Credit Newswise — Health care systems and providers need to understand the unique realities of military culture in order to work effectively with veterans and military families, according to the findings of a study by a University at Buffalo research team. Results of the paper published in the journal Military Behavioral Health suggest that health care and mental health care providers and staff should receive training that provides them with enough knowledge to understand the military’s culture and values and how that belief system also affects the veterans’ transition from a service member identity to a civilian identity. The paper is among the first to also document the necessity of addressing the many difficulties facing military families in the community, everything from challenges arising when family members are deployed to their return home following their discharge. “Military service – and combat experience in particular – is a profound life experience that many civilians do not understand – and veterans are well aware of this,” says Lisa Butler, associate professor in the UB School of Social Work and the paper’s first author. Using four different focus groups – two male veterans groups, one female veterans group and one comprised of veterans’ family members – the researchers asked about the collective health care experience and what participants perceived to be the gaps and needs in health care and mental health care provision. The research team used a sample of veterans in the community rather than one recruited from patients in the U.S. Department of Veterans Affairs (VA) health care system.“The VA research is important, but we don’t know if those findings can be generalized across the entire veteran population,” says Butler, who is also the principal investigator of Joining Forces-UB, a team comprised of UB faculty and staff from the schools of Social Work and Nursing who are collaborating to better address the needs of veterans and military families through research and by developing training programs for students in both schools. “Many people do not realize that only about one in three veterans turn to the VA for their health and mental health care and that most research on veterans is conducted with those in the VA system. This is why the research mission of our Joining Forces-UB project is so unique – we are seeking to better understand the needs of all veterans and military families by conducting community-based research.”Butler says health care and mental health care providers require what Joining Forces-UB is calling “military/veteran cultural competence.” “Just as you want to be culturally competent working with any population, with veterans it is particularly important because they may shut you out if they suspect a lack of understanding. They’ll walk away.” A military service history can have wide-ranging effects on a veteran’s life, according to Butler. Veterans feel the framework from which they emerge is not appreciated by the population at large and she says that shortcoming may create obstacles for health care providers that make it difficult for them to understand a veteran’s health care needs. “Providers who bring military/veteran cultural competence to their interactions with veterans have the potential to enhance outcomes and increase quality of care. This is in addition to preventing veterans from walking away from care that may be beneficial,” says Braden Linn, a doctoral candidate in the UB School of Social Work and one of the paper’s co-authors, along with Mary Ann Meeker, associate professor in the UB School of Nursing, Katie McClain-Meeder, project manager on Joining Forces-UB, and Thomas Nochajski, research professor in the UB School of Social Work.But the questions that might fill the gaps and satisfy the needs of veterans often go unasked because of the absence of that cultural competence. Butler says that outside of Veterans Affairs hospitals, asking about military service is rarely part of a patient’s intake.“Providers outside of the VA often don’t think about a client having military experience or how that service might affect the veteran’s presenting condition; how to treat them; or how they’ll respond to treatment,” she says. “The critical issue is to ask about past military service, and then follow up with questions about hazardous exposures that are known to be specific to their era of service – these are listed on the VA’s website. It is also important to have a basic knowledge of military culture and what that could mean for how veterans approach their health care.” Even the paper’s title, “We don’t complain about small things,” alludes to an ideal obvious to veterans that health care providers don’t always grasp.“That’s a quote from a veteran,” says Butler. “She was speaking to the lack of understanding often present in health care. She was saying that it takes a lot for a veteran to seek help and so a medical complaint should never be viewed as trivial.”She says that veterans are proud of their toughness but it can make it difficult for them to seek services. “Cultivating military/veteran cultural competence can help providers deliver better care—care that acknowledges the veteran’s unique history and its significance in a veteran’s life even after they transition to the civilian world,” says Butler. “If providers don’t understand that, they won’t be as effective in the care they provide.”
