scholarly journals Teleophthalmology in the United States Army: A Review From 2004 Through 2018

2021 ◽  
Author(s):  
Christopher M Anthony ◽  
Adam H Altman ◽  
Benjamin Otte ◽  
Michael J Mines ◽  
Robert A Mazzoli ◽  
...  
Keyword(s):  
Response Time ◽  
Military Medicine ◽  
Anterior Segment ◽  
Diagnostic Category ◽  
Case Series ◽  
The United States ◽  
The Usa ◽  
Coordination System ◽  
Military Status ◽  
The U.S

ABSTRACT Introduction We describe results of the U.S. Army Ocular Teleconsultation program from 2004 through 2018 as well as the current condition, benefits, barriers, and future opportunities for teleophthalmology in the clinical settings and disease areas specific to the U.S. Military. Materials and Methods This was a retrospective, noncomparative, consecutive case series. A total of 653 ocular teleconsultations were reviewed; 76 concerned general policy questions and underwent initial screening to determine the year each request was received, the average and median initial consultant response time, the number of participating consultants, the country from which the request originated, the military status and branch of each U.S. patient for which a request was submitted, and the nationality, age, and military status of foreign patients for whom consults were requested. The remaining 577 requests were further analyzed to determine the diagnostic category of the request, whether or not an evacuation recommendation was provided by a consultant, the relationship of the request to trauma, if and what type of nonocular specialty consultant(s) participated in the consultation request, and if and what type of ancillary imaging accompanied the request. Results The number of requests was 13 in 2004, compared to 80 in 2011 and 11 in 2018. The average response time in 2018 was 2.27 hours compared to 9. 73 hours in 2004. The number of participating ocular specialists was 5 in 2004, compared to 39 in 2013 and 13 in 2018. Requests originating from Iraq and Afghanistan comprised 61.1% (399/653) of requests. The U.S. Army personnel comprised the largest percentage of consults at 38.6% (252/653). Nonmilitary patients from the USA accounted for 18.5% (121/653) of consults. Non-U.S. patients including coalition forces, contractors, detainees, and noncombatants accounted for 14.4% (94/653) of consults, of which 22% (21/94) were children. Anterior segment consults accounted for 45.1% (260/577) of consults, with corneal surface disease being the largest subset within this diagnostic category. Evacuation was recommended in 22.7% (131/577) of overall cases and 41.1% (39/95) of trauma cases. Requests were associated with either combat-related or accidental trauma in 16.5% (95/577) of cases. Dermatology and neurology were the most commonly co-consulted specialties, representing 40.0% (32/80) and 33.75% (27/80) of consults, respectively. Photographs of suspected ocular pathology accompanied 37.4% of consults, with the likelihood requesters included photographs being greatest in cases involving pediatric ophthalmology (7/9, 77.8%) and oculoplastics (86/120, 71.7%). Conclusions Army teleophthalmology has been an indispensable resource in supporting and advancing military medicine, helping to optimize the quality, efficiency, and accessibility of ophthalmic care for U.S. Military personnel, beneficiaries, allied forces, and local nationals worldwide. A dedicated ophthalmic care and coordination system which utilizes new advances in teleconsultation technology could further enhance our current capability to care for the ophthalmic needs of patients abroad, with opportunity for improving domestic care as well.

scholarly journals Current Nuclear Strategies and Arsenals of the United States of America and the Russian Federation

2021 ◽  
Vol 30 (4) ◽  
pp. 23-44
Author(s):  
Adam Potočňák
Keyword(s):  
Cold War ◽  
United States Of America ◽  
The United States ◽  
The Other ◽  
Nuclear Forces ◽  
Nuclear Strategy ◽  
The Usa ◽  
The Russian Federation ◽  
The Cold War ◽  
The U.S

The article holistically analyses current strategies for the use and development of nuclear forces of the USA and Russia and analytically reflects their mutual doctrinal interactions. It deals with the conditions under which the U.S. and Russia may opt for using their nuclear weapons and reflects also related issues of modernization and development of their actual nuclear forces. The author argues that both superpowers did not manage to abandon the Cold War logic or avoid erroneous, distorted or exaggerated assumptions about the intentions of the other side. The text concludes with a summary of possible changes and adaptations of the American nuclear strategy under the Biden administration as part of the assumed strategy update expected for 2022.

