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Construction, Cost, Schedule, Overrun, Delay, Growth, Computer applications to medicine. Medical informatics, R858-859.7, Science (General), and Q1-390

Nearly one-half of all construction projects exceed planned costs and schedule, globally [1]. Owners and construction managers can analyze historical project performance data to inform cost and schedule overrun risk-reduction strategies. Though, the majority of open-source project datasets are limited by the number of projects, data dimensionality, and location. A significant global customer of the construction industry, the Department of Defense (DoD) maintains a vast database of historical project data that can be used to determine the sources and magnitude of construction schedule and cost overruns for many continental and international locations. The selection of data provided by the authors is a subset of the U.S. Federal Procurement Data System-Next Generation (FPDS-NG), which stores contractual obligations made by the U.S. Federal Government [2]. The data comprises more than ten fiscal years (1 Oct 2009 – 04 June 2020) of construction contract attributes that will enable researchers to investigate spatiotemporal schedule and cost performance by, but not limited to: contract type, construction type, delivery method, award date, and award value. To the knowledge of the authors, this is the most extensive open-source dataset of its kind, as it provides access to the contract data of 132,662 uniquely identified construction projects totaling $865 billion. Because the DoD's facilities and infrastructure construction requirements and use of private construction firms are congruent with the remainder of the public sector and the private sector, results obtained from analyses of this dataset may be appropriate for broader application.

Adult, Burnout, Professional epidemiology, Burnout, Professional psychology, Cross-Sectional Studies, Education, Medical, Graduate methods, Education, Medical, Graduate standards, Education, Medical, Graduate statistics numerical data, Faculty, Medical statistics numerical data, Female, Humans, Job Satisfaction, Male, Medicine statistics numerical data, Middle Aged, Military Personnel psychology, Military Personnel statistics numerical data, Physicians psychology, Physicians statistics numerical data, Psychometrics instrumentation, Psychometrics methods, Psychometrics statistics numerical data, Surveys and Questionnaires, United States epidemiology, United States Department of Defense organization administration, United States Department of Defense statistics numerical data, Burnout, Professional diagnosis, Faculty, Medical psychology, and Prevalence

Introduction: In military populations, physician burnout has potential to adversely affect medical readiness to deploy in support of joint operations. Burnout among Graduate Medical Education (GME) faculty may further threaten the welfare of the medical force given the central role these officers have in training and developing junior physicians. The primary aim of this investigation was to estimate the prevalence of burnout among faculty physicians in United States (US) Army, Navy, and Air Force GME programs.
Materials and Methods: We conducted a cross-sectional study of faculty physicians at US military GME training programs between January 2018 and July 2018. Through direct coordination with Designated Institutional Officials, we administered the Maslach Burnout Inventory Health Services Survey (MBI-HSS) via online web link to faculty physicians listed in Accreditation Data System at each sponsoring institution. In addition to the MBI-HSS, we collected demographic data and queried physicians about common occupational stressors in order to assist institutional leaders with identifying at-risk physicians and developing future interventions to address burnout.
Results: Sixteen of 21 institutions that currently sponsor military GME programs agreed to distribute the MBI-HSS survey to core faculty. We received completed assessments from 622 of the 1,769 (35.1%) reported physician core faculty at these institutions. Of the 622 physician respondents, 162 demonstrated high levels of emotional exhaustion and depersonalization for an estimated 26% prevalence of burnout. We identified only one independent risk factor for burnout: increasing numbers of deployments (OR 1.38, 95% CI 1.07-1.77). Physicians in our cohort who reported a desire to stay beyond their initial active duty service obligation were less likely to be classified with burnout (OR 0.45, 95% CI 0.26-0.77). The most common drivers of occupational distress were cumbersome bureaucratic tasks, insufficient administrative support, and overemphasis on productivity metrics.
Conclusions: We estimate that 26% of physician faculty in military GME programs are experiencing burnout. No specialty, branch of service, or specific demographic was immune to burnout in our sample. Institutional leaders in the MHS should take action to address physician burnout and consider using our prevalence estimate to assess effectiveness of future interventions.
(Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2019. This work is written by (a) US Government employee(s) and is in the public domain in the US.)

Cooperative Behavior, Health Services Needs and Demand, Humans, Research Personnel, United States, Biomedical Research, Military Health Services, Research Support as Topic, Schools, Health Occupations, and United States Department of Defense

The Military Health System (MHS) has a medical research program aimed at a wide range of health-, disease-, and injury-related topic areas that works with civilian academic institutions and the biomedical industry to accomplish its goals. There are many opportunities for civilian academic institutions and the biomedical industry to engage with this program, but its unique features are important to understand to optimize the chances for successful partnerships. Unlike the National Institutes of Health, which uses an "investigator-initiated" approach, the Department of Defense (DoD) aligns its funding with specific needs, also referred to as requirements; thus, DoD research is often described as "requirements-driven" research. At the highest level, requirements are aligned with the National Security Strategy and National Defense Strategy, though requirements documents list specific areas in medicine with unmet needs. Military labs and the Uniformed Services University of the Health Sciences, which can also receive DoD appropriations to conduct medical research, serve as hubs that interface with civilian academic institutions and the biomedical industry and organize and track the overall progress of DoD investments. As a mechanism to propel findings from "bench to bedside," the military budgets funds for the various phases of research and development for a given topic area. Research programs are most effective when they are integrated into the MHS learning health system, which allows MHS clinical communities to inform and track research investments and evaluate the utility of research products in real clinical practice settings. This Perspective provides introductory information and a basic framework for those interested in performing DoD-funded medical research or collaborating with researchers in military labs. It is hoped that as academic institutions and the biomedical industry look to increase efficiency in medical research, they will find ways to engage with DoD research opportunities and consider elements of the military's approach useful.

EDUCATION & EDUCATIONAL RESEARCH, blogosfera militar, guerra contra el terror, medios sociales, Milblogs, War on Terror, and Social Media

Nueva mirada a la política del Departamento de Defensa de los Estados Unidos en torno el uso que de las capacidades basadas en Internet y, en especial, el de la blogosfera y de los medios sociales en este siglo. Se considera que, el Departamento de Defensa de los Estados Unidos ha atravesado por distintas etapas hasta lograr un papel proactivo en la blogosfera y los medios sociales. Se habla del surgimiento del blog y de la blogosfera en términos generales, para luego enfocarse en las características de la blogosfera militar. Explica las distintas etapas por las que ha atravesado la política del Pentágono en torno a la misma, y con relación a los medios sociales.
Fresh look upon the United States Defense Department's policy on the use of Internet-based capabilities, and especially the blogosphere and social media, in this century. It shows that this Department has passed through several stages until it has played a proactive role in the blogosphere and social media. The paper is divided into several sections. First, the emergence of blogging and the blogosphere is broadly talked about, and then features of milblogs are examined. It also examines several stages passed through by the Pentagon policy on milblogs and social media.