PENN NURSING AWARDED GRANT FROM JONAS CENTER FOR NURSING AND VETERANS HEALTHCARE TO FUND DOCTORAL NURSING STUDENTS
Credit Newswise — The University of Pennsylvania School of Nursing (Penn Nursing) today announced that with a new grant of $60,000 from the Jonas Center for Nursing and Veterans Healthcare, matched by $40,000 of its own monies, it will fund the scholarship of five doctoral nursing students in 2016. As a recipient of the Jonas Center grant, Penn Nursing is part of a national effort to stem the faculty shortage and prepare the next generation of nurses – critical as a clinical nurse shortage is anticipated just as an aging population requires care. The Penn Nursing Jonas Scholars join more than 1,000 future nurse educators and leaders at 140 universities across all 50 states supported by Jonas Center programs, the Jonas Nurse Leaders Scholars Program and Jonas Veterans Healthcare Program (JVHP). These scholarships support nurses pursuing PhDs and DNPs, the terminal degrees in the field. As the nation’s leading philanthropic funder of graduate nursing education, the Jonas Center is addressing the critical need for qualified nursing faculty. U.S. nursing schools turned away nearly 70,000 qualified applicants from baccalaureate and graduate nursing programs in 2014 due in large part to an insufficient number of faculty . Further, nearly two-thirds of registered nurses over age 54 say they are considering retirement . “In 2008, we set an ambitious goal to support 1,000 Jonas Nurse Scholars. This year, on our Center’s 10th anniversary, we celebrate this achievement and are amazed by the talent of this cohort of future nurse leaders,” said Donald Jonas, who co-founded the Center with Barbara Jonas, his wife. “In the decade to come, we look forward to continuing to work with our partner nursing schools and to the great impact that the Jonas Scholars will have on improving healthcare around the world.”The Penn Nursing Jonas Scholars will begin their graduate careers in the fall and will be supported through 2018. ###About the University of Pennsylvania School of Nursing The University of Pennsylvania School of Nursing is one of the world’s leading schools of nursing and is ranked the #1 graduate nursing school in the United States by U.S. News & World Report. Penn Nursing is consistently among the nation’s top recipients of nursing research funding from the National Institutes of Health. Penn Nursing prepares nurse scientists and nurse leaders to meet the health needs of a global society through research, education, and practice.
VETERANS AND CIVILIAN PATIENTS AT RISK OF ICU-RELATED PTSD UP TO A YEAR FOLLOWING HOSPITAL DISCHARGE
Credit Newswise — One in ten patients is at risk of having new post-traumatic stress disorder (PTSD) related to their ICU experience up to a year post-discharge. This was the finding from a multicenter, prospective cohort research study of veterans and civilians. The research was published online ahead of print in the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine. In the study “Incidence and Risk Factors for ICU-related Posttraumatic Stress Disorder in Veterans and Civilians,” researchers led by Mayur Patel, MD, MPH, FACS, Assistant Professor of Surgery & Neurosurgery at Vanderbilt University Medical Center and Staff Surgeon and Surgical Intensivist at the Nashville VA Medical Center, analyze data from a cohort of medical and surgical ICU survivors enrolled in studies from three Veterans Affairs hospitals (MIND-ICU Study, NCT00400062) and one civilian hospital (BRAIN-ICU Study, NCT00392795). Using the PTSD Checklist for the DSM-IV to determine PTSD for this study, among PTSD measurements listed by the U.S. Department of Veteran Affairs’ National Center for PTSD, a total of 181 patients were assessed at three months and 160 were further assessed at 12 months. The cumulative incidence of PTSD was 6 percent to 12 percent within one year following hospitalization. “Although lower than prior research and public perception suggests, the rate of ICU-related PTSD is very comparable to the 8 percent PTSD rates seen in current and former service members deployed to the recent Iraq and Afghanistan conflicts,” Patel said. “It is important to understand more about PTSD following the traumatizing events of a critical illness so we can better support the growing number of ICU survivors.” PTSD can occur in patients after the traumatizing events of critical illness, and this study provides estimates on new cases of PTSD stemming specifically from the ICU experience. Pre-existing PTSD has rarely been systematically assessed in prior cohorts, and this study took extra effort to distinguish pre-existing PTSD from new PTSD cases. Civilian populations have dominated the literature of PTSD after critical illness, and this study is the first to also include the expanding and aging Veteran population. Assessing risk factors for ICU-related PTSD, the researchers found that pre-existing PTSD as well as prior depression were strong risk factors associated with ICU-related PTSD at three and 12 months post-discharge. Being a veteran did not increase risk of ICU-related PTSD, nor did duration of delirium, amount of pain medication, or amount of sedative. “Currently, the international psychological aftercare for ICU survivors is not organized proactively; rather, it is largely reactive in response to disabling reports from survivors, caregivers, and primary care providers. The Institute of Medicine in the United States has recommended a systematic collection, analysis, and dissemination of data assessing the quality of post-conflict PTSD care in the military and veteran populations. We suggest that the same should apply to the large civilian and veteran populations of critically ill survivors,” the authors advised.
