A prospective cohort study evaluating the state of medical readiness in the United States Air Force and risk factors to improve the medical readiness posture

A cohort of 418 United States Air Force (USAF) personnel from over 15 different bases deployed to Morocco in 1994. This was the first study of its kind and was designed with two primary goals: to determine if the USAF was medically prepared to deploy with its changing mission in the new world order, and to evaluate factors that might improve or degrade USAF medical readiness. The mean length of deployment was 21 days. The cohort was 95% male, 86% enlisted, 65% married, and 78% white.^ This study shows major deficiencies indicating the USAF medical readiness posture has not fully responded to meet its new mission requirements. Lack of required logistical items (e.g., mosquito nets, rainboots, DEET insecticide cream, etc.) revealed a low state of preparedness. The most notable deficiency was that 82.5% (95% CI = 78.4, 85.9) did not have permethrin pretreated mosquito nets and 81.0% (95% CI = 76.8, 84.6) lacked mosquito net poles. Additionally, 18% were deficient on vaccinations and 36% had not received a tuberculin skin test. Excluding injections, the overall compliance for preventive medicine requirements had a mean frequency of only 50.6% (95% CI = 45.36, 55.90).^ Several factors had a positive impact on compliance with logistical requirements. The most prominent was "receiving a medical intelligence briefing" from the USAF Public Health. After adjustment for mobility and age, individuals who underwent a briefing were 17.2 (95% CI = 4.37, 67.99) times more likely to have received an immunoglobulin shot and 4.2 (95% CI = 1.84, 9.45) times more likely to start their antimalarial prophylaxsis at the proper time. "Personnel on mobility" had the second strongest positive effect on medical readiness. When mobility and briefing were included in models, "personnel on mobility" were 2.6 (95% CI = 1.19, 5.53) times as likely to have DEET insecticide and 2.2 (95% CI = 1.16, 4.16) times as likely to have had a TB skin test.^ Five recommendations to improve the medical readiness of the USAF were outlined: upgrade base level logistical support, improve medical intelligence messages, include medical requirements on travel orders, place more personnel on mobility or only deploy personnel on mobility, and conduct research dedicated to capitalize on the powerful effect from predeployment briefings.^ Since this is the first study of its kind, more studies should be performed in different geographic theaters to assess medical readiness and establish acceptable compliance levels for the USAF. ^

A comprehensive review of the environmental impacts and human health risks associated with the occurrence of waste pharmaceuticals in water sources of the United States, and policy implications

The occurrence of waste pharmaceuticals has been identified and well documented in water sources throughout North America and Europe. Many studies have been conducted which identify the occurrence of various pharmaceutical compounds in these waters. This project is an extensive review of the documented evidence of this occurrence published in the scientific literature. This review was performed to determine if this occurrence has a significant impact on the environment and public health. This project and review found that pharmaceuticals such as sex hormone drugs, antibiotic drugs and antineoplastic/cytostatic agents as well as their metabolites have been found to occur in water sources throughout the United States at levels high enough to have noticeable impacts on human health and the environment. It was determined that the primary sources of this occurrence of pharmaceuticals were waste water effluent and solid wastes from sewage treatment plants, pharmaceutical manufacturing plants, healthcare and biomedical research facilities, as well as runoff from veterinary medicine applications (including aquaculture). ^ In addition, current public policies of US governmental agencies such as the Environmental Protection Agency (EPA), Food and Drug Administration (FDA), and Drug Enforcement Agency (DEA) have been evaluated to see if they are doing a sufficient job at controlling this issue. Specific recommendations for developing these EPA, FDA, and DEA policies have been made to mitigate, prevent, or eliminate this issue.^ Other possible interventions such as implementing engineering controls were also evaluated in order to mitigate, prevent and eliminate this issue. These engineering controls include implementing improved current treatment technologies such as the advancement and improvement of waste water treatment processes utilized by conventional sewage treatment and pharmaceutical manufacturing plants. In addition, administrative controls such as the use of “green chemistry” in drug synthesis and design were also explored and evaluated as possible alternatives to mitigate, prevent, or eliminate this issue. Specific recommendations for incorporating these engineering and administrative controls into the applicable EPA, FDA, and DEA policies have also been made.^

