WorldWideScience

Sample records for veterans service center

  1. 38 CFR 21.6420 - Coordination with the Veterans Service Center.

    Science.gov (United States)

    2010-07-01

    ... VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Temporary Program of Vocational... Coordination with the Veterans Service Center. It is the responsibility of the VR&E Division to inform the...

  2. Center for Women Veterans

    Science.gov (United States)

    ... various organizations and individuals are doing to challenge perceptions about women Veterans. Learn more » #VeteranOfTheDay - Nominate a Veteran Today! Veteran of the Day has been a tradition on VA’s social media pages for more than two years now. This ...

  3. VeteranOtherInformationService

    Data.gov (United States)

    Department of Veterans Affairs — This service is used to create, read, delete and update additional information captured during the EVSS Disability Compensation interview in an effort to align with...

  4. 75 FR 68975 - Supportive Services for Veteran Families Program

    Science.gov (United States)

    2010-11-10

    ..., National Center for Homelessness Among Veterans, Supportive Services for Veteran Families Program Office... services pursuant to payments from the grantee be State-licensed because ``home run daycare and other... some jurisdictions, may include home run daycares. The commenter also requested that VA consider...

  5. Distance to Veterans Administration Medical Centers as a Barrier to Specialty Care for Homeless Women Veterans.

    Science.gov (United States)

    Gawron, Lori M; Pettey, Warren B P; Redd, Andrew M; Suo, Ying; Gundlapalli, Adi V

    2017-01-01

    Homeless women Veterans have a high prevalence of chronic mental and physical conditions that necessitate frequent healthcare visits, but travel burdens to specialty services may be overwhelming to navigate for this population, especially for those in rural settings. Access to specialty care is a key priority in the Veterans Health Administration (VHA) and understanding the geographic distribution and rural designation of this population in relation to medical centers (VAMC) can assist in care coordination. We identified 41,747 women Veterans age 18-44y with administrative evidence of homelessness in the VHA anytime during 2002-2015. We found 7% live in rural settings and 29% live >40miles from a VAMC. The mean travel distance for homeless women Veterans with a rural designation to a VAMC specialty center was 107 miles. Developing interventions to overcome this travel burden and engage vulnerable Veterans in necessary care can improve overall health outcomes for this high-risk population.

  6. 38 CFR 21.272 - Veteran-student services.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Veteran-student services.... Chapter 31 Monetary Assistance Services § 21.272 Veteran-student services. (a) Eligibility. Veterans who.... Veteran-student services may be utilized in connection with: (1) VA outreach service program as carried...

  7. Veterans' Mental Health in Higher Education Settings: Services and Clinician Education Needs.

    Science.gov (United States)

    Niv, Noosha; Bennett, Lauren

    2017-06-01

    Utilization of the GI Bill and attendance at higher education institutions among student veterans have significantly increased since passage of the Post-9/11 GI Bill. Campus counseling centers should be prepared to meet the mental health needs of student veterans. This study identified the mental health resources and services that colleges provide student veterans and the education needs of clinical staff on how to serve student veterans. Directors of mental health services from 80 California colleges completed a semistructured phone interview. Few schools track the number, demographic characteristics, or presenting needs of student veterans who utilize campus mental health services or offer priority access or special mental health services for veterans. Directors wanted centers to receive education for an average of 5.8 veteran-related mental health topics and preferred workshops and lectures to handouts and online training. Significant training needs exist among clinical staff of campus mental health services to meet the needs of student veterans.

  8. 75 FR 24514 - Supportive Services for Veteran Families Program

    Science.gov (United States)

    2010-05-05

    ... eligible homeless veterans, such as the Health Care for Homeless Veterans (HCHV) Program, the Grant and Per... AFFAIRS 38 CFR Part 62 RIN 2900-AN53 Supportive Services for Veteran Families Program AGENCY: Department... concerning the Supportive Services for Veteran Families Program (SSVF Program) of the Department of Veterans...

  9. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Topics For Veterans For Researchers Research Oversight Special Groups Caregivers Combat Veterans & their Families Readjustment Counseling (Vet Centers) War Related Illness & Injury Study Center Homeless Veterans Returning Service Members Rural Veterans Seniors & Aging Veterans Volunteers Women Veterans ...

  10. Service Utilization of Veterans Dually Eligible for VA...

    Data.gov (United States)

    U.S. Department of Health & Human ServicesService Utilization of Veterans Dually Eligible for VA and Medicare Fee-For-Service, 1999-2004 According to findings in Service Utilization of Veterans Dually...

  11. The Application of Strategic Planning Tools for Enhanced Palliative Care Services at the Minneapolis Veterans Affairs Medical Center

    National Research Council Canada - National Science Library

    Mylan, Marci M

    2005-01-01

    .... Using selected strategic planning tools, the study examined the gaps in services by gathering staff opinions, examining local statistics regarding end-of-life care, and looking at community and national trends...

  12. Barriers to Psychosocial Services among Homeless Women Veterans

    Science.gov (United States)

    HAMILTON, ALISON B.; POZA, INES; HINES, VIVIAN; WASHINGTON, DONNA L.

    2015-01-01

    Veterans comprise a disproportionate fraction of the nation's homeless population, with women veterans up to four times more likely to be homeless than non-veteran women. This paper provides a grounded description of barriers to psychosocial services among homeless women veterans. Three focus groups were held in Los Angeles, CA, with a total of 29 homeless women veterans. These women described three primary, proximal (current) barriers: lack of information about services, limited access to services, and lack of coordination across services. Compared to non-veteran homeless women, women veterans potentially face additional challenges of trauma exposure during military service, post-military readjustment issues, and few services specific to women veterans. Understanding their service needs and experiences is critical to the development of relevant and appropriate services that move homeless women veterans away from vulnerability, into safety. PMID:26617471

  13. Barriers to Psychosocial Services among Homeless Women Veterans.

    Science.gov (United States)

    Hamilton, Alison B; Poza, Ines; Hines, Vivian; Washington, Donna L

    2012-01-01

    Veterans comprise a disproportionate fraction of the nation's homeless population, with women veterans up to four times more likely to be homeless than non-veteran women. This paper provides a grounded description of barriers to psychosocial services among homeless women veterans. Three focus groups were held in Los Angeles, CA, with a total of 29 homeless women veterans. These women described three primary, proximal (current) barriers: lack of information about services, limited access to services, and lack of coordination across services. Compared to non-veteran homeless women, women veterans potentially face additional challenges of trauma exposure during military service, post-military readjustment issues, and few services specific to women veterans. Understanding their service needs and experiences is critical to the development of relevant and appropriate services that move homeless women veterans away from vulnerability, into safety.

  14. Barriers to Psychosocial Services among Homeless Women Veterans

    OpenAIRE

    HAMILTON, ALISON B.; POZA, INES; HINES, VIVIAN; WASHINGTON, DONNA L.

    2012-01-01

    Veterans comprise a disproportionate fraction of the nation's homeless population, with women veterans up to four times more likely to be homeless than non-veteran women. This paper provides a grounded description of barriers to psychosocial services among homeless women veterans. Three focus groups were held in Los Angeles, CA, with a total of 29 homeless women veterans. These women described three primary, proximal (current) barriers: lack of information about services, limited access to se...

  15. Veterans Integrated Services Networks (VISN), Markets, Submarkets, Sectors and Counties by Geographic Location

    Data.gov (United States)

    Department of Veterans Affairs — The Department of Veterans Affairs (VA) provides healthcare services to its veterans across the USA including territories and possessions. Healthcare services are...

  16. Salt Lake Community College Veterans Services: A Model of Serving Veterans in Higher Education

    Science.gov (United States)

    Ahern, Aaron; Foster, Michael; Head, Darlene

    2015-01-01

    This chapter outlines the birth and growth of a veterans' program in Salt Lake City, Utah, and discusses next steps in spurring additional innovations and advancements to improve service for student veterans in community colleges.

  17. Colleges' Experiences: Integrating Support Services for Military Veterans

    Science.gov (United States)

    Karp, Melinda Mechur; Klempin, Serena

    2017-01-01

    To improve the educational experiences and outcomes of student veterans, the Kisco Foundation developed the Kohlberg Prize in 2015. Two cohorts of colleges were awarded competitive grants to enhance their veterans services. This piece examines the process of creating integrated services for student veterans through the institutionalization of…

  18. Effect of center-based counseling for veterans and veterans' families on long-term mental health outcomes.

    Science.gov (United States)

    O'Donnell, Meaghan; Varker, Tracey; Perry, Desmond; Phelps, Andrea

    2013-12-01

    The Veterans and Veterans Families Counselling Service (VVCS), established by the Australian government, plays a pivotal role in providing mental health services to veterans and their families. This research explored the impact of center-based psychological counseling on depression, anxiety, stress, and alcohol use severity. A stratified sample of VVCS clients were invited to participate in this study. Data were collected on intake to the program, at the fifth counseling session, and 12 months after the commencement of counseling. Repeated-measures general linear model analyses were conducted to examine the impact of center-based counseling on depression, anxiety, stress, and alcohol severity over time. VVCS center-based counseling resulted in a significant reduction in depression, anxiety, stress, and alcohol use severity after five sessions, and these improvements were maintained over the next 12 months. Despite these improvements, however, participants continued to report moderate-to-severe levels of mental health problems. VVCS center-based counseling successfully reduced depression, anxiety, stress, and alcohol use symptom severity of veterans and their families. However, the clinical profiles of this population are often complex and challenges remain in terms of addressing the mental health needs of this group. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

  19. Adaptation of Lean Six Sigma Methodologies for the Evaluation of Veterans Choice Program at 3 Urban Veterans Affairs Medical Centers.

    Science.gov (United States)

    Ball, Sherry L; Stevenson, Lauren D; Ladebue, Amy C; McCreight, Marina S; Lawrence, Emily C; Oestreich, Taryn; Lambert-Kerzner, Anne C

    2017-07-01

    The Veterans Health Administration (VHA) is adapting to meet the changing needs of our Veterans. VHA leaders are promoting quality improvement strategies including Lean Six Sigma (LSS). This study used LSS tools to evaluate the Veterans Choice Program (VCP), a program that aims to improve access to health care services for eligible Veterans by expanding health care options to non-VHA providers. LSS was utilized to assess the current process and efficiency patterns of the VCP at 3 VHA Medical Centers. LSS techniques were used to assess data obtained through semistructured interviews with Veterans, staff, and providers to describe and evaluate the VCP process by identifying wastes and defects. The LSS methodology facilitated the process of targeting priorities for improvement and constructing suggestions to close identified gaps and inefficiencies. Identified key process wastes included inefficient exchange of clinical information between stakeholders in and outside of the VHA; poor dissemination of VCP programmatic information; shortages of VCP-participating providers; duplication of appointments; declines in care coordination; and lack of program adaptability to local processes. Recommendations for improvement were formulated using LSS. This evaluation illustrates how LSS can be utilized to assess a nationally mandated health care program. By focusing on stakeholder, staff, and Veteran perspectives, process defects in the VCP were identified and improvement recommendations were made. However, the current LSS language used is not intuitive in health care and similar applications of LSS may consider using new language and goals adapted specifically for health care.

  20. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Veterans Not Enrolled in VA Health Care Family Members Frequently Asked Questions Schedule a VA Appointment Conditions & ... Illness & Injury Study Center Homeless Veterans Returning Service Members Rural Veterans Seniors & Aging Veterans Volunteers Women Veterans ...

  1. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Employment Center Returning Service Members Vocational Rehabilitation & Employment Homeless Veterans Women Veterans Minority Veterans Plain Language Surviving Spouses & Dependents Adaptive Sports Program ADMINISTRATION Veterans Health Administration Veterans Benefits Administration National ...

  2. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... at VA Employment Center Returning Service Members Vocational Rehabilitation & Employment Homeless Veterans Women Veterans Minority Veterans Plain Language Surviving Spouses & Dependents Adaptive Sports Program ADMINISTRATION Veterans Health Administration Veterans Benefits Administration ...

  3. Effectiveness of Service Dogs for Veterans with PTSD: Preliminary Outcomes.

    Science.gov (United States)

    Vincent, Claude; Belleville, Geneviève; Gagnon, Dany H; Dumont, Frédéric; Auger, Edouard; Lavoie, Vicky; Besemann, Markus; Champagne, Noël; Lessart, Geneviève

    2017-01-01

    Limited scientific evidence on the effectiveness of psychiatric service dogs used by Veterans with post-traumatic stress disorder (PTSD) is available. This study investigated their short-term effectiveness among 15 Canadian veterans who received a first psychiatric service dog. Preliminary results suggest potential beneficial effects at 3 months on the psychiatric symptoms.

  4. Employing Our Veterans. Part 2. Service Member Transition

    Science.gov (United States)

    2013-01-01

    one common website that will consolidate the web based resources available to the transitioning veteran. 3. Professional outplacement service...consolidate the web based resources available to the transitioning veteran. 3. Professional outplacement service providers should be used to enhance the

  5. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Topics For Veterans For Researchers Research Oversight Special Groups Caregivers Combat Veterans & their Families Readjustment Counseling (Vet Centers) War Related Illness & Injury Study Center Homeless Veterans Returning Service Members Rural Veterans ...

  6. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... and Media Research Topics For Veterans For Researchers Research Oversight Special Groups Caregivers Combat Veterans & their Families Readjustment Counseling (Vet Centers) War Related Illness & Injury Study Center Homeless Veterans Returning Service Members Rural Veterans ...

  7. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Readjustment Counseling (Vet Centers) War Related Illness & Injury Study Center Homeless Veterans Returning Service Members Rural Veterans ... Strat Plan FY 2014-2020 VA Plans, Budget, & Performance VA Claims Representation RESOURCES ... Veterans Health Administration Veterans Benefits Administration ...

  8. Use of Veterans Affairs and Medicaid Services for Dually Enrolled Veterans.

    Science.gov (United States)

    Yoon, Jean; Vanneman, Megan E; Dally, Sharon K; Trivedi, Amal N; Phibbs, Ciaran S

    2017-06-13

    To examine how dual coverage for nonelderly, low-income veterans by Veterans Affairs (VA) and Medicaid affects their demand for care. Veterans Affairs utilization data and Medicaid Analytic Extract Files. A retrospective, longitudinal study of VA users prior to and following enrollment in Medicaid 2006-2010. Veterans Affairs reliance, or proportion of care provided by VA, was estimated with beta-binomial models, adjusting for patient and state Medicaid program factors. In a cohort of 19,890 nonelderly veterans, VA utilization levels were similar before and after enrolling in Medicaid. VA outpatient reliance was 0.65, and VA inpatient reliance was 0.53 after Medicaid enrollment. Factors significantly associated with greater VA reliance included sociodemographic factors, having a service-connected disability, comorbidity, and higher state Medicaid reimbursement. Factors significantly associated with less VA reliance included months enrolled in Medicaid, managed care enrollment, Medicaid eligibility type, longer drive time to VA care, greater Medicaid eligibility generosity, and better Medicaid quality. Veterans Affairs utilization following new Medicaid enrollment remained relatively unchanged, and the VA continued to provide the large majority of care for dually enrolled veterans. There was variation among patients as Medicaid eligibility and other program factors influenced their use of Medicaid services. © Health Research and Educational Trust.

  9. 38 CFR 21.155 - Services to a veteran's family.

    Science.gov (United States)

    2010-07-01

    ... (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Vocational Rehabilitation and Employment Under 38 U.S.C... furnished to family members under these provisions. (c) Providing services to a veteran's family. VR&E Staff...

  10. Defense and Veterans Brain Injury Center

    Science.gov (United States)

    ... Warrior Care Month The military community recognizes the strength and resilience of our wounded, ill, and injured service members, and their families and caregivers in November. This year’s theme is “Show of Strength.” 1 2 DVBIC 25 Years of Service Read ...

  11. 20 CFR 404.1311 - Ninety-day active service requirement for World War II veterans.

    Science.gov (United States)

    2010-04-01

    ... World War II veterans. 404.1311 Section 404.1311 Employees' Benefits SOCIAL SECURITY ADMINISTRATION... Uniformed Services World War II Veterans § 404.1311 Ninety-day active service requirement for World War II veterans. (a) The 90 days of active service required for World War II veterans do not have to be...

  12. Veterans Administration Databases

    Science.gov (United States)

    The Veterans Administration Information Resource Center provides database and informatics experts, customer service, expert advice, information products, and web technology to VA researchers and others.

  13. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Injury Study Center Homeless Veterans Returning Service Members Rural Veterans Seniors & Aging Veterans Volunteers Women Veterans Careers, Job Help & Training Find a Job with VA Health Care Jobs (VA Careers) Travel Nurses Get Job ...

  14. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Related Illness & Injury Study Center Homeless Veterans Returning Service Members Rural Veterans Seniors & Aging Veterans Volunteers Women Veterans Careers, Job Help & Training Find a Job with VA Health Care Jobs (VA Careers) Travel Nurses Get Job Help ...

  15. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Us FAQs Ask a Question Toll Free Numbers Homeless Veterans Chat VA » Health Care » PTSD: National Center ... Vet Centers) War Related Illness & Injury Study Center Homeless Veterans Returning Service Members Rural Veterans Seniors & Aging ...

  16. Factors Affecting Post-Service Wage Growth for Veterans

    Science.gov (United States)

    1991-12-01

    block number) FIELD GROUP SUBGROUP National Longitudinal Survey of Youth (NLSY I, veterans, local unemployment 19. ABSTRACT (continue on reverse if...ings in these two years was the local unemployment rate. It was also discovered that the determinants of earnings in 1982 differed significantly...analyzes factors affecting the post-service -arnings and wage growth of veterans. The 1979-1987 National Longitudi-’nal Survey of Youth was tlbe

  17. Migration by Veterans Who Received Homeless Services From the Department of Veterans Affairs.

    Science.gov (United States)

    Metraux, Stephen; Treglia, Dan; O'Toole, Thomas P

    2016-10-01

    We examined migration patterns among 113,400 homeless veterans, focusing on the prevalence and the basic geographic patterns of this migration. Data were for all veterans who initiated use of Veterans Affairs homeless services in 2011 or 2012; and we followed them using Veterans Affairs administrative records for up to 2 years following this initial contact. Results showed that 15.3% of the veterans migrated across regions while homeless. Those who were homeless for longer periods were more likely to migrate, and migration, were it to occur, was most likely earlier on in veterans' homelessness episodes. There were no clear geographic correlates that explained the dynamics of this migration as, overall, in-migration tended to roughly balance out-migration in a region. These findings suggest that concerns about the extent of migration and its impact on localities are exaggerated, but also sets forth an agenda for more in-depth study of these data to gain a deeper and more expansive understanding of this phenomenon. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  18. Gender and the use of Veterans Health Administration homeless services programs among Iraq/Afghanistan veterans.

    Science.gov (United States)

    Blackstock, Oni J; Haskell, Sally G; Brandt, Cynthia A; Desai, Rani A

    2012-04-01

    Female Veterans comprise 12% of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans, the largest proportion of women to serve of any prior cohort. We sought to determine the sex-specific risk of using a Veterans Health Administration (VHA) homeless program among OEF/OIF Veterans and to identify factors associated with increased risk of program use for women compared with men. We included OEF/OIF Veterans with at least 1 VHA clinical visit between October 1, 2001, and September 30, 2009. The study's outcome was the time to first use of a VHA homeless program. Cox proportional-hazards regression was used to estimate the relative risk of using a homeless program by sex, adjusting for relevant sociodemographic and clinical variables. Exploratory analyses examined interactions between sex and all covariates. Of 445,319 Veterans, 7431 (1.7%) used a VHA homeless program, of which 961 were females (1.8%), and 6470 were males (1.7%) during a median follow-up period of 3.20 years. Women were as likely as men to use a homeless program (adjusted hazard ratio, 1.02; 95% confidence interval, 0.95-1.09); median time to first use was similar for female and male Veterans (1.88 vs. 1.88 y, respectively, P=0.53). In exploratory analyses, we found increased risk of program use for women compared with men for the following subgroups: ages 26-35 years, 100% service-connected disability rating, posttraumatic stress disorder diagnosis, and northeast location. Overall, there was no substantial difference in the sex-specific risk of using a VHA homeless program. In light of this finding, VHA homeless programs must be prepared to recognize and address the unique needs of female OEF/OIF Veterans.

  19. Assessment of Service Members Knowledge and Trust of the Department of Veterans Affairs

    Science.gov (United States)

    2015-06-12

    OIF Operation Iraqi Freedom VA Department of Veterans Affairs VA OIG Department of Veterans Affairs Office of Inspector General VBA Veterans Benefits...reorganization into the three administrations: Veterans Health Administration (VHA), Veterans Benefits Administration ( VBA ) and National Cemetery...features. VBA also implemented a similar program in coordination with DoD called eBenefits which allows Veterans, Service Members and their families to

  20. A Home-Based Palliative Care Consult Service for Veterans.

    Science.gov (United States)

    Golden, Adam G; Antoni, Charles; Gammonley, Denise

    2016-11-01

    We describe the development and implementation of a home-based palliative care consult service for Veterans with advanced illness. A retrospective chart review was performed on 73 Veterans who received a home-based palliative care consult. Nearly one-third were 80 years of age or older, and nearly one-third had a palliative diagnosis of cancer. The most common interventions of the consult team included discussion of advance directives, completion of a "do not resuscitate" form, reduction/stoppage of at least 1 medication, explanation of diagnosis, referral to home-based primary care program, referral to hospice, and assessment/support for caregiver stress. The home-based consult service was therefore able to address clinical and psychosocial issues that can demonstrate a direct benefit to Veterans, families, and referring clinicians. © The Author(s) 2015.

  1. 38 CFR 3.453 - Veterans compensation or service pension or retirement pay.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Veterans compensation or service pension or retirement pay. 3.453 Section 3.453 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS ADJUDICATION Pension, Compensation, and Dependency and Indemnity Compensation...

  2. Use of VA and Medicare services by dually eligible veterans with psychiatric problems.

    Science.gov (United States)

    Carey, Kathleen; Montez-Rath, Maria E; Rosen, Amy K; Christiansen, Cindy L; Loveland, Susan; Ettner, Susan L

    2008-08-01

    To examine how service accessibility measured by geographic distance affects service sector choices for veterans who are dually eligible for veterans affairs (VA) and Medicare services and who are diagnosed with mental health and/or substance abuse (MH/SA) disorders. Primary VA data sources were the Patient Treatment (acute care), Extended Care (long-term care), and Outpatient Clinic files. VA cost data were obtained from (1) inpatient and outpatient cost files developed by the VA Health Economics and Resource Center and (2) outpatient VA Decision Support System files. Medicare data sources were the denominator, Medicare Provider Analysis Review (MEDPAR), Provider-of-Service, Outpatient Standard Analytic and Physician/Supplier Standard Analytic files. Additional sources included the Area Resource File and Census Bureau data. We identified dually eligible veterans who had either an inpatient or outpatient MH/SA diagnosis in the VA system during fiscal year (FY)'99. We then estimated one- and two-part regression models to explain the effects of geographic distance on both VA and Medicare total and MH/SA costs. Results provide evidence for substitution between the VA and Medicare, demonstrating that poorer geographic access to VA inpatient and outpatient clinics decreased VA expenditures but increased Medicare expenditures, while poorer access to Medicare-certified general and psychiatric hospitals decreased Medicare expenditures but increased VA expenditures. As geographic distance to VA medical facility increases, Medicare plays an increasingly important role in providing mental health services to veterans.

  3. A Health Assessment Survey of Veteran Students: Utilizing a Community College-Veterans Affairs Medical Center Partnership.

    Science.gov (United States)

    Misra-Hebert, Anita D; Santurri, Laura; DeChant, Richard; Watts, Brook; Sehgal, Ashwini R; Aron, David C

    2015-10-01

    To assess health status among student veterans at a community college utilizing a partnership between a Veterans Affairs Medical Center and a community college. Student veterans at Cuyahoga Community College in Cleveland, Ohio, in January to April 2013. A health assessment survey was sent to 978 veteran students. Descriptive analyses to assess prevalence of clinical diagnoses and health behaviors were performed. Logistic regression analyses were performed to assess for independent predictors of functional limitations. 204 students participated in the survey (21% response rate). Self-reported depression and unhealthy behaviors were high. Physical and emotional limitations (45% and 35%, respectively), and pain interfering with work (42%) were reported. Logistic regression analyses confirmed the independent association of self-reported depression with functional limitation (odds ratio [OR] = 3.3, 95% confidence interval [CI] 1.4-7.8, p student veterans at a community college. A partnership between a Veterans Affairs Medical Center and a community college can be utilized to help understand the health needs of veteran students. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  4. Veteran Parents in Child Protective Services: Theory and Implementation

    Science.gov (United States)

    Nilsen, Wendy J.; Affronti, Melissa L.; Coombes, Margaret L.

    2009-01-01

    "Veteran parents" (VPs), or parents who have experienced challenges concerning their children's health and then mentor other families through similar situations, are widely used for parent support. This model has been adopted by Child Protective Services (CPS) to increase parent engagement. Here, we expand the theoretical discussion of VPs in CPS…

  5. Identifying US veterans who access services from health care for the homeless clinics.

    Science.gov (United States)

    Knopf-Amelung, Sarah M; Jenkins, Darlene M

    2013-12-01

    Research on veterans experiencing homelessness is predominantly focused on the US Department of Veterans Affairs setting, despite the fact that substantial numbers receive services from Health Care for the Homeless (HCH) clinics. We explored how HCH clinics identified veteran patients through a survey of administrators (49% response rate). The majority (98%) identified veterans but used varied language and approaches. Implementing a streamlined, culturally competent identification process is vital to collecting accurate data, connecting veterans with benefits, and informing treatment plans.

  6. 38 CFR 21.6519 - Eligibility of qualified veterans for employment and counseling services.

    Science.gov (United States)

    2010-07-01

    ... veterans for employment and counseling services. 21.6519 Section 21.6519 Pensions, Bonuses, and Veterans... employment and counseling services. (a) General. A qualified veteran for whom vocational rehabilitation and achievenment of a vocational goal are reasonably feasible may be provided the employment and counseling...

  7. Availability of gynecologic services in the department of veterans affairs.

    Science.gov (United States)

    Seelig, Michelle D; Yano, Elizabeth M; Bean-Mayberry, Bevanne; Lanto, Andy B; Washington, Donna L

    2008-01-01

    The optimum approach to providing the Congressionally mandated gender-specific services for which women veterans are eligible is unknown. We evaluated onsite availability of gynecologic services, clinic type and staffing arrangements, and the impact of having a gynecology clinic (GYN) and/or an obstetrician gynecologist (OBGYN) routinely available. We analyzed data from the 2001 national VHA Survey of Women Veterans Health Programs and Practices (n = 136 sites; response rate, 83%). We assessed availability of gynecologic services, and evaluated differences in availability by clinic type (designated women's health provider in primary care [PC], separate women's health clinic for primary care [WHC], and/or separate GYN) and staffing arrangements (OBGYN routinely involved versus not). Out of 133 sites, 77 sites (58%) offered services through a GYN and 56 sites (42%) did not have GYN. Seventy-two (54%) sites had a WHC. More sites with an OBGYN provided endometrial biopsies (91% vs. 20%), IUD insertion (85% vs. 14%), infertility evaluation (56% vs. 23%), infertility treatment (25% vs. none), gynecologic surgery (65 vs. 28%), p gynecologic surgery 2.3 (1.0-5.4). As the VA develops strategic plans for accommodating the growing number of women veterans, leaders should consider focusing on establishing WHC for primary care and routine availability of OBGYN or other qualified clinicians, rather than establishing separate GYN.

  8. 38 CFR 17.351 - Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Grants for the..., Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Grants to the Republic of the Philippines § 17.351 Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center...

  9. Protocol for the evaluation of a digital storytelling approach to address stigma and improve readiness to seek services among veterans.

    Science.gov (United States)

    Bunnell, Brian E; Davidson, Tatiana M; Hamblen, Jessica L; Cook, Danna L; Grubaugh, Anouk L; Lozano, Brian E; Tuerk, Peter W; Ruggiero, Kenneth J

    2017-01-01

    Research suggests that at least 10% of veterans returning from Iraq and Afghanistan meet criteria for posttraumatic stress disorder (PTSD) related to their military experiences. National dissemination initiatives have increased veterans' access to best-practice interventions. However, treatment-seeking remains low among veterans with PTSD, often due to perceived stigma and other associated barriers. The National Center for PTSD recently developed and launched AboutFace, a digital storytelling (DST) resource designed to help veterans recognize PTSD and motivate them to seek evidence-based treatment. The Ralph H. Johnson Veterans Affairs Medical Center (VAMC) and the National Center for PTSD have partnered to conduct pilot work to evaluate veterans' reactions to AboutFace to set the stage for a large-scale study to examine whether AboutFace effectively reduces stigma and improves attitudes toward treatment-seeking among veterans. If effective, this DST approach may serve as a valuable national model for a variety of treatment-seeking populations. During the first phase of the pilot, in-person usability assessments of AboutFace will be conducted via semi-structured interviews with 20 veterans. Audio recordings of interviews will undergo transcription and coding. A report of the results of qualitative analyses of these interviews will be provided to the National Center for PTSD and will inform revisions to the site. In the second phase of the pilot, 60 veterans referred to a specialized PTSD clinic will be recruited to demonstrate and refine the methodology that we propose to use in a larger randomized controlled trial evaluation of AboutFace. Veterans will be randomly assigned to receive AboutFace plus standard education vs. standard education alone. Baseline and 2-week telephone assessments will be conducted with participating veterans to measure stigma, attitudes toward seeking mental health services, and treatment access/engagement. The feedback we receive in this

  10. Long-Term Care Services for Veterans

    Science.gov (United States)

    2017-02-14

    palliative care ,  adult day health care ,  homemaker/home health aide care ,  respite care , Long-Term Care Services for...8111A; §1785. 2 The VHA also provides dementia care ; transitional care ; health care workforce development; Geriatric Research Education, and...text (bold) = both VA and purchased community care . In addition, the VHA provides dementia care ; transitional care ; health care

  11. Remote eye care screening for rural veterans with Technology-based Eye Care Services: a quality improvement project.

    Science.gov (United States)

    Maa, April Y; Wojciechowski, Barbara; Hunt, Kelly; Dismuke, Clara; Janjua, Rabeea; Lynch, Mary G

    2017-01-01

    Veterans are at high risk for eye disease because of age and comorbid conditions. Access to eye care is challenging within the entire Veterans Hospital Administration's network of hospitals and clinics in the USA because it is the third busiest outpatient clinical service and growing at a rate of 9% per year. Rural and highly rural veterans face many more barriers to accessing eye care because of distance, cost to travel, and difficulty finding care in the community as many live in medically underserved areas. Also, rural veterans may be diagnosed in later stages of eye disease than their non-rural counterparts due to lack of access to specialty care. In March 2015, Technology-based Eye Care Services (TECS) was launched from the Atlanta Veterans Affairs (VA) as a quality improvement project to provide eye screening services for rural veterans. By tracking multiple measures including demographic and access to care metrics, data shows that TECS significantly improved access to care, with 33% of veterans receiving same-day access and >98% of veterans receiving an appointment within 30 days of request. TECS also provided care to a significant percentage of homeless veterans, 10.6% of the patients screened. Finally, TECS reduced healthcare costs, saving the VA up to US$148 per visit and approximately US$52 per patient in round trip travel reimbursements when compared to completing a face-to-face exam at the medical center. Overall savings to the VA system in this early phase of TECS totaled US$288,400, about US$41,200 per month. Other healthcare facilities may be able to use a similar protocol to extend care to at-risk patients.

  12. Developing a Meaningful Life: Social Reintegration of Service-Members and Veterans with SCI

    Science.gov (United States)

    2014-10-01

    Award Number: W81XWH-11-1-0811 TITLE: Developing a Meaningful Life: Social Reintegration of Service- Members and Veterans with SCI PRINCIPAL...criteria to include all veterans as well as civilians. 8 Products DISABILITY AND REHABILITATION RESEARCH PAPER Long-term community reintegration ...2014 Presentation on rehabilitation outcomes and community reintegration experiences of servicemembers and veterans with extremity amputation or

  13. Services utilization among recently homeless veterans: a gender-based comparison.

    Science.gov (United States)

    Montgomery, Ann Elizabeth; Byrne, Thomas H

    2014-03-01

    As women emerge as a significant segment of the Veteran population, there is a need to understand how they enter the homeless system, the impact of homelessness on healthcare, and how this varies by gender. This study provides a gender-based comparison of Veterans' utilization of U.S. Department of Veterans Affairs (VA) health and behavioral health services following the onset of a homeless episode and assesses the relationship between services utilization and Veterans' entry into the homeless system. Male and female veterans were equally as likely to use mainstream and VA homeless services. There were few differences between genders in inpatient services use following a homeless episode. Men used more substance abuse outpatient treatment and emergency services whereas women used outpatient medical treatment. Veterans who sought non-VA homeless services were less likely to use outpatient services but more likely to access emergency services. Veterans experiencing homelessness who do not use VA homeless assistance services are less engaged with preventative VA health and behavioral healthcare. Veterans who are homeless but not identified as such by VA, particularly women, need additional engagement. Ongoing study of gender-based differences in services utilization among homeless and at-risk Veterans is needed. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  14. Growing Use of Mental and General Health Care Services Among Older Veterans With Mental Illness.

    Science.gov (United States)

    Wiechers, Ilse R; Karel, Michele J; Hoff, Rani; Karlin, Bradley E

    2015-11-01

    National data from Veterans Health Administration (VHA) electronic medical records were used to examine rates of mental illness and service use among older veterans since mental health care transformation efforts were implemented in 2005. Data were extracted from VHA electronic medical records for each fiscal year from 2005 through 2013 for veterans ages 65 and older. Among those receiving any health care services, the number and proportion treated for a confirmed mental illness and the utilization of non-mental health care services were identified. In 2013, 2.6 million older veterans utilized services in VHA, 14% of whom had a confirmed mental illness, which was a 57% increase from 2005. Older veterans with confirmed mental illness accounted for a sizable and growing proportion of non-mental health service utilization. Preparing the workforce to address the mental health needs of older veterans and nonveterans is essential.

  15. Developing a Meaningful Life: Social Reintegration of Service-Members and Veterans with Spinal Cord Injury

    Science.gov (United States)

    2013-10-01

    Reintegration of Service-Members and Veterans with Spinal Cord Injury PRINCIPAL INVESTIGATOR: Seth D. Messinger...SUBTITLE Developing a Meaningful Life: Social Reintegration of Service- Social Reintegration of Service Me Members and Veterans with Spinal Cord...communities and cultural identities that is key to long-term success . 15. SUBJECT TERMS Spinal Cord Injury, Community Reintegration , Qualitative

  16. State Policies on Service Dogs for Military Veterans.

    Science.gov (United States)

    Reed, James B

    2015-12-01

    U.S. service members returning home from combat often face physical, mental and emotional challenges. Providing service dogs to these veterans is one method being used successfully to help address the difficulties they face. Under the federal Americans with Disabilities Act (ADA), a service animal is defined as "any dog that is individually trained to do work or perform tasks for the benefit of an individual with a disability, including a physical, sensory, psychiatric, intellectual or other mental disability." The work the dog undertakes must be directly related to the person's disability. Examples include guiding people who are blind, pulling a wheelchair, alerting a person with hearing loss, protecting a person having a seizure, and calming someone with post-traumatic stress disorder (PTSD) during an anxiety attack or psychiatric episode.

  17. Nicotine Dependence and Its Risk Factors Among Users of Veterans Health Services, 2008-2009

    OpenAIRE

    Tsai, Jack; Edens, Ellen L.; Rosenheck, Robert A.

    2011-01-01

    Introduction Tobacco use is the leading preventable cause of death in the United States and is disproportionately higher among veterans than nonveterans. We examined the prevalence of nicotine dependence and its associated risk factors among veterans who used health services in the US Department of Veterans Affairs (VA) system. Methods Using a case-control design, we compared all VA health service users in fiscal year 2008-2009 (N = 5,031,381) who received a nicotine dependence diagnosis with...

  18. An End of Service Life Assessment of PMMA Lenses from Veteran Concentrator Photovoltaic Systems

    Energy Technology Data Exchange (ETDEWEB)

    Miller, David C.; Khonkar, Hussameldin I.; Herrero, Rebecca; Anton, Ignacio; Johnson, David K.; Vinzant, Todd B.; Deutch, Steve; To, Bobby; Sala, Gabriel; Kurtz, Sarah R.

    2017-03-21

    The optical performance of poly(methyl methacrylate) lenses from veteran concentrator photovoltaic modules was examined after the end of their service life. Lenses from the Martin-Marietta and Intersol module designs were examined from the 'Solar Village' site near Riyadh, Saudi Arabia, as well as the Phoenix Sky Harbor airport, followed by the Arizona Public Service Solar Test and Research (APS-STaR) center in Tempe, Arizona. The various lens specimens were deployed for 20, 27, and 22 years, respectively. Optical characterizations included lens efficiency (Solar Simulator instrument), material transmittance and haze (of coupons cut from veteran lenses, then measured again after their faceted back surface was polished, and then measured again after the incident front surface was polished), and direct transmittance (as a function of detector's acceptance angle, using the Very Low Angular Beam Spread ('VLABS') instrument). Lens efficiency measurements compared the central region to the entire lens, also using hot and cold mirror measurements to diagnose differences in performance. A series of subsequent characterizations was performed because a decrease in performance of greater than 10% was observed for some of the veteran lenses. Surface roughness was examined using atomic force microscopy and scanning electron microscopy. Facet geometry (tip and valley radius) was quantified on cross-sectioned specimens. Molecular weight was compared between the incident and faceted surfaces of the lenses.

  19. Alcohol Use and Trauma Exposure among Male and Female Veterans Before, During, and After Military Service

    Science.gov (United States)

    Kelley, Michelle L.; Runnals, Jennifer; Pearson, Matthew R.; Miller, Marinell; Fairbank, John A.; Brancu, Mira

    2017-01-01

    The present study examined lifespan and combat-related trauma exposure as predictors of alcohol use among male and female veterans. Posttraumatic stress and depressive symptoms were examined as mediators of the effects of trauma exposure on alcohol use. Data were examined from 1825 (1450 male, 375 female) veterans and active duty service members who took part in a multi-site research study conducted through the Department of Veterans Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Centers (VISN 6 MIRECC). For both men and women, depressive symptoms significantly mediated the effects of non-combat trauma exposure experienced before, during and after the military, as well as combat- exposure, on alcohol use. With posttraumatic stress symptoms, the models for men and women differed. For men, the effects of non-combat trauma exposure during and after military service, and combat exposure, on alcohol use were mediated by PTSD symptoms; however, for women, PTSD symptoms did not mediate these relationships. Findings are discussed in the context of potential gender differences in response to trauma such as use of alcohol to cope with traumatic events. PMID:24054989

  20. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Us FAQs Ask a Question Toll Free Numbers Homeless Veterans Chat VA » Health Care » PTSD: National Center for ... Vet Centers) War Related Illness & Injury Study Center Homeless Veterans Returning Service Members Rural Veterans Seniors & Aging Veterans ...

  1. 77 FR 70210 - Agency Information Collection (VA Subcontracting Report for Service Disabled Veteran-owned Small...

    Science.gov (United States)

    2012-11-23

    ... AFFAIRS Agency Information Collection (VA Subcontracting Report for Service Disabled Veteran-owned Small....'' SUPPLEMENTARY INFORMATION: Title: VA Subcontracting Report for Service Disabled Veteran-owned Small Business and... from subcontractors to compare information obtained from subcontracting plans submitted by prime...

  2. Student service members/veterans on campus: Challenges for reintegration.

    Science.gov (United States)

    Borsari, Brian; Yurasek, Ali; Miller, Mary Beth; Murphy, James G; McDevitt-Murphy, Meghan E; Martens, Matthew P; Darcy, Monica G; Carey, Kate B

    2017-01-01

    Many returning OIF/OEF/OND Veterans are seeking higher education in an effort to develop a meaningful career and financial stability. Evidence suggests that student service members/veterans (SSM/Vs) are experiencing less academic success than other students. The purpose of this review is to identify the unique challenges of SSM/Vs and evaluate current campus efforts to facilitate their retention and academic performance. With a focus on SSM/Vs attending colleges and universities, we obtained 57 peer-reviewed and 73 gray literature records published between 2001 and 2015. The current SSM/V literature contains an abundance of gray literature, and the empirical research tends to be limited by cross-sectional design and small sample sizes. SSM/Vs encounter significant personal and environmental challenges when transitioning from the military to college campuses. A variety of services have been developed to address the needs of the SSM/V population, but the efficacy of these services remains largely unknown. In conclusion, there is a clear need to provide education to faculty, students, and staff regarding the experiences of SSM/Vs. Efforts to enhance screening for, availability of, and SSM/V engagement in mental health services would also be beneficial, as would improved availability of and SSM/V access to academic support. All future programs designed to address the unique challenges of SSM/Vs in the academic environment should also be systematically implemented and evaluated. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  3. Family-centered care for military and veteran families affected by combat injury.

    Science.gov (United States)

    Cozza, Stephen J; Holmes, Allison K; Van Ost, Susan L

    2013-09-01

    The US military community includes a population of mostly young families that reside in every state and the District of Columbia. Many reside on or near military installations, while other National Guard, Reserve, and Veteran families live in civilian communities and receive care from clinicians with limited experience in the treatment of military families. Though all military families may have vulnerabilities based upon their exposure to deployment-related experiences, those affected by combat injury have unique additional risks that must be understood and effectively managed by military, Veterans Affairs, and civilian practitioners. Combat injury can weaken interpersonal relationships, disrupt day-to-day schedules and activities, undermine the parental and interpersonal functions that support children's health and well-being, and disconnect families from military resources. Treatment of combat-injured service members must therefore include a family-centered strategy that lessens risk by promoting positive family adaptation to ongoing stressors. This article reviews the nature and epidemiology of combat injury, the known impact of injury and illness on military and civilian families, and effective strategies for maintaining family health while dealing with illness and injury.

  4. Differences in cause of death of Washington State veterans who did and did not use Department of Veterans Affairs healthcare services.

    Science.gov (United States)

    Maynard, Charles; Boyko, Edward J

    2006-01-01

    Relatively little is known about the cause of death in the veteran population, although more is known about the cause of death in Vietnam veterans or veterans receiving mental health services. This article compares characteristics and causes of death in Washington State veterans who did and did not use Department of Veterans Affairs (VA) healthcare services in the 5 years prior to death. This study included 62,080 veterans who died between 1998 and 2002, of whom 21% were users of VA healthcare services. The veterans who used VA healthcare services were younger, more often men, less educated, more often divorced, and more often smokers than the veterans who did not use VA healthcare services. Both female and male veterans who used VA healthcare services were more likely to die from drug- and/or alcohol-related causes. These findings suggest that the VA patient population is socially disadvantaged and more severely affected by substance-use disorders compared with veterans who do not use VA healthcare services.

  5. An Exploratory Study of Student Service Members/Veterans' Mental Health Characteristics by Sexual Orientation.

    Science.gov (United States)

    Pelts, Michael D; Albright, David L

    2015-01-01

    Explore the mental health differences of student veterans by sexual orientation. Student service members/veterans (N = 702) from the Fall 2011 National College Health Assessment. Descriptive statistics and 2-sample proportion and mean tests were used to compare mental health characteristics. Student veterans who identify as lesbian, gay, bisexual, or unsure had higher levels of mental health symptoms and treatment. Results suggest a need for continued examination of student service members/veterans as related to disparities in mental health by sexual orientation.

  6. The Earnings of Veterans: Effects of Military Service

    Science.gov (United States)

    2015-03-01

    Hirsch & Mehay, 2003, p. 681). Then, the authors use a logit model that predicts the selection sample are likely veterans serving on active duty using...veteran data, veteran regression model 17. SECURITY 18. SECURITY CLASSIFICATION OF CLASSIFICATION OF TffiS REPORT PAGE Unclassified Unclassified NSN...3 B. RESEARCH MODELS

  7. 76 FR 21107 - Veterans' Rural Health Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2011-04-14

    ... AFFAIRS Veterans' Rural Health Advisory Committee; Notice of Meeting The Department of Veterans Affairs... VA health care to enrolled Veterans residing in rural areas and discusses ways to improve and enhance... Secretary, VA Veteran Centers services, rural women Veteran health care, and the meeting agenda and planning...

  8. 20 CFR 404.1321 - Ninety-day active service requirement for post-World War II veterans.

    Science.gov (United States)

    2010-04-01

    ... post-World War II veterans. 404.1321 Section 404.1321 Employees' Benefits SOCIAL SECURITY... of the Uniformed Services Post-World War II Veterans § 404.1321 Ninety-day active service requirement for post-World War II veterans. (a) The 90 days of active service required for post-World War II...

  9. 13 CFR 125.8 - What definitions are important in the Service-Disabled Veteran-Owned (SDVO) Small Business...

    Science.gov (United States)

    2010-01-01

    ... undertake responsibility for managing the well-being of the service-disabled veteran with a permanent and... by one or more service-disabled veterans; (2) The management and daily business operations of which... the Service-Disabled Veteran-Owned (SDVO) Small Business Concern (SBC) Program? 125.8 Section 125.8...

  10. VA Health Service Utilization for Homeless and Low-income Veterans

    Science.gov (United States)

    Gabrielian, Sonya; Yuan, Anita H.; Andersen, Ronald M.; Rubenstein, Lisa V.; Gelberg, Lillian

    2016-01-01

    Background The US Department of Housing and Urban Development (HUD)-VA Supportive Housing (VASH) program—the VA’s Housing First effort—is central to efforts to end Veteran homelessness. Yet, little is known about health care utilization patterns associated with achieving HUD-VASH housing. Objectives We compare health service utilization at the VA Greater Los Angeles among: (1) formerly homeless Veterans housed through HUD-VASH (HUD-VASH Veterans); (2) currently homeless Veterans; (3) housed, low-income Veterans not in HUD-VASH; and (4) housed, not low-income Veterans. Research Design We performed a secondary database analysis of Veterans (n = 62,459) who received VA Greater Los Angeles care between October 1, 2010 and September 30, 2011. We described medical/surgical and mental health utilization [inpatient, outpatient, and emergency department (ED)]. We controlled for demographics, need, and primary care use in regression analyses of utilization data by housing and income status. Results HUD-VASH Veterans had more inpatient, outpatient, and ED use than currently homeless Veterans. Adjusting for demographics and need, HUD-VASH Veterans and the low-income housed Veterans had similar likelihoods of medical/surgical inpatient and outpatient utilization, compared with the housed, not low-income group. Adjusting first for demographics and need (model 1), then also for primary care use (model 2), HUD-VASH Veterans had the greatest decrease in incident rates of specialty medical/surgical, mental health, and ED care from models 1 to 2, becoming similar to the currently homeless, compared with the housed, not low-income group. Conclusions Our findings suggest that currently homeless Veterans underuse health care relative to housed Veterans. HUD-VASH may address this disparity by providing housing and linkages to primary care. PMID:24714583

  11. 78 FR 59861 - VA Acquisition Regulation: Service-Disabled Veteran-Owned and Veteran-Owned Small Business Status...

    Science.gov (United States)

    2013-09-30

    ... VOSBs to increase their Federal contracting and subcontracting. VA solicited comments on an interim... bears the risk that the delivery method chosen will not result in timely receipt by the Executive... and disruption of services for the benefit of veterans or a construction project may be so extensive...

  12. American Military Veteran Entrepreneurs: A Comprehensive Profile of Demographic, Service History, and Psychosocial Characteristics

    Science.gov (United States)

    Heinz, Adrienne J.; Freeman, Michael A.; Harpaz-Rotem, Ilan; Pietrzak, Robert H.

    2017-01-01

    American military veterans are nearly twice as likely to be self-employed compared to non-veterans, and are majority owners in nine percent of all businesses nationwide. Despite their contribution to the broader economy and the potential for training programs to cultivate and foster successful self-employment and veteran-lead entrepreneurial ventures, research on veteran entrepreneurs remains limited. In order to gain a better understanding of the potential strengths and vulnerabilities of veteran entrepreneurs, the current study utilized data from a large, nationally representative sample to profile self-employed veterans (n=230) and compare them to veterans who work as employees (n=1,055) with respect to demographic, military service history, and psychosocial characteristics. Results indicated that self-employed veterans were older and more educated and more likely to utilize VA healthcare. Self-employed veterans were more likely to serve in Vietnam and to serve in the military for fewer years. No differences were noted in perceived military experience, level of combat exposure, or military branch served as a function of self-employment. Although reporting more lifetime traumas, self-employed veterans did not experience higher rates of current or lifetime psychopathology or lower perceived quality of life. Potential protective resilience-promoting factors may be associated with the higher levels of openness, extraversion, optimism, achievement-orientation (purpose in life), and greater need for autonomy and professional development observed among self-employed veterans. Moreover, self-employed veterans demonstrated higher levels of gratitude, community integration, and altruistic service to others. Findings have potential to inform human resources management strategies and vocational training and reintegration initiatives for veterans. PMID:29290645

  13. An Observational Study of Service Dogs for Veterans With Posttraumatic Stress Disorder.

    Science.gov (United States)

    Yarborough, Bobbi Jo H; Owen-Smith, Ashli A; Stumbo, Scott P; Yarborough, Micah T; Perrin, Nancy A; Green, Carla A

    2017-07-01

    This study examined needs related to posttraumatic stress disorder (PTSD), assistance by service dogs, and feasibility of data collection among veterans receiving service dogs. Questionnaires assessed PTSD-related needs and services performed or expected to be performed by service dogs among 78 veterans who had or were on a wait list for a service dog (average age, 42; women, 31%). Analyses compared pre-post characteristics among 22 veterans who received a service dog as part of the study (91% follow-up; average follow-up=3.37±2.57 months). Veterans reported that the most important services performed were licking or nudging veterans to help them "stay present," preventing panic, and putting space between veterans and strangers. High follow-up rates and improvements in outcomes with moderate to large effect sizes among recipients of study-provided dogs suggest further study is warranted. Service dogs may be feasible supports for veterans with PTSD; randomized clinical trials are needed to assess effectiveness.

  14. Homelessness among a nationally representative sample of US veterans: prevalence, service utilization, and correlates.

    Science.gov (United States)

    Tsai, Jack; Link, Bruce; Rosenheck, Robert A; Pietrzak, Robert H

    2016-06-01

    To examine the prevalence of lifetime homelessness among veterans and use of Veterans Affairs (VA) homeless services, as well as their association with sociodemographic and clinical characteristics. A nationally representative sample of 1533 US veterans was surveyed July-August 2015. Among all veterans, 8.5 % reported any lifetime homelessness in their adult life, but only 17.2 % of those reported using VA homeless services. Prevalence of homelessness and VA homeless service use did not significantly differ by gender. Being low income, aged 35-44, and having poor mental and physical health were each independently associated with lifetime homelessness. Veterans who were White or lived in rural areas were significantly less likely to have used VA homeless services. Homelessness remains a substantial problem across different generations of veterans. The low reported uptake of VA homeless services suggests there are barriers to care in this population, especially for veterans who live in rural areas. Governmental resources dedicated to veteran homelessness should be supported, and obtaining accurate prevalence estimates are important to tracking progress over time.

  15. Open access in the patient-centered medical home: lessons from the Veterans Health Administration.

    Science.gov (United States)

    True, Gala; Butler, Anneliese E; Lamparska, Bozena G; Lempa, Michele L; Shea, Judy A; Asch, David A; Werner, Rachel M

    2013-04-01

    The Veterans Health Administration (VHA) has undertaken a 5-year initiative to transform to a patient-centered medical home model. An early focus of implementation was on creating open access, defined as continuity and capacity in primary care. We describe the impact of readiness for implementation on efforts of pilot teams to make changes to improve access and identify successful strategies used by early adopters to overcome barriers to change. A qualitative, formative evaluation of the first 18 months of implementation in one Veterans Integrated Service Network (VISN) spread across six states. Members of local implementation teams including administrators, primary care providers, and staff from primary care clinics located at 10 medical centers and 45 outpatient clinics. We conducted site visits during the first 6 months of implementation, observations at Learning Collaboratives, semi-structured interviews, and review of internal organizational documents. All data collection took place between April 2010 and December 2011. Early adopters employed various strategies to enhance access, with a focus on decreasing demand for face-to-face care, increasing supply of different types of primary care encounters, and improving clinic efficiencies. Our interviews with key contacts revealed three important areas where readiness for implementation (or lack thereof) had an impact on interventions to improve access: leadership engagement, staffing resources, and access to information and knowledge. Key factors related to readiness for implementation had an impact on which interventions pilot teams could put into place, as well as the viability and sustainability of access gains. Wide variations in interventions to improve access occurring across sites situated within one organization have important implications for efforts to measure the impact of enhanced access on patient outcomes, costs, and other systems-level indicators of the Medical Home.

  16. 77 FR 38395 - Agency Information Collection (Appointment of Veterans Service Organization/or Individuals as...