Credit Newswise — BIRMINGHAM, Ala. – As the daughter of a 27-year veteran of the U.S. Air Force, and herself an intensive care nurse for more than 20 years, University of Alabama at Birmingham School of Nursing Professor Jacqueline Moss, Ph.D., is familiar with the U.S. military and caring for its veterans. In a research partnership with the Veterans Health Administration, Moss has sought to understand veterans’ struggles and to help find ways to address their issues. As an educator of nurses, she has worked to teach others that they must be specially attuned to recognizing and caring for this group. To improve awareness of veterans’ health care needs, Moss collaborated with colleagues, Associate Dean for Clinical and Global Partnership and Professor Cynthia Selleck, Ph.D., and Assistant Professor Randy Moore, R.N., to develop a set of competencies designed to help new nurses be better prepared to identify and assist veterans and their families across the health care continuum. The resulting research paper, “Veteran Competencies for Undergraduate Nursing Education,” was published in the October/December 2015 issue of Advances in Nursing Science and is featured as an “Editor’s Pick” on the journal’s website. “There are 23 million military veterans living in the United States, and more than 16 percent have service-connected disabilities, yet only about 38 percent of those receive any portion of their health care at a VA facility,” Moss said. “That means 62 percent are receiving care at community hospitals, university medicals centers, local clinics and the like. So any nurse anywhere can encounter a veteran.” In clinical settings outside the VA, Moss says, a veteran’s prior military service often is not recognized — or even mentioned — so a nurse can be unaware of potential issues related to a patient’s military service that can arise. “Veterans come with unique backgrounds and needs, and it is imperative that nurses are adequately prepared to care for veteran patients and their families, regardless of the setting in which they practice,” Moss added. Using the Quality and Safety Education for Nursing Competencies as a framework, Moss and her colleagues developed a set of 10 competencies and associated knowledge, skills and attitudes new nurses need to be able to adequately care for veteran patients and their families. The QSEN Competencies are guidelines that have been developed as part of a national project to prepare future nurses with the knowledge, skills and attitudes to continuously improve the quality and safety of the health care systems in which they work, and provide the best care possible for the patients they serve. The overall competencies are: • Military and veteran culture• Post-traumatic stress disorder• Amputation and assistive devices• Environmental and chemical exposures• Substance use disorder• Military sexual trauma• Traumatic brain injury• Suicide• Homelessness• Serious illness at end of life At their core, the competencies are the basic tools nurses need to help them recognize veterans, recognize whether they have a problem, and determine whether they can address it themselves or need to refer it to someone else. “Wherever you practice, you are going to encounter veterans,” Moss said. “Understanding their experiences and knowing what to look for, how to intervene and when to refer are extremely important skills for nurses, and we want to do our best to make sure they have these skills.” The UAB School of Nursing and its faculty are uniquely positioned for this and other veteran health care research. The school has a strong working relationship with the U.S. Department of Veterans Affairs, which since 2009 has included the VA Nursing Academic Partnership in conjunction with the Birmingham Veterans Affairs Medical Center. This partnership — which won the 2015 American Association of Colleges of Nursing Exemplary Academic-Partnership Award — is part of an initiative to facilitate stronger and mutually beneficial ties between schools of nursing and VA Medical Centers across the country, and it has provided unique insights that shaped the competencies. This is something Moss hopes other schools of nursing and health care institutions hiring new graduates will note as they consider implementing the work. “We hope schools of nursing will take these competencies and knowledge, skills and attitudes and see where they might be able to implement either some or all of these suggestions into their curriculum,” Moss said. “We also hope institutions that are hiring new graduates may also look and see where they might be able to incorporate them into their new-hire orientations.”
