United Mission Research Articles

Collaboration between oncogeriatrics and DAC: the experience of Ucog Poitou-Charentes

The mission of oncogeriatric coordination units (OCU) is to facilitate the coordination of professionals at all stages of the care pathway for cancer patients aged 75 and over. OCU Poitou-Charentes works with the Vienne coordination support unit (CSU 86) to ensure that patients in vulnerable and complex situations receive regular follow-up and support at home. Here's a look back at an experiment launched ten years ago.

A MATHEMATICAL MODEL FOR IDENTIFYING MILITARY TRAINING FLIGHTS

The main tasks of the Training Air Base concern the practical training of cadets in piloting techniques as well as maintaining and improving the piloting skills of the instructors. It is essential to maintain the infrastructure of the airfield and the Base as a whole ready for operation. This allows for fulfilling the fundamental mission of such military units, which is to provide effective operations for the defence of the state. Therefore, measures to support and improve the operation of such military facilities are extremely important and also became the genesis of this article. It analyses and evaluates the number of flights carried out over seven years (2016–2022) at the studied training base using mathematical modelling, allowing to assess the variability of the studied series. The phase trends method was used for this purpose, preceded by a seasonality study. It allowed the identification of periods in which the number of flights performed varies significantly. Such knowledge enables better regulation of the airport’s operation, adjustment of activities to the needs, and the determination of further directions for airport development and the justification of potential investments. An additional value of the article is the presentation of a mathematical modelling method specifically designed for seasonal time series, along with their diagnostics. It also provides an opportunity for other institutions to carry out tasks while upholding the highest standards.

Missionary involvement with the Simele massacre in 1933: the end of American sympathy for the Assyrians

ABSTRACT The Simele massacre of 1933 in Iraq, in which over 600 Assyrian Christians lost their lives, is an important part of Assyrian national history and is one of the few well-known events in twentieth-century Iraqi history where Christians are involved. While there was a general outcry in Western Europe and the United States against the Iraqi government following the massacre, the American missionaries present locally of the United Mission in Mesopotamia/Iraq did not support the Assyrians following the massacre despite the generally humanitarian approach of their mission and their support for the Assyrian cause in the early years after the First World War. In this article, I argue that apparent apathy from the side of the missionaries was largely the result of a radical change in thinking about missionary involvement in political debates concerning the future of non-Muslim minorities in the Middle East.

Post appendectomy incisional hernia: a case report

A 31-year-old man presented to the outpatient clinic at United Mission Hospital with colicky abdominal pain and bulge over the incision site which was more prominent on coughing. There was no fever. The abdomen was soft with no tenderness over the incision site and an expansive though reducible swelling was present over the right iliac fossa. The patient had undergone open appendectomy recently for acute appendicitis twenty days back. Ultrasonography revealed a 2.21cm muscle defect- findings consistent with interstitial incisional hernia. The patient underwent exploration through the same incision site electively. The subcutaneous tissue was found to be healthy. Anatomical repair with mesh placement was done. The postoperative period was uneventful and he was discharged on third postoperative day with instructions regarding dressing, removal of sutures on tenth postoperative day and avoidance of heavy weight lifting or straining and to follow up after a month.

Interregional secure hospital units in the somatic care system for prisoners

The mission of the inter-regional secure hospital units is to care for incarcerated prisoners. There are eight of them in metropolitan France, one in each prison region. They are jointly managed by the health establishments for care and by the prison administration for security. Each prisoner receives care equivalent to that provided to the rest of the population.

TriService Nursing Research Program: A critical component to support military nursing science

TriService Nursing Research Program: A critical component to support military nursing science

Editorial introductions.

Editorial introductions.

Rising to the Challenge: How Medical Reserve Corps Volunteers Serve as a Scalable Workforce for Local Health Departments in Response to COVID-19 and Beyond.

Rising to the Challenge: How Medical Reserve Corps Volunteers Serve as a Scalable Workforce for Local Health Departments in Response to COVID-19 and Beyond.

Army Reserve Participation in Tropic Care 2018: An Innovative Readiness Training to Assess Unit Defense Support of Civil Authorities Response.

ABSTRACTCoronavirus disease 2019 highlighted the Army Reserve as a key partner in Defense Support of Civil Authorities (DSCA). Tropic Care, an Innovative Readiness Training mission, led by the 1984th U.S. Army Hospital, served as a venue to train on unit Mission Essential Task Lists while providing an initial assessment on its DSCA response capability.

