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Journal articles on the topic 'Institution of veteran service'
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Hinojosa, Ramon, Melanie Sberna Hinojosa, and Jenny Nguyen. "Military Service and Physical Capital: Framing Musculoskeletal Disorders Among American Military Veterans Using Pierre Bourdieu’s Theory of Cultural Capital." Armed Forces & Society 45, no. 2 (December 4, 2017): 268–90. http://dx.doi.org/10.1177/0095327x17741888.
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There are 22 million veterans in the U.S. Armed Forces. Past research on the musculoskeletal health of military veterans has explored the prevalence of musculoskeletal disorders (MSDs) but largely avoids situating findings within a theoretical framework. This article uses Pierre Bourdieu’s theory of cultural capital to contextualize veteran’s greater rates of MSDs compared to nonmilitary civilians. Cultural capital consists of objectified, institutional, and embodied capital that can be transubstantiated to capital in other areas. Embodied or physical capital is central to military service, and military veteran status is beneficial in accessing social and institutional capital. Using the 2012–2014 National Health Interview Survey, we show veterans are more likely to report activity-limiting MSDs, and at younger ages, compared to nonveterans. Physical capital is central to, and impaired by, status as a veteran.
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Primack, Jennifer M., Matthew Thompson, Rachel Doyle, and Cynthia L. Battle. "Are Fathering Interventions Acceptable to Veterans? A Needs and Preferences Survey." Military Medicine 185, no. 3-4 (December 24, 2019): e410-e413. http://dx.doi.org/10.1093/milmed/usz422.
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Abstract Introduction Military deployments cause stress for both service members and their families. Returning Veterans often report significant trauma exposure, and experience increased stress and mental health problems following deployment. These factors can in turn increase family problems and parenting strain among Veterans who are parents, exacerbating mental health symptoms. Men are generally less likely to seek treatment for mental health problems, and male Veterans, in particular, report lower rates of mental health treatment use. Interventions that target fathering or parenting skills may be more acceptable and less stigmatizing to male Veterans while serving the dual function of improving parental relationships and reducing mental health symptoms. However, it is unclear whether Veteran fathers will engage in these services. Materials and Methods As a preliminary evaluation of the acceptability of fathering interventions, 50 returning Veteran fathers completed an anonymous survey designed to assess their needs and preferences regarding this type of service. All procedures were approved by the local Institutional Review Board and Research and Development Committee. Results Ninety-eight percent of participants reported experiencing at least one parenting issue either that started postdeployment or that got noticeably worse following postdeployment. The majority (86%) stated that they would be open to participating in a fathering program if offered. Conclusions Returning Veteran fathers demonstrate interest in and willingness to participate in fathering programs suggesting that parenting programs may be a way to engage Veterans in mental health care following deployment.
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Semeah, Luz M., Colleen L. Campbell, Diane C. Cowper, and Amanda C. Peet. "Serving Our Homeless Veterans: Patient Perpetrated Violence as a Barrier to Health Care Access." Journal of Public and Nonprofit Affairs 3, no. 2 (July 31, 2017): 223. http://dx.doi.org/10.20899/jpna.3.2.223-234.
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In 2009, the Department of Veterans Affairs (VA) set a goal to end veteran homelessness by 2015. Since then there has been a 36% reduction in homelessness due, in part, to the VA Supportive Housing (HUD-VASH) program. These services include the receipt of home-based services to the veterans’ home. However, safety concerns and the threat of violence toward health care workers remain problematic in non-institutional care settings. This article discusses the concept of access to care and how safety concerns act as a barrier to services and optimal patient outcomes. Our study provides information on the prevalence of patient violence toward health care workers in the HUD-VASH program in a large veterans’ health system. Results suggest 70% of home-based service providers were exposed to violence and aggression. Providing services to veterans outside of institutional care settings, and the goal of eradicating homelessness among veterans, warrants further examination of access barriers.
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Erbes, Christopher R., Eric Kuhn, Melissa A. Polusny, Josef I. Ruzek, Michele Spoont, Laura A. Meis, Elizabeth Gifford, et al. "A Pilot Trial of Online Training for Family Well-Being and Veteran Treatment Initiation for PTSD." Military Medicine 185, no. 3-4 (October 17, 2019): 401–8. http://dx.doi.org/10.1093/milmed/usz326.
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Abstract Introduction Family members are important supports for veterans with Posttrauamtic Stress Disroder (PTSD), but they often struggle with their own distress and challenges. The Veterans Affairs—Community Reinforcement and Family Training (VA-CRAFT) website was designed to teach family members of veterans with PTSD effective ways to interact with their veterans to encourage initiation of mental health services as well as to care for themselves and improve their relationships. This article presents a pilot investigation of VA-CRAFT. Materials and Method Spouse/partners of veterans who had screened positive for PTSD but were not in mental health treatment were randomized to either use the VA-CRAFT website (n = 22) or to a waitlist control condition (n = 19) for 3 months. Veteran mental health service initiation was assessed posttreatment. Spouse/partner distress, caregiver burden, quality of life, and relationship quality were assessed pre and posttreatment. The study was approved by the Minneapolis VA Health Care System Institutional Review Board (IRB). Results Differences between groups on veteran treatment initiation were small (Phi = 0.17) and not statistically significant. VA-CRAFT participants reported large and statistically significantly greater decreases in overall caregiver burden (η2 = 0.10) and objective caregiver burden (η2 = 0.14) than control participants. Effects were larger for those with greater initial distress. Effects sizes for other partner outcomes were negligible (η2 = 0.01) to medium (η2 = 0.09) and not statistically significant. Postintervention interviews suggested that only 33% of the VA-CRAFT participants talked with their veterans about starting treatment for PTSD during the trial. Conclusion Results from this pilot trial suggest that VA-CRAFT holds initial promise in reducing caregiver burden and as such it could be a useful resource for family members of veterans with PTSD. However, VA-CRAFT does not enhance veteran treatment initiation. It may benefit from enhancements to increase effectiveness and caregiver engagement.
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Pyne, Jeffrey M., P. Adam Kelly, Ellen P. Fischer, Christopher J. Miller, Patricia Wright, Kara Zamora, Christopher J. Koenig, Regina Stanley, Karen Seal, and John C. Fortney. "Development of a Perceived Access Inventory for Community Care Mental Healthcare Services for Veterans." Military Medicine 184, no. 7-8 (January 23, 2019): e301-e308. http://dx.doi.org/10.1093/milmed/usy429.
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Abstract Introduction Access to high-quality healthcare, including mental healthcare, is a high priority for the Department of Veterans Affairs (VA). Meaningful monitoring of progress will require patient-centered measures of access. To that end, we developed the Perceived Access Inventory focused on access to VA mental health services (PAI-VA). However, VA is purchasing increasing amounts of mental health services from community mental health providers. In this paper, we describe the development of a PAI for users of VA-funded community mental healthcare that incorporates access barriers unique to community care service use and compares the barriers most frequently reported by veterans using community mental health services to those most frequently reported by veterans using VA mental health services. Materials and Methods We conducted mixed qualitative and quantitative interviews with 25 veterans who had experience using community mental health services through the Veterans Choice Program (VCP). We used opt-out invitation letters to recruit veterans from three geographic regions. Data were collected on sociodemographics, rurality, symptom severity, and service satisfaction. Participants also completed two measures of perceived barriers to mental healthcare: the PAI-VA adapted to focus on access to mental healthcare in the community and Hoge’s 13-item measure. This study was reviewed and approved by the VA Central Institutional Review Board. Results Analysis of qualitative interview data identified four topics that were not addressed in the PAI-VA: veterans being billed directly by a VCP mental health provider, lack of care coordination and communication between VCP and VA mental health providers, veterans needing to travel to a VA facility to have VCP provider prescriptions filled, and delays in VCP re-authorization. To develop a PAI for community-care users, we created items corresponding to each of the four community-care-specific topics and added them to the 43-item PAI-VA. When we compared the 10 most frequently endorsed barriers to mental healthcare in this study sample to the ten most frequently endorsed by a separate sample of current VA mental healthcare users, six items were common to both groups. The four items unique to community-care were: long waits for the first mental health appointment, lack of awareness of available mental health services, short appointments, and providers’ lack of knowledge of military culture. Conclusions Four new barriers specific to veteran access to community mental healthcare were identified. These barriers, which were largely administrative rather than arising from the clinical encounter itself, were included in the PAI for community care. Study strengths include capturing access barriers from the veteran experience across three geographic regions. Weaknesses include the relatively small number of participants and data collection from an early stage of Veteran Choice Program implementation. As VA expands its coverage of community-based mental healthcare, being able to assess the success of the initiative from the perspective of program users becomes increasingly important. The 47-item PAI for community care offers a useful tool to identify barriers experienced by veterans in accessing mental healthcare in the community, overall and in specific settings, as well as to track the impact of interventions to improve access to mental healthcare.
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Haro, Elizabeth, Michael Mader, Polly H. Noël, Hector Garcia, Dawne Vogt, Nancy Bernardy, Mary Bollinger, Mary Jo V. Pugh, and Erin P. Finley. "The Impact of Trust, Satisfaction, and Perceived Quality on Preference for Setting of Future Care Among Veterans With PTSD." Military Medicine 184, no. 11-12 (April 20, 2019): e708-e714. http://dx.doi.org/10.1093/milmed/usz078.
