The Unified Combatant Command System: Centerpiece of the 1986 U.S. Armed Forces Reforms

This article highlights the pivotal nature of the Goldwater-Nichols Department of Defense Reorganization Act of 1986 regarding reforms made in the armed forces of the United States. The unified combatant command system is often seen as the centerpiece of these reforms. The goal of this study is to examine whether the unified combatant command system, which consists of 11 Joint combatant commands within the U.S. Department of Defense, indeed constitutes the centerpiece of these reforms. To fully answer this research question, the study presented here first examines the modern reforms of the U.S. armed forces to provide a solid foundation for subsequent research. It will be concluded that Goldwater-Nichols was the reform most directly relevant to this study. The majority of the article is then devoted to an examination of the 11 combatant commands, identifying how each contributes to the achievement of the goals laid out by Goldwater-Nichols. The author concludes that these 11 unified combatant commands constitute the centerpiece of, and provide the most essential toolset for, the achievement of Goldwater-Nichols.

Challenges of Adopting DevOps for Combat Systems Development Environment

The Department of Defense (DoD) is often exhorted to adopt best practices from industry, and more recently, innovation in software development as exemplified by Silicon Valley. Yet, the DoD is vastly different from industry in multiple aspects, and adoption of such practices is not as straightforward as in industry. This article investigates the challenges of adopting Development and Operations (DevOps) in the U.S. Navy for combat systems. The authors conducted interviews of multiple subject matter experts in the Navy and DoD familiar with software development, DevOps, and the DoD’s acquisition processes. The observations collected from the interviews were organized and classified into either organizational, process, regulatory challenges, and technical challenges. The majority of the challenges cited were nontechnical challenges dealing with regulations, organization culture, and process. Knowledge of the challenges could help acquisition leaders in planning for, and adapting DevOps to, the Navy’s acquisition process to improve DoD’s software development and maintenance processes.

Influenza Vaccine Effectiveness Estimates among US Department of Defense Adult Beneficiaries over Four Consecutive Influenza Seasons: A Test-Negative Design Study with Different Control Groups

A test-negative design study with different control groups (influenza test-negative controls, non-influenza virus positive controls, and pan-negative controls) was conducted to assess inactivated influenza vaccine effectiveness (VE) in adults aged ≥18 years, 2016–2017 through 2019–2020 influenza seasons. A database was developed from the US Department of Defense Global Respiratory Pathogen Surveillance Program. VE was estimated using a generalized linear mixed model with logit link and binomial distribution, adjusted for confounding effects. A total of 7114 adults including 2543 medically attended, laboratory-confirmed influenza-positive cases were identified. Using influenza test-negative controls, the adjusted VE in adults was 40% [95% confidence interval (CI): 33–46%] overall, including 46% (95% CI: 36–55%) for influenza A(H1N1)pdm09, 32% (95% CI: 19–42%) for influenza A(H3N2), and 54% (95% CI: 44–62%) for influenza B. The age-stratified analysis showed that VE estimates against influenza A(H1N1)pdm09 (34%; 95% CI: −29–66%) and influenza A(H3N2) (6%; 95% CI: −60–45%) were low and non-significant for elderly adults ≥65 years of age. Overall VE estimates against any influenza or by influenza (sub)types in adults were consistent when using influenza test-negative controls, non-influenza virus positive controls, and pan-negative controls. Inactivated influenza vaccination provided moderate protection against influenza virus infection, based on the analysis from a large number of adults aged ≥18 years over multiple influenza seasons.

A Review of Genome-Based Precision Medicine Efforts Within the Department of Defense

ABSTRACT Introduction Providing patient-specific clinical care is an expanding focus for medical professionals and researchers, more commonly referred to as personalized or precision medicine. The goal of using a patient-centric approach is to provide safer care while also increasing the probability of therapeutic success through careful consideration of the influence of certain extrinsic and intrinsic human factors in developing the patient care plan. Of increasing influence on patient care is the phenotype and genotype information gathered from employing various next-generation sequencing methods. Guided by and partnered with our civilian colleagues, clinical components within the DoD are embracing and advancing genomic medicine in many facets—from the bench to the bedside—and in many therapeutic areas, from Psychiatry to Oncology. In this PubMed-based review, we describe published clinical research and interventions within the DoD using genome-informed data and emphasize precision medicine efforts in earlier stages of development with the potential to revolutionize the approach to therapeutics. Materials and Methods The new PubMed database was searched for articles published between 2015 and 2020 with the following key search terms: precision medicine, genomic, pharmacogenetic, pharmacogenomic, US military, and Department of Defense. Results Eighty-one articles were retrieved in our initial search. After screening the abstracts for studies that only involved direct testing of (or clinical interaction with) active duty, Reserve, National Guard, or civilian personnel working within the DoD and excluding any epidemiological or microbial isolation studies, seven were included in this review. Conclusion There are several programs and studies within the DoD, which investigate or use gene-based biomarkers or gene variants to deliver more precise clinical assessment and treatment. These genome-based precision medicine efforts aim to optimize the clinical care of DoD beneficiaries, particularly service members in the operational environment.

The department of defense high performance computing modernization program

The Department of Defense High Performance Computing Modernization Program celebrates its 30th birthday in 2021. It was created to modernize the supercomputer capability of Department of Defense laboratories and test centers and continues to excel in that mission, providing hardware, software, networks and domain expertise. We describe the Program, the environment in which it was created, the people who helped bring it into existence, and future directions.

Mental Health Stigma in Department of Defense Policies: Analysis, Recommendations, and Outcomes

ABSTRACT Introduction Mental health stigma is one of the most frequently reported barriers to mental health help-seeking in the military. Previous research has identified that stigma-increasing language in the United States military policies was a potential deterrent to treatment-seeking. In response to a 2016 Government Accountability Office report recommendation, the current study conducted a comprehensive review of Department of Defense and military service-specific policies to identify stigmatizing language provisions and recommend appropriate language changes. Methods This review of policies comprised three sequential phases. First, a key-term search strategy was conducted on mental health (Phase 1) and substance misuse policies (Phase 2) to identify language that may contribute to stigma. Recommended language changes were identified, and the results of each phase were briefed to service-level Directors of Psychological Health. Approximately three years after initial identification, all mental health policies from Phase 1 for which language change recommendations had been made were examined to determine whether or not recommended changes had been incorporated (Phase 3). Results Out of 285 mental health and substance misuse policies, 191 (67%) contained potentially stigmatizing language. Subsequent review of implementation showed that partial or full recommended language changes had been made in 58.9% of 129 mental health-related policies that had been re-issued. Conclusions This collaborative effort to identify and modify potentially stigmatizing language contributed to a substantial reduction in problematic policies across the military services. Future efforts should focus on reviewing new and re-issued policies to ensure that stigma-increasing language is not present as part of routine issuance. These efforts are part of ongoing work to address the association that language and terminology have on stigma and barriers to care.

Analysis Criteria for Defense Expenditure Performance – Economy, Efficiency, and Effectiveness

Based on the analysis of public expenditure performance, this article discusses the economy, efficiency, and effectiveness of defense expenditure performance, explains the relationship of the three, and emphasizes their unity, interaction, and priority. The defense expenditure performance evaluation system, which is a comprehensive assessment of processes and results, is put forward along with the unification of economy, efficiency, and effectiveness. This system can be used to analyze whether the allocation and use of defense funds have achieved the strategic objectives of the Department of Defense.

Engineering With Nature® : supporting mission resilience and infrastructure value at Department of Defense installations

This book illustrates some of the current challenges and hazards experienced by military installations, and the content highlights activities at seven military installations to achieve increased resilience through natural infrastructure.