    Science.gov (United States)

    2012-06-27

    ... AFFAIRS Agency Information Collection (Appointment of Veterans Service Organization/or Individuals as... of Veterans Affairs, will submit the collection of information abstracted below to the Office of... information collection and its expected cost and burden; it includes the actual data collection instrument...

  17. 77 FR 56709 - Proposed Information Collection (VA Subcontracting Report for Service Disabled Veteran-Owned...

    Science.gov (United States)

    2012-09-13

    ... Information Collection (VA Subcontracting Report for Service Disabled Veteran-Owned Small Business and Veteran... needed to collect information from subcontractors to compare information obtained from subcontracting... collection techniques or the use of other forms of information technology. Title: VA Subcontracting Report...

  18. Qualitative Student Responses to Service Learning with Veterans who are Homeless

    Directory of Open Access Journals (Sweden)

    Lindsay A. Phillips

    2012-04-01

    Full Text Available This article presents a description of a service learning activity in which students assisted veterans who are homeless. The article outlines how the event was organized, provides resources for implementation, discusses student response using evaluations from 15 students, and discusses considerations made in organizing such an event. KEYWORDSService Learning, Qualitative Evaluation, Homeless Veterans

  19. Nicotine dependence and its risk factors among users of veterans health services, 2008-2009.

    Science.gov (United States)

    Tsai, Jack; Edens, Ellen L; Rosenheck, Robert A

    2011-11-01

    Tobacco use is the leading preventable cause of death in the United States and is disproportionately higher among veterans than nonveterans. We examined the prevalence of nicotine dependence and its associated risk factors among veterans who used health services in the US Department of Veterans Affairs (VA) system. Using a case-control design, we compared all VA health service users in fiscal year 2008-2009 (N = 5,031,381) who received a nicotine dependence diagnosis with those who did not. Independent risk and protective factors associated with receiving a nicotine dependence diagnosis were identified using logistic regression analysis. We conducted subgroup analyses on 2 groups of particular policy concern: homeless veterans and veterans who served in Iraq and Afghanistan. Among all recent VA health service users, 15% (n = 749,353) received a diagnosis of nicotine dependence. Substance abuse, other mental health diagnoses, and homelessness were identified as major risk factors. Veterans who served in Iraq and Afghanistan were not found to be at increased risk compared to veterans from other war eras. Major risk and protective factors within the subgroups of homeless veterans and veterans who served in Iraq and Afghanistan were broadly similar to those in the general VA population. Given that other studies have found higher rates of nicotine dependence among veterans, this risk behavior may be underdiagnosed in VA medical records. Veterans who are homeless or have mental health or substance abuse problems are at highest risk and should be targeted for smoking prevention and cessation interventions. These results support, in principle, efforts to integrate smoking cessation programs with mental health and homeless services.

  20. The mental health of partners of Australian Vietnam veterans three decades after the war and its relation to veteran military service, combat, and PTSD.

    Science.gov (United States)

    O'Toole, Brian I; Outram, Sue; Catts, Stanley V; Pierse, Katherine R

    2010-11-01

    This study assessed psychiatric diagnoses in female partners of Australian Vietnam veterans, compared these with national Australian population statistics, and assessed their relationship with veterans' military service and mental health. Independent assessments of 240 veteran-partner couples used standardized physical and psychiatric diagnostic interviews that permitted comparison with Australian population data. Multivariate regression modeling examined associations of veterans' war service, combat, and psychiatric status with women's mental health. Anxiety disorders and severe recurrent depression were among 11 of 17 psychiatric diagnoses that were significantly in excess of population expectations. Veterans' combat and post-traumatic stress disorder were significant predictors of women's depressive disorder, particularly severe depression. We conclude that veterans' war service and mental health sequelae including post-traumatic stress disorder are associated with higher rates of mental disorder in their female partners 3 decades after the war.

  1. Veterans Health Administration

    Science.gov (United States)

    ... code here VA » Veterans Health Administration Veterans Health Administration Veterans – Here's how to Avoid Getting the Flu ... Read more » VA Medical Centers The Veterans Health Administration is home to the United States’ largest integrated ...

  2. Motor neurone disease and military service: evidence from the Scottish Veterans Health Study.

    Science.gov (United States)

    Bergman, Beverly P; Mackay, Daniel F; Pell, Jill P

    2015-12-01

    In 2003, it was reported that motor neurone disease was linked to military service in the 1990-1991 Gulf War. A large study in the US confirmed an association with military service but found no association with specific conflicts or length of service. Non-veteran studies have suggested an association with physical activity, smoking and other risk factors. We used data from the Scottish Veterans Health Study to investigate the association between motor neurone disease and military service in UK veterans. Retrospective cohort study of 57,000 veterans born 1945-1985, and 173,000 demographically matched civilians, using Cox proportional hazard models to compare the risk of motor neurone disease overall, and by sex, birth cohort, length of service and year of recruitment. We had no data on smoking prevalence. Veterans had an increased risk of motor neurone disease compared with non-veterans (adjusted HR 1.49, 95% CI 1.01 to 2.21, p=0.046). The increase was independent of birth cohort, length or period of service, or year of recruitment. Risk was associated with a history of trauma or road traffic accident in veterans and non-veterans. We confirmed an increased risk of motor neurone disease in military veterans, although the absolute risk is extremely low. We found no evidence that the increased risk was associated with any specific conflict. We could not rule out that smoking (and perhaps other lifestyle factors) may be responsible for our findings. Trauma may play a role in the increased risk but further studies are needed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  3. Using a service sector segmented approach to identify community stakeholders who can improve access to suicide prevention services for veterans.

    Science.gov (United States)

    Matthieu, Monica M; Gardiner, Giovanina; Ziegemeier, Ellen; Buxton, Miranda

    2014-04-01

    Veterans in need of social services may access many different community agencies within the public and private sectors. Each of these settings has the potential to be a pipeline for attaining needed health, mental health, and benefits services; however, many service providers lack information on how to conceptualize where Veterans go for services within their local community. This article describes a conceptual framework for outreach that uses a service sector segmented approach. This framework was developed to aid recruitment of a provider-based sample of stakeholders (N = 70) for a study on improving access to the Department of Veterans Affairs and community-based suicide prevention services. Results indicate that although there are statistically significant differences in the percent of Veterans served by the different service sectors (F(9, 55) = 2.71, p = 0.04), exposure to suicidal Veterans and providers' referral behavior is consistent across the sectors. Challenges to using this framework include isolating the appropriate sectors for targeted outreach efforts. The service sector segmented approach holds promise for identifying and referring at-risk Veterans in need of services. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  4. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... America's Freedoms Special Events Adaptive Sports Program Creative Arts Festival Golden Age Games Summer Sports Clinic Training - ... Readjustment Counseling (Vet Centers) War Related Illness & Injury Study Center Homeless Veterans Returning Service Members Rural Veterans ...

  5. Supporting Our Troops: Library Services and Support for Veterans

    Science.gov (United States)

    LeMire, Sarah

    2017-01-01

    Veterans are a unique population that can be found in libraries across the United States. Libraries of all types are developing new approaches to the veterans in their patron populations in the wake of the wars in Iraq and Afghanistan. This study identifies several common strategies that libraries, especially public and academic libraries, are…

  6. Community Reintegration Problems Among Veterans and Active Duty Service Members With Traumatic Brain Injury.

    Science.gov (United States)

    McGarity, Suzanne; Barnett, Scott D; Lamberty, Greg; Kretzmer, Tracy; Powell-Cope, Gail; Patel, Nitin; Nakase-Richardson, Risa

    To examine community reintegration problems among Veterans and military service members with mild or moderate/severe traumatic brain injury (TBI) at 1 year postinjury and to identify unique predictors that may contribute to these difficulties. VA Polytrauma Rehabilitation Centers. Participants were 154 inpatients enrolled in the VA TBI Model Systems Program with available injury severity data (mild = 28.6%; moderate/severe = 71.4%) and 1-year postinjury outcome data. Prospective, longitudinal cohort. Community reintegration outcomes included independent driving, employability, and general community participation. Additional measures assessed depression, posttraumatic stress, and cognitive and motor functioning. In the mild TBI (mTBI) group, posttraumatic stress disorder and depressive symptoms were associated with lower levels of various community reintegration outcomes. In the moderate/severe TBI group, cognition and motor skills were significantly associated with lower levels of community participation, independent driving, and employability. Community reintegration is problematic for Veterans and active duty service members with a history of TBI. Unique comorbidities across injury severity groups inhibit full reintegration into the community. These findings highlight the ongoing rehabilitation needs of persons with TBI, specifically evidence-based mental healthcare, in comprehensive rehabilitation programs consistent with a chronic disease management model.

  7. Patient-Centered Pain Care Using Artificial Intelligence and Mobile Health Tools: Protocol for a Randomized Study Funded by the US Department of Veterans Affairs Health Services Research and Development Program.

    Science.gov (United States)

    Piette, John D; Krein, Sarah L; Striplin, Dana; Marinec, Nicolle; Kerns, Robert D; Farris, Karen B; Singh, Satinder; An, Lawrence; Heapy, Alicia A

    2016-04-07

    Cognitive behavioral therapy (CBT) is one of the most effective treatments for chronic low back pain. However, only half of Department of Veterans Affairs (VA) patients have access to trained CBT therapists, and program expansion is costly. CBT typically consists of 10 weekly hour-long sessions. However, some patients improve after the first few sessions while others need more extensive contact. We are applying principles from "reinforcement learning" (a field of artificial intelligence or AI) to develop an evidence-based, personalized CBT pain management service that automatically adapts to each patient's unique and changing needs (AI-CBT). AI-CBT uses feedback from patients about their progress in pain-related functioning measured daily via pedometer step counts to automatically personalize the intensity and type of patient support. The specific aims of the study are to (1) demonstrate that AI-CBT has pain-related outcomes equivalent to standard telephone CBT, (2) document that AI-CBT achieves these outcomes with more efficient use of clinician resources, and (3) demonstrate the intervention's impact on proximal outcomes associated with treatment response, including program engagement, pain management skill acquisition, and patients' likelihood of dropout. In total, 320 patients with chronic low back pain will be recruited from 2 VA healthcare systems and randomized to a standard 10 sessions of telephone CBT versus AI-CBT. All patients will begin with weekly hour-long telephone counseling, but for patients in the AI-CBT group, those who demonstrate a significant treatment response will be stepped down through less resource-intensive alternatives including: (1) 15-minute contacts with a therapist, and (2) CBT clinician feedback provided via interactive voice response calls (IVR). The AI engine will learn what works best in terms of patients' personally tailored treatment plans based on daily feedback via IVR about their pedometer-measured step counts, CBT skill

  8. PTSD and Use of Outpatient General Medical Services Among Veterans of the Vietnam War

    National Research Council Canada - National Science Library

    Schlenger, William E; Mulvaney-Day, Norah; Williams, Christianna S; Kulka, Richard A; Corry, Nida H; Mauch, Danna; Nagler, Caryn F; Ho, Chia-Lin; Marmar, Charles R

    2016-01-01

    Objective:The primary goal of this analysis was to assess whether recent use of outpatient services for general medical concerns by Vietnam veterans varies according to level of posttraumatic stress disorder (PTSD...

  9. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Data VA App Store National Resource Directory Grants Management Services Veterans Service Organizations Office of Accountability & Whistleblower ... Immunizations Flu Vaccination Prevention / Wellness Public Health Weight Management (MOVE!) Locations Hospitals & Clinics Vet Centers Veterans Canteen ...

  10. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Immunizations Flu Vaccination Prevention / Wellness Public Health Weight Management (MOVE!) Locations Hospitals & Clinics Vet Centers Veterans Canteen Service (VCS) Research Research Home About VA Research Services Programs News, Events and Media Research Topics For Veterans For Researchers ...

  11. The Effects of Migration and Training on Post-Service Earnings of All- Volunteer Force Veterans

    Science.gov (United States)

    1990-06-01

    with military service. Daymont and Andrisani [Ref. 6] investigated the earnings trajectories of veterans and non-veterans. They used the NLSY to...exceed civilian earnings within two or three years after discharge from the service. Daymont and Andrisani argue that the conditions which generally...on civilian earnings. This result is similar to the previous results obtained by Daymont and Andrisani [Ref. 61, who used the NLSY survey. When

  12. Osteoporosis screening and treatment among Veterans with recent fracture after implementation of an electronic consult service

    Science.gov (United States)

    Lee, Richard H.; Lyles, Kenneth W.; Pearson, Megan; Barnard, Karen; Colón-Emeric, Cathleen

    2014-01-01

    Purpose Less than 24 percent of Veterans received appropriate evaluation and/or treatment for osteoporosis within 6 months of an index fracture. An electronic consult (E-consult) service was implemented at 3 Veterans Affairs Medical Centers to facilitate identification of and to recommend management for patients with recent fracture. Method The E-consult service used clinical encounter data based on ICD9 diagnosis codes to prospectively identify patients with potential osteoporotic fractures. Eligible patients' medical records were reviewed by a metabolic bone specialist and an E-consult note was sent to the patient's primary provider with specific recommendations for further management. Recommendations were initiated at the provider's discretion. Results Between 2011 and 2013, the E-consult service identified 444 eligible patients with a low-trauma fracture who were not already on treatment. One hundred twenty-nine (29.1%) consults recommended immediate bisphosphonate treatment and 258 (58.1%) recommended bone density assessments. Primary providers responded by prescribing bisphosphonates in 74 patients (57.4%) and by ordering bone density testing in 183 (70.9%) patients. At the facility level, prior to implementation of the E-consult service, the rate of osteoporosis treatment following a fracture was 4.8% for bisphosphonates and 21.3% for calcium/vitamin D. After implementation, the treatment rate increased to 7.3% for bisphosphonates (P = 0.02) and 35.2% for calcium/vitamin D (P < 0.01). Conclusion While feasible and relatively low cost, an E-consult service modestly improved the rate of osteoporosis treatment among patients with a recent fracture. These results suggest that a program with direct patient interaction is probably required to substantially improve treatment rates. PMID:24699797

  13. Mental Health and Self-directed Violence Among Student Service Members/Veterans in Postsecondary Education

    Science.gov (United States)

    Blosnich, John R.; Kopacz, Marek S.; McCarten, Janet; Bossarte, Robert M.

    2014-01-01

    Objectives Using a sample of student service members/veterans, the current study aimed to examine the prevalence of psychiatric diagnoses and suicide-related outcomes and the association of hazardous duty with mental health. Participants Data are from the Fall 2011 National College Health Assessment (n=27,774). Methods Logistic regression was used to examine (1) the association of student service member/veteran status with mental health outcomes and (2) the association of hazardous duty with mental health outcomes among student service members/veterans (n=706). Results Student service members/veterans had higher odds of self-harm than students without military experience. Among student service members/veterans, hazardous duty was positively associated (OR=2.00, 95% CI: 1.30–3.07) with having a psychiatric diagnosis but negatively associated (OR=0.41, 95% CI: 0.20–0.85) with suicidal ideation. Conclusions Self-harm may be a unique phenomenon among service members/veterans. Suicide prevention with this population should include information about self-harm, and future research should explore whether suicidal intent underlies self-harm. PMID:24918517

  14. Sociodemographic Correlates of Suicidal Thoughts and Behaviors Among College Student Service Members/Veterans.

    Science.gov (United States)

    Bryan, Craig J; Bryan, AnnaBelle O

    2015-01-01

    The purpose of the study is to quantify the lifetime, past-year, and past-month incidence rates of suicidal ideation, planning, and attempts; frequency of suicide attempts; and suicide attempt methods among college student service members/veterans. Four hundred twenty-two college student service members/veterans completing an online survey from January to October 2013. An anonymous online survey was conducted. Lifetime incidence rates were 33.4% (ideation), 13.7% (plan), and 6.9% (attempt). Past-year incidence rates were 14.7% (ideation), 3.6% (plan), and 0.7% (attempt). Past-month incidence rates were 7.6% (ideation), 1.9% (plan), and 0.5% (attempt). Rates among student service member/veterans were similar to general college student population rates. Native American student service members/veterans report significantly increased rates of ideation, plans, and attempts. Observed rates of suicidal thoughts and behaviors among student service members/veterans are comparable to general college study rates, but Native American student service members/veterans demonstrate increased risk.

  15. Multiple Agencies Provide Assistance to Service-disabled Veterans or Entrepreneurs, but Specific Needs Are Difficult to Identify and Coordination Is Weak

    National Research Council Canada - National Science Library

    2008-01-01

    .... In the Veterans Entrepreneurship and Small Business Development Act of 1999 (P.L. 106-50), Congress stated that too little had been done to help veterans particularly service-disabled veterans, in starting small businesses...

  16. PTSD and Use of Outpatient General Medical Services Among Veterans of the Vietnam War.

    Science.gov (United States)

    Schlenger, William E; Mulvaney-Day, Norah; Williams, Christianna S; Kulka, Richard A; Corry, Nida H; Mauch, Danna; Nagler, Caryn F; Ho, Chia-Lin; Marmar, Charles R

    2016-05-01

    The primary goal of this analysis was to assess whether recent use of outpatient services for general medical concerns by Vietnam veterans varies according to level of posttraumatic stress disorder (PTSD) symptomatology over time. Another goal was to determine whether PTSD symptomatology was associated with veterans' reports of discussing behavioral health issues as part of a general medical visit. Self-reported service use data and measures of PTSD were from a nationally representative sample of 848 male and female Vietnam theater veterans (individuals who were deployed to the Vietnam theater of operations) who participated in the National Vietnam Veterans Longitudinal Study, a 25-year follow-up of a cohort of veterans originally interviewed from 1984-1988 as part of the National Vietnam Veterans Readjustment Study. Four categories of PTSD symptomatology course over 25 years were defined, and logistic regression models were used to assess their relationship with recent use of outpatient general medical services. Male and female theater veterans with high or increasing PTSD symptomatology over the period were more likely than those with low symptomatology to report recent VA outpatient visits. Males in the increasing and high categories were also more likely to discuss behavioral health issues at general medical visits. Vietnam veterans with high and increasing PTSD symptomatology over time were likely to use VA outpatient general health services. Attention to stressors of the aging process and to persistence of PTSD symptoms is important for Vietnam veterans, as is addressing PTSD with other psychiatric and medical comorbidities within the context of outpatient general medical care.

  17. Utilization of Mental Health Services by Veterans Living in Rural Areas.

    Science.gov (United States)

    Teich, Judith; Ali, Mir M; Lynch, Sean; Mutter, Ryan

    2017-06-01

    There is concern that veterans living in rural areas may not be receiving the mental health (MH) treatment they need. This study uses recent national survey data to examine the utilization of MH treatment among military veterans with a MH condition living in rural areas, providing comparisons with estimates of veterans living in urban areas. Multivariable logistic regression is utilized to examine differences in MH service use by urban/rural residence, controlling for other factors. Rates of utilization of inpatient and outpatient treatment, psychotropic medication, any MH treatment, and perceived unmet need for MH care are examined. There were significant differences in MH treatment utilization among veterans by rural/urban residence. Multivariate estimates indicate that compared to veterans with a MH condition living in urban areas, veterans in rural areas had 70% lower odds of receiving any MH treatment. Veterans with a MH condition in rural areas have approximately 52% and 64% lower odds of receiving outpatient treatment and prescription medications, respectively, compared to those living in urban areas. Differences in perceived unmet need for mental health treatment were not statistically significant. While research indicates that recent efforts to improve MH service delivery have resulted in improved access to services, this study found that veterans' rates of MH treatment are lower in rural areas, compared to urban areas. Continued efforts to support the provision of behavioral health services to rural veterans are needed. Telemedicine, using rural providers to their maximum potential, and engagement with community stakeholder groups are promising approaches. © 2016 National Rural Health Association.

  18. Effect of Lean Processes on Surgical Wait Times and Efficiency in a Tertiary Care Veterans Affairs Medical Center.

    Science.gov (United States)

    Valsangkar, Nakul P; Eppstein, Andrew C; Lawson, Rick A; Taylor, Amber N

    2017-01-01

    There are an increasing number of veterans in the United States, and the current delay and wait times prevent Veterans Affairs institutions from fully meeting the needs of current and former service members. Concrete strategies to improve throughput at these facilities have been sparse. To identify whether lean processes can be used to improve wait times for surgical procedures in Veterans Affairs hospitals. Databases in the Veterans Integrated Service Network 11 Data Warehouse, Veterans Health Administration Support Service Center, and Veterans Information Systems and Technology Architecture/Dynamic Host Configuration Protocol were queried to assess changes in wait times for elective general surgical procedures and clinical volume before, during, and after implementation of lean processes over 3 fiscal years (FYs) at a tertiary care Veterans Affairs medical center. All patients evaluated by the general surgery department through outpatient clinics, clinical video teleconferencing, and e-consultations from October 2011 through September 2014 were included. Patients evaluated through the emergency department or as inpatient consults were excluded. The surgery service and systems redesign service held a value stream analysis in FY 2013, culminating in multiple rapid process improvement workshops. Multidisciplinary teams identified systemic inefficiencies and strategies to improve interdepartmental and patient communication to reduce canceled consultations and cases, diagnostic rework, and no-shows. High-priority triage with enhanced operating room flexibility was instituted to reduce scheduling wait times. General surgery department pilot projects were then implemented mid-FY 2013. Planned outcome measures included wait time, clinic and telehealth volume, number of no-shows, and operative volume. Paired t tests were used to identify differences in outcome measures after the institution of reforms. Following rapid process improvement workshop project rollouts, mean

  19. Traumatic Brain Injury: A Guide for Caregivers of Service Members and Veterans: Becoming a Family Caregiver for a Service Member/Veteran with TBI. Module 3

    Science.gov (United States)

    2010-04-01

    Liaison 64 Becoming a Family Caregiver for a Service Member/Veteran with TBI PROFESSIONAL - NAME CONTACT INFORMATION Orthopedic Specialist Physical...leave Turn off appliances when you finish using them Take out the garbage (attention, memory problems) 7. Is your front door house key color

  20. Trauma-informed care: a paradigm shift needed for services with homeless veterans.

    Science.gov (United States)

    Dinnen, Stephanie; Kane, Vince; Cook, Joan M

    2014-01-01

    Exposure to traumatic events is a highly prevalent, although often overlooked, aspect in the lives of homeless veterans. In this study, the prevalence and correlates of potentially traumatic events, including posttraumatic stress disorder, in the homeless veteran population are presented. Presently, there exists a lack of trauma-informed case management services for homeless veterans. Failing to recognize the association between trauma and homelessness may lead to further victimization, exacerbate mental health symptomology, and hinder a provider's ability to effectively intervene on behalf of homeless veterans. Subgroups of homeless veterans such as those who served in the Vietnam and post-Vietnam era, more recent returnees from Iraq and Afghanistan, women, rural-residing veterans, and those who are justice involved, are discussed for unique trauma histories and service needs. Barriers to receiving trauma-informed care among homeless veterans are reviewed. Information to assist providers in assessing trauma histories and current best practices in the treatment of posttraumatic stress disorder are noted. Suggestions for how this document can be used in varied organizational settings are made.

  1. Racial And Ethnic Disparities Persist At Veterans Health Administration Patient-Centered Medical Homes.

    Science.gov (United States)

    Washington, Donna L; Steers, W Neil; Huynh, Alexis K; Frayne, Susan M; Uchendu, Uchenna S; Riopelle, Deborah; Yano, Elizabeth M; Saechao, Fay S; Hoggatt, Katherine J

    2017-06-01

    Patient-centered medical homes are widely promoted as a primary care delivery model that achieves better patient outcomes. It is unknown if their benefits extend equally to all racial/ethnic groups. In 2010 the Veterans Health Administration, part of the Department of Veterans Affairs (VA), began implementing patient-centered medical homes nationwide. In 2009 significant disparities in hypertension or diabetes control were present for most racial/ethnic groups, compared with whites. In 2014 hypertension disparities were similar for blacks, had become smaller but remained significant for Hispanics, and were no longer significant for multiracial veterans, whereas disparities had become significant for American Indians/Alaska Natives and Native Hawaiians/other Pacific Islanders. By contrast, in 2014 diabetes disparities were similar for American Indians/Alaska Natives, blacks, and Hispanics, and were no longer significant for Native Hawaiians/other Pacific Islanders. We found that the modest benefits of the VA's implementation of patient-centered medical homes were offset by competing multifactorial external, health system, provider, and patient factors, such as increased patient volume. To promote health equity, health care innovations such as patient-centered medical homes should incorporate tailored strategies that account for determinants of racial/ethnic variations. Evaluations of patient-centered medical homes should monitor outcomes for racial/ethnic groups. Project HOPE—The People-to-People Health Foundation, Inc.

  2. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Budget, & Performance VA Center for Innovation (VACI) Agency Financial Report (AFR) Budget ... Management Services Veterans Service Organizations Office of Accountability & Whistleblower ...

  3. The Department of Defense and Veteran Affairs Health Care Joint Venture at Tripler Army Medical Center Needs More Management Oversight

    Science.gov (United States)

    2013-09-18

    E M B E R 1 8 , 2 0 1 3 The Department of Defense and Veteran Affairs Health Care Joint Venture at Tripler Army Medical Center Needs More...Department of Defense and Veteran Affairs Health Care Joint Venture at Tripler Army Medical Center Needs More Management Oversight 5a. CONTRACT NUMBER...Health Care Joint Venture at Tripler Army Medical Center Needs More Management Oversight Objective Our audit objective was to determine whether the

  4. Conflict of interest issues pertinent to Veterans Affairs Medical Centers.

    Science.gov (United States)

    Hanna, Jennifer; Simiele, Ernest; Lawson, D Curtis; Tyler, Douglas

    2011-09-01

    Conflicts of interest exist when an arrangement potentially exerts inappropriate influence on decision making or professional judgment, or is perceived to do so, and can thus damage the public trust and undermine the integrity of those decisions. Concerns regarding financial conflicts of interest in the medical arena have reached their height as of late, given that physicians now function in a milieu of complex and delicate relationships with pharmaceutical, biotechnology, and medical device industries. Even when such relationships do not correlate with actual compromise of judgment or patient care, it threatens the credibility of both the health care professional and the institution because of the social perception of the effect of these relationships. Although most institutions in the Western world set forth a code of ethics and conflict-of-interest policies to be followed under threat of termination, the Veterans Health Administration (VHA) presents itself as a unique environment in which conflicts of interest are subject to governmental laws, violation of which may not only result in employment-related discipline, but may be sanctioned by civil and criminal penalties. Moreover, these provisions are developed by a national authoritative organization rather than being institution-specific guidelines. Given that many academic physicians working within the VHA may also have a component of their practice in a University setting, it becomes important to understand the differences in policy between these contexts so as not to threaten the public trust in the veracity of decisions made and, therefore, maintain the integrity of the relationship between physician and patient. This article will review aspects of conflict-of-interest policies in the realm of research, financial relationships, foreign travel, and vendor contracting that are particular to the VHA and make it a unique environment to function in as a physician and scientist. Copyright © 2011 Society for

  5. Challenges associated with screening for traumatic brain injury among US veterans seeking homeless services.

    Science.gov (United States)

    Russell, Leah M; Devore, Maria D; Barnes, Sean M; Forster, Jeri E; Hostetter, Trisha A; Montgomery, Ann Elizabeth; Casey, Roger; Kane, Vincent; Brenner, Lisa A

    2013-12-01

    We identified the prevalence of traumatic brain injury (TBI) among homeless veterans and assessed the TBI-4, a screening tool created to identify TBI history. Between May 2010 and October 2011, 800 US veterans from two hospitals, one eastern (n = 122) and one western (n = 678) completed some or all measures. Findings suggested that 47% of veterans seeking homeless services had a probable history of TBI (data for prevalence obtained only at the western hospital). However, psychometric results from the screening measure suggested that this may be an underestimate and supported comprehensive assessment of TBI in this population.

  6. Characteristics and service use of homeless veterans and nonveterans residing in a low-demand emergency shelter.

    Science.gov (United States)

    Petrovich, James C; Pollio, David E; North, Carol S

    2014-06-01

    This study examined use of U.S. Department of Veterans Affairs (VA) and non-VA services and predictors of service use among veterans and nonveterans who resided in a low-demand emergency shelter. Equal numbers (N=110) of veterans and nonveterans recruited between January and June 2008 at a low-demand emergency shelter were interviewed about demographic characteristics, histories of military service and homelessness, general medical and mental functioning, current alcohol and drug problems and substance use, and use of medical, psychiatric, and substance abuse services. The Behavioral Model for Vulnerable Populations was used to identify need-based, enabling, and predisposing variables for analysis. Both groups reported high rates of arrest and incarceration, very low incomes, extensive histories of homelessness, and a similar need for services. However, significantly more veterans than nonveterans used psychiatric services, nonemergency medical services, and inpatient substance use services. Similar proportions of veterans and nonveterans used public non-VA health care services. Need-based variables appropriately predicted service use, but veterans and individuals with insurance were also more likely to access services. The veterans and nonveterans residing in a low-demand shelter faced several barriers to escaping homelessness. Both groups made similar use of non-VA services, but veterans used more services overall because of their access to VA services. The predictive power of insurance indicated that veterans may experience barriers to care despite the availability of VA services. The presence of veterans in this low-demand shelter may represent evidence of barriers to veteran and other public housing services.

  7. Veterans and Homelessness

    Science.gov (United States)

    2013-11-29

    health care and rehabilitation services for homeless veterans (the Health Care for Homeless Veterans and Domiciliary Care for Homeless Veterans...Health Care for Homeless Veterans ................................................................................... 19 Domiciliary Care for Homeless...for Homeless Veterans (HCHV), Domiciliary Care for Homeless Veterans (DCHV), the Compensated Work Therapy/Therapeutic Residences Program, and the

  8. Mental Health Symptoms Among Student Service Members/Veterans and Civilian College Students.

    Science.gov (United States)

    Cleveland, Sandi D; Branscum, Adam J; Bovbjerg, Viktor E; Thorburn, Sheryl

    2015-01-01

    The aim of this study was to investigate if and to what extent student service members/veterans differ from civilian college students in the prevalence of self-reported symptoms of poor mental health. The Fall 2011 implementation of the American College Health Association-National College Health Assessment included 27,774 respondents from 44 colleges and universities. Participants were matched using propensity scores, and the prevalence of symptoms was compared using logistic regression and zero-inflated negative binomial regression models. The odds of feeling overwhelmed in the last 12 months were significantly lower among student service members/veterans with a history of hazardous duty (odd ratio [OR] = 0.46, adjusted p value students. Military service, with and without hazardous duty deployment, was not a significant predictor of the total number of symptoms of poor mental health. Current student service members/veterans may not be disproportionately affected by poor psychological functioning.

  9. Labor Force Reentry: Issues for Injured Service Members and Veterans

    Science.gov (United States)

    2012-01-01

    Johanna Klaus, James D. Tew, David Barrett, Erin Ingram, and David W. Oslin, “Psychiatric Status and Work Per- formance of Veterans of Operations...90407-2138 Offices Santa Monica, CA Washington, DC Pittsburgh, PA New Orleans , LA/Jackson, MS Boston, MA Doha, QA Abu Dhabi, AE Cambridge, Uk Brussels, BE

  10. Military service member and veteran self reports of efficacy of cranial electrotherapy stimulation for anxiety, posttraumatic stress disorder, insomnia, and depression.

    Science.gov (United States)

    Kirsch, Daniel L; Price, Larry R; Nichols, Francine; Marksberry, Jeffrey A; Platoni, Katherine T

    2014-01-01

    Cranial electrotherapy stimulation (CES) is being prescribed for service members and veterans for the treatment of anxiety, posttraumatic stress disorder (PTSD), insomnia and depression. The purpose of this study was to examine service members' and veterans' perceptions of the effectiveness and safety of CES treatment. Service members and veterans (N=1,514) who had obtained a CES device through the Department of Defense or Veterans Affairs Medical Center from 2006-2011 were invited to participate in the web based survey via email. One hundred fifty-two participants returned questionnaires. Data were analyzed using descriptive statistics. Participants reported clinical improvement of 25% or more from using CES for anxiety (66.7%), PTSD (62.5%), insomnia (65.3%) and depression (53.9%). The majority of these participants reported clinical improvement of 50% or more. Respondents also perceived CES to be safe (99.0%). Those individuals who were not taking any prescription medication rated CES more effective than the combined CES and prescription medication group. CES provides service members and veterans with a safe, noninvasive, nondrug, easy to use treatment for anxiety, PTSD, insomnia, and depression that can be used in the clinical setting or self-directed at home.

  11. Use of outpatient mental health services by homeless veterans after hurricanes.

    Science.gov (United States)

    Brown, Lisa M; Barnett, Scott; Hickling, Edward; Frahm, Kathryn; Campbell, Robert R; Olney, Ronald; Schinka, John A; Casey, Roger

    2013-05-01

    Little is known about the impact of hurricanes on people who are homeless at the time a disaster occurs. Although researchers have extensively studied the psychosocial consequences of disaster produced homelessness on the general population, efforts focused on understanding how homeless people fare have been limited to a few media reports and the gray literature. In the event of a hurricane, homeless veterans may be at increased risk for negative outcomes because of their cumulative vulnerabilities. Health care statistics consistently document that homeless veterans experience higher rates of medical, emotional, substance abuse, legal, and financial problems compared with the general population. This study used the 2004 to 2006 Veterans Health Administration (VHA) Outpatient Medical Dataset to examine the effects of hurricanes on use of outpatient mental health services by homeless veterans. Homeless veterans residing in hurricane-affected counties were significantly more likely to participate in group psychotherapy (32.4% vs. 13.4%, p homeless programs and the provision of VHA mental health services to homeless veterans postdisaster. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  12. Impact of Vietnam War Service on Veterans' Perceptions of Family Life.

    Science.gov (United States)

    Hendrix, Charles C.; Anelli, Lisa M.

    1993-01-01

    Surveyed Vietnam veterans' (n=131 males, 4 females) perceptions of impact of their wartime experiences on their current family life. Found direct effects of war service on psychological impact and direct effects of psychological impact on family satisfaction and functioning. Found no direct effects between war service and family satisfaction and…

  13. Facilitating reintegration for military service personnel, veterans, and their families: An introduction to the special issue.

    Science.gov (United States)

    Elnitsky, Christine A; Kilmer, Ryan P

    2017-01-01

    As service members return from active duty and, in some cases, exit the military, they face a process of reintegration (also referred to as community reintegration) as they seek to resume participation in their life roles as civilians. Facilitating this dynamic process of reintegration for service members, veterans, and their families-including outlining potential strategies for supporting this return to civilian life and its demands, roles, and responsibilities-is the focus of this Special Issue. Reintegration has been framed as a national priority (U.S. Department of Veterans Affairs, 2015) and has been a point of emphasis of efforts at federal, state, and local levels. As the articles in this issue suggest, multiple public, private, and voluntary systems and the communities to which service members, veterans, and their families return can help influence their health outcomes and, ultimately, their reintegration. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  14. The Use of University Services and Student Retention: Differential Links for Student Service Members or Veterans and Civilian Students

    Science.gov (United States)

    Southwell, Kenona H.; Whiteman, Shawn D.; MacDermid Wadsworth, Shelley M.; Barry, Adam E.

    2018-01-01

    Grounded in research and theory on college student retention, this study assessed differences in the use of various university services and the influence of key personnel on retention-related outcomes of student service members or veterans (SSM/Vs) compared with civilian students. Participants included 386 students, 199 (154 male, 45 female) of…

  15. 75 FR 29366 - ``Homeless Veterans' Reintegration Program (HVRP) National Technical Assistance Center...

    Science.gov (United States)

    2010-05-25

    ... of the Assistant Secretary for Veterans' Employment and Training ``Homeless Veterans' Reintegration... the Homeless Veterans' Reintegration Program (HVRP) to include the Homeless Female Veterans and... to expedite the reintegration of homeless Veterans into the labor force. In order to assist the USDOL...

  16. Persistent Super-Utilization of Acute Care Services Among Subgroups of Veterans Experiencing Homelessness.

    Science.gov (United States)

    Szymkowiak, Dorota; Montgomery, Ann Elizabeth; Johnson, Erin E; Manning, Todd; O'Toole, Thomas P

    2017-10-01

    Acute health care utilization often occurs among persons experiencing homelessness. However, knowing which individuals will be persistent super-utilizers of acute care is less well understood. The objective of the study was to identify those more likely to be persistent super-utilizers of acute care services. We conducted a latent class analysis of secondary data from the Veterans Health Administration Corporate Data Warehouse, and Homeless Operations Management and Evaluation System. The study sample included 16,912 veterans who experienced homelessness and met super-utilizer criteria in any quarter between July 1, 2014 and December 31, 2015. The latent class analysis included veterans' diagnoses and acute care utilization. Medical, mental health, and substance use morbidity rates were high. More than half of the sample utilized Veterans Health Administration Homeless Programs concurrently with their super-utilization of acute care. There were 7 subgroups of super-utilizers, which varied considerably on the degree to which their super-utilization persisted over time. Approximately a third of the sample met super-utilizer criteria for ≥3 quarters; this group was older and disproportionately male, non-Hispanic white, and unmarried, with lower rates of post-9/11 service and higher rates of rural residence and service-connected disability. They were much more likely to be currently homeless with more medical, mental health, and substance use morbidity. Only a subset of homeless veterans were persistent super-utilizers, suggesting the need for more targeted interventions.

  17. 38 CFR 17.82 - Contracts for outpatient services for veterans with alcohol or drug dependence or abuse...

    Science.gov (United States)

    2010-07-01

    ... services for veterans with alcohol or drug dependence or abuse disabilities. 17.82 Section 17.82 Pensions... Agencies § 17.82 Contracts for outpatient services for veterans with alcohol or drug dependence or abuse...) Comply with the requirements of the “Confidentiality of Alcohol and Drug Abuse Patient Records” (42 CFR...

  18. Health Programs for Veterans

    Science.gov (United States)

    ... Health Administration » Health Programs for Veterans Veterans Health Administration Health Programs for Veterans Beyond the doctors and ... families of patients receiving medical care at major military and VA medical centers Geriatrics & Extended Care Geriatric ...

  19. Long-term effects of military service on mental health among veterans of the Vietnam War era.

    Science.gov (United States)

    Brooks, Matthew S; Laditka, Sarah B; Laditka, James N

    2008-06-01

    Comparing outcomes of veterans who served in Vietnam and those who served elsewhere, we examined treatment of post-traumatic stress disorder, treatment of other mental health conditions, psychiatric treatment location, and six mental health well-being measures. The analytic sample consisted of nationally representative data from the 2001 National Survey of Veterans. Analyses included multivariate logistic regression that controlled for sociodemographic characteristics. Of Vietnam War-era veterans in the National Survey of Veterans (N = 7,914), 3,937 served in Vietnam and 3,977 served elsewhere. These veterans were stratified into or = 60 years of age (N = 1,766). Veterans who served in Vietnam had notably poorer mental health than did those who served elsewhere. There were striking mental health differences between younger and older veterans; younger veterans had substantially worse measures of mental health. These results suggest greater resource needs among younger Vietnam War veterans. Clinicians and the Department of Veterans Affairs should focus on mental health services for younger veterans.

  20. Veterans health administration vocational services for operation iraqi freedom/operation enduring freedom veterans with mental health conditions

    OpenAIRE

    Elizabeth W. Twamley, PhD; Dewleen G. Baker, MD; Sonya B. Norman, PhD; James O. E. Pittman, MSW; James B. Lohr, MD; Sandra G. Resnick, PhD

    2013-01-01

    High rates of mental health conditions and unemployment are significant problems facing Veterans of Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF). We examined two national Veterans Health Administration (VHA) databases from fiscal years 2008–2009: a larger database (n = 75,607) of OIF/OEF Veterans with posttraumatic stress disorder, depression, substance use disorder, or traumatic brain injury (TBI) and a smaller subset (n = 1,010) of those Veterans whose employment was tracked...

  1. Male veterans with complicated urinary tract infections: Influence of a patient-centered antimicrobial stewardship program.

    Science.gov (United States)

    Carbo, James F; Ruh, Christine A; Kurtzhalts, Kari E; Ott, Michael C; Sellick, John A; Mergenhagen, Kari A

    2016-12-01

    The influence of antimicrobial stewardship programs (ASPs) on outcomes in male veterans treated for complicated urinary tract infection has not been determined. This was a retrospective cohort study encompassing the study period January 1, 2005-October 31, 2014, which was conducted at a 150-bed Veterans Affairs Healthcare System facility in Buffalo, NY. Male veterans admitted for treatment of complicated urinary tract infection were identified using ICD-9-CM codes. Outcomes before and after implementation of a patient-centered ASP, including duration of antibiotic therapy, length of hospitalization, readmission within 30 days, and Clostridium difficile infection were compared. Interventions resulting from the ASP were categorized. Of the 1,268 patients screened, 241 met criteria for inclusion in the study (n = 118 and n = 123 in the pre-ASP and ASP group, respectively). Duration of antibiotic therapy was significantly shorter in the ASP group (10.32 days vs 11.96 days; P complicated urinary tract infection. Implementation of an ASP was associated with significant decreases in duration of antibiotic therapy and length of hospitalization, without adversely affecting 30-day readmission rates. Published by Elsevier Inc.

  2. 77 FR 20890 - Proposed Information Collection (Appointment of Veterans Service Organization/or Individuals as...

    Science.gov (United States)

    2012-04-06

    ... AFFAIRS Proposed Information Collection (Appointment of Veterans Service Organization/or Individuals as... of certain information by the agency. Under the Paperwork Reduction Act (PRA) of 1995, Federal... information, including each proposed extension of currently approved collection, and allow 60 days for public...

  3. 75 FR 17771 - Comment Request for Information Collection for Jobs for Veterans Act Priority of Service...

    Science.gov (United States)

    2010-04-07

    ... Comment Request for Information Collection for Jobs for Veterans Act Priority of Service Provisions: OMB...: Notice. SUMMARY: The Department of Labor, as part of its continuing effort to reduce paperwork and... data can be provided in the desired format, reporting burden (time and financial resources) is...

  4. Behavioral Health and Adjustment to College Life for Student Service Members/Veterans

    Science.gov (United States)

    Schonfeld, Lawrence; Braue, Lawrence A.; Stire, Sheryl; Gum, Amber M.; Cross, Brittany L.; Brown, Lisa M.

    2015-01-01

    Objective: Increasing numbers of student service members/veterans (SSM/Vs) are enrolling in college. However, little is known about how their previous military experience affects their adjustment to this new role. The present study tested the hypothesis that SSM/Vs who report adjustment problems in college have a higher incidence of posttraumatic…

  5. Community Reintegration, Participation, and Employment Issues in Veterans and Service Members With Traumatic Brain Injury.

    Science.gov (United States)

    Dillahunt-Aspillaga, Christina; Powell-Cope, Gail

    2018-02-01

    Traumatic brain injury (TBI) has been called the signature injury of the post-9/11 wars in Iraq, Afghanistan, and neighboring countries. Although similarities exist between veterans and service members with TBI, levels of severity and different constellations of coexisting comorbid conditions affect them differently. These conditions affect physical, cognitive, and emotional function, which in turn can complicate community reintegration (CR), or the ability to return to family, vocational, and community life. This special supplement of the Archives of Physical Medicine and Rehabilitation consists of articles written by accomplished teams from multiple disciplines, including anthropology, neuropsychology, nursing, occupational therapy, psychology, and rehabilitation sciences. Each article brings a different perspective to bear on what CR means for veterans and service members from examination of predictors and perceptions of veterans and service members and others to measurement studies. Collectively, this group of articles represents current thinking about CR and lays the groundwork for testing interventions to improve CR outcomes for veterans and service members (eg, employment, living situation, family life). Published by Elsevier Inc.

  6. Posttraumatic Stress and Growth in Student Service Members and Veterans: The Role of Personal Growth Initiative

    Science.gov (United States)

    Borowa, Dominika; Robitschek, Christine; Harmon, Kevin Andrew; Shigemoto, Yuki

    2016-01-01

    Objective: This study explored the extent to which personal growth initiative (PGI) may predict posttraumatic stress and growth in student service members/veterans (SSM/V). Participants: Participants were 136 SSM/V (79% men) representing multiple branches of the armed forces. Forty-four percent of participants reported having combat experience.…

  7. Mental health and health service use among post-national service veterans: results from the 2007 Adult Psychiatric Morbidity Survey of England.

    Science.gov (United States)

    Woodhead, C; Rona, R J; Iversen, A; MacManus, D; Hotopf, M; Dean, K; McManus, S; Meltzer, H; Brugha, T; Jenkins, R; Wessely, S; Fear, N T

    2011-02-01

    There is concern surrounding the psychological health and uptake of treatment services among veterans of the UK Armed Forces. Data from a cross-sectional, nationally representative sample were used to compare health outcomes and treatment seeking among 257 post-national service veterans aged 16-64 years and 504 age and sex frequency-matched non-veterans living in the community in England. Early leavers (<4 years service) were compared with longer serving veterans. Male veterans reported more childhood adversity and were more likely to have experienced a major trauma in adulthood than non-veterans. There was no association between any measure of mental health and veteran status in males, except reporting more violent behaviours [adjusted odds ratio (aOR) 1.44, 95% confidence interval (CI) 1.01-2.06]. In females, a significant association was found between veteran status and ever having suicidal thoughts (aOR 2.82, 95% CI 1.13-7.03). No differences in treatment-seeking behaviour were identified between veterans and non-veterans with any mental disorder. Early service leavers were more likely to be heavy drinkers (aOR 4.16, 95% CI 1.08-16.00), to have had suicidal thoughts (aOR 2.37, 95% CI 1.21-4.66) and to have self-harmed (aOR 12.36, 95% CI 1.61-94.68) than longer serving veterans. The findings of this study do not suggest that being a veteran is associated with adversity in terms of mental health, social disadvantage or reluctance to seek treatment compared with the general population. Some evidence implies that early service leavers may experience more mental health problems than longer-serving veterans.

  8. Chronic Pain Treatment and Health Service Utilization of Veterans with Hepatitis C Virus Infection

    Science.gov (United States)

    Lovejoy, Travis I.; Dobscha, Steven K.; Cavanagh, Renee; Turk, Dennis C.; Morasco, Benjamin J.

    2012-01-01

    Objectives Hepatitis C virus (HCV) infection is estimated to affect 2% of the general U.S. population and chronic pain is a common comorbidity among persons with HCV. The primary purpose of this study was to compare health service utilization of U.S. military veterans with HCV with and without the presence of comorbid chronic pain. Design Cross-sectional study with retrospective review of patient medical records. Patients One hundred seventy-one U.S. military veterans with confirmed HCV, recruited through a single U.S. Veterans Administration hospital. Outcome Measures Medical service utilization data from the past five years were extracted from participants’ electronic medical records. Results Sixty-four percent of veterans with HCV (n = 110) had chronic pain. Veterans with HCV and chronic pain utilized more health services including total inpatient stays (OR = 2.58 [1.46, 4.56]) and days hospitalized for psychiatric services (OR = 5.50 [3.37, 8.99]), compared to participants with HCV and no chronic pain, after statistically adjusting for demographic, psychiatric, substance use, medical comorbidity, and disability covariates. In addition, those with HCV and chronic pain had more total outpatient visits with primary care providers (OR = 1.73 [1.15, 2.59]), physical therapists (OR = 9.57 [4.79, 19.11]), and occupational therapists (OR = 2.72 [1.00, 7.48]). Conclusions Patients with HCV and chronic pain utilize medical services to a greater extent than patients with HCV but no chronic pain. Future studies that examine the efficacy of both pharmacological and nonpharmacological pain treatment for patients with comorbid HCV and chronic pain appear warranted. PMID:22958315

  9. Psychopharmacologic Services for Homeless Veterans: Comparing Psychotropic Prescription Fills Among Homeless and Non-Homeless Veterans with Serious Mental Illness.

    Science.gov (United States)

    Hermes, Eric; Rosenheck, Robert

    2016-02-01

    Using national Veterans Health Administration (VHA) administrative data, this study evaluated differences in psychotropic medication use between homeless and non-homeless adults with serious mental illness (SMI) who used VHA services in 2010. The adjusted mean number of psychotropic prescription fills associated with homeless individuals were identified using regression models adjusted for socio-demographics, diagnoses, and use of health services. Of the 876,989 individuals with SMI using VHA services, 7.2 % were homeless at some time during 2010. In bivariate analysis, homeless individuals filled more psychotropic medication prescriptions compared with non-homeless individuals. However, after adjusting for potentially confounding variables, homeless individuals were found to have filled 16.2 % fewer prescriptions than non-homeless individuals when all psychotropics were analyzed together (F = 6947.1, p < .001) and for most individual classes of psychotropics. Greater use of residential/inpatient mental health services by the homeless was the most important single factor associated with filling more psychotropic prescriptions than non-homeless individuals.

  10. Developing, Managing and Operating Community Service Centers.

    Science.gov (United States)

    Ringers, Joseph, Jr.

    This manual presents ideas, techniques, strategies, and suggestions for those interested in creating interagency programs and planning development of Community Service Centers. Chapter 1 overviews linkages leading to formation of Community Service Centers. It considers motivation, levels of interagency linkages, and interagency opportunities for…

  11. NASA Shared Services Center breaks ground

    Science.gov (United States)

    2006-01-01

    NASA officials and elected leaders were on hand for the groundbreaking ceremony of the NASA Shared Services Center Feb. 24, 2006, on the grounds of Stennis Space Center. The NSSC provides agency centralized administrative processing, human resources, procurement and financial services. From left, Louisiana Economic Development Secretary Mike Olivier, Stennis Space Center Director Rick Gilbrech, Computer Sciences Corp. President Michael Laphen, NASA Deputy Administrator Shana Dale, Rep. Gene Taylor, Sen. Trent Lott, Mississippi Gov. Haley Barbour, NASA Administrator Mike Griffin and Shared Services Center Executive Director Arbuthnot use golden shovels to break ground at the site.

  12. What do veterans service organizations' web sites say about tobacco control?

    Science.gov (United States)

    Poston, Walker S C; Haddock, Christopher K; Jahnke, Sara A; Jitnarin, Nattinee

    2013-01-01

    Little is known about veterans service organizations (VSOs) and their perspectives on veterans smoking or military tobacco control. Veterans have high smoking rates and many started smoking in the military, where a culture promoting use exists. A qualitative content analysis of VSO Web sites was conducted to classify health topics and identify tobacco-related information. Web sites were coded by trained raters from January to June of 2011. Data were entered, cleaned, and analyzed from July 2011 to January 2012. Twenty-four active VSO Web sites meeting inclusion criteria were rated independently. A comprehensive form was used to code 15 veteran-relevant health topics across multiple content areas/domains within the Web sites. Raters achieved 94.5% interrater agreement over nearly 5000 data points. Health content was coded as present or not within multiple VSO Web site areas/domains. The frequency of coverage by each VSO Web site and the number of VSO Web sites that mentioned a health topic in different Web site areas/domains were tabulated. A total of 277 health topics were addressed, with the top five being insurance/Tricare/Veterans Administration issues (28.2%), posttraumatic stress disorder (PTSD; 15.5%), disability/amputation/wounds (13.4%), Agent Orange (10.5%), and traumatic brain injury (9.0%). Tobacco was mentioned four times (1.4%) across all 24 VSO Web sites, and smoking cessation was never addressed. VSO Web sites provide little information on tobacco-related topics and none offered information about smoking cessation. Given the high rates of tobacco use among veterans and active-duty service members, and the interaction between smoking and PTSD symptoms and treatment outcomes, VSOs should consider making tobacco control and smoking cessation higher-priority health issues on their Web sites.

  13. Clean Energy Solutions Center Services

    Energy Technology Data Exchange (ETDEWEB)

    2016-03-01

    The Solutions Center offers no-cost expert policy assistance, webinars and training forums, clean energy policy reports, data, and tools provided in partnership with more than 35 leading international and regional clean energy organizations.

  14. Sexual Assault, Sexual Harassment, and Physical Victimization during Military Service across Age Cohorts of Women Veterans.

    Science.gov (United States)

    Gibson, Carolyn J; Gray, Kristen E; Katon, Jodie G; Simpson, Tracy L; Lehavot, Keren

    2016-01-01

    Exposure to sexual and physical trauma during military service is associated with adverse mental and physical health outcomes. Little is known about their prevalence and impact in women veterans across age cohorts. Data from a 2013 national online survey of women veterans was used to examine associations between age and trauma during military service, including sexual assault, sexual harassment, and physical victimization. Analyses were conducted using logistic regression, adjusting for service duration and demographic factors. In secondary analyses, the moderating role of age in the relationship between trauma and self-reported health was examined. The sample included 781 women veterans. Compared with the oldest age group (≥ 65), all except the youngest age group had consistently higher odds of reporting trauma during military service. These differences were most pronounced in women aged 45 to 54 years (sexual assault odds ratio [OR], 3.81 [95% CI, 2.77-6.71]; sexual harassment, OR, 3.99 [95% CI, 2.25-7.08]; and physical victimization, OR, 5.72 [95% CI, 3.32-9.85]). The association between trauma during military service and self-reported health status also varied by age group, with the strongest negative impact observed among women aged 45 to 54 and 55 to 64. Compared with other age groups, women in midlife were the most likely to report trauma during military service, and these experiences were associated with greater negative impact on their self-reported health. Providers should be aware that trauma during military service may be particularly problematic for the cohort of women currently in midlife, who represent the largest proportion of women who use Department of Veterans Affairs health care. Published by Elsevier Inc.