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Abstract Introduction Among US veterans, posttraumatic stress disorder (PTSD) is a high-prevalence condition; more than a million veterans of all combat eras are service-connected for this condition. Research on factors driving veterans’ decision-making regarding preferred setting for PTSD care has been limited. The purpose of this study was to understand factors associated with preferences for setting of future PTSD care among veterans service-connected for PTSD. Materials and Methods We conducted a cross-sectional mailed survey among veterans with service connection for PTSD in Texas and Vermont identified from the Veterans Services Network Corporate Mini Master File (VETSNET). Survey items were intended to elucidate PTSD healthcare decision-making and queried utilization, perceived need for care, and satisfaction and preferences for VA, community, and/or military setting for receipt of future PTSD care. Logistic regression was used to identify factors associated with preference for care setting. UT Health San Antonio’s Institutional Review Board determined this quality improvement project to be non-research. Results Veterans (n = 2,327) were surveyed with an overall response rate of 37.1%. Most veterans (72.4%) identified VA as a preferred site for their future PTSD care; a substantial, but smaller, number of veterans identified being interested in receiving care in community (39.9%) and military (12.7%) settings. Factors associated with preferences for future care setting included demographics (e.g., ethnicity, income), availability of healthcare coverage, prior experiences of care, and attitudes related to perceived quality of care and trust in VA. Conclusions These findings suggest that it is important to retain foundational mental health services within VA, as well as to continue to invest in building provider and network capacity in community settings, to ensure alignment with veteran preferences for care setting.
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Kincaid, Jenevieve, Elaine Reno, Jay Lemery, and Todd Miner. "Disaster First Responder Training: A Train-the-Trainer Veterans Program to Combat PTSD." Prehospital and Disaster Medicine 34, s1 (May 2019): s10. http://dx.doi.org/10.1017/s1049023x19000402.
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Introduction:There are many health challenges faced by those returning from military service. Posttraumatic stress disorder (PTSD) is a serious problem in veterans. PTSD is a risk factor for suicide in veterans. Standard treatments include medication and talk therapy. Non-traditional treatments include civil service and leadership training.Aim:Assess the effectiveness of Veteran Focused Train-the-Trainer (TTT) Community Disaster Response and First Aid (DRAFA) Programs in promoting health, wellness, reintegration, and decreasing PTSD symptoms of veterans.Methods:A longitudinal cohort study was conducted using a convenience sample of veterans living in Denver, Colorado or Reno, Nevada. The sample size was over 50 (N=50+), with 25+ case-matched veterans at each location. This is an ongoing project lasting through the end of 2020. Inclusion criteria selected veterans interested in DRAFA training and education. Exclusion criteria disqualified those who are not a veteran or those unable to perform physical tasks required by curriculum. The null hypothesis was that there is no relationship between the DRAFA TTT program and the health, well-being, and reintegration of veterans back into their communities. Statistical tools used were SPSS Statistics (Version 25) and NVivo 12-12.2.0.3262. Research activities were conducted under the auspices of the University of Colorado and guided by the principles of the Institutional Review Board (IRB).Results:Results are being evaluated using a mixed methods impact model. The main outcomes measured health, wellness, and reintegration using Veterans RAND-12 Health Quality of Life Survey, the Military to Civilian Reintegration Survey, and a satisfaction survey. Preliminary analysis may indicate a correlation between participation in the DRAFA TTT program and improved health/wellness outcomes, better reintegration into society, and decreased PTSD.Discussion:There is growing evidence that expedited structured reintegration programs in community preparedness and disaster leadership roles for veterans alleviate PTSD symptoms and improves quality of life.
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Ward, Carol J., Curtis Child, Bret L. Hicken, S. Matthew Stearmer, Michael R. Cope, Scott R. Sanders, and Jorden E. Jackson. "“We Got an Invite into the Fortress”: VA-Community Partnerships for Meeting Veterans’ Healthcare Needs." International Journal of Environmental Research and Public Health 18, no. 16 (August 6, 2021): 8334. http://dx.doi.org/10.3390/ijerph18168334.
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Responding to identified needs for increased veterans’ access to healthcare, in 2010 the United States Department of Veterans Affairs (VA) launched the Veteran Community Partnership (VCP) initiative to “foster seamless access to, and transitions among, the full continuum of non-institutional extended care and support services in VA and the community”. This initiative represents an important effort by VA to promote collaboration with a broad range of community organizations as equal partners in the service of veteran needs. The purpose of the study is an initial assessment of the VCP program. Focus group interviews conducted in six sites in 2015 included 53 representatives of the local VA and community organizations involved with rural and urban VCPs across the US. Interview topics included the experiences and practices of VCP members, perceived benefits and challenges, and the characteristics and dynamics of rural and urban areas served by VCPs. Using a community-oriented conceptual framework, the analyses address VCP processes and preliminary outcomes, including VCP goals and activities, and VCP members’ perceptions of their efforts, benefits, challenges, and achievements. The results indicate largely positive perceptions of the VCP initiative and its early outcomes by both community and VA participants. Benefits and challenges vary by rural-urban community context and include resource limitations and the potential for VA dominance of other VCP partners. Although all VCPs identified significant benefits and challenges, time and resource constraints and local organizational dynamics varied by rural and urban context. Significant investments in VCPs will be required to increase their impacts.
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Kuzmin, Vyacheslav, and Ekatherina Borodina. "Technologies of social rehabilitation in improving the quality of life of disabled living in stationary social service institutions." Collection of humanitarian researches, no. 1(26) (May 20, 2021): 27–34. http://dx.doi.org/10.21626/j-chr/2021-1(26)/4.
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The article is devoted to the analysis of a sociological study conducted with the aim of studying technologies that contribute to improving the quality of life of people with disabilities living in stationary social service institutions The article discusses the quality of the services provided, the level of competence and benevolence of the staff of the Kursk boarding house for war and labor veterans; identifies the needs and opportunities of disabled people in the types of social rehabilitation. The ways to improve the quality of life of people with disabilities in a stationary institution of social services have been identified; trends in the development of life difficulties of disabled people; needs for types of assistance. The opinion of the surveyed citizens on the improvement of the health care system was investigated.
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Landefeld, C. Seth, Gary E. Rosenthal, John Aucott, Christopher C. Whalen, Jackson T. Wright, Wahoub Hout, Andre Midgette, Jonathan I. Ravdin, and David C. Aron. "The Cleveland Veterans Affairs Medical Center Firm System." International Journal of Technology Assessment in Health Care 8, no. 02 (March 1992): 325–34. http://dx.doi.org/10.1017/s0266462300013556.
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AbstractHospital-based “firms” provide a means for combatting the fragmentation experienced by both patients and caregivers in the modern teaching hospital environment. A “firm” is an academic group practice that includes attending physicians, physician trainees, nurses, other staff, and patients. Each person's relationship with a firm lasts throughout his or her association with a particular institution. This article describes the firm system that was recently implemented on the Medical Service of the Cleveland VAMC. This system incorporates both inpatient and outpatient general medical services and provides for unbiased assignment of patients, physicians, and nurses.
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Taylor, Zachary W. "At Attention: What Student Veteran Mission Statements Say About Public Flagships." IRA International Journal of Education and Multidisciplinary Studies (ISSN 2455-2526) 8, no. 1 (August 10, 2017): 130. http://dx.doi.org/10.21013/jems.v8.n1.p13.
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Expanding Wilson, Meyer, and McNeal’s (2012) work focusing on university mission statements, this study further explicates the values expressed by public flagship institutions (n = 50) through the linguistic examination of student veteran services mission statements disseminated by student veterans services offices, representing a gap in the literature. A quantitative linguistic analysis reveals only 24% of student veteran services offices feature official mission statements on their websites, these mission statements do not support extant research or the U.S. Department of Education’s guidelines for supporting student veterans, and mission statements do not directly address student veterans, evidenced by first- and third-person pronouns. Implications for student veteran support and adult learning are addressed.
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McNeil, Julie, Catherine Johnson, and Dean Krahn. "Implementation and outcomes of a pharmacy managed clinic for veterans in a substance abuse residential rehabilitation treatment program." Mental Health Clinician 1, no. 2 (August 1, 2011): 25–28. http://dx.doi.org/10.9740/mhc.n77171.
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ABSTRACT Purpose: The purpose of this study is to evaluate the impact of a newly implemented pharmacy managed service in a Substance Abuse Residential Rehabilitation Treatment Program (SARRTP) within a Veterans Medical Center setting. Patients receiving residential treatment may have a lapse in primary care services if their primary care provider is based out of a different facility. This can result in undesirable outcomes, including unnecessary emergency department (ED) visits or unaddressed medical needs. Additionally, these patients have often made significant lifestyle modifications that can have a major impact on the treatment of their chronic medical conditions. A pharmacy-managed clinic was created for these patients to provide medication therapy management as appropriate within the scope of a pharmacist. Methods: A retrospective chart review was performed using the Computerized Patient Record System to assess outcomes of the newly implemented pharmacy managed clinic for SARRTP patients. Institutional Review Board approval was obtained prior to data collection. Outcomes assessed included number of ED visits before and after clinic initiation, as well as number and type of pharmacist interventions. Fisher's exact test was used to determine statistical significance, defined as p<0.05. Results: Thirty-seven patients were seen in a total of 46 clinic visits over a period of six months. ED visits had a statistically significant decrease of 27.9% following clinic initiation (p<0.05). There was an average of 4.3 problems assessed per patient. Average number of interventions per patient was 2.7 with an average of 3.5 educational topics documented. Conclusion: ED visits decreased significantly following clinic initiation, resulting in cost savings. Multiple interventions were made through this new clinical service to improve Veteran care. Lifestyle modifications made by this patient population often require therapy adjustments and education to optimize care. This type of innovative clinical service would likely be beneficial for other facilities to consider providing.
