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Information and communication technologies in behavioral health : a literature review with recommendations for the Air Force
Authors: --- --- ---
ISBN: 0833093444 0833090127 9780833093448 9780833090126 Year: 2015 Publisher: [Place of publication not identified] Rand Corporation

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Mental health services --- Medical informatics --- Methods --- Telemedicine --- Military Medicine --- Mental Health Services --- Military Psychiatry --- Medicine --- Delivery of Health Care --- Health Services --- Psychiatry --- Telecommunications --- Investigative Techniques --- Behavioral Disciplines and Activities --- Communications Media --- Psychiatry and Psychology --- Analytical, Diagnostic and Therapeutic Techniques and Equipment --- Patient Care Management --- Health Care Facilities, Manpower, and Services --- Health Occupations --- Behavioral Sciences --- Health Services Administration --- Information Science --- Health Care --- Disciplines and Occupations --- Mental Illness Prevention --- Public Health --- Health & Biological Sciences --- Information technology --- Community-Based Distribution --- Contraceptive Distribution --- Delivery of Healthcare --- Dental Care Delivery --- Distribution, Non-Clinical --- Distribution, Nonclinical --- Distributional Activities --- Healthcare --- Healthcare Delivery --- Healthcare Systems --- Non-Clinical Distribution --- Nonclinical Distribution --- Delivery of Dental Care --- Health Care Delivery --- Health Care Systems --- Activities, Distributional --- Activity, Distributional --- Care, Health --- Community Based Distribution --- Community-Based Distributions --- Contraceptive Distributions --- Deliveries, Healthcare --- Delivery, Dental Care --- Delivery, Health Care --- Delivery, Healthcare --- Distribution, Community-Based --- Distribution, Contraceptive --- Distribution, Non Clinical --- Distributional Activity --- Distributions, Community-Based --- Distributions, Contraceptive --- Distributions, Non-Clinical --- Distributions, Nonclinical --- Health Care System --- Healthcare Deliveries --- Healthcare System --- Non Clinical Distribution --- Non-Clinical Distributions --- Nonclinical Distributions --- System, Health Care --- System, Healthcare --- Systems, Health Care --- Systems, Healthcare --- Information Sciences --- Science, Information --- Sciences, Information --- Administration, Health Services --- Proxemics --- Behavioral Science --- Proxemic --- Science, Behavioral --- Sciences, Behavioral --- Health Professions --- Health Occupation --- Health Profession --- Occupation, Health --- Occupations, Health --- Profession, Health --- Professions, Health --- Healthcare Facilities, Manpower, and Services --- Care Management, Patient --- Management, Patient Care --- Media, Communications --- Investigative Technics --- Investigative Technic --- Investigative Technique --- Technic, Investigative --- Technics, Investigative --- Technique, Investigative --- Techniques, Investigative --- Teleconference --- Telegraphy --- Telecommunication --- Teleconferences --- Telegraphies --- Psychiatrists --- Psychiatrist --- Services, Health --- Health Service --- Service, Health --- Medical Specialities --- Medical Specialties --- Medical Specialty --- Specialities, Medical --- Specialties, Medical --- Specialty, Medical --- Medical Speciality --- Speciality, Medical --- Psychiatry, Military --- Health Services, Mental --- Services, Mental Health --- Services, Mental Hygiene --- Mental Hygiene Services --- Health Service, Mental --- Hygiene Service, Mental --- Hygiene Services, Mental --- Mental Health Service --- Mental Hygiene Service --- Service, Mental Health --- Service, Mental Hygiene --- Medicine, Military --- Mobile Health --- Telehealth --- eHealth --- mHealth --- Health, Mobile --- Methodological Studies --- Methodological Study --- Procedures --- Studies, Methodological --- Study, Methodological --- Method --- Procedure --- Clinical informatics --- Health informatics --- Medical information science --- Behavioral health care --- Mental health care --- Psychiatric care --- Psychiatric services --- organization & administration --- Occupations --- Telemetry --- Information science --- Medical care --- Data processing --- Health Workforce --- Mental Health Services. --- Telemedicine. --- Smartphone --- trends. --- methods. --- United States. --- Tele-ICU --- Tele-Intensive Care --- Tele-Referral --- Virtual Medicine --- Medicine, Virtual --- Tele ICU --- Tele Intensive Care --- Tele Referral --- Tele-Referrals --- Medical informatics.