  15. Service Utilization of Veterans Dually Eligible for VA and Medicare Fee-For-Service: 1999–2004

    Science.gov (United States)

    Humensky, Jennifer; Carretta, Henry; de Groot, Kristin; Brown, Melissa M.; Tarlov, Elizabeth; Hynes, Denise M.

    2012-01-01

    Objective To examine care system choices for Veterans dually-eligible for VA and Medicare FFS following changes in VA eligibility policy, which expanded availability of VA health care services. Data Sources VA and Medicare FFS enrollment and outpatient utilization databases in 1999 and 2004. Study Design: Multinomial logistic regression was used to examine odds of VA-only and Medicare-only utilization, relative to dual utilization, in 1999 and 2004. Observational cohort comprising a 5% random sample of dually-eligible Veterans: 73,721 in 1999 and 125,042 in 2004. Principal Findings From 1999 to 2004, persons with the highest HCC risk scores had decreasing odds of exclusive VA reliance (OR=0.26 in 1999 and 0.17 in 2004, p<0.05), but had increasing odds of exclusive Medicare reliance (OR=0.43 in 1999 and 0.56 in 2004, p<0.05).Persons in high VA priority groups had decreasing odds of exclusive VA reliance, as well as decreasing odds of exclusive Medicare reliance, indicating increasing odds of dual use. Newly eligible Veterans with the highest HCC risk scores had higher odds of dual system use, while newly eligible Black Veterans had lower odds of dual system use. Conclusions Veterans newly eligible for VA healthcare services, particularly those with the highest risk scores, had higher odds of dual system use compared to earlier eligibles. Providers should ensure coordination of care for Veterans who may be receiving care from multiple sources. Provisions of the Patient Protection and Affordable Care Act may help to ensure care coordination for persons receiving care from multiple systems. PMID:24800148

  16. Client-Centered Employee Assistance Services.

    Science.gov (United States)

    Bayer, Darryl Lee

    This paper addresses delivery aspects and benefits of client-centered Employee Assistance Program (EAP) services through a review of the literature and research. EAP services are described as educational and mental health services utilized to assist employees and their families to respond constructively to job, personal, interpersonal or…

  17. Shared services centers can drive significant savings.

    Science.gov (United States)

    McDowell, Jim

    2011-06-01

    A study of more than 30 U.S. integrated delivery systems (IDSs) found that implementing effective shared services centers can drive significant cost savings in human resources, accounts payable, and procurement. Many IDSs have not adopted effective shared services strategies. Implementing administrative shared services involves low risk and a relatively low start-up investment.

  18. Characteristics of traumatic brain injuries sustained among veterans seeking homeless services.

    Science.gov (United States)

    Barnes, Sean M; Russell, Leah M; Hostetter, Trisha A; Forster, Jeri E; Devore, Maria D; Brenner, Lisa A

    2015-02-01

    This hypothesis-generating research describes the characteristics of traumatic brain injuries (TBIs) sustained among 229 Veterans seeking homeless services. Nearly all participants (83%) had sustained at least one TBI prior to their first episode of homelessness. Among participants with a TBI, assaults, transportation-related accidents, and falls were the most common causes of these injuries. Thirty percent of individuals sustained injuries with severity levels that would be expected to be associated with ongoing TBI-related deficits. Forty-three percent of the Veterans sustained at least one brain injury following their first episode of homelessness. Median lifetime number of TBIs was three. The severity of TBIs was similar among Veterans who sustained injuries before or after their first incident of homelessness. Findings suggest that future research should directly examine the potential bi-directional relationship between TBI and homelessness, as well as the impact of TBI-related deficits on Veterans' ability to benefit from homeless services and/or maintain stable housing.

  19. Exploring Student Service Members/Veterans Social Support and Campus Climate in the Context of Recovery

    Directory of Open Access Journals (Sweden)

    Susan M. Love

    2015-09-01

    Full Text Available Now that the financial needs of post 9/11 student service members/veterans have begun to be addressed, the attention has shifted to disabilities and recovery strategies of student service members/veterans. Therefore, in a cross sectional design, this study electronically surveyed 189 enrolled student service members/veterans attending a large urban state university about their experiences of returning to school. Specifically, this study described the students’ rates of Post-Traumatic Stress Disorder (PTSD and alcohol abuse, perceived stress, adaptive and non-adaptive coping strategies, social support, participation in campus activities, and perceived campus climate. Moreover, correlates of recovery were examined. Although the majority of the returning students were doing well, 36.1% reported a high level of stress, 15.1% reported a high level of anger, 17.3% reported active symptoms of PTSD, and 27.1% screened positive for alcohol problems. Social networks were found to be the most salient factor in recovery. The study’s limitations are discussed and specific support strategies are presented that can be employed by disability services, counseling services and college administrators.

  20. Validity of Center for Epidemiologic Studies Depression (CES-D scale in a sample of Iraq and Afghanistan Veterans

    Directory of Open Access Journals (Sweden)

    Ana R Quiñones

    2016-04-01

    Full Text Available Objectives: Optimal depression screening necessitates measurement tools that are valid across varied populations and in the presence of comorbidities. Methods: This study assessed the test properties of two versions of the Center for Epidemiologic Studies Depression scale against psychiatric diagnoses established by the Mini International Neuropsychiatric Interview among a clinical sample of US Veterans deployed during Operations Enduring Freedom, Iraqi Freedom, and New Dawn. Participants (N = 359 recruited from two Department of Veterans Affairs hospitals completed a clinical interview, structured diagnostic interview, and self-reported measures. Results: Based on diagnostic interview and the Diagnostic and Statistical Manual of Mental Disorders 4th Edition criteria, 29.5% of the sample met diagnostic criteria for major depressive disorder and 26.5% met diagnostic criteria for post-traumatic stress disorder. Both Center for Epidemiologic Studies Depression-20 and Center for Epidemiologic Studies Depression-10 scales performed well and almost identically against the Mini International Neuropsychiatric Interview-major depressive disorder in identifying Veterans with major depressive disorder (Center for Epidemiologic Studies Depression-20 area under the Receiver Operating Characteristic curve 91%; Center for Epidemiologic Studies Depression-10 area under the ROC curve 90%. Overall, higher cut points for the Center for Epidemiologic Studies Depression scales performed better in correctly identifying true positives and true negatives for major depressive disorder (Center for Epidemiologic Studies Depression-20 cut point 18+ sensitivity 92% specificity 72%; Center for Epidemiologic Studies Depression-10 cut point 10+ sensitivity 92% specificity 69%. Conclusions: The specificity of the Center for Epidemiologic Studies Depression scales was poor among Veterans with co-occurring post-traumatic stress disorder (13% and 16%. Veterans with post

  1. Treatment of Post-Traumatic Stress Disorder Nightmares at a Veterans Affairs Medical Center

    Science.gov (United States)

    Detweiler, Mark B.; Pagadala, Bhuvaneshwar; Candelario, Joseph; Boyle, Jennifer S.; Detweiler, Jonna G.; Lutgens, Brian W.

    2016-01-01

    The effectiveness of medications for PTSD in general has been well studied, but the effectiveness of medicatio.ns prescribed specifically for post-traumatic stress disorder (PTSD) nightmares is less well known. This retrospective chart review examined the efficacy of various medications used in actual treatment of PTSD nightmares at one Veteran Affairs Hospital. Records at the Salem, VA Veterans Affairs Medical Center (VAMC) were examined from 2009 to 2013 to check for the efficacy of actual treatments used in comparis.on with treatments suggested in three main review articles. The final sample consisted of 327 patients and 478 separate medication trials involving 21 individual medications plus 13 different medication combinations. The three most frequently utilized medications were prazosin (107 trials), risperidone (81 trials), and quetiapine (72 trials). Five medications had 20 or more trials with successful results (partial to full nightmare cessation) in >50% of trials: risperidone (77%, 1.0–6.0 mg), clonidine (63%, 0.1–2.0 mg), quetiapine (50%, 12.5–800.0 mg), mirtazapine (50%; 7.5–30.0 mg), and terazosin (64%, 50.0–300.0 mg). Notably, olanzapine (2.5–10.0) was successful (full remission) in all five prescription trials in five separate patients. Based on the clinical results, the use of risperidone, clonidine, terazosin, and olanzapine warrants additional investigation in clinically controlled trials as medications prescribed specifically for PTSD nightmares. PMID:27999253

  2. Supercomputing Centers and Electricity Service Providers

    DEFF Research Database (Denmark)

    Patki, Tapasya; Bates, Natalie; Ghatikar, Girish

    2016-01-01

    Supercomputing Centers (SCs) have high and variable power demands, which increase the challenges of the Electricity Service Providers (ESPs) with regards to efficient electricity distribution and reliable grid operation. High penetration of renewable energy generation further exacerbates this pro......Supercomputing Centers (SCs) have high and variable power demands, which increase the challenges of the Electricity Service Providers (ESPs) with regards to efficient electricity distribution and reliable grid operation. High penetration of renewable energy generation further exacerbates...

  3. From profession-based leadership to service line management in the Veterans Health Administration: impact on mental health care.

    Science.gov (United States)

    Greenberg, Greg A; Rosenheck, Robert A; Charns, Martin P

    2003-09-01

    To investigate the impact of implementing service line organization on the delivery of mental health services. Survey data on the implementation of service lines and facility-level administrative data on the delivery of mental health services at 139 Department of Veterans Affairs medical centers (VAMCs), over a 6-year period, were used to examine the relationship between service line implementation and subsequent performance in 4 areas: 1) continuity of care (COC), 2) readmission after inpatient discharge, 3) emphasis on community-based mental health care (as contrasted with inpatient care), and 4) maintenance of proportionate funding for mental health care. Models were analyzed using hierarchical linear modeling techniques to control for potential autocorrelation. Of 6 COC measures, 1 strongly improved in all years following service line implementation, and 3 of the 5 other measures demonstrated improvement in the first year. One of 2 readmission measures showed a decline in the first year after service line implementation. Service line implementation was associated with only 1 indicator of increased emphasis on community-based mental health care (and only in the first year), whereas 3 of the 4 other measures suggested a decline in such emphasis. Lastly, although there were increases in per capita mental health expenditures 3 or more years after service line implementation, 2 related measures indicated that service line implementation was associated with a decline in mental health expenditures relative to nonmental health services. Service line implementation was associated with significant, although predominantly short-term, improvement in patient level variables such as continuity of care and hospital readmission, but less so with regard to institutional measures addressing emphasis on outpatient care and maintaining proportionate funding of mental health services.

  4. Clean Energy Solutions Center Services (Portuguese Translation)

    Energy Technology Data Exchange (ETDEWEB)

    2016-03-01

    This is a Portuguese translation of the Clean Energy Solutions Center Services fact sheet. The Solutions Center offers no-cost expert policy assistance, webinars and training forums, clean energy policy reports, data, and tools provided in partnership with more than 35 leading international and regional clean energy organizations.

  5. Veterans Affairs: Presumptive Service Connection and Disability Compensation

    Science.gov (United States)

    2011-03-28

    associated with nutritional deficiencies such as osteoporosis. Section 106 of P.L. 110-389 provides a presumptive service connection for...tissue sarcoma (soft tissue sarcoma is a cancer of soft tissues such as muscles, tendons , and blood vessels). Does not include osteosarcoma... tendon sheath; Malignant schwannoma, including malignant schwannoma with rhabdomyoblastic differentiation (malignant Triton tumor); glandular and

  6. 38 CFR 12.21 - Action upon death of veteran.

    Science.gov (United States)

    2010-07-01

    ... veteran at a Department of Veterans Affairs hospital, center or domiciliary activity while receiving care... of the Department of Veterans Affairs hospital, center, or domiciliary activity having jurisdiction...

  7. Rationale and design: telepsychology service delivery for depressed elderly veterans

    Directory of Open Access Journals (Sweden)

    Richardson Lisa K

    2009-04-01

    Full Text Available Abstract Background Older adults who live in rural areas experience significant disparities in health status and access to mental health care. "Telepsychology," (also referred to as "telepsychiatry," or "telemental health" represents a potential strategy towards addressing this longstanding problem. Older adults may benefit from telepsychology due to its: (1 utility to address existing problematic access to care for rural residents; (2 capacity to reduce stigma associated with traditional mental health care; and (3 utility to overcome significant age-related problems in ambulation and transportation. Moreover, preliminary evidence indicates that telepsychiatry programs are often less expensive for patients, and reduce travel time, travel costs, and time off from work. Thus, telepsychology may provide a cost-efficient solution to access-to-care problems in rural areas. Methods We describe an ongoing four-year prospective, randomized clinical trial comparing the effectiveness of an empirically supported treatment for major depressive disorder, Behavioral Activation, delivered either via in-home videoconferencing technology ("Telepsychology" or traditional face-to-face services ("Same-Room". Our hypothesis is that in-homeTelepsychology service delivery will be equally effective as the traditional mode (Same-Room. Two-hundred twenty-four (224 male and female elderly participants will be administered protocol-driven individual Behavioral Activation therapy for depression over an 8-week period; and subjects will be followed for 12-months to ascertain longer-term effects of the treatment on three outcomes domains: (1 clinical outcomes (symptom severity, social functioning; (2 process variables (patient satisfaction, treatment credibility, attendance, adherence, dropout; and (3 economic outcomes (cost and resource use. Discussion Results from the proposed study will provide important insight into whether telepsychology service delivery is as effective

  8. America's Women Veterans: Military Service History and VA Benefit Utilization Statistics

    Data.gov (United States)

    Department of Veterans Affairs — This comprehensive report chronicles the history of women in the military and as Veterans, profiles the characteristics of women Veterans in 2009, illustrates how...

  9. The Availability and Utility of Services to Address Risk Factors for Recidivism among Justice-Involved Veterans.

    Science.gov (United States)

    Blonigen, Daniel M; Rodriguez, Allison L; Manfredi, Luisa; Britt, Jessica; Nevedal, Andrea; Finlay, Andrea K; Rosenthal, Joel; Smelson, David; Timko, Christine

    2017-10-01

    The availability and utility of services to address recidivism risk factors among justice-involved veterans is unknown. We explored these issues through qualitative interviews with 63 Specialists from the Department of Veterans Affairs' (VA) Veterans Justice Programs. To guide the interviews, we utilized the Risk-Need-Responsivity (RNR) model of offender rehabilitation. Specialists reported that justice-involved veterans generally have access to services to address most RNR-based risk factors (substance abuse; lack of positive school/work involvement; family/marital dysfunction; lack of prosocial activities/interests), but have less access to services targeting risk factors of antisocial tendencies and associates and empirically-based treatments for recidivism in VA. Peer-based services, motivational interviewing/cognitive-behavioral therapy, and Veterans Treatment Courts were perceived as useful to address multiple risk factors. These findings highlight potential gaps in provision of evidence-based care to address recidivism among justice-involved veterans, as well as promising policy-based solutions that may have widespread impact on reducing recidivism in this population.

  10. Push-Pull Tensions: A Grounded Theory on Social Experience of Use of Healthcare Services Among Homeless Veterans

    OpenAIRE

    Samiley, Romanitchiko

    2016-01-01

    The purpose of the study was to develop, from the perspective of the user, a better understanding of the factors that influence use of healthcare services by homeless veterans in the U.S. The study employed the Grounded Theory (GT) methodology and was guided by Critical Social Theory (CST) and Symbolic Interactionism (SI) as the philosophical underpinnings. There is a scant but growing number of studies on the social experience of homeless veterans in accessing care at the Department of Vete...

  11. Patient prioritization of comorbid chronic conditions in the Veteran population: Implications for patient-centered care

    Directory of Open Access Journals (Sweden)

    Lorilei M Richardson

    2016-11-01

    Full Text Available Objective: Patients with comorbid chronic conditions may prioritize some conditions over others; however, our understanding of factors influencing those prioritizations is limited. In this study, we sought to identify and elaborate a range of factors that influence how and why patients with comorbid chronic conditions prioritize their conditions. Methods: We conducted semi-structured, one-on-one interviews with 33 patients with comorbidities recruited from a single Veterans Health Administration Medical Center. Findings: The diverse factors influencing condition prioritization reflected three overarching themes: (1 the perceived role of a condition in the body, (2 self-management tasks, and (3 pain. In addition to these themes, participants described the rankings that they believed their healthcare providers would assign to their conditions as an influencing factor, although few reported having shared their priorities or explicitly talking with providers about the importance of their conditions. Conclusion: Studies that advance understanding of how and why patients prioritize their various conditions are essential to providing care that is patient-centered, reflecting what matters most to the individual while improving their health. This analysis informs guideline development efforts for the care of patients with comorbid chronic conditions as well as the creation of tools to promote patient–provider communication regarding the importance placed on different conditions.

  12. Military Service Member and Veteran Reintegration: A Conceptual Analysis, Unified Definition, and Key Domains

    Science.gov (United States)

    Elnitsky, Christine A.; Fisher, Michael P.; Blevins, Cara L.

    2017-01-01

    Returning military service members and veterans (MSMVs) may experience a variety of stress-related disorders and challenges when reintegrating from the military to the community. Facilitating the reintegration, transition, readjustment and coping, and community integration, of MSMVs is a societal priority. To date, research addressing MSMV reintegration has not identified a comprehensive definition of the term or defined the broader context within which the process of reintegration occurs although both are needed to promote valid and reliable measurement of reintegration and clarify related challenges, processes, and their impact on outcomes. Therefore, this principle-based concept analysis sought to review existing empirical reintegration measurement instruments and identify the problems and needs of MSMV reintegration to provide a unified definition of reintegration to guide future research, clinical practice, and related services. We identified 1,459 articles in the health and social sciences literature, published between 1990 and 2015, by searching multiple electronic databases. Screening of abstracts and full text review based on our inclusion/exclusion criteria, yielded 117 articles for review. Two investigators used constant conceptual comparison to evaluate relevant articles independently. We examined the term reintegration and related terms (i.e., transition, readjustment, community integration) identifying trends in their use over time, analyzed the eight reintegration survey instruments, and synthesized service member and veteran self-reported challenges and needs for reintegration. More reintegration research was published during the last 5 years (n = 373) than in the previous 10 years combined (n = 130). The research suggests coping with life stresses plays an integral role in military service member and veteran post-deployment reintegration. Key domains of reintegration include individual, interpersonal, community organizations, and societal factors

  13. Military Service Member and Veteran Reintegration: A Conceptual Analysis, Unified Definition, and Key Domains.

    Science.gov (United States)

    Elnitsky, Christine A; Fisher, Michael P; Blevins, Cara L

    2017-01-01

    Returning military service members and veterans (MSMVs) may experience a variety of stress-related disorders and challenges when reintegrating from the military to the community. Facilitating the reintegration, transition, readjustment and coping, and community integration, of MSMVs is a societal priority. To date, research addressing MSMV reintegration has not identified a comprehensive definition of the term or defined the broader context within which the process of reintegration occurs although both are needed to promote valid and reliable measurement of reintegration and clarify related challenges, processes, and their impact on outcomes. Therefore, this principle-based concept analysis sought to review existing empirical reintegration measurement instruments and identify the problems and needs of MSMV reintegration to provide a unified definition of reintegration to guide future research, clinical practice, and related services. We identified 1,459 articles in the health and social sciences literature, published between 1990 and 2015, by searching multiple electronic databases. Screening of abstracts and full text review based on our inclusion/exclusion criteria, yielded 117 articles for review. Two investigators used constant conceptual comparison to evaluate relevant articles independently. We examined the term reintegration and related terms (i.e., transition, readjustment, community integration) identifying trends in their use over time, analyzed the eight reintegration survey instruments, and synthesized service member and veteran self-reported challenges and needs for reintegration. More reintegration research was published during the last 5 years ( n = 373) than in the previous 10 years combined ( n = 130). The research suggests coping with life stresses plays an integral role in military service member and veteran post-deployment reintegration. Key domains of reintegration include individual, interpersonal, community organizations, and societal factors

  14. Governance and Control of Shared Service Centers

    NARCIS (Netherlands)

    Minnaar, R.A.

    2014-01-01

    - Purpose - The study aims to add to the knowledge of governance and control aspects of intrafirm relationships by exploring a transaction costs economics perspective (TCE perspective) on governance and management control structure choices related to the development of a shared service center (SSC).

  15. Health of national service veterans: an analysis of a community-based sample using data from the 2007 Adult Psychiatric Morbidity Survey of England.

    Science.gov (United States)

    Woodhead, Charlotte; Rona, Roberto J; Iversen, Amy C; MacManus, Deirdre; Hotopf, Matthew; Dean, Kimberlie; McManus, Sally; Meltzer, Howard; Brugha, Traolach; Jenkins, Rachel; Wessely, Simon; Fear, Nicola T

    2011-07-01

    In the context of increasing concerns for the health of UK armed forces veterans, this study aims to compare the prevalence of current mental, physical and behavioural difficulties in conscripted national service veterans with population controls, and to assess the impact of length of service in the military. The compulsory nature of national service sets these veterans apart from younger veterans. Data are drawn from a nationally representative community-dwelling sample of England. We compared 484 male national service veterans to 301 male non-veterans aged 65+ years. There were no differences in mental, behavioural or physical outcomes, except that veterans were less likely to have "any mental disorder" than non-veterans (age adjusted OR = 0.56, 95% CI 0.31, 0.99). Longer serving veterans were older but were not different in terms of mental, behavioural or physical outcomes. Community-dwelling national service veterans are at no greater risk of current adverse mental, physical or behavioural health than population controls.

  16. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available ... About About the Veterans Crisis Line FAQs Veteran Suicide Spread the Word Videos Homeless Resources Additional Information ... About About the Veterans Crisis Line FAQs Veteran Suicide The Veterans Crisis Line text-messaging service does ...

  17. 77 FR 14600 - Public Availability of the Department of Veterans Affairs Fiscal Year (FY) 2011 Service Contract...

    Science.gov (United States)

    2012-03-12

    ... Management Service, in the Office of Acquisition, Logistics, and Construction at (202) 461-6918, or email... Inventory AGENCY: Department of Veterans Affairs. ACTION: Notice of Public Availability of FY 2011 Service Contract Inventories. SUMMARY: In accordance with Section 743 of Division C of the Consolidated...

  18. Trabeculectomy Outcomes by Supervised Trainees in a Veterans Affairs Medical Center.

    Science.gov (United States)

    Biggerstaff, Kristin S; Vincent, Ryan D; Lin, Albert P; Orengo-Nania, Silvia; Frankfort, Benjamin J

    2016-08-01

    To evaluate the outcomes of trabeculectomy performed in an ophthalmology training program. Retrospective study. A total of 160 patients undergoing trabeculectomy performed by a resident or fellow under attending supervision. Trabeculectomy surgeries performed by a supervised resident or fellow surgeon between October 2000 and April 2010 were reviewed. Success was considered to be complete or partial if intraocular pressure (IOP)-lowering medications were not or were required to achieve IOP≤21 mm Hg, respectively. Failure was defined as IOP>21 mm Hg on 2 consecutive visits, loss of light perception vision, IOP≤5 on 2 consecutive visits with associated visual acuity loss of ≥2 lines, or need for surgical intervention. Trabeculectomy survival was determined using Kaplan-Meier analysis through 60 months of follow-up. Final IOP, success/failure rate. Complete success was achieved in 65 patients (41%). The average final IOP of this group was 9.1±3.7 mm Hg. Qualified success was achieved in 56 patients (35%). The average final IOP of this group was 11.5±6.4 mm Hg. At 60 months, the estimated cumulative probability of survival for complete and qualified successes was 28.9% and 63.7%, respectively. Among patients undergoing trabeculectomy by supervised residents or glaucoma fellows in a large Veterans Affairs Medical Center, IOP reduction was significant and similar to published studies. Trabeculectomy remains a successful intervention to lower IOP, with satisfactory success rates in the hands of trainee surgeons.

  19. Health Hazard Evaluation Report HETA 91-395-2244, Veterans Administration Medical Center, Los Angeles, California

    Energy Technology Data Exchange (ETDEWEB)

    Kelly, J.E.; Miller, A.

    1992-08-01

    In response to a request from an employee of the Veterans Administration Medical Center (SIC-8062), Los Angeles, California, an investigation was undertaken of exposures to chemicals in the laboratory department, excessive heat and humidity in the kitchen area of the dietetics department, and carbon-monoxide (630080) exposures inside the building. In three of five personal breathing zone samples taken in the histopathology laboratory, formaldehyde (50000) was detected at concentrations up to 0.17 part per million (ppm) and it was also present in all four of the area air samples at concentrations up to 1.1ppm. The predominant symptoms associated with work in the laboratory included occasional headaches and nose/throat irritation. Mild episodes of dermal irritation and rash were also reported. All carbon-monoxide levels were less than 5ppm. In the kitchens, relative humidity levels were below the recommended range. Temperatures were above the range of temperatures recommended for a medium level of work. The authors conclude that a potential carcinogenic risk existed for workers in laboratories which use formaldehyde. The authors recommend specific measures to lower the risk of formaldehyde exposures in the laboratory.

  20. Exploring the association between exposure to suicide and suicide risk among military service members and veterans.

    Science.gov (United States)

    Hom, Melanie A; Stanley, Ian H; Gutierrez, Peter M; Joiner, Thomas E

    2017-01-01

    Past research suggests that suicide has a profound impact on surviving family members and friends; yet, little is known about experiences with suicide bereavement among military populations. This study aimed to characterize experiences with suicide exposure and their associations with lifetime and current psychiatric symptoms among military service members and veterans. A sample of 1753 United States military service members and veterans completed self-report questionnaires assessing experiences with suicide exposure, lifetime history of suicidal thoughts and behaviors, current suicidal symptoms, and perceived likelihood of making a future suicide attempt. The majority of participants (57.3%) reported knowing someone who had died by suicide, and of these individuals, most (53.1%) reported having lost a friend to suicide. Chi-square tests, one-way ANOVAs, and logistic regression analyses revealed that those who reported knowing a suicide decedent were more likely to report more severe current suicidal symptoms and a history of suicidal thoughts and behaviors compared to those who did not know a suicide decedent. Hierarchical linear regression analyses indicated that greater self-reported interpersonal closeness to a suicide decedent predicted greater self-reported likelihood of a future suicide attempt, even after controlling for current suicidal symptoms and prior suicidal thoughts and behaviors. This study utilized cross-sectional data, and information regarding degree of exposure to suicide was not collected. Military personnel and veterans who have been bereaved by suicide may themselves be at elevated risk for suicidal thoughts and behaviors. Additional work is needed to delineate the relationship between these experiences. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. The development and implications of peer emotional support for student service members/veterans and civilian college students.

    Science.gov (United States)

    Whiteman, Shawn D; Barry, Adam E; Mroczek, Daniel K; Macdermid Wadsworth, Shelley

    2013-04-01

    Student service members/veterans represent a growing population on college campuses. Despite this growth, scholarly investigations into their health- and adjustment-related issues are almost nonexistent. The limited research that is available suggests that student service members/veterans may have trouble connecting with their civilian counterparts and be at risk for social isolation. The present study compared the development and implications of emotional support from peers among 199 student service members/veterans and 181 civilian students through 3 distinct occasions over the course of 1 calendar year. Data were collected via electronic survey. Measured constructs included perceived emotional support from university friends, mental health, alcohol use, and academic functioning. A series of multilevel models revealed that student service members/veterans reported less emotional support from their peers compared with their civilian counterparts; yet, emotional support from peers increased similarly for both groups over time. Although, increasing peer emotional support was generally related to better academic and mental health outcomes for both groups, the links between emotional support and mental health were stronger for civilian students. Results suggest that mental health practitioners, particularly those on college campuses, should be prepared to deal with veteran-specific experiences that occur before and during college.

  2. Veterans’s Medical Care: FY2014 Appropriations

    Science.gov (United States)

    2013-08-14

    B and flu vaccinations . 25 Department of Veterans Affairs, FY2014 Budget Submission, Medical Programs and Information Technology Programs, Volume 2...veterans of World War II allied nations, and employees receiving preventative occupational immunizations such as Hepatitis A&B and flu vaccinations . The...based counseling centers that provide a wide range of social and psychological services such as professional readjustment counseling to veterans who

  3. For Homeless Veterans

    Science.gov (United States)

    ... for VA health care services and are experiencing homelessness. VA case managers may connect these Veterans with ... Veterans who have experienced long-term or repeated homelessness. As of Sept. 30, 2015, HUD had allocated ...

  4. Master Veteran Index (MVI)

    Data.gov (United States)

    Department of Veterans Affairs — As of June 28, 2010, the Master Veteran Index (MVI) database based on the enhanced Master Patient Index (MPI) is the authoritative identity service within the VA,...

  5. 38 CFR 21.6521 - Employment of qualified veterans.

    Science.gov (United States)

    2010-07-01

    ... (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Temporary Program of Vocational Training and....S.C. 1163(c)) (b) Coordination with the Veterans Service Center. The VR&E Division will inform the...

  6. The patient-centered medical home in the Veterans Health Administration.

    Science.gov (United States)

    Rosland, Ann-Marie; Nelson, Karin; Sun, Haili; Dolan, Emily D; Maynard, Charles; Bryson, Christopher; Stark, Richard; Shear, Joanne M; Kerr, Eve; Fihn, Stephan D; Schectman, Gordon

    2013-07-01

    The Veterans Health Administration (VHA) is the largest integrated US health system to implement the patient-centered medical home. The Patient Aligned Care Team (PACT) initiative (implemented 2010-2014) aims to achieve team based care, improved access, and care management for more than 5 million primary care patients nationwide. To describe PACT and evaluate interim changes in PACT-related care processes. Data from the VHA Corporate Data Warehouse were obtained from April 2009 (pre- PACT) to September 2012. All patients assigned to a primary care provider (PCP) at all VHA facilities were included. Nonparametric tests of trend across time points. VHA increased primary care staff levels from April 2010 to December 2011 (2.3 to 3.0 staff per PCP full-time equivalent). In-person PCP visit rates slightly decreased from April 2009 to April 2012 (53 to 43 per 100 patients per calendar quarter; P < .01), while in-person nurse encounter rates remained steady. Large increases were seen in phone encounters (2.7 to 28.8 per 100 patients per quarter; P < .01), enhanced personal health record use (3% to 13% of patients enrolled), and electronic messaging to providers (0.01% to 2.3% of patients per quarter). Post hospitalization follow-up improved (6.6% to 61% of VA hospital discharges), but home telemonitoring (0.8% to 1.4% of patients) and group visits (0.2 to 0.65 per 100 patients per quarter; P < .01) grew slowly. Thirty months into PACT, primary care staff levels and phone and electronic encounters have greatly increased; other changes have been positive but slower.

  7. Women Veterans' Experiences of Intimate Partner Violence and Non-Partner Sexual Assault in the Context of Military Service: Implications for Supporting Women's Health and Well-Being.

    Science.gov (United States)

    Dichter, Melissa E; Wagner, Clara; True, Gala

    2016-09-20

    Women who have served in the military in the United States experience high rates of intimate partner violence (IPV) and non-partner sexual assault (SA). The military setting presents challenges and opportunities not experienced in other employment contexts that may compound the negative impacts of IPV/SA on women's lives. The purpose of this study was to explore the intersection of women's experiences of IPV/SA and military service through analysis of women veterans' narrative accounts. We conducted in-depth face-to-face qualitative interviews with 25 women veterans receiving primary care at a U.S. Veterans Affairs Medical Center. We draw upon Adler and Castro's (2013) Military Occupational Mental Health Model to frame our understanding of the impact of IPV/SA as a stressor in the military cultural context and to inform efforts to prevent, and support women service members who have experienced, these forms of violence. Our findings highlight the impact of IPV/SA on women's military careers, including options for entering and leaving military service, job performance, and opportunities for advancement. Women's narratives also reveal ways in which the military context constrains their options for responding to and coping with experiences of IPV/SA. These findings have implications for prevention of, and response to, intimate partner or sexual violence experienced by women serving in the military and underscore the need for both military and civilian communities to recognize and address the negative impact of such violence on women service members before, during, and after military service. © The Author(s) 2016.

  8. Higher Education Benefits for Post-9/11 Military Service Members and Veterans. Testimony. CT-428

    Science.gov (United States)

    Gonzalez, Gabriella C.; Miller, Laura L.; Buryk, Peter; Wenger, Jennie W.

    2015-01-01

    This testimony was presented before the House Veterans' Affairs Committee, Subcommittee on Economic Opportunity on March 17, 2015. To inform the Subcommittee hearing on the Department of Veterans Affairs' administration of its education programs, and the educational and training needs of post-9/11 veterans, the presenters offered the statement in…

  9. 78 FR 55671 - Hospital Care and Medical Services for Camp Lejeune Veterans

    Science.gov (United States)

    2013-09-11

    ..., Drug abuse, Health care, Health facilities, Health professions, Health records, Homeless, Medical.... 17.400;''. 0 3. Amend Sec. 17.108(e)(2) by removing ``or post-Gulf War combat- exposed veterans'' and adding, in its place, ``post-Gulf War combat- exposed veterans, or Camp Lejeune veterans pursuant to Sec...

  10. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Quitting Smoking Vaccines & Immunizations Flu Vaccination Prevention / Wellness Public Health Weight Management (MOVE!) Locations Hospitals & Clinics Vet Centers Veterans Canteen Service (VCS) Research Research Home About VA Research Services ...

  11. Mental health measurement among women veterans receiving co-located, collaborative care services.

    Science.gov (United States)

    Lilienthal, Kaitlin R; Buchholz, Laura J; King, Paul R; Vair, Christina L; Funderburk, Jennifer S; Beehler, Gregory P

    2017-12-01

    Routine use of measurement to identify patient concerns and track treatment progress is critical to high quality patient care. This is particularly relevant to the Primary Care Behavioral Health model, where rapid symptom assessment and effective referral management are critical to sustaining population-based care. However, research suggests that women who receive treatment in co-located collaborative care settings utilizing the PCBH model are less likely to be assessed with standard measures than men in these settings. The current study utilized regional retrospective data obtained from the Veterans Health Administration's electronic medical record system to: (1) explore rates of mental health measurement for women receiving co-located collaborative care services (N = 1008); and (2) to identify predictors of mental health measurement in women veterans in these settings. Overall, only 8% of women had documentation of standard mental health measures. Measurement was predicted by diagnosis, facility size, length of care episode and care setting. Specifically, women diagnosed with depression were less likely than those with anxiety disorders to have standard mental health measurement documented. Several suggestions are offered to increase the quality of mental health care for women through regular use of measurement in integrated care settings.

  12. Veterans service organization engagement in 'POWER,' a peer-led hypertension intervention.

    Science.gov (United States)

    Mosack, Katie E; Wendorf, Angela R; Brouwer, Amanda M; Patterson, Leslie; Ertl, Kristyn; Whittle, Jeff; Morzinski, Jeff; Fletcher, Kathlyn

    2012-12-01

    The purpose of this study was to determine the influence of program factors on participant engagement in POWER, a peer-led intervention designed to reduce hypertension, increase hypertension knowledge, and improve other relevant health behaviors, such as diet and exercise, among US veterans involved in veterans service organizations throughout Southeastern Wisconsin. Two hundred and nineteen hypertensive members from 58 VSOs participated in a year-long peer-led intervention designed to improve hypertension knowledge, disease self-management behaviors, and health outcomes. This study represents a qualitative evaluation of post and participant engagement in this intervention. We triangulated data collected via three qualitative approaches (observations, focus groups, and in-depth interviews) from intervention posts to derive a model of engagement. Our findings indicate that discrete characteristics of the peer leaders, post members, posts, and the intervention itself contributed to intervention engagement. We make suggestions for future research studies, particularly as related to understanding how peer leader identities and cultural norms within VSOs might contribute to peer-led health intervention success.

  13. Collaborating across the Departments of Veterans Affairs and Defense to integrate mental health and chaplaincy services.

    Science.gov (United States)

    Nieuwsma, Jason A; Jackson, George L; DeKraai, Mark B; Bulling, Denise J; Cantrell, William C; Rhodes, Jeffrey E; Bates, Mark J; Ethridge, Keith; Lane, Marian E; Tenhula, Wendy N; Batten, Sonja V; Meador, Keith G

    2014-12-01

    Recognizing that clergy and spiritual care providers are a key part of mental health care systems, the Department of Veterans Affairs (VA) and Department of Defense (DoD) jointly examined chaplains' current and potential roles in caring for veterans and service members with mental health needs. Our aim was to evaluate the intersection of chaplain and mental health care practices in VA and DoD in order to determine if improvement is needed, and if so, to develop actionable recommendations as indicated by evaluation findings. A 38-member multidisciplinary task group partnered with researchers in designing, implementing, and interpreting a mixed methods study that included: 1) a quantitative survey of VA and DoD chaplains; and 2) qualitative interviews with mental health providers and chaplains. Quantitative: the survey included all full-time VA chaplains and all active duty military chaplains (n = 2,163 completed of 3,464 invited; 62 % response rate). Qualitative: a total of 291 interviews were conducted with mental health providers and chaplains during site visits to 33 VA and DoD facilities. Quantitative: the online survey assessed intersections between chaplaincy and mental health care and took an average of 37 min to complete. Qualitative: the interviews assessed current integration of mental health and chaplain services and took an average of 1 h to complete. When included on interdisciplinary mental health care teams, chaplains feel understood and valued (82.8-100 % of chaplains indicated this, depending on the team). However, findings from the survey and site visits suggest that integration of services is often lacking and can be improved. Closely coordinating with a multidisciplinary task group in conducting a mixed method evaluation of chaplain-mental health integration in VA and DoD helped to ensure that researchers assessed relevant domains and that findings could be rapidly translated into actionable recommendations.

  14. Benchmarking US Department of Veterans Affairs dermatologic services: results from a national survey.

    Science.gov (United States)

    Krause, L Kendall; Townsend, Leilani; Orser, Michael L; Mulhausen, Jennifer; Duke, Jodi; Waxweiler, Weston T; Dellavalle, Robert P

    2012-03-01

    How well Department of Veterans Affairs (VA) dermatology services provide clinical care, medical education, and innovative research is a largely unexplored topic in the literature. We sought to benchmark VA dermatology services by surveying VA dermatologists about their environment, resources, and the pros and cons of working in the VA. Printed surveys were mailed to VA dermatologists and responses were compiled and analyzed. Of 105 dermatology services surveyed, 48% returned surveys completed by board-certified dermatologists (n = 50); 20 surveys completed by nondermatologists were excluded from the analysis. Most services trained dermatology residents (72%) and medical students (80%). One third of services reported significant research involvement. Qualitative analysis revealed the academic environment, patient population, and decreased business management responsibilities as the 3 most commonly cited advantages to VA employment. The most commonly listed disadvantages included low salaries, bureaucracy, and lack of resources. The survey data were self-reported and not independently verified. Not all services returned the survey. Outpatient VA dermatology services accomplish significant primary care and preventive services (eg, sun safety counseling, skin cancer screening, and treatment). However, the small number of dedicated dermatology services, their irregular geographic distribution, and the lack of staffing and resources may adversely affect optimal patient care. Dermatologist responses regarding the positive and negative aspects of working in the VA system may lead to improved management strategies to better retain and recruit dermatologists to provide patient care, medical education, and medical research despite dramatically lower dermatologist salaries within the VA system compared with private practice. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  15. Preparing MSW Students to Provide Mental and Behavioral Health Services to Military Personnel, Veterans, and Their Families in Rural Settings

    Science.gov (United States)

    Rishel, Carrie W.; Hartnett, Helen P.

    2015-01-01

    The prevalence of mental health disorders constitutes a nationwide public health crisis. Estimates suggest that more than 90 million people live in areas designated mental health professional shortage areas, with almost 6,000 additional practitioners needed to meet the service needs in these areas. Military personnel and veterans have greater…

  16. 77 FR 14707 - Vet Center Services

    Science.gov (United States)

    2012-03-13

    ... marriage and family counseling is a necessary component of counseling provided to a veteran to assist in... (including potential economic, environmental, public health and safety effects, and other advantages... action that is likely to result in a rule that may: (1) Have an annual effect on the economy of $100...

  17. Center for Surveillance, Epidemiology and Laboratory Services (CSELS)

    Data.gov (United States)

    Federal Laboratory Consortium — The mission of the Center for Surveillance, Epidemiology and Laboratory Services (CSELS) is to provide scientific service, expertise, skills, and tools in support of...

  18. Posttraumatic stress and growth in student service members and veterans: The role of personal growth initiative.

    Science.gov (United States)

    Borowa, Dominika; Robitschek, Christine; Harmon, Kevin Andrew; Shigemoto, Yuki

    2016-10-01

    This study explored the extent to which personal growth initiative (PGI) may predict posttraumatic stress and growth in student service members/veterans (SSM/V). Participants were 136 SSM/V (79% men) representing multiple branches of the armed forces. Forty-four percent of participants reported having combat experience. Data collection occurred from October 2013 to February 2014. Data were collected via a Web-based survey that included demographics and measures of personal growth initiative, posttraumatic stress, posttraumatic growth, and perceived social support. Results indicated that PGI is not a unique predictor of posttraumatic stress but is a unique predictor of higher levels of posttraumatic growth. PGI appears to be at least as important as perceived social support in facilitating growth in SSM/V. This study provides further evidence for PGI's potential to facilitate growth after a traumatic event.

  19. VA health service utilization for homeless and low-income Veterans: a spotlight on the VA Supportive Housing (VASH) program in greater Los Angeles.

    Science.gov (United States)

    Gabrielian, Sonya; Yuan, Anita H; Andersen, Ronald M; Rubenstein, Lisa V; Gelberg, Lillian

    2014-05-01

    The US Department of Housing and Urban Development (HUD)-VA Supportive Housing (VASH) program-the VA's Housing First effort-is central to efforts to end Veteran homelessness. Yet, little is known about health care utilization patterns associated with achieving HUD-VASH housing. We compare health service utilization at the VA Greater Los Angeles among: (1) formerly homeless Veterans housed through HUD-VASH (HUD-VASH Veterans); (2) currently homeless Veterans; (3) housed, low-income Veterans not in HUD-VASH; and (4) housed, not low-income Veterans. We performed a secondary database analysis of Veterans (n=62,459) who received VA Greater Los Angeles care between October 1, 2010 and September 30, 2011. We described medical/surgical and mental health utilization [inpatient, outpatient, and emergency department (ED)]. We controlled for demographics, need, and primary care use in regression analyses of utilization data by housing and income status. HUD-VASH Veterans had more inpatient, outpatient, and ED use than currently homeless Veterans. Adjusting for demographics and need, HUD-VASH Veterans and the low-income housed Veterans had similar likelihoods of medical/surgical inpatient and outpatient utilization, compared with the housed, not low-income group. Adjusting first for demographics and need (model 1), then also for primary care use (model 2), HUD-VASH Veterans had the greatest decrease in incident rates of specialty medical/surgical, mental health, and ED care from models 1 to 2, becoming similar to the currently homeless, compared with the housed, not low-income group. Our findings suggest that currently homeless Veterans underuse health care relative to housed Veterans. HUD-VASH may address this disparity by providing housing and linkages to primary care.

  20. The loss of a fellow service member: Complicated grief in post-9/11 service members and veterans with combat-related posttraumatic stress disorder.

    Science.gov (United States)

    Simon, Naomi M; O'Day, Emily B; Hellberg, Samantha N; Hoeppner, Susanne S; Charney, Meredith E; Robinaugh, Donald J; Bui, Eric; Goetter, Elizabeth M; Baker, Amanda W; Rogers, Andrew H; Nadal-Vicens, Mireya; Venners, Margaret R; Kim, Hyungjin M; Rauch, Sheila A M

    2018-01-01

    Bereavement is a potent and highly prevalent stressor among service members and veterans. However, the psychological consequences of bereavement, including complicated grief (CG), have been minimally examined. Loss was assessed in 204 post-9/11, when service members and veterans with combat-related posttraumatic stress disorder (PTSD) took part in a multicenter treatment study. Those who reported the loss of an important person completed the inventory of complicated grief (ICG; n = 160). Over three quarters (79.41%) of the sample reported an important lifetime loss, with close to half (47.06%) reporting the loss of a fellow service member (FSM). The prevalence of CG was 24.75% overall, and nearly one third (31.25%) among the bereaved. CG was more prevalent among veterans who lost a fellow service member (FSM) (41.05%, n = 39) compared to those bereaved who did not (16.92%, n = 11; OR = 3.41, 95% CI: 1.59, 7.36). CG was associated with significantly greater PTSD severity, functional impairment, trauma-related guilt, and lifetime suicide attempts. Complicated grief was prevalent and associated with adverse psychosocial outcomes in veterans and service members with combat-related PTSD. Clinicians working with this population should inquire about bereavement, including loss of a FSM, and screen for CG. Additional research examining CG in this population is needed. © 2017 Wiley Periodicals, Inc.

  1. Examining the Effects of Self-Reported Posttraumatic Stress Disorder Symptoms and Positive Relations with Others on Self-Regulated Learning for Student Service Members/Veterans

    Science.gov (United States)

    Ness, Bryan M.; Middleton, Michael J.; Hildebrandt, Michael J.

    2015-01-01

    Objectives: To examine the relationships between self-reported posttraumatic stress disorder (PTSD) symptoms, perceived positive relations with others, self-regulation strategy use, and academic motivation among student service members/veterans (SSM/V) enrolled in postsecondary education. Participants: SSM/V (N = 214), defined as veterans, active…

  2. 47 CFR 25.284 - Emergency Call Center Service.

    Science.gov (United States)

    2010-10-01

    ... mobile satellite service to end-user customers (part 25, subparts A-D) must provide Emergency Call Center... Emergency Call Center service for such terminals. (b) Beginning February 11, 2005, each mobile satellite... following October 15, mobile satellite service carriers providing service in the 1.6/2.4 GHz and 2 GHz bands...

  3. Use of health services and medicines amongst Australian war veterans: a comparison of young elderly, near centenarians and centenarians.

    Science.gov (United States)

    Roughead, Elizabeth E; Kalisch, Lisa M; Ramsay, Emmae N; Ryan, Philip; Gilbert, Andrew L

    2010-11-04

    Age and life expectancy of residents in many developed countries, including Australia, is increasing. Health resource and medicine use in the very old is not well studied. The purpose of this study was to identify annual use of health services and medicines by very old Australian veterans; those aged 95 to 99 years (near centenarians) and those aged 100 years and over (centenarians). The study population included veterans eligible for all health services subsidised by the Department of Veterans' Affairs (DVA) aged 95 years and over at August 1st 2006. A cohort of veterans aged 65 to 74 years was identified for comparison. Data were sourced from DVA claims databases. We identified all claims between August 1st 2006 and July 31st 2007 for medical consultations, pathology, diagnostic imaging and allied health services, hospital admissions, number of prescriptions and unique medicines. Chi squared tests were used to compare the proportion of centenarians (those aged 100 years and over) and near centenarians (those aged 95 to 99 years) who accessed medicines and health services with the 65 to 74 year age group. For those who accessed health services during follow up, Poisson regression was used to compare differences in the number of times centenarians and near centenarians accessed each health service compared to 65 to 74 year olds. A similar proportion (98%) of centenarians and near centenarians compared to those aged 65 to 74 consulted a GP and received prescription medicine during follow up. A lower proportion of centenarians and near centenarians had claims for specialist visits (36% and 57% respectively), hospitalisation (19% and 24%), dental (12% and 18%), physiotherapy (13% and 15%), pathology(68% and 78%) and diagnostic imaging services (51% and 68%) (p < 0.0001) and a higher proportion had claims for care plans (19% and 25%), occupational therapy (15% and 17%) and podiatry services (54% and 58%) (p < 0.0001). Compared to those aged 65 to 74, a lower proportion

  4. Use of health services and medicines amongst Australian war veterans: a comparison of young elderly, near centenarians and centenarians

    Directory of Open Access Journals (Sweden)

    Ryan Philip

    2010-11-01

    Full Text Available Abstract Background Age and life expectancy of residents in many developed countries, including Australia, is increasing. Health resource and medicine use in the very old is not well studied. The purpose of this study was to identify annual use of health services and medicines by very old Australian veterans; those aged 95 to 99 years (near centenarians and those aged 100 years and over (centenarians. Methods The study population included veterans eligible for all health services subsidised by the Department of Veterans' Affairs (DVA aged 95 years and over at August 1st 2006. A cohort of veterans aged 65 to 74 years was identified for comparison. Data were sourced from DVA claims databases. We identified all claims between August 1st 2006 and July 31st 2007 for medical consultations, pathology, diagnostic imaging and allied health services, hospital admissions, number of prescriptions and unique medicines. Chi squared tests were used to compare the proportion of centenarians (those aged 100 years and over and near centenarians (those aged 95 to 99 years who accessed medicines and health services with the 65 to 74 year age group. For those who accessed health services during follow up, Poisson regression was used to compare differences in the number of times centenarians and near centenarians accessed each health service compared to 65 to 74 year olds. Results A similar proportion (98% of centenarians and near centenarians compared to those aged 65 to 74 consulted a GP and received prescription medicine during follow up. A lower proportion of centenarians and near centenarians had claims for specialist visits (36% and 57% respectively, hospitalisation (19% and 24%, dental (12% and 18%, physiotherapy (13% and 15%, pathology(68% and 78% and diagnostic imaging services (51% and 68% (p Conclusions Medical consultations and medicines are the health services most frequently accessed by Australian veteran centenarians and near centenarians. For most

  5. The use of data to assist in the design of a new service system for homeless veterans in New York City.

    Science.gov (United States)

    Henderson, Claire; Bainbridge, Jay; Keaton, Kim; Kenton, Martha; Guz, Meghan; Kanis, Becky

    2008-03-01

    Operation Home is an agreement between the City of New York and the US Department of Veterans Affairs to design a new service system to help end veteran homelessness in New York City. The authors' task was to obtain data to inform the design of this new system. A variety of methods were used. The group reviewed relevant literature and data from street homeless survey samples, analyzed shelter data, and consulted with VA homeless program staff on the findings. We then surveyed case managers at a veterans' shelter regarding their clients and determined their housing eligibility using a standardized logic model, and led two focus groups of veterans at this shelter regarding their views of the current shelter system and services for homeless veterans and how these might be improved. Among those resident in shelters during 2006, 37.2% of self-identified veterans compared to 0.9% of others reported their prior residence as supported housing, suggesting the need for more intensive case management at veterans' supported housing sites to help them sustain their tenure. The lack of interconnectedness among the various information systems made it more difficult to collect and analyze pertinent data. To begin to address this, a data match was undertaken to estimate the proportion of veterans resident in the veterans' shelter who were not in receipt of VA benefits to which they may be entitled. The data obtained through collaboration between staff from NYC's Department of Homelessness Services, US Department of Veterans Affairs facilities in the New York/New Jersey region and Common Ground Community led to information that informed the evaluation design of the new system. The identification of gaps in available data on homeless veterans will lead to projects both to improve and share data.

  6. Beck PRIDE Center - An Effective Solution for Combat Injured Student Veterans

    Science.gov (United States)

    2016-09-01

    issues included back, neck, knee, and shoulder pain . A coin flip determined if the veteran received Treatment A or Treatment B first. The following is...intake form, 79% reported suffering from mobility impairments (e.g., back, knee, or shoulder pain ), 76% reported suffering from sleep problems (e.g...THIS PAGE U UU 19b. TELEPHONE NUMBER (include area code) 9Sep2011 - 30Jun2016 Nothing listed 54 One purpose of the study is to evaluate the effects

  7. The physical and mental health of Australian Vietnam veterans 3 decades after the war and its relation to military service, combat, and post-traumatic stress disorder.

    Science.gov (United States)

    O'Toole, Brian I; Catts, Stanley V; Outram, Sue; Pierse, Katherine R; Cockburn, Jill

    2009-08-01

    The long-term health consequences of war service remain unclear, despite burgeoning scientific interest. A longitudinal cohort study of a random sample of Australian Vietnam veterans was designed to assess veterans' postwar physical and mental health 36 years after the war (2005-2006) and to examine its relation to Army service, combat, and post-traumatic stress disorder (PTSD) assessed 14 years previously (1990-1993). Prevalences in veterans (n = 450) were compared with those in the Australian general population. Veterans' Army service and data from the first assessments were evaluated using multivariate logistic regression prediction modeling. Veterans' general health and some health risk factors were poorer and medical consultation rates were higher than Australian population expectations. Of 67 long-term conditions, the prevalences of 47 were higher and the prevalences of 4 were lower when compared with population expectations. Half of all veterans took some form of medication for mental well-being. The prevalence of psychiatric diagnoses exceeded Australian population expectations. Military and war service characteristics and age were the most frequent predictors of physical health endpoints, while PTSD was most strongly associated with psychiatric diagnoses. Draftees had better physical health than regular enlistees but no better mental health. Army service and war-related PTSD are associated with risk of illness in later life among Australian Vietnam veterans.

