美军战场心理救治及其进展

战争使军人的生理和心理遭受巨大压力，导致部队战斗力降低和非战斗减员。海湾战争美军仅伤亡896人，而战斗精神疾病却高达547人。战争对军人的心理杀伤力以及由此产生的非战斗减员，得到了各国军队的高度重视。美军在二十世纪末经历了多次战争或战斗，在战场心理救治积累了丰富的经验，对我军战时心理卫生保障工作具有借鉴意义。     

空降作战卫生防疫保障工作特点及对策

目的分析空降作战卫生防疫保障的特点,为做好军事斗争卫生防疫保障工作研究制订对策和措施提供依据。方法根据战时卫生防疫保障要求,对空降作战卫生防疫保障方式进行前瞻性理论分析与总结。结果总结出受空降作战方式和战场条件影响,卫生防疫保障工作具有的4个特点:(1)空降作战地域深,无直接后方依托,卫生防疫保障工作独立性强;(2)空降作战行动快,战场环境复杂,疾病诱发因素增多;(3)空隆作战方向多,作战机动半径大,传染源侵入渠道多,传染疾病监控难度大;(4)空降作战艰苦,环境恶劣,生活卫生条件难以保障,卫生防疫措施不易落实。针对这些特点,提出4点对策:(1)加强防疫保障力量的组织,筹措准备防疫物质;(2)加强流行病学调查,掌握卫生防疫工作的主动权;(3)坚持预防为主方针,降低因疾病导致非战斗减员;(4)采取机动灵活方式,组织实施各项防疫保障措施。结论所提出的对策对空降作战卫生防疫工作具有一定的指导意义。     

现代战争中心理健康教育初探

现代战争中心理健康教育初探兰州军区后勤部卫生防疫大队吴峰，李庆，贺拴友随着科学技术的发展，大量高新、尖端武器不断装备部队。未来战争将发起突然，战争环境条件艰苦，除战争本身给参战人员造成战斗减员外，心理压力、战斗应激症、战时精神病等非战斗减员显著增加，...     

渡海登岛作战演训时卫生防疫工作的特点与对策

目的 探讨渡海登岛作战战前演训卫生防疫工作的特点.方法 对近几年渡海登岛实战演练过程中卫生防疫工作的特点及问题进行归纳总结.结果 通过近几年的实战演练,找到了渡海登岛部队卫生防疫工作特点和措施,使官兵昼夜发病率都控制在1.5‰以下,总结出了渡海登岛作战卫生防疫工作的主要规律,为搞好登岛作战时卫生防疫保障,减少非战斗减员提供了重要卫勤保障经验.结论 摸索出渡海登岛作战演训过程中一系列的卫生防疫工作好的做法,为未来渡海登岛作战战时卫生防疫工作提供了重要参考.     

中国国际救援队赴海地主动卫生防疫策略实践与应用

目的 探讨在野战条件下要把握主动卫生防疫,同步地实施早期的医疗救助和卫生防疫,是提升部队战斗力,预防非战斗减员重要策略.方法 建立应急卫生防疫预案,其综合技术措施是抓环境治理、消杀灭防御、自身防护、健康保健、接触尸源防护.结果 通过全方佗落实卫生防疫管理目标,保护了易感人群,医疗队员在余震不断和环境极端灾害的情况下,克服了种种困难成功地救治了2500例受伤患者,抢救重危患者12例.结论 大灾之后确保了参与救援部队及医疗队共计300多余人员,无一例发生传染性疾病和营区内暴发流行性疾病.     

野战医疗所战备预案自动化指挥管理系统

一、前言部队医院担负着战时卫勤保障的重要任务。为了提高医院野战医疗所等卫勤力量的保障和机动能力,以适应战时救治伤病员和平时抢险救灾任务的需要,我院开发了《野战医疗所战备预案自动化指挥管理系统》。以实现对医院卫勤机动力量的人员调配、战时卫生减员(战斗减员、非战斗减员)的预计和分析、药材装备管理、战备知识的咨询和战时伤病员的登记等。经不断充实完善,通过本院和兄弟医院使用实践表明,系统功能全面。包括了医院医疗所等卫勤力量保障的主要工作,并且具有运行速度快、操作简单、     

现代战争时军人心理异常与对策

为提高现代战争时军人的心理与心理素质，本阐述了战时军人心理异常的致病因素；防止军人心理异常应采取的对策。为现代战争时减少非战斗减员提供经验。     

牙科疾病对军队战斗力的影响

通过历次战争的总结和军事训练研究发现,牙科疾病对军队战斗力的影响已得到各国军队的广泛关注.牙科疾病平时普遍流行,发展缓慢,往往不受重视,但是在战争紧张、疲劳及卫生条件差等情况下,牙科急症可大范围出现,导致非战斗减员,严重影响军队战斗力.文章参考大量国内外文献,概述了牙科疾病对中外军队战斗力的影响及其评价标准,并提出加强牙科卫勤保障、减少非战斗减员的建议.     