Bojový potenciál a bojová sila

The terms "fighting power" and "combat power" are directly related to the ability to employ military force. They express the capabilities and possibilities of action capacity of the military force, the scope of which is defined by the mission of the military units. The similarity of the definitions of both terms in the military doctrinal framework creates a condition for confusing the understanding of their different meanings, which causes inefficient use of the offered possibilities of fighting power and combat power and the ability to create their joint synergy to achieve the success. The correct understanding of their differences, but also of their interdependence, could be a key aspect of achieving success in military operations.

Demonstrating Equitable and Inclusive Crisis Leadership in Higher Education

Academic leadership faces tremendous pressure to build sustainable environments that demonstrate a commitment to the principles of inclusive excellence. Currently, the convergence of dual global crises—the COVID-19 pandemic and reckoning of systemic violence and racism toward individuals from historically marginalized and oppressed groups—has led to prioritizing impactful inclusive excellence leadership processes that address justice, equity, diversity, and inclusion. However, too often, in times of crisis, the strategic prioritizing and, more importantly, allocation of resources to support inclusive excellence initiatives are seen as secondary, tangential, or nonessential to the core operational mission of academic units. In this article, the authors discuss the unique realities, challenges, and opportunities academic leaders face when leading an equitable and inclusive academic workplace and culture during and after a crisis. The authors provide fundamental inclusive excellence and justice, equity, diversity, and inclusion terminology and definitions. In addition, the authors provide attributes, behaviors, and action steps for demonstrating equitable and inclusive crisis leadership.

Mitigating the Impact of Reemergence From a Pandemic on Healthcare.

ABSTRACTHealthcare workers have never faced a medical crisis that compares to the coronavirus disease-2019 pandemic. This modern-day pandemic fight draws parallels to a war. Because of these similarities, it would make sense that the experiences frontline providers have when transitioning to a normal healthcare routine would emulate experiences service members voice when reintegrating home from a battlefield. These common experiences include a unified mission, an exhausting, adrenaline-packed responsibility, and a celebrity-like status to the public. The pandemic response consumed healthcare with one united mission, but as we reemerge from the pandemic and restore other aspects of our healthcare system, multiple missions develop and compete. Returning to a common routine and regular status can manifest feelings of disappointment in healthcare workers’ everyday lives and career choices and lead to a reexamination of priorities and professions. As an organization with a focus on high reliability, mitigating the harm to staff and delivery system may be our new priority. The risk of not facing this situation head on is a potential exodus of seasoned professionals contemplating their future and selecting other career paths, thus draining the current institutional knowledge and potentially deterring future generations from healthcare. Leaders in the healthcare industry need to take a proactive stance in addressing this reemergence. Integrated, proactive programming is needed utilizing evidence-based resiliency training from professional organizations such as the National Alliance on Mental Illness, the Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration, as well as the existing Department of Defense programs. The Veterans Affairs has the backbone to develop and offer these programs and make a positive difference with Employee Whole Health efforts. Organized, evidence-based programming such as second victim education, mindfulness, and other personal skill building could be key to improving the lifelong well-being of our caregivers.

Gestão educacional com enfoque em indicadores de desempenho do balanced scorecard

O objetivo deste estudo foi propor um modelo de maturidade para gestão educacional de instituições de ensino superior com enfoque no balanced scorecard - BSC. Com base no instrumento de avaliação do sistema nacional de avaliação da educação superior - Sinaes - e no BSC foi elaborado o roadmap de gestão educacional. Este Roadmap foi avaliado por um grupo de especialistas. Pôde-se verificar que este modelo apresentou um mapa estratégico que pode funcionar como um instrumento para a orientação de esforços por melhores resultados de desempenho de unidades de ensino. A missão da unidade de ensino foi traduzida num conjunto de medidas de desempenho que servirão de alicerce para um sistema de medição e gestão estratégica. No roadmap o desempenho foi medido por quatro perspectivas balanceadas: pessoas, processos, posicionamento e performance que, por meio de um conjunto de objetivos e metas, se articularam numa relação de causa e efeito. O roadmap poderá ser utilizado na prescrição de ações estratégicas em unidades de ensino para que possam evoluir de um determinado nível de maturidade para um nível mais elevado, configurando um processo de melhoria contínua, tanto administrativa, quanto acadêmica.