  8. Grants for transportation of veterans in highly rural areas. Final rule.

    Science.gov (United States)

    2013-04-02

    The Department of Veterans Affairs (VA) amends its regulations to establish a new program to provide grants to eligible entities to assist veterans in highly rural areas through innovative transportation services to travel to VA medical centers, and to otherwise assist in providing transportation services in connection with the provision of VA medical care to these veterans, in compliance with section 307 of title III of the Caregivers and Veterans Omnibus Health Services Act of 2010. This final rule establishes procedures for evaluating grant applications under the new grant program, and otherwise administering the new grant program.

  9. Art Therapy Services to Support Veterans' Transition to Civilian Life: The Studio and the Gallery

    Science.gov (United States)

    DeLucia, Jennifer Marie

    2016-01-01

    Beyond having knowledge of the treatment of combat-related trauma, art therapists need to understand veterans' experiences of transition from military to civilian life in order to offer effective interventions. This article reviews the literature on veteran transition and the challenges common to transition difficulty and describes two major…

  10. 76 FR 4245 - Herbicide Exposure and Veterans With Covered Service in Korea

    Science.gov (United States)

    2011-01-25

    ... and Drug Dependence; 64.022, Veterans Home Based Primary Care; 64.026, Veterans State Adult Day Health... procedure, Alcohol abuse, Alcoholism, Claims, Day care, Dental health, Drug abuse, Foreign relations... prisoner-of-war related disease, or disease associated with exposure to certain herbicide agents; wartime...

  11. Dissemination of family-centered prevention for military and veteran families: adaptations and adoption within community and military systems of care.

    Science.gov (United States)

    Beardslee, William R; Klosinski, Lee E; Saltzman, William; Mogil, Catherine; Pangelinan, Susan; McKnight, Carl P; Lester, Patricia

    2013-12-01

    In response to the needs of military families confronting the challenges of prolonged war, we developed Families OverComing Under Stress (FOCUS), a multi-session intervention for families facing multiple deployments and combat stress injuries adapted from existing evidence-based family prevention interventions (Lester et al. in Mil Med 176(1): 19-25, 2011). In an implementation of this intervention contracted by the US Navy Bureau of Medicine and Surgery (BUMED), FOCUS teams were deployed to military bases in the United States and the Pacific Rim to deliver a suite of family-centered preventive services based on the FOCUS model (Beardslee et al. in Prev Sci 12(4): 339-348, 2011). Given the number of families affected by wartime service and the changing circumstances they faced in active duty and veteran settings, it rapidly became evident that adaptations of this approach for families in other contexts were needed. We identified the core elements of FOCUS that are essential across all adaptations: (1) Family Psychological Health Check-in; (2) family-specific psychoeducation; (3) family narrative timeline; and (4) family-level resilience skills (e.g., problem solving). In this report, we describe the iterative process of adapting the intervention for different groups of families: wounded, ill, and injured warriors, families with young children, couples, and parents. We also describe the process of adopting this intervention for use in different ecological contexts to serve National Guard, Reserve and veterans, and utilization of technology-enhanced platforms to reach geographically dispersed families. We highlight the lessons learned when faced with the need to rapidly deploy interventions, adapt them to the changing, growing needs of families under real-world circumstances, and conduct rigorous evaluation procedures when long-term, randomized trial designs are not feasible to meet an emergent public health need.

  12. Vet Centers. Final rule.

    Science.gov (United States)

    2016-03-02

    The Department of Veterans Affairs (VA) adopts as final an interim final rule that amends its medical regulation that governs Vet Center services. The National Defense Authorization Act for Fiscal Year 2013 (the 2013 Act) requires Vet Centers to provide readjustment counseling services to broader groups of veterans, members of the Armed Forces, including a member of a reserve component of the Armed Forces, and family members of such veterans and members. This final rule adopts as final the regulatory criteria to conform to the 2013 Act, to include new and revised definitions.

  13. Rehospitalization in the First Year Following Veteran and Service Member TBI: A VA TBI Model Systems Study.

    Science.gov (United States)

    Tran, Johanna; Hammond, Flora; Dams-OʼConnor, Kristen; Tang, Xinyu; Eapen, Blessen; McCarthy, Marissa; Nakase-Richardson, Risa

    To determine the incidence and causes of rehospitalization following military or Veteran traumatic brain injury (TBI). Department of Veterans Affairs (VA) Veterans Health Administration Polytrauma Rehabilitation Centers (VHA PRCs). Consecutive sample of VHA TBI Model System participants (N = 401). Prospective observational cohort study. Number and type of rehospitalizations in first year post-TBI. Forty-one percent of 401 participants were rehospitalized. Rehospitalization status was associated with greater injury severity and receipt of TBI while active duty. Of those rehospitalized, 30% had 2 or more readmissions. Participants experiencing multiple rehospitalizations (2+) were more likely to have sustained their TBI during deployment than those with none or single rehospitalization. This group also sustained more severe injuries and spent more time in VA PRC inpatient rehabilitation. Common reasons for rehospitalization included inpatient rehabilitation (33%), unspecified (26%), orthopedic (10%), seizures (8%), infection (8%), and psychiatric (7%). This is the first study examining military and Veteran rehospitalization following TBI requiring inpatient rehabilitation at a VA PRC. Findings indicate frequent rehospitalizations in the first year postinjury, suggesting the need for preventive models of health maintenance following inpatient rehabilitation discharge. Greater surveillance of those with deployment-related TBI or active duty at the time of injury and greater TBI severity may be warranted.

  14. [Development and application of hospital customer service center platform].

    Science.gov (United States)

    Chen, Minya; Zheng, Konglin; Xia, Yong

    2012-01-01

    This paper introduces the construction and application of the platform of client service center in the general hospital and discusses how to provide patients with an entire service including service before clinic, on clinic and after clinic. It can also provide references for a new service mode for clinic service.

  15. A descriptive analysis of medical health services utilization of Veterans living in Ontario: a retrospective cohort study using administrative healthcare data.

    Science.gov (United States)

    Aiken, Alice B; Mahar, Alyson L; Kurdyak, Paul; Whitehead, Marlo; Groome, Patti A

    2016-08-04

    Health services utilization by Veterans following release may be different than the general population as the result of occupational conditions, requirements and injuries. This study provides the first longitudinal overview of Canadian Veteran healthcare utilization in the Ontario public health system. This is a retrospective cohort study designed to use Ontario's provincial healthcare data to study the demographics and healthcare utilization of Canadian Armed Forces (CAF) & RCMP Veterans living in Ontario. Veterans were eligible for the study if they released between January 1, 1990 and March 31, 2013. Databases at the Institute for Clinical Evaluative Sciences were linked by a unique identifier to study non-mental health related hospitalizations, emergency department visits, and physician visits. Overall and age-stratified descriptive statistics were calculated in five-year intervals following the date of release. The cohort is comprised of 23, 818 CAF or RCMP Veterans. Following entry into the provincial healthcare system, 82.6 % (95 % CI 82.1-83.1) of Veterans saw their family physician at least once over the first five years following release, 60.7 % (95 % CI 60.0-61.3) saw a non-mental health specialist, 40.8 % (95 % CI 40.2-41.5) went to the emergency department in that same time period and 9.9 % (9.5-10.3) were hospitalized for non-mental health related complaints. Patterns of non-mental health services utilization appeared to be time and service dependant. Stratifying health services utilization by age of the Veteran at entry into the provincial healthcare system revealed significant differences in service use and intensity. This study provides the first description of health services utilization by Veterans, following release from the CAF or RCMP. This work will inform the planning and delivery of support to Veterans in Ontario.

  16. Human Rights-Based Assessment Tool for Citizen Service Centers

    OpenAIRE

    Pfeil, Helene; Schott, Berenike; Agarwal, Sanjay

    2017-01-01

    This note provides practical advice on how to adopt a human rights-based assessment for the design, strategy, and implementation of service delivery by citizen service centers. Designed for World Bank teams conducting preliminary assessments, the tool presented here can also beuseful to clients such as citizen service center managers to deepen their understanding of the value of a human rights ...

  17. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available ... Help see more videos from Veterans Health Administration Suicide Prevention PSA for Military Families see more videos ... About About the Veterans Crisis Line FAQs Veteran Suicide The Veterans Crisis Line text-messaging service does ...

  18. Military service member and veteran reintegration: A critical review and adapted ecological model.

    Science.gov (United States)

    Elnitsky, Christine A; Blevins, Cara L; Fisher, Michael P; Magruder, Kathryn

    2017-01-01

    Returning military service members and veterans (MSMVs) experience a wide range of stress-related disorders in addition to social and occupational difficulties when reintegrating to the community. Facilitating reintegration of MSMVs following deployment is a societal priority. With an objective of identifying challenges and facilitators for reintegration of MSMVs of the current war era, we critically review and identify gaps in the literature. We searched 8 electronic databases and identified 1,764 articles. Screening of abstracts and full-text review based on our inclusion/exclusion criteria, yielded 186 articles for review. Two investigators evaluating relevant articles independently found a lack of clear definition or comprehensive theorizing about MSMV reintegration. To address these gaps, we linked the findings from the literature to provide a unified definition of reintegration and adapted the social ecological systems theory to guide research and practice aimed at MSMV reintegration. Furthermore, we identified individual, interpersonal, community, and societal challenges related to reintegration. The 186 studies published from 2001 (the start of the current war era) to 2015 included 6 experimental studies or clinical trials. Most studies do not adequately account for context or more than a narrow set of potential influences on MSMV reintegration. Little evidence was found that evaluated interventions for health conditions, rehabilitation, and employment, or effective models of integrated delivery systems. We recommend an ecological model of MSMV reintegration to advance research and practice processes and outcomes at 4 levels (individual, interpersonal, organizational, and societal). (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  19. Clean Energy Solutions Center Services (Arabic Translation) (Fact Sheet)

    Energy Technology Data Exchange (ETDEWEB)

    2014-06-01

    This is the Arabic translation of the Clean Energy Solutions Center Services fact sheet. The Clean Energy Solutions Center (Solutions Center) helps governments, advisors and analysts create policies and programs that advance the deployment of clean energy technologies. The Solutions Center partners with international organizations to provide online training, expert assistance, and technical resources on clean energy policy.

  20. Clean Energy Solutions Center Services (Fact Sheet)

    Energy Technology Data Exchange (ETDEWEB)

    2014-04-01

    The Clean Energy Solutions Center (Solutions Center) helps governments, advisors and analysts create policies and programs that advance the deployment of clean energy technologies. The Solutions Center partners with international organizations to provide online training, expert assistance, and technical resources on clean energy policy.

  1. Fit to Serve? Exploring Mental and Physical Health and Well-Being Among Transgender Active-Duty Service Members and Veterans in the U.S. Military

    Science.gov (United States)

    Hill, Brandon J.; Bouris, Alida; Barnett, Joshua Trey; Walker, Dayna

    2016-01-01

    Abstract Purpose: Although transgender people are currently excluded from enlistment and discharged from service based on medical and psychological fitness policies, the current mental and physical health of transgender active-duty U.S. military personnel and veterans is poorly understood. The purpose of the current study was to investigate the military histories, lifetime mental and physical health diagnoses, and transgender transition-related health of transgender active-duty service members (ADSM) and veterans. Methods: Participants were recruited through private LGBT military and veteran organizational listservs, snowball sampling, and in-person recruitment to complete an anonymous and confidential self-administered online questionnaire. Results: A total of 106 transgender ADSM (n=55) and veterans (n=51) completed the questionnaire. Transgender veterans were significantly older (44 mean years vs. 29.5 mean years, t=−6.23, ptransgender transition-related health. Conclusion: Our data represent the first descriptive statistics of lifetime mental and physical health issues among transgender ADSM and veterans. Data indicate that transgender ADSM report fewer lifetime mental and physical health problems than transgender veterans. Taken together, our findings suggest that more research, specifically among transgender ADSM, is needed to challenge the exclusion of transgender persons from U.S. military service based on the presumption of poor mental or physical health. PMID:29159293

  2. Helping You Choose Quality Nursing and Rehabilitation Center Services

    Science.gov (United States)

    ... About The Joint Commission Joint Commission Officers Our History Reprint Permission ... to Topic Library Helping You Choose Quality Nursing and Rehabilitation Center Services September 13, 2013 When ...

  3. Sexual dysfunction is associated with suicidal ideation in female service members and veterans.

    Science.gov (United States)

    Blais, Rebecca K; Monteith, Lindsey L; Kugler, Jordan

    2018-01-15

    Suicide is a leading cause of premature death among military service members/veterans (SM/Vs). The Interpersonal Theory of Suicide (Joiner, 2007) proposes that higher thwarted belonging, perceived burdensomeness, and acquired capability confer increased risk for suicide. However, no studies have examined the association of sexual dysfunction, a possible component of thwarted belonging and perceived burdensomeness, with suicidal ideation. The present study explored whether sexual dysfunction was associated with suicidal ideation when accounting for mental health, demographic, and military characteristics among female SM/Vs. Female SM/Vs (n = 710) completed an anonymous online survey assessing demographics, mental health, military characteristics, sexual dysfunction, and suicidal ideation. One hundred fifty-nine participants (22.39%) reported suicidal ideation during the preceding two weeks. A multivariable ordinal regression adjusted for age, marital status, probable posttraumatic stress disorder (PTSD), probable depression, race/ethnicity, Army service, and deployment history. Lower sexual functioning (adjusted odds ratio [AOR] = 0.98, 95% confidence interval[CI] = 0.95-0.99), probable PTSD (AOR = 2.54, 95% CI = 1.61-4.01), and probable depression (AOR = 5.28, 95% CI = 3.34-8.34) were associated with suicidal ideation. Post-hoc analyses examined the association of suicidal ideation with specific components of sexual functioning: difficulties with sexual arousal (AOR = 0.87, 95% CI = 0.79-0.97) and sexual satisfaction (AOR = 0.85, 95% CI = 0.75-0.96) were associated with suicidal ideation. Data were cross-sectional and limited to self-report. Sexual dysfunction is associated with suicidal ideation, accounting for established mental health, military, and demographic characteristics among female SM/Vs. Efforts to prevent suicidal ideation in female SM/Vs may be enhanced by screening for and treating sexual dysfunction, particularly sexual arousal and satisfaction

  4. Tri-Service Center for Oral Health Studies (TSCOHS)

    Data.gov (United States)

    Federal Laboratory Consortium — The Tri-Service Center for Oral Health Studies (TSCOHS), a service of the Postgraduate Dental College, is chartered by the Department of Defense TRICARE Management...

  5. 76 FR 13022 - Agency Information Collection (Application for Service-Disabled Veterans Insurance) Activity...

    Science.gov (United States)

    2011-03-09

    ... review and comment. The PRA submission describes the nature of the information collection and its.... Veterans completing VA Form 29-4364c do not need to provide medical information to qualify for this...

  6. Perspectives of family and veterans on family programs to support reintegration of returning veterans with posttraumatic stress disorder.

    Science.gov (United States)

    Fischer, Ellen P; Sherman, Michelle D; McSweeney, Jean C; Pyne, Jeffrey M; Owen, Richard R; Dixon, Lisa B

    2015-08-01

    Combat deployment and reintegration are challenging for service members and their families. Although family involvement in mental health care is increasing in the U.S. Department of Veterans Affairs (VA) system, little is known about family members' preferences for services. This study elicited the perspectives of returning Afghanistan and Iraq war veterans with posttraumatic stress disorder and their families regarding family involvement in veterans' mental health care. Semistructured qualitative interviews were conducted with 47 veterans receiving care for posttraumatic stress disorder at the Central Arkansas Veterans Healthcare System or Oklahoma City VA Medical Center and 36 veteran-designated family members. Interviews addressed perceived needs related to veterans' readjustment to civilian life, interest in family involvement in joint veteran/family programs, and desired family program content. Interview data were analyzed using content analysis and constant comparison. Both groups strongly supported inclusion of family members in programs to facilitate veterans' postdeployment readjustment and reintegration into civilian life. Both desired program content focused on information, practical skills, support, and gaining perspective on the other's experience. Although family and veteran perspectives were similar, family members placed greater emphasis on parenting-related issues and the kinds of support they and their children needed during and after deployment. To our knowledge, this is the first published report on preferences regarding VA postdeployment reintegration support that incorporates the perspectives of returning male and female veterans and those of their families. Findings will help VA and community providers working with returning veterans tailor services to the needs and preferences of this important-to-engage population. (c) 2015 APA, all rights reserved).

  7. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Flu Vaccination Prevention / Wellness Public Health Weight Management (MOVE!) Locations Hospitals & Clinics Vet Centers Veterans Canteen Service ( ... Close Video Help Problems viewing videos in pop up windows? See our alternate video page. For information ...

  8. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Injury Telehealth Womens Health Issues Wellness Programs MyHealtheVet Nutrition Quitting Smoking Vaccines & Immunizations Flu Vaccination Prevention / Wellness Public Health Weight Management (MOVE!) Locations Hospitals & Clinics Vet Centers Veterans Canteen Service (VCS) Research ...

  9. The Impact of Couple Therapy on Service Utilization among Military Veterans: The Moderating Roles of Pretreatment Service Utilization and Premature Termination.

    Science.gov (United States)

    Madsen, Joshua W; Tomfohr-Madsen, Lianne M; Doss, Brian D

    2017-09-01

    Couple therapy reduces relational and individual distress and may affect utilization of other health services, particularly among higher service utilizers. Although average decreases in service utilization are predicted among recipients of couple therapy, low utilizers of services may appropriately increase use. The relationship between couple therapy and service utilization was examined among a sample of 179 U.S. military veterans who received treatment in Veterans Affairs (VA) specialty couple therapy clinics. Consistent with hypotheses, overall mental and physical health visits decreased from the 12 months preceding couple therapy to the 12 months following treatment. Moderator analyses showed that decreases were greatest among individuals who were rated by their therapist as having completed a full course of couple therapy, suggesting that change was attributable to intervention. Pretreatment service utilization also moderated observed change-higher utilizers' use of services decreased substantially, whereas lower utilizers' slightly increased. Cost analyses revealed that the estimated per person mean cost in our sample decreased by $930.33 in the year following compared to the year prior to couple therapy, as per 2008 VA cost data. As service utilization data were only available for one partner and only for 1 year posttherapy, the true magnitude of this effect may be underestimated. Our findings are relevant to policy makers as they demonstrate that couple therapy reduces average service utilization and associated costs and addresses calls for analyses of cost effectiveness of systemic interventions. © 2016 Family Process Institute.

  10. Service Members in School: Military Veterans’ Experiences Using the Post-9/11 GI Bill and Pursuing Postsecondary Education

    Science.gov (United States)

    2010-11-01

    Afghanistan Veterans of America (IAVA); Brian Hawthorne, legisla- tive director of the Student Veterans of America ( SVA ); Derek Blumke, president of SVA ...Veterans of America ( SVA ), a national student veterans’ organization; the National Association of Veterans’ Program Administrators (NAVPA), a

  11. National Survey of Veterans, Active Duty Service Members, Demobilized National Guard and Reserve Members, Family Members, and Surviving Spouses

    Data.gov (United States)

    Department of Veterans Affairs — The 2010 National Survey of Veterans (NSV) is the sixth in a series of comprehensive nationwide surveys designed to help the Department of Veterans Affairs (VA) plan...

  12. Obese Veterans Enrolled in a Veterans Affairs Medical Center Outpatient Weight Loss Clinic Are Likely to Experience Disordered Sleep and Posttraumatic Stress.

    Science.gov (United States)

    Mayer, Stephanie B; Levy, James R; Farrell-Carnahan, Leah; Nichols, Michelle G; Raman, Shekar

    2016-07-15

    This cross-sectional study aimed to characterize sleep patterns, the quality and duration of sleep, and estimate the prevalence of common sleep disorders and posttraumatic stress disorder (PTSD) in a hospital-based Veterans Affairs MOVE! (Managing Overweight Veterans Everywhere) clinic. Participants completed five instruments: the Pittsburgh Sleep Quality Index (PSQI), Smith's Measure of Morningness/Eveningness, Restless Legs Syndrome Rating Scale, the STOP Questionnaire, and the Posttraumatic Stress Disorder (PTSD) Checklist - Civilian Version (PCL-C). Enrolled Veterans (n = 96) were mostly male (78%), African American (49%), mean age 58 (standard deviation [SD] 10.6) years, and mean body mass index (BMI) 38.4 kg/m(2) (SD 8.4). By PSQI, 89% rated sleep quality as "poor" (mean = 11.1, SD = 5.1), consistent with severely impaired sleep. Most were at high risk for sleep disorders including restless leg syndrome (53%), obstructive sleep apnea (66%), and circadian sleep disorders (72%). Forty-seven percent endorsed clinically significant symptoms of PTSD. Hypotheses-generating regression models suggest sleep latency (minutes before falling asleep) was associated with BMI (p = 0.018). Bedtime, getting up time, hours of sleep, waking up in the middle of the night or early morning, having to get up to use the bathroom, inability to breathe comfortably, cough or snore loudly, feeling too cold or too hot, having bad dreams, pain, and frequency of having trouble sleeping, were not significantly associated with BMI. Our cross-sectional study suggests that sleep difficulties are common among Veterans referred to a weight loss program at a Veterans Affairs Hospital. Controlled studies are needed to investigate whether the results are generalizable and whether obesity among veterans is a risk factor for sleep disorders and PTSD. A commentary on this article appears in this issue on page 943. © 2016 American Academy of Sleep Medicine.

  13. Clean Energy Solutions Center Services (Vietnamese Translation)

    Energy Technology Data Exchange (ETDEWEB)

    2016-03-01

    This is a Vietnamese translation of the Clean Energy Solutions Center fact sheet. The Solutions Center offers no-cost expert policy assistance, webinars and training forums, clean energy policy reports, data, and tools provided in partnership with more than 35 leading international and regional clean energy organizations.

  14. Clean Energy Solutions Center Services (Arabic Translation)

    Energy Technology Data Exchange (ETDEWEB)

    2016-03-01

    This is an Arabic translation of the Clean Energy Solutions Center fact sheet. The Solutions Center offers no-cost expert policy assistance, webinars and training forums, clean energy policy reports, data, and tools provided in partnership with more than 35 leading international and regional clean energy organizations.

  15. Clean Energy Solutions Center Services (French Translation)

    Energy Technology Data Exchange (ETDEWEB)

    2016-03-01

    This is a French translation of the Clean Energy Solutions Center fact sheet. The Solutions Center offers no-cost expert policy assistance, webinars and training forums, clean energy policy reports, data, and tools provided in partnership with more than 35 leading international and regional clean energy organizations.

  16. Offshore financial centers, accounting services and the global economy

    National Research Council Canada - National Science Library

    McKee, David L; Garner, Don E; McKee, Yosra AbuAmara

    2000-01-01

    ... and Business Environments in the Caribbean and the North Atlantic 101vi Contents 8. The Climate for Accounting and Business Services in Selected European Centers 123 9. Accounting and Business Environments in the Persian Gulf, the Indian Ocean and the Far East 147 IV. Implications for Growth and Change 171 10. Offshore Financial Centers, Accounting Services ...

  17. Elevated rates of memory impairment in military service-members and veterans with posttraumatic stress disorder.

    Science.gov (United States)

    Stricker, Nikki H; Lippa, Sara M; Green, Deborah L; McGlynn, Susan M; Grande, Laura J; Milberg, William P; McGlinchey, Regina E

    2017-10-01

    Studies investigating the neurocognitive effects of posttraumatic stress disorder (PTSD) routinely find "deficits" in various cognitive domains. However, the rate of cognitive impairment in individuals with PTSD remains unclear, as studies have focused on null hypothesis testing (NHT) and inferring patterns of impairment rather than empirically determining the rate of cognitive impairment in this sample. This study examined rates of cognitive impairment using a domain-specific approach in non-treatment-seeking Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn service members and veterans with (n = 92) and without (n = 79) PTSD and without substance abuse/dependence who passed a performance validity measure and were matched on age, education, estimated IQ, and ethnicity. Chi-square analyses were used to compare the rate of cognitive impairment across groups based on normative scores using three cutoffs (-1, -1.5, and -2 SDs). NHT was also used to compare performances across groups. Individuals with PTSD showed higher rates of impairment in memory (-1-SD cutoff) than controls, but equivalent rates of impairment in attention, processing speed, and executive functioning; no significant differences were found on NHT. Impairment in any domain was also more prevalent in PTSD (-1-, -1.5-, and -2-SD cutoffs). No differences were found on NHT or rates of impairment in individuals with PTSD with (n = 34) and without (n = 58) depression. Patients with PTSD were more likely to meet criteria for memory impairment and to show impairment in any domain than controls. Patients with PTSD and comorbid depression were no more likely to be impaired in any cognitive domain or to have lower scores on individual cognitive tasks than patients with PTSD alone. Clinicians noting cognitive impairment in individuals with PTSD should exercise caution before ascribing that impairment to another etiology if deficits are limited to memory.

  18. Professional Quality of Life of Veterans Affairs Staff and Providers in a Patient-Centered Care Environment.

    Science.gov (United States)

    Locatelli, Sara M; LaVela, Sherri L

    2015-01-01

    Changes to the work environment prompted by the movement toward patient-centered care have the potential to improve occupational stress among health care workers by improving team-based work activities, collaboration, and employee-driven quality improvement. This study was conducted to examine professional quality of life among providers at patient-centered care pilot facilities. Surveys were conducted with 76 Veterans Affairs employees/providers at facilities piloting patient-centered care interventions, to assess demographics, workplace practices and views (team-based environment, employee voice, quality of communication, and turnover intention), and professional quality of life (compassion satisfaction, burnout, and secondary traumatic stress).Professional quality-of-life subscales were not related to employee position type, age, or gender. Employee voice measures were related to lower burnout and higher compassion satisfaction. In addition, employees who were considering leaving their position showed higher burnout and lower compassion satisfaction scores. None of the work practices showed relationships with secondary traumatic stress.

  19. Student Centered Financial Services: Innovations That Succeed

    Science.gov (United States)

    Sinsabaugh, Nancy, Ed.

    2007-01-01

    This collection of best practices shares how 18 higher education institutions across the country have successfully evaluated and redesigned their student financial services programs to improve services to students and their parents and find cost savings for the institution. This volume illustrates how other institutions have successfully tackled…

  20. 78 FR 37278 - Proposed Information Collection (Veterans Benefits Administration (VBA) Voice of the Veteran (VOV...

    Science.gov (United States)

    2013-06-20

    ... AFFAIRS Proposed Information Collection (Veterans Benefits Administration (VBA) Voice of the Veteran (VOV... Veterans Affairs. ACTION: Notice. SUMMARY: The Veterans Benefits Administration (VBA), Department of... application and servicing processes for the VBA Compensation Service (CS), Pension Service (P&F), Education...

  1. Patient-centered medical home initiative produced modest economic results for Veterans Health Administration, 2010-12.

    Science.gov (United States)

    Hebert, Paul L; Liu, Chuan-Fen; Wong, Edwin S; Hernandez, Susan E; Batten, Adam; Lo, Sophie; Lemon, Jaclyn M; Conrad, Douglas A; Grembowski, David; Nelson, Karin; Fihn, Stephan D

    2014-06-01

    In 2010 the Veterans Health Administration (VHA) began a nationwide initiative called Patient Aligned Care Teams (PACT) that reorganized care at all VHA primary care clinics in accordance with the patient-centered medical home model. We analyzed data for fiscal years 2003-12 to assess how trends in health care use and costs changed after the implementation of PACT. We found that PACT was associated with modest increases in primary care visits and with modest decreases in both hospitalizations for ambulatory care-sensitive conditions and outpatient visits with mental health specialists. We estimated that these changes avoided $596 million in costs, compared to the investment in PACT of $774 million, for a potential net loss of $178 million in the study period. Although PACT has not generated a positive return, it is still maturing, and trends in costs and use are favorable. Adopting patient-centered care does not appear to have been a major financial risk for the VHA. Project HOPE—The People-to-People Health Foundation, Inc.

  2. Arthritis and Veterans

    Centers for Disease Control (CDC) Podcasts

    2015-11-09

    One in three veterans has arthritis. This podcast provides information on how veterans can improve their quality of life with physical activity and other arthritis management strategies.  Created: 11/9/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 11/9/2015.

  3. National Support Center: A Service of IBM.

    Science.gov (United States)

    Exceptional Parent, 1990

    1990-01-01

    This article describes (1) IBM's National Support Center for Persons with Disabilities, a clearinghouse of information about adaptive devices, software, and support groups helping disabled persons use IBM computers; (2) special IBM products, including the Screen Reader, SpeechViewer, and PhoneCommunicator; and (3) an IBM-sponsored program whereby…

  4. Vet Centers. Interim final rule.

    Science.gov (United States)

    2015-08-04

    The Department of Veterans Affairs (VA) is amending its medical regulation that governs Vet Center services. The National Defense Authorization Act for Fiscal Year 2013 (the 2013 Act) requires Vet Centers to provide readjustment counseling services to broader groups of veterans, members of the Armed Forces, including a member of a reserve component of the Armed Forces, and family members of such veterans and members. This interim final rule amends regulatory criteria to conform to the 2013 Act, to include new and revised definitions.

  5. Assessing uncertainty in outsourcing clinical services at tertiary health centers.

    Science.gov (United States)

    Billi, John E; Pai, Chih-Wen; Spahlinger, David A

    2007-01-01

    When tertiary health centers face capacity constraint, one feasible strategy to meet service demand is outsourcing clinical services to qualified community providers. Clinical outsourcing enables tertiary health centers to meet the expectations of service timeliness and provides good opportunities to collaborate with other health care providers. However, outsourcing may result in dependence and loss of control for the tertiary health centers. Other parties involved in clinical outsourcing such as local partners, patients, and payers may also encounter potential risks as well as enjoy benefits in an outsourcing arrangement. Recommendations on selecting potential outsourcing partners are given to minimize the risks associated with an outsourcing contract. Copyright (c) 2006 John Wiley & Sons, Ltd.

  6. War Veterans' Memoirs as Narrated to Students: An Intergenerational Service-Learning Project for Interpersonal Communication

    Science.gov (United States)

    Whitfield, Toni S.; Conis, Annick D.

    2006-01-01

    Faculty members constantly struggle to integrate "learning" and "doing" in the classroom in order to increase their students' understanding of course concepts--the interpersonal communication class is no different. The Library of Congress Veterans History Project seemed perfectly adapted to the goal of bringing interpersonal communication theories…

  7. Federally Qualified Health Center Substitution of Local Health Department Services.

    Science.gov (United States)

    Snider, Jeremy W; Bekemeier, Betty R; Conrad, Douglas A; Grembowski, David E

    2017-10-01

    Strategic and budgetary considerations have shifted local health departments (LHDs) away from safety net clinical services and toward population-focused services. Federally Qualified Health Centers (FQHCs) play an increasing role in the safety net, and may complement or substitute for LHD clinical services. The authors examined the association between FQHC service levels in communities and the presence of specific LHD clinical services in 2010 and 2013. Data from LHD surveys and FQHC service data were merged for 2010 and 2013. Multivariate regression and instrumental variable methods were used to examine FQHC service levels that might predict related LHD service presence or discontinuation from 2010 to 2013. There were modest reductions in LHD service presence and increases in FQHC service volume over the time period. LHD primary care and dental service presence were inversely associated with higher related FQHC service volume. LHD prenatal care service presence, as well as a measure of change in general service approach, were not significantly associated with FQHC service volume. LHDs were less likely to provide certain clinical services where FQHCs provide a greater volume of services, suggesting a substitution effect. However, certain clinical services, such as prenatal care, may complement the public health mission-and LHDs may be strategically placed to continue to deliver these services. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  8. E-cigarette Use in Veterans Seeking Mental Health and/or Substance Use Services.

    Science.gov (United States)

    Hefner, Kathryn; Rosenheck, Robert; Merrel, Jeremy; Coffman, Marcedes; Valentine, Gerry; Sofuoglu, Mehmet

    2016-01-01

    Individuals with mental illness and substance use disorders smoke at elevated rates and tend to have greater difficulty quitting smoking as compared to the general population. Some believe that e-cigarettes may reduce harm associated with smoking, but little is known about e-cigarette use, perceptions, and motivations for their use among individuals with mental health and/or substance use disorders. Rates and correlates of e-cigarette use, perceptions, and sources of information about e-cigarettes among smokers seeking mental health and/or substance use services (N = 188) at the VA Connecticut Healthcare System were assessed via a brief survey. The Pearson χ(2) test of independence was used to compare veterans who currently used e-cigarettes with those who did not. Logistic regression was used to examine independent attitudinal differences controlling for potentially confounding variables. Participants were generally male (90%), Caucasian (54%), and older than 50 (69%), with high rates of at least one mental health condition (82%), at least one substance use disorder (73%), and comorbid mental health and substance use disorders (55%). A relatively high proportion of the sample (30.9%) used e-cigarettes. These participants, compared to those who did not use e-cigarettes, were more likely to have a mental health disorder and less likely to have a substance use disorder, started smoking later in life, spent less money on smoking, and were more likely to have tried to quit "cold turkey." Knowledge of e-cigarettes originated most often from TV, radio, or personal contacts. Respondents held generally positive perceptions and motivations regarding e-cigarette use (i.e., it is socially acceptable, may help reduce/quit smoking, less harmful to others). Despite positive attributions, rates of dual use of e-cigarettes and traditional cigarettes was high (86.2%), and very few people using e-cigarettes (6.9%) indicated that e-cigarettes actually helped them quit smoking

  9. Infertility Care Among OEF/OIF/OND Women Veterans in the Department of Veterans Affairs

    Science.gov (United States)

    Mattocks, Kristin; Kroll-Desrosiers, Aimee; Zephyrin, Laurie; Katon, Jodie; Weitlauf, Julie; Bastian, Lori; Haskell, Sally; Brandt, Cynthia

    2015-01-01

    Background An increasing number of young women Veterans seek reproductive health care through the VA, yet little is known regarding the provision of infertility care for this population. The VA provides a range of infertility services for Veterans including artificial insemination, but does not provide in vitro fertilization. This study will be the first to characterize infertility care among OEF/OIF/OND women Veterans using VA care. Methods We analyzed data from the OEF/OIF/OND roster file from the Defense Manpower Data Center (DMDC)—Contingency Tracking System Deployment file of military discharges from October 1, 2001–December 30, 2010, which includes 68,442 women Veterans between the ages of 18 and 45 who utilized VA health care after separating from military service. We examined the receipt of infertility diagnoses and care using ICD-9 and CPT codes. Results Less than 2% (n = 1323) of OEF/OIF/OND women Veterans received an infertility diagnosis during the study period. Compared with women VA users without infertility diagnosis, those with infertility diagnosis were younger, obese, black, or Hispanic, have a service-connected disability rating, a positive screen for military sexual trauma, and a mental health diagnosis. Overall, 22% of women with an infertility diagnosis received an infertility assessment or treatment. Thirty-nine percent of women Veterans receiving infertility assessment or treatment received this care from non-VA providers. Conclusions Overall, a small proportion of OEF/OIF/OND women Veterans received infertility diagnoses from the VA during the study period, and an even smaller proportion received infertility treatment. Nearly 40% of those who received infertility treatments received these treatments from non-VA providers, indicating that the VA may need to examine the training and resources needed to provide this care within the VA. Understanding women’s use of VA infertility services is an important component of understanding VA

  10. Infertility care among OEF/OIF/OND women Veterans in the Department of Veterans Affairs.

    Science.gov (United States)

    Mattocks, Kristin; Kroll-Desrosiers, Aimee; Zephyrin, Laurie; Katon, Jodie; Weitlauf, Julie; Bastian, Lori; Haskell, Sally; Brandt, Cynthia

    2015-04-01

    An increasing number of young women Veterans seek reproductive health care through the VA, yet little is known regarding the provision of infertility care for this population. The VA provides a range of infertility services for Veterans including artificial insemination, but does not provide in vitro fertilization. This study will be the first to characterize infertility care among OEF/OIF/OND women Veterans using VA care. We analyzed data from the OEF/OIF/OND roster file from the Defense Manpower Data Center (DMDC)-Contingency Tracking System Deployment file of military discharges from October 1, 2001-December 30, 2010, which includes 68,442 women Veterans between the ages of 18 and 45 who utilized VA health care after separating from military service. We examined the receipt of infertility diagnoses and care using ICD-9 and CPT codes. Less than 2% (n=1323) of OEF/OIF/OND women Veterans received an infertility diagnosis during the study period. Compared with women VA users without infertility diagnosis, those with infertility diagnosis were younger, obese, black, or Hispanic, have a service-connected disability rating, a positive screen for military sexual trauma, and a mental health diagnosis. Overall, 22% of women with an infertility diagnosis received an infertility assessment or treatment. Thirty-nine percent of women Veterans receiving infertility assessment or treatment received this care from non-VA providers. Overall, a small proportion of OEF/OIF/OND women Veterans received infertility diagnoses from the VA during the study period, and an even smaller proportion received infertility treatment. Nearly 40% of those who received infertility treatments received these treatments from non-VA providers, indicating that the VA may need to examine the training and resources needed to provide this care within the VA. Understanding women's use of VA infertility services is an important component of understanding VA's commitment to comprehensive medical care for

  11. Geographic access and use of infectious diseases specialty and general primary care services by veterans with HIV infection: implications for telehealth and shared care programs.

    Science.gov (United States)

    Ohl, Michael E; Richardson, Kelly; Kaboli, Peter J; Perencevich, Eli N; Vaughan-Sarrazin, Mary

    2014-01-01

    Rural-dwelling persons with HIV infection often have limited access to HIV specialty care, and they may instead use more nearby primary care. This study described use of infectious disease (ID) specialty and general primary care services among rural compared with urban veterans with HIV in the United States and determined associations between geographic access to ID and primary care and use of care. The sample included all veterans in the national Veterans Administration (VA) HIV clinical case registry in 2009 (N = 23,669, 10.2% rural). Geographic access was measured by calculating travel times to the nearest VA primary care and ID specialty clinic. Rural veterans were less likely than urban to use ID clinics (82% of rural vs 87% of urban, P shared care" relationships with distant primary care providers. © 2014 National Rural Health Association.

  12. 38 CFR 17.101 - Collection or recovery by VA for medical care or services provided or furnished to a veteran for...

    Science.gov (United States)

    2010-07-01

    ... VA for medical care or services provided or furnished to a veteran for a nonservice-connected... MEDICAL Charges, Waivers, and Collections § 17.101 Collection or recovery by VA for medical care or... section covers collection or recovery by VA, under 38 U.S.C. 1729, for medical care or services provided...

  13. Goddard Earth Sciences Data and Information Services Center (GES DISC)

    Data.gov (United States)

    National Aeronautics and Space Administration — The NASA Goddard Earth Sciences (GES) Data and Information Services Center (DISC) is the home (archive) of Precipitation, Atmospheric Chemistry and Dynamics, and...

  14. Systems innovation model: an integrated interdisciplinary team approach pre- and post-bariatric surgery at a veterans affairs (VA) medical center.

    Science.gov (United States)

    Eisenberg, Dan; Lohnberg, Jessica A; Kubat, Eric P; Bates, Cheryl C; Greenberg, Lauren M; Frayne, Susan M

    2017-04-01

    Provision of bariatric surgery in the Veterans Health Administration must account for obese veterans' co-morbidity burden and the geographically dispersed location of patients relative to Veterans Affairs (VA) bariatric centers. To evaluate a collaborative, integrated, interdisciplinary bariatric team of surgeons, bariatricians, psychologists, dieticians, and physical therapists working in a hub-and-spokes care model, for pre- and post-bariatric surgery assessment and management. This is a description of an interdisciplinary clinic and bariatric program at a VA healthcare system and a report on program evaluation findings. Retrospective data of a prospective database was abstracted. For program evaluation, we abstracted charts to characterize patient data and conducted a patient survey. Since 2009, 181 veterans have undergone bariatric surgery. Referrals came from 7 western U.S. states. Mean preoperative body mass index was 46 kg/m2 (maximum 71). Mean age was 53 years, with 33% aged>60 years; 79% were male. Medical co-morbidity included diabetes (70%), hypertension (85%), and lower back or extremity joint pain (84%). A psychiatric diagnosis was present in 58%. At 12 months, follow-up was 81% and percent excess body mass index loss was 50.5%. Among 54 sequential clinic patients completing anonymous surveys, overall satisfaction with the interdisciplinary team approach and improved quality of life were high (98% and 94%, respectively). The integrated, interdisciplinary team approach using a hub-and-spokes model is well suited to the VA bariatric surgery population, with its heavy burden of medical and mental health co-morbidity and its system of geographically dispersed patients receiving treatment at specialty centers. As the VA seeks to expand the use of bariatric surgery as an option for obese veterans, interdisciplinary models crafted to address case complexity, care coordination, and long-term outcomes should be part of policy planning efforts. Published by

  15. A SIMULATION MODEL FOR EMERGENCY MEDICAL SERVICES CALL CENTERS

    NARCIS (Netherlands)

    M. van Buuren (Martin); G.J. Kommer (Geert Jan); R.D. van der Mei (Rob); S. Bhulai (Sandjai); L. Yilmaz; W.K.V. Chan; I. Moon; T.M.K. Roeder; C. Macal; M.D. Rosetti

    2015-01-01

    htmlabstractIn pre-hospital health care the call center plays an important role in the coordination of emergency medical services (EMS). An EMS call center handles inbound requests for EMS and dispatches an ambulance if necessary. The time needed for triage and dispatch is part of the total response

  16. A simulation model for emergency medical services call centers

    NARCIS (Netherlands)

    van Buuren, M.; Kommer, G.J.; van der Mei, R.D.; Bhulai, S.

    2015-01-01

    In pre-hospital health care the call center plays an important role in the coordination of emergency medical services (EMS). An EMS call center handles inbound requests for EMS and dispatches an ambulance if necessary. The time needed for triage and dispatch is part of the total response time to the

  17. A simulation model for emergency medical services call centers

    NARCIS (Netherlands)

    M. van Buuren (Martin); G.J. Kommer (Geert Jan); R.D. van der Mei (Rob); S. Bhulai (Sandjai)

    2015-01-01

    htmlabstractIn pre-hospital health care the call center plays an important role in the coordination of emergency medical services (EMS). An EMS call center handles inbound requests for EMS and dispatches an ambulance if necessary. The time needed for triage and dispatch is part of the total response

  18. Health Services Cost Analyzing in Tabriz Health Centers 2008

    Directory of Open Access Journals (Sweden)

    Massumeh gholizadeh

    2015-08-01

    Full Text Available Background and objectives : Health Services cost analyzing is an important management tool for evidence-based decision making in health system. This study was conducted with the purpose of cost analyzing and identifying the proportion of different factors on total cost of health services that are provided in urban health centers in Tabriz. Material and Methods : This study was a descriptive and analytic study. Activity Based Costing method (ABC was used for cost analyzing. This cross–sectional survey analyzed and identified the proportion of different factors on total cost of health services that are provided in Tabriz urban health centers. The statistical population of this study was comprised of urban community health centers in Tabriz. In this study, a multi-stage sampling method was used to collect data. Excel software was used for data analyzing. The results were described with tables and graphs. Results : The study results showed the portion of different factors in various health services. Human factors by 58%, physical space 8%, medical equipment 1.3% were allocated with high portion of expenditures and costs of health services in Tabriz urban health centers. Conclusion : Based on study results, since the human factors included the highest portion of health services costs and expenditures in Tabriz urban health centers, balancing workload with staff number, institutionalizing performance-based management and using multidisciplinary staffs may lead to reduced costs of services. ​

  19. The empowerment paradox as a central challenge to patient centered medical home implementation in the veteran's health administration.

    Science.gov (United States)

    Solimeo, Samantha L; Ono, Sarah S; Lampman, Michelle A M; Paez, Monica B W; Stewart, Gregory L

    2015-01-01

    In this paper we present results of a mixed methods study conducted to identify barriers to team function among staff implementing patient aligned care teams - the Department of Veterans Affairs' patient centered medical home (PCMH) model. Using a convergent mixed methods design, we administered a standardized survey measure (Team and Individual Role Perception Survey) to assess work role challenge and engagement; and conducted discussion groups to gather context pertaining to role change. We found that the role of primary care providers is highly challenging and did not become less difficult over the initial year of implementation. Unexpectedly over the course of the first year nurse care managers reported a decrease in their perceptions of empowerment and clerical associates reported less skill variety. Qualitative data suggest that more skilled team members fail to delegate and share tasks within their teams. We characterize this interprofessional knowledge factor as an empowerment paradox where team members find it difficult to share tasks in ways that are counter to traditionally structured hierarchical roles. Health care systems seeking to implement PCMH should dedicate resources to facilitating within-team role knowledge and negotiation.

  20. Traumatic Brain Injury: A Guide for Caregivers of Service Members and Veterans. Welcome

    Science.gov (United States)

    2010-04-01

    pages 90-91 Traumatic Servicemembers’ Group Life Insurance ( TSGLI ) - Module 4, page 85 Intensive Care Unit (ICU) - Module 1, page 31...PNOK – Primary Next of Kin SSN – Social Security Number TSGLI – Traumatic Servicemembers’ Group Life Insurance VA – Department of Veterans Affairs...pages 90-92 TBI Prevalence - Module 1, page 3 TBI Types - Module 1, pages 13-14 TSGLI (Traumatic Servicemembers’ Group Life Insurance

  1. 76 FR 4152 - Proposed Information Collection (Veterans Benefits Administration (VBA) Voice of the Veteran (VOV...

    Science.gov (United States)

    2011-01-24

    ... AFFAIRS Proposed Information Collection (Veterans Benefits Administration (VBA) Voice of the Veteran (VOV... Veterans Affairs. ACTION: Notice. SUMMARY: The Veterans Benefits Administration (VBA), Department of... application and servicing processes for the VBA Compensation and Pension (C&P) Service, Education (EDU...

  2. A Health Services Research Agenda for Bariatric Surgery Within the Veterans Health Administration.

    Science.gov (United States)

    Funk, L M; Gunnar, W; Dominitz, J A; Eisenberg, D; Frayne, S; Maggard-Gibbons, M; Kalarchian, M A; Livingston, E; Sanchez, V; Smith, B R; Weidenbacher, H; Maciejewski, Matthew L

    2017-04-01

    In 2016, the Veterans Health Administration (VHA) held a Weight Management State of the Art conference to identify evidence gaps and develop a research agenda for population-based weight management for veterans. Included were behavioral, pharmacologic, and bariatric surgery workgroups. This article summarizes the bariatric surgery workgroup (BSWG) findings and recommendations for future research. The BSWG agreed that there is evidence from randomized trials and large observational studies suggesting that bariatric surgery is superior to medical therapy for short- and intermediate-term remission of type 2 diabetes, long-term weight loss, and long-term survival. Priority evidence gaps include long-term comorbidity remission, mental health, substance abuse, and health care costs. Evidence of the role of endoscopic weight loss options is also lacking. The BSWG also noted the limited evidence regarding optimal timing for bariatric surgery referral, barriers to bariatric surgery itself, and management of high-risk bariatric surgery patients. Clinical trials of pre- and post-surgery interventions may help to optimize patient outcomes. A registry of overweight and obese veterans and a workforce assessment to determine the VHA's capacity to increase bariatric surgery access were recommended. These will help inform policy modifications and focus the research agenda to improve the ability of the VHA to deliver population-based weight management.

  3. Adolescent smoking cessation services of school-based health centers.

    Science.gov (United States)

    Price, James H; Yingling, Faith; Dake, Joseph A; Telljohann, Susan K

    2003-04-01

    A national sample of 390 junior and senior high school-based centers were mailed an 18-item survey to assess their institutional stages of change regarding smoking cessation education, referral, and prescription nicotine replacement therapy (NRT) services and their perceived barriers and benefits regarding the provision of these services. Nearly half were in the maintenance stage for cessation education programs, one-third were in maintenance stage for referral services, and 12% were in the maintenance stage for NRT. The most frequently cited perceived benefits included an increased awareness of short- and long-term effects of smoking (education programs and referral services) and increasing student access to cessation methods (NRT). The greatest barriers cited were a lack of financial resources (education programs), problems with student transportation (referral services), and staff not having the authority to provide prescription services (NRT). School-based centers can do more to help stop adolescents from using tobacco.

  4. Do faith-based residential care services affect the religious faith and clinical outcomes of homeless veterans?

    Science.gov (United States)

    Tsai, Jack; Rosenheck, Robert A; Kasprow, Wesley J; McGuire, James F

    2012-12-01

    Data on 1,271 clients in three residential care services funded by the Department of Veterans Affairs was used to examine: (1) how religious-oriented programs differ in their social environment from secular programs, (2) how religious-oriented programs affect the religiosity of clients, and (3) how client religiosity is associated with outcomes. Programs were categorized as: secular, secular now but religious in the past, and currently religiously oriented. Results showed (1) participants in programs that were currently religious reported the greatest program clarity, but secular services reported the most supportive environments; (2) participants in programs that were currently religious did not report increases in religious faith or religious participation over time; nevertheless (3) greater religious participation was associated with greater improvement in housing, mental health, substance abuse, and quality of life. These findings suggest religious-oriented programs have little influence on clients' religious faith, but more religiously oriented clients have somewhat superior outcomes.

  5. Do Alcohol Misuse, Service Utilisation, and Demographic Characteristics Differ between UK Veterans and Members of the General Public Attending an NHS General Hospital?

    Directory of Open Access Journals (Sweden)

    Dominic Murphy

    2016-11-01

    Full Text Available The aim of this paper was to provide insights into alcohol misuse within UK veterans to inform as to whether their presentations differ from the general public. This was done by exploring differences in the severity of alcohol misuse between UK veterans and the general public admitted to a general NHS hospital over an 18 month period using retrospective data. All patients admitted to the hospital were screened for alcohol misuse. Those deemed as experiencing problems were referred for specialist nurse-led support. A total of 2331 individuals were referred for this supported and administered with a standardised assessment that included measures of the severity of alcohol difficulties (AUDIT, dependency levels (LDQ, and assessed for the presence of withdrawal symptoms (CIWA-Ar. In addition, information was collected on service utilisation, referral category (medical or mental health, other substance misuse, and demographic characteristics. No differences were found between the severity of reported alcohol difficulties between veterans and non-veterans. Evidence was found to suggest that veterans were more likely to be referred for support with alcohol difficulties at an older age and to be admitted to hospital for longer periods of time. This could have considerable cost implications for the NHS. It was more common for veterans to present at hospital with physical health difficulties prior to being referred for support for alcohol.

  6. Women Veterans’ Healthcare Delivery Preferences and Use by Military Service Era: Findings from the National Survey of Women Veterans

    National Research Council Canada - National Science Library

    Washington, Donna L; Bean-Mayberry, Bevanne; Hamilton, Alison B; Cordasco, Kristina M; Yano, Elizabeth M

    2013-01-01

    The number of women Veterans (WVs) utilizing the Veterans Health Administration (VA) has doubled over the past decade, heightening the importance of understanding their healthcare delivery preferences and utilization patterns...

  7. 76 FR 36955 - West Los Angeles VA Medical Center Veterans Programs Enhancement Act of 1998; Master Plan

    Science.gov (United States)

    2011-06-23

    .... One commenter stated that the ``inclusion of the State Veterans Home as Federal VA land in all maps... of the NHV (i.e., the Pacific Branch of the National Home for Disabled Volunteer Soldiers) in the...

  8. Supporting School Success for Homeless Children of Veterans and Military Service Members. Best Practices in Interagency Collaboration Brief Series

    Science.gov (United States)

    National Center for Homeless Education at SERVE, 2015

    2015-01-01

    According to research (Fargo et al, 2012) and federal data (U.S. Department of Housing and Urban Development [HUD], 2015), veterans experience homelessness at a higher rate than non-veterans. Many veterans experience homelessness as individuals, while others experience homelessness with their families (2015), which may include school-age children.…

  9. Veterans Crisis Line: Videos About Reaching out for Help

    Science.gov (United States)

    Veterans Crisis Line Skip to Main Content SuicidePreventionLifeline.org Get Help Materials Get Involved Crisis Centers About Be There ... see more videos from Veterans Health Administration Veterans Crisis Line -- After the Call see more videos from ...

  10. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available ... Administration I'm Good. But are you ready to listen? see more videos from Veterans Health Administration ... videos from Veterans Health Administration Vet Centers: Here to Help see more videos from Veterans Health Administration ...

  11. Characteristics and Use of Services Among Literally Homeless and Unstably Housed U.S. Veterans With Custody of Minor Children.