scholarly journals HISTORICAL OVERVIEW OF U.S. INCLUSIVE EDUCATION FEDERAL LEGISLATION

2021 ◽  
pp. 39-43
Author(s):  
Tamara Bondar
Keyword(s):  
No Child Left Behind ◽  
Inclusive Education ◽  
The United States ◽  
Federal Legislation ◽  
Second Phase ◽  
Court Decisions ◽  
Equal Rights ◽  
Education Development ◽  
The Usa ◽  
The U.S

 The relevance of the research problem tackling the inclusive education evolution in the United States is explained by the fact that it the USA has been a leader in developing a rights-based model of inclusive education. The research is conditioned by the current stage of national education that undergoes modernization, the steady course of Ukraine to create an inclusive school, and government’s request to implement its initiatives. The purpose of this article is to present a reconsidered historical analysis of the inclusive education in the USA that represents an expansion of earlier research conducted by the author. Methods applied include historical and comparative research. The author’s periodization that describes the phases in the inclusive education development in the USA is presented. This is based on the chronologically arranged U.S. federal legislation related to ensuring equal rights and opportunities. It is stated that some court decisions and federal legislation that incorporated court decisions clearly marked the phases in inclusive education development. These legislative milestones beginning each phase include the U.S. Supreme Court decision Brown v. Board of Education of Topeka (1954), the Education for All Handicapped Children Act (1975), the Education of the Handicapped Students Act Amendments (1986), No Child Left Behind Act (2001), and Every Student Succeeds Act (2015). Consequently, there are five phases in the inclusive education development and each phase reflects the general trend in the U.S. inclusive education. The initial phase is referred to as the active social movement for the right to education (1954–1974). In the second phase, children with disabilities were integrated into regular schools through mainstreaming (1975–1985). Then comes the so-called Regular Education Initiative phase or full inclusion (1986–2000), followed by the accountable inclusive education phase (2001–2014). Finally, the phase of the high-quality inclusive education started in 2015 and continues today.

I Am Curious (Yellow) as Sex Education in the USA

2019 ◽  
pp. 319-326
Author(s):  
Saniya Lee Ghanoui
Keyword(s):  
United States ◽  
Sex Education ◽  
The United States ◽  
International Scale ◽  
Box Office ◽  
The Usa ◽  
The U.S

This chapter explores I Am Curious (Yellow) and the public’s response during its first box office run in the United States. It argues that the film functioned as a non-normative form of sex education, and that the U.S. government wanted to censor it swiftly not because it was pornographic, but precisely because it was deemed not to be. In other words, the film presented itself as a creative pseudo-documentary endeavor while the U.S. interpreted it as obscene and tasteless; the film pushed the definitions of what is and is not documentary and informational film. I place I Am Curious (Yellow) in the historical canon of internationally (in)famous Swedish sex education films, the most notable example being Language of Love (Ur kärlekens språk). I Am Curious (Yellow) was the first of several films that further blurred the line between sex education and pornography on an international scale.

scholarly journals The Impact of Physical Activity on Disability Incidence among Older Adults in Mexico and the United States

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Kerstin Gerst ◽  
Alejandra Michaels-Obregon ◽  
Rebeca Wong
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Developed Countries ◽  
The United States ◽  
Healthy Habits ◽  
Aging Study ◽  
The Usa ◽  
The Impact ◽  
Positive Effect ◽  
The U.S

Evidence suggests that transitions among older adults towards healthy habits, such as physical activity, appear underway in developed countries such as the USA but not in developing countries such as Mexico. However, little is known about the potential benefit of physical activity in preventing disability among elders in countries at different stages of epidemiological transition. We explore the impact of physical activity on the disablement process among elders in Mexico compared to the USA. Data are from two waves of the Mexican Health and Aging Study and the Health and Retirement Study. We examine the impact of exercise on the transition from no disability to ADL limitations two years later. Findings indicate that exercise is more common in the U.S. than in Mexico. There is a positive effect of exercise on negative outcomes in both countries. However, the protective effect of exercise is stronger in the U.S. than in Mexico.

scholarly journals The Association between Medication Experiences and Beliefs and Low Medication Adherence in Patients with Chronic Disease from Two Different Societies: The USA and the Sultanate of Oman