地空导弹兵夏季戈壁演习卫生防疫措施与体会

目的总结地空导弹兵某部新疆戈壁夏季演习卫生防疫措施,为确保季节性戈壁演习部队官兵健康,改善生活质量,防止非战斗减员提供借鉴。方法对演习的卫生防疫工作进行总结分析。结果总结出开展卫生防疫工作的4项措施:(1)动态流行病学侦察;(2)合理布局宿营区,有效利用保障车辆和防晒网;(3)保证饮水、饮食供应,做好日常防疫;(4)加强卫生监督,努力减少伤病发生率。通过采取上述措施,演习期间取得了无重度中暑、无食物中毒、无因伤病减员的"三无"目标,确保了演习官兵的身体健康。结论总结出的措施为确保地空导弹兵夏季戈壁演习期间身体健康起到积极作用,可供相关部队借鉴。     

刍议美军军事医学科研机构

美军医学科研机构成立较早、机构完善、运行高效;战场上决定士兵生死的不光是敌人的武器是否先进,建立完善的战场医疗新体系也极其重要.美军医学科研机构研制的卫生装备为战时美军提供有效的防护,同时也为美军打赢几次局部战争发挥重要作用;通过对美军军事医学科研机构的学习,有利于提升我军军事医学科研水平,更好地为军队现代化建设服务.     

美军联合作战血液保障体制与方式探讨

在战场上,失血是伤员可预防性死亡的首要原因,因此,输血对降低战伤死亡率具有非常重要的意义。本文阐述美军联合作战血液保障体制和血液保障内容,以及美军在伊拉克和阿富汗战争中血液保障的做法与经验。     

Heat illness. I. Epidemiology.

Reliable information on the epidemiology of heat illness has come, until recently, mainly from the armed forces and, to a lesser extent, from some industries and civil communities. Data from the records of the British Army, Royal Navy, Royal Air Force, Indian Armed Forces, U.S. Army and forces engaged in the Arab-Israeli wars, from the South African gold mining corporations and Persian Gulf oil tankers, and from civilian communities, mainly in the U.S.A., are reviewed and discussed with particular reference to the classification of heat illness and definition of the terms used, and the effects on acclimatized and non-acclimatized personnel and on other sections of the civilian communities most at risk, i.e. the old and very young. This section concludes with an outline of the classification of acute heat illnesses from 1899 to the eighth revision of the WHO International Classification of Diseases in 1967.     

Continuing education and residency program of occupational medicine in U. S. A

To investigate postgraduate education of occupational medicine in the U. S. A., the author was sent to take some courses in occupational medicine continuing education supported by the National Institute of Occupational Health (NIOSH) in February and March of 1988. The course participants were mainly industrial hygienists. The contents of the courses were approximately the same as those of the Three-Month Course in Fundamental Occupational Health held in UOEH for medical doctors. The physicians in occupational medicine in the U. S. A. take mainly mini-residency courses from the NIOSH programs. The Curriculum of the Intensive Residency Program at the University of California San Francisco (UCSF) is presented in this report as a reference. According to the information I acquired, well-trained industrial hygienists are maintaining a high standard of control over the workplace environment. I received the impression that the industrial hygienists are playing an important part in occupational health in the U. S. A. Physicians specializing in occupational medicine are interested more in the clinical diagnosis of occupational diseases than in preventive measures such as environmental control of the workplace.     

赴美移民预防接种统计分析及建议

目的为保障赴美移民的健康安全和防止传染病的传播。方法对1999～2006年以来福建国际旅行卫生保健中心赴美移民预防接种情况进行回顾分析。结果7年来共为96359位赴美移民进行了预防接种,其中以中、青年和女性占较大比例。共接种253497针次,接种一般反应占0.19%,开具的禁忌证明中药物过敏居多数。结论加强管理工作,总结经验,不断改进,以有效确保赴美移民健康。     

A disease and non-battle injury model based on Persian Gulf War admission rates

BACKGROUND: Military planners must ensure adequate medical care for deployed troops-including care for disease and non-battle injuries (DNBI). This study develops a heuristic model with the three distinct phases of a warfighting operation (build-up, ground combat, post-combat) to assist in predicting DNBI incidence during warfighting deployments. METHODS: Inpatient healthcare records of soldiers deployed to the Persian Gulf War who were admitted with DNBI diagnoses were analyzed. DNBI admission rates for the three phases of the operation were examined and compared to rates for US Army Forces Command (FORSCOM) posts in the US. RESULTS: DNBI admission rates among the phases were distinctly different. The operation's overall rate and 95th percentile daily rate were less than the FORSCOM FY 1990 annual rate. CONCLUSIONS: The level of combat must be considered. The traditional use of average or overall rates should be abandoned when forecasting DNBI rates. Medical support projections should use separate 95th percentile DNBI admission rates for each of the phases.     

