific. Demonstration of these devices, lessons learned on usability testing and building of cooperative research networks between users and the training community will be described.
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Clemmons, Nakia S., Nikki N. Jordan, Alfonza D. Brown, Erin M. Kough, Laura A. Pacha, Susan M. Varner, Anthony W. Hawksworth, Christopher A. Myers i Joel C. Gaydos. "Outbreak of Chlamydia pneumoniae Infections and X-ray-Confirmed Pneumonia in Army Trainees at Fort Leonard Wood, Missouri, 2014". Military Medicine 184, nr 7-8 (23.01.2019): e196-e199. http://dx.doi.org/10.1093/milmed/usy402.
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Abstract Introduction Chlamydia pneumoniae (Cp) is a bacterium that causes pneumonia and other respiratory diseases. Fever may be present early but absent by time of presentation to clinic. Increases in X-ray-confirmed pneumonia (XCP) and laboratory-confirmed Cp infections were observed in new soldiers in training at Fort Leonard Wood (FLW), Missouri, early in 2014. These findings prompted a site assistance visit from the U.S. Army Public Health Command, Aberdeen Proving Ground, Maryland, with a review of available data and information to describe the outbreak, and inspections of barracks and training facilities and review of training practices to identify opportunities for interventions to reduce the risk of respiratory disease agent transmission. Materials and Methods The study population was trainee soldiers at FLW in 2013–2014. Data from two acute respiratory disease surveillance systems were studied. A local surveillance system operated by the FLW General Leonard Wood Army Community Hospital Preventive Medicine Department tracked weekly chest X-rays taken and the numbers positive for pneumonia. A Naval Health Research Center, San Diego, California, laboratory-based Febrile Respiratory Illness Surveillance Program collected clinical data and nasal, or nasal and pharyngeal swabs, for nucleic acid amplification testing from up to 15 trainees/week with fever and either cough or sore throat. Up to 4 of the 15 specimens could be from afebrile patients with XCP. Specimens were tested for a variety of agents. Results Monthly rates of XCP rose quickly in 2014 and peaked at 0.9/100 trainees in May. The percentage of the San Diego surveillance system specimens that were positive for Cp also increased quickly in 2014, peaking at 54% in May. During the first half of 2014, the San Diego program studied specimens from 141 ill trainees; 37% (52/141) were positive for Cp, making it the most common organism identified, followed by rhinoviruses (8%), influenza viruses (4%), Mycoplasma pneumoniae (2%), and adenoviruses (1%). The remaining specimens (48%) were negative for all respiratory pathogens. Only 12% (6/52) of Cp positive patients were febrile. Facilities inspections and review of training practices failed to identify variables that might be contributing to an increased risk of respiratory agent transmission. Conclusion The XCP rate and the percentage of specimens positive for Cp increased in early 2014, peaking in May. Only 12% of trainees with laboratory-confirmed Cp were febrile. Historically, acute respiratory disease surveillance at military training centers focused on febrile diseases, particularly those caused by adenoviruses. With introduction of an adenovirus vaccine in late 2011, respiratory disease rates dropped with only sporadic occurrences of adenovirus-associated disease. In 2012, the San Diego surveillance program began providing data on multiple respiratory disease agents, in addition to adenoviruses and influenza viruses. Since then, Cp, rhinoviruses and Mycoplasma pneumoniae have frequently been detected in trainees with acute respiratory disease. Respiratory surveillance programs supporting Army training centers should be re-evaluated in this post-adenovirus vaccine era, to include assessment of the fever criterion for selecting patients for study, the value of chest X-ray surveillance and the value of rapidly providing laboratory results to inform provider decisions regarding antibiotic use.
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Hananel, David, Dan Silverglate, Dan Burke, Benjamin Riggs, Jack Norfleet i Robert M. Sweet. "The Advanced Modular Manikin Open Source Platform for Healthcare Simulation". Military Medicine 186, Supplement_1 (1.01.2021): 49–57. http://dx.doi.org/10.1093/milmed/usaa420.