Book
Limb Salvage and Recovery After Severe Blast Injury: Literature Review for the Eighth Department of Defense International State-of-the-Science Meeting on Blast Injury Research
Authors: --- --- --- --- --- et al.
Year: 2020 Publisher: Santa Monica, Calif. RAND Corporation

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During the conflicts in Iraq and Afghanistan, there have been changes in the mechanism, severity, and complexity of injuries from improvised explosive devices⁠—changes that have resulted in a higher incidence of combat-related traumatic injuries. Battlefield medical advances and improvements in protective equipment have resulted in a greater proportion of blast-exposed service members surviving their severe injuries, and progress in surgical reconstruction and rehabilitation has resulted in an increased medical capacity to salvage limbs. Collectively, these developments have led to important questions about when to emphasize limb salvage over other treatment options, most notably amputation, for individuals with severe blast-related limb injuries. To better understand limb salvage and recovery after severe blast-related injury, the authors conducted a literature review of recent research on the topic. They considered completed research addressing one or more of four objectives: (1) injury epidemiology and outcomes; (2) the clinical decision to salvage the limb; (3) the process of limb restoration and reconstruction; and (4) rehabilitation, reintegration, and recovery strategies. They found that although there is a vast literature on limb salvage, there is limited research on military blast-related limb salvage. The authors make several recommendations related to future research into limb salvage and recovery after severe blast injury.

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Book
Neurological Effects of Repeated Exposure to Military Occupational Levels of Blast: A Review of Scientific Literature
Authors: --- --- --- --- --- et al.
Year: 2020 Publisher: Santa Monica, Calif. RAND Corporation

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Over the past decade, there has been increasing awareness of the central nervous system (CNS) effects of exposure to explosive blast. A key driver of that awareness has been the blast-related injuries suffered during combat operations in Iraq and Afghanistan. With the near cessation of U.S. combat operations in these regions, concern has grown over common, repetitive forms of blast exposure during military service that are, most often, unrelated to combat. An example of such an exposure is routine military training involving heavy weaponry, such as artillery, recoilless rifles, and shoulder-held rocket launchers. These blast exposures are of a lower intensity than those causing acute combat-related injuries; however, repeated exposure may also have impacts on CNS structure, function, and development, as well as on the broader health of military service members. The authors of this report review the relevant literature on the effects of repeated, military occupational blast (MOB) exposures; prioritize the key research and policy gaps related to repeated MOB exposure; and examine the projects and initiatives that attempt to address those research and policy gaps.

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Book
Improving pain care for service members : administrator, provider, and patient perspectives on treatment, policies, and opportunities for change
Authors: --- --- --- ---
Year: 2023 Publisher: RAND Corporation

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Acute and chronic pain are common among service members, with musculoskeletal pain and injuries being the leading cause of nondeployability among active-duty service members. Given the significant implications for individual health and force readiness, providing high-quality pain care to service members is a priority of the Military Health System (MHS). Prior RAND research used administrative data to assess the quality and safety of pain care and opioid prescribing in the MHS, generated a set of quality measures that the MHS could adopt going forward, and identified strengths and opportunities for improvement in care provided to service members with pain conditions. In this report, authors document findings from interviews with MHS administrators, providers, and patients, providing valuable detail and context for those findings, along with on-the-ground perspectives on MHS pain care policies and guidance in practice. Staff and patients recommended prioritizing increases in treatment access and availability to improve pain care, and patients emphasized effective treatment and patient-centered care as the most important facilitators of high-quality pain care.


Book
A process evaluation of primary care behavioral health integration in the Military Health System
Authors: --- --- --- --- --- et al.
Year: 2021 Publisher: Santa Monica, Calif. RAND Corporation

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Behavioral health (BH) problems are common in the military and can adversely affect force readiness. Research suggests that primary care–behavioral health (PCBH) integration can improve BH outcomes by making high-quality BH care available in more accessible settings. However, sustaining high-quality implementation of PCBH is challenging. The authors conducted a process evaluation of the PCBH program in the military health system to understand why the program is working as it is and provide recommendations for quality improvement. They conducted semistructured interviews, rigorously coded the qualitative data to identify causal links, and created and validated causal loop diagrams that provide a visualization of how the system is working. Findings fall into four key areas: staffing and capabilities, valued tasks, program stewardship, and fostering program awareness and support. Overall, the authors found that the PCBH program is highly valued by primary care staff. However, the PCBH care model is inconsistently adhered to, owing to a combination of staff preferences, local pressures, and lack of knowledge of PCBH staff roles. Recommendations are offered to improve program implementation.