Back in 2005, Kristofer Goldsmith thought he was prepared for war. Then just 19-years-old, the Army sergeant deployed to Iraq with the Third Infantry Division. It was a moment that he had been waiting years for. “I wanted nothing more but to be in the military my entire life, from the time that I was a little kid,” he says. Goldsmith’s assignment was to act as a documentarian and intelligence collector for his platoon. He wound up photographing mass graves, and dead Iraqi police officers and children. “It was something that I wasn’t prepared to deal with,” he says. “Even when I got home, PTSD was little more than an acronym to me—I didn’t understand what it meant. I didn’t understand the way that it would haunt me for years, and possibly the rest of my life.” In 2014, more than 530,000 service members received treatment for post-traumatic stress disorder (PTSD) at facilities run by the U.S. Department of Veterans Affairs. Before he even left the military, Goldsmith says that PTSD began to affect his life. He was written up in 2007 for missing his flight to Baghdad for his second deployment. The reason why Goldsmith wasn't on that plane? He was in a hospital after attempting suicide the night before. Goldsmith was hit with a misconduct charge for missing that flight, and he was subsequently forced out of the military with a general discharge—one rung below the honorable discharge that entitles veterans to full benefits. Because of his discharge status, he’s been denied access to healthcare services from the Department of Veterans Affairs (VA). “The Army knew why I missed my flight—when I survived my suicide attempt it was at Fort Stewart, Georgia, and I was found by military police,” he says. “I struggled for a year and a half, getting almost no help at all from the Army when I was asking for it, desperately.” But Goldsmith’s case is not unique. Though 85 percent of the more than 2.5 million veterans of the Iraq and Afghanistan wars have been released from their service with honorable discharges, 300,000 have been forced out of the military with less-than-honorable discharges. The U.S. government has acknowledged that some of these discharges were the result of PTSD. Goldsmith says that the military could have prevented his suicide attempt but failed to act when his cries grew louder. “Even when I told an Army psychiatrist that I was thinking about suicide, she told me that I had three choices,” he says. “She told me that I could one, suck it up, be a man, and I could deploy; two, I could go AWOL and live like a convicted felon for the rest of my life; or three, I could give up and commit suicide. Those were the suggestions that an Army psychiatrist offered me when I told her how I was feeling after struggling for so long with nightmares from Iraq.” When Goldsmith approached the U.S. military and asked that his discharge status be changed because of his untreated PTSD, the Army reject his appeal. He has spent the last eight years trying to get Washington to recognize that PTSD is often the source of the behavior that gets many vets pushed out. Congress has tried to put a stop to this practice—Section 512 of the 2009-2010 National Defense Authorization Act says that the Defense Department may not issue a discharge other than honorable if the service member has been diagnosed with PTSD or a traumatic brain injury. But since 2009, over 20,000 soldiers with mental health problems have been dismissed for misconduct. Without an honorable discharge, veterans cannot receive VA healthcare benefits. "I think it's damn near criminal that you could take a person, send them to war, they come home sick, and then you don't even provide them healthcare once they get home," Goldsmith says. In 2014, former Defense Secretary Chuck Hagel took things a step further and attempted to amend the rules regarding PTSD and discharge status. But Goldsmith says Hagel’s memo primarily focused on Vietnam-era veterans. “Secretary Hagel’s memorandum was too narrow—it doesn’t effect my generation at all,” he says. “Today, the discharge review boards, they’re still not recognizing PTSD the way Secretary Hagel intended.” Goldsmith says lawmakers in the House and Senate are signing on to the Fairness For Veterans Act, which he says will be formally introduced at the end of this week. He hopes to get others to sign on on to the bill, and is trying raise awareness among the public. “We could use all the help in the world,” he says. Click Here to see full story Credit The Take Away