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Sergeyeva, E. A., and T. A. Pogorelskaya. "DIAGNOSTICS AND IMPROVEMENT OF THE PERSONNEL POLICY IN A MEDICAL ORGANIZATION." Scientific Review: Theory and Practice 10, no. 10 (October 30, 2020): 2480–90. http://dx.doi.org/10.35679/2226-0226-2020-10-10-2480-2490.
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Personnel policy in the health care institution is one of the main activities, which contains a system of methods and principles implemented by the personnel department of the organization. Only under the condition of a systematic analysis of the activities of a health care institution and an assessment of human potential, a personnel strategy is it possible to competently and effectively manage the medical personnel. The issues of forming an effective personnel policy in a medical institution in the modern conditions of global reform of the industry are not sufficiently covered in the open press. The materials of the study were data on the composition and structure of the personnel of the medical institution “Stavropol Regional Hospital for War Veterans”, and the regulations governing the activities of the personnel service. To identify the type of personnel policy and its main components, the methods of questioning and statistical processing of information were used. As a result of the study, the type of personnel policy of the hospital was determined, namely, the institution adopted a reactive personnel policy, since the efforts of the personnel service and the management of the organization are mainly aimed at tracking the causes and consequences of negative aspects related to personnel. In terms of the degree of openness and the level of interaction with the environment, personnel policy is more characterized by a closed type, which is typical for medical organizations and is explained by the specifics of their activities. A new type of personnel policy is proposed, which is adequate to the modern conditions of the external environment in which the hospital operates, namely, a strategically oriented personnel policy, the main characteristics of which will be, firstly, the correct ratio of openness and closedness towards the external environment, and, secondly, high flexibility and quick adaptability to the changes in the external and internal environment, including those in the long term. The article will be of interest to managers and employees of the personnel service of medical organizations responsible for the formation of personnel policy.
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Ryan, Shawn W., Aaron H. Carlstrom, Kenneth F. Hughey, and Brandonn S. Harris. "From Boots to Books: Applying Schlossberg's Model to Transitioning American Veterans." NACADA Journal 31, no. 1 (March 1, 2011): 55–63. http://dx.doi.org/10.12930/0271-9517-31.1.55.
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This introduction to the strengths, needs, and challenges of veterans as they transition from the military to higher education is presented within the framework of Schlossberg's transition model (Schlossberg, Waters, & Goodman, 1995). Academic advisors must understand the way that veteran transitions to college are both similar to and different from those of the general student population so they can explore relevant topics and help connect student-veterans to appropriate supports and services that facilitate their personal and academic success. Advisors are given questions to employ in soliciting information about the ways they and their institutions can better serve student-veterans.
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Grant, Shakira J., Lindsay M. Hannan, Jessica L. Brand, Robert E. Richard, Daniel Y. Wu, Solomon A. Graf, Jonathan Grim, Nicholas Burwick, and Thomas R. Chauncey. "Impact of Neurocognitive Dysfunction in a Veteran Population Undergoing First Outpatient Autologous Hematopoietic Stem Cell Transplantation for Multiple Myeloma." Blood 134, Supplement_1 (November 13, 2019): 5883. http://dx.doi.org/10.1182/blood-2019-122580.
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INTRODUCTION Older adults (age > 70 years) with multiple myeloma (MM) are at higher risk of early mortality partly due to age-related factors, including impairments of cognition and function. To date, few studies have investigated the prevalence of neurocognitive impairment prior to autologous hematopoietic stem cell transplantation (ASCT) and its impact on post-transplant outcomes. We hypothesize, for patients with MM undergoing first outpatient ASCT, age >70 years or the presence of comorbid neurocognitive dysfunction decreases the time to first unplanned hospitalization occurring within 30 days post ASCT, and increases the overall length of stay (LOS) on the transplant service. METHODS We conducted a retrospective cohort study of 76 consecutive patients who underwent first ASCT at the Puget Sound Veterans Health Administration, for MM between January 2017 and December 2018. Patients with the following were excluded: amyloidosis, anaplastic plasmacytoma, and POEMS. Comprehensive psychological evaluations performed within 30 days prior to ASCT included: cognitive screening [Montreal Cognitive Assessment (MOCA)], depression [Patient Health Questionnaire-9 (PHQ-9)], and anxiety [General Anxiety Disorder- 7 (GAD-7)]. Functional status was assessed by activities of daily living (ADLS) and instrumental activities of daily living (IADLS). Data sources for table 1, included the institutional stem cell transplant database, and comprehensive electronic medical record review for each patient. This included vital status as of 7/15/19. Total LOS on the transplant service was measured as the time from arrival until discharge post-engraftment. For eligible patients, all portions of ASCT, including, stem cell collection, conditioning and stem cell infusion were completed as an outpatient. Statistical analyses were performed using SAS version 9.4. Kaplan Meier curves were generated to explore the association of cognitive scores and 1) time until first unplanned hospitalization within 30 days post-ASCT and 2) outpatient LOS on the stem cell transplant service. RESULTS Of the 76 patients undergoing ASCT, median age was 67 (range 40-79), 29% (22/76) were ≥ 70 years old . 67% (51/76) underwent ASCT within 1 year from diagnosis. The majority (73/76) scored ≥ 70 on a provider-assessed Karnofsky performance scale. Of those with MOCA scores available (n=64), impairments in cognition ranged from suspected mild cognitive impairment (MOCA 20-25) to probable cognitive impairment (MOCA 15-19), in 50% (32/64) and 6%( 8/64) of patients respectively. Those with MOCA scores< 26 were more likely to have ≥ 1 IADL impairment compared to those with scores ≥ 26 (Fisher Exact p=0.014). A total of 19 patients underwent planned hospitalization for conditioning followed by stem cell rescue, and therefore were not included in our analysis of unplanned hospitalization. Of the 57% (33/59) of patients with an unplanned inpatient admission within 30 days post-ASCT, the median time to first admission was 11 days. A total of 61% (17/28) and 53%(10/19) patients with MOCA <26 and ≥26, respectively, required hospitalization post-ASCT (log-rank p-value=0.70). There was no difference in the time to first unplanned hospitalization by age (<70, ≥70 years; log-rank p-value 0.58). Median time spent on the transplant service was 78 days (range 30 - 118). Suspected cognitive impairment did not influence time on the outpatient transplant service (median: 79 days MOCA <26 and 77 days MOCA ≥ 26, log-rank p-value=0.38). Median number of days on the transplant service differed by age group (log-rank p-value=0.02),) 76 vs 79 days in those age <70 and ≥70 respectively. CONCLUSION We found a high prevalence of cognitive impairment in MM patients undergoing first ASCT. However, we found no significant association between cognitive impairment or age and 30-day unplanned hospitalization. Older age (>70 years) was associated with a longer transplant service LOS. Thus, select older patients may have higher utilization of hospital resources post-ASCT compared to their younger counterparts. However confounding variables and selection bias may have influenced these preliminary results and additional analyses are ongoing. Future studies will evaluate the impact of age and pre-transplant neurocognitive function on additional outcomes, including longitudinal neurocognitive deterioration and impact on long-term morbidity and mortality. Disclosures Graf: TG Therapeutics: Research Funding; AstraZeneca: Research Funding; BeiGene: Research Funding.
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Mills, Chloe Persian, Emily Bounds Paladino, and Jacqueline Courtney Klentzin. "Student veterans and the academic library." Reference Services Review 43, no. 2 (June 8, 2015): 262–79. http://dx.doi.org/10.1108/rsr-10-2014-0049.
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Purpose – The purpose of this study is to investigate whether student veterans have specific library-related needs and how librarians can best meet them. Design/methodology/approach – Researchers developed a survey which was administered both online and in paper copies. The survey results indicated need for further investigation; six face-to-face interviews with volunteers were conducted. Findings – Principle findings were that while student veterans do resemble nontraditional students in their needs and characteristics, important distinctions from that population could be noted. In addition, dedicated student veteran centers and/or offices provide librarians with the best possible means of communications with this particular population. Research limitations/implications – This case study demonstrates that individual institutions are well-served to investigate the specific characteristics of their own student veteran population. Librarians can utilize outreach to student veterans through their institution’s veteran center (if available), and may wish to employ the specific outreach practices detailed in the study. Originality/value – Virtually no other qualitative or quantitative research regarding the specific needs and characteristics of this academic population exists in the literature of the library sciences, and the academic literature that does address the population, coming from the student services arena, does not include mention of academic libraries.
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Almklov, Erin, Niloofar Afari, Elizabeth Floto, Laurie Lindamer, Samantha Hurst, and James O. E. Pittman. "Post-9/11 Veteran Satisfaction With the VA eScreening Program." Military Medicine 185, no. 3-4 (February 15, 2020): 519–29. http://dx.doi.org/10.1093/milmed/usz324.