    Science.gov (United States)

    Tsai, Jack; Rosenheck, Robert A; Kasprow, Wesley J; Kane, Vincent

    2015-10-01

    The study examined the number of homeless veterans with minor children in their custody ("children in custody"), compared sociodemographic and clinical characteristics among homeless veterans with and without children in custody, and observed differences in referral and admission patterns among veterans with and without children in custody for a variety of U.S. Department of Veterans Affairs (VA) programs for homeless veterans. Data were obtained from the VA Homeless Operations Management and Evaluation System for 89,142 literally homeless and unstably housed veterans. Sociodemographic, housing, health, and psychosocial characteristics of veterans were analyzed. Among literally homeless veterans, 9% of men and 30% of women had children in custody; among unstably housed veterans, 18% of men and 45% of women had children in custody. Both male and female veterans with children in custody were younger and less likely to have chronic general medical conditions and psychiatric disorders compared with other veterans, but, notably, 11% of homeless veterans with children in custody had psychotic disorders. Veterans with children in custody were more likely than other veterans to be referred and admitted to the VA's permanent supported housing program, and women were more likely than men to be admitted to the program. A substantial proportion of homeless veterans served by the VA have severe mental illness and children in custody, which raises concerns about the parenting environment for their children. Particular focus should be directed at VA's supported-housing program, and the practical and ethical implications of serving homeless parents and their children need to be considered.

  12. Thwarted belongingness as an explanatory link between insomnia symptoms and suicidal ideation: Findings from three samples of military service members and veterans.

    Science.gov (United States)

    Hom, Melanie A; Chu, Carol; Schneider, Matthew E; Lim, Ingrid C; Hirsch, Jameson K; Gutierrez, Peter M; Joiner, Thomas E

    2017-02-01

    Although insomnia has been identified as a robust predictor of suicidal ideation and behaviors, little is known about the mechanisms by which sleep disturbances confer risk for suicide. We investigated thwarted belongingness as an explanatory link between insomnia symptoms and suicidal ideation across three military service member and veteran samples. Data were collected among United States military service members and veterans (N1=937, N2=3,386, N3=417) who completed self-report measures of insomnia symptoms, thwarted belongingness, suicidal ideation, and related psychiatric symptoms (e.g., anxiety, hopelessness). Bias-corrected bootstrap mediation analyses were utilized to examine the indirect effects of insomnia symptoms on suicidal ideation through thwarted belongingness, controlling for related psychiatric symptoms. Consistent with study hypotheses, thwarted belongingness significantly accounted for the relationship between insomnia and suicidal ideation across all three samples; however, insomnia symptoms did not significantly account for the relationship between thwarted belongingness and suicidal ideation, highlighting the specificity of our findings. This study utilized cross-sectional self-report data. Insomnia may confer suicide risk for military service members and veterans, in part, through the pathway of thwarted belongingness. Additional prospective studies are warranted to further delineate this model of risk. Our results offer a potential therapeutic target for the prevention of suicide, via the promotion of belongingness, among service members and veterans experiencing insomnia symptoms. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. Efficacy of a Web-based Intervention for Concerned Spouses of Service Members and Veterans with Alcohol Misuse.

    Science.gov (United States)

    Osilla, Karen Chan; Trail, Thomas E; Pedersen, Eric R; Gore, Kristie L; Tolpadi, Anagha; Rodriguez, Lindsey M

    2017-10-03

    Concerned partners (CPs) of service members and veterans who misuse alcohol face help-seeking barriers and mental health problems. We used multiple regression to evaluate the efficacy of Partners Connect, a four-session web-based intervention (WBI) to address military CPs' mental health and communication. We randomized 312 CPs to the WBI or a control group. Five months later, WBI CPs reported significant reductions in their anxiety and increases in their social support compared to control CPs. Intervention dose was also associated with improved WBI CP outcomes. Partners Connect appears to fill a need for families who face help-seeking barriers and provides an alternative to traditional care for those who may not otherwise seek help. © 2017 American Association for Marriage and Family Therapy.

  14. Who is served by programs for the homeless? Admission to a domiciliary care program for homeless veterans.

    Science.gov (United States)

    Rosenheck, R; Leda, C

    1991-02-01

    Demographic and clinical data are presented on 4,138 veterans assessed in the 20-site Department of Veterans Affairs (VA) Domiciliary Care for Homeless Veterans program during its first year of operation. More than two-thirds of the veterans who were screened had been hospitalized in VA medical centers during the year before assessment, and 34 percent were hospitalized at the time of assessment. Compared with veterans who were not admitted for residential treatment, veterans who were admitted were more likely to be previously involved in mental health treatment, literally homeless rather than at risk for homelessness, and without public financial support. Specialized service programs for the homeless such as the VA domiciliary care program may also be called on to play a broader role in the discharge and rehabilitative efforts of public mental health service systems.

  15. Lessons learned from a quality improvement intervention with homeless veteran services.

    Science.gov (United States)

    Chinman, Matthew; Hannah, Gordon; McCarthy, Sharon

    2012-08-01

    Homeless veterans are a vulnerable population, with high mortality and morbidity rates. Evidence-based practices for homelessness have been challenging to implement. This study engaged staff members from three VA homeless programs to improve their quality using Getting-To-Outcomes (GTO), a model and intervention of trainings and technical assistance that builds practitioner capacity to plan, implement, and self-evaluate evidence-based practices. Primarily used in community-based, non-VA settings, this study piloted GTO in VA by creating a GTO project within each homeless program and one across all three. The feasibility and acceptability of GTO in VA is examined using the results of the projects, time spent on GTO, and data from focus groups and interviews. With staff members averaging 33 minutes per week on GTO, each team made significant programmatic changes. Homeless staff stated GTO was helpful, and that high levels of communication, staff member commitment to the program, and technical assistance were critical.

  16. Experience with Server Self Service Center (S3C)

    CERN Multimedia

    Sucik, J

    2009-01-01

    CERN has a successful experience with running Server Self Service Center (S3C) for virtual server provisioning which is based on Microsoft® Virtual Server 2005. With the introduction of Windows Server 2008 and its built-in hypervisor based virtualization (Hyper-V) there are new possibilities for the expansion of the current service. This paper describes the architecture of the redesigned virtual Server Self Service based on Hyper-V which provides dynamically scalable virtualized resources on demand as needed and outlines the possible implications on the future use of virtual machines at CERN.

  17. Fanning the Flame: National Center for Service-Learning.

    Science.gov (United States)

    Baird, Lyn

    1982-01-01

    Describes the concept and purpose of the National Center for Service-Learning (Washington, D.C.) and outlines some of the resources available to people interested in pursuing the concepts (giving and getting, acting and reflecting, serving and learning) further. (ERB)

  18. Hospital image and the positioning of service centers: an application in market analysis and strategy development.

    Science.gov (United States)

    Smith, S M; Clark, M

    1990-09-01

    The research confirms the coexistence of different images for hospitals, service centers within the same hospitals, and service programs offered by each of the service centers. The images of individual service centers are found not to be tied to the image of the host facility. Further, service centers and host facilities have differential rankings on the same service decision attributes. Managerial recommendations are offered for "image differentiation" between a hospital and its care centers.

  19. Understanding Barriers to Mental Health Care for Recent War Veterans Through Photovoice.

    Science.gov (United States)

    True, Gala; Rigg, Khary K; Butler, Anneliese

    2015-10-01

    Despite an urgent need for mental health care among U.S. service members returning from deployments to Iraq and Afghanistan, many veterans do not receive timely or adequate treatment. We used photovoice methods to engage veterans in identifying barriers to utilizing mental health services. Veterans described how key aspects of military culture and identity, highly adaptive during deployment, can deter help-seeking behavior and hinder recovery. Veterans' photographs highlighted how mental health symptoms and self-coping strategies operated as barriers to care. Many veterans' photos and stories revealed how negative health care encounters contributed to avoidance and abandonment of treatment; some veterans described these experiences as re-traumatizing. Visual methods can be a powerful tool for engaging recent war veterans in research. In particular, community-based participatory research approaches, which have rarely been used with veterans, hold great promise for informing effective interventions to improve access and enhance provision of patient-centered care for veterans. © The Author(s) 2014.

  20. Impact of Patient-Centered Care Innovations on Access to Providers, Ambulatory Care Utilization, and Patient Clinical Indicators in the Veterans Health Administration.

    Science.gov (United States)

    Burkhart, Lisa; Sohn, Min-Woong; Jordan, Neil; Tarlov, Elizabeth; Gampetro, Pamela; LaVela, Sherri L

    2016-01-01

    The Veterans Health Administration piloted patient-centered care (PCC) innovations beginning in 2010 to improve patient and provider experience and environment in ambulatory care. We use secondary data to look at longitudinal trends, evaluate system redesign, and identify areas for further quality improvement. This was a retrospective, observational study using existing secondary data from multiple US Department of Veteran Affairs sources to evaluate changes in veteran and facility outcomes associated with PCC innovations at 2 innovation and matched comparison sites between FY 2008-2010 (pre-PCC innovations) and FY 2011-2012 (post-PCC innovations). Outcomes included access to primary care providers (PCPs); primary, specialty, and emergency care use; and clinical indicators for chronic disease. Longitudinal trends revealed a different story at each site. One site demonstrated better PCP access, decrease in emergency and primary care use, increase in specialty care use, and improvement in diabetic glucose control. The other site demonstrated a decrease in PCP access and primary care use, no change in specialty care use, and an increase in diastolic blood pressure in relation to the comparison site. Secondary data analysis can reveal longitudinal trends associated with system changes, thereby informing program evaluation and identifying opportunities for quality improvement.

  1. NOAA Coastal Services Center Coastal Inundation Digital Elevation Model: National Weather Service Forecast Office - Wilmington (ILM)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — These data were created as part of the National Oceanic and Atmospheric Administration Coastal Services Center's efforts to create an online mapping viewer called...

  2. AVTA Federal Fleet PEV Readiness Data Logging and Characterization Study for Department of Veterans Affairs. James J. Peters VA Medical Center, Bronx, NY

    Energy Technology Data Exchange (ETDEWEB)

    Schey, Stephen [Intertek Testing Services, North America, Phoenix, AZ (United States); Francfort, Jim [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2014-10-01

    This report focuses on the Department of Veterans Affairs, James J. Peters VA Medical Center (VA - Bronx) fleet to identify daily operational characteristics of select vehicles and report findings on vehicle and mission characterizations to support the successful introduction of PEVs into the agencies’ fleets. Individual observations of these selected vehicles provide the basis for recommendations related to electric vehicle adoption and whether a battery electric vehicle or plug-in hybrid electric vehicle (collectively referred to as PEVs) can fulfill the mission requirements.

  3. VHA Support Service Center Electronic Wait List (EWL)

    Data.gov (United States)

    Department of Veterans Affairs — The goal of the Electronic Wait List (EWL) is to provide care to the patient as quickly as possible. To facilitate this goal, patients may be placed on a Wait List...

  4. VHA Support Service Center Primary Care Management Module (PCMM)

    Data.gov (United States)

    Department of Veterans Affairs — The Primary Care Management Module (PCMM) was developed to assist VA facilities in implementing Primary Care. PCMM supports both Primary Care and non-Primary Care...

  5. Protective and Vulnerability Factors Contributing to Resilience in Post-9/11 Veterans With Service-Related Injuries in Postsecondary Education.

    Science.gov (United States)

    Eakman, Aaron M; Schelly, Catherine; Henry, Kimberly L

    2016-01-01

    To examine differences in psychosocial protective factors (social support, meaningful occupation, and academic self-efficacy) and health-related vulnerability factors (posttraumatic stress, depression, and somatic symptoms) contributing to resilience in post-9/11 veterans with service-related injuries and nonveterans in postsecondary education. A cross-sectional, matched-participants design using propensity score matching was used to test differences in mean levels of protective and vulnerability factors between injured veterans (n = 26) and nonveterans (n = 19); zero-order correlations explored relationships among study variables. The veteran sample demonstrated lower levels of psychosocial protective factors and higher levels of health-related vulnerability factors compared with nonveterans (|0.49| to |1.56|). Psychosocial protective factors were consistently negatively associated with health-related vulnerability factors (-.27 to -.63). Post-9/11 veterans with service-related injuries are at a substantial disadvantage in terms of resilience; lower protective factors and elevated vulnerability factors may increase their risk for poor campus integration and impede academic achievement. Copyright © 2016 by the American Occupational Therapy Association, Inc.

  6. Contents operation center for 'mopera' information service; Mopera joho service muke contents un'ei center

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-03-01

    'Mopera' information service is a mobile information service in which NTT Mobile Communications Network, Inc. offers information of various fields such as business and hobbies for the users of the portable telephone or PHS of the company. Toshiba Corp. started the contents operation center consistently performing from the preparation of contents to the management of a server for the above information service, making efforts in expanding the contents since the beginning of the service in the fall of 1998, and operating at present more than ten kinds of contents such as news, weather forecast, and stock information other than mobile 'Ekimae-Tanken Club' (adventure club in front of a station). Moreover, Toshiba takes it into consideration to build a system aiming at a stable operation like a duplex operation of a server, 24-hour automatic surveillance, etc., continuously providing highly reliable services. (translated by NEDO)

  7. Mobile healthcare services in school-based health center.

    Science.gov (United States)

    Jen, Wen-Yuan

    2009-06-01

    In Taiwan, campus health problems are placing more and more pressure on school-based health centers (SBHCs). Moreover, SBHCs have insufficient resources to actively provide follow-up healthcare for students and faculty found to be overweight, chronically ill, or at high risk. In order to improve the quality of SBHC healthcare, a project was begun to enhance the efficiency of campus healthcare services by employing web-based and cell phone-based services. This project employed the Mobile Automated Medical Alert (MAMA) system, which was designed especially for campus health center use. Before implementing the MAMA system, a focus group of healthcare related staff identified areas in which SBHC healthcare services might be improved by the system and created a questionnaire to measure student and faculty response to the proposed services. Modifications to the MAMA design and service offerings were made based upon these questionnaire results. After the initial brainstorming session, the MAMA team created a survey instrument that was administered to students and faculty in order to understand their attitudes toward the proposed mobile healthcare services. Two hundred questionnaires were distributed to students and faculty at a private technical college in central Taiwan. Among the respondents, 100% had cellular phones and used short-text messages. Ninety-five percent of the student respondents and 85% of the faculty respondents agreed that mobile healthcare system would improve the quality of the health care their SBHC was currently providing. Based on these positive survey responses, the MAMA system was implemented. The current paper describes the process by which the MAMA team brainstormed proposed services and administered their survey. Survey results and the consequent changes to the MAMA system are discussed. Finally, recommendations are made for MAMA system use and a description is offered of the impact such systems might have on the future of college campus

  8. Veterans Benefits: Burial Benefits and National Cemeteries

    Science.gov (United States)

    2010-10-18

    hospital, nursing home, or domiciliary care facility; and (2) a plot allowance for a veteran eligible for burial in a national cemetery who is not... domiciliary care . The VA was permitted to enter into contracts to provide the burial and funeral services for veterans who died in VA facilities...Veterans Affairs (VA) provides a range of benefits and services to veterans who meet certain eligibility rules; benefits include hospital and medical care

  9. Tobacco use among Iraq- and Afghanistan-era veterans: a qualitative study of barriers, facilitators, and treatment preferences.

    Science.gov (United States)

    Gierisch, Jennifer M; Straits-Tröster, Kristy; Calhoun, Patrick S; Beckham, Jean C; Acheson, Shawn; Hamlett-Berry, Kim

    2012-01-01

    Military service and combat exposure are risk factors for smoking. Although evidence suggests that veterans are interested in tobacco use cessation, little is known about their reasons for quitting, treatment preferences, and perceived barriers to effective tobacco use cessation treatment. Our study objective was to elicit perspectives of Iraq- and Afghanistan-era veterans who had not yet quit smoking postdeployment to inform the development of smoking cessation services for this veteran cohort. We conducted 3 focus groups among 20 participants in October 2006 at the Durham Veterans Affairs Medical Center to explore issues on tobacco use and smoking cessation for Iraq- and Afghanistan-era veterans who continued to smoke postdeployment. We used qualitative content analysis to identify major themes and organize data. Veterans expressed the belief that smoking was a normalized part of military life and described multiple perceived benefits of smoking. Although veterans expressed a high level of interest in quitting, they listed several behavioral, situational, and environmental triggers that derailed smoking cessation. They expressed interest in such cessation treatment features as flexible scheduling, free nicotine replacement therapy, peer support, and family inclusion in treatment. Our results indicate that the newest cohort of veterans perceives smoking as endemic in military service. However, they want to quit smoking and identified several personal and environmental obstacles that make smoking cessation difficult. Our findings may inform programmatic efforts to increase successful quit attempts in this unique veteran population.

  10. Implementation of the patient-centered medical home in the Veterans Health Administration: associations with patient satisfaction, quality of care, staff burnout, and hospital and emergency department use.

    Science.gov (United States)

    Nelson, Karin M; Helfrich, Christian; Sun, Haili; Hebert, Paul L; Liu, Chuan-Fen; Dolan, Emily; Taylor, Leslie; Wong, Edwin; Maynard, Charles; Hernandez, Susan E; Sanders, William; Randall, Ian; Curtis, Idamay; Schectman, Gordon; Stark, Richard; Fihn, Stephan D

    2014-08-01

    In 2010, the Veterans Health Administration (VHA) began implementing the patient-centered medical home (PCMH) model. The Patient Aligned Care Team (PACT) initiative aims to improve health outcomes through team-based care, improved access, and care management. To track progress and evaluate outcomes at all VHA primary care clinics, we developed and validated a method to assess PCMH implementation. To create an index that measures the extent of PCMH implementation, describe variation in implementation, and examine the association between the implementation index and key outcomes. We conducted an observational study using data on more than 5.6 million veterans who received care at 913 VHA hospital-based and community-based primary care clinics and 5404 primary care staff from (1) VHA clinical and administrative databases, (2) a national patient survey administered to a weighted random sample of veterans who received outpatient care from June 1 to December 31, 2012, and (3) a survey of all VHA primary care staff in June 2012. Composite scores were constructed for 8 core domains of PACT: access, continuity, care coordination, comprehensiveness, self-management support, patient-centered care and communication, shared decision making, and team-based care. Patient satisfaction, rates of hospitalization and emergency department use, quality of care, and staff burnout. Fifty-three items were included in the PACT Implementation Progress Index (Pi2). Compared with the 87 clinics in the lowest decile of the Pi2, the 77 sites in the top decile exhibited significantly higher patient satisfaction (9.33 vs 7.53; P burnout (Maslach Burnout Inventory emotional exhaustion subscale, 2.29 vs 2.80; P = .02), lower hospitalization rates for ambulatory care-sensitive conditions (4.42 vs 3.68 quarterly admissions for veterans 65 years or older per 1000 patients; P emergency department use (188 vs 245 visits per 1000 patients; P < .001). The extent of PCMH implementation, as

  11. 75 FR 45600 - Information Collection; Customer Data Worksheet Request for Service Center Information Management...

    Science.gov (United States)

    2010-08-03

    ... Farm Service Agency Information Collection; Customer Data Worksheet Request for Service Center Information Management System (SCIMS) Record Changes AGENCY: Farm Service Agency, USDA. ] ACTION: Notice and... a currently approved information collection to support Customer Data Worksheet Request for Service...

  12. The long-term hospitalization experience following military service in the 1991 Gulf War among veterans remaining on active duty, 1994–2004

    Science.gov (United States)

    Hooper, Tomoko I; DeBakey, Samar F; Nagaraj, Barbara E; Bellis, Kimberly S; Smith, Besa; Smith, Tyler C; Gackstetter, Gary D

    2008-01-01

    Background Despite more than a decade of extensive, international efforts to characterize and understand the increased symptom and illness-reporting among veterans of the 1991 Gulf War, concern over possible long-term health effects related to this deployment continue. The purpose of this study was to describe the long-term hospitalization experience of the subset of U.S. Gulf War veterans still on active duty between 1994 and 2004. Methods Gulf War veterans on active duty rosters as of October 1, 1994, were identified (n = 211 642) and compared with veterans who had separated from military service and then assessed for attrition at three-year intervals during a 10-year follow-up period, examining demographic and military service characteristics, Gulf War exposure variables, and hospitalization data. Cox proportional hazard modeling was used to evaluate independent predictors of all-cause hospitalization among those still on active duty and to estimate cumulative probability of hospitalization, 1994–2004, by service branch. Results Members of our 1994 active duty cohort were more likely to be officers, somewhat older, and married compared with those who had separated from the military after serving in the 1991 Gulf War. Selected war-related exposures or experiences did not appear to influence separation with the exception of in-theater presence during the brief ground combat phase. Overall the top three diagnostic categories for hospitalizations were musculo-skeletal, injury and poisoning, and digestive disorders. Diseases of the circulatory system and symptoms, signs, and ill-defined conditions increased proportionately over time. In-theater hospitalization was the only significant independent predictor of long-term hospitalization risk among selected war-related exposures or experiences examined. The cumulative probability of hospitalization was highest for Army and lowest for Marines. Conclusion Our results were generally consistent with a previous

  13. The long-term hospitalization experience following military service in the 1991 Gulf War among veterans remaining on active duty, 1994–2004

    Directory of Open Access Journals (Sweden)

    Smith Besa

    2008-02-01

    Full Text Available Abstract Background Despite more than a decade of extensive, international efforts to characterize and understand the increased symptom and illness-reporting among veterans of the 1991 Gulf War, concern over possible long-term health effects related to this deployment continue. The purpose of this study was to describe the long-term hospitalization experience of the subset of U.S. Gulf War veterans still on active duty between 1994 and 2004. Methods Gulf War veterans on active duty rosters as of October 1, 1994, were identified (n = 211 642 and compared with veterans who had separated from military service and then assessed for attrition at three-year intervals during a 10-year follow-up period, examining demographic and military service characteristics, Gulf War exposure variables, and hospitalization data. Cox proportional hazard modeling was used to evaluate independent predictors of all-cause hospitalization among those still on active duty and to estimate cumulative probability of hospitalization, 1994–2004, by service branch. Results Members of our 1994 active duty cohort were more likely to be officers, somewhat older, and married compared with those who had separated from the military after serving in the 1991 Gulf War. Selected war-related exposures or experiences did not appear to influence separation with the exception of in-theater presence during the brief ground combat phase. Overall the top three diagnostic categories for hospitalizations were musculo-skeletal, injury and poisoning, and digestive disorders. Diseases of the circulatory system and symptoms, signs, and ill-defined conditions increased proportionately over time. In-theater hospitalization was the only significant independent predictor of long-term hospitalization risk among selected war-related exposures or experiences examined. The cumulative probability of hospitalization was highest for Army and lowest for Marines. Conclusion Our results were generally consistent

  14. 76 FR 74849 - Fund Availability Under the Supportive Services for Veteran Families Program

    Science.gov (United States)

    2011-12-01

    ... unanticipated delays, computer service outages, or other delivery-related problems. For a Copy of the... from an institution in which the person has been a resident for more than 180 days (including prisons... standards for the housing unit size); o. Past institutional care (prison, treatment facility, hospital); p...

  15. Invisible Wounds: Serving Service Members and Veterans with PTSD and TBI

    Science.gov (United States)

    National Council on Disability, 2009

    2009-01-01

    More than 1.6 million American service members have deployed to Iraq and Afghanistan in Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). As of December 2008, more than 4,000 troops have been killed and over 30,000 have returned from a combat zone with visible wounds and a range of permanent disabilities. In addition, an…

  16. Unemployment, earnings and enrollment among post 9/11 veterans.

    Science.gov (United States)

    Kleykamp, Meredith

    2013-05-01

    This paper examines three outcomes characterizing different aspects of post 9/11 veterans' economic reintegration to civilian life: unemployment, earnings and college enrollment, using Current Population Survey data from 2005 to 2011. Analyses include interactions of veteran status with sex, race/ethnicity and educational attainment to evaluate whether diverse veterans experience diverse consequences of service. In brief, I find that the basic unemployment differences between veterans and non-veterans often reported in the media understate the effect of military service on unemployment for men, since veterans have other characteristics that are associated with higher employment rates. Female veterans appear to suffer a steeper employment penalty than male veterans, but black veterans appear to suffer less of a penalty than white veterans. But on two other measures, earnings and college enrollment, veterans appear to be doing better than their civilian peers. Veterans with a high school education or less outearn their civilian peers, but veterans with at least some college education appear to lose some or all of the veteran earnings advantage compared to veterans with a high school degree, suggesting the greatest wage returns to military service accrue among the least educated. Veterans with at least a high school education are more likely to be enrolled in college than their civilian peers. Treating veterans as a monolithic block obscures differences in the consequences of military service across diverse groups. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. Hewlett-Packard’s global business center in Poland as an example of a successful shared services center

    OpenAIRE

    Pisarczyk, Anna

    2010-01-01

    This master thesis investigates the Hewlett-Packard’s global business center in Poland as a successful example of a shared services center. The center performs and manages global business processes for the corporation in an effective and efficient way. The thesis focuses on three main aspects such as resources and capabilities, location and organization of the shared services center in Poland which is illustrated by the TCE model. OLI paradigm examines more in details the impor...

  18. 77 FR 20849 - Homeless Veterans' Reintegration Program

    Science.gov (United States)

    2012-04-06

    ... Veterans' Reintegration Program AGENCY: Veterans' Employment and Training Service (VETS), Department of...: Section 2021 of Title 38 of the United States Code (U.S.C.) reauthorizes the Homeless Veterans Reintegration Program (HVRP) through fiscal year (FY) 2012 and indicates: ``the Secretary of Labor shall conduct...

  19. Consolidated Copayment Processing Center (CCPC)

    Data.gov (United States)

    Department of Veterans Affairs — The Consolidated Copayment Processing Center (CCPC) database contains Veteran patient contact and billing information in order to support the printing and mailing of...

  20. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available Veterans Crisis Line Skip to Main Content SuicidePreventionLifeline.org Get Help Materials Get Involved Crisis Centers About Be There Show You ... more videos from Veterans Health Administration Veterans Crisis Line -- After the Call see more videos from Veterans ...

  1. The Department of Veterans Health Administration Office of Nursing Service, "transforming nursing in a national healthcare system: an example of transformation in action".

    Science.gov (United States)

    Wertenberger, Sydney; Chapman, Kathleen M; Wright-Brown, Salena

    2011-01-01

    The Department of Veterans Health Administration Office of Nursing Service has embarked on a multiyear transformational process, an example of which is the development of an organization-wide nursing handbook. The development of this handbook offered the opportunity to improve collaboration, redefine expectations and behavior, as well as prepare for the future of Nursing within the Veterans Health Administration. The lessons learned from this process have revolved around the themes of leadership skills for managing high-level change often in a virtual environment; constant collaboration; that the practice of nursing will continue to evolve on the basis of new evidence, technology, customer expectations, and resources; and that the process to accomplish this goal is powerful.

  2. Optimization for Service Routes of Pallet Service Center Based on the Pallet Pool Mode

    Directory of Open Access Journals (Sweden)

    Kang Zhou

    2016-01-01

    Full Text Available Service routes optimization (SRO of pallet service center should meet customers’ demand firstly and then, through the reasonable method of lines organization, realize the shortest path of vehicle driving. The routes optimization of pallet service center is similar to the distribution problems of vehicle routing problem (VRP and Chinese postman problem (CPP, but it has its own characteristics. Based on the relevant research results, the conditions of determining the number of vehicles, the one way of the route, the constraints of loading, and time windows are fully considered, and a chance constrained programming model with stochastic constraints is constructed taking the shortest path of all vehicles for a delivering (recycling operation as an objective. For the characteristics of the model, a hybrid intelligent algorithm including stochastic simulation, neural network, and immune clonal algorithm is designed to solve the model. Finally, the validity and rationality of the optimization model and algorithm are verified by the case.

  3. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Home Apply for VA Care Apply Online Application Process Veteran Eligibility Active Duty Families of Veterans Women ... Immunizations Flu Vaccination Prevention / Wellness Public Health Weight Management (MOVE!) Locations Hospitals & Clinics Vet Centers Veterans Canteen ...

  4. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Active Duty Families of Veterans Women Veterans Determine Costs Copays Means Test Health Insurance Make a Payment ... Immunizations Flu Vaccination Prevention / Wellness Public Health Weight Management (MOVE!) Locations Hospitals & Clinics Vet Centers Veterans Canteen ...

  5. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... VA Research Services Programs News, Events and Media Research Topics For Veterans For Researchers Research Oversight Special Groups Caregivers Combat Veterans & their Families ...

  6. Shared services centers and work sustainability: which contributions from ergonomics?

    Science.gov (United States)

    Arnoud, Justine; Falzon, Pierre

    2012-01-01

    This study examines the way in which Shared Services Centers (SSCs) were implemented in a French multinational company. It aims to characterize the change according to the capabilities model developed by Amartya Sen: what are the effects of SSCs in terms of capabilities development and developmental quality of work, i.e. in the enabling potential of work? A 3-step methodology has been used: first, an investigation was conducted in a pay service of a local entity moving into SSC in 2013; second, two investigations were conducted in another pay service of a SSC: first, a few months after the change, and then, one year after the change (the same operators were interviewed). Results show a tendency to the decrease of the enabling potential. Additionally, it was noted that administrators are kept away from the design process and have to struggle with inappropriate rules. The efficiency and sustainability of the SSC are questioned; in this context, the human factor specialist has an important role to play.

  7. New to care: demands on a health system when homeless veterans are enrolled in a medical home model.

    Science.gov (United States)

    O'Toole, Thomas P; Bourgault, Claire; Johnson, Erin E; Redihan, Stephen G; Borgia, Matthew; Aiello, Riccardo; Kane, Vincent

    2013-12-01

    We compared service use among homeless and nonhomeless veterans newly enrolled in a medical home model and identified patterns of use among homeless veterans associated with reductions in emergency department (ED) use. We used case-control matching with a nested cohort analysis to measure 6-month health services use, new diagnoses, and care use patterns in veterans at the Providence, Rhode Island, Veterans Affairs Medical Center from 2008 to 2011. We followed 127 homeless and 106 nonhomeless veterans. Both groups had similar rates of chronic medical and mental health diagnoses; 25.4% of the homeless and 18.1% of the nonhomeless group reported active substance abuse. Homeless veterans used significantly more primary, mental health, substance abuse, and ED care during the first 6 months. Homeless veterans who accessed primary care at higher rates (relative risk ratio [RRR] = 1.46; 95% confidence interval [CI] = 1.11, 1.92) or who used specialty and primary care (RRR = 10.95; 95% CI = 1.58, 75.78) had reduced ED usage. Homeless veterans in transitional housing or doubled-up at baseline (RRR = 3.41; 95% CI = 1.24, 9.42) had similar reductions in ED usage. Homeless adults had substantial health needs when presenting for care. High-intensity primary care and access to specialty care services could reduce ED use.

  8. [Medical controlling as medical economical service center. Successful concept for orthopedics and trauma surgery centers?].

    Science.gov (United States)

    Auhuber, T C; Hoffmann, R

    2015-01-01

    The management of patients from administrative admission through the orthopedic-surgical treatment to completion of the billing is complex. Additional challenges originate from the necessity to treat patients in both outpatient and inpatient departments and in more than one medical sector. A superior coordination is essential for a successful cooperation of the various procedures of controlling. The model of a medical controlling department as a service center with effective competence in the management of service and cost, functions as a successful solution to the problem. Central elements of a successful medical economical case management are a well-defined assignment of tasks and definitions of intersections, the integration of health professionals and administrative employees, the utilization of software for process control and the implementation of inlier controlling.

  9. Veterans Affairs Information Technology: Management Attention Needed to Improve Critical System Modernizations, Consolidate Data Centers, and Retire Legacy Systems

    Science.gov (United States)

    2017-02-07

    Consolidate Data Centers, and Retire Legacy Systems Statement of Statement of David A. Powner, Director Information Technology Management Issues...Management Attention Needed to Improve Critical System Modernizations, Consolidate Data Centers, and Retire Legacy Systems What GAO Found GAO...department had not assessed user satisfaction, or established user satisfaction goals. In addition, VA’s consolidation and closure of data centers

  10. Veterans and Military Family Health

    Science.gov (United States)

    Service members and veterans face some different health issues from civilians. Their families also face some unique challenges. Families may have to cope with Separation from their loved ones Anxiety over loved ones' safety in combat ...

  11. National Service Center, St. Louis County, Missouri - USA

    Directory of Open Access Journals (Sweden)

    Hellmuth, -

    1979-11-01

    Full Text Available The new building housing the National Service Center stands in a 40 Ha property in the outskirts of the city and it resembles more a university campus than an administrative centre. The building has only two levels above grade in an attempt to blend into the eminently rural surroundings, avoiding any architectural aggression to the natural environment. With a similar intention, earth hues were used in the precast concrete façade panels finish, completed by the horizontal emphasis of the dark bronze fenestration. Interiorly, the building is outstanding by its flexible arrangement, creating open and integrated office spaces. The modular structure allows for future expansion that will eventually double its present size without affecting its architectural unity.

    La nueva sede del National Service Center, situada en una parcela de más de 40 Há en el extrarradio de la ciudad, parece un campus universitario más que un centro administrativo. El edificio, que consta de sólo dos plantas sobre rasante, procura su integración en un paisaje marcadamente rural evitando la posible imposición agresiva de la arquitectura en el entorno natural. Con este fin se emplearon colores terrosos, en el acat>ado de los paneles prefabricados de cemento, complementados por una carpintería de marcado trazado horizontal en tonos bronce oscuro. Interiormente el edificio destaca por su flexibilidad, constituyendo espacios de oficinas abiertos e integrados. Su estructura modular permite la ampliación futura de la construcción, hasta duplicar su dimensión actual, sin alterar la unidad arquitectónica.

  12. Veterans' homecomings

    DEFF Research Database (Denmark)

    Sørensen, Birgitte Refslund

    2015-01-01

    social identity and find a meaningful life in the civilian world. When doing so, they need to navigate an ambiguous political environment and emergent public imaginaries of the veteran while also wrestling with their own military socialization and personal experiences of war. The certainty previously...... experiences, present conditions, and future ambitions are embedded in webs of concealment, disclosure, exposure, deception, lying, silence, and so forth, only partially controlled by the veterans themselves. The intricacies and anxieties associated with secrecy work are discussed in relation to three veteran...

  13. Barriers and Facilitators Related to Mental Health Care Use Among Older Veterans in the United States

    National Research Council Canada - National Science Library

    Blais, Rebecca K; Tsai, Jack; Southwick, Steven M; Pietrzak, Robert H

    2015-01-01

    Objective: Psychiatric disorders are more prevalent among older veterans compared with their civilian counterparts, but many veterans with symptoms of psychiatric disorders do not utilize mental health services...

  14. 77 FR 38398 - Agency Information Collection (National Acquisition Center Customer Response Survey) Activities...

    Science.gov (United States)

    2012-06-27

    ... customer's feedback and suggestions on delivered products and services administered by the National... AFFAIRS Agency Information Collection (National Acquisition Center Customer Response Survey) Activities Under OMB Review AGENCY: Office of Acquisition and Logistics, Department of Veterans Affairs. ACTION...

  15. 77 FR 20887 - Proposed Information Collection (National Acquisition Center Customer Response Survey) Activity...

    Science.gov (United States)

    2012-04-06

    ... 0863 will be used to collect customer's feedback and suggestions on delivered products and services... AFFAIRS Proposed Information Collection (National Acquisition Center Customer Response Survey) Activity; Comment Request AGENCY: Office of Acquisition and Logistics, Department of Veterans Affairs. ACTION...

  16. Policy Evaluation of District Mobile Internet Service Center Program (MPLIK

    Directory of Open Access Journals (Sweden)

    Mulyono Yalia

    2013-12-01

    Full Text Available The research was motivated by a problem that is interesting to study the Provision of Facilities Policy Evaluation Program Universal Service Obligation (USO Internet Service Center District Mobile Program (MPLIK In Kuningan regency of West Java. The problem is how the Department of Communication and Information Policy in the Kuningan District MPLIK program in Kuningan District,? The aim is (1 want to know the Department of Communication and Information Policy in the Kuningan district MPLIK program in Kuningan district, (2 What factors are a supporter and obstacles in the implementation of policies in support of the Office of Communications and Informatics Program at Kabupaten MPLIK Brass, (3 Efforts effort whether carried out in the implementation of policies in support of the program Diskominfo MPLIK in Kuningan regency. The theory used as an approach to the problem of this research is the Evaluation of Policies Bardach. The research method used is a qualitative method of data collection techniques through participant observation and in-depth interviews. The results showed that in the Provision of Facilities Policy Evaluation Program USO MPLIK In Kuningan West Java through policy evaluation approach found another dimension, namely the importance of control, supervision, and coordination in addition to the four main dimensions of the policy evaluation is used as the approach in this study.

  17. Implementing goals of care conversations with veterans in VA long-term care setting: a mixed methods protocol.

    Science.gov (United States)

    Sales, Anne E; Ersek, Mary; Intrator, Orna K; Levy, Cari; Carpenter, Joan G; Hogikyan, Robert; Kales, Helen C; Landis-Lewis, Zach; Olsan, Tobie; Miller, Susan C; Montagnini, Marcos; Periyakoil, Vyjeyanthi S; Reder, Sheri

    2016-09-29

    The program "Implementing Goals of Care Conversations with Veterans in VA LTC Settings" is proposed in partnership with the US Veterans Health Administration (VA) National Center for Ethics in Health Care and the Geriatrics and Extended Care Program Offices, together with the VA Office of Nursing Services. The three projects in this program are designed to support a new system-wide mandate requiring providers to conduct and systematically record conversations with veterans about their preferences for care, particularly life-sustaining treatments. These treatments include cardiac resuscitation, mechanical ventilation, and other forms of life support. However, veteran preferences for care go beyond whether or not they receive life-sustaining treatments to include issues such as whether or not they want to be hospitalized if they are acutely ill, and what kinds of comfort care they would like to receive. Three projects, all focused on improving the provision of veteran-centered care, are proposed. The projects will be conducted in Community Living Centers (VA-owned nursing homes) and VA Home-Based Primary Care programs in five regional networks in the Veterans Health Administration. In all the projects, we will use data from context and barrier and facilitator assessments to design feedback reports for staff to help them understand how well they are meeting the requirement to have conversations with veterans about their preferences and to document them appropriately. We will also use learning collaboratives-meetings in which staff teams come together and problem-solve issues they encounter in how to get veterans' preferences expressed and documented, and acted on-to support action planning to improve performance. We will use data over time to track implementation success, measured as the proportions of veterans in Community Living Centers (CLCs) and Home-Based Primary Care (HBPC) who have a documented goals of care conversation soon after admission. We will work with

  18. Factors Concerning Veterans With Dementia, Their Caregivers, and Coordination of Care: A Systematic Literature Review.

    Science.gov (United States)

    Mileski, Michael; Scott Kruse, Clemens; Brooks, Matthew; Haynes, Christine; Collingwood, Ying; Rodriguez, Rachel

    2017-11-01

    Military veterans diagnosed with dementia compose a large portion of our population. Often ignored are their caregivers and their plight as well as the availability, quality, and accessibility of health care for this demographic. The purpose of this systematic literature review is three fold: to identify opportunities available to increase public awareness on the subject; to identify areas of improvement in the level of care and quality of life for our nation's veterans; and to identify if adequate resources are available to veterans with dementia and their caregivers. The authors conducted systematic searches of three databases: PubMed via The National Center for Biotechnology Information, the Cumulative Index of Nursing and Allied Health Literature (CINAHL) Complete via Ebson B. Stephens Company (EBSCO Host), and Google. Data were collected regarding providing care to veterans who are suffering from dementia or Alzheimer's disease and their caregivers between 2008 and June 2016. Search results were filtered by date range, full text, English language, Boolean operators, and academic journals (n = 14). The review confirmed there are many facilitators and barriers in the coordination of care offered to veterans with dementia. Facilitators of quality care include veteran's expectations, family support, program development, and the availability of services. These positive aspects are aided by several community-based support services, new technology, and preventative care. Barriers are caregiver expectations, coordination of care, providers, and informal and formal costs. These negative facets are due to lack of educational resources, an increased veteran population diagnosed with dementia, limited knowledge of resources, and limited medical service in rural areas. Overall, there are a number of community programs that want to, and can, help veterans with dementia. There are also a number of ways to help veterans with dementia cope with their issues, which include

  19. Elements of the Veterans Health Administration Patient-Centered Medical Home are Associated with Greater Adherence to Oral Hypoglycemic Agents in Patients with Diabetes.

    Science.gov (United States)

    Meo, Nicholas; Wong, Edwin; Sun, Haili; Curtis, Idamay; Batten, Adam; Fihn, Stephan D; Nelson, Karin

    2017-07-05

    In 2010, Veterans Health Administration (VHA) primary care clinics adopted a patient-centered medical home (PCMH) model. This study sought to examine the association between the organizational features related to adoption of PCMH and the level of adherence to oral hypoglycemic agents (OHAs) among patients with diabetes. This retrospective cohort study involved 757 VA clinics that provide primary care to 440,971 patients with diabetes who were taking OHAs in fiscal year 2012. One-year refill-based medication possession ratios (MPRs) were calculated at the patient level. Clinic-level adherence was defined as the proportion of clinics with MPR ≥80%. Risk adjustment of adherence was performed using logistic regression to account for differences in patient populations at clinics. Eight domains of the PCMH model (ie, access, continuity, coordination, teamwork, comprehensive care, self-management, communication, shared decision making) were assessed using items from a previously validated index. Multivariate linear regression was applied to identify PCMH components associated with clinic-level adherence. Patients with diabetes per clinic ranged from 100 to 5011. The average level of adherence to OHAs among clinics ranged from 52.8% to 61.9% (interquartile range = 57.9% to 59.4%). In multivariate analysis, organizational features associated with higher clinic-level adherence included access to routine care (standardized beta [Sβ] = .21, P = .004), having a respectful office staff (Sβ = 0.21, P = .002), and utilization of telephone encounters (Sβ = 0.23, P < .001). Among a national cohort of veterans with diabetes, overall PCMH implementation did not significantly increase adherence to oral hypoglycemic agents, although aspects of implementation were associated with increased adherence. Measures of access to care appear the most significant.

  20. Rural veteran access to healthcare services: investigating the role of information and communication technologies in overcoming spatial barriers.

    Science.gov (United States)

    Schooley, Benjamin L; Horan, Thomas A; Lee, Pamela W; West, Priscilla A

    2010-04-01

    This multimethod pilot study examined patient and practitioner perspectives on the influence of spatial barriers to healthcare access and the role of health information technology in overcoming these barriers. The study included a survey administered to patients attending a Department of Veterans Affairs (VA) health visit, and a focus group with VA care providers. Descriptive results and focus group findings are presented. Spatial distance is a significant factor for many rural veterans when seeking healthcare. For this sample of rural veterans, a range of telephone, computer, and Internet technologies may become more important for accessing care as Internet access becomes more ubiquitous and as younger veterans begin using the VA health system. The focus group highlighted the negative impact of distance, economic considerations, geographic barriers, and specific medical conditions on access to care. Lack of adequate technology infrastructure was seen as an obstacle to utilization. This study discusses the need to consider distance, travel modes, age, and information technology infrastructure and adoption when designing health information technology to care for rural patients.

  1. Role of prolonged surveillance in the eradication of nosocomial scabies in an extended care Veterans Affairs medical center.

    Science.gov (United States)

    Jimenez-Lucho, V E; Fallon, F; Caputo, C; Ramsey, K

    1995-02-01

    Although general guidelines for control of institutional outbreaks of scabies have been published, little information is available on the long-term efficacy of these measures in extended care facilities. An epidemic of scabies occurred in a comprehensive care Veterans Affairs facility as a result of an unrecognized case of crusted scabies, with a total of 112 persons affected during a 12-month period. The initial outbreak occurred in the acute care units, with highest attack rates among roommates of the index patient (11/14, 78%) and nursing staff (27/55, 49%). Despite sustained infection control measures, secondary outbreaks continued to occur in the extended care units. Factors contributing to the persistence of the epidemic were transfer of patients with unrecognized infestation within the facility, prolonged latency period and atypical manifestations in elderly patients, and failure of scabicide treatment. In addition, a role may be played by carriage of scabies mites by infested staff members before they have symptoms. Control of the epidemic was only achieved with the following: increased awareness and better scabies recognition, restriction of staff rotation in the facility, and improved communication among primary providers and infection control personnel. Prolonged surveillance may be required for eradication of nosocomial scabies in extended care settings.

  2. Homeless Aging Veterans in Transition: A Life-Span Perspective

    OpenAIRE

    Thompson, Carla J.; Bridier, Nancy L.

    2013-01-01

    The need for counseling and career/educational services for homeless veterans has captured political and economic venues for more than 25 years. Veterans are three times more likely to become homeless than the general population if veterans live in poverty or are minority veterans. This mixed methods study emphasized a life-span perspective approach for exploring factors influencing normative aging and life-quality of 39 homeless veterans in Alabama and Florida. Seven descriptive quantitative...

  3. 20 CFR 404.1310 - Who is a World War II veteran.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Who is a World War II veteran. 404.1310... DISABILITY INSURANCE (1950- ) Wage Credits for Veterans and Members of the Uniformed Services World War II Veterans § 404.1310 Who is a World War II veteran. You are a World War II veteran if you were in the active...

  4. Women Veteran Report

    Data.gov (United States)

    Department of Veterans Affairs — This report summarizes the history of women Veterans in the military and as Veterans. It profiles the characteristics of women Veterans in 2015, and illustrates how...

  5. Quality of Prenatal Care Services in Karabuk Community Health Center

    Directory of Open Access Journals (Sweden)

    Binali Catak

    2012-04-01

    Full Text Available The aim of the study was to evaluate the quality and quantity of prenatal care services according to gestastional week in Karabuk Community Health Center (CHC. Methods: In this descriptive study 365 pregnant women was selected as sample among 753 pregnant women registered at Karabuk CHC in 18/01/2011. 93.0% of women in the selected sample has been visited in their homes and the face to face interviews were done. The questionnaire was prepared according to Prenatal Care Management Guidelines (PCMG of Ministry of Health. Findings The number of follow-ups was not complete in 23.7% of 15-24 month, 34.4% of 25-32 month, 52,1% of 33-42 month pregnant women. At least four follow-up visits were completed only in 66,7% of postpartum women. Timing of first visit was after 15th week in 15,6% of women. In follow up visits 62.5% of of women’s height were never measured, in 13,0% the women hearth sound of infants didn’t monitored at least once. Laboratory test numbers were under the level required by PCMG. The delivery conditions weren’t planned in 41,8% of last trimester and postpartum women and training about breastfeeding wasn’t given to 15,5 of the same group. Result In family medicine model in Karabuk CHC developments in number of prenatal follow-up visits were observed, but no substantial improvements were found in quality of prenatal visits. Regular in service trainings shoud be given to family doctors and midwives. The use of prenatal care guideline published by MoH should be increased. Keywords: Prenatal care, pregnancy, timing of first visit, qality of prenatal care [TAF Prev Med Bull 2012; 11(2.000: 153-162

  6. 78 FR 14303 - Statement of Delegation of Authority; Health Resources and Services Administration and Centers...

    Science.gov (United States)

    2013-03-05

    ... HUMAN SERVICES Statement of Delegation of Authority; Health Resources and Services Administration and Centers for Disease Control and Prevention I hereby delegate to the Administrator, Health Resources and Services Administration (HRSA), and the Director, Centers for Disease Control and Prevention (CDC), with...

  7. ParticipantService

    Data.gov (United States)

    Department of Veterans Affairs — Given a VeteranÆs File Number or Social Security Number the service will return information about the other people and organizations related to the Veteran (family...

  8. Examining aggression in male Vietnam veterans who receive VA services: the role of traumatic events and combat exposure.

    Science.gov (United States)

    Lenhardt, Jenna M; Howard, Jamie M; Taft, Casey T; Kaloupek, Danny G; Keane, Terence M

    2012-08-01

    We examined the relationship between trauma exposure and the perpetration of aggression by male Vietnam veterans (N = 1,328) using archival data from a multisite study conducted by the Cooperative Studies Program of the Department of Veteran Affairs (CSP-334) in the early 1990s. Both traumatic events in civilian life and combat exposure were examined as correlates of aggression. Results indicated that pre- and postmilitary traumatic events and combat exposure were all related to perpetration of aggression at the bivariate level; r = .07, r = .20, and r = .13, respectively. When these variables were examined simultaneously, only combat exposure (β = .14, p traumatic events (β = .20, p effects were found for civilian traumatic events and combat in relation to aggression. Results highlight the importance of attending to the psychological aftermath of exposure to traumatic events experienced during and following deployment before aggressive patterns develop. Copyright © 2012 International Society for Traumatic Stress Studies.

  9. Veterans Medical Care: FY2011 Appropriations

    Science.gov (United States)

    2011-03-21

    services to veterans who meet certain eligibility rules including hospital and medical care , disability compensation and pensions,3 education ,4...prosthetic and orthotic devices, including eyeglasses and hearing aids; home health services, hospice care , palliative care , and institutional respite care ...CRS Report for Congress Prepared for Members and Committees of Congress Veterans Medical Care : FY2011 Appropriations Sidath Viranga

  10. Prazosin for Prophylaxis of Chronic Post Traumatic Headaches in OEF/OIF/OND Service Members and Veterans with Mild TBI

    Science.gov (United States)

    2016-10-01

    Department of Veterans Affairs, 4/1/12-3/31/16 New Support on: 1. Neurobehavior, Neuropathology, and Risk Factors in Alzheimer’s Disease (T32 AG052354...Detection, Diagnosis, Course, and Risk Factors (U01 NS093334, Robert Stern), National Institutes of Health / NINDS, 12/15/15-11/30/22, $2,252,000, 0.6 CM...Role: Co-Investigator  What other organizations were involved as partners? A subcontract to Henry Jackson Foundation provides support for

  11. Terrestrial Hydrological Data from NASA's Hydrology Data and Information Services Center (HDISC): Products, Services, and Applications

    Science.gov (United States)

    Fang, Hongliang; Beaudoing, Hiroko K.; Mocko, David M.; Rodell, Matthew; Teng, Bill; Vollmer, Bruce

    2010-01-01

    Terrestrial hydrological variables are important in global hydrology, climate, and carbon cycle studies. The North American and Global Land Data Assimilation Systems (NLDAS and GLDAS, respectively) have been generating a series of land surface states (soil moisture, snow, and temperature) and fluxes (evapotranspiration, radiation, and heat flux) variables. These data, hosted at and available from NASA s Hydrology Data and Information Services Center (HDISC), include the NLDAS hourly 1/8 degree products and the GLDAS 3-hourly 0.25 and 1.0 degree products. HDISC provides easy access and visualization and analysis capabilities for these products, thus reducing the time and resources spent by scientists on data management and facilitating hydrological research. Users can perform spatial and parameter subsetting, data format transformation, and data analysis operations without needing to first download the data. HDISC is continually being developed as a data and services portal that supports weather and climate forecasts, and water and energy cycle research.

  12. College and Community Partnerships: Extending the Benefits of Therapeutic Recreation to Veterans

    Science.gov (United States)

    Fuchs, Steven J.; Cannella, Lee grace; Pisano, Susan

    2014-01-01

    In fall 2010, St. Joseph's College initiated a partnership between the college, Northport VA Medical Center, and Long Island State Veterans Home that provides a therapeutic platform for the integration of the three communities through sustainable and mutually beneficial curricular and co-curricular service and experiential learning programs. In…

  13. Assessing the ecosystem services provided by urban green spaces along urban center-edge gradients.

    Science.gov (United States)

    Chang, Jie; Qu, Zelong; Xu, Ronghua; Pan, Kaixuan; Xu, Bin; Min, Yong; Ren, Yuan; Yang, Guofu; Ge, Ying

    2017-09-11

    Urban green spaces provide various ecosystem services, especially cultural services. Previous assessment methods depend either on hypothetic payments for ecosystems or real payments not directly related to ecosystems. In this paper, we established a method for assessing the cultural ecosystem services in any location in urban area using only two variables, green space (ecosystem) and land rent (real payment). We integrated the cultural and the regulating services into the total ecosystem services because urban green spaces provide almost no provisioning services. Results showed that the same area of green spaces near the center provided much higher cultural services than that near the urban edge; the regulating services accounted for 5% to 40% of the total ecosystem services from the center to the edge of urban area; along the center-edge gradient, there was a threshold out which the ecosystem services were lower than the maintenance cost of green spaces.

  14. 42 CFR 410.165 - Payment for rural health clinic services and ambulatory surgical center services: Conditions.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Payment for rural health clinic services and... (SMI) BENEFITS Payment of SMI Benefits § 410.165 Payment for rural health clinic services and ambulatory surgical center services: Conditions. (a) Medicare Part B pays for covered rural health clinic and...

  15. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available ... facility near you. Spread the Word Download logos, Web ads, and materials and help get the word ... Veteran Suicide The Veterans Crisis Line text-messaging service does not store mobile phone numbers of users ...

  16. Documentation of the Federal Financial System Process at the Defense Finance and Accounting Service Indianapolis Center

    National Research Council Canada - National Science Library

    Gimble, Thomas

    1997-01-01

    .... In September 1994, the Defense Finance and Accounting Service (DFAS) transferred the responsibility for preparing the departmental accounting reports for Department 971 appropriations to the DFAS Indianapolis Center...