Credit WSB-TV Atlanta A Gordon County veteran said he spent six months and $1,000 building a handmade memorial honoring the armed services and emergency workers on his own property. He told Channel 2’s Matt Johnson that he couldn’t imagine his surprise and heartache when he says his patriotic flags were stolen from him. Richard Rogers has nothing but kind words for his country and his fellow veterans. “They protect us and this is a great nation,” Rogers said. And now he has nothing but disgust for whoever he says stole the flags from his homemade memorial. “A low life. That's all I can say, they’re just sorry and low,” Rogers told Johnson. Rogers spent six months and about $1,000 building the memorial on his property off of Highway 136 in Gordon County. When he looked at it Monday morning, he noticed the American flag and the others for the military, law enforcement and first responders, were all gone. “It just breaks your heart, especially something like that, it honored so many and everything,” Rogers said. The flags were gone but he says the perpetrator left behind a clue for the Gordon County Sheriff's Office. “There was a knife left behind. They had cut them down,” Rogers said. Rogers told Johnson he has no doubts that he will put new flags back up where they belong. “I’m going to try and get a camera to go out here before I put anything back up,” Rogers said. Still, he says this is a personal crime that he won't soon forget. “It was the disrespect that they were showing for the people that protect us,” Rogers said. The Sheriff's Office told Johnson when the sheriff found out about what happened he had volunteers organize and cover the costs of replacement flags. Rogers told Johnson he appreciates the gesture but says he would rather see that money spent on charity.
WHITMAN SCHOOL OF MANAGEMENT RECEIVES FEDERAL FUNDING TO EXPAND ENTREPRENEURSHIP OUTREACH THROUGH A VETERANS BUSINESS OUTREACH CENTER
Credit Newswise — The Falcone Center for Entrepreneurship atSyracuse University’s Martin J. Whitman School of Management has received funding from the U.S. Small Business Administration (SBA) to support the expansion of services for veterans through its newly established Veterans Business Outreach Center (VBOC). The funding, which is approximately $330,000 for the first year, will enable Whitman’s VBOC to provide counseling, training, assistance, comprehensive business assessment and mentoring to veteran and service-disabled veteran entrepreneurs. It also will help Reserve Component, National Guard and transitioning service members who are interested in starting or expanding a small business.“This is a tremendous opportunity to expand Syracuse University’s service to our veterans who have sacrificed so much for us,” said Terry Brown, executive director of Whitman’s Falcone Center for Entrepreneurship. “A key responsibility of Whitman’s VBOC is to support transitioning service members as they embark on post military service careers that often include small business ownership and other forms of self-employment. We’re proud to be able to offer the valuable support our veterans need to be successful.”A portion of the funding will be used to cover costs associated with coordinating, delivering and conducting outreach to increase participation in the entrepreneurship track of the Department of Defense’s (DOD’s) Transition Assistance Program (TAP), known as Boots to Business, on military installations in the continental United States and its territories. VBOCs are directed by the Small Business Act to participate in the DOD’s Transition Assistance Program. Initiated as a pilot in 2012 and expanded nationally in 2013, Boots to Business leverages SBA resource partners including VBOCs, Small Business Development Centers (SBDC), Women’s Business Centers (WBC), SCORE and the Institute for Veterans and Military Families (IVMF) at Syracuse University to deliver entrepreneurship education and training to transitioning service members, Reservists and National Guard members as well as their spouses or caregivers who are exploring or pursuing small business ownership. “In 2014, Boots to Business and Boots to Business: Reboot were delivered to more than 18,000 veterans and family members by SBA resource partners, including VBOCs, SBDCs, Women Business Outreach Centers, SCORE, and others, as well as IVMF instructors,” said James Schmeling, IVMF managing director for programming. “The Whitman School has provided instructors from its world-class entrepreneurship faculty, both in the two-day courses, and the eight-week online courses, and we’re thrilled to extend our work with Whitman to include the new VBOC.“We were able to deliver the SBA program for TAP in 175 locations in the continental U.S. with our partners at 431 trainings, and overseas at 65 trainings in eight countries. Our Whitman colleagues were instrumental in reaching this number of people and locations, and designing the curricula delivered worldwide.”