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Abstract Introduction eScreening is a mobile health technology resource for veterans and staff to support Veterans Health Administration initiatives such as early identification of health problems, shared decision-making, and measurement-based care. Methods We conducted an exploratory mixed methods retrospective study with newly enrolling post-9/11 veterans to (1) understand eScreening user experience and obtain practical feedback on the technology to guide improvements, (2) assess veteran satisfaction with eScreening following improvements to the technology, and (3) examine veteran characteristics associated with eScreening satisfaction. Focus group data were collected on user experience with eScreening from a sample of veterans who participated in an eScreening pilot. Guided by a user-centered design approach, findings informed improvements to the technology. Survey data were subsequently collected from a large cohort of veterans to assess satisfaction with the improved program. Questionnaire data were also collected to examine variables associated with eScreening satisfaction. Qualitative focus group data were analyzed using content analysis. Descriptive statistics were used to characterize sociodemographic variables, questionnaires, and satisfaction ratings. Correlations were run to examine the relationship between certain veteran characteristics (eg, age, resiliency, anxiety, insomnia, post-traumatic stress disorder, somatic symptoms, depression, pain) and satisfaction with eScreening. All research activities were conducted at VA San Diego Healthcare System and approved by the Institutional Review Board. Results Focus group data revealed that veterans were largely satisfied with eScreening, but they suggested some improvements (eg, to interface functionality), which were integrated into an updated version of eScreening. Following these changes, survey data revealed that veterans were highly satisfied with eScreening, including its usability, information security, and impact on health services. There were statistically significant, though not clinically meaningful relationships between health-related characteristics and satisfaction with eScreening. However, millennials showed significantly higher satisfaction ratings compared with non-millennials. Conclusions These findings support the use of patient experiences and feedback to aide product development. In addition, post-9/11 veterans support the use of eScreening to assist health screening. However, evaluating the eScreening program in more diverse veteran groups and Veterans Affairs settings is needed to improve the generalizability of these findings to the larger veteran population.
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Prasada, Sahil, Cecil Rambarat, David Winchester, and Ki Park. "Implementation and Impact of Home-Based Cardiac Rehabilitation in a Veterans Affair Medical Center." Military Medicine 185, no. 5-6 (October 28, 2019): e859-e863. http://dx.doi.org/10.1093/milmed/usz366.
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Abstract Introduction In patients with prior myocardial infarction (MI), cardiac rehabilitation (CR) has been shown to reduce all-cause mortality, cardiac mortality, and risk of recurrent MI. Medically supervised cardiac rehab has challenges such as increased patient and center cost, patient transportation issues, patient time commitment, and increased need for resources. Home-based cardiac rehabilitation (HBCR) is an innovative alternative to medically supervised CR which can help to address some of the aforementioned issues. HBCR has been shown to have similar patient outcomes when compared to medically supervised CR; however, implantation efforts and experiences within Veteran Affair (VA) facilities were limited. Thus, we sought to describe our implementation efforts and outcomes of HBCR at our VA medical center, since our VA medical center does not offer an on-site medically supervised CR program. Materials and Methods The project was not reviewed by our institutional review board as this quality improvement project was determined by our VA medical service chief to not qualify as human subjects research. Veterans eligible for CR in our VA medical system were enrolled in a 12-week HBCR program. Veterans performed exercise training at home with equipment provided at no cost. In addition, participating veterans received nutrition counseling, smoking cessation encouragement, stress management, and psychosocial consultation through weekly telephone calls performed by registered nurses. Progress was measured using Life’s Simple 7, Duke Activity status index, 6-minute walk test, and Short Form Health Survey (SF-36) before and after HBCR. Medical records were monitored for death, MI, and readmission to the hospital for CHF within the VA medical system for 1 year after the program was complete. SAS and R were used for data input and analysis. Results Data from 213 veterans were available for analysis and 136 of these veterans completed the HBCR program; the 95 veterans who did not complete the program either declined enrollment, discontinued follow-up with this program, or failed to actively participate and thus were removed from the program. Veterans who completed the 12-week HBCR program reported significant improvement, when compared before and after HBCR program, in Simple 7, Duke Activity status index metabolic equivalent of tasks, 6-minute walk test, SF-36 physical functioning, SF-36 bodily pain, and SF-36 vitality. Overall survival and recurrent MIs were similar between the veterans who completed and the veterans who did not complete the HBCR program in the 1 year follow-up. Hospital admission for heart failure in the 1-year follow-up was lower among veterans who completed the HBCR program when compared to the veterans who did not complete the HBCR program. Conclusions HBCR is an effective alternative to facility-based CR. Veterans who completed the program showed improvement in physical capacity and functional status. Compared to those who were eligible but did not complete the program, hospitalization for heart failure was reduced after completing HBCR.
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Delasos, Lukas, Anna Kookoolis, Meghana Singh, Alla Turshudzhyan, Nerea Lopetegui-Lia, and Radhika Kulkarni. "Differences in rates of low-dose computed tomography screening for lung cancer amongst various outpatient care centers." Journal of Clinical Oncology 38, no. 29_suppl (October 10, 2020): 245. http://dx.doi.org/10.1200/jco.2020.38.29_suppl.245.
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245 Background: Despite low-dose computed tomography (LDCT) screening for lung cancer recommended by the United States Preventive Services Task Force (USPSTF) demonstrating a relative reduction in mortality, there remains low rates of testing nationwide. Yet studies are limited regarding specific differences in screening rates amongst various outpatient care settings. Methods: We performed retrospective chart reviews of patients followed by resident providers within an academic internal medicine residency program who met USPSTF guidelines for lung cancer screening between 2015-2020. This was conducted at three separate outpatient clinic sites including a state-funded academic institution, inner city community health center, and veteran affairs medical center. Data collection included patient demographic and smoking histories as well as rates of ordered and completed LDCT screening. Results: A total of 832 patients were identified as current or former smokers between the ages of 55 and 80 years: 320 from Hartford Hospital Community Health Center (HHCHC), 262 from University of Connecticut Health Center (UCHC), and 250 from the Veteran Affairs (VA) Medical Center. 85 (27%) of these patients from HHCHC, 84 (32%) from UCHC, and 56 (22%) from the VA met USPSTF eligibility criteria for LDCT screening. Overall compliance rates of screening were found to be 44% at HHCHC, 59.5% at UCHC, and 51.8% at the VA. Results are outlined in Table. Conclusions: Screening rates for lung cancer with LDCT remain low but have been steadily improving throughout the United States following new recommendations and increased awareness provided by multiple medical organizations. We sought to compare differences in compliance rates amongst various outpatient clinics within the same internal medicine residency program at University of Connecticut. Our findings demonstrate significant differences in LDCT screening for lung cancer between the program’s community health center versus its state and federally funded outpatient clinics. Automatic reminders to providers can potentially improve rates of lung cancer screening. Patients should also be educated about the importance of screening to improve adherence with imaging. [Table: see text]
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Suharyati, Suharyati, and Ika Nurlaili Isnainiyah. "Education of Internet Marketing for Traditional Craftsmen of Baduy." MITRA: Jurnal Pemberdayaan Masyarakat 3, no. 2 (November 26, 2019): 130–40. http://dx.doi.org/10.25170/mitra.v3i2.843.
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Regulation of the Minister of Home Affairs of the Republic of Indonesia No.1 of 2013 explain that the Indonesian government continues to strive to alleviate poverty and improve the welfare of the population through community empowerment activities. The 4.0 industrial revolution era triggered the digital technology trend, especially the internet to support product marketing, e.g. by reducing marketing costs and labor costs. However, the lack of technological knowledge is undeniable on a number of Indonesian population, such as MSME entrepreneurs of Outer Baduy traditional craftsmen in the Kanekes village. Government support is needed through ongoing activities with higher education institutions to provide education and assistance on product marketing (internet marketing). Community service held by lecturers from the Faculty of Economics, UPN Veteran Jakarta, aims to empower and raise the knowledge of the Outer Baduy community regarding internet marketing education and practice using social media. The approach used in this activity consists of talks, module creation, tutorials and practice on product marketing strategies using social media such as Instagram and Facebook. Based on the questionnaire analysis results, it is identified that the understanding of social media features for the promotion, networking and marketing expansion from participants has reached 68,57%.
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Benedict, Timothy M., Michael D. Singleton, Arthur J. Nitz, Tracie L. Shing, and Joseph R. Kardouni. "Effect of Chronic Low Back Pain and Post-Traumatic Stress Disorder on the Risk for Separation from the US Army." Military Medicine 184, no. 9-10 (February 22, 2019): 431–39. http://dx.doi.org/10.1093/milmed/usz020.
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AbstractIntroductionCo-morbid post-traumatic stress disorder (PTSD) and low back pain (LBP) are common reasons for increased disability in the Veteran communities. Medical discharge from the military represents a considerable financial cost to society. Little is currently known about the impact of LBP and PTSD as longitudinal risk factors for medical discharge from Active Duty military service.Materials and MethodsA retrospective analysis of US Army Active Duty Soldiers from 2002 to 2012 was performed to determine the risk for medical discharge. Four levels of exposure for were identified as independent variables: no chronic LBP or PTSD, chronic LBP only, PTSD only, and co-morbid PTSD present with chronic LBP. Statistical analysis utilized modified Poisson regression controlling for sex, age, rank, time in service, deployment, mental health, sleep disorders, alcohol use, tobacco use, obesity, and military occupation. This study was approved by a Department of Defense Institutional Review Board.ResultsAfter controlling for potential confounding variables, the RR for chronic LBP and PTSD independently was 3.65 (95% CI: 3.59–3.72) and 3.64 (95% CI: 3.53–3.75), respectively, and 5.17 (95% CI: 5.01–5.33) when both were present.ConclusionsThis is the first study to identify a history of both chronic LBP and PTSD as substantial risk factors for medical discharge from the US Army. PTSD and chronic LBP may mutually reinforce one another and deplete active coping strategies, making Soldiers less likely to be able to continue military service. Future research should target therapies for co-morbid PTSD and chronic LBP as these conditions contribute a substantial increase in risk of medical discharge from the US Army.