Pharmacy ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 31
Author(s):  
Kamla M. Ibrahim ◽  
Jon C. Schommer ◽  
Donald E. Morisky ◽  
Raquel Rodriguez ◽  
Caroline Gaither ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Online Survey ◽  
Medical Center ◽  
The United States ◽  
Sultanate Of Oman ◽  
Improve Medication Adherence ◽  
Cross Sectional ◽  
The Usa ◽  
Chi Square Analysis ◽  
The U.S

This cross-sectional study aimed to describe the association between medication experiences and beliefs and self-reported medication adherence in patients with chronic diseases in two different samples from two different societies: the USA and the Sultanate of Oman. The Morisky Medication Adherence Score (MMAS-8) questionnaire was used to measure medication adherence. Three items (statements) were used for measuring medication experiences and beliefs variable on a four-point Likert scale adapted from the 2015 National Consumer Survey of the Medication Experience and Pharmacists’ Role (NCSME&PR). In the U.S., quantitative secondary data analysis of 13,731 participants was conducted using the 2015 NCSME&PR, a self-administered online survey coordinated by Qualtrics Panels between 28 April 2015 and 22 June 2015. The same variables were translated into Arabic, with studies conducted at the Royal Court Medical Center in Oman, and data from 714 participants were collected between 16 June 2019 and 16 August 2019. Data were analyzed using IMB/SPSS version 24.0 software. Chi-square analysis and descriptive statistics were used. The results showed that the low adherence rates for medication (MMAS-8 < 6) were 56% and 52% in Omani and U.S. groups, respectively. Approximately 90% of the U.S. and Omani participants believed that “medicines are a life-saver”; however, medication adherence was higher in Oman (30%) than in the United States (9%) for these participants. In total, 60% of the U.S. and 29% of Omani participants believed that “medicines are a burden”; however, about 60–65% of participants in both countries were in the low medication adherence group. Additionally, 63% of the U.S. and 83% of the Omani participants disagreed that “medicines do more harm than good”; however, medication adherence in the U.S. (15%) was higher than in Oman (8%). In conclusion, a decrease in low medication adherence was observed with positive medication experiences and beliefs. However, the impacts of medication experiences and beliefs on low medication adherence rates were different from one population to another. The “medication burden” statement resulted in the highest percentage of difference in terms of low medication adherence rates between those who agree and those who disagree in the U.S. group (20%), whereas the “medicines are a life-saver” statement resulted in a greater difference in the Omani group (30%). Proper communication between patients and healthcare providers based on the patient’s medication experiences and beliefs will substantially improve medication adherence.

The War of Words

2017 ◽  
Author(s):  
Jose V. Fuentecilla
Keyword(s):  
The United States ◽  
The Philippines ◽  
First Year ◽  
Investment Climate ◽  
Tourist Destination ◽  
Martial Law ◽  
The Usa ◽  
The Media ◽  
Business Week ◽  
The U.S

This chapter details the continuous lobbying and organizing efforts of political exiles as well as their efforts to draw attention to their anti-Marcos and anti-martial law rhetoric. Reflecting their bias for a free press and scorn for the controlled press in the Philippines, the major U.S. media consistently gave the exiles favorable coverage. By and large, the exiles had won the media war in the United States against the regime. The generally critical attitude of the U.S. media acutely troubled Mrs. Marcos. She summoned the American ambassador, Michael Armacost, to express her husband's “anxieties about his upcoming [1982] visit to the USA.” The regime countered as best as it could. During the first year of martial law, it ran colorful multipage spreads in influential U.S. business magazines such as Fortune and Business Week. The message: there was a new, much better investment climate in the country, and it was a safe tourist destination.

scholarly journals REGIONS OF DISCORD: ANALYZING SUBNATIONAL INFLUENCES ON CHILE'S FOREIGN TRADE AND INVESTMENT POLICIES TOWARDS THE USA DURING CRITICAL EVENTS

2020 ◽  
Vol 9 (17) ◽  
Author(s):  
Rodolfo Disi Pavlic
Keyword(s):  
Foreign Trade ◽  
The United States ◽  
Critical Events ◽  
Investment Policies ◽  
Country Level ◽  
Policy Conflicts ◽  
The Usa ◽  
History Of ◽  
Trade And Investment ◽  
The U.S