“VBOCs play a significant role in the veteran community,” said Barbara Carson, acting associate administrator, SBA’s Office of Veteran Business Development (OVBD). “We look forward to working closely with these centers to provide resources to enhance entrepreneurship opportunities for veterans as they continue to serve our country by contributing to the local economy and creating jobs in their communities.“The brave men and women who served our country deserve access to every available resource when they return home,” said Senator Kirsten Gillibrand. “I fought to get the Veterans Business Outreach Center this federal funding so that Central New York veteran entrepreneurs can get the assistance and guidance they need to start successful businesses, create new jobs and grow our economy.”The nationwide VBOC competition was open to all eligible institutions of higher learning, private organizations or businesses, veterans’ nonprofit community-based organizations, state, local or tribal governmental agencies and nonprofit organizations. Each award is made for a base project period of 12 months, with up to two renewal option periods of 12 months each. “I’m proud to support funding to help Syracuse University remain a critical leader in veterans’ higher education and post-service outreach,” said Rep. John Katko (NY-24). “We owe it to our veterans to provide quality education opportunities – and with our rich history of service to veterans and burgeoning entrepreneurial culture, Central New York is the ideal location for this program. The Veterans Business Outreach Center will deliver small business mentorship and entrepreneurship training for our veterans while boosting our regional economic development.”About the Whitman School’s Entrepreneurship and Emerging Enterprises ProgramThe Entrepreneurship and Emerging Enterprises (EEE) program is a flagship program at the Whitman School at Syracuse University. Consistently ranked as one of the top programs in the nation, Whitman’s entrepreneurship program helps undergraduate, masters and Ph.D. students discover their innate entrepreneurial potential, giving them a set of tools and perspective to capitalize on that potential and help launch their careers.The Whitman School heavily emphasizes experiential learning, and the entrepreneurship department is committed to providing a myriad of opportunities for students to gain and apply real-world perspective and skills. The Falcone Center of Entrepreneurship at Whitman makes connections with the community and supports the entrepreneurship program’s outreach efforts. Through outreach programs at Women Igniting the Spirit of Entrepreneurship (WISE) Symposium, WISE Women's Business Center and South Side Innovation Center, Whitman’s Falcone Center serves more than 2,000 clients annually who have grossed over $10 million in revenue.The EEE program is also the originator of the Entrepreneurship Bootcamp for Veterans with Disabilities(EBV), which is now offered at seven other institutions around the United States. The EBV program, and its partner programs, provides the skills, resources and infrastructure for entrepreneurship and small business management for service-connected disabilities and military family members who serve in a caregiver role to a veteran with a service-connected disability. More than 700 veterans have graduated from EBV universities since 2007.The Martin J. Whitman School of Management at Syracuse University was established as the College of Business Administration in 1919. In 1920, it was only the 16th collegiate business school in the nation to be accredited by the AACSB. Today, the Whitman School of Management includes programs in accounting, entrepreneurship, finance, management, marketing, real estate, retail management and supply chain management. In any given year, the Whitman School is home to nearly 2,000 doctoral, graduate and undergraduate students.About the Institute for Veterans and Military Families (IVMF)The IVMF is the first interdisciplinary national institute in higher education focused on the social, economic, education and policy issues impacting veterans and their families post-service. Through our focus on veteran-facing programming, research and policy, employment and employer support, and community engagement, the institute provides in-depth analysis of the challenges facing the veteran community, captures best practices and serves as a forum to facilitate new partnerships and strong relationships between the individuals and organizations committed to making a difference for veterans and military families.About Syracuse University’s Office of Veteran and Military AffairsThe Office of Veteran and Military Affairs (OVMA) serves as Syracuse University’s single point of entry for all veteran and military related programs and initiatives. It collaborates and coordinates with all stakeholders to best serve veterans, military connected students, and military family members who are students or employees at Syracuse University.
