Civilian context

For a discussion of the systems approach to training, we briefly review the Branson et al. (1975) ISD model. This model is possibly the most widely used and comprehensive method of training development. It has been in existence for over 20 years and has revolutionized the design of instruction in many nulitary and civilian contexts. The evolutionary premises behind the model are that performance objectives are developed to address specific behavioral events (identified by task analyses), that criterion tests are developed to address the training objectives, and that training is essentially developed to teach students to pass the tests and thus achieve the requisite criteria. 

The M8 and M9 detection papers provide rapid (<1 minute), inexpensive tests for the presence of liquid mustard or nerve agents. Use of the paper is a screening test only, and results must be verified with more accurate methods of detection, particularly because of the paper s propensity to show false positive results for substances such as petroleum products and antifreeze. False positives are especially undesirable in a civilian context, where the mere rumor of "nerve gas" may cause hysteria. 

An analogous example in the civilian context could be made in the case of polio immunizations, where a 1 in 2.4 million chance exists that an oral polio virus vaccine will actually cause the disease. The risk posed by the vaccine is extremely small, but it is real, and yet poliomyelitis hasn t been seen in the Western Hemisphere since 1991. On an individual basis, a case could be made that the chances of acquiring polio, unless one travels abroad or has contact with people from endemic regions, is even less than that of acquiring vaccine-associated paralytic poliomyelitis. But there is no question that continued polio vaccinations are required in the United States, and indeed a global eradication campaign is underway to completely eliminate the virus. 

Because there are exposure scenarios that are unique to the Navy s work environment, the subcommittee also recommends that the Navy consider developing a research program to meet needs that are not being met by civilian research (e.g., the study of reproductive and developmental toxicity in the context of naval operations). Such a program would allow the Navy to anticipate and rank the agents it would like to use and to study the reproductive and developmental toxicity of those agents before its personnel are exposed. 

Now, much of the emphasis, in terms of national security, has shifted to the use of unconventional weapons unleashed on civilian targets by terrorists. Sometimes referred to as superterrorism, this includes the possible use of nuclear (that is, a fission-reaction explosion), radiological (as in the so-called dirty bomb), biological, or chemical weapons. In the context of terrorism, this chapter concerns itself with the latter two types. 

With the recent heightened awareness of the possibility of man-made disasters and bioterrorism, it is even more important to understand the current state of the science. Although there are still very few specific studies in the bioterrorism literature conducted by nurses, federal sector and military nurses have been quite active in research. In the context of the framework mentioned previously, the majority of the research conducted still focuses primarily on the provider role, with some focused on health systems implications. Much of the research focuses on the role of nurses and the care of patients in wartime or deployed environment (s) where biochemical hazards could be encountered. Although before 9/11 these studies did not appear to be relevant to disaster response in the civilian sectors, there is increasing relevance to the understanding of the role and preparation of nurses as providers in mass casualty events on U.S. soil. 

Thus we come to the present work. Not simply a story of drugs and druggists, this book is designed to be a complete treatment of pharmacy care for Union and Confederate forces for four of the most brutal years of conflict ever witnessed by this nation as such, it will seek to treat the subject in its many civilian and military contexts. It is a... 

Policies for federal funding of civilian research and development should be formulated in the larger context of the complex process of industrial innovation."... 

The techniques of mechanical dermabrasion and lasablation represent notable advances in the management of chemical agent bums. In addition to their use in a military context, it seems likely that such procedures would similarly benefit the management of civilian chemical and thermal injuries to the skin. 

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