  17. About Region 3's Laboratory and Field Services at EPA's Environmental Science Center

    Science.gov (United States)

    Mission & contact information for EPA Region 3's Laboratory and Field Services located at EPA's Environmental Science Center: the Office of Analytical Services and Quality Assurance & Field Inspection Program

  18. Evaluation of the Veterans Health Administration's Specialty Care Transformational Initiatives to Promote Patient-Centered Delivery of Specialty Care: A Mixed-Methods Approach.

    Science.gov (United States)

    Williams, Katherine M; Kirsh, Susan; Aron, David; Au, David; Helfrich, Christian; Lambert-Kerzner, Anne; Lowery, Julie; Battaglia, Catherine; Graham, Glenn D; Doukas, Michael; Jain, Rajiv; Ho, P Michael

    2017-07-01

    Veteran's Affairs Office of Specialty Care (OSC) launched four national initiatives (Electronic-Consults [e-Consults], Specialty Care Access Networks-Extension for Community Healthcare Outcomes [SCAN-ECHO], Mini-Residencies, and Specialty Care Neighborhood) to improve specialty care delivery and funded a center to evaluate the initiatives. The evaluation, guided by two implementation frameworks, provides formative (administrator/provider interviews and surveys) and summative data (quantitative data on patterns of use) about the initiatives to OSC. Evaluation of initiative implementation is assessed through CFIR (Consolidated Framework for Implementation Research)-grounded qualitative interviews to identify barriers/facilitators. Depending on high or low implementation, factors such as receiving workload credit, protected time, existing workflow/systems compatibility, leadership engagement, and access to information/resources were considered implementation barriers or facilitators. Findings were shared with OSC and used to further refine implementation at additional sites. Evaluation of other initiatives is ongoing. The mixed-methods approach has provided timely information to OSC about initiative effect and impacted OSC policies on implementation at additional sites.

  19. Effect of Outsourced Pharmacies of Rural Healthcare Centers on Service Quality in Abharand Soltanieh Counties

    OpenAIRE

    Ali Maher; Alireza Saadati; Seyed Mojtaba Hosseini

    2016-01-01

    Recently, a part of healthcare services has been assigned to the private sector to increase the quality of medical services, increase patient satisfaction and reduce costs. In this regard, the outsourcing approach has been significantly considered for pharmaceutical services provided by healthcare centers. The purpose of this study is to evaluate the effect of outsourced pharmacies of rural healthcare centers on service quality using structural equations modelling. The methodology used was...

  20. Preliminary Data from the Caring for Older Adults and Caregivers at Home (COACH) Program: A Care Coordination Program for Home-Based Dementia Care and Caregiver Support in a Veterans Affairs Medical Center.

    Science.gov (United States)

    D'Souza, Maria F; Davagnino, Judith; Hastings, S Nicole; Sloane, Richard; Kamholz, Barbara; Twersky, Jack

    2015-06-01

    Caring for Older Adults and Caregivers at Home (COACH) is an innovative care coordination program of the Durham Veteran's Affairs Medical Center in Durham, North Carolina, that provides home-based dementia care and caregiver support for individuals with dementia and their family caregivers, including attention to behavioral symptoms, functional impairment, and home safety, on a consultation basis. The objectives of this study were to describe the COACH program in its first 2 years of operation, assess alignment of program components with quality measures, report characteristics of program participants, and compare rates of placement outside the home with those of a nontreatment comparison group using a retrospective cohort design. Participants were community-dwelling individuals with dementia aged 65 and older who received primary care in the medical center's outpatient clinics and their family caregivers, who were enrolled as dyads (n = 133), and a control group of dyads who were referred to the program and met clinical eligibility criteria but did not enroll (n = 29). Measures included alignment with Dementia Management Quality Measures and time to placement outside the home during 12 months of follow-up after referral to COACH. Results of the evaluation demonstrated that COACH aligns with nine of 10 clinical process measures identified using quality measures and that COACH delivers several other valuable services to enhance care. Mean time to placement outside the home was 29.6 ± 14.3 weeks for both groups (P = .99). The present study demonstrates the successful implementation of a home-based care coordination intervention for persons with dementia and their family caregivers that is strongly aligned with quality measures. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

  1. Optimizing fitness for duty and post-combat clinical services for military personnel and combat veterans with ADHD—a systematic review of the current literature

    Directory of Open Access Journals (Sweden)

    Iliyan Ivanov

    2014-08-01

    Full Text Available Background: Attention deficit hyper activity disorder (ADHD is a developmental disorder, most often diagnosed in childhood, and characterized by hyperactivity and inattention that negatively impacts one's ability to function and fulfill social and personal obligations. Individuals with past history of ADHD may enlist in the military under certain conditions, however the full impact of military training and deployment of later in life ADHD symptoms is unclear. It is of particular interest how military experience may affect ADHD in remission and if such individuals might be at elevated risk for relapse of ADHD symptoms. Method: We performed a systematic review f the available literature including the Department of Defense (DOD guidelines for both eligibility to enlist and fitness for deployment based on reported history and current symptomatology of ADHD. Results: The after care for veterans with ADHD relapse is inconsistent and presents with number of challenges. We evaluate the DOD policies regarding the implications of ADHD for fitness for military service and post-combat mental health. Conclusion: The full extend of the interaction between pre-existing ADHD and post-combat PTSD are not fully understood. The development of comprehensive and clear algorithms for diagnosing and treating ADHD in the military before and after deployment will have a strong positive impact on the quality of care delivered to soldiers and veterans.

  2. A national evaluation of homeless and nonhomeless veterans' experiences with primary care.

    Science.gov (United States)

    Jones, Audrey L; Hausmann, Leslie R M; Haas, Gretchen L; Mor, Maria K; Cashy, John P; Schaefer, James H; Gordon, Adam J

    2017-05-01

    Persons who are homeless, particularly those with mental health and/or substance use disorders (MHSUDs), often do not access or receive continuous primary care services. In addition, negative experiences with primary care might contribute to homeless persons' avoidance and early termination of MHSUD treatment. The patient-centered medical home (PCMH) model aims to address care fragmentation and improve patient experiences. How homeless persons with MHSUDs experience care within PCMHs is unknown. This study compared the primary care experiences of homeless and nonhomeless veterans with MHSUDs receiving care in the Veterans Health Administration's medical home environment, called Patient Aligned Care Teams. The sample included VHA outpatients who responded to the national 2013 PCMH-Survey of Health Care Experiences of Patients (PCMH-SHEP) and had a past-year MSHUD diagnosis. Veterans with evidence of homelessness (henceforth "homeless") were identified through VHA administrative records. PCMH-SHEP survey respondents included 67,666 veterans with MHSUDs (9.2% homeless). Compared with their nonhomeless counterparts, homeless veterans were younger, more likely to be non-Hispanic Black and nonmarried, had less education, and were more likely to live in urban areas. Homeless veterans had elevated rates of most MHSUDs assessed, indicating significant co-occurrence. After controlling for these differences, homeless veterans reported more negative and fewer positive experiences with communication; more negative provider ratings; and more negative experiences with comprehensiveness, care coordination, medication decision-making, and self-management support than nonhomeless veterans. Homeless persons with MHSUDs may need specific services that mitigate negative care experiences and encourage their continuation in longitudinal primary care services. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  3. The rise of concurrent care for veterans with advanced cancer at the end of life.

    Science.gov (United States)

    Mor, Vincent; Joyce, Nina R; Coté, Danielle L; Gidwani, Risha A; Ersek, Mary; Levy, Cari R; Faricy-Anderson, Katherine E; Miller, Susan C; Wagner, Todd H; Kinosian, Bruce P; Lorenz, Karl A; Shreve, Scott T

    2016-03-01

    Unlike Medicare, the Veterans Health Administration (VA) health care system does not require veterans with cancer to make the "terrible choice" between receipt of hospice services or disease-modifying chemotherapy/radiation therapy. For this report, the authors characterized the VA's provision of concurrent care, defined as days in the last 6 months of life during which veterans simultaneously received hospice services and chemotherapy or radiation therapy. This retrospective cohort study included veteran decedents with cancer during 2006 through 2012 who were identified from claims with cancer diagnoses. Hospice and cancer treatment were identified using VA and Medicare administrative data. Descriptive statistics were used to characterize the changes in concurrent care, hospice, palliative care, and chemotherapy or radiation treatment. The proportion of veterans receiving chemotherapy or radiation therapy remained stable at approximately 45%, whereas the proportion of veterans who received hospice increased from 55% to 68%. The receipt of concurrent care also increased during this time from 16.2% to 24.5%. The median time between hospice initiation and death remained stable at around 21 days. Among veterans who received chemotherapy or radiation therapy in their last 6 months of life, the median time between treatment termination and death ranged from 35 to 40 days. There was considerable variation between VA medical centers in the use of concurrent care (interquartile range, 16%-34% in 2012). Concurrent receipt of hospice and chemotherapy or radiation therapy increased among veterans dying from cancer without reductions in the receipt of cancer therapy. This approach reflects the expansion of hospice services in the VA with VA policy allowing the concurrent receipt of hospice and antineoplastic therapies. Cancer 2016;122:782-790. © 2015 American Cancer Society. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

  4. The Long-Term Impact of Military Service on Health: Evidence from World War II and Korean War Veterans.

    Science.gov (United States)

    Bedard, Kelly; Deschênes, Olivier

    2006-03-01

    During the World War II and Korean War era, the U.S. military freely distributed cigarettes to overseas personnel and provided low-cost tobacco products on domestic military bases. In fact, even today the military continues to sell subsidized tobacco products on its bases. Using a variety of instrumental variables approaches to deal with nonrandom selection into the military and into smoking, we provide substantial evidence that cohorts with higher military participation rates subsequently suffered more premature mortality. More importantly, we show that a large fraction, 35 to 79 percent, of the excess veteran deaths due to heart disease and lung cancer are attributable to military-induced smoking.

  5. Military Sexual Trauma Among Homeless Veterans

    OpenAIRE

    Pavao, Joanne; Turchik, Jessica A.; Hyun, Jenny K.; Karpenko, Julie; Saweikis, Meghan; McCutcheon, Susan; Kane, Vincent; Kimerling, Rachel

    2013-01-01

    ABSTRACT BACKGROUND Military sexual trauma (MST) is the Veteran Health Administration?s (VHA) term for sexual assault and/or sexual harassment that occurs during military service. The experience of MST is associated with a variety of mental health conditions. Preliminary research suggests that MST may be associated with homelessness among female Veterans, although to date MST has not been examined in a national study of both female and male homeless Veterans. OBJECTIVE To estimate the prevale...

  6. 42 CFR 405.2462 - Payment for rural health clinic and Federally qualified health center services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Payment for rural health clinic and Federally... AND DISABLED Rural Health Clinic and Federally Qualified Health Center Services Payment for Rural Health Clinic and Federally Qualified Health Center Services § 405.2462 Payment for rural health clinic...

  7. 41 CFR 101-30.504 - Cataloging data from Defense Logistics Services Center (DLSC).

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Cataloging data from Defense Logistics Services Center (DLSC). 101-30.504 Section 101-30.504 Public Contracts and Property... data from Defense Logistics Services Center (DLSC). Upon receipt of cataloging data from civil agencies...

  8. 15 CFR 950.7 - Center for Environmental Assessment Services (CEAS).

    Science.gov (United States)

    2010-01-01

    ... REGULATIONS OF THE ENVIRONMENTAL DATA SERVICE ENVIRONMENTAL DATA AND INFORMATION § 950.7 Center for Environmental Assessment Services (CEAS). EDIS assists National decisionmakers in solving problems by providing... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Center for Environmental Assessment...

  9. Military sexual trauma among homeless veterans.

    Science.gov (United States)

    Pavao, Joanne; Turchik, Jessica A; Hyun, Jenny K; Karpenko, Julie; Saweikis, Meghan; McCutcheon, Susan; Kane, Vincent; Kimerling, Rachel

    2013-07-01

    Military sexual trauma (MST) is the Veteran Health Administration's (VHA) term for sexual assault and/or sexual harassment that occurs during military service. The experience of MST is associated with a variety of mental health conditions. Preliminary research suggests that MST may be associated with homelessness among female Veterans, although to date MST has not been examined in a national study of both female and male homeless Veterans. To estimate the prevalence of MST, examine the association between MST and mental health conditions, and describe mental health utilization among homeless women and men. National, cross-sectional study of 126,598 homeless Veterans who used VHA outpatient care in fiscal year 2010. All variables were obtained from VHA administrative databases, including MST screening status, ICD-9-CM codes to determine mental health diagnoses, and VHA utilization. Of homeless Veterans in VHA, 39.7 % of females and 3.3 % of males experienced MST. Homeless Veterans who experienced MST demonstrated a significantly higher likelihood of almost all mental health conditions examined as compared to other homeless women and men, including depression, posttraumatic stress disorder, other anxiety disorders, substance use disorders, bipolar disorders, personality disorders, suicide, and, among men only, schizophrenia and psychotic disorders. Nearly all homeless Veterans had at least one mental health visit and Veterans who experienced MST utilized significantly more mental health visits compared to Veterans who did not experience MST. A substantial proportion of homeless Veterans using VHA services have experienced MST, and those who experienced MST had increased odds of mental health diagnoses. Homeless Veterans who had experienced MST had higher intensity of mental health care utilization and high rates of MST-related mental health care. This study highlights the importance of trauma-informed care among homeless Veterans and the success of VHA homeless

  10. 77 FR 72868 - The Centers for Disease Control (CDC)/Health Resources and Services Administration (HRSA...

    Science.gov (United States)

    2012-12-06

    ... HUMAN SERVICES Centers for Disease Control and Prevention The Centers for Disease Control (CDC)/Health... period through November 25, 2014. Contact Person for More Information: Kevin Fenton, M.D., Ph.D... announcements of meetings and other committee management activities, for both the Centers for Disease Control...

  11. Promoting Library Services with User-Centered Language

    Science.gov (United States)

    Benedetti, Allison R.

    2017-01-01

    As libraries respond to new teaching and research practices in the twenty-first century, it is important to consider how to advertise library services. Users are often surprised to learn about the varied expertise of library staff and the many services the staff provides. To investigate this issue, the author designed a study to identify a more…

  12. Pediatric Oncology Branch - Support Services | Center for Cancer Research

    Science.gov (United States)

    Support Services As part of the comprehensive care provided at the NCI Pediatric Oncology Branch, we provide a wide range of services to address the social, psychological, emotional, and practical facets of pediatric cancer and to support patients and families while they are enrolled in clinical research protocols.

  13. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available Veterans Crisis Line Skip to Main Content SuicidePreventionLifeline.org Get Help Materials Get Involved Crisis Centers About Be There ... see more videos from Veterans Health Administration Veterans Crisis Line -- After the Call see more videos from ...

  14. A participatory approach to designing and enhancing integrated health information technology systems for veterans: protocol.

    Science.gov (United States)

    Haun, Jolie N; Nazi, Kim M; Chavez, Margeaux; Lind, Jason D; Antinori, Nicole; Gosline, Robert M; Martin, Tracey L

    2015-02-27

    The Department of Veterans Affairs (VA) has developed health information technologies (HIT) and resources to improve veteran access to health care programs and services, and to support a patient-centered approach to health care delivery. To improve VA HIT access and meaningful use by veterans, it is necessary to understand their preferences for interacting with various HIT resources to accomplish health management related tasks and to exchange information. The objective of this paper was to describe a novel protocol for: (1) developing a HIT Digital Health Matrix Model; (2) conducting an Analytic Hierarchy Process called pairwise comparison to understand how and why veterans want to use electronic health resources to complete tasks related to health management; and (3) developing visual modeling simulations that depict veterans' preferences for using VA HIT to manage their health conditions and exchange health information. The study uses participatory research methods to understand how veterans prefer to use VA HIT to accomplish health management tasks within a given context, and how they would like to interact with HIT interfaces (eg, look, feel, and function) in the future. This study includes two rounds of veteran focus groups with self-administered surveys and visual modeling simulation techniques. This study will also convene an expert panel to assist in the development of a VA HIT Digital Health Matrix Model, so that both expert panel members and veteran participants can complete an Analytic Hierarchy Process, pairwise comparisons to evaluate and rank the applicability of electronic health resources for a series of health management tasks. This protocol describes the iterative, participatory, and patient-centered process for: (1) developing a VA HIT Digital Health Matrix Model that outlines current VA patient-facing platforms available to veterans, describing their features and relevant contexts for use; and (2) developing visual model simulations based on

  15. An academic hospitalist model to improve healthcare worker communication and learner education: results from a quasi-experimental study at a Veterans Affairs medical center.

    Science.gov (United States)

    Saint, Sanjay; Fowler, Karen E; Krein, Sarah L; Flanders, Scott A; Bodnar, Timothy W; Young, Eric; Moseley, Richard H

    2013-12-01

    Although hospitalists may improve efficiency and quality of inpatient care, their effect on healthcare-worker communication and education has been less well-studied. To test various approaches to improving healthcare-worker communication and learner education within the context of a newly designed academic hospital medicine program. Before-and-after design with concurrent control group. A Midwestern Veterans Affairs medical center. Multimodal systems redesign of 1 of 4 medical teams (Gold team) that included clinical modifications (change in rounding structure, with inclusion of nurses, a Clinical Care Coordinator, and a pharmacist) and educational interventions (providing explicit expectations of learners and providing a reading list for both learners and attending physicians). Number of admissions, length of stay, readmissions, house officer and medical student ratings of attendings' teaching, medical student internal medicine National Board of Medical Examiners Subject Examination ("shelf" exam) scores, and clinical staff surveys. Length of stay was reduced by about 0.3 days on all teams after the initiative began (P = 0.004), with no significant differences between Gold and non-Gold teams. The majority of physicians (83%) and nurses (68%) felt that including nurses during rounds improved healthcare-worker communication; significantly more nurses were satisfied with communication with the Gold team than with the other teams (71% vs 53%; P = 0.02). Gold attendings generally received higher teaching scores compared with non-Gold attendings, and third-year medical students on the Gold team scored significantly higher on the shelf exam compared with non-Gold team students (84 vs 82; P = 0.006). Academic hospitalists working within a systems redesign intervention were able to improve healthcare-worker communication and enhance learner education without increasing patient length of stay or readmission rates. © 2013 Society of The Authors. Journal of Hospital Medicine

  16. Veterans' use of Department of Veterans Affairs care and perceptions of outsourcing inpatient care.

    Science.gov (United States)

    Wakefield, Bonnie J; Tripp-Reimer, Toni; Rosenbaum, Marcy E; Rosenthal, Gary E

    2007-06-01

    The objective of the study was to examine veterans' perceptions of problems and benefits of outsourcing inpatient care from Veterans Affairs (VA) hospitals to private sector hospitals. Primary data were collected from a cross-section of 42 veterans who were VA users and nonusers using focus groups. Focus group discussion examined reasons patients use VA care, differences between VA and civilian care, positive and negative impacts of outsourcing, and special needs of veterans. Analyses revealed five domains related both to use of VA services and perceptions of outsourcing: costs, access, quality of care, contract (i.e., a covenant between veterans and the U.S. government), veteran milieu, and special needs. Participants identified a variety of potential positive and negative impacts. In general, veterans perceived more advantages than disadvantages to outsourcing VA care but still expressed significant concerns related to outsourcing. These issues should be considered in the development of future policy toward outsourcing VA care to the private sector.

  17. 75 FR 25845 - Office of Special Education and Rehabilitative Services (OSERS); Overview Information; Centers...

    Science.gov (United States)

    2010-05-10

    ... Office of Special Education and Rehabilitative Services (OSERS); Overview Information; Centers for... Administration (RSA) staff from the Office of Special Education and Rehabilitative Services. The pre-application.... Alexa Posny, Assistant Secretary for Special Education and Rehabilitative Services. BILLING CODE 4000-01...

  18. Center for Medicare & Medicaid Services (CMS) , Medicare Claims data

    Data.gov (United States)

    U.S. Department of Health & Human Services — 2003 forward. CMS compiles claims data for Medicare and Medicaid patients across a variety of categories and years. This includes Inpatient and Outpatient claims,...

  19. Veterans Crisis Line

    Data.gov (United States)

    Department of Veterans Affairs — The caring responders at the Veterans Crisis Line are specially trained and experienced in helping Veterans of all ages and circumstances. Some of the responders are...

  20. 75 FR 14633 - Veterans Workforce Investment Program

    Science.gov (United States)

    2010-03-26

    ...' Employment and Training Service Veterans Workforce Investment Program AGENCY: Veterans' Employment and...' Workforce Investment Program (VWIP) for Program Year (PY) 2010, as authorized under section 168 of the Workforce Investment Act (WIA) of 1998. This Solicitation for Grant Applications (SGA) notice contains all...

  1. Risk factors for homelessness among women veterans.

    Science.gov (United States)

    Washington, Donna L; Yano, Elizabeth M; McGuire, James; Hines, Vivian; Lee, Martin; Gelberg, Lillian

    2010-02-01

    Women veterans are three to four times more likely than non-veteran women to become homeless. However, their risk factors for homelessness have not been defined. Case-control study of non-institutionalized homeless women veterans (n533) and age-matched housed women veterans (n=165). Health, health care, and factors associated with homelessness were assessed using multiple logistic regression with a Monte Carlo algorithm to estimate exact standard errors of the model coefficients and p-values. Characteristics associated with homelessness were sexual assault during military service, being unemployed, being disabled, having worse overall health, and screening positive for an anxiety disorder or post-traumatic stress disorder. Protective factors were being a college graduate or married. Efforts to assess housed women veterans' risk factors for homelessness should be integrated into clinical care programs within and outside the Veterans Administration. Programs that work to ameliorate risk factors may prevent these women's living situations from deteriorating over time.

  2. VHA Support Service Center Primary Care Support Staff and Exam Room Database

    Data.gov (United States)

    Department of Veterans Affairs — Networks are able to update on an ongoing basis data originally added to the Veterans Health Administration Physician Productivity and Staffing initiative to ensure...

  3. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Mental Health PTSD Public Health Veterans Access, Choice & Accountability Act Benefits General Benefits Information Disability Compensation Pension ... Grants Management Services Veterans Service Organizations Office of Accountability & Whistleblower ... Rights & Protections Transparency Media Room ...

  4. HR Shared Service Centers: From Brand Management Towards Success

    NARCIS (Netherlands)

    van Balen, Mitchell; Bondarouk, Tatiana; Ruel, Hubertus Johannes Maria; Guiderdoni-Jourdain, Karine; Oiry, Ewan

    2009-01-01

    In this chapter the authors consider articles in professional literature regarding Human Resource Centers, with the goal to explore issues raised by practice: motivation, risk analysis, structure and implementation. Using Grounded Theory approach, they analysed 34 articles, and through open and

  5. NUCLEAR INFORMATION SERVICES AT THE NATIONAL NUCLEAR DATA CENTER.

    Energy Technology Data Exchange (ETDEWEB)

    BURROWS,T.W.; DUNFORD,C.L.

    2004-09-26

    The National Nuclear Data Center has provided remote access to its databases and other resources since 1986. This year we have completed the modernization of our databases and Web site. Resources available from our Web site will be summarized and some of the major improvements described in more detail.

  6. A Latent Content Analysis of Barriers and Supports to Healthcare: Perspectives From Caregivers of Service Members and Veterans With Military-Related Traumatic Brain Injury.

    Science.gov (United States)

    Carlozzi, Noelle E; Lange, Rael T; French, Louis M; Sander, Angelle M; Freedman, Jenna; Brickell, Tracey A

    2018-01-30

    To identify barriers and supports that caregivers of individuals with military-related traumatic brain injury (TBI) encounter when navigating the military healthcare system; this information will be used as the foundation of a new patient-reported outcome measure. Community. Forty-five caregivers of service members and veterans (SMV) who sustained a medically documented mild, moderate, severe, or penetrating TBI. Latent content analysis. Nine focus group discussions of barriers and supports to navigating the military healthcare system and community resources. Latent content analysis indicated that caregivers discussed barriers (66%) and supports (34%) to obtaining care within the military healthcare system and the community. Caregivers most frequently discussed SMVs' interactions with healthcare, their own interactions with healthcare, family care, and community organizations. Caregivers confront numerous challenges while pursuing healthcare services. Although much of the discussion focused on barriers and perceived unmet needs within the military healthcare system, caregivers also recognized supports within the military healthcare system and general community. Increased attention to accessibility and quality of services, as well as reducing financial burden, can lead to improved health-related quality of life for caregivers and their SMVs.

  7. Human‐Centered Design: Integrating Services & Systems Around People By Providing A Common Ground for Action

    DEFF Research Database (Denmark)

    Junginger, Sabine

    2014-01-01

    to both professional fields. Yet, how human‐centered design is being practiced and applied depends on the interpretation of the concept, or the “designer’s stance” (Buchanan 2011). In this paper, I trace the shifts in design thinking and the role of people in service engineering and in service design. I...... argue that human-centered design challenges the systems view of service engineers and service designers and requires them to reach out to each other. For this reason, I conclude that for these two disciplines, human-centered design provides a common ground for purposeful action: to arrive at the best......Service engineering and service design, though distinct in their origins, theories, concepts, methods and practices, share that they are both consequential productive arts for people who depend on their outcomes. The ideas, methods and practices of human‐centred design are therefore relevant...

  8. Structured Communication-Centered Programming for Web Services

    DEFF Research Database (Denmark)

    Carbone, Marco; Honda, Kohei; Yoshida, Nobuko

    2012-01-01

    This article relates two different paradigms of descriptions of communication behavior, one focusing on global message flows and another on end-point behaviors, using formal calculi based on session types. The global calculus, which originates from a Web service description language (W3C WS...

  9. Street Children's Problems and Services in Indonesia : Centering on Jakarta

    OpenAIRE

    松本, 眞一; Shin-ichi, Matsumoto; 桃山学院大学社会学部

    2003-01-01

    This paper concerning street children in Indonesia aims to clarify what street children are doing, why they have become street children and live in streets, and how they are supported in Indonesia, centering on Jakarta. As a result, this paper consists of five chapters. The first chapter is Introduction. The second chapter presents the description of current situation of street children, and the third chapter reviews the legislation on street children. The fourth chapter describes the care an...

  10. Barriers to utilization of childbirth services of a rural birthing center in Nepal: A qualitative study.

    Directory of Open Access Journals (Sweden)

    Resham Bahadur Khatri

    Full Text Available Maternal mortality and morbidity are public health problems in Nepal. In rural communities, many women give birth at home without the support of a skilled birth attendant, despite the existence of rural birthing centers. The aim of this study was to explore the barriers and provide pragmatic recommendations for better service delivery and use of rural birthing centers.We conducted 26 in-depth interviews with service users and providers, and three focus group discussions with community key informants in a rural community of Rukum district. We used the Adithya Cattamanchi logic model as a guiding framework for data analysis.Irregular and poor quality services, inadequate human and capital resources, and poor governance were health system challenges which prevented service delivery. Contextual barriers including difficult geography, poor birth preparedness practices, harmful culture practices and traditions and low level of trust were also found to contribute to underutilization of the birthing center.The rural birthing center was not providing quality services when women were in need, which meant women did not use the available services properly because of systematic and contextual barriers. Approaches such as awareness-raising activities, local resource mobilization, ensuring access to skilled providers and equipment and other long-term infrastructure development works could improve the quality and utilization of childbirth services in the rural birthing center. This has resonance for other centers in Nepal and similar countries.

  11. Barriers to utilization of childbirth services of a rural birthing center in Nepal: A qualitative study

    Science.gov (United States)

    Shrestha, Khadka Narayan; Homer, Caroline S. E.

    2017-01-01

    Background Maternal mortality and morbidity are public health problems in Nepal. In rural communities, many women give birth at home without the support of a skilled birth attendant, despite the existence of rural birthing centers. The aim of this study was to explore the barriers and provide pragmatic recommendations for better service delivery and use of rural birthing centers. Methods We conducted 26 in-depth interviews with service users and providers, and three focus group discussions with community key informants in a rural community of Rukum district. We used the Adithya Cattamanchi logic model as a guiding framework for data analysis. Results Irregular and poor quality services, inadequate human and capital resources, and poor governance were health system challenges which prevented service delivery. Contextual barriers including difficult geography, poor birth preparedness practices, harmful culture practices and traditions and low level of trust were also found to contribute to underutilization of the birthing center. Conclusion The rural birthing center was not providing quality services when women were in need, which meant women did not use the available services properly because of systematic and contextual barriers. Approaches such as awareness-raising activities, local resource mobilization, ensuring access to skilled providers and equipment and other long-term infrastructure development works could improve the quality and utilization of childbirth services in the rural birthing center. This has resonance for other centers in Nepal and similar countries. PMID:28493987

  12. Barriers to utilization of childbirth services of a rural birthing center in Nepal: A qualitative study.

    Science.gov (United States)

    Khatri, Resham Bahadur; Dangi, Tara Prasad; Gautam, Rupesh; Shrestha, Khadka Narayan; Homer, Caroline S E

    2017-01-01

    Maternal mortality and morbidity are public health problems in Nepal. In rural communities, many women give birth at home without the support of a skilled birth attendant, despite the existence of rural birthing centers. The aim of this study was to explore the barriers and provide pragmatic recommendations for better service delivery and use of rural birthing centers. We conducted 26 in-depth interviews with service users and providers, and three focus group discussions with community key informants in a rural community of Rukum district. We used the Adithya Cattamanchi logic model as a guiding framework for data analysis. Irregular and poor quality services, inadequate human and capital resources, and poor governance were health system challenges which prevented service delivery. Contextual barriers including difficult geography, poor birth preparedness practices, harmful culture practices and traditions and low level of trust were also found to contribute to underutilization of the birthing center. The rural birthing center was not providing quality services when women were in need, which meant women did not use the available services properly because of systematic and contextual barriers. Approaches such as awareness-raising activities, local resource mobilization, ensuring access to skilled providers and equipment and other long-term infrastructure development works could improve the quality and utilization of childbirth services in the rural birthing center. This has resonance for other centers in Nepal and similar countries.

  13. Design and challenges for a randomized, multi-site clinical trial comparing the use of service dogs and emotional support dogs in Veterans with post-traumatic stress disorder (PTSD).

    Science.gov (United States)

    Saunders, Gabrielle H; Biswas, Kousick; Serpi, Tracey; McGovern, Stephanie; Groer, Shirley; Stock, Eileen M; Magruder, Kathryn M; Storzbach, Daniel; Skelton, Kelly; Abrams, Thad; McCranie, Mark; Richerson, Joan; Dorn, Patricia A; Huang, Grant D; Fallon, Michael T

    2017-11-01

    Posttraumatic stress disorder (PTSD) is a leading cause of impairments in quality of life and functioning among Veterans. Service dogs have been promoted as an effective adjunctive intervention for PTSD, however published research is limited and design and implementation flaws in published studies limit validated conclusions. This paper describes the rationale for the study design, a detailed methodological description, and implementation challenges of a multisite randomized clinical trial examining the impact of service dogs on the on the functioning and quality of life of Veterans with PTSD. Trial design considerations prioritized participant and intervention (dog) safety, selection of an intervention comparison group that would optimize enrollment in all treatment arms, pragmatic methods to ensure healthy well-trained dogs, and the selection of outcomes for achieving scientific and clinical validity in a Veteran PTSD population. Since there is no blueprint for conducting a randomized clinical trial examining the impact of dogs on PTSD of this size and scope, it is our primary intent that the successful completion of this trial will set a benchmark for future trial design and scientific rigor, as well as guiding researchers aiming to better understand the role that dogs can have in the management of Veterans experiencing mental health conditions such as PTSD. Published by Elsevier Inc.

  14. 77 FR 3842 - Proposed Information Collection (Conversion from Servicemembers' Group Life Insurance to Veterans...

    Science.gov (United States)

    2012-01-25

    ... (SGLI) to Veterans' Group Life Insurance (VGLI) for Disabled Service Members. OMB Control Number: 2900... members, especially service members with disabilities are informed about their life insurance option... AFFAIRS Proposed Information Collection (Conversion from Servicemembers' Group Life Insurance to Veterans...

  15. Homeless veterans' experiences with substance use, recovery, and treatment through photo elicitation.

    Science.gov (United States)

    Sestito, Samuel F; Rodriguez, Keri L; Saba, Shaddy K; Conley, James W; Mitchell, Michael A; Gordon, Adam J

    2017-01-01

    Homeless veterans often have addictions and comorbidities that complicate utilization of longitudinal health care services, such as primary care. An understanding of experiences of veterans enrolled in a Homeless Patient Aligned Care Team (H-PACT) may improve addiction treatment engagement in these settings. The authors aimed to describe H-PACT veterans' experiences with substance use (SU), substance use recovery (SUR), and substance use treatment (SUT). Homeless veterans were recruited from a veteran primary care medical home clinic between September 2014 and March 2015. Twenty veterans were given digital cameras and prompts for taking photographs about their health and health care and participated in 2 photo elicitation interviews. For this secondary analysis, transcripts from the audio-recorded interviews were analyzed by 2 coders using qualitative content analysis. The majority of participants (75%, n = 15) discussed SU, SUR, and/or SUT in regards to their health and health care utilization. SU themes centered on disclosure of addiction or dependency; substances used; repercussions of SU; SU as a coping mechanism; and association of SU with military service. SUR themes included disclosure of length of sobriety; perceived facilitators of SUR in health, beliefs, social, environmental, financial, and creative pursuit domains; and perceived barriers to SUR in beliefs, social, and environmental domains. SUT themes focused on perceived facilitators of SUT in access to Department of Veterans Affairs (VA) and non-VA services and social domains and perceived barriers to SUT in the social domain. Providers seeking to elicit addiction-related clinical history and facilitate SUR and SUT might look to the current findings for guidance. Provider training in motivational interviewing may be warranted, which allows for an exploration of health-related consequences of SU and supports patients' self-efficacy.

  16. Engagement in mental health treatment among veterans returning from Iraq

    Directory of Open Access Journals (Sweden)

    Tracy Stecker

    2010-03-01

    Full Text Available Tracy Stecker1,2, John Fortney3,4, Francis Hamilton1,2, Cathy D Sherbourne5, Icek Ajzen61Psychiatric Research Center, Dartmouth Medical School, Lebanon, NH, USA; 2VA Health Services Research and Development, White River Junction Veterans Administration, White River Junction, VT, USA; 3VA Health Services Research and Development (HR S&D, Center for Mental Health and Outcomes Research, Central Arkansas Veterans Healthcare System, North Little Rock, AR, USA; 4Division of Health Services Research, Department of Psychiatry, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA; 5RAND, Santa Monica, CA, USA; 6Department of Psychology, University of Massachusetts, Amherst, MA, USAObjectives: Many veterans return from combat experiencing a variety of mental health concerns. Previous research has documented a stigma associated with seeking treatment that interferes with the decision to seek treatment. This study, conceptualized using the theory of planned behavior, assessed beliefs about mental health treatment in order to understand mental health treatment seeking behavior among a group of returning National Guard soldiers who served in the war in Iraq.Methods: Participants were one hundred and fifty Operation Iraqi Freedom National Guard soldiers who screened positive for depression, posttraumatic stress disorder, generalized anxiety disorder, panic disorder or alcohol abuse disorder on the Mini International Neuropsychiatric Interview (MINI. Participants were asked to complete a questionnaire assessing beliefs about mental health treatment and treatment-seeking behavior.Results: Beliefs related to symptom reduction and work were significantly related to mental health treatment-seeking behavior. Conclusions: Interventions developed to engage veterans into care must be directed toward cognitive factors that motivate treatment seeking in addition to traditionally targeted structural barriers.Keywords: treatment

  17. Cost-Benefit Analysis of Radiation Therapy Services at Tripler Army Medical Center

    National Research Council Canada - National Science Library

    Diehl, Diane S

    2004-01-01

    The purpose of this analysis was to examine the costs and benefits associated with continuance of "in-house" radiation therapy services to eligible beneficiaries at Tripler Army Medical Center (TAMC...

  18. LED Provides Effective and Efficient Parking Area Lighting at the NAVFAC Engineering Service Center

    Energy Technology Data Exchange (ETDEWEB)

    None

    2010-08-12

    U.S. Department of Energy (DOE) Federal Energy Management Program (FEMP) emerging technology case study showcasing LED lighting to improve energy efficiency in parking areas at the NAVFAC Engineering Services Center.

  19. 78 FR 55338 - Advisory Committee on Homeless Veterans, Notice of Meeting Amendment

    Science.gov (United States)

    2013-09-10

    ... AFFAIRS Advisory Committee on Homeless Veterans, Notice of Meeting Amendment The Department of Veterans... Committee on Homeless Veterans meeting on September 11-13, 2013, in the William Phillip King room at The... services of the Department in assisting homeless Veterans. The Committee shall assemble and review...

  20. 76 FR 56881 - Advisory Committee on Homeless Veterans; Notice of Meeting

    Science.gov (United States)

    2011-09-14

    ... AFFAIRS Advisory Committee on Homeless Veterans; Notice of Meeting The Department of Veterans Affairs (VA... Committee on Homeless Veterans will be held on September 20- 21, 2011. On September 20, the Committee will... services of the Department in assisting homeless Veterans. The Committee shall assemble and review...

  1. 78 FR 53820 - Advisory Committee on Homeless Veterans, Notice of Meeting

    Science.gov (United States)

    2013-08-30

    ... AFFAIRS Advisory Committee on Homeless Veterans, Notice of Meeting The Department of Veterans Affairs (VA... Committee on Homeless Veterans will be held on September 11- 13, 2013, in the William Phillip King Room at..., organizational structures, and services of the Department in assisting homeless Veterans. The Committee shall...

  2. 75 FR 4453 - Advisory Committee on Homeless Veterans; Notice of Meeting

    Science.gov (United States)

    2010-01-27

    ... AFFAIRS Advisory Committee on Homeless Veterans; Notice of Meeting The Department of Veterans Affairs (VA... Committee on Homeless Veterans will be held February 24-26, 2010, in the Lafayette Park Room at the Hamilton... services of the Department in assisting homeless Veterans. The Committee shall assemble and review...

  3. 76 FR 24087 - Advisory Committee on Homeless Veterans; Notice of Meeting

    Science.gov (United States)

    2011-04-29

    ... AFFAIRS Advisory Committee on Homeless Veterans; Notice of Meeting The Department of Veterans Affairs (VA... Committee on Homeless Veterans will be held May 18-20, 2011, in the Harbor View Room at the Best Western Bay... services of the Department in assisting homeless Veterans. The Committee shall assemble and review...

  4. 77 FR 26069 - Advisory Committee on Homeless Veterans, Notice of Meeting

    Science.gov (United States)

    2012-05-02

    ...: 2012-10524] DEPARTMENT OF VETERANS AFFAIRS Advisory Committee on Homeless Veterans, Notice of Meeting... Committee Act) that a meeting of the Advisory Committee on Homeless Veterans will be held on June 1-2, 2012..., organizational structures, and services of the Department in assisting homeless Veterans. The Committee shall...

  5. Mortality patterns among women Vietnam-era veterans: results of a retrospective cohort study.

    Science.gov (United States)

    Cypel, Yasmin; Kang, Han

    2008-03-01

    This research compiled and analyzed the data of two cohorts of women veterans who either served in Vietnam ("Vietnam veteran" cohort, n = 4586) or served elsewhere during the Vietnam War ("non-Vietnam veteran" cohort, n = 5325). All cause and cause-specific mortality were compared between Vietnam and non-Vietnam veteran cohorts, to the U.S. population, and to earlier research. Similar analyses were performed for nurses only. Vital status was determined through December 31, 2004, using primarily the U.S. Department of Veterans Affairs beneficiary file and the Social Security Administration Death Master File. Selected data were submitted to the National Center for Health Statistics for merging with the National Death Index to obtain cause of death. Cox proportional hazard analysis modeling was used to obtain adjusted relative risks (ARR). SEER( *)Stat software was used to compute standardized mortality ratios (SMR) for comparisons to the U.S. population. Women Vietnam veterans showed a significant deficit (ARR = 0.78, 95% confidence interval [CI] 0.62-0.98) in circulatory system disease relative to non-Vietnam veterans, but significant deficits also were observed when the Vietnam and non-Vietnam cohorts were each compared with women in the U.S. population (SMR = 0.65, 95% CI 0.54-0.77; SMR=0.82, 95% CI 0.73-0.93, respectively). Vietnam veterans had significantly lower mortality than women in the U.S. population for all causes (SMR = 0.87, 95% CI 0.80-0.94). Vietnam veterans were at significantly greater risk of mortality from motor vehicle accidents than non-Vietnam veterans (ARR = 2.60, 95% CI 1.22-5.55) and this appeared to be specific to service in Vietnam based on comparisons to the U.S. population. Patterns did not differ greatly for the analysis on nurse veterans or to earlier mortality studies of these cohorts. Mortality from motor vehicle accidents was significantly associated with service in Vietnam. Mortality patterns generally resembled those reported on

  6. [SOROKA UNIVERSITY MEDICAL CENTER: THE ROAD TO LEADERSHIP IN QUALITY OF MEDICAL CARE, SERVICE AND RESEARCH].

    Science.gov (United States)

    Davidson, Ehud; Sheiner, Eyal

    2016-02-01

    Soroka University Medical Center is a tertiary hospital, and the sole medical center in the Negev, the southern part of Israel. Soroka has invested in quality, service and research. The region has developed joint programs in order to advance the quality of medical care whilst optimizing the utilization of available resources. In this editorial we describe the path to leadership in quality of medical care, service and research.

  7. Taylor-Leaver FSC (Family Service Center): A Prototype for Program Evaluation of Navy Family Service Centers

    Science.gov (United States)

    1988-08-01

    Premarital counseling Anti-drinking campaign Single-parent programs -" Legal services * •Housing assistance Recreation programs Welcome package...Latin American -USE NO 2 PENCIL ONLY 3. Sex 0o Asia n/F ilipino/Pac. Islande- 0Male 0White/Caucasian 0 DO NOT USE INK OR BALLPOINT PENS.0Mae1 Wit/ucin

  8. National Space Science Data Center and World Data Center A for Rockets and Satellites - Ionospheric data holdings and services

    Science.gov (United States)

    Bilitza, D.; King, J. H.

    1988-01-01

    The activities and services of the National Space Science data Center (NSSDC) and the World Data Center A for Rockets and Satellites (WDC-A-R and S) are described with special emphasis on ionospheric physics. The present catalog/archive system is explained and future developments are indicated. In addition to the basic data acquisition, archiving, and dissemination functions, ongoing activities include the Central Online Data Directory (CODD), the Coordinated Data Analysis Workshopps (CDAW), the Space Physics Analysis Network (SPAN), advanced data management systems (CD/DIS, NCDS, PLDS), and publication of the NSSDC News, the SPACEWARN Bulletin, and several NSSD reports.

  9. Utilization of Mental Health Services in School-Based Health Centers

    Science.gov (United States)

    Bains, Ranbir M.; Cusson, Regina; White-Frese, Jesse; Walsh, Stephen

    2017-01-01

    Background: We summarize utilization patterns for mental health services in school-based health centers. Methods: Administrative data on school-based health center visits in New Haven, Connecticut were examined for the 2007-2009 school years. Relative frequencies of mental health visits by age were calculated as a percentage of all visits and were…

  10. Effect of Outsourced Pharmacies of Rural Healthcare Centers on Service Quality in Abharand Soltanieh Counties

    Directory of Open Access Journals (Sweden)

    Ali Maher

    2016-05-01

    Full Text Available Recently, a part of healthcare services has been assigned to the private sector to increase the quality of medical services, increase patient satisfaction and reduce costs. In this regard, the outsourcing approach has been significantly considered for pharmaceutical services provided by healthcare centers. The purpose of this study is to evaluate the effect of outsourced pharmacies of rural healthcare centers on service quality using structural equations modelling. The methodology used was descriptive using correlation by structural equations modelling. The studied population included those patients who provided their medicines from pharmacies of rural healthcare centers in Abhar and Soltanieh counties. The samples included 384 of these patients. Data was collected by outsourcing and service quality questionnaires. A structural equation modelling was used to analyze data by LISREAL software. Results indicated a positive significant effect of outsourced pharmacies of rural healthcare centers on quality of tangibles, reliability, responsiveness, assurance and empathy. findings emphasize the role of outsourcing on quality of services. Outsourced pharmacies of rural healthcare centers of Abhar and Soltanieh counties lead to improved service quality.

  11. A Variable Service Broker Routing Policy for data center selection in cloud analyst

    Directory of Open Access Journals (Sweden)

    Ahmad M. Manasrah

    2017-07-01

    Full Text Available Cloud computing depends on sharing distributed computing resources to handle different services such as servers, storage and applications. The applications and infrastructures are provided as pay per use services through data center to the end user. The data centers are located at different geographic locations. However, these data centers can get overloaded with the increase number of client applications being serviced at the same time and location; this will degrade the overall QoS of the distributed services. Since different user applications may require different configuration and requirements, measuring the user applications performance of various resources is challenging. The service provider cannot make decisions for the right level of resources. Therefore, we propose a Variable Service Broker Routing Policy – VSBRP, which is a heuristic-based technique that aims to achieve minimum response time through considering the communication channel bandwidth, latency and the size of the job. The proposed service broker policy will also reduce the overloading of the data centers by redirecting the user requests to the next data center that yields better response and processing time. The simulation shows promising results in terms of response and processing time compared to other known broker policies from the literature.

  12. Evaluation of poison information services provided by a new poison information center

    OpenAIRE

    Churi, Shobha; Abraham, Lovin; Ramesh, M.; Narahari, M. G.

    2013-01-01

    Aim: The aim of this study is to assess the nature and quality of services provided by poison information center established at a tertiary-care teaching hospital, Mysore. Settings and Design: This was a prospective observational study. Materials and Methods: The poison information center was officially established in September 2010 and began its functioning thereafter. The center is equipped with required resources and facility (e.g., text books, Poisindex, Drugdex, toll free telephon...

  13. Mental Health Among Military Personnel and Veterans

    National Research Council Canada - National Science Library

    Pickett, Treven; Rothman, David; Crawford, Eric F; Brancu, Mira; Fairbank, John A; Kudler, Harold S

    2015-01-01

    This commentary describes the prevalence of mental health problems affecting military service members and veterans in North Carolina and the rest of the nation, with a special emphasis on those who...

  14. Attitudes about the VA health-care setting, mental illness, and mental health treatment and their relationship with VA mental health service use among female and male OEF/OIF veterans.

    Science.gov (United States)

    Fox, Annie B; Meyer, Eric C; Vogt, Dawne

    2015-02-01

    In the present study, the authors explored gender differences in attitudinal barriers to and facilitators of care for Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans and examined the relationship of those factors with VA mental health service use among female and male veterans with probable mental health conditions. Data were collected as part of a national cross-sectional survey of OEF/OIF veterans; the current sample was limited to participants with a probable diagnosis of posttraumatic stress disorder, depression, or alcohol abuse (N = 278). Although negligible gender differences were observed in attitudes about VA care and perceived fit in the VA setting, men reported slightly more negative beliefs about mental illness and mental health treatment than women. In addition, logistic regressions revealed different associations with VA mental health service use for women and men. For women only, positive perceptions of VA care were associated with increased likelihood of seeking mental health treatment. For men only, perceived similarity to other VA care users and negative beliefs about mental health treatment were associated with increased likelihood of service use, whereas negative beliefs about mental illness were associated with lower likelihood of service use. For both women and men, perceived entitlement to VA care was associated with increased likelihood of service use and negative beliefs about treatment-seeking were associated with a reduced likelihood of seeking mental health care in the past 6 months. Results support the need for tailored outreach to address unique barriers to mental health treatment for female and male OEF/OIF veterans.

  15. Enhancing HR shared service centers through resource orchestration : uncovering the dynamic capabilities of the administrative expert

    NARCIS (Netherlands)

    Maatman, Marco

    2017-01-01

    Many organizations have introduced transactional HR Shared Service Centers (HR SSCs) that are responsible for supporting the business by providing administrative HR services. Many of these HR SSCs are faced with headcount and cost reduction objectives and therefore unable to respond to the

  16. Mental Health Services in School-Based Health Centers: Systematic Review

    Science.gov (United States)

    Bains, Ranbir Mangat; Diallo, Ana F.

    2016-01-01

    Mental health issues affect 20-25% of children and adolescents, of which few receive services. School-based health centers (SBHCs) provide access to mental health services to children and adolescents within their schools. A systematic review of literature was undertaken to review evidence on the effectiveness of delivery of mental health services…

  17. The History of SHSAAMc: Student Health Services at Academic Medical Centers

    Science.gov (United States)

    Veeser, Peggy Ingram; Hembree, Wylie; Bonner, Julia

    2008-01-01

    This article presents an historical review of the organization known as Student Health Services at Academic Medical Centers (SHSAAMc). The authors discuss characteristics of health service directors as well as the history of meetings, discussion, and leadership. The focus of the group is the healthcare needs of health professions students at…

  18. Computerizing the Management of Media Center Services on College Level--A Case Study.

    Science.gov (United States)

    Hefzallah, Ibrahim M.; Katz, Adolph I.

    1992-01-01

    Discusses the role of university media centers and describes a spreadsheet reporting system for media services developed at Fairfield University (Connecticut). The need to revise the reporting system resulting from a growth in media services is discussed, and cooperation with an information system analyst to develop a new system is described. (LRW)

  19. Introduction to Recreation Services for People with Disabilities: A Person-Centered Approach. 3rd Edition

    Science.gov (United States)

    Bullock, Charles C.; Mahon, Michael J.; Killingsworth, Charles L.

    2010-01-01

    Ultimately, all successful recreation programs center around its participants wants and needs. Serving people with disabilities is no exception. "Introduction to Recreation Services for People with Disabilities" is intended to be an introductory book for anyone planning or working in the parks, recreation, and leisure service industry. Through…

  20. Use of Adult Day Care Centers: Do They Offset Utilization of Health Care Services?

    Science.gov (United States)

    Iecovich, Esther; Biderman, Aya

    2013-01-01

    Purpose: Based on the medical offset effect, the goal of the study was to examine the extent to which users and nonusers of adult day care centers (ADCC) differ in frequency of use of out-patient health services (visits to specialists) and in-patient health services (number of hospital admissions, length of hospitalizations, and visits to…

  1. Comparing life experiences in active addiction and recovery between veterans and non-veterans: a national study.

    Science.gov (United States)

    Laudet, Alexandre; Timko, Christine; Hill, Thomas

    2014-01-01

    The costs of addiction are well documented, but the potential benefits of recovery are less well known. Similarly, substance use issues among both active duty military personnel and veterans are well known but their recovery experiences remain underinvestigated. Furthermore, little is known about whether and how addiction and recovery experiences differ between veterans and non-veterans. This knowledge can help refine treatment and recovery support services. Capitalizing on a national study of individuals in recovery (N = 3,208), we compare addiction and recovery experiences among veterans (n = 481) and non-veterans. Veterans' addiction phase was 4 years longer than non-veterans and they experienced significantly more financial and legal problems. Dramatic improvements in functioning were observed across the board in recovery with subgroup differences leveling off. We discuss possible strategies to address the specific areas where veterans are most impaired in addiction and note study limitations including the cross-sectional design.

  2. 2007 Veterans Employability Research Survey

    Data.gov (United States)

    Department of Veterans Affairs — The 2007 Veterans Employability Research Survey (VERS) was conducted to determine the factors that impact veterans' employability resulting from participation in the...

  3. Achieving scalability of human-centered service systems: Insights from the active and assisted living context

    OpenAIRE

    Kleinschmidt, Stefan; Peters, Christoph; Leimeister, Jan Marco

    2017-01-01

    Human-centered service systems (HCSSs) create value in personal interaction. This fact impedes the dissemination of HCSSs. To counter the problem, service providers in healthcare or education enable their services with information and communication technology (ICT). This approach allows to maintain or even enhance their offerings while handling a growing amount of work. However, the integration of ICT in the HCSSs requires reconfigurations for value creation and value caption. How this reconf...

  4. Virtualized Multi-Mission Operations Center (vMMOC) and its Cloud Services

    Science.gov (United States)

    Ido, Haisam Kassim

    2017-01-01

    His presentation will cover, the current and future, technical and organizational opportunities and challenges with virtualizing a multi-mission operations center. The full deployment of Goddard Space Flight Centers (GSFC) Virtualized Multi-Mission Operations Center (vMMOC) is nearly complete. The Space Science Mission Operations (SSMO) organizations spacecraft ACE, Fermi, LRO, MMS(4), OSIRIS-REx, SDO, SOHO, Swift, and Wind are in the process of being fully migrated to the vMMOC. The benefits of the vMMOC will be the normalization and the standardization of IT services, mission operations, maintenance, and development as well as ancillary services and policies such as collaboration tools, change management systems, and IT Security. The vMMOC will also provide operational efficiencies regarding hardware, IT domain expertise, training, maintenance and support.The presentation will also cover SSMO's secure Situational Awareness Dashboard in an integrated, fleet centric, cloud based web services fashion. Additionally the SSMO Telemetry as a Service (TaaS) will be covered, which allows authorized users and processes to access telemetry for the entire SSMO fleet, and for the entirety of each spacecrafts history. Both services leverage cloud services in a secure FISMA High and FedRamp environment, and also leverage distributed object stores in order to house and provide the telemetry. The services are also in the process of leveraging the cloud computing services elasticity and horizontal scalability. In the design phase is the Navigation as a Service (NaaS) which will provide a standardized, efficient, and normalized service for the fleet's space flight dynamics operations. Additional future services that may be considered are Ground Segment as a Service (GSaaS), Telemetry and Command as a Service (TCaaS), Flight Software Simulation as a Service, etc.