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Shepherd-Banigan, Megan, Valerie A. Smith, Karen M. Stechuchak, Katherine E. M. Miller, Susan Nicole Hastings, Gilbert Darryl Wieland, Maren K. Olsen, et al. "Comprehensive Support for Family Caregivers of Post-9/11 Veterans Increases Veteran Utilization of Long-term Services and Supports: A Propensity Score Analysis." INQUIRY: The Journal of Health Care Organization, Provision, and Financing 55 (January 1, 2018): 004695801876291. http://dx.doi.org/10.1177/0046958018762914.
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Family caregivers are an important component of the long-term services and supports (LTSS) system. However, caregiving may have negative consequences for caregiver physical and emotional health. Connecting caregivers to formal short-term home- and community-based services (HCBS), through information resources and referrals, might alleviate family caregiver burden and delay nursing home entry for the patient. The aim of this study was to evaluate the early impact of the Program of Comprehensive Assistance for Family Caregivers (PCAFC) (established by P.L. 111-163 for family caregivers of seriously injured post-9/11 Veterans) on Veteran use of LTSS. A two-cohort pre-post design with a nonequivalent comparison group (treated n = 15 650; comparison n = 8339) was used to (1) examine the association between caregiver enrollment in PCAFC and any VA-purchased or VA-provided LTSS use among Veterans and (2) describe program-related trends in HCBS and institutional LTSS use. The comparison group was an inverse-propensity-score weighted sample of Veterans whose caregivers applied for, but were not accepted into, the program. From baseline through 24 months post application, use of any LTSS ranged from 13.1% to 17.8% for Veterans whose caregivers were enrolled in PCAFC versus from 3.8% to 5.3% for Veterans in the comparison group. Participation in PCAFC was associated with a statistically significant increased use of any LTSS from 1 to 24 months post application (over time odds ratios ranged from 2.71 [95% confidence interval: 2.31-3.17] to 4.86 [3.93-6.02]). Support for family caregivers may enhance utilization of LTSS for Veterans with physical, emotional, and/or cognitive conditions.
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Smith, Claire Elizabeth Powers, Pat Coke, Monica Kluger, Arif Kamal, and Michael J. Kelley. "National trends in end of life care for veterans with advanced cancer." Journal of Clinical Oncology 36, no. 30_suppl (October 20, 2018): 3. http://dx.doi.org/10.1200/jco.2018.36.30_suppl.3.
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3 Background: It is imperative to provide quality end of life (EOL) care for cancer patients. This entails minimizing aggressive measures at the EOL. Although rates of hospice utilization within the Veteran’s Health Administration have improved, chemotherapy administration and intensive care unit (ICU) admission at the EOL, indicators of aggressive care, are not clearly declining over recent years. Methods: We identified 32,665 veterans diagnosed with stage IV lung, colorectal, or pancreatic cancer who died between 2009-2016 using VA cancer registry and Corporate Data Warehouse data through a novel EOL Dashboard Tool, which has been validated at multiple VA sites. This EOL tool reports three indicators; incidence of chemotherapy use in the last 14 days of life, ICU admission in the last 30 days of life and hospice admission or consult. Change over time, 2009-2016, was assessed using a repeated measures one-way ANOVA with post hoc test for linear trend of time for individual cancers and two-way ANOVA for all cancers combined. Results: Chemotherapy use in the last 14 days of life declined from 6.8% in 2009 to 4.4% in 2016 (p < 0.05). ICU admission in the last 30 days did not change significantly, from 13.3% in 2009 to 14.7% in 2016. The exception was stage IV lung cancer patients in whom ICU admissions increased from 12.9% to 16.2% (p = 0.01). Patients utilizing hospice services increased from 32.4% to 52.6% (p < 0.01). When combined for all years in an unadjusted analysis by VA regional network (VISN), chemotherapy use ranged geographically from 4.2% to 8.1% and for ICU admission from 8.4% to 18.0%. Conclusions: While chemotherapy administration at the EOL is declining for veterans with stage IV cancer, ICU admissions are unchanged and becoming more common in stage IV lung cancer despite increasing hospice utilization. Compared to prior Medicare reports, veterans have similar rates of EOL chemotherapy use and fewer EOL ICU admissions, adding to a growing body of literature showing that despite veterans having poorer health and utilizing more medical resources, the VA performs at or above non-veteran health care institutions on end of life cancer care. There is notable geographic variation in aggressive EOL care.
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Dillard, Robert J., and Helen H. Yu. "Best Practices in Student Veteran Education: Making a “Veteran-Friendly” Institution." Journal of Continuing Higher Education 64, no. 3 (September 2016): 181–86. http://dx.doi.org/10.1080/07377363.2016.1229106.
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Shorr, Ronald I., Sherry Ahrentzen, Stephen L. Luther, Chad Radwan, Bridget Hahm, Mahshad Kazemzadeh, Slande Alliance, Gail Powell-Cope, and Gary M. Fischer. "Examining the Relationship Between Environmental Factors and Inpatient Hospital Falls: Protocol for a Mixed Methods Study." JMIR Research Protocols 10, no. 7 (July 13, 2021): e24974. http://dx.doi.org/10.2196/24974.
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Background Patient falls are the most common adverse events reported in hospitals. Although it is well understood that the physical hospital environment contributes to nearly 40% of severe or fatal hospital falls, there are significant gaps in the knowledge about the relationship between inpatient unit design and fall rates. The few studies that have examined unit design have been conducted in a single hospital (non-Veterans Health Administration [VHA]) or a small number of inpatient units, limiting generalizability. The goal of this study is to identify unit design factors contributing to inpatient falls in the VHA. Objective The first aim of the study is to investigate frontline and management perceptions of and experiences with veteran falls as they pertain to inpatient environmental factors. An iterative rapid assessment process will be used to analyze the data. Interview findings will directly inform the development of an environmental assessment survey to be conducted as part of aim 2 and to contribute to interpretation of aim 2. The second aim of this study is to quantify unit design factors and compare spatial and environmental factors of units with higher- versus lower-than-expected fall rates. Methods We will first conduct walk-through interviews with facility personnel in 10 medical/surgical units at 3 VHA medical centers to identify environmental fall risk factors. Data will be used to finalize an environmental assessment survey for nurse managers and facilities managers. We will then use fall data from the VA Inpatient Evaluation Center and patient data from additional sources to identify 50 medical/surgical nursing units with higher- and lower-than-expected fall rates. We will measure spatial factors by analyzing computer-aided design files of unit floorplans and environmental factors from the environmental assessment survey. Statistical tests will be performed to identify design factors that distinguish high and low outliers. Results The VA Health Services Research and Development Service approved funding for the study. The research protocol was approved by institutional review boards and VA research committees at both sites. Data collection started in February 2018. Results of the data analysis are expected by February 2022. Data collection and analysis was completed for aim 1 with a manuscript of results in progress. For aim 2, the medical/surgical units were categorized into higher- and lower-than-expected fall categories, the environmental assessment surveys were distributed to facility managers and nurse managers. Data to measure spatial characteristics are being compiled. Conclusions To our knowledge, this study is the first to objectively identify spatial risks for falls in hospitals within in a large multihospital system. Findings can contribute to evidence-based design guidelines for hospitals such as those of the Facility Guidelines Institute and the Department of Veterans Affairs. The metrics for characterizing spatial features are quantitative indices that could be incorporated in larger scale contextual studies examining contributors to falls, which to date often exclude physical environmental factors at the unit level. Space syntax measures could be used as physical environmental factors in future research examining a range of contextual factors—social, personal, organizational, and environmental—that contribute to patient falls. International Registered Report Identifier (IRRID) DERR1-10.2196/24974
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Bonura, Kimberlee Bethany, and Nicole Lovald. "Military Cultural Competency: Understanding How to Serve Those Who Serve." Higher Learning Research Communications 5, no. 2 (June 26, 2015): 4. http://dx.doi.org/10.18870/hlrc.v5i2.226.
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<p>Institutions of higher education who serve military populations need clear understanding of federal regulations and of military organization best practices in education. They also need a baseline understanding of the broader military population, as well as the unique challenges and opportunities for military subgroups, based on branch, type, and extent of service. The intent of this article is to provide a baseline understanding of military populations, including the unique needs, challenges, and opportunities for service to population subgroups (i.e., active duty service members, prior service members, including disabled veterans and retirees, and military family members). Overall, we propose that “military cultural competence” is a unique cultural competence which is necessary to develop both at the institutional level and for individual staff and faculty, in order to ensure appropriate service for military students in higher education.</p>
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Shin, David H., Kristopher G. Hooten, Brian D. Sindelar, Brian M. Corliss, William R. Y. Carlton, Christopher P. Carroll, Jeffrey M. Tomlin, and W. Christopher Fox. "Direct enhancement of readiness for wartime critical specialties by civilian-military partnerships for neurosurgical care: residency training and beyond." Neurosurgical Focus 45, no. 6 (December 2018): E17. http://dx.doi.org/10.3171/2018.8.focus18387.
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Military neurosurgery has played an integral role in the development and innovation of neurosurgery and neurocritical care in treating battlefield injuries. It is of paramount importance to continue to train and prepare the next generation of military neurosurgeons. For the Army, this is currently primarily achieved through the military neurosurgery residency at the National Capital Consortium and through full-time out-service positions at the Veterans Affairs–Department of Defense partnerships with the University of Florida, the University of Texas–San Antonio, and Baylor University. The authors describe the application process for military neurosurgery residency and highlight the training imparted to residents in a busy academic and level I trauma center at the University of Florida, with a focus on how case variety and volume at this particular civilian-partnered institution produces neurosurgeons who are prepared for the complexities of the battlefield. Further emphasis is also placed on collaboration for research as well as continuing education to maintain the skills of nondeployed neurosurgeons. With ongoing uncertainty regarding future conflict, it is critical to preserve and expand these civilian-military partnerships to maintain a standard level of readiness in order to face the unknown with the confidence befitting a military neurosurgeon.