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ABSTRACT Introduction Current thinking in healthcare education stipulates a holistic approach with a focus on patient management, bringing together technical skills, decision-making, and team performance. In parallel, training opportunities with actual patients have diminished, and the number of different interventions to master has increased. Training on simulators has become broadly accepted; however, requirements for such training devices have outpaced the development of new simulators. The Department of Defense (DoD) targeted this gap with a development challenge. This article introduces the Advanced Modular Manikin (AMM) platform and describes the path followed to address the challenge. Materials and Methods Under Contract # W81XWH-14-C-0101, our interdisciplinary team of healthcare providers, educators, engineers, and scientists, together with partners in industry and the government collaborated to establish a set of comprehensive requirements and develop an overarching system architecture and specifications to meet healthcare simulation needs. In order to instantiate the architecture and investigate usability of the platform, a demonstration modular manikin was created that incorporated physical and digital peripherals. Results The system architecture and corresponding data models have been completed and published as open source. A developer’s tool kit has been created, including instructional materials and required hardware and software for interested parties to develop AMM-compatible modules. A reference manikin was created based on the platform specifications and successfully supported a usability study that was performed by the American College of Surgeons, Education Division at the Naval Medical Center San Diego. Conclusions The formal release of a functional modular, interoperable open-source healthcare simulation platform is complete. Next steps involve a strategy for maintaining the open standards and verification of AMM-compatibility for modules. Increasing awareness of this powerful tool and prioritization of module-development to address the wide range of healthcare education needs could lead to a renaissance in military and civilian healthcare simulation-based training.
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Cancio, Jill M., Annemarie Orr, Susan Eskridge, Kaeley Shannon, Brittney Mazzone i Shawn Farrokhi. "Occupational Therapy Practice Patterns for Military Service Members With Upper Limb Amputation". Military Medicine 185, nr 3-4 (28.10.2019): 444–50. http://dx.doi.org/10.1093/milmed/usz341.
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Abstract Introduction Military Service Members (SMs) with upper limb (UL) amputation have unrestricted access to occupational therapy (OT) services. Identifying OT interventions used based on clinical rationale and patient needs can provide insight toward developing best practice guidelines. The purpose of this retrospective observational study was to identify preferred OT practice patterns for U.S. Military SMs treated in Military Treatment Facilities, who have sustained various levels of deployment-related UL amputation. Methods The study sample was ascertained from the Expeditionary Medical Encounter Database housed at the Naval Health Research Center in San Diego, California. SMs with an immediate (within 24 hours of injury) deployment-related unilateral major UL amputation (partial hand and proximal), occurring between January 2001 and December 2014 were identified. SMs with concurrent major lower limb amputation (partial foot and proximal) were excluded. Frequency of OT outpatient visits and units of treatment received were quantified in 3-month increments during the first year after amputation and compared for individuals with above elbow (at or proximal to elbow joint) and below elbow (distal to the elbow joint including partial hand) amputation. This study was approved by the Naval Health Research Center Institutional Review Board. Results A total of 29,878 encounters occurred during first year after amputation in 148 patients, who had sustained UL loss during the first year after amputation. Active treatments were included in 79.2% of all treatments, followed by manual therapy (13.7%) and modalities (13.5%). A higher number of OT encounters occurred in the above elbow amputation group—the first year of treatment with significantly higher mean number of treatments months 4 to12. A similar pattern in OT encounters was observed in the active therapy category with significantly higher mean number of treatments occurring in above elbow limb loss group in months 10 to 12. Conclusion Findings of the current study suggest SMs with UL amputation utilize OT services often within the first year after injury and those who have sustained amputation proximal to the elbow received more therapy visits than their below elbow counterparts during months 4 to 12. Prosthetic training, therapeutic activities, and therapeutic exercise can be expected to be the highest used active interventions in the first year following UL amputation. Further research is needed to determine details on types and frequency of therapy utilization and recommended therapy strategies.
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Schmidt, Gerald, Michelle Valdez, Maureen Farrell, Frank Bishop, Warren P. Klam i Andrew P. Doan. "Behaviors Associated with Internet Use in Military Medical Students and Residents". Military Medicine 184, nr 11-12 (2.04.2019): 750–57. http://dx.doi.org/10.1093/milmed/usz043.
