The article argues that recent executive overreach and politicization have severely undermined established norms of U.S. civil-military relations. To restore professional standards, the incoming Congress must actively exercise its oversight powers, moving beyond mere criticism to demanding transparency in defense policy and personnel decisions. Key reforms include enforcing meritocratic promotion processes, requiring documented justification for senior officer removals, and preventing the partisan use of the military. These actions are crucial for bolstering public trust and ensuring the military remains a nonpartisan instrument of civilian control.
Examining the Implementation and Impact of Pediatric ACE Screening: Results from a Cohort of California Clinics
English Summary
The evaluation found that integrating Adverse Childhood Experiences (ACEs) education, screening, and response into primary care is both feasible and consequential for improving patient outcomes. Quantitatively, ACE-screened patients demonstrated more favorable health utilization patterns, including reduced emergency department (ED) use and increased access to supportive services like psychotherapy and family therapy. For policy, the findings strongly recommend sustaining and expanding these integrated models of care due to their proven ability to improve routine preventative care while reducing costly acute care utilization. Successful implementation requires systemic support, including dedicated linkage staff, comprehensive trauma-informed training across all clinic roles, and improved data-sharing infrastructure.
中文摘要
評估結果指出，將「不良童年經歷」（ACEs）的教育、篩檢與應對措施整合至初級照護體系，不僅是可行的，對於改善病患預後也極具意義。從量化數據來看，接受ACEs篩檢的病患展現出更為理想的健康利用模式，包括減少急診室（ED）的使用率，並提高了對心理治療和家庭治療等支持性服務的可及性。在政策層面，研究結果強烈建議維持並擴大這些整合式照護模式，因為它們已被證明能夠改善常規預防性照護，同時降低高成本的急性病照護需求。成功的實施需要系統性的支援，包括專職的轉介人員、對所有診所角色進行全面的「創傷知情」培訓，以及提升數據共享基礎設施。
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