Development and performance testing of the low-cost, 3D-printed, smartphone-compatible 'Tansen Videolaryngoscope' vs. Pentax-AWS videolaryngoscope vs. direct Macintosh laryngoscope: A manikin study.

While videolaryngoscopes help in the management of difficult airways, they remain too expensive for those with limited resources. We have developed a robust, re-usable, low-cost videolaryngoscope at United Mission Hospital Tansen, Nepal, by combining a smartphone-compatible endoscope capable of capturing still and video images with a three dimensional-printed, channelled, hyperangulated blade. The computer-aided design file for the videolaryngoscope blade was emailed and printed in London before evaluation of its performance on a difficult airway manikin. To benchmark the intubation performance of the Tansen Videolaryngoscope (TVL) in a 'difficult airway' manikin (SimMan3G, tongue fully inflated, neck stiff), against a commercially available videolaryngoscope and a conventional Macintosh laryngoscope. A manikin study. Forty-three experienced videolaryngoscope users in two London teaching hospitals. Primary outcome: Intubation success rate. grade of laryngeal view, median time to intubation and intubator-rated 'ease of use'. Our device was equivalent to Pentax-AWS and superior to Macintosh laryngoscope (TVL vs. Pentax-AWS vs. Macintosh) in overall intubation success rate (88 vs. 98 vs. 67%, P < 0.05); grade of view (median Cormack-Lehane grade 1 vs. 1 vs. 3, P < 0.01); median time to intubation (17.5 vs. 15.5 vs. 27 s, P < 0.01). In subjective 'ease of use' scores, Pentax-AWS was superior to the TVL, which was superior to Macintosh laryngoscope (Likert-type 1 to 5 scale: 4 vs. 4 vs. 1, P < 0.00001). In this manikin simulation of a difficult airway, the 'TVL' was superior to the Macintosh laryngoscope, and noninferior to the Pentax-AWS videolaryngoscope in intubation success rate, grade of laryngeal view and time to intubation. Participants found the Pentax device easier to use, and their feedback has given us valuable insights for improving our device. The TVL is well suited to settings in which resources are limited, being inexpensive, simple and re-usable.

Battlefield Ontology for Communication Unit Mission

Battlefield Ontology for Communication Unit Mission

Looking beyond COVID‐19: Crisis Leadership Implications for Chairs

Looking beyond COVID‐19: Crisis Leadership Implications for Chairs

Inpatient Unit Leaders' Perspectives on Parent Engagement in Neonatal and Pediatric Intensive Care: A Secondary, Qualitative Analysis.

Hospital unit leaders help set the unit's priorities and are responsible for guiding the unit mission and philosophy of care; however, the perspective of leaders in facilitating parent engagement within intensive care units is limited. The purpose of this study was to explore how medical and nursing unit leaders facilitate parent engagement in intensive care settings. Qualitative secondary analysis of 16 semistructured interviews of unit leadership (medical directors and nurse managers). Directed content analysis explored themes within the interviews using systematic strategies to ensure rigor. Unit leadership described 3 main features of care delivery necessary for supporting parent engagement: (1) culture of care, (2) relationships in care, and (3) environment of care. Communication among providers and parents and timing of decision-making were key areas addressed, along with concerns about physical space limiting parent engagement. Unit leaders discussed how the 3 main features (unit culture, relationships, and physical space) of care delivery were interconnected to optimize parent engagement. Overall, unit leaders recognized the importance of each feature of care delivery in facilitating engagement. Parent engagement is ultimately influenced by the optimization of delivering inclusive care: the physical space, the policies surrounding medical and nursing care, and the overall culture of the unit. Future research needs to explore best practices around relationship building and managing space limitations. Further clarification of the needs and expectations of both parents and providers surrounding parent engagement in intensive care settings is needed.