Book
Assessing the Quality of Outpatient Pain Care and Opioid Prescribing in the Military Health System
Authors: --- --- --- --- --- et al.
Year: 2022 Publisher: Santa Monica, CA : ©2022 RAND Corporation,

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Pain conditions are the leading cause of disability among active-duty service members. Given the significant implications for force readiness and service member well-being, the Military Health System (MHS) has made it a strategic priority to provide service members with the highest-quality treatment for pain conditions. RAND researchers assessed MHS outpatient care for acute and chronic pain, including opioid prescribing. The assessment involved developing a set of 14 quality measures designed to assess aspects of outpatient care for pain, including care associated with dental and ambulatory procedures, acute low back pain, chronic pain, opioid prescribing, and medication treatment for opioid use disorder. This report offers the most comprehensive examination to date of the quality and safety of pain care in the MHS and its alignment with evidence-based clinical practice guidelines. It identifies several areas of strength in pain care delivery, along with some areas for improvement, and provides recommendations to support the MHS in continuing to improve pain care for service members.


Book
2018 Department of Defense Health Related Behaviors Survey (HRBS): Results for the Reserve Component

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The Health Related Behaviors Survey (HRBS) is the Department of Defense's (DoD's) flagship survey for understanding the health, health behaviors, and well-being of service members. Originally implemented to assess substance use — illicit drugs, alcohol, and tobacco — the survey now includes a number of content areas that can potentially impact force readiness, or the ability to meet the demands of military life, including mental and physical health, sexual behavior, and postdeployment problems. In 2016, the Defense Health Agency asked the RAND Corporation to update survey content, administer a revised version of the survey, and analyze data from the resulting 2018 HRBS of reserve component personnel, including those in the Air Force Reserve, Air National Guard, Army Reserve, Army National Guard, Marine Corps Reserve, Navy Reserve, and Coast Guard Reserve. This report details the methodology, sample demographics, and results from that survey in the domains of health promotion and disease prevention, substance use, mental and emotional health, physical health and functional limitations, and sexual behavior and health. Two special sections focus on sexual orientation and health and deployment experiences and health. Differences across subgroups are examined, including service branch, pay grade, gender, race/ethnicity, and age group. The results presented here are intended to supplement data already collected by DoD and inform policy initiatives to help improve the readiness, health, and well-being of the force.

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Book
The Effect of Blast-Related Burn Injuries from Prolonged Field Care to Rehabilitation and Resilience: A Review of the Scientific Literature
Authors: --- --- --- --- --- et al.
Year: 2020 Publisher: Santa Monica, Calif. RAND Corporation

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Burns, a leading cause of fatality among military service members, are one of the most difficult injuries for which to care. Additionally, blast-related burn injuries are associated with infection, disability, mental illness, discharge from the military, and mortality. To identify areas that are understudied, RAND researchers conducted a comprehensive literature review and synthesis of the evidence surrounding blast-related burn injury. The authors found sufficient information regarding treatment; however, there remains a need for additional research concerning prevention of blast-related burn injury. They also observed a lack of studies addressing prolonged field care for burns. Because U.S. military forces have expanded their scope and mission into more remote and rugged terrain, it is not always possible to immediately evacuate injured soldiers—and personnel exposed to burn injuries are at heightened risk of infection and complications. In this type of situation, burn injuries might need to be treated and managed in the field for an extended period of time. Therefore, strategic thinking and specific planning are necessary to develop, practice, and refine potential strategies to care for burns in prolonged field settings.

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2018 Department of Defense Health Related Behaviors Survey (HRBS): Results for the Active Component

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The Health Related Behaviors Survey (HRBS) is the U.S. Department of Defense's (DoD's) flagship survey for understanding the health, health behaviors, and well-being of service members. Originally implemented to assess substance use — illicit drugs, alcohol, and tobacco — the survey now includes a number of content areas that can potentially affect force readiness, or the ability to meet the demands of military life, including mental and physical health, sexual behavior, and postdeployment problems. In 2016, the Defense Health Agency asked the RAND Corporation to update survey content, administer a revised version of the survey, and analyze data from the resulting 2018 HRBS of active component personnel, including those in the U.S. Air Force, Army, Marine Corps, Navy, and Coast Guard. This report details the methodology, sample demographics, and results from that survey in the domains of health promotion and disease prevention, substance use, mental and emotional health, physical health and functional limitations, and sexual behavior and health. Two special sections focus on sexual orientation and health and deployment experiences and health. Differences across subgroups are examined, including service branch, pay grade, gender, race/ethnicity, and age group. The results presented are intended to supplement data already collected by DoD and to inform policy initiatives to help improve the readiness, health, and well-being of the force.

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