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Abstract Introduction Problematic use of video games, social media, and Internet-related activities may be associated with sleep deprivation and poor work performance. The Internet Addiction Test was given to military medical and nursing students and housestaff to assess problematic Internet use. Methods Medical and nursing students at the Uniformed Services University of the Health Sciences and residents from Naval Medical Center San Diego were contacted via email (n = 1,000) and given a survey that included the Internet Addiction Test (IAT) and questions asking about other specific lifestyle variables. Individuals who received an Internet Addiction Score (IAS) ≥50 were identified as likely experiencing harmful effects of Internet addiction (IA). Results Of 399 surveys submitted, 68 were omitted due to gross incompletion or failing to finish the entirety of the IAT. Of the participants included, 205 (61.1%) were male and 125 (37.9%) were female. The mean age was 28.6 years old (S.D. = 5.1 years). In regards to training status, completed surveys were assessed for 94 medical residents, 221 School of Medicine students, and 16 Graduate School of Nursing students. Our survey showed 5.5% of the participants (n = 18) indicated problems with Internet use that are concerning for IA. Conclusions The study results indicated that our population showed problematic Internet use in the lower range of global estimates of IA. Rates of IA further decreased between medical students and residents. Multiple lifestyle variables were significantly associated with IA score and may serve as indicators of a higher score. Interestingly, the use of social media during sleeping hours was most significantly associated with increased IAS. This paper discusses IA among military medical and nursing trainees and how problematic Internet use may affect work performance and force readiness.
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LeardMann, Cynthia A., Yohannes G. Haile, Jennifer McAnany, Valerie A. Stander, Diane Williams, Jeffrey Millegan i Keyia N. Carlton. "Pre-service factors associated with sexual misconduct among male U.S. Marines". PLOS ONE 17, nr 12 (9.12.2022): e0278640. http://dx.doi.org/10.1371/journal.pone.0278640.
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Purpose Sexual assault is a prevalent and persistent problem in the military, yet few studies have examined predictors of sexual offenses. The study aim was to determine pre-service factors associated with sexual offense conviction among U.S. Marines. Methods This retrospective cohort study analyzed data from male active duty U.S. Marines (2003–2018). Pre-service factors were assessed using survey data from the Recruit Assessment Program, obtained prior to recruit training at the Marine Corps Recruit Depot, San Diego, California. These survey data were linked with sexual offense conviction data obtained from the Naval Criminal Investigative Service Consolidated Law Enforcement Operations Center. Results Of the 146,307 participants, the majority were 18–19 years old (66.7%) and non-Hispanic, White (62.1%) with a high school education or less (76.8%); 107 received convictions for a sexual offense. In unadjusted analyses, race and ethnicity, parental education, type of primary caregiver, parental death, family economic status, childhood emotional trauma, childhood physical abuse, childhood sexual abuse, and unprotected sex were associated with a sexual offense conviction. In the final multivariable model, race and ethnicity (American Indian/Alaskan Native, odds ratio [OR]: 5.28, 95% confidence interval [CI]: 1.86–14.98; Hispanic, OR: 1.83, 95% CI: 1.06–3.18; multiracial/other, OR: 3.28, 95% CI: 1.56–6.89), education (≤ high school, OR: 2.65; 95% CI: 1.21–5.80), parental death (OR: 2.27; 95% CI: 1.16–4.45), unprotected sex (OR: 1.78; 95% CI: 1.03–3.05), and school suspension/expulsion (OR: 1.64; 95% CI: 1.02–2.65) were significant predictors of a subsequent sexual offense conviction. Conclusions Results underscore the importance of understanding factors associated with sexual offense and highlight the large discrepancy between self-reported estimates of sexual assault and sexual offense convictions. Findings may inform the development of effective strategies to reduce sexual misconduct, such as technology-facilitated programs that provide private, targeted education; supportive assistance; and prevention materials to individuals who may have elevated sexual misconduct risk.
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King, Heather C., Natalie Spritzer i Nahla Al-Azzeh. "Perceived Knowledge, Skills, and Preparedness for Disaster Management Among Military Health Care Personnel". Military Medicine 184, nr 9-10 (16.03.2019): e548-e554. http://dx.doi.org/10.1093/milmed/usz038.