Red under Blue: Chinese Humanitarian Action in UN Peacekeeping Missions

ABSTRACTThis article documents humanitarian action undertaken by Chinese troops in six UN peacekeeping missions and shows that Chinese peacekeepers engaged in very similar types of humanitarian action regardless of their unit type or mission area. The patterns in their behaviour strongly suggest that their activities constitute a humanitarian program that is coordinated systematically at the level of China’s national military organization. Potential explanations for the humanitarianism of Chinese peacekeepers include China’s broader foreign policy objectives, its internal model of civil–military relations, the ‘developmental peace’ theory of peacekeeping and domestic public relations in China. Despite the UN’s official policy of discouraging humanitarian action by military actors, national contingents can still implement humanitarian tactics largely due to the decentralized and fragmented command and control structure of UN peacekeeping missions. More broadly, such failure to protect the humanitarian space speaks to shortcomings of the current system of UN peacekeeping. Overall, closer attention to the role of national military doctrines and national military cultures would add significantly to our understanding of the behaviour of UN peacekeepers.

Corporate Strategy for Medium Scale Manufacturing Enterprises in Kenya

Sustainable Development Goals and Africa Agenda 2063 acknowledges Small and Medium Enterprises as critical in promoting sustainable global economic development. However, most studies on corporate strategy in Kenya have mainly examined micro, small and large enterprises creating a missing middle with inadequate empirical data on medium scale enterprises, including those in the manufacturing sector. Moreover, Kenya’s big four agenda proposes support to the manufacturing sector so as to raise its GDP share to 15 percent by 2022 in support of the realization of Vision 2030. Unfortunately, growth in the manufacturing sector has stagnated at about USD 5 billion for over a decade and continues to lose market share and competitiveness internationally. This study therefore investigated corporate strategy and competitiveness of medium scale manufacturing enterprises in Kenya. Data was collected from 56 senior management staff. Mean responses received in a Likert scale of 1 – 5 for each of the tested item was calculated by summing up all the codes and getting the average of the 56 respondents. This study established MSMEs which are within the SME sector are on average performing below par on issues to do with business strategy. The results show that in 56.1% of the MSMEs, there is a clearly written business unit mission statement (mean response of 4.3). In 54.5% of the firms, the business unit strategy is not adequate in light of competitive pressure (mean response 2.5) and the business unit strategy is not appropriate for exploiting opportunities in the future. In 48.5% of the firms, the business unit strategy is not formulated carefully by all levels of management (mean response 2.7) and there is no clearly developed long term business unit strategy (mean response 2.9). In 39.4% of these firms, the business unit strategy does not adequately reflect the strengths of the business unit (mean response 2.8). The study concluded that lack of an effective business strategy to direct the efforts of human resources in the desired direction would result in inability to realize the set organizational objectives. This means these MSMEs are struggling to operate, manage and improve their businesses efficiency and effectiveness in order to deliver quality products and services consistently and on time. This has a negative effect on MSMEs performance as it implies internal inefficiencies, ineffectiveness and negative bottom line, reduced job opportunities and low contribution to the gross domestic product (GDP) in Kenya. The study recommended that the MSMEs should organise strategic focus workshops and use a combination of Porter’s five force model components to plan, organise and formulate their business strategy mechanism after a comprehensive SWOT analysis. The MSMEs should periodically review their strategy in line with the prevailing competitive pressures using the following criteria to identify crucial strategic issues: (a) The impact they could have on their enterprises, (b) the likelihood that the identified issues would materialize, and (c) the time frame over which they could develop. The number of these issues needs to be limited to a manageable number (three to nine) to enhance the chances of securing the commitment and resources necessary to effectively act on them. The expected study output would be enhanced competitiveness of MSME and realization of Kenya’s vision 2030.

Efficacy and safety of intravaginal Misoprostol versus intracervical Foley’s catheter for cervical ripening

Introduction: The purpose was to compare the efficacy and safety of the intravaginal Misoprostol versus intracervical Foley’s catheter for cervical ripening and labor inductions. &#x0D; Methods: A prospective Randomized controlled trial done among pregnant women requiring induction of labor at the United Mission Hospital, Tansen, Nepal. Primary outcome was proportion of women achieving change in cervical ripening and time required achieving it.&#x0D; Results: One hundred women were randomly assigned to receive intravaginal Misoprostol (n=50) or intracervical Foley’s catheter (n=50). Catheter group showed statistically significant change in Bishop Score than Misoprostol (P &lt;0.037). Oxytocin augmentation (16% vs 58%, P &lt;0.001) and Caesarean delivery (20% vs 28%) were lower in misoprostol group, compared to Foley’s catheter group. &#x0D; Conclusions: Intracervical Foley’s Catheter is a cheap and equally effective method with less complication for cervical ripening as compared with intravaginal Misoprostol.