What explains variation on Chile’s foreign trade and investment policies toward the United States? While previous studies have underscored international and country-level factors, this work focuses on how subnational economic differences lead to conflicts that shape the country’s policymaking. It examines Chile’s history of commercial policies toward the U.S., focusing on critical events between 1965 and 2005, finding that foreign trade and investment policy conflicts develop along regional lines during democratic periods and on issues where subnational differences in export dependence are stronger.

scholarly journals The Republic of Poland as Part of American Security Factor in Central-Eastern

2018 ◽  
pp. 688-706
Author(s):  
Liudmyla Chekalenko
Keyword(s):  
United States ◽  
Foreign Policy ◽  
United States Of America ◽  
The United States ◽  
Strategic Partnership ◽  
Scientific Cooperation ◽  
The Usa ◽  
Leading Position ◽  
Bilateral Cooperation ◽  
The U.S

The article states that the world is marked by deep changes and unexpected tendencies in security, political, economic and social fields. European West, the leading position of which is questioned with increasing frequency, has to make significant adjustments to its own policies, to strengthen its role by applying new instruments of influence in order to adequately respond to rising challenges. All participants of the European integration association, including Poland, face a range of common problems, which they cannot solve by their own. This situation determined strategic objectives of Poland’s foreign policy one of which is the establishment of long-term and allied relations with the United States of America. With the collapse of the Warsaw military bloc, Poland has implemented two major vectors: the path to the NATO and EU membership. The author points out that the position of the USA and cooperation with Washington is currently important for Poland. Among the main areas of partnership, there are economic, military, scientific cooperation, visa issues, cooperation in the field of energy and climate, etc. The priority objective is to strengthen the position of Poland on the international scene, provide country security through collaborative relations with NATO, as well as systematically expand the scope of bilateral cooperation. The Poland’s path to NATO has not been easy. Following the actual denial of membership from the US, Poland was concerned. Nevertheless in 1996 the U.S. House of Representatives and the U.S. Senate passed the NATO Enlargement Facilitation Act, particularly through Poland’s involvement. Poland’s actions in the international arena reflect the values that are the basis of the Polish state. They are democracy, the rule of law, respect for human rights and solidarity. That is why Poland follows certain priorities to achieve these goals. Foreign policy vectors are determined by the President and Parliament, among them the priority is given to strengthening Poland’s position in the international arena, to guarantee the security of the country through cooperation with NATO, etc. Consequently, Warsaw is frank that the future of Poland will depend on how the country will use its strategic partnership with the United States. Keywords: Republic of Poland, NATO, United States of America, bilateral cooperation.

scholarly journals Withdrawing Drugs in the U.S. Versus Other Countries

2012 ◽  
Vol 3 (3) ◽  
Author(s):  
Benson Ninan ◽  
Albert I Wertheimer
Keyword(s):  
United States ◽  
United Nations ◽  
The United States ◽  
Drug Products ◽  
Local Decision ◽  
The Usa ◽  
Decision Guidance ◽  
The United Nations ◽  
The U.S

Since 1979, the United Nations has maintained a list of drugs banned from sale in member countries. Interestingly, there are a number of pharmaceuticals on the market in the USA that have been banned elsewhere and similarly, there are some drug products that have been banned in the United States, but remain on the market in other countries. This report provides a look into the policies for banning drug sales internationally and the role of the United Nations in maintaining the master list for companies and countries to use for local decision guidance.   Type: Commentary

scholarly journals The Root cause of the Anti-globalization Movement in the United States: the Erosion of the Level-standard Economy

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Keren Sun
Keyword(s):  
United States ◽  
The United States ◽  
Tax Rates ◽  
Root Cause ◽  
Transnational Cooperation ◽  
The Usa ◽  
The U.S ◽  
Great Harm

This paper uses Qian’s level-standard economy approach to analyze the losses and gains of American globalization in the Neoliberal Era. Analysis found that: level-standard economy’s sectors are the losers during the process of American globalization in the Neoliberal Era; and super level-standard economy’s sectors are the winners during the process of American globalization in the Neoliberal Era. The erosion of the level-standard economy has great harm and impact on related parties, so that the USA emerges the movement of populist backlash against globalization. This paper proposes 4 measures to solve this dilemma, i.e., to impose higher tax rates on the winners of American globalization in the Neoliberal Era, to subsidize more to the losers of American globalization in the Neoliberal Era, to moderately relocate manufacturing and other industries back to the U.S., and to further strengthen transnational cooperation.

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