Credit Newswise — To protect our nation’s Veterans, the American Society of Anesthesiologists (ASA) urges extreme caution when considering the “Veterans Health Care Staffing Improvement Act,” S. 2279. As currently drafted, this legislation contains a misguided provision that removes physician anesthesiologists from surgery and replaces them with nurses. Veterans will receive a lower standard of care, jeopardizing their safety and lives, if physician involvement is eliminated from anesthesia care in surgery. Although the purpose of the legislation, introduced Nov. 10 in the U.S. Senate, is admirable, proposing to ease the transition of military health care providers to the Department of Veterans Affairs (VA); it also includes provisions abandoning the physician-nurse team-based model of care for all advanced practice registered nurses (APRN), including nurse anesthetists, in the VA. Senators sponsoring the legislation note the act proposes “common-sense” changes in staffing policies to improve Veterans’ care at health care facilities by addressing the shortfall of medical staff. However, there is no shortage of physician anesthesiologists or nurse anesthetists in the VA system. Surgery and anesthesia care inherently contain risk, and this is true even more so for Veterans, who often have complex medical conditions that pose a heightened risk of complications during surgery. Physician involvement when performing surgery on our Veterans is much more critical than providing typical primary care or treating chronic health conditions. The legislation would eliminate the existing and proven model of care where physician anesthesiologists and nurse anesthetists work together as a team to ensure our Veterans receive the highest quality and safest anesthesia care. “Taking physicians out of surgical care is not a common-sense solution for our VA patients who are often sicker, older and have multiple medical conditions that put them at greater risk for complications,” said ASA President Daniel J. Cole, M.D. “The team-based model of care ensures all Veterans have access to a physician anesthesiologist should an emergency or complication occur. This legislation will place our Veterans at increased risk. There can be no compromise on the highest-quality, safest medical care for those who have served our country” Similar dangerous proposals have been considered, and when it comes to the subject of substituting nurses for physicians in anesthesia care, the VA’s own experts on surgical anesthesia care, the Chiefs of Anesthesiology, have told VA leadership that a policy substituting nurses for physicians “would directly compromise patient safety and limit our ability to provide quality care to Veterans.” (Letter from VA Chiefs to Secretary Shinseki, Dr. Petzel, and Dr. Jesse - Oct 1, 2013.) Physician anesthesiologists receive 12 to 14 years of education, including medical school, and 12,000 to 16,000 hours of clinical training to specialize in anesthesia care and pain control, with the necessary knowledge to understand and treat the entire human body. By comparison, nurse anesthetists have only about 1,650 hours of clinical training. The Veterans Health Care Staffing Improvement Act was introduced by Senators Merkley (Oregon) and Rounds (South Dakota). The bill has also been co-sponsored by Senators Tillis (North Carolina), Warner (Virginia), Shaheen (New Hampshire), Wyden (Oregon), Tester (Montana) and Brown (Ohio). ASA strongly urges reconsideration of the provisions that lower the standard of care for Veterans and puts their health and lives at risk in surgery.More information about the proposed legislation and the importance of physician-led, anesthesia care is available at www.asahq.org. THE AMERICAN SOCIETY OF ANESTHESIOLOGISTS®Founded in 1905, the American Society of Anesthesiologists (ASA®) is an educational, research and scientific society with more than 52,000 members organized to raise and maintain the standards of the medical practice of anesthesiology. ASA is committed to ensuring physician anesthesiologists evaluate and supervise the medical care of patients before, during and after surgery to provide the highest quality and safest care every patient deserves.