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Derrien, Monika M., Lee K. Cerveny, and David G. Havlick. "Outdoor Programs for Veterans: Public Land Policies and Practices to Support Therapeutic Opportunities." Journal of Forestry 118, no. 5 (June 14, 2020): 534–47. http://dx.doi.org/10.1093/jofore/fvaa023.
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Abstract Many veterans returning from military deployment experience stress- or trauma-related symptoms that make reintegration with civilian society difficult. Nature exposure and outdoor recreation can be important parts of alternative and complementary approaches to reduce symptoms and build on veterans’ pre-existing strengths. Multiple outdoor programs now exist for veterans; many of these occur on federal public lands and present a variety of needs, opportunities, and challenges. This paper relies on interviews (n = 36) with public land managers, program providers and participants, health professionals, and veterans to enhance understanding about outdoor programs for veterans (OPVs). We develop a typology of OPVs to help land managers understand current and potential programs, and then describe programs’ varying dimensions. We examine opportunities and challenges for land managers in their interactions with OPVs. Results inform policymakers and public officials interested in developing more effective institutional partnerships and programs that engage and serve veterans and their communities. Study Implications: With growing scientific evidence of the benefits of nature-based therapy, nature exposure, and outdoor recreation for veterans, programming for veterans on public lands has proliferated. Public land-management agencies vary in the extent to which they have systematically organized to provide opportunities for veterans, developed partnerships to support veterans’ health, and explicitly acknowledged agency roles in serving veterans. We describe seven types of outdoor programs for veterans (OPVs) that currently serve this population: supported outdoor activity; guided outdoor activity; retreat; outdoor job training; stewardship or service; horticulture, farming or gardening; and animal-assisted therapy. Each OPV type has different needs for infrastructure, outdoor spaces, and administrative or programmatic engagement. OPVs occurring on public lands typically involve one or more partner organizations, such as commercial outfitters and guides, health providers, veterans’ associations, foundations, corporations, and research institutions. There is potential for public land-management agencies to expand their role as institutional leaders in support of veterans’ health by facilitating the use of public lands as therapeutic landscapes. By enhancing new and existing relations with OPV providers, health providers, and other government agencies, public land agencies could expand benefits to veterans and spur broader societal benefits.
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Gee, Ellen M., and A. Margeny Boyce. "Veterans and Veterans Legislation in Canada: An Historical Overview." Canadian Journal on Aging / La Revue canadienne du vieillissement 7, no. 3 (1988): 204–17. http://dx.doi.org/10.1017/s0714980800007923.
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ABSTRACTThis article provides a descriptive account of the history of Canadian veterans and veterans legislation focussing upon five time periods: pre–1918; 1918–1939; 1939–1950; 1950–1980; and the present time. Emphasis is placed on issues and legislation relating to aging and elderly persons, with particular concentration on pensions and health. It is shoivn that veterans legislation and veterans issues have played a facilitating role in the development of Canadian health and social services, and argued that a social historical perspective on aging provides for an enhanced understanding of current age-related institutions, services and policies.
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Moore, Colin D. "Innovation without Reputation: How Bureaucrats Saved the Veterans’ Health Care System." Perspectives on Politics 13, no. 2 (June 2015): 327–44. http://dx.doi.org/10.1017/s1537592715000067.
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The Veterans Health Administration (VA) is among the most unusual and misunderstood institutions in the American welfare state. Unlike most American social services, veterans’ medical care continues to be administered directly by the state, contrary to the “antibureaucratic strategy” of “hidden” or “submerged” state-building that has dominated US social policy for decades. Drawing on extensive archival research, I attempt to make sense of the VA’s unique policy trajectory by exploring two puzzling episodes of institutional change in the delivery of veterans’ health care. Although many bureaucratic models predict large new undertakings initiated by agencies only when they benefit from the advantages of being well-regarded and relatively autonomous, both instances of institutional change occurred at the nadir of the VA’s reputation as a competent, innovative, and politically-powerful agency. To explain these unexpected transformations, I investigate the role of bureaucrats in shaping the development of the American welfare state and develop the concept of collaborative state-building to demonstrate how public-private partnerships may contribute to the expansion of social welfare programs in liberal states. Although public-private partnerships are usually seen as an erosion of state power or a way to hide the state’s role in the provision of social services, the case of the VA suggests that such partnerships may be used to support and expand such programs. I also focus on the VA’s many scandals and show how agency officials used these policy failures to expand the VA.
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Lim, Hyunjoon. "Compulsory military service, civilian wages, and retirement decision." International Journal of Manpower 39, no. 1 (April 3, 2018): 106–32. http://dx.doi.org/10.1108/ijm-04-2016-0094.
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Purpose The purpose of this paper is to evaluate the effect of veteran status on civilian wages and on retirement age through employing individual-level data. Design/methodology/approach Instrumental variable (IV) estimation specifications show that, contrary to public perception, veteran status has a statistically significant positive impact on an individual’s civilian wage and thus helps him retire earlier than his non-veteran counterpart. Findings Moreover, the wage premium effect largely holds for less-educated men; however, for highly educated men, military service has adverse effects on their subsequent wages, and thus, on their retirement age. In line with this result, the effects of veteran status on retirement age largely hold for the relatively less-educated group. Originality/value This is the first finding to shed light on the link between veteran status and the decision to retire. This work is also first attempt to explore relationship between compulsory military service and subsequent civilian labor market performance, using the Korean individual-level data via relevant IV estimation methodology.
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Puzin, S. N., Marina A. Shurgaya, M. A. Shkurko, I. A. Krasnomyasova, S. N. Khristophorov, and S. S. Memetov. "Aspects of rehabilitation of disabled elderly persons in the Russian Federation." Medical and Social Expert Evaluation and Rehabilitation 19, no. 3 (September 15, 2016): 116–22. http://dx.doi.org/10.18821/1560-9537-2016-19-3-116-122.
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The article presents the results of the study of recommendations both for the rehabilitation of citizens, recognized primary and re-examination as disabled patients in the Russian Federation (2014). A positive result of the implementation of individual rehabilitation program was achieved in 45.1% of persons with disabilities, with the most significant recovery rates being at the level of 51.7% (integration of disabled persons in the family and society) and 50.8% (achievement of a partial compensation of lost functions). Disturbed functions were partially restored in 28.6% ofpersons with disabilities. As a result of the analysis of questionnaires of the evaluation tool (308forms), performed in the Care Home of Labor Veterans number 17, the Department of Labor and Social Protection of Moscow, there was revealed the medical and social status of persons with disabilities staying in this institution. The gender structure ofpersons with disabilities is characterized by a slight predominance ofwomen (59.7%) versus 40.3% of men. Among of all persons with disabilities there are dominated people aged of 75-89 years (51.9%). In the implementation of the comprehensive rehabilitation of disabled patients the need in drug therapy accounts of 100%, in the physiotherapy treatment - 89.6%, and physical therapy methods are used in 99.4% ofpersons with disabilities. With bearing in mind medical indications there are applied methods of socio-environmental, social and domestic, socio-psychological, sociocultural (art therapy, library therapy and adaptive physical education). For the creation of a barrier-free environment patients with disabilities are provided with the technical means of Rehabilitation. At the end of 2014 16.0 thousand people stand on the waiting list for the admission in stationary social care institutions for adults in the Russian Federation. With taking into account of demographical situation of an aging of the population and the gain in the demand for stationary establishments [2] intended for living of the older generation of people who cannot take care of themselves independently and need constant assistance, the further development of the social service system is feasible and has an important medical health value.
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Minnis, Sarah E. "Consider whether your institution truly qualifies as veteran-friendly." Recruiting & Retaining Adult Learners 17, no. 6 (February 13, 2015): 1–4. http://dx.doi.org/10.1002/nsr.30026.
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Singh, Jasleen, Kimberly Lovelace, Jennifer Patnaik, and Robert Enzenauer. "Pediatric Ophthalmology Fellowship Survey: Fellows Selection Criteria for Training Programs." Journal of Academic Ophthalmology 10, no. 01 (January 2018): e140-e142. http://dx.doi.org/10.1055/s-0038-1669930.
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Purpose This article investigates the characteristics that trainees look for in a pediatric ophthalmology fellowship program. Methods A 14-question anonymous survey was created and sent out via the United States Postal Service to all physicians of American Association of Pediatric Ophthalmology and Strabismus. The survey addressed demographics, the interview process, and the qualities of fellowship training programs that were important factors in ranking fellowship training programs. A Likert scale was used to rate different qualities (1: not important, 9: very important) and summary statistics were reported as overall means and standard deviations. Results In total, 1,061 were mailed out with 413 returned amounting to a 38.9% response rate. The qualities with the highest mean were diversity of surgical procedures, volume of procedures/surgeries, reputation of the fellowship director, advice from mentor, emphasis on type of surgery performed, program association with an academic institution, and national reputation of program. The characteristics that ranked the lowest were presence of a Veteran's Administration hospital and presence of a county hospital. Females rated proximity to family significantly higher than males. Among responders who ranked volume of procedures/surgeries as very important, strabismus surgery was the most important. Conclusion Pediatric ophthalmologists chose fellowship training programs based on the diversity and surgical volume of procedures and the reputation of the program director.