  5. Service of Remembrance: a comprehensive cancer center's response to bereaved family members.

    Science.gov (United States)

    Knight, Louise; Cooper, Rhonda S; Hypki, Cinder

    2012-01-01

    Comprehensive cancer centers that offer an array of clinical trials and treatment options often experience significant patient mortality rates. Bereavement resources may not be routinely incorporated into the service delivery model in these specialty hospitals. In response, an interdisciplinary team at one cancer center proposed, planned, and implemented an annual Service of Remembrance. The incorporation of music, poetry, and visual arts was important in designing a program that would provide a meaningful, spiritual experience. A community artist who designed an interactive memorial art piece played a pivotal role. This article outlines the process of institutional culture change and describes future challenges in the implementation of this type of bereavement service.

  6. Business Process Reengineering–A Case Study on Computer Center Service

    Directory of Open Access Journals (Sweden)

    Phiphopsuthipaiboon Soontorn

    2016-01-01

    Full Text Available This paper used Business process reengineering (BPR for improve operation of computer service processes in the computer center. Change of service processes were conducted by implementing four-phase: 1 Finding of current process 2 Analysis current process 3 Redesign Process 4 Applying new process and realization framework to support redesign decision making. The framework based on policies and rules of organization. Finally, the new process was implemented at the computer center. The results showed that the new process was better than the current process, time of service decrease and reduce workload.

  7. Taking it to the streets: family therapy and family-centered services.

    Science.gov (United States)

    Madsen, William C

    2014-09-01

    This article examines the interconnections between family therapy, specifically postmodern and poststructural approaches, and family-centered services. It introduces particular applications of family-centered services such as systems of care, wraparound, family-driven care, the recovery movement, and family group conferencing and then summarizes the heart of family-centered approaches as a shift in how services are provided to families. It examines the "fit" between the values and principles of family-centered practice and postmodern/poststructural approaches and then offers particular ideas and practices from these approaches that can help frontline workers inhabit a spirit of respect, connection, curiosity and hope in their work. © 2014 FPI, Inc.

  8. Variation in Veteran Identity as a Factor in Veteran-Targeted Interventions.

    Science.gov (United States)

    Hack, Samantha M; DeForge, Bruce R; Lucksted, Alicia

    2017-07-01

    The sociocultural identities that people self-assign or accept influence their interpersonal interactions and decision making. Identity-based interventions attempt to influence individuals by associating healthy behaviors with in-group membership. Outreach and educational efforts aimed at veterans may rely on "typical" veteran identity stereotypes. However, as discussed in this Open Forum, there is evidence that veteran identity is not monolithic but rather fluctuates on the basis of personal characteristics and individual military service experiences. Overall, the impact of veteran identity on veterans' health behaviors and use of health care is not known and has been understudied. A major limiting factor is the lack of a standardized measure of veteran identity that can assess variations in salience, prominence, and emotional valence.

  9. Utilization of professional mental health services according to recognition rate of mental health centers.

    Science.gov (United States)

    Lee, Hyo Jung; Ju, Young Jun; Park, Eun-Cheol

    2017-04-01

    Despite the positive effect of community-based mental health centers, the utilization of professional mental health services appears to be low. Therefore, we analyzed the relationship between regional recognition of mental health centers and utilization of professional mental health services. We used data from the Community Health Survey (2014) and e-provincial indicators. Only those living in Seoul, who responded that they were either feeling a lot of stress or depression, were included in the study. Multiple logistic regression analysis using generalized estimating equations was performed to examine both individual- and regional-level variables associated with utilization of professional mental health services. Among the 7338 participants who reported depression or stress, 646 (8.8%) had consulted a mental health professional for their symptoms. A higher recognition rate of mental health centers was associated with more utilization of professional mental health services (odds ratio [OR]=1.05, 95% confidence interval [CI]=1.03-1.07). Accessibility to professional mental health services could be improved depending on the general population's recognition and attitudes toward mental health centers. Therefore, health policy-makers need to plan appropriate strategies for changing the perception of mental health services and informing the public about both the benefits and functions of mental health centers. Copyright © 2017. Published by Elsevier B.V.

  10. Specialized stroke rehabilitation services in seven countries: Preliminary results from nine rehabilitation centers.

    Science.gov (United States)

    Langhammer, Birgitta; Becker, Frank; Sunnerhagen, Katharina S; Zhang, Tong; Du, Xiaoxia; Bushnik, Tamara; Panchenko, Maria; Keren, Ofer; Banura, Samir; Elessi, Khamis; Luzon, Fuad; Lundgren-Nilsson, Åsa; Li, Xie; Sällström, Susanne; Stanghelle, Johan Kvalvik

    2015-12-01

    There is a lack of defined levels of rehabilitation, indicating possibly random content and access to specialized services. The aim of the study was to perform a multinational descriptive study of specialized rehabilitation in persons with stroke, to elucidate what the different centers define as prerequisites for specialized rehabilitation, and to analyze whether these descriptions map to currently applied standards or constructs of specialized rehabilitation. A secondary aim was to look for similarities and differences between therapies and services for persons with stroke in the sub-acute stage in the different institutions. Descriptive data of the collaborating centers regarding structure and processes of services were recorded and compared with the British Society of Rehabilitation Medicine and Specialized Services National Definitions sets. Comparisons of the definitions showed that all centers admitted severely disabled persons with stroke, in need of complex rehabilitation, and provided high levels of physical services, with specialized equipment and facilities. However, funding, size, university affiliation, quality accreditation, staffing levels, specialist training, cognitive and vocational services, coordination of the professional teams, admission procedures, time and type of therapies, estimated length of stay, and follow-up procedures differed between the centers. This multinational study of specialized stroke rehabilitation centers shows that a universal definition of specialized rehabilitation is possible, even in quite different countries and settings, in terms of general principles. There were however differences in structures and procedures, which may influence patients' outcomes, indicating a need for refinement of the definitions to be globally applicable. © 2015 World Stroke Organization.

  11. The quality of health care services provided in health care centers of Khorramabad using SERVQUAL model in 2010

    Directory of Open Access Journals (Sweden)

    mohammad javad tarrahi

    2012-06-01

    Conclusion: Expectations of the clients in all aspects of offering services are beyond than their perceptions, and needed to improve the quality of offering services in these centers in all the dimensions especially empathy dimension. It is recommended that the quality of the offering services be assessed periodically in these centers and intervene to improve the delivering of health services.

  12. 76 FR 52272 - Technical Revisions To Conform to the Caregivers and Veterans Omnibus Health Services Act of 2010

    Science.gov (United States)

    2011-08-22

    ... active duty service in the Southwest Asia theater of operations during the Gulf War. Consistent with the... designee, approved this document and authorized the undersigned to sign and submit the document to the...

  13. Ensuring Appropriate Care for LGBT Veterans in the Veterans Health Administration.

    Science.gov (United States)

    Sharpe, Virginia Ashby; Uchendu, Uchenna S

    2014-09-01

    Within health care systems, negative perceptions of lesbian, gay, bisexual, and transgender persons have often translated into denial of services, denial of visitation rights to same-sex partners, reluctance on the part of LGBT patients to share personal information, and failure of workers to assess and recognize the unique health care needs of these patients. Other bureaucratic forms of exclusion have included documents, forms, and policies that fail to acknowledge a patient's valued relationships because of, for example, a narrow definition of "spouse," "parent," or "family." Bureaucratic exclusion has taken a particularly prominent form in the U.S. military. Until its repeal and termination in 2011, the "Don't Ask, Don't Tell" policy had for eighteen years barred openly gay men and lesbians from serving in the military. Among the effects of DADT is a dearth of information about the number and needs of LGBT service members who transition to the Veterans Health Administration for health care at the end of their military service. The long-standing social stigma against LGBT persons, the silence mandated by DADT, and the often unrecognized bias built into the fabric of bureaucratic systems make the task of creating a welcoming culture in the VHA urgent and challenging. The VHA has accepted a commitment to that task. Its Strategic Plan for fiscal years 2013 through 2018 stipulates that "[v]eterans will receive timely, high quality, personalized, safe, effective and equitable health care irrespective of geography, gender, race, age, culture or sexual orientation." To achieve this goal, the VHA undertook a number of coordinated initiatives to create an environment and culture that is informed, welcoming, positive, and empowering for the LGBT veterans and families whom the agency serves. © 2014 by The Hastings Center.

  14. Social networks, mental health problems, and mental health service utilization in OEF/OIF National Guard veterans.

    Science.gov (United States)

    Sripada, Rebecca K; Bohnert, Amy S B; Teo, Alan R; Levine, Debra S; Pfeiffer, Paul N; Bowersox, Nicholas W; Mizruchi, Mark S; Chermack, Stephen T; Ganoczy, Dara; Walters, Heather; Valenstein, Marcia

    2015-09-01

    Low social support and small social network size have been associated with a variety of negative mental health outcomes, while their impact on mental health services use is less clear. To date, few studies have examined these associations in National Guard service members, where frequency of mental health problems is high, social support may come from military as well as other sources, and services use may be suboptimal. Surveys were administered to 1448 recently returned National Guard members. Multivariable regression models assessed the associations between social support characteristics, probable mental health conditions, and service utilization. In bivariate analyses, large social network size, high social network diversity, high perceived social support, and high military unit support were each associated with lower likelihood of having a probable mental health condition (p social support (OR .90, CI .88-.92) and high unit support (OR .96, CI .94-.97) continued to be significantly associated with lower likelihood of mental health conditions. Two social support measures were associated with lower likelihood of receiving mental health services in bivariate analyses, but were not significant in adjusted models. General social support and military-specific support were robustly associated with reduced mental health symptoms in National Guard members. Policy makers, military leaders, and clinicians should attend to service members' level of support from both the community and their units and continue efforts to bolster these supports. Other strategies, such as focused outreach, may be needed to bring National Guard members with need into mental health care.

  15. Harvard Catalyst | The Clinical Translational Science Center IND/IDE Consult Service: Providing an IND/IDE Consult Service in a Decentralized Network of Academic Healthcare Centers

    Science.gov (United States)

    Winkler, Sabune J.; Bierer, Barbara E.; Wolf, Delia

    2014-01-01

    Abstract The Food and Drug Administration (FDA) regulations require sponsors of clinical investigations involving an investigational drug or device to submit an Investigational New Drug (IND) or Investigational Device Exemption (IDE) application. Strict adherence to applicable regulations is vital to the success of clinical research. Unlike most major pharmaceutical sponsors, investigator sponsors often do not fully appreciate their regulatory obligations nor have resources to ensure compliance. As a result they can place themselves and their institutions at risk. Nevertheless, investigator‐initiated clinical trials are vital to the further development of innovative drugs, biologics, and medical devices. The IND/IDE Subcommittee under the Regulatory Knowledge and Support Program at Harvard Catalyst, The Harvard Clinical and Translational Science Center worked in collaboration with Harvard and Harvard affiliated institutions to create and launch an IND/IDE Consult Service in a decentralized network of collaborating Academic Healthcare Centers (AHC). The IND/IDE Consult Service offers expertise, resources, and shared experiences to assist sponsor‐investigators and IRBs in meeting regulatory requirements for conducting and reviewing investigator‐initiated IND/IDE studies. The scope of the services provided by the Harvard Catalyst IND/IDE Consult Service are described, including the specifics of the service, lessons learned, and challenges faced, in a scalable model that builds inter‐institutional capacity. PMID:24455986

  16. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... All Measures Treatment Treatment Overview Early Intervention Veterans Cultural Considerations Women Children Older Adults Working with Families ... Immunizations Flu Vaccination Prevention / Wellness Public Health Weight Management (MOVE!) Locations Hospitals & Clinics Vet Centers Veterans Canteen ...

  17. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Performance VA Plans, Budget, & Performance VA Center for Innovation (VACI) Agency Financial Report (AFR) Budget Submission Recovery ... Home Apply for VA Care Apply Online Application Process Veteran Eligibility Active Duty Families of Veterans Women ...

  18. Joint replacement surgery in homeless veterans

    Directory of Open Access Journals (Sweden)

    Chase G. Bennett, MD

    2017-12-01

    Full Text Available Total joint arthroplasty (TJA in a homeless patient is generally considered contraindicated. Here, we report our known medical and social (housing and employment results of homeless veterans who had TJA. Thirty-seven TJAs were performed on 33 homeless patients (31 men at our hospital between November 2000 and March 2014. This was 1.2% of all TJAs. Average age was 54 years. Average hospital stay was 4.1 days. There were no major inpatient complications. Thirty-four cases had at least 1-year follow-up in any clinic within the Veterans Affairs health care system. There were no known surgery-related reoperations or readmissions. At final follow-up, 24 patients had stable housing and 9 were employed. The extensive and coordinated medical and social services that were provided to veterans from the Department of Veterans Affairs contributed to our positive results. Keywords: Homeless, Veteran, Joint replacement, Total hip, Total knee, Employment

  19. Innovation in user-centered skills and performance improvement for sustainable complex service systems.

    Science.gov (United States)

    Karwowski, Waldemar; Ahram, Tareq Z

    2012-01-01

    In order to leverage individual and organizational learning and to remain competitive in current turbulent markets it is important for employees, managers, planners and leaders to perform at high levels over time. Employee competence and skills are extremely important matters in view of the general shortage of talent and the mobility of employees with talent. Two factors emerged to have the greatest impact on the competitiveness of complex service systems: improving managerial and employee's knowledge attainment for skills, and improving the training and development of the workforce. This paper introduces the knowledge-based user-centered service design approach for sustainable skill and performance improvement in education, design and modeling of the next generation of complex service systems. The rest of the paper cover topics in human factors and sustainable business process modeling for the service industry, and illustrates the user-centered service system development cycle with the integration of systems engineering concepts in service systems. A roadmap for designing service systems of the future is discussed. The framework introduced in this paper is based on key user-centered design principles and systems engineering applications to support service competitiveness.

  20. Honoring our Nation's Veterans

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2015-11-01

    Full Text Available No abstract available. Article truncated at 150 words. Today is Armistice Day, renamed Veterans Day in 1954, to honor our Nation's Veterans. In Washington the rhetoric from both the political right and left supports our Veterans. My cynical side reminds me that this might have something to do with Veterans voting in a higher percentage than the population as a whole, but let me give the politicians this one. Serving our Country in the military is something that deserves to be honored. I was proud to serve our Veterans over 30 years at the four Department of Veterans Affairs (VA hospitals. However, the VA has had a very bad year. First, in Washington there were the resignations of the Secretary of Veterans Affairs, Eric Shinseki; the undersecretary for the Veterans Health Administration, Robert Petzel; and the undersecretary for the Veterans Benefits Administration, Allison Hickey. Locally, in the light of the VA wait scandal there were the firing of ...

  1. Identifying and overcoming implementation challenges: Experience of 59 noninstitutional long-term services and support pilot programs in the Veterans Health Administration.

    Science.gov (United States)

    Sullivan, Jennifer L; Adjognon, Omonyêlé L; Engle, Ryann L; Shin, Marlena H; Afable, Melissa K; Rudin, Whitney; White, Bert; Shay, Kenneth; Lukas, Carol VanDeusen

    2017-01-25

    From 2010 to 2013, the Department of Veterans Affairs (VA) funded a large pilot initiative to implement noninstitutional long-term services and supports (LTSS) programs to support aging Veterans. Our team evaluated implementation of 59 VA noninstitutional LTSS programs. The specific objectives of this study are to (a) examine the challenges influencing program implementation comparing active sites that remained open and inactive sites that closed during the funding period and (b) identify ways that active sites overcame the challenges they experienced. Key informant semistructured interviews occurred between 2011 and 2013. We conducted 217 telephone interviews over four time points. Content analysis was used to identify emergent themes. The study team met regularly to define each challenge, review all codes, and discuss discrepancies. For each follow-up interview with the sites, the list of established challenges was used as a priori themes. Emergent data were also coded. The challenges affecting implementation included human resources and staffing issues, infrastructure, resources allocation and geography, referrals and marketing, leadership support, and team dynamics and processes. Programs were able to overcome challenges by communicating with team members and other areas in the organization, utilizing information technology solutions, creative use of staff and flexible schedules, and obtaining additional resources. This study highlights several common challenges programs can address during the program implementation. The most often mentioned strategy was effective communication. Strategies also targeted several components of the organization including organizational functions and processes (e.g., importance of coordination within a team and across disciplines to provide good care), infrastructure (e.g., information technology and human resources), and program fit with priorities in the organization (e.g., leadership support). Anticipating potential pitfalls of

  2. 20 CFR 404.1320 - Who is a post-World War II veteran.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Who is a post-World War II veteran. 404.1320... DISABILITY INSURANCE (1950- ) Wage Credits for Veterans and Members of the Uniformed Services Post-World War II Veterans § 404.1320 Who is a post-World War II veteran. You are a post-World War II veteran if you...

  3. 38 CFR 8.30 - Appeal to Board of Veterans Appeals.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Appeal to Board of Veterans Appeals. 8.30 Section 8.30 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS NATIONAL SERVICE LIFE INSURANCE Appeals § 8.30 Appeal to Board of Veterans Appeals. (a) The provisions of Part 19 of this chapter will be followed i...

  4. How Are Race, Cultural, and Psychosocial Factors Associated With Outcomes in Veterans With Spinal Cord Injury?

    Science.gov (United States)

    Myaskovsky, Larissa; Gao, Shasha; Hausmann, Leslie R M; Bornemann, Kellee R; Burkitt, Kelly H; Switzer, Galen E; Fine, Michael J; Phillips, Samuel L; Gater, David; Spungen, Ann M; Boninger, Michael L

    2017-09-01

    To understand the role of cultural and psychosocial factors in the outcomes of veteran wheelchair users with spinal cord injury (SCI) to help clinicians identify unique factors faced by their patients and help researchers identify target variables for interventions to reduce disparities in outcomes. Cross-sectional cohort study. Three urban Veterans Affairs medical centers affiliated with academic medical centers. Of the patients (N=516) who were eligible to participate, 482 completed the interview and 439 had SCI. Because of small numbers in other race groups, analyses were restricted to white and African American participants, resulting in a final sample of 422. Not applicable. Quality of life (QOL, Veterans RAND 12-Item Health Survey); satisfaction (Client Satisfaction Questionnaire); and participation (Craig Handicap Assessment and Reporting Technique Short Form). African American Veterans reported poorer physical QOL but better mental QOL than did white Veterans. No other significant race differences were found in unadjusted analyses. Multivariable analyses showed that psychosocial factors were predominantly associated with patients' QOL outcomes and satisfaction with service, but demographic and medical factors were predominantly associated with participation outcomes. Interaction analyses showed that there was a stronger negative association between anxiety and mental QOL for African Americans than for whites, and a positive association between higher self-esteem and social integration for whites but not African Americans. Findings suggest that attempts to improve the outcomes of Veterans with SCI should focus on a tailored approach that emphasizes patients' demographic, medical, and psychosocial assets (eg, building their sense of self-esteem or increasing their feelings of mastery), while providing services targeted to their specific limitations (eg, reducing depression and anxiety). Published by Elsevier Inc.

  5. The Health and Social Isolation of American Veterans Denied Veterans Affairs Disability Compensation.

    Science.gov (United States)

    Fried, Dennis Adrian; Passannante, Marian; Helmer, Drew; Holland, Bart K; Halperin, William E

    2017-02-01

    Authors comparatively analyzed health and social isolation between U.S. military veterans denied Veterans Affairs (VA) disability compensation and veterans awarded VA disability compensation. The 2001 National Survey of Veterans was used to create a sample of 4,522 veterans denied or awarded VA disability compensation. Using the Andersen health services utilization model as a conceptual framework, multivariate logistic regression was applied to assess relationships between VA disability compensation award status, three separate domains of health, and correlates of social isolation. Results indicate that denied applicants were more likely than those awarded to have poor overall health (odds ratio [OR] = 1.45, 95% confidence interval [CI]: 1.23, 1.70), and limitations in activities of daily living (OR = 1.12, 95% CI: 1.03, 1.21). Denied applicants' physical functioning (40.3) and mental functioning (41.2) composite summary scores were not clinically different from those of awarded applicants (39.0 and 40.1, respectively), indicating that both were comparably impaired. Veterans denied VA disability compensation had poor health and functional impairments. They also experienced poverty and isolation, suggesting that they may be in need of additional supportive services. Connecting veterans to community resources could be a vital service to provide to all veterans applying for disability compensation. © 2016 National Association of Social Workers.

  6. Audit of the Transfer of DoD Service Treatment Records to the Department of Veterans Affairs

    Science.gov (United States)

    2014-07-31

    2010, an STR is a record of all essential medical, mental health, and dental care received by service members during their military career . The STR is...care repository that contains results of annual health care assessments and information from private physicians and dentists . Although the Army

  7. Spatial Data Services for Interdisciplinary Applications from the NASA Socioeconomic Data and Applications Center

    Science.gov (United States)

    Chen, R. S.; MacManus, K.; Vinay, S.; Yetman, G.

    2016-12-01

    The Socioeconomic Data and Applications Center (SEDAC), one of 12 Distributed Active Archive Centers (DAACs) in the NASA Earth Observing System Data and Information System (EOSDIS), has developed a variety of operational spatial data services aimed at providing online access, visualization, and analytic functions for geospatial socioeconomic and environmental data. These services include: open web services that implement Open Geospatial Consortium (OGC) specifications such as Web Map Service (WMS), Web Feature Service (WFS), and Web Coverage Service (WCS); spatial query services that support Web Processing Service (WPS) and Representation State Transfer (REST); and web map clients and a mobile app that utilize SEDAC and other open web services. These services may be accessed from a variety of external map clients and visualization tools such as NASA's WorldView, NOAA's Climate Explorer, and ArcGIS Online. More than 200 data layers related to population, settlements, infrastructure, agriculture, environmental pollution, land use, health, hazards, climate change and other aspects of sustainable development are available through WMS, WFS, and/or WCS. Version 2 of the SEDAC Population Estimation Service (PES) supports spatial queries through WPS and REST in the form of a user-defined polygon or circle. The PES returns an estimate of the population residing in the defined area for a specific year (2000, 2005, 2010, 2015, or 2020) based on SEDAC's Gridded Population of the World version 4 (GPWv4) dataset, together with measures of accuracy. The SEDAC Hazards Mapper and the recently released HazPop iOS mobile app enable users to easily submit spatial queries to the PES and see the results. SEDAC has developed an operational virtualized backend infrastructure to manage these services and support their continual improvement as standards change, new data and services become available, and user needs evolve. An ongoing challenge is to improve the reliability and performance

  8. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Data VA App Store National Resource Directory Grants Management Services Veterans Service Organizations Whistleblower Rights & Protections Transparency Media Room Inside the ...

  9. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Grants Management Services Veterans Service Organizations Office of Accountability & Whistleblower Protection Whistleblower Rights & Protections Transparency Media Room Inside the Media Room Public Affairs ...

  10. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Store National Resource Directory Grants Management Services Veterans Service Organizations Whistleblower Rights & ... and Friends PTSD and Communities Paginas en Espanol Apps, Videos and More Mobile ...

  11. [Out-Patient Psychosocial Cancer Counseling Centers and their Clients - Services Provided and Service Utilization by Patients and Patients' Relatives].

    Science.gov (United States)

    Giesler, JürgenM; Weis, Joachim; Schreib, Melanie; Eichhorn, Svenja; Kuhnt, Susanne; Faust, Tanja; Mehnert, Anja; Ernst, Jochen

    2015-12-01

    Psychosocial cancer counseling centers represent an increasingly important part of comprehensive psychosocial cancer care. Research on the services provided by those centers is sparse, however, as is research on person-, disease-, and treatment-related characteristics of their clients. Therefore, the present study analyzes the services provided by 26 psychosocial cancer counseling centers temporarily being funded by the German Cancer Aid as well as selected characteristics of their clients. Analyses are based on data collected during 2011 by means of a documentation system specifically designed for the purposes of psychosocial cancer counseling. Testing focuses on whether cancer patients and cancer patients' relatives differ with respect to various characteristics and the services used. The results show that psychosocial and benefit counseling represent a major part of counseling services, followed by giving information and employing relaxation techniques. Clients seek counseling primarily in early phases of disease and treatment. Women with breast cancer are over-represented among clients. Analyses also reveal significant differences between cancer patients and patients' relatives. Psychotherapeutic interventions and grief-counseling are more frequent in counseling relatives, whereas benefit counseling is more frequent in working with patients. The results emphasize the relevance of outpatient psychosocial cancer counseling. They may also help support initiatives aiming at establishing psychosocial cancer counseling targeted to the needs of each individual client. © Georg Thieme Verlag KG Stuttgart · New York.

  12. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Veterans Day Memorial Day Celebrating America's Freedoms Special Events Adaptive Sports Program Creative Arts Festival Golden Age ... Research Home About VA Research Services Programs News, Events and Media Research Topics For Veterans For Researchers ...

  13. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Media Room Inside the Media Room Public Affairs News Releases Speeches Videos Publications National Observances Veterans Day ... Research Research Home About VA Research Services Programs News, Events and Media Research Topics For Veterans For ...

  14. Evaluation of poison information services provided by a new poison information center.

    Science.gov (United States)

    Churi, Shobha; Abraham, Lovin; Ramesh, M; Narahari, M G

    2013-01-01

    The aim of this study is to assess the nature and quality of services provided by poison information center established at a tertiary-care teaching hospital, Mysore. This was a prospective observational study. The poison information center was officially established in September 2010 and began its functioning thereafter. The center is equipped with required resources and facility (e.g., text books, Poisindex, Drugdex, toll free telephone service, internet and online services) to provide poison information services. The poison information services provided by the center were recorded in documentation forms. The documentation form consists of numerous sections to collect information on: (a) Type of population (children, adult, elderly or pregnant) (b) poisoning agents (c) route of exposure (d) type of poisoning (intentional, accidental or environmental) (e) demographic details of patient (age, gender and bodyweight) (f) enquirer details (background, place of call and mode of request) (g) category and purpose of query and (h) details of provided service (information provided, mode of provision, time taken to provide information and references consulted). The nature and quality of poison information services provided was assessed using a quality assessment checklist developed in accordance with DSE/World Health Organization guidelines. Chi-Square test (χ(2)). A total of 419 queries were received by the center. A majority (n = 333; 79.5%) of the queries were asked by the doctors to provide optimal care (n = 400; 95.5%). Most of the queries were received during ward rounds (n = 201; 48.0%), followed by direct access (n = 147; 35.1%). The poison information services were predominantly provided through verbal communication (n = 352; 84.0%). Upon receipt of queries, the required service was provided immediately (n = 103; 24.6%) or within 10-20 min (n = 296; 70.6%). The queries were mainly related to intentional poisoning (n = 258; 64.5%), followed by accidental poisoning

  15. Prevalence of probable mental disorders and help-seeking behaviors among veteran and non-veteran community college students.

    Science.gov (United States)

    Fortney, John C; Curran, Geoffrey M; Hunt, Justin B; Cheney, Ann M; Lu, Liya; Valenstein, Marcia; Eisenberg, Daniel

    2016-01-01

    Millions of disadvantaged youth and returning veterans are enrolled in community colleges. Our objective was to determine the prevalence of mental disorders and help-seeking behaviors among community college students. Veterans (n=211) and non-veterans (n=554) were recruited from 11 community colleges and administered screeners for depression (PHQ-9), generalized anxiety (GAD-7), posttraumatic stress disorder (PC-PTSD), non-lethal self-injury, suicide ideation and suicide intent. The survey also asked about the perceived need for, barriers to and utilization of services. Regression analysis was used to compare prevalence between non-veterans and veterans adjusting for non-modifiable factors (age, gender and race/ethnicity). A large proportion of student veterans and non-veterans screened positive and unadjusted bivariate comparisons indicated that student veterans had a significantly higher prevalence of positive depression screens (33.1% versus 19.5%, Pdepression (OR=2.10, P=.01) and suicide ideation (OR=2.31, P=.03). Student veterans had significantly higher odds of perceiving a need for treatment than non-veterans (OR=1.93, P=.02) but were more likely to perceive stigma (beta=0.28, P=.02). Despite greater need among veterans, there were no significant differences between veterans and non-veterans in use of psychotropic medications, although veterans were more likely to receive psychotherapy (OR=2.35, P=.046). Findings highlight the substantial gap between the prevalence of probable mental health disorders and treatment seeking among community college students. Interventions are needed to link community college students to services, especially for student veterans. Copyright © 2016. Published by Elsevier Inc.

  16. Clients’ Viewpoints about the Quality of Services in the Premarital Counseling Classes in Tabriz Health Centers

    OpenAIRE

    Parvin Mohebbi; Padide Malekpour; Mahin Kamalifard; Shirin Barzanje Atri; Abdolrasoul Safaeiyan; Kamyab Alizadeh

    2014-01-01

    Background: Premarital counseling equips couples with information about all aspects of sexuality and the related health issues. This study was aimed to assess the quality of premarital counseling services in health care centers in Tabriz. Methods: A cross-sectional study was conducted on 236 randomly selected women from premarital counseling centers in Tabriz was carried out and a self-structured instrument including items on demographic characteristics, the quality of counseling conditio...

  17. Managing service potentiality of small urban centers case study: City of Sardasht, south east of Iran

    Directory of Open Access Journals (Sweden)

    Farjam Rasoul

    2017-06-01

    Finding showed that those services which are more important in role fulfillment of Sardasht market-town include: sanitation house, health, remedial centers, drugstore, dentistry, high school, pre-university, library, transportation, trading agricultural instrument, referring to the banks, foodstuff and nonfood stuffs stores, post office and telecommunication, referring to official & disciplinary centers, medical services, veterinary. And to some extent farming instruments markets doesn’t affect role fulfillment so it should be focused by those locals in charge. Also the results showed that three settlements, Khomeinishahr, Jakdan and Goharan are going to continue the role fulfillment of Sardasht market- town.

  18. Multipath protection for data center services in OpenFlow-based software defined elastic optical networks

    Science.gov (United States)

    Yang, Hui; Cheng, Lei; Yuan, Jian; Zhang, Jie; Zhao, Yongli; Lee, Young

    2015-06-01

    With the rapid growth of data center services, the elastic optical network is a very promising networking architecture to interconnect data centers because it can elastically allocate spectrum tailored for various bandwidth requirements. In case of a link failure, to ensure a high-level quality of service (QoS) for user request after the failure becomes a research focus. In light of it, in this paper, we propose and experimentally demonstrate multipath protection for data center services in OpenFlow-based software defined elastic optical network testbed aiming at improving network reliability. We first propose an OpenFlow-based software defined elastic optical network architecture for data center service protection. Then, based on the proposed architecture, multipath protection scheme is figured based on the importance level of the service. To implement the proposed scheme in the architecture, OpenFlow protocol is extended to support multipath protection in elastic optical network. The performance of our proposed multipath protection scheme is evaluated by means of experiment on our OpenFlow-based testbed. The feasibility of our proposed scheme is also demonstrated in software defined elastic optical networks.

  19. Returning Home from Iraq and Afghanistan: Assessment of Readjustment Needs of Veterans, Service Members, and Their Families

    Science.gov (United States)

    2013-01-01

    Don’t worry, we got it, Honey , you go. We got it.” And no matter what’s happening we’re not allowed to talk about that because he has to be safe...soldier, “Don’t worry, we got it, Honey , you go. We got it.” And no matter what’s happening we’re not allowed to talk about that because he has to be safe...community. Team members were told that local civilians use marijuana, crystal methamphetamine, and heroin, but service members are tested monthly, so

  20. Veterans and Homelessness

    National Research Council Canada - National Science Library

    Perl, Libby

    2007-01-01

    .... The Department of Veterans Affairs (VA) estimates that it has served approximately 300 returning veterans in its homeless programs and has identified over 1,000 more as being at risk of homelessness...

  1. Minority Veteran Report

    Data.gov (United States)

    Department of Veterans Affairs — This report is the first comprehensive report that chronicles the history of racial and ethnic minorities in the military and as Veterans, profiles characteristics...

  2. Minority Veteran Report 2014

    Data.gov (United States)

    Department of Veterans Affairs — This report is the first comprehensive report that chronicles the history of racial and ethnic minorities in the military and as Veterans, profiles characteristics...

  3. Paralyzed Veterans of America

    Science.gov (United States)

    ... Clothing Donate a Vehicle Matching Gifts Buy PVA Gear Donate Donate Now Give Monthly Planned Giving View ... PVA1946 National Veterans Wheelchair Games App Download Now TOP Contact Us Paralyzed Veterans of America 801 Eighteenth ...

  4. 20 CFR 670.700 - What are Job Corps centers' responsibilities in preparing students for placement services?

    Science.gov (United States)

    2010-04-01

    ... in preparing students for placement services? 670.700 Section 670.700 Employees' Benefits EMPLOYMENT... INVESTMENT ACT Placement and Continued Services § 670.700 What are Job Corps centers' responsibilities in preparing students for placement services? Job Corps centers must test and counsel students to assess their...

  5. 78 FR 22909 - Mondelez Global LLC, Business Services Center, Including On-Site Leased Workers From Abacus...

    Science.gov (United States)

    2013-04-17

    ... Employment and Training Administration Mondelez Global LLC, Business Services Center, Including On-Site... February 20, 2013, applicable to workers of Mondelez Global LLC, Business Services Center, including on... additional leasing agencies are part of the certified worker group at Mondelez Global LLC, Business Services...

  6. The land use and the participation of commercial and service activities in the city center

    Directory of Open Access Journals (Sweden)

    Denise de Cassia Rossetto Januzzi

    2012-04-01

    Full Text Available This paper aims to show how the activities of the tertiary sector are distributed in city center and therefore within the city of Londrina. To obtain more information the city’s center land use and occupation was studied and compared with the 90´s existing data. The research showed that the urban center´s perimeter was enlarged and that the activities were intensified in some regions. The obtained results were mapped permitting to verify how commercial activities and services have expanded. It was also possible to better understand the dynamics of land use and occupation in the studied area.

  7. Regional variation in post-stroke multidisciplinary rehabilitation care among veteran residents in community nursing homes

    Directory of Open Access Journals (Sweden)

    Jia H

    2017-03-01

    Full Text Available Huanguang Jia,1 Qinglin Pei,1 Charles T Sullivan,1 Diane C Cowper Ripley,1 Samuel S Wu,1 W Bruce Vogel,1 Xinping Wang,1 Douglas E Bidelspach,2 Jennifer L Hale-Gallardo,1 Barbara E Bates3 1Center of Innovation on Disability and Rehabilitation Research, North Florida/South Georgia Veterans Health System, Gainesville, FL, 2Physical Medicine and Rehabilitation Service, Department of Veterans Affairs, Washington, DC, 3Aleda E. Lutz VA Medical Center, Saginaw, MI, USA Introduction: Effective post-acute multidisciplinary rehabilitation therapy improves stroke survivors’ functional recovery and daily living activities. The US Department of Veterans Affairs (VA places veterans needing post-acute institutional care in private community nursing homes (CNHs. These placements are made under the same rules and regulations across the VA health care system and through individual per diem contracts between local VA facilities and CNHs. However, there is limited information about utilization of these veterans’ health services as well as the geographic variation of the service utilization. Aim: The aims of this study were to determine rehabilitation therapy and restorative nursing care utilization by veterans with stroke in VA-contracted CNHs and to assess risk-adjusted regional variations in the utilization of rehabilitation therapy and restorative nursing care. Methods: This retrospective study included all veterans diagnosed with stroke residing in VA-contracted CNHs between 2006 and 2009. Minimum Dataset (a health status assessment tool for CNH residents for the study CNHs was linked with veterans’ inpatient and outpatient data within the VA health care system. CNHs were grouped into five VA-defined geographic regions: the North Atlantic, Southeast, Midwest, Continental, and Pacific regions. A two-part model was applied estimating risk-adjusted utilization probability and average weekly utilization days. Two dependent variables were rehabilitation

  8. 38 CFR 17.40 - Additional services for indigents.

    Science.gov (United States)

    2010-07-01

    ... has authorized care at the Veterans Memorial Medical Center, any such patient determined by the U.S... MEDICAL Enrollment Provisions and Medical Benefits Package § 17.40 Additional services for indigents. In addition to the usual medical services agreed upon between the governments of the United States and the...

  9. Using the "customer service framework" to successfully implement patient- and family-centered care.

    Science.gov (United States)

    Rangachari, Pavani; Bhat, Anita; Seol, Yoon-Ho

    2011-01-01

    Despite the growing momentum toward patient- and family-centered care at the federal policy level, the organizational literature remains divided on its effectiveness, especially in regard to its key dimension of involving patients and families in treatment decisions and safety practices. Although some have argued for the universal adoption of patient involvement, others have questioned both the effectiveness and feasibility of patient involvement. In this article, we apply a well-established theoretical perspective, that is, the Service Quality Model (SQM) (also known as the "customer service framework") to the health care context, to reconcile the debate related to patient involvement. The application helps support the case for universal adoption of patient involvement and also question the arguments against it. A key contribution of the SQM lies in highlighting a set of fundamental service quality determinants emanating from basic consumer service needs. It also provides a simple framework for understanding how gaps between consumer expectations and management perceptions of those expectations can affect the gap between "expected" and "perceived" service quality from a consumer's perspective. Simultaneously, the SQM also outlines "management requirements" for the successful implementation of a customer service strategy. Applying the SQM to the health care context therefore, in addition to reconciling the debate on patient involvement, helps identify specific steps health care managers could take to successfully implement patient- and family-centered care. Correspondingly, the application also provides insights into strategies for the successful implementation of policy recommendations related to patient- and family-centered care in health care organizations.

  10. Is exposure to Agent Orange a risk factor for hepatocellular cancer?-A single-center retrospective study in the U.S. veteran population.

    Science.gov (United States)

    Krishnamurthy, Padmini; Hazratjee, Nyla; Opris, Dan; Agrawal, Sangeeta; Markert, Ronald

    2016-06-01

    Approximately 15% to 35% of those with chronic hepatitis C (CHC) related cirrhosis will develop hepatocellular cancer (HCC). With this burden increasing across the globe, identification of risk factors for HCC has become imperative. Exposure to Agent Orange has been implicated as a possible risk factor for liver cancer in a study from the Republic of Korea. However, there has been no study in U.S. veterans with CHC and cirrhosis that has evaluated exposure to Agent Orange as a risk factor for HCC. We conducted a retrospective study of U.S. military veterans diagnosed with CHC and cirrhosis over a period of 14 years to evaluate potential risk factors for HCC including exposure to Agent Orange. We retrospectively reviewed 390 patients with confirmed CHC-related cirrhosis between 2000 and 2013 and identified patients with HCC. We compared demographic, laboratory, and other clinical characteristics of patients with and without HCC. The mean age of the cohort was 51 years (SD =7.5), with the majority being male (98.5%). Seventy-nine of 390 (20.2%) patients developed HCC, diagnosed on average 8 (SD =4.8) years after diagnosis of CHC. Nearly half (49.4%) were Childs A, 40.5% were Childs B, and 10.1% were Childs C. HCC patients were more likely to be African American than non-HCC patients (40.5% vs. 25.4%, P=0.009) and to be addicted to alcohol (86.1% vs. 74.3%, P=0.027). A trend toward significance was seen in the HCC group for exposure to Agent Orange (16.5% vs. 10.0%, P=0.10) and smoking addiction (88.6% vs. 80.7%, P=0.10). Consequently, race, alcohol addiction, Agent Orange exposure, and smoking addiction were included in the multivariable logistic regression (MLR) analysis. Alcohol addiction [odds ratio (OR) =2.17; 95% confidence interval (CI), 1.07-4.43] and African American race (OR =2.07; 95% CI, 1.22-3.51) were found to be the only two definitive independent risk factors for HCC in our sample. African American race and alcohol addiction were independent risk

  11. Couple Therapy with Veterans: Early Improvements and Predictors of Early Dropout.

    Science.gov (United States)

    Fischer, Melanie S; Bhatia, Vickie; Baddeley, Jenna L; Al-Jabari, Rawya; Libet, Julian

    2017-07-28

    Family services within Veterans Affairs Medical Centers fulfill an important role in addressing relationship distress among Veterans, which is highly prevalent and comorbid with psychopathology. However, even for evidence-based couple therapies, effectiveness is weaker compared to controlled studies, maybe because many Veteran couples drop out early and do not reach the "active" treatment stage after the 3-4 session assessment. In order to improve outcomes, it is critical to identify couples at high risk for early dropout, and understand whether couples may benefit from the assessment as an intervention. The current study examined (a) demographics, treatment delivery mode, relationship satisfaction, and psychological symptoms as predictors of dropout during and immediately following the assessment phase, and (b) changes in relationship satisfaction during assessment. 174 couples completed questionnaires during routine intake procedures. The main analyses focused on 140 male Veterans and their female civilian partners; 36.43% dropped out during the assessment phase and 24.74% of the remaining couples immediately following the first treatment session. More severe depressive symptoms in non-Veteran partners were associated with dropout during assessment. Relationship satisfaction improved significantly during the assessment phase for couples who did not drop out, with larger gains for non-Veteran partners. No demographics or treatment delivery mode were associated with dropout. Although more research is needed on engaging couples at risk for early dropout and maximizing early benefits, the findings suggest that clinicians should attend to the civilian partner's and Veteran's depressive symptoms at intake and consider the assessment part of active treatment. © 2017 Family Process Institute.

  12. Faith-Based Organizations and Veteran Reintegration

    Science.gov (United States)

    Werber, Laura; Derose, Kathryn Pitkin; Rudnick, Mollie; Harrell, Margaret C.; Naranjo, Diana

    2015-01-01

    Abstract Faith-based organizations (FBOs) are an important community-based resource for veterans as they readjust to civilian life. Through interviews with both national-level and smaller, local FBOs, the authors sought to understand better the current and potential roles for FBOs in veteran reintegration. Interviewees suggested that veterans may look to FBOs for support because they offer privacy and confidentiality, two features that may be especially critical when a potential stigma is involved. Some FBOs have also developed a reputation as safe places for veterans, providing supportive, judgment-free environments. FBOs not only help veterans with spiritual matters but address diverse areas of veteran health and wellness, including vocation, education, financial and legal stability, shelter, access to goods and services, mental health, access to health care, physical health, family, and social networks. In some cases, the support is offered to veterans directly; in other instances, the support is indirect, via training individuals to help veterans or educating the public about them. In the process of providing support, FBOs interact with varied organizations, including government entities, private nonprofits, and one another, for training, outreach, referrals, information exchange, obtaining donations, and collaboration. Yet challenges exist, including insufficient connections with chaplains working in different settings and others in the web of support, resource and capacity constraints, lack of awareness of experience with veterans, issues related to religious philosophy or orientation, and characteristics of veterans themselves. To move forward, the authors offer recommendations for policymakers, organizations that interact with FBOs, and FBOs themselves to help FBOs engage fully in the web of reintegration support. PMID:28083391

  13. Behavioral Health and Service Use Among Civilian Wives of Service Members and Veterans: Evidence from the National Survey of Drug Use and Health

    Science.gov (United States)

    2015-01-01

    residents of micropolitan and small towns and rural areas. • Military wives living close to an MTF showed lower use of behavioral health services than...residing in rural areas was negatively associated with behavioral health care service use for both groups. That is, women who lived small towns or...comparison group. Compared with those living in urban cores of metropolitan areas, people in noncore areas, small towns , or rural areas are less likely to

  14. Psychotherapy for Depression in Older Veterans Via Telemedicine: Effect on Quality of Life, Satisfaction, Treatment Credibility, and Service Delivery Perception.

    Science.gov (United States)

    Egede, Leonard E; Acierno, Ron; Knapp, Rebecca G; Walker, Rebekah J; Payne, Elizabeth H; Frueh, B Christopher

    2016-12-01

    To analyze the impact of telepsychology and same-room care on functioning, satisfaction, and perception of care based on a noninferiority trial of psychotherapy delivered via telemedicine or same-room care to elderly patients with depression. 241 elderly patients with depression (meeting DSM-IV diagnostic criteria) were randomly assigned to either telemedicine (n = 120) or same-room treatment (n = 121) between April 1, 2007, and July 31, 2011. The primary outcomes included quality of life (36-item Short Form Survey [SF-36]), satisfaction (Charleston Psychiatric Outpatient Satisfaction Scale), treatment credibility, and service delivery perception scores obtained at 4 weeks, 8 weeks, 3 months, and 12 months. Comparisons of intervention means were carried out at each time point using independent sample t tests and SAS Procedure MIANALYZE to combine results across the multiply imputed complete data sets. If significant differences were detected for a given outcome within a domain, a Bonferroni correction was applied to determine if significance was maintained. None of the SF-36 scores showed a significant difference between the 2 treatment groups by the end of the study period, with little significance shown throughout the intermediate time points. Similarly, over all time points, there was no statistically significant difference in patient satisfaction or treatment credibility. This study found that telemedicine is a viable alternative modality for providing evidence-based psychotherapy for elderly patients with depression. Results provide evidence that quality of life and satisfaction with care are not adversely influenced by the decision to use a telehealth modality instead of in-person treatment, and, as a result, resources can be devoted to offering services in patients' homes through telemedicine. ClinicalTrials.gov identifier: NCT00324701.

  15. 78 FR 45996 - Interagency Task Force on Veterans Small Business Development

    Science.gov (United States)

    2013-07-30

    ... goals for small business concerns owned and controlled by veterans (VOB's) and service-disabled veterans... emailed prior to the meeting for inclusion in the public record, verbal presentations; however, will be...

  16. 75 FR 62438 - Interagency Task Force on Veterans Small Business Development Meeting

    Science.gov (United States)

    2010-10-08

    ... concerns owned and controlled by veterans (VOB's) and service-disabled veterans (SDVOSB'S). Moreover, the... to the meeting for inclusion in the public record, verbal presentations; however, will be limited to...

  17. 78 FR 21492 - Interagency Task Force on Veterans Small Business Development

    Science.gov (United States)

    2013-04-10

    ... small business concerns owned and controlled by veterans (VOB's) and service-disabled veterans (SDVOSB'S... emailed prior to the meeting for inclusion in the public record, verbal presentations; however, will be...

  18. 78 FR 70087 - Interagency Task Force on Veterans Small Business Development

    Science.gov (United States)

    2013-11-22

    ... small business concerns owned and controlled by veterans (VOB's) and service-disabled veterans (SDVOSB'S... emailed prior to the meeting for inclusion in the public record, verbal presentations; however, will be...

  19. 77 FR 71471 - Interagency Task Force on Veterans Small Business Development; Notice of Meeting

    Science.gov (United States)

    2012-11-30

    ... veterans (VOB's) and service-disabled veterans (SDVOSB'S). Moreover, the Task Force shall coordinate... ``six focus areas'' of the Task Force and emailed prior to the meeting for inclusion in the public...

  20. 78 FR 23970 - Interagency Task Force on Veterans Small Business Development

    Science.gov (United States)

    2013-04-23

    ... business concerns owned and controlled by veterans (VOB's) and service-disabled veterans (SDVOSB'S... emailed prior to the meeting for inclusion in the public record, verbal presentations; however, will be...

  1. Community-Centered Service Learning: A Transformative Lens for Teaching-Learning in Nursing.

    Science.gov (United States)

    Yancey, Nan Russell

    2016-04-01

    Although service learning has been proposed as a teaching-learning modality in response to an ongoing challenge to transform nursing education, there is a risk to community and student when service learning is poorly conceived. A community-centered service learning approach founded on a nursing theoretical perspective and community model is explored as a way to honor the wisdom and perspective of the community in changing while illuminating a new way of being a nurse in community for the nursing student. © The Author(s) 2016.

  2. Outcomes of a Freedom of Choice Reform in Community Mental Health Day Center Services.

    Science.gov (United States)

    Eklund, Mona; Markström, Urban

    2015-11-01

    A freedom-of-choice reform within mental health day center services was evaluated. The reform aimed to (1) facilitate users' change between units and (2) increase the availability of service providers. Seventy-eight users responded to questionnaires about the reform, empowerment, social network, engagement and satisfaction and were followed-up after 15 months. Fifty-four percent knew about the reform. A majority stated the reform meant nothing to them; ~25 % had a negative and ~20 % a positive opinion. Satisfaction with the services had decreased after 15 months. Empowerment decreased for a more intensively followed subgroup. No positive consequences of the reform could thus be discerned.

  3. Family-Centered Care for Children Needing Specialized Health and Developmental Services. Third Edition.

    Science.gov (United States)

    Shelton, Terri L.; Stepanek, Jennifer Smith

    This monograph articulates eight key elements of a family-centered approach to policy and practice for children needing specialized health and developmental services. An introductory section reviews the development of the first edition of the monograph in 1987 and its widespread dissemination and acceptance since that time. Each of the following…

  4. Racial Differences in Perceptions of Social Support in Consumer-Centered Services

    Science.gov (United States)

    Woodward, Amanda Toler; Mowbray, Carol T.; Holter, Mark C.; Bybee, Deborah

    2007-01-01

    The purpose of this study was to explore potential racial differences in the experience of support offered by consumer-centered services for adults with serious mental illness. The study used hierarchical linear modeling to examine the level of support consumers report receiving from programs and the extent to which program-level characteristics…

  5. Steps to Service; A Handbook of Procedures for the School Media Center.

    Science.gov (United States)

    Nickel, Mildred L.

    Designed as a practical aid to staff members, this guide outlines the functional procedures in a modern school media center and offers practical suggestions for facilitating service to students and teachers. Administrative procedures are described in terms of budgeting; the selection and evaluation of materials; and the technical aspects of…

  6. Hazardous Waste Cleanup: Niagara Mohawk Power Corporation – Seventh North Service Center in Liverpool, New York

    Science.gov (United States)

    Niagara Mohawk Power Corporation (NMPC) - Seventh North Service Center is located on an approximately 119 acre-parcel of property located in the Town of Clay, Onondaga County, New York. The facility is located in an industrially zoned area, and is bordered

  7. 77 FR 64386 - Agency Information Collection Activities (Per Diem for Nursing Home Care of Veterans in State...

    Science.gov (United States)

    2012-10-19

    ... AFFAIRS Agency Information Collection Activities (Per Diem for Nursing Home Care of Veterans in State Homes; Per Diem for Adult Day Care of Veterans in State Homes) Under OMB Review AGENCY: Veterans Health... day health services care to Veterans. VA requires facilities providing nursing home and adult day...

  8. 78 FR 46421 - Proposed Information Collection (Per Diem for Nursing Home Care of Veterans in State Homes; Per...

    Science.gov (United States)

    2013-07-31

    ... AFFAIRS Proposed Information Collection (Per Diem for Nursing Home Care of Veterans in State Homes; Per Diem for Adult Day Care of Veterans in State Homes): Comment Request AGENCY: Veterans Health... home and adult day health services care to Veterans. VA requires facilities providing nursing home and...

  9. US veterans and their unique issues: enhancing health care professional awareness.

    Science.gov (United States)

    Olenick, Maria; Flowers, Monica; Diaz, Valerie J

    2015-01-01

    United States veterans are a multifaceted population with a distinct culture that includes, but is not limited to, values, customs, ethos, selfless duty, codes of conduct, implicit patterns of communication, and obedience to command. Veterans experience mental health disorders, substance use disorders, post-traumatic stress, and traumatic brain injury at disproportionate rates compared to their civilian counterparts. Eighteen to 22 American veterans commit suicide daily and young veterans aged 18-44 are most at risk. Health care professionals must be aware of patients' military history and be able to recognize suicide-risk factors, regardless of age. Advancement in medical technology has allowed servicemen to survive their injuries but, for many, at the cost of a traumatic limb amputation and associated mental scarring. Health care professionals must be able to address physical safety concerns, as well as, emotional health of veterans. Approximately 49,933 American veterans are homeless and face the same difficulties as non-veterans in addition to service-related matters. Separation from military service and issues related to complex multiple deployments are among specifically identified veteran issues. Successful veteran reintegration into civilian life rests upon providing veterans with training that builds on their military knowledge and skill, employment post-separation from service, homelessness prevention, and mental health programs that promote civilian transition. Preparing health care providers to meet the complex needs of a vast veteran population can be facilitated by implementing veteran content into curricula that includes veteran patient simulations and case studies, and utilizes veteran clinical faculty.

  10. Lean Six Sigma in health care and the challenge of implementation of Six Sigma methodologies at a Veterans Affairs Medical Center.