Credit Newswise — A University of Iowa researcher is working with the Veterans Administration on a pilot program to help female veterans suffering from postpartum depression. MomMoodBooster is an online intervention tool that helps mothers who live in rural areas cope with their depression. “Women in rural areas often don’t seek out or have access to mental health care,” saysMichael O’Hara, professor and Starch Faculty Fellow in the UI Department of Psychological and Brain Sciences. “Reaching out in particular to rural veteran women seemed to me like it was just something important to do.” Each year, about 300,000 new mothers in the United States suffer from postpartum depression, experiencing low moods, loss of interest in normally enjoyable activities, insomnia, appetite disturbances, difficulty concentrating, and suicidal thoughts—and O’Hara says this estimate is low. So far, about 40 women from across the country have taken part in MomMoodBooster with positive results. Over a six-week period, women participate in six sessions that target managing mood, increasing pleasant activities, managing negative thoughts, increasing positive thoughts, and planning for the future. Phone coaches also call to check in with the women, tracking progress, answering questions, and providing encouragement. O’Hara says it seems possible, given the combat experience of many female veterans, that they may be more at risk for depression, though that has not been quantified. “I was in the Navy for four-and-a-half years, and it’s not an easy life,” O’Hara says. “These are women who have served our country, and we have a way of contacting them. You put that together, and it’s sort of a winning combination.” Treating postpartum depression is important not only for mothers, but also for the well-being of their children. A depressed parent often pays less attention to the baby’s cues, either interacting less and neglecting the child or working so hard to interact that the baby becomes overwhelmed, leading to developmental problems. The self-focus caused by depression can be harmful to children in other ways as well. For example, when parents choose whether to make a meal or drive to a fast food restaurant, depression can influence them to make the easier choice. “Any time a parent is distracted by mental health concerns, this can lead to problems with the children,” O’Hara says. “We know that inconsistent parenting often makes it harder for children to internalize societal rules, a situation that often sets the stage for behavior problems. Having parents who are emotionally stable is quite a benefit to the child.” For some women, postpartum depression represents a recurrence of depression at a stressful time in their lives. For others, it stems from issues surrounding the marriage, finances, or simply the challenge of caring for an infant. Biologically, there is increasing evidence that pregnancy hormones may the set the stage for low mood, which, when combined with environmental factors, may cause postpartum depression. “The most dominant things I see are poor social support systems and conflict with the partner,” O’Hara says. The program will continue at least through the end of September, when the VA will determine whether to continue funding, and O’Hara expects to write a research study based on the results of the pilot. The MomMoodBooster project is funded by the VA Office of Rural Health and the VA Office of Women’s Health Services.
Service members returning from active duty can face many challenges—including finding a new job or even a new career. To help veterans succeed, we’ve worked with the Department of Veterans Affairs to make AWS Certification exams eligible for VA reimbursement under the GI Bill’s education provision. About AWS CertificationsAWS Certifications recognize IT professionals with the technical expertise to design, deploy, and operate applications and infrastructure on AWS. Career transitions are never easy, but cloud IT presents one promising path forward—especially when industry surveys show that these skills remain in short supply. Our hope is that easier access to our certification exam, combined with the unique talents veterans already possess, will open up more career possibilities for retired servicemen and servicewomen and help them achieve success in their post-military careers. How it WorksQualifying US veterans covered under a GI Bill with an education provision can now submit a reimbursement request to the Department of Veterans Affairs for exams taken after December 10, 2015 and purchased from Webassessor. The VA will cover exam fees up to $2000 (costs connected with preparing for a certification such as training courses or practice exams are not reimbursable). To read ths full story Click Here Credit Jeff Barr