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Marchand, William R., Julie Beckstrom, Elena Nazarenko, Renn U. Sweeny, Tracy Herrmann, McKenzi R. Yocus, Jennifer Romesser, Jeremy Roper, Brandon Yabko, and Ashley Parker. "The Veterans Health Administration Whole Health Model of Care: Early Implementation and Utilization at a Large Healthcare System." Military Medicine 185, no. 11-12 (November 1, 2020): e2150-e2157. http://dx.doi.org/10.1093/milmed/usaa198.
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Abstract Introduction The U.S. Veterans Health Administration (VHA) is changing the way it provides healthcare to a model known as Whole Health (WH). The aim is to shift from a primarily medical/disease-oriented system to a model that focuses on health promotion and disease prevention; utilizes personalized, proactive, and patient-driven care; and emphasizes the use of complementary and integrative health. This investigation aimed to examine referral and utilization patterns in early implementation at tertiary care VHA medical care system. Specific aims were to evaluate (1) referral patterns, (2) initial treatment engagement, and (3) continuity of treatment engagement. Materials and methods This is an institutional review board-approved, retrospective study of the first 561 veterans referred to WH programming in the first 20 months of implementation. Data analyses included a chi-square goodness of fit to compare demographics of veterans who were referred to WH Services with those of local patient population. At this facility, WH offers services in three tracks (General WH, Mindfulness Center [MC], and WH Nutrition), which offer unique services to veterans. A chi-square test for independence was conducted to analyze differences in initial engagement among the WH components, in referrals and retention among WH components by time period, and in demographics or diagnoses among self-referred or veterans referred by a consult. Finally, a regression model was used to assess for predictive factors that might influence continuity of treatment engagement across all the WH tracks. Results Key findings indicated potential implementation challenges including disproportionate numbers of referrals from clinical services; poor initial and ongoing treatment engagement; and older, male, and non-service-connected Veterans being less likely to be referred. Conclusion Implementation of the WH model of care has the potential to transform the way VHA delivers healthcare and improve the health and lives of veterans. However, a shift of this magnitude is likely to face challenges during implementation. This article reports on initial barriers to implementation, which can guide implementation at other sites as well as future investigations. Further research is needed to replicate these results as well as to determine underlying causal factors. However, if replicated, these results indicate that successful implementation of WH, or similar models of care, will require extensive efforts focused on outreach to, and education of, facility providers and certain patient demographic groups. Finally, efforts will be required to enhance treatment engagement.
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Poernomo, Eddy, Rusdi Hidayat, and Rangga Restu Prayogo. "Application of Personal Branding as a Campus “Bela Negara” at UPN “Veteran” Jawa Timur." JURNAL ILMU KOMUNIKASI, no. 2 (December 7, 2018): 18–30. http://dx.doi.org/10.33005/jkom.v0i2.20.
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The application of personal branding has become a central element in new management practices throughout the University. Personal branding plays a role in shaping the differentiation produced by a university. Personal branding is considered important for the sustainability of an organization in introducing brands in the community. Some organizations continue to improve and introduce personal branding, including universities in Indonesia. One of the higher education that has strong personal branding is the East Java National Development University 'UPN' East Java. UPN "Veteran" East Java as a Campus “Bela Negara” that emphasizes the values of defending the country as a good citizen to be applied in universities. Various theories and literature approach, applying positive personal branding can be influenced by institution image, institution reputation, and social media. The purpose of the study was to see how much institution image, institution reputation and social media influence the personal branding owned by UPN "Veteran" East Java. The sample in this study were students who chose to study in the Study Program of FISIP Business Administration UPN "Veteran" East Java as many as 200 respondents, with a sampling technique method that is purposive sampling. Data analysis uses a model structure (PLS-SEM) with smart pls that are used to test the relationship and influence between research variables. The results of this research show that institution image is positively and significantly related to institution reputation but insignificant on personal branding. On the other hand, the institution reputation is positively and significantly related to personal branding and social media owned by universities can influence personal branding.
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Burdett, Howard, Charlotte Woodhead, Amy C. Iversen, Simon Wessely, Christopher Dandeker, and Nicola T. Fear. "“Are You a Veteran?” Understanding of the Term “Veteran” among UK Ex-Service Personnel." Armed Forces & Society 39, no. 4 (July 11, 2012): 751–59. http://dx.doi.org/10.1177/0095327x12452033.
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Goldberg, J., W. True, S. Eisen, W. Henderson, and C. D. Robinette. "The Vietnam Era Twin (VET) Registry: Ascertainment Bias." Acta geneticae medicae et gemellologiae: twin research 36, no. 1 (January 1987): 67–78. http://dx.doi.org/10.1017/s0001566000004608.
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AbstractAn examination of ascertainment bias in identification of twin pairs in the Vietnam Era Twin Registry has been conducted. A complete listing of all male-male Vietnam era veteran twin pairs born in Connecticut between 1939 and 1955 was obtained (N = 150). An attempt was made to match these pairs with a listing of Vietnam era veteran twin pairs derived from the United States Department of Defense's Defense Manpower Data Center (DMDC) computer files. The results indicate that the DMDC files identified only 46.7% of the 150 Connecticut born Vietnam era veteran pairs. Statistically significant differences (P < 0.05) between pairs found on the DMDC files and Connecticut veteran pairs missing from the DMDC files are observed for the following variables: a) year of discharge from military service, b) total length of active military service, c) branch of service, and d) foreign service. No consistent pattern of bias is observed for factors related to the physical and psychosocial healt of veteran pairs. The implications of the ascertainment biases in the Vietnam Era Twin Registry are discussed.
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Hein, Tyler C., Benjamin Muz, Halima Ahmadi-Montecalvo, and Tyler Smith. "Associations among ACEs, Health Behavior, and Veteran Health by Service Era." American Journal of Health Behavior 44, no. 6 (November 1, 2020): 876–92. http://dx.doi.org/10.5993/ajhb.44.6.11.
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Objectives: Despite substantial research linking adverse childhood experiences (ACEs) and health, it is unclear how associations differ by veteran status and military service era (draft, volunteer era). The current study evaluated differences in ACEs and health by veteran status and era, increasing understanding important for service provision as the volunteer era veteran population increases. Methods: Behavioral Risk Factor Surveillance System 2012 data were used in univariate and weighted multivariable logistic regression models to assess associations among veteran status, service era, ACEs, and health. Results: Volunteer era veterans experienced the most ACEs (M = 2.42); draft era veterans experienced the fewest (M = 1.04). Individuals reporting 3 or more ACEs were 3.67 times (95% CI = 3.22-4.19) more likely to endorse depression, 1.32 times (95% CI = 1.17-1.48) more likely to report poorer general health, and 1.77 times (95% CI = 1.58-1.97) more likely to endorse poorer physical health, compared to those reporting none. Volunteer era veterans were 2.43 times more likely to report poorer physical health (95% CI = 1.49-3.97) than draft era veterans, adjusting for ACEs. Conclusions: ACEs were associated with poorer health independent of veteran status and service era. Volunteer era veterans experienced more ACEs; need for trauma-informed services supporting whole health may increase.
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Cowper, D. C., and C. F. Longino. "Veteran Interstate Migration and VA Health Service Use." Gerontologist 32, no. 1 (February 1, 1992): 44–50. http://dx.doi.org/10.1093/geront/32.1.44.
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Cotner, Bridget A., Danielle O'Connor, Marc A. Silva, Christina Dillahunt-Aspillaga, Racine Marcus Brown, and Risa Nakase-Richardson. "Veteran and Service Members’ Access to Rehabilitation Services." Archives of Physical Medicine and Rehabilitation 99, no. 10 (October 2018): e35. http://dx.doi.org/10.1016/j.apmr.2018.07.120.
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Fyffe, Denise C., Joyce Williams, Paul Tobin, and Carol Gibson-Gill. "Spinal Cord Injury Veterans’ Disability Benefits, Outcomes, and Health Care Utilization Patterns: Protocol for a Qualitative Study." JMIR Research Protocols 8, no. 10 (October 4, 2019): e14039. http://dx.doi.org/10.2196/14039.
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Background An estimated 42,000 people currently living with chronic spinal cord injury (SCI) are veterans. SCI was a common combat-related injury in the World Wars and Vietnam era and now affects more than 11% of military personnel injured in Operation Iraqi Freedom and Operation Enduring Freedom. The Veterans Benefits Administration primarily offers financial compensation for disabilities sustained or re-aggravated during military service, called service-connected disability compensation. With the overwhelming cost of living with an SCI, this monthly financial compensation can provide service-connected veterans and their families with access to additional supportive resources (eg, assistive devices and personal aide) and maintain their quality of life (QOL). Little is known about personal, health, functional, and QOL outcomes associated with service-connected and nonservice-connected status for veterans living with an SCI. Objective The aim of this study is to compare the ways in which Veterans Affairs’ (VA) service-connected and nonservice-connected status may be associated with health and functional outcomes, choice of health care provider, and overall QOL for veterans living with an SCI and their caregivers. Methods This cross-sectional qualitative study will gather data using retrospective chart reviews, semistructured interviews, and focus groups. After obtaining institutional review board (IRB) approval, purposeful sampling techniques will be used to recruit and enroll the following key stakeholders: veterans living with an SCI, family caregivers, and SCI health care providers. Concurrent data collection will take place at 2 sites: Veterans Administration New Jersey Healthcare System and Northern New Jersey Spinal Cord Injury System. Results This study was funded in July 2015. IRB approval was obtained by November 2016 at both sites. Enrollment and data collection for phase 1 to phase 4 are complete. A total of 69 veterans, 18 caregivers, and 19 SCI clinicians enrolled in the study. Data analyses for these phases are underway. In phase 5, the follow-up focus group activities are scheduled. The final results are expected by the end of 2019. Conclusions The factors that contribute to veterans living with SCI seeking and not seeking VA disability compensation benefits are not well understood in rehabilitation research. Triangulation of these data sources will allow us to compare, contrast, and integrate the results, which can be used to develop clinical guidelines, caregiver training, and patient education programs. International Registered Report Identifier (IRRID) DERR1-10.2196/14039
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HASIAK, Mariana, Maureen P. FLAHERTY, Nina HAYDUK, and Sofiya STAVKOVA. "BUILDING CIVIL SOCIETY WITH FORMER MILITARY AND THEIR FAMILIES: THE ROLE OF HIGHER EDUCATION IN BRIDGING THE GAP BETWEEN MILITARY SERVICE AND CIVIL LIFE." Cherkasy University Bulletin: Pedagogical Sciences, no. 4 (2020): 110–19. http://dx.doi.org/10.31651/2524-2660-2020-4-110-119.