3.4 United States Supreme Court 1938

Gaines’ legal team, led by Houston, had faith in the justice system of the United States and anticipated getting a fair trial at the federal level. So far, all decisions had occurred in Missouri, a state with a segregated system.The fact that Gaines v Canada had reached the Supreme Court was promising indeed. It was rare that any case involving African-Americans would be considered by the highest court in the land. President Franklin D. Roosevelt had been appointing Justices that were more willing to consider cases concerned with civil rights. On November 9, 1938, the Supreme Court of the United States heard arguments in the Gaines v Canada case. The defense was unmoved by the rude treatment and made their presentation with professionalism and aplomb. Houston’s argument remained steadfast; not only was the state of Missouri’s statute concerning out-of-state tuition for blacks in violation of the 14th Amendment, but the very idea of segregation itself violated the Constitution. William Hogsett, the attorney for the University of Missouri, countered that the school was merely following state laws. The MU legal team was flustered as questions from the bench forced them to correct overstatements regarding Missouri’s “generosity to Negro students”. With crossed fingers and high hopes, the Gaines legal team rested their case and awaited the verdict. Meanwhile, Lloyd Gaines was still in Michigan. Lloyd held a W.P.A. job as a Civil Service Clerk and was in constant contact with his family and attorneys. His mood in his correspondence was hopeful and positive.

Trends and patterns in research and development expenditures in the United States

This paper is a review of recent trends in United States expenditures on research and development (R&D). Real expenditures by both the government and the private sector increased rapidly between the mid-1970s and the mid-1980s, and have since leveled off. This is true of both overall expenditures and expenditures on basic research, as well as funding of academic research. Preliminary estimates indicate that about $170 billion was spent on R&D in the United States in 1995, with ≈60% of that funding coming from the private sector and about 35% from the federal government. In comparison to other countries, we have historically spent more on R&D relative to our economy than other advanced economies, but this advantage appears to be disappearing. If defense-related R&D is excluded, our expenditures relative to the size of the economy are considerably smaller than those of other similar economies.

Russia's Clandestine War against the United States: The Resurrection of the KGB and Russian Organized Crime Post 9/11

As American leadership has narrowly focused on fighting global terror in Iraq and Afghanistan, the modern version of the KGB, now known as the FSB, has been conducting continuous clandestine warfare operations against the United States. These warfare operations include strategic economic and political partnerships with anti-American entities worldwide and direct embedding of double agents in the US intelligence community. This paper investigates the role of Russia's cultural history leading to the merger of the Russian Federal Security Service (FSB) and Russian Organized Crime (ROC). This paper concludes that the FSB is the most pervasive security threat to the United States and that employing Russian native and heritage speakers of Russian in the US intelligence community compromises US national security.

Foreign aid : questions on the Central American regional program need to be resolved : report to the Honorable Patrick Leahy, United States Senate /

"B-221422"--P. [1].

Evaluation of selective erosion control techniques : Piedmont region of S.E. United States /

Mode of access: Internet.

Use of solar energy to heat anaerobic digesters : part I, technical and economic feasibility study : part II, economic feasibility throughout the United States /

Mode of access: Internet.

Impacts of sediment and nutrients on biota in surface waters of the United States /

"Grant no. R804868020."

Examination of the pricing of Falcon missiles under Department of the Air Force contracts with Hughes Aircraft Company, Culver City, California ; report to the Congress of the United States

Mode of access: Internet.

High risk areas : for civil preparedness nuclear defense planning purposes /

"TR-82."

Research needs assessment : livestock manure management in the United States /

Issued Aug. 1979.

Manual for courts-martial, 1951, United States, effective 31 May 1951. Naval supplement. 1951-.

Mode of access: Internet.

The United States and Brazil : opening a new dialogue /

Item 378-H

United States Army in World War II.

[v. 11] The framework of hemisphere defense / by S. Conn and B. Fairchild -- [v. 2.] Guarding the United States and its outposts / by S. Conn and B. Fairchild.