    Science.gov (United States)

    Pocha, Christine

    2010-01-01

    Six Sigma and Lean Thinking are quality initiatives initially deployed in industry to improve operational efficiency leading to better quality and subsequent cost savings. The financial rationale for embarking on this quality journey is clear; applying it to today's health care remains challenging. The cost of medical care is increasing at an alarming rate; most of these cost increases are attributed to an aging population and technological advances; therefore, largely beyond control. Furthermore, health care cost increases are caused by unnecessary operational inefficiency associated with the direct medical service delivery process. This article describes the challenging journey of implementing Six Sigma methodology at a tertiary care medical center. Many lessons were learned; however, of utmost importance were team approach, "buy in" of the stakeholders, and the willingness of team members to change daily practice and to adapt new and innovative ways how health care can be delivered. Six Sigma incorporated as part of the "company's or hospital's culture" would be most desirable but the learning curve will be steep.

  11. The Cost analysis of cervical cancer screening services provided by Damavand health center in 2013

    Directory of Open Access Journals (Sweden)

    Arezoo Chouhdari

    2015-03-01

    Full Text Available Background: Today, the health sector in many countries is facing with severe resource constraints; hence it is absolutely necessary that cost-benefit and cost-effectiveness assessment have a major role in design of health services. The purpose of this study was to evaluate the cost-benefit and effectiveness of cervical cancer screening service (Pap smear test done by the health centers in Damavand County in 2013.  Methods: This is a descriptive study with cross-sectional method. All data was extracted from existing documents in Damavand health network.Cost of service screening for doing Pap smear test (manpower costs of performing the service, the cost of transferring samples, water, electricity, telephone and gas was estimated in all health centers then results, were compared with the incomes of this service.  Results: Screening program coverage was 22.3%, 6.9% and 6.05% in 2011, 2012 and 2013 respectively. All costs and incomes of units performing Pap smear screening test were calculated. Entire costs and incomes of this service during 2013 were respectively 303,009,000 and 11,640,000 RLS equal $12,227 and $496.73. Therefore, the cost-benefit ratio of this screening test was approximately 0.040.  Conclusion: The costs of units performing cervical cancer screening test in Damavand Health Center were much more than this benefit and because of a none-positive Pap smear test in spite of high cost, performing this test in Damavand health centers was not cost effective.

  12. Analysis of the Service Quality of Medical Centers Using Servqual Model (Case:Shaheed Rahnemoon Hospital

    Directory of Open Access Journals (Sweden)

    H Zare Ahmadabadi

    2007-07-01

    Full Text Available Introduction: Many organizations, especially service oriented ones, relative to their goals and mission, have a special view towards quality phenomena and its management. Methods: This paper analyzes medical service quality in one case; The internal section of Shaheed Rahnemoon Hospital Based on the basis of gap analysis model and Servqual technique. A questionnaire was designed and applied to measure expectations and perceptions of patients and personnel of the hospital. Results: On application of non-parametric statistical tests, we propose certain recommendations. These tests drive on five conceptual dimensions of service quality including intangibility, responsiveness, reliability, assurance and empathy. Results show that patients in this section were satisfied from the service provider’s responsiveness, but there are significant differences between expectations and perceptions in other dimensions. Conclusion: The service quality analysis models are useful for managers of medical centers to distinguish gaps between the two sides of service representation; patients and medical centers personnel. Ultimately, they can reinforce strengths and control weaknesses.

  13. Model of Emergency and Observation Nursing Services at the Community Health Center in East Java

    Directory of Open Access Journals (Sweden)

    Dwi Ananto Wibrata

    2017-07-01

    Full Text Available Public health centers as the spearhead of health services, also provide 'emergency and observation' nursing services, due to the high number of accidents in East Java. The purpose of this study was to develop the nurse's performance model in providing 'emergency and obeservation' nursing services at Puskesgadarsi ('Emergency and Observation' Community Health Center in East Java, using cross sectional design. The subjects of 120 nurses were selected by multi stage sampling technique. Data were collected through questionnaires and FGDs, and then analyzed using structural equation modeling to produce an model of ‘emergency and observation’ nursing service for nurses at Puskesgadarsi. Components of the model were reinforcing factors, personal factors, cognition factors, affection factors, commitment, interpersonal, reinforcement and nurse performance. Nurses can use this model in providing nursing services with due regard to their knowledge and skills, facilities and infrastructure, as well as interaction and self-reinforcement, so as to be able to perform nursing services 'emergency and observation' well.

  14. VnpPersonService

    Data.gov (United States)

    Department of Veterans Affairs — Common Web Service for VONAPP. Retrieves, creates, updates and deletes a veteranÆs VNP_PERSON record in the Corporate database for a claim selected in the GUI by the...

  15. Gender disparities in Veterans Health Administration care: importance of accounting for veteran status.

    Science.gov (United States)

    Frayne, Susan M; Yano, Elizabeth M; Nguyen, Vu Q; Yu, Wei; Ananth, Lakshmi; Chiu, Victor Y; Phibbs, Ciaran S

    2008-05-01

    In an effort to assess and reduce gender-related quality gaps, the Veterans Health Administration (VHA) has promoted gender-based research. Historically, such appraisals have often relied on secondary databases, with little attention to methodological implications of the fact that VHA provides care to some nonveteran patients. To determine whether conclusions about gender differences in utilization and cost of VHA care change after accounting for veteran status. Cross-sectional. All users of VHA in 2002 (N = 4,429,414). Veteran status, outpatient/inpatient utilization and cost, from centralized 2002 administrative files. Nonveterans accounted for 50.7% of women (the majority employees) but only 3.0% of men. Among all users, outpatient and inpatient utilization and cost were far lower in women than in men, but in the veteran subgroup these differences decreased substantially or, in the case of use and cost of outpatient care, reversed. Utilization and cost were very low among women employees; women spouses of fully disabled veterans had utilization and costs similar to those of women veterans. By gender, nonveterans represent a higher proportion of women than of men in VHA, and some large nonveteran groups have low utilization and costs; therefore, conclusions about gender disparities change substantially when veteran status is taken into account. Researchers seeking to characterize gender disparities in VHA care should address this methodological issue, to minimize risk of underestimating health care needs of women veterans and other women eligible for primary care services.

  16. The Geodetic Seamless Archive Centers Service Layer: A System Architecture for Federating Geodesy Data Repositories

    Science.gov (United States)

    McWhirter, J.; Boler, F. M.; Bock, Y.; Jamason, P.; Squibb, M. B.; Noll, C. E.; Blewitt, G.; Kreemer, C. W.

    2010-12-01

    Three geodesy Archive Centers, Scripps Orbit and Permanent Array Center (SOPAC), NASA's Crustal Dynamics Data Information System (CDDIS) and UNAVCO are engaged in a joint effort to define and develop a common Web Service Application Programming Interface (API) for accessing geodetic data holdings. This effort is funded by the NASA ROSES ACCESS Program to modernize the original GPS Seamless Archive Centers (GSAC) technology which was developed in the 1990s. A new web service interface, the GSAC-WS, is being developed to provide uniform and expanded mechanisms through which users can access our data repositories. In total, our respective archives hold tens of millions of files and contain a rich collection of site/station metadata. Though we serve similar user communities, we currently provide a range of different access methods, query services and metadata formats. This leads to a lack of consistency in the userís experience and a duplication of engineering efforts. The GSAC-WS API and its reference implementation in an underlying Java-based GSAC Service Layer (GSL) supports metadata and data queries into site/station oriented data archives. The general nature of this API makes it applicable to a broad range of data systems. The overall goals of this project include providing consistent and rich query interfaces for end users and client programs, the development of enabling technology to facilitate third party repositories in developing these web service capabilities and to enable the ability to perform data queries across a collection of federated GSAC-WS enabled repositories. A fundamental challenge faced in this project is to provide a common suite of query services across a heterogeneous collection of data yet enabling each repository to expose their specific metadata holdings. To address this challenge we are developing a "capabilities" based service where a repository can describe its specific query and metadata capabilities. Furthermore, the architecture of

  17. Helping Veterans and Their Families Fight On!

    Directory of Open Access Journals (Sweden)

    Megan Hazle

    2012-04-01

    Full Text Available This new generation of veterans is coming home to families, friends, employers, and communities that likely do not understand military culture, nor the effects that military service and reintegration have on a veteran’s life, leading to the next war – the Reintegration War. Military servicemembers, veterans, and their families face challenges within the Reintegration War that are different from their civilian counterparts and are complicated by military-specific circumstances. In order to more effectively and efficiently address the challenges servicemembers, veterans, and their families face, we need to work together in a comprehensive effort. Strategies are presented to help win the Reintegration War and ease the transition for servicemembers, veterans, and their families.

  18. US veterans and their unique issues: enhancing health care professional awareness

    Directory of Open Access Journals (Sweden)

    Olenick M

    2015-12-01

    Full Text Available Maria Olenick,1 Monica Flowers,1 Valerie J Diaz1,21Nicole Wertheim College of Nursing and Health Science, Florida International University, Miami, FL, USA; 2Operational Health Support Unit Jacksonville, United States Navy Nurse Corps, Jacksonville, FL, USAAbstract: United States veterans are a multifaceted population with a distinct culture that includes, but is not limited to, values, customs, ethos, selfless duty, codes of conduct, implicit patterns of communication, and obedience to command. Veterans experience mental health disorders, substance use disorders, post-traumatic stress, and traumatic brain injury at disproportionate rates compared to their civilian counterparts. Eighteen to 22 American veterans commit suicide daily and young veterans aged 18–44 are most at risk. Health care professionals must be aware of patients' military history and be able to recognize suicide-risk factors, regardless of age. Advancement in medical technology has allowed servicemen to survive their injuries but, for many, at the cost of a traumatic limb amputation and associated mental scarring. Health care professionals must be able to address physical safety concerns, as well as, emotional health of veterans. Approximately 49,933 American veterans are homeless and face the same difficulties as non-veterans in addition to service-related matters. Separation from military service and issues related to complex multiple deployments are among specifically identified veteran issues. Successful veteran reintegration into civilian life rests upon providing veterans with training that builds on their military knowledge and skill, employment post-separation from service, homelessness prevention, and mental health programs that promote civilian transition. Preparing health care providers to meet the complex needs of a vast veteran population can be facilitated by implementing veteran content into curricula that includes veteran patient simulations and case studies

  19. A Randomized Trial of Dialectical Behavior Therapy in High-Risk Suicidal Veterans.

    Science.gov (United States)

    Goodman, Marianne; Banthin, David; Blair, Nicholas J; Mascitelli, Kathryn A; Wilsnack, Jaime; Chen, Jennifer; Messenger, Julie W; Perez-Rodriguez, M Mercedes; Triebwasser, Joseph; Koenigsberg, Harold W; Goetz, Raymond R; Hazlett, Erin A; New, Antonia S

    2016-12-01

    Despite advances in suicide prevention implemented throughout the US Department of Veterans Affairs (VA) including the hiring of Suicide Prevention Coordinators (SPCs) at every VA hospital, enhanced monitoring, and the availability of 24-hour crisis hotline services, suicide by veterans remains a critical problem affecting 20 veterans daily. Few empirically based treatment strategies for suicide prevention for postdeployment military personnel exist. This study aimed to test whether dialectical behavior therapy (DBT), one of the few psychosocial treatments with proven efficacy in diminishing suicidal behavior in individuals with personality disorder, can be applied to veterans irrespective of personality diagnosis. From January 2010 to December 2014, 91 nonpsychotic veterans at high risk for suicide (61 men, 30 women) were randomly assigned to a 6-month treatment trial at a veterans' medical center comparing standard DBT to treatment as usual (TAU) and followed for 6 months after trial completion. Primary outcome was suicide attempts, measured with the Columbia-Suicide Severity Rating Scale, and secondary outcomes were suicide ideation, depression, hopelessness, and anxiety. There were no exclusions pertaining to substance abuse, homelessness, or medical comorbidity. Both DBT and TAU resulted in improvements in suicidal ideation, depression, and anxiety during the course of the 6-month treatment trial that did not differ between treatment arms. Survival analyses for suicide attempts and hospitalizations did not differ between treatment arms. However, DBT subjects utilized significantly more individual mental health services than TAU subjects (28.5 ± 19.6 vs 14.7 ± 10.9, F₁,₇₇ = 11.60, P = .001). This study is the first to examine 6-month DBT in a mostly male, veteran population. Increased mental health treatment service delivery, which included enhanced monitoring, outreach, and availability of a designated SPC, did not yield statistically significant

  20. Student-reported satisfaction with academic enhancement services at an academic health science center.

    Science.gov (United States)

    Gaughf, Natalie White; Foster, Penni Smith; Williams, Dara A

    2014-01-01

    Although support services are needed to address students' concerns associated with academic demands, there is little research exploring these interventions within health sciences education. The current study examined students' perceptions of academic enhancement services at an academic health science center. Academic enhancement services provided to students included assessment of learning approaches and problems interfering with academic performance. Specific services may have addressed the transition to professional school, study skills assessment and training, time management and organization, testing strategies, clarifying career goals and interests, increasing self-confidence and coping with self-doubt, coping with depression and/or anxiety, stress management, relationship issues, and/or loss and bereavement. All students receiving academic enhancement services received a survey for programmatic improvement at the end of each semester. The online survey was voluntary and anonymous and solicited feedback about the students' experiences. Sixty-three percent of respondents (N = 104; 62% female, 38% male; 62% White, 27% Black/African American, 10% Asian; 2% Hispanic) reported receiving a one-session intervention, while 34% received 2-6 sessions. Eighty-three percent of respondents reported that academic enhancement services improved their situation and 89% reported overall satisfaction. The individual services rated as most helpful addressed time management, study skills training, increasing self-confidence, and testing strategies. It is recommended that health science centers (i) consider providing brief-term academic enhancement services to students addressing time management/organization, study skills, self-confidence, and testing strategies and (ii) engage in empirical investigations of these academic interventions.

  1. Availability of Outpatient Clinical Nutrition Services for Patients With Cancer Undergoing Treatment at Comprehensive Cancer Centers.

    Science.gov (United States)

    Platek, Mary E; Johnson, Jordan; Woolf, Kathleen; Makarem, Nour; Ompad, Danielle C

    2015-01-01

    The mission of US Comprehensive Cancer Centers (CCC) is to reduce cancer morbidity and mortality. The type of clinical nutrition services available to outpatients seeking treatment at CCCs is unknown. The purpose of this cross-sectional study was to determine the prevalence and types of outpatient clinical nutrition services available at CCCs. A list of the National Cancer Institute (NCI) -designated CCCs was compiled. A telephone survey that queried clinical nutrition services available to outpatients undergoing treatment was developed. The survey was conducted with clinical nutrition personnel during usual working hours between April and October 2012. Of the 40 CCCs, 32 (80%) completed the survey. Thirty CCCs offered referral- or consult-based services with a clinical nutrition professional such as a registered dietitian (RD). Other services included nutrition classes (56%), nutrition pamphlets (94%), and counseling by non-nutrition health care providers (81%). Twenty-three of the centers monitored patients regularly, but less than half followed a clinical nutrition protocol such as those established by the Academy of Nutrition and Dietetics. Referral-based services were provided for cancers with a high prevalence of malnutrition, such as head and neck and GI, with most monitoring patients regularly but less than half using evidence-based protocols. CCCs rely on referral-based clinical nutrition service, which are not consistently a part of multidisciplinary care. An in-depth comparison of clinical nutrition services among other approaches to cancer care, including a comparison of clinical outcomes among these different approaches, is needed. Copyright © 2015 by American Society of Clinical Oncology.

  2. Helping Student Servicemembers and Veterans Succeed

    Science.gov (United States)

    Callahan, Ron; Jarrat, Dave

    2014-01-01

    Hundreds of thousands of current and former service members enter college each year, and their ranks are expected to swell as several major US military engagements overseas wind down. This article presents the following questions: (1) What is the overall success rate for student service members and veterans attending US colleges and universities;…

  3. Using secure web services to visualize poison center data for nationwide biosurveillance: a case study.

    Science.gov (United States)

    Savel, Thomas G; Bronstein, Alvin; Duck, William; Rhodes, M Barry; Lee, Brian; Stinn, John; Worthen, Katherine

    2010-01-01

    Real-time surveillance systems are valuable for timely response to public health emergencies. It has been challenging to leverage existing surveillance systems in state and local communities, and, using a centralized architecture, add new data sources and analytical capacity. Because this centralized model has proven to be difficult to maintain and enhance, the US Centers for Disease Control and Prevention (CDC) has been examining the ability to use a federated model based on secure web services architecture, with data stewardship remaining with the data provider. As a case study for this approach, the American Association of Poison Control Centers and the CDC extended an existing data warehouse via a secure web service, and shared aggregate clinical effects and case counts data by geographic region and time period. To visualize these data, CDC developed a web browser-based interface, Quicksilver, which leveraged the Google Maps API and Flot, a javascript plotting library. Two iterations of the NPDS web service were completed in 12 weeks. The visualization client, Quicksilver, was developed in four months. This implementation of web services combined with a visualization client represents incremental positive progress in transitioning national data sources like BioSense and NPDS to a federated data exchange model. Quicksilver effectively demonstrates how the use of secure web services in conjunction with a lightweight, rapidly deployed visualization client can easily integrate isolated data sources for biosurveillance.

  4. An Open Door and a Leg Up: Increasing Service-Disabled Veteran-Owned Small Business (SDVOSB) Participation in Defense Contracting Through Simplified Acquisitions (Briefing Charts)

    Science.gov (United States)

    2015-05-01

    4/1999 Rejection of Access to 8(a) Program in HR 1460 Veterans Entrepreneurship and Benefits Improvement Act of 2003 6/5/2003 Unutilized...acquisition threshold… (1) of the simplified acquisition threshold definition at 2.101), the requirement at 19.502-2(a) to exclusively reserve

  5. 77 FR 58913 - Veterans' Rural Health Advisory Committee, Notice of Meeting

    Science.gov (United States)

    2012-09-24

    ... AFFAIRS Veterans' Rural Health Advisory Committee, Notice of Meeting The Department of Veterans Affairs... provision of VA health care to enrolled Veterans residing in rural areas, and discusses ways to improve and... Office of Rural Health (ORH) Telehealth Projects funded; Louis A. Johnson Medical Center Women's Health...

  6. Quality-improvement initiatives focused on enhancing customer service in the outpatient pharmacy.

    Science.gov (United States)

    Poulin, Tenley J; Bain, Kevin T; Balderose, Bonnie K

    2015-09-01

    The development and implementation of quality-improvement initiatives to enhance customer service in an outpatient pharmacy of a Veterans Affairs (VA) medical center are described. Historically low customer service satisfaction rates with the outpatient pharmacy at the Philadelphia Veterans Affairs Medical Center prompted this quality-improvement project. A three-question survey was designed to be easily and quickly administered to veterans in the outpatient pharmacy waiting area. Using 5-point Likert scale, veterans were asked to rate (1) their overall experience with the outpatient pharmacy service and (2) their satisfaction with the customer service provided by the pharmacy department. They were also asked how they thought the pharmacy department could improve its customer service. After receiving feedback from the survey, several quality-improvement initiatives were developed. The initiatives were categorized as environmental, personnel, communicative, and technological. For each initiative, one or more tasks were developed and the initiatives were subsequently implemented over eight months. After each task was completed, veterans were surveyed to measure the impact of the change. A total of 79 veterans were surveyed before the implementation of the quality-improvement initiatives, and 49% and 68% rated their experience with the outpatient pharmacy and customer service favorably, respectively. Twenty-five veterans were surveyed after the implementation of numerous quality-improvement interventions, with 44% and 72% rating their experience with the outpatient pharmacy and customer service favorably. Customer service satisfaction with an outpatient pharmacy service at a VA medical center was enhanced through the implementation of various quality-improvement initiatives. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  7. 34 CFR 645.13 - What additional services do Upward Bound Math and Science Centers provide and how are they...

    Science.gov (United States)

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false What additional services do Upward Bound Math and... Program? § 645.13 What additional services do Upward Bound Math and Science Centers provide and how are... provided under § 645.11(b), an Upward Bound Math and Science Center must provide— (1) Intensive instruction...

  8. 78 FR 30916 - CenterPoint Energy Bakken Crude Services, LLC; Notice of Petition for Declaratory Order

    Science.gov (United States)

    2013-05-23

    ... Counties, North Dakota and transport it to an interconnection with Great Northern Gathering and Marketing... Energy Regulatory Commission CenterPoint Energy Bakken Crude Services, LLC; Notice of Petition for... Practices and Procedure, 18 CFR 385.207(a)(2)(2012), CenterPoint Energy Bakken Crude Services, LLC filed a...

  9. [Analysis of the flow of users of health services at a diagnostic center].

    Science.gov (United States)

    Serebrennikov, V A; Rasova, L K

    2000-01-01

    A marketing investigation was carried out in 1998 in the Yekaterinburg Multiprofile Diagnostic Center in order to detect the problems in the activity of this institution and adopt the managing decisions. A random sampling of 405 subjects was selected, 58.8% of them were examined at the expense of budget financing and 41.2% for extra payment. The results indicate that 50.5% patients consulting the specialists of the Center were in need of diagnosis, 26.2% needed a more accurate diagnosis of a previously diagnosed condition, 9.4% patients consulted for correcting their treatment protocols, 8.4% were followed up at the Center, and 4.9% were examined within the framework of prophylactic check-ups. Half of patients were completely satisfied, about one-third were satisfied partially, and only 2% were not satisfied at the Center. 86.9% respondents aid that they would apply into the Center again, if necessary. The main sources of information of the city and region population were local physicians (52.7%), friends and relatives previously examined at the Center (19.8%). Marketing investigations in public health become an integral part of effective management under conditions of expanding the scope of marketing services in practical medicine.

  10. 77 FR 54368 - Service Dogs

    Science.gov (United States)

    2012-09-05

    ... Service Dogs AGENCY: Department of Veterans Affairs. ACTION: Final rule. SUMMARY: The Department of Veterans Affairs (VA) amends its regulations concerning veterans in need of service dogs. Under this final... use of a service dog as part of the management of such impairments. The benefits include assistance...

  11. Epidemiologic field investigations by the Centers for Disease control and Epidemic Intelligence Service, 1946-87.

    OpenAIRE

    Goodman, R A; Bauman, C F; Gregg, M. B.; Videtto, J F; Stroup, D F; Chalmers, N P

    1990-01-01

    The epidemiologic field investigation is an important tool used by the Centers for Disease Control (CDC) to provide assistance to State, local, and international public health agencies. The Epidemic Intelligence Service (EIS) of the CDC is an ongoing program that gives physicians and other health professionals opportunities to learn and practice epidemiology. In the period 1946-87, EIS Officers and other professional staff based at CDC headquarters participated in 2,900 epidemiologic field in...

  12. THE SHARED SERVICES CENTERS OF THE MULTINATIONAL COMPANIES: LOCALIZATION AND CULTURAL CHALLENGES.

    OpenAIRE

    Patino, Marco Túlio Ospina; Almeida, Glauco Pedro de; Paseto, Luísa Amélia

    2014-01-01

    The challenges faced for Multinational Companies (MTNs) at elaboration and consolidation of their strategic planning, in a even more competitive global market, compel them to search for new alternatives to deal with this competitive environment, as well as, look for specific actions in structure and organizational development in order to increase investments and maximize profits. In this context, the MTNs adopt the model of the Shared Service Centers (SSCs) where, after identifying the essent...

  13. Chronic Childhood Trauma, Mental Health, Academic Achievement, and School-Based Health Center Mental Health Services

    OpenAIRE

    Larson, S.; Chapman, S; Spetz, J; Brindis, CD

    2017-01-01

    Children and adolescents exposed to chronic trauma have a greater risk for mental health disorders and school failure. Children and adolescents of minority racial/ethnic groups and those living in poverty are at greater risk of exposure to trauma and less likely to have access to mental health services. School-based health centers (SBHCs) may be one strategy to decrease health disparities.Empirical studies between 2003 and 2013 of US pediatric populations and of US SBHCs were included if rese...

  14. An Electronic Commerce Program for the Defence Finance and Accounting Service-Columbus Center

    Science.gov (United States)

    1991-05-01

    AD-A237 636 JU0 0 u5 11111 IN III III1 m11i AN ELECTRONIC COMMERCE PROGRAM FOR THE DEFENSE FINANCE AND ACCOUNTING SERVICE - COLUMBUS CENTER Report...MANAGEMENT INSTITUTE 6400 Goldsboro Road Bethesda, Maryland 20817-5886 91-04373 LMI Executive Summary AN ELECTRONIC COMMERCE PROGRAM FOR THE DEFENSE...some Electronic Commerce techniques, such as electronic data interchange and electronic funds transfer. We believe additional applications of those

  15. Service utilization in community health centers in China: a comparison analysis with local hospitals

    Directory of Open Access Journals (Sweden)

    Wang Xiaohang

    2006-08-01

    Full Text Available Abstract Background Being an important part of China's Urban Health Care Reform System, Community Health Centers (CHCs have been established throughout the entire country and are presently undergoing substantial reconstruction. However, the services being delivered by the CHCs are far from reaching their performance targets. In order to assess the role of the CHCs, we examined their performance in six cities located in regions of South-East China. The purpose of this investigation was to identify the utilization and the efficiency of community health resources that are able to provide basic medical and public health services. Methods The study was approved by Peking University Health Science Center Institutional Reviewing Board (NO: IRB00001052-T1. Data were collected from all the local health bureaux and processed using SPSS software. Methods of analysis mainly included: descriptive analysis, paired T-test and one-way ANOVA. Results The six main functions of the CHCs were not fully exploited and the surveys that were collected on their efficiency and utilization of resources indicate that they have a low level of performance and lack the trust of local communities. Furthermore, the CHCs seriously lack funding support and operate under difficult circumstances, and residents have less positive attitudes towards them. Conclusion The community health service must be adjusted according to the requirements of urban medical and health reform, taking into account communities' health needs. More research is required on the living standards and health needs of residents living within the CHC's range, taking into consideration the users' needs in expanding the newly implemented service, and at the same time revising the old service system so as to make the development of CHCs realistic and capable of providing a better service to patients. Several suggestions are put forward for an attainable scheme for developing a community health service.

  16. Veterans' Employment and Training Service

    Science.gov (United States)

    ... Military Spouse Employment Partnership #MSEP2017 NOTICE: Impact from Hurricanes Harvey and Irma NOTICE: In order to accommodate the needs of those impacted by Hurricanes Harvey and Irma, Federal contractors who file their VETS-4212 Reports ...

  17. Traumatic Brain Injury service (TBI) Service

    Data.gov (United States)

    Department of Veterans Affairs — This Service provides access to Tramatic Brain injury patient data consult notes. The service also provides one write service method writeNote. The Service supports...

  18. Characteristics of service requests and service processes of fire and rescue service dispatch centers: analysis of real world data and the underlying probability distributions.

    Science.gov (United States)

    Krueger, Ute; Schimmelpfeng, Katja

    2013-03-01

    A sufficient staffing level in fire and rescue dispatch centers is crucial for saving lives. Therefore, it is important to estimate the expected workload properly. For this purpose, we analyzed whether a dispatch center can be considered as a call center. Current call center publications very often model call arrivals as a non-homogeneous Poisson process. This bases on the underlying assumption of the caller's independent decision to call or not to call. In case of an emergency, however, there are often calls from more than one person reporting the same incident and thus, these calls are not independent. Therefore, this paper focuses on the dependency of calls in a fire and rescue dispatch center. We analyzed and evaluated several distributions in this setting. Results are illustrated using real-world data collected from a typical German dispatch center in Cottbus ("Leitstelle Lausitz"). We identified the Pólya distribution as being superior to the Poisson distribution in describing the call arrival rate and the Weibull distribution to be more suitable than the exponential distribution for interarrival times and service times. However, the commonly used distributions offer acceptable approximations. This is important for estimating a sufficient staffing level in practice using, e.g., the Erlang-C model.

  19. Global Land Data Assimilation System (GLDAS) Products, Services and Application from NASA Hydrology Data and Information Services Center (HDISC)

    Science.gov (United States)

    Fang, Hongliang; Beaudoing, Hiroko K.; Rodell, matthew; Teng, William L.; Vollmer, Bruce E.

    2009-01-01

    The Global Land Data Assimilation System (GLDAS) is generating a series of land surface state (e.g., soil moisture and surface temperature) and flux (e.g., evaporation and sensible heat flux) products simulated by four land surface models (CLM, Mosaic, Noah and VIC). These products are now accessible at the Hydrology Data and Information Services Center (HDISC), a component of the NASA Goddard Earth Sciences Data and Information Services Center (GES DISC). Current data holdings include a set of 1.0 degree resolution data products from the four models, covering 1979 to the present; and a 0.25 degree data product from the Noah model, covering 2000 to the present. The products are in Gridded Binary (GRIB) format and can be accessed through a number of interfaces. Users can search the products through keywords and perform on-the-fly spatial and parameter subsetting and format conversion of selected data. More advanced visualization, access and analysis capabilities will be available in the future. The long term GLDAS data are used to develop climatology of water cycle components and to explore the teleconnections of droughts and pluvial.

  20. National Coalition for Homeless Veterans

    Science.gov (United States)

    ... Continues Support of National Campaign to End Veteran Homelessness Nov. 14, 2017 This Veterans Day, Harbor Freight ... support of the national campaign to end veteran homelessness through generous contributions to the National Coalition for ...

  1. Korean War Veterans by State

    Data.gov (United States)

    Department of Veterans Affairs — The spreadsheet of Korean War Veterans by State includes the total Korean War Veteran population for each state and broken out by age and gender. It also includes...

  2. Patients' satisfaction with primary health care centers services in kuwait city, kuwait.

    Science.gov (United States)

    Al-Doghaither, A H; Abdelrhman, B M; Saeed, A A; Al-Kamil, A A; Majzoub, M M

    2001-09-01

    Assessment of patient satisfaction offers a way of optimizing health status and prevents waste of medical resources. The direct measurement of patient satisfaction is a new phenomenon in Kuwait. Assess patient satisfaction with respect to primary health care services and study any patterns of association of sociodemographic variables on the patient satisfaction level. The sample consisted of 301 patients selected systematically from five primary health care centers to represent various geographic areas in Kuwait City. Just over 56% of the sample were females, 59% were married, the great majority (70.4%) were government employees, more than 60% had a monthly income of less than 900 KD, more than 54% were intermediate and high secondary school graduates, and 37% were university graduates or had advanced degrees. The data was collected by personal interview using structured questionnaire. The overall mean satisfaction was 3.1 points out of five (62%). The mean satisfaction scores were 3.64, 3.29, 3.08, 3.05, 2.21 for laboratory, pharmacy, radiology, dental and physician services, respectively. The highest mean score for physician services was obtained for communication skills (2.23); for pharmacy services, the availability of medicine (4.01); for laboratory services, the availability of lab materials (3.73); for radiology services, the waiting time for x-ray (3.60); and for dental services, the adequacy of dentists (3.27). The results indicated that gender, income, marital status and occupation were the most consistent demographic predictors of satisfaction, with females, those with lower income, lower education levels and the unemployed having higher mean satisfaction scores. There is a need for corrective intervention in some service areas and for an educational program to inform patients of the objectives and limitations of primary health services.

  3. Provider Perception of Pharmacy Services in the Patient-Centered Medical Home.

    Science.gov (United States)

    Albanese, Nicole P; Pignato, Alyssa M; Monte, Scott V

    2017-12-01

    Despite the positive data on clinical outcomes, cost savings, and provider experience, no study has surveyed providers to evaluate what pharmacy services they find to be worthwhile. To determine what clinical, cost/access, and educational pharmacy services providers in a patient-centered medical home (PCMH) consider worthwhile and the perceived barriers to successful pharmacist incorporation. A cross-sectional online survey was distributed to primary care physicians, nurse practitioners, and physician assistants in a PCMH physician group. The survey response rate was 78%. Top-tier clinical services were identified as medication counseling, reconciliation, adherence assessment, polypharmacy assessment, and drug information. Formulary review was the only top-tier cost- or access-related service. Top-tier educational services included new black-boxed warnings, drug market withdrawals, and new drug reviews. Ninety-one percent of providers were comfortable referring to a pharmacist for diabetes medication selection and dose titration, but no other disease state eclipsed 75%. More than twice as many providers found the pharmacy service to be very or extremely valuable when the pharmacist is physically located in the office versus virtual interactions (70% vs 34%). Top-tier clinical, cost/access, and educational services considered worthwhile by providers in a PCMH have been identified. In addition to these services, when developing or evaluating a pharmacy service, special attention should be paid to provider preference for physical location in the office and perceived barriers to the pharmacist availability, concern over complex disease management competency and patient confusion as to the role of the pharmacist.

  4. Research on rural veterans: an analysis of the literature.

    Science.gov (United States)

    Weeks, William B; Wallace, Amy E; West, Alan N; Heady, Hilda R; Hawthorne, Kara

    2008-01-01

    The Veterans Health Administration (VA) provides comprehensive health care services to veterans across the United States. Recently, the VA established an Office of Rural Health to address the health care needs of rural veterans. To review the literature on rural veterans' health care needs in order to identify areas for future research. We conducted a literature review of articles listed in the Medline, CINAHL, and BIOSIS datasets since 1950. We reviewed and summarized the findings of 50 articles that specifically examined rural veterans. The literature on rural veterans included 4 articles examining access to care, 7 evaluating distance technology, 4 examining new models of care delivery, 11 studying rural veterans' patient characteristics, 10 evaluating programs provided in a rural setting, 6 examining rural health care settings, and 8 exploring rural veterans' health services utilization patterns. Most studies were small, based on data obtained before 2000, and consisted of uncontrolled, retrospective, descriptive studies of health care provided in rural VA settings. Definitions of rural were inconsistent, and in 20% of the articles examined the rural aspect of the setting was incidental to the study. The literature on rural veterans' health care needs warrants expansion and investment so that policy makers can make informed decisions in an environment of limited resources and competing interests.

  5. 78 FR 48543 - Veterans Health Administration Fund Availability Under the VA's Homeless Providers Grant and Per...

    Science.gov (United States)

    2013-08-08

    ... AFFAIRS Veterans Health Administration Fund Availability Under the VA's Homeless Providers Grant and Per... continue to deliver services to the homeless Special Need veteran population as outlined in their FY 2009.... Quarles, Director, VA's Homeless Providers GPD Program, Department of Veterans Affairs, 10770 N. 46th...

  6. 5 CFR 335.106 - Special selection procedures for certain veterans under merit promotion.

    Science.gov (United States)

    2010-01-01

    ... veterans under merit promotion. 335.106 Section 335.106 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PROMOTION AND INTERNAL PLACEMENT General Provisions § 335.106 Special selection procedures for certain veterans under merit promotion. Preference eligibles or veterans who have...

  7. Impact of the seeking safety program on clinical outcomes among homeless female veterans with psychiatric disorders.

    Science.gov (United States)

    Desai, Rani A; Harpaz-Rotem, Ilan; Najavits, Lisa M; Rosenheck, Robert A

    2008-09-01

    Seeking Safety is a manualized cognitive-behavioral therapy intervention that is designed to treat clients with comorbid substance abuse and trauma histories. This study examined its effectiveness when used with homeless women veterans with psychiatric or substance abuse problems at 11 Department of Veterans Affairs medical centers that had Homeless Women Veterans Programs. The intervention consists of 25 sessions that cover topics to help build safety in clients' lives and is present-focused, offering psychoeducation and coping skills. A cohort of homeless women veterans (N=359) was recruited before Seeking Safety was implemented (phase I). After clinicians were trained and certified in Seeking Safety, a postimplementation cohort was recruited and offered Seeking Safety treatment (phase II, N=91). Phase I lasted from January 2000 to June 2003. Phase II lasted from June 2003 to December 2005. The intervention lasted for six months. All participants were interviewed every three months for one year and received intensive case management and other services during the study. Mixed models were used to compare one-year clinical outcomes across phases. There were few differences across groups at baseline. All women entering the Homeless Women Veterans Programs showed significant improvement on most clinical outcome measures over one year. The Seeking Safety cohort reported significantly better outcomes over one year in employment, social support, general symptoms of psychiatric distress, and symptoms of posttraumatic stress disorder, particularly in the avoidance and arousal clusters. However, the Seeking Safety cohort was significantly more likely to have used drugs in the past 30 days. Seeking Safety appears to have had a moderately beneficial impact on several clinical outcomes. Although the nonequivalent comparison groups and low follow-up rates limit the internal validity of these results, availability of Seeking Safety may be of benefit for homeless female veterans

  8. Effect of the Veterans Affairs Medical System on plastic surgery residency training.

    Science.gov (United States)

    Ravin, Adam G; Gottlieb, Neil B; Wang, Howard T; Meade, Ricardo A; Humphrey, J Stewart; Schwarz, Karl W; Levin, L Scott; Tyler, Douglas S; Erdmann, Detlev

    2006-02-01

    Teaching hospitals within the Veterans Affairs Health System perform the majority of complex and high-risk surgical procedures in the veteran patient population. Residency positions in the Veterans Affairs Medical System are usually part of a rotational educational system within a university-based residency, and plastic surgeons in training are a major work force and health care provider. The purpose of this study was to evaluate the current effect of the Veterans Affairs Medical System on plastic surgery residency training. A 6-year (January of 1998 to December of 2003) review was performed of procedures completed at the Durham Veterans Affairs Medical Center, Section of Plastic Surgery. Procedures were divided into the following categories: extremities and trunk; breast and cosmetic; head and neck, including excision of skin lesions; hand surgery; craniomaxillofacial surgery; and other. Only procedures performed in the main operating room were reviewed and analyzed. In addition, a detailed review was performed of major head and neck reconstructions with free tissue transfer. A total of 1655 operative procedures were performed in 1290 patients. The ratio of men to women was 6:1 (1112 men and 178 women). Patients ranged in age from 26 to 97 years (average age, 62.7 years). Procedures in the extremities and trunk (n = 193, 11.7 percent), breast and cosmetic (n = 228, 13.8 percent), hand surgery (n = 155, 9.4 percent), and other (n = 275, 16.6 percent) categories were comparably distributed. Although the head and neck category accounted for the highest number of procedures (n = 766, 46.3 percent), the majority of these procedures were simple excisions of skin tumors (n = 612). There were significantly fewer major craniomaxillofacial cases (n = 38, 2.3 percent). Data from the retrospective analysis reveal that a broad spectrum of plastic surgical procedures is performed within the Veterans Affairs Health System, serving as a tremendous resource for resident training

  9. Predictors of smoking cessation group treatment engagement among veterans with serious mental illness.

    Science.gov (United States)

    Travaglini, Letitia E; Li, Lan; Brown, Clayton H; Bennett, Melanie E

    2017-12-01

    High prevalence rates of tobacco use, particularly cigarettes, pose a serious health threat for individuals with serious mental illness (SMI), and research has demonstrated the effectiveness of pharmacotherapy and psychosocial interventions to reduce tobacco use in this group. However, few studies have considered predictors of tobacco cessation treatment engagement among individuals with SMI. The current study examined predictors of engagement in smoking cessation groups among veterans with SMI engaged in mental health services at three VA medical centers. All veterans were participating in a smoking cessation treatment study. Of 178 veterans who completed baseline assessments, 127 (83.6%) engaged in treatment, defined as attending at least three group sessions. Forty-one (N=41) predictors across five domains (demographics, psychiatric concerns, medical concerns, smoking history, and self-efficacy to quit smoking) were identified based on previous research and clinical expertise. Using backward elimination to determine a final multivariable logistic regression model, three predictors were found to be significantly related to treatment engagement: marital status (never-married individuals more likely to engage); previous engagement in group smoking cessation services; and greater severity of positive symptoms on the Brief Psychiatric Rating Scale. When included in the multivariable logistic regression model, the full model discriminates between engagers and non-engagers reasonably well (c statistic=0.73). Major considerations based on these findings are: individuals with SMI appear to be interested in smoking cessation services; and serious psychiatric symptomatology should not discourage treatment providers from encouraging engagement in smoking cessation services. Published by Elsevier Ltd.

  10. Highlights of Space Weather Services/Capabilities at NASA/GSFC Space Weather Center

    Science.gov (United States)

    Fok, Mei-Ching; Zheng, Yihua; Hesse, Michael; Kuznetsova, Maria; Pulkkinen, Antti; Taktakishvili, Aleksandre; Mays, Leila; Chulaki, Anna; Lee, Hyesook

    2012-01-01

    The importance of space weather has been recognized world-wide. Our society depends increasingly on technological infrastructure, including the power grid as well as satellites used for communication and navigation. Such technologies, however, are vulnerable to space weather effects caused by the Sun's variability. NASA GSFC's Space Weather Center (SWC) (http://science.gsfc.nasa.gov//674/swx services/swx services.html) has developed space weather products/capabilities/services that not only respond to NASA's needs but also address broader interests by leveraging the latest scientific research results and state-of-the-art models hosted at the Community Coordinated Modeling Center (CCMC: http://ccmc.gsfc.nasa.gov). By combining forefront space weather science and models, employing an innovative and configurable dissemination system (iSWA.gsfc.nasa.gov), taking advantage of scientific expertise both in-house and from the broader community as well as fostering and actively participating in multilateral collaborations both nationally and internationally, NASA/GSFC space weather Center, as a sibling organization to CCMC, is poised to address NASA's space weather needs (and needs of various partners) and to help enhancing space weather forecasting capabilities collaboratively. With a large number of state-of-the-art physics-based models running in real-time covering the whole space weather domain, it offers predictive capabilities and a comprehensive view of space weather events throughout the solar system. In this paper, we will provide some highlights of our service products/capabilities. In particular, we will take the 23 January and the 27 January space weather events as examples to illustrate how we can use the iSWA system to track them in the interplanetary space and forecast their impacts.

  11. Universal screening for homelessness and risk for homelessness in the Veterans Health Administration.

    Science.gov (United States)

    Montgomery, Ann Elizabeth; Fargo, Jamison D; Byrne, Thomas H; Kane, Vincent R; Culhane, Dennis P

    2013-12-01

    We examined data for all veterans who completed the Veterans Health Administration's national homelessness screening instrument between October 1, 2012, and January 10, 2013. Among veterans who were not engaged with the US Department of Veterans Affairs homeless system and presented for primary care services, the prevalence of recent housing instability or homelessness was 0.9% and homelessness risk was 1.2%. Future research will refine outreach strategies, targeting of prevention resources, and development of novel interventions.

  12. Arthritis, comorbidities, and care utilization in veterans of operations enduring and Iraqi Freedom.

    Science.gov (United States)

    Rivera, Jessica C; Amuan, Megan E; Morris, Ruth M; Johnson, Anthony E; Pugh, Mary Jo

    2017-03-01

    Veteran populations are known to have frequencies of arthritis higher than civilian populations. The aim of this study is to define the prevalence of arthritis among a cohort of veterans from ongoing U.S. military operations. A retrospective cohort study using Veterans Administration data sources for service connected disability, comorbidities, clinic utilization, and pharmacy utilization was conducted including veterans who deployed in service to operations in Afghanistan or Iraq, comparing veterans with a diagnosis of arthritis, arthritis plus back pain, and veterans with no pain diagnoses. The frequency of arthritis was 11.8%. Veterans with arthritis and arthritis plus back pain had greater frequencies of diabetes, hyperlipidemia, hypertension, and obesity compare to veterans with no pain diagnosis. Veterans with arthritis plus back pain had the highest pain clinic utilization and prescription use of opioids and anti-inflammatories. Veterans with no pain diagnosis had higher frequencies of diagnosis and clinic utilization for mental health disorders. Arthritis is prevalent among the latest generation of combat veterans and is associated with diabetes, obesity, and cardiovascular comorbidities. The need for arthritis care and associated comorbidities is expected to increase as the Veterans Administration and the civilian health care sector assumes care of these veterans. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:682-687, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  13. The influence of veteran race and psychometric testing on veterans affairs posttraumatic stress disorder (PTSD) disability exam outcomes.

    Science.gov (United States)

    Marx, Brian P; Engel-Rebitzer, Eden; Bovin, Michelle J; Parker-Guilbert, Kelly S; Moshier, Samantha; Barretto, Kenneth; Szafranski, Derek; Gallagher, Matthew W; Holowka, Darren W; Rosen, Raymond C; Keane, Terence M

    2017-06-01

    This study examined the influence of veterans' race and examiners' use of psychometric testing during a Department of Veterans Affairs posttraumatic stress disorder (PTSD) disability examination on diagnostic and service connection status outcomes. Participants were 764 veterans enrolled in a national longitudinal registry. Current and lifetime PTSD diagnostic status was determined with the Structured Clinical Interview for DSM-IV (SCID) and was compared with PTSD diagnosis conferred upon veterans by their compensation and pension (C&P) examiners as well as with ultimate Veterans Affairs (VA) PTSD service connected status. The concordance rate between independent SCID current PTSD diagnosis and PTSD disability examination diagnosis was 70.4%, and between SCID lifetime PTSD diagnosis and PTSD disability examination diagnosis was 77.7%. Among veterans with current SCID diagnosed PTSD, Black veterans were significantly less likely than White veterans to receive a PTSD diagnosis from their C&P examiner (odds ratio [OR] = .39, p = .003, confidence interval [CI] = .20-.73). Among veterans without current SCID diagnosed PTSD, White veterans were significantly more likely than Black veterans to receive a PTSD diagnosis from their C&P examiner (OR = 4.07, p = .005, CI = 1.51-10.92). Splitting the sample by use of psychometric testing revealed that examinations that did not include psychometric testing demonstrated the same relation between veteran race and diagnostic concordance. However, for examinations in which psychometric testing was used, the racial disparity between SCID PTSD status and disability exam PTSD status was no longer significant. Results suggest that psychometric testing may reduce disparities in VA PTSD disability exam outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  14. An analysis of patient-provider secure messaging at two Veterans Health Administration medical centers: message content and resolution through secure messaging.

    Science.gov (United States)

    Shimada, Stephanie L; Petrakis, Beth Ann; Rothendler, James A; Zirkle, Maryan; Zhao, Shibei; Feng, Hua; Fix, Gemmae M; Ozkaynak, Mustafa; Martin, Tracey; Johnson, Sharon A; Tulu, Bengisu; Gordon, Howard S; Simon, Steven R; Woods, Susan S

    2017-09-01

    We sought to understand how patients and primary care teams use secure messaging (SM) to communicate with one another by analyzing secure message threads from 2 Department of Veterans Affairs facilities. We coded 1000 threads of SM communication sampled from 40 primary care teams. Most threads (94.5%) were initiated by patients (90.4%) or caregivers (4.1%); only 5.5% were initiated by primary care team members proactively reaching out to patients. Medication renewals and refills (47.2%), scheduling requests (17.6%), medication issues (12.9%), and health issues (12.7%) were the most common patient-initiated requests, followed by referrals (7.0%), administrative issues (6.5%), test results (5.4%), test issues (5.2%), informing messages (4.9%), comments about the patient portal or SM (4.1%), appreciation (3.9%), self-reported data (2.8%), life issues (1.5%), and complaints (1.5%). Very few messages were clinically urgent (0.7%) or contained other potentially challenging content. Message threads were mostly short (2.7 messages), comprising an average of 1.35 discrete content types. A substantial proportion of issues (24.2%) did not show any evidence of being resolved through SM. Time to response and extent of resolution via SM varied by message content. Proactive SM use by teams varied, but was most often for test results (32.7%), medication-related issues (21.8%), medication renewals (16.4%), or scheduling issues (18.2%). The majority of messages were transactional and initiated by patients or caregivers. Not all content categories were fully addressed over SM. Further education and training for both patients and clinical teams could improve the quality and efficiency of SM communication.

  15. Implementing lifestyle medicine with medication therapy management services to improve patient-centered health care.

    Science.gov (United States)

    Lenz, Thomas L; Monaghan, Michael S

    2011-01-01

    To describe a patient-centered medication therapy management (MTM) program that focuses on lifestyle medicine. Community pharmacy in Omaha, NE, from August 2008 to September 2010. Traditional MTM services are combined with lifestyle medicine interventions for employees of a self-insured organization who have dyslipidemia, hypertension, and/or diabetes. Program participants meet one-on-one with a pharmacist 12 times during the first year of the program to ensure proper drug therapy and modify lifestyle behaviors (physical activity, nutrition, weight control, sleep, stress, and alcohol and tobacco use) through individualized programming. Several patient-centered activities have been developed for the program with an emphasis on modifying lifestyle behaviors in conjunction with medications to manage participants' chronic condition. In addition, a new specialty position in health care is being developed (the ambulatist) that focuses on maintaining the ambulatory status of individuals with chronic medical conditions through appropriate drug therapy, lifestyle medicine, and care coordination. Biometric data collection and participant survey data at baseline and after 12 months. Pilot data for 15 participants showed improvements in all measurements, including blood cholesterol, low-density lipoprotein cholesterol, blood glucose, body weight, physical activity level, fruit and vegetable intake, risk for myocardial infarction, risk for any cardiovascular disease event, self-reported unhealthy days, and qualitative survey data. Pharmacists are in an ideal position to implement lifestyle medicine strategies in combination with MTM services to enhance patient-centered health care in a community pharmacy setting.

  16. Factors influencing the behavior of pregnant women towards using prenatal care services in Iranian healthcare centers

    Directory of Open Access Journals (Sweden)

    Parisa Parsa

    2018-01-01

    Full Text Available Background & aim: Care provision is one of the most important factors in preventing and reducing mortality among pregnant mothers. Despite availability, the uptake of health services in health centers is undesirable. This study aimed to investigate the factors influencing the behavior of pregnant women towards using prenatal care services based on health belief model in healthcare centers of Tuyserkan, Hamadan Province, Iran. Methods: In this descriptive, analytical, cross-sectional study, 165 mothers visiting the health care centers of Tuyserkan, Hamadan Province, Iran, 1-15 days postpartum were chosen using the convenient sampling method during 2015. A self-structured questionnaire comprising items on demographics, knowledge, and health belief model constructs was employed for data collection. The data were analyzed using Pearson correlation coefficient, independent t-test, and logistic regression. Results: The study revealed that 72.1% of the pregnant women had regular visits, while 27.9% had irregular visits. Logistic regression reflected that knowledge (OR=0.929 and self-efficacy (OR= 0.976 were effective variables on regular prenatal visits. Conclusion: Considering pregnant women's physiological and anatomical conditions, prenatal care and regular visits are essential; thus, effective interventions in this area should be planned and implemented.

  17. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available ... SuicidePreventionLifeline.org Get Help Materials Get Involved Crisis Centers About ... Live Chat Deaf - Hard of Hearing Contact Us About About the Veterans Crisis Line FAQs ...

  18. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available ... Involved Crisis Centers About Be There Show You Care Find Resources Graphic Generator Toolkit Signs of Crisis ... out for help. Bittersweet More Videos from Veterans Health Administration Watch additional videos about getting help. Be ...

  19. Help-Seeking Stigma and Mental Health Treatment Seeking Among Young Adult Veterans

    Science.gov (United States)

    Kulesza, Magdalena; Corrigan, Patrick; Marshall, Grant

    2015-01-01

    Veterans underutilize mental health services. We investigated the association between treatment seeking stigma and utilization of mental health services in a sample of 812 young adult veterans. Higher perceived public stigma of treatment seeking was significantly related to lower treatment utilization. Although many veterans were concerned about negative perceptions if they were to seek treatment, a much smaller number of them endorsed that they would judge a fellow veteran negatively in similar situation. Targeting perceived public stigma of treatment seeking, through perceived norms interventions, might help in narrowing the gap between the need and receipt of help among veterans. PMID:26664795

  20. Serotonin transporter genotype and mild traumatic brain injury independently influence resilience and perception of limitations in veterans.

    Science.gov (United States)

    Graham, David P; Helmer, Drew A; Harding, Mark J; Kosten, Thomas R; Petersen, Nancy J; Nielsen, David A

    2013-06-01

    Evidence indicates that individuals with the 5-HTTLPR variant short/short genotype have increased sensitivity to both positive and negative perceptions of perceived social support. The aim of this study was to evaluate this association among Veterans in the context of mild traumatic brain injury (TBI). As part of a larger TBI center, we performed a cross-sectional study of 67 OEF/OIF/OND Veterans (41 with TBI and 26 controls without TBI) who completed the questionnaires and consented to genetic testing. The primary measures included the Connor-Davidson Resilience Scale (CDRISC) and the Perceived Limitations in community participation subscale of the Community Reintegration of Service Members Instrument (CRIS-PL). Both 5-HTTLPR genotype and TBI status were independently associated with the CRIS-PL (p = .009 for genotype, p = .001 for TBI) and the CDRISC (p = .015 for genotype, p = .003 for TBI) scores. This study suggests that both the 5-HTTLPR genotype and TBI status independently, in an almost equal but opposite direction, influence resilience and perceived limitations to social participation. Further, resilience appears more sensitive to perceived limitations in Veterans carrying an S'S' genotype than in L' carriers, but only in the context of having sustained a TBI. While having a TBI appeared to increase a Veteran's sensitivity to social stress, the Veteran's who were L' allele carriers with a TBI fared the worst, with lower resilience and more perceived limitations for community participation compared to L' carrier Veterans without a TBI or Veterans with the S'S' genotype regardless of TBI status. Published by Elsevier Ltd.