A threat to the public health workforce: evidence from trends in preventive medicine certification and training

Evidence of a growing need for preventive medicine specialists is the congruence between needed competencies for practice in the current health care environment, as identified by the Council on Graduate Medical Education (COGME) and in other national reports, and the core competencies of preventive medicine residents. The total number of certified specialists in preventive medicine is 6091. The proportion of self-designated preventive medicine specialists among all U.S. physicians is on the decline and the greatest decline has been among those in public health (PH) and general preventive medicine (GPM). In addition, the total number of preventive medicine residents is on the decline, and the decline has been greatest among those training in PH and combined PH/GPM. One of the reasons for this decline has been inadequate funding due to the absence of Medicare graduate medical education (GME) financing for population-based vs. individual patient care services and meager and diminishing Title VII support. A paucity of faculty is apparent in medical schools with residency training and board certification in preventive medicine. Several actions may help reverse this trend and assure adequate numbers of preventive medicine specialists: expansion of Title VII to increase the number of residents receiving stipends and tuition, adding infrastructure support for faculty development and funding of demonstration projects in distance learning and in joint generalist/ preventive medicine residency training. Medicare GME reform should include recognition of population-based services and inclusion of preventive medicine residencies in provisions for "nonhospital-based" training and in up-weighting methodologies for primary care training. Expansion of Veterans Affairs, National Institute for Occupational Safety and Health, and Department of Defense support is also needed as is attention to resident debt reduction.     

Healthcare Access and Utilization Among Women 40 and Older at the U.S.-Mexico Border: Predictors of a Routine Check-Up

Mexican Americans are more likely to experience barriers to access and utilization of healthcare services than any other U.S. Hispanic group. In Mexico, where the majority of the population has access to care, the pressing issue is the underutilization of preventive services among adults. This study was conducted to assess access and utilization barriers among a U.S.-Mexico border population. A cross-sectional, population-based survey was conducted during 1999–2000 in a pair of contiguous U.S.-Mexico border communities. Household surveys were administered to U.S. and Mexican women, 40 years of age and older, to assess healthcare access and utilization, participation in chronic disease screenings, orientation toward prevention and personal history of chronic disease. Analysis indicates few statistically significant differences (p < 0.05) among access and utilization variables by country. Mexican participants were more likely to have a regular source of care and to have had a blood sugar test within the past 12 months. U.S. participants more often reported having had a Pap smear and mammogram during the previous year. Factors independently positively associated with having had a routine check-up during the past 12 months included age and having a regular provider or place to go when sick. Only going to the doctor when ill was independently inversely associated with routine check-ups in the past 12 months. Findings suggest that U.S. and Mexican border populations are similar with regard to healthcare access and utilization characteristics. Efforts to increase utilization of preventive health screenings among women are needed at the U.S.-Mexico border.     

Training of aerospace medicine physicians

In the U. S. there are 23 recognized medical specialty boards. One of these is preventive medicine. Within preventive medicine there are three areas: Aerospace Medicine, Occupational Medicine, and Public Health/General Preventive Medicine. The preventive medicine specialties have a common core of required training including biostatistics, epidemiology, health services administration and environmental health. These, plus associated topics are covered during year one of training. Year two of training involves clinical rotations specifically tailored to the eye, ear, heart, lungs and brain, plus flight training to the private pilot level, and a Masters Degree research project for the required thesis. During year three the physicians in aerospace medicine practice full-time aerospace medicine in a NASA or other government laboratory or a private facility. To date, more than 40 physicians have received aerospace medicine training through the Wright State University School of Medicine program. Among these are physicians from Japan, Australia, Taiwan, Canada and Mexico. In addition to the civilian program at Wright State University, there are programs conducted by the U. S. Air Force and Navy. The Wright State program has been privileged to have officers from the U. S. Army, Navy and Air Force. A substantial supporter of the Wright State program is the National Aeronautics and Space Administration and a strong space component is contained in the program.     

The need for black specialists in preventive medicine

The disparity in health status between black and white Americans exists chiefly because of an excess of preventable disease in blacks. This situation calls for an increase in preventive services for blacks, services which might best be implemented or directed by black specialists in preventive medicine. However, there exists both an absolute shortage of preventive medicine specialists (of all races) and a relative shortage of black preventive medicine specialists. The immediate need for additional black specialists exceeds the total U.S. preventive medicine residency corps.