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Introduction. While the military is viewed differently in Canada and Ukraine, inclusion of veterans into civil society is important for both countries. Transition from the military service to civilian life can be challenging. Therefore, the role of different institutions and organizations, that focus on trying to improve what is available for former soldiers and their families has to be discussed. The purpose of the article is to explore the role that higher educational institutions can and should play in assisting former military to better integrate into civilian society – civil society. Methods. Researchers conducted a literature review of journal articles and other relevant written materials as well as informal interviews with key informants. Results. Using the mixed methods of literature search, informal interviews with key informants, and observation, the article considers the way “veterans” are conceptualized in both Canada and Ukraine and how two particular universities in Canada and Ukraine now attempt to meet the needs of former military members, wondering how their needs may differ and be similar to other students of higher education. Originality. The article concludes that, since civil society in general has a responsibility to support veterans in their transition, and notes that there are gaps in both understanding of need and awareness/availability of appropriate resources, a full needs assessment is the next step. Conclusion. The authors recommend a pilot needs assessment at the LPNU in Lviv Oblast where a number of veterans have made their homes.
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Hartman, Richard T., and Mark E. Oxley. "Clinical and Social Determinants to Improve Dod/Veteran Well Being: The Service Member Veteran Risk Profile." Health Informatics - An International Journal 10, no. 02 (May 31, 2021): 5–16. http://dx.doi.org/10.5121/hiij.2021.10202.
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This paper introduces the Service member Veteran Risk Profile (SVRP), a mathematical process/solution to quantitatively represent transitioning Service member (TSM) and/or Veteran quality of life risks by integrating clinical and social determinant data into an individual risk profile. The SVRP creates, for the first time, a mechanism for the Department of Defense (DoD) and Department of Veterans Affairs (VA) to holistically represent the challenges of military members transitioning into civilian life that can lead to negative outcomes and proactively identify transitioning Service members and Veterans at risk. More importantly, the SVRP supports clinical and non-clinical modalities to reduce the negative impacts of transition and beyond for TSM and Veterans. Lastly, the SVRP can be displayed through user-friendly visualizations so DoD/VA policymakers and decision-makers can make more informed policy and resource decisions to improve TSM/Veteran overall quality of life.
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ZUNIGA, I. A., J. J. CHEN, D. S. LANE, J. ALLMER, and V. E. JIMENEZ-LUCHO. "Analysis of a hepatitis C screening programme for US veterans." Epidemiology and Infection 134, no. 2 (August 18, 2005): 249–57. http://dx.doi.org/10.1017/s095026880500498x.
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This study analyses a screening programme for hepatitis C virus (HCV) infection among US veterans in a suburban Veterans Affairs Medical Center, in New York. This is the first study examining all 11 potential risk factors listed in the 2001 National U.S. Veterans Health Administration Screening Guidelines. A retrospective study was conducted of 5400 veterans ‘at risk’ of HCV, identified through a questionnaire in this institution's primary-care outpatient departments between 1 October 2001 and 31 December 2003. Multivariate logistic regression models were built to identify independent predictors of infection. Of 2282 veterans tested for HCV, 4·6% were confirmed by HCV PCR to be HCV infected. In the multivariate model developed, injection drug use, blood transfusion before 1992, service during the Vietnam era, tattoo, and a history of abnormal liver function tests were independent predictors of HCV infection. Our data support considering a more targeted screening approach that includes five of the 11 risk factors.
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Pittman, James O. E., Judith Baer, Joyce Everett, Mary E. Dozier, Erin Almklov, and Niloofar Afari. "Post-9/11 Latino Veteran Mental Health Service Utilization." Military Behavioral Health 7, no. 4 (May 10, 2019): 414–25. http://dx.doi.org/10.1080/21635781.2019.1595228.
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Hunt. "Ordinary Claims: War, Work, Service, and the Victorian Veteran." Victorian Studies 61, no. 3 (2019): 395. http://dx.doi.org/10.2979/victorianstudies.61.3.02.
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LePage, Patty. "Retaining Military Veterans in the Civilian Workforce." Muma Business Review 4 (2020): 091–106. http://dx.doi.org/10.28945/4584.
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With veteran retention rates as low as 20% to 35%, in the first two years post-service transition, organizations need to have a better understanding of the factors that affect veteran churn (Ford, 2017). This high rate of churn has a huge financial impact on employers, costing billions of dollars in addition to the loss of productivity. In addition to the high cost for employers, veterans are also negatively impacted by post-service employment churn with periods of unemployment, difficulty assimilating into civilian culture, a lack of peer and social support, and social isolation. This study provides a systematic review of the literature regarding the factors affecting veteran churn rates and how organizations can increase veteran retention. The findings of this research discussed six common themes that contribute to veteran retention and attrition: social/peer support, culture, mental and physical disabilities and functional impairment, supportive leadership, cultural competency, and mismatched job skills. The themes were viewed through the theoretical lens of social identity theory (Tajfel & Turner, 1979) and Maslow’s (1943) hierarchy of needs. The article provides concrete recommendations for employers that may help to reduce veteran churn, saving employers money and improving the veteran transition process. The recommendations, for employers, on the findings and flow through the theoretical lens and consist of: 1) culturally competent hiring and training, and 2) social/peer support and supportive leadership.
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Poorani, Ali A., and Vincent Kane. "Veteran Patient Experience Academy: Putting Veterans First." Journal of Patient Experience 8 (January 1, 2021): 237437352110346. http://dx.doi.org/10.1177/23743735211034619.
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With a national priority to make the Veteran Health Administration (VA) a leading customer service organization and provide patient-centric services to veterans and their families, the Wilmington VA Medical Center (W VAMC) partnered with the University of Delaware’s Department of Hospitality and Sport Business Management at the Lerner College of Business & Economics to develop the VA Patient Experience Academy. The program focused on employee training and provided tools to enhance the veterans’ experience, operationalized the VA Way (VA Core Values, Service Behaviors, Service Recovery), and Own the Moment. Phase 1 of the VA Patient Experience Academy launched with 25 managers in February 2019 and were followed by 5 cohorts including physicians, nurse practitioners, registered nurses, licensed practical nurses, medical staff assistants, and staff. The participants were selected from the W VAMC and 5 Community-Based Outpatient Clinics. The results were measured on 3 levels: Learning outcomes, application of training to practice, and the veterans’ satisfaction scores. Scores in all 3 areas showed significant improvements.
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Sheen, Yi-Jing, Chien-Chung Huang, Shih-Che Huang, Ming-De Huang, Ching-Heng Lin, I.-Te Lee, Shih-Yi Lin, and Wayne H.-H. Sheu. "IMPLEMENTATION OF AN ELECTRONIC DASHBOARD WITH A REMOTE MANAGEMENT SYSTEM TO IMPROVE GLYCEMIC MANAGEMENT AMONG HOSPITALIZED ADULTS." Endocrine Practice 26, no. 2 (February 2020): 179–91. http://dx.doi.org/10.4158/ep-2019-0264.
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Objective: Better glycemic control for hospitalized diabetic patients significantly reduces health expenditures and improves disease outcomes. We developed a dynamic dashboard with a remote management system and evaluated its impact on inpatient glycemic control. Methods: This was an observational institution-wide study; study participants were enrolled from a 1,500-bed public medical center from 2016 to 2018. We evaluated the impact of a dynamic dashboard system, which analyzed and monitored all glucose data with virtual glycemic management recommendation by a team of endocrinologists, over 3 × 1-year periods: 2016 (pre-implementation), 2017 (development), and 2018 (implementation). Results: A total of 51,641 discharges with 878,159 blood glucose measurements were obtained during the 3-year period. After implementation of the dashboard system, the proportion of patients with poor glycemic control (hyperglycemia or hypoglycemia) was reduced by 31% (from 10.2 to 7.0 per day per 100 patients with glucose monitoring; P<.001); hyperglycemia decreased by 25% (from 6.1 to 4.6 per day per 100 patients with glucose monitoring; P<.001), and hypoglycemia decreased by 45% (from 4.2 to 2.3 per day per 100 patients with glucose monitoring; P<.001). Furthermore, the trend in the proportion of patients within the treat-to-target range showed significant improvement ( P<.001) during the development period, with effectiveness maintained throughout the implementation period. Conclusion: We successfully installed a dynamic, electronic medical records-based dashboard monitoring system to improve inpatient glycemic control. The system, supported by a team of endocrinologists via remote recommendations, could efficiently fill an important need for improved glycemic management among hospitalized adults. Abbreviations: CDE = certified diabetes educator; DM = diabetes mellitus; EMR = electronic medical record; POC = point-of-care; TCVGH = Taichung Veterans General Hospital; UCSF = University of California, San Francisco; U.S. = United States; vGMS = virtual glucose management service