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Abstract Introduction The Indo-Asia-Pacific region has the highest incidence of natural disasters world-wide. Since 2000, approximately 1.6 billion people in this region have been affected by earthquakes, volcanos, tsunamis, typhoons, cyclones, and large-scale floods. The aftermath of disasters can quickly overwhelm available resources, resulting in loss of basic infrastructure, shelter, health care, food and water, and ultimately, loss of life. Over the last 12 years, US military forces have collaborated with countries throughout the Indo-Asia-Pacific region to enhance disaster preparedness and management during shipboard global health engagement missions. Military health care personnel are integral in this effort and have planned subject-matter expert exchanges, multidisciplinary conferences, courses, and hyper realistic simulated military-to-military training exercises related to disaster preparedness. Military health care providers are essential not only to providing international education and training, but also to ensuring optimal readiness to respond to future disasters in the Indo-Asia-Pacific region and worldwide. The ability to effectively respond to disasters and collaborate with other nations promotes international stability. Yet, few studies have examined disaster preparedness among US military health care personnel. This study aimed to assess knowledge, skills, and preparedness for disaster management among US military health care personnel preparing to deploy on a global health engagement mission. Materials and Methods A descriptive, cross-sectional study utilizing the Disaster Preparedness Evaluation Tool (DPET) examined self-reported perceptions of disaster preparedness among US military health care personnel preparing to deploy on a shipboard global health engagement mission. The DPET assessed perceived knowledge of disaster preparedness, disaster mitigation and response, and disaster recovery. Three hundred Hospital Corpsmen/Medics and officers in the Nurse Corps, Medical Corps, Medical Service Corps, and Dental Corps were invited to participate. One hundred fifty-four surveys were completed (response rate, 51%). Nineteen surveys were excluded from the analysis due to incomplete responses. Participants rated responses to 46 Likert items (scale of 1–6) and responded to 23 descriptive items. The study protocol was approved by the Naval Medical Center San Diego Institutional Review Board, protocol number NMCSD.2017.0061, in compliance with all applicable federal regulations governing the protection of human subject research. Results All item mean scores on each of the three DPET subscales resulted in moderate levels of perceived disaster preparedness among military healthcare personnel (disaster preparedness means ranged from 3.04 to 4.67, disaster response means ranged from 3.76 to 4.29, and disaster recovery means ranged from 3.47 to 4.29). The final regression model had 6 significant variables that predicted DPET scores: previous disaster drills (p = 0.00), experiencing a real disaster (p = 0.002), bioterrorism training (p = 0.02), education level (p = 0.025), years in specialty (p = 0.019), and previous global health engagement missions (p = 0.016), with R2 = 0.39, R2adj = 0.36, F (7, 127) = 12.04. Conclusions Disaster preparedness among military healthcare personnel could be improved to function optimally for future global health engagement missions. This study expands current understandings of disaster preparedness among US military health care providers and identifies ways to improve and enhance training.
Rozprawy doktorskie na temat "Naval Training Center (San Diego, Calif.)"
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Gillard, Elizabeth K. "An analysis of the nurse internship program at Naval Medical Center San Diego". Thesis, Monterey, Calif. : Springfield, Va. : Naval Postgraduate School ; Available from National Technical Information Service, 2003. http://library.nps.navy.mil/uhtbin/hyperion-image/03Mar%5FGillard.pdf.
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Symposium on Coastal Oceanography and Littoral Warfare (1993 San Diego, Calif.). Proceedings of Symposium on Coastal Oceanography and Littoral Warfare (Unclassified Summary): Fleet Combat Training Center, Tactical Training Group, Pacific, San Diego, CA, August 2-5, 1993. Washington, D.C: National Academy Press, 1994.
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Office, General Accounting. Purchase cards: Control weaknesses leave two Navy units vulnerable to fraud and abuse : report to congressional requesters. Washington, D.C. (P.O. Box 37050, Washington, D.C. 20013): U.S. General Accounting Office, 2001.
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Preston, Lucille. Lucille Preston: A World War II journey, from Clarkesdale, Mississippi, to Richmond, California, 1942. Berkeley, Calif: Regional Oral History Office, Bancroft Library, University of California, 1992.
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Garey, Jennifer A. San Diego's Naval Training Center. Arcadia Publishing, 2008.
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Garey, Jennifer A. San Diego's Naval Training Center. Arcadia Publishing, 2008.
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