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Anticoagulant Prescribing For Non-Valvular Atrial Fibrillation In The Veterans Health Administration, Adam J. Rose, Robert J. Goldberg, David D. McManus, Alok Kapoor, Victoria Wang, Weisong Liu, Hong Yu 2019 Boston University

Anticoagulant Prescribing For Non-Valvular Atrial Fibrillation In The Veterans Health Administration, Adam J. Rose, Robert J. Goldberg, David D. Mcmanus, Alok Kapoor, Victoria Wang, Weisong Liu, Hong Yu

Open Access Articles

Background: Direct acting oral anticoagulants (DOACs) theoretically could contribute to addressing underuse of anticoagulation in non-valvular atrial fibrillation (NVAF). Few studies have examined this prospect, however. The potential of DOACs to address underuse of anticoagulation in NVAF could be magnified within a healthcare system that sharply limits patients' exposure to out-of-pocket copayments, such as the Veterans Health Administration (VA).

Methods and Results: We used a clinical data set of all patients with NVAF treated within VA from 2007 to 2016 (n=987 373). We examined how the proportion of patients receiving any anticoagulation, and which agent was prescribed, changed over ...


Index To Donald Rea Interview, Melvin van Hurck 2019 Linfield College

Index To Donald Rea Interview, Melvin Van Hurck

Linfield College Public History Project: World War II as Experience and Memory

This index provides a time-stamped overview of the subjects discussed during an oral history interview with Donald Rea, Linfield College class of 1949.


Good For The Military - Bad For The Nation?, George Fust 2019 United States Military Academy

Good For The Military - Bad For The Nation?, George Fust

West Point Research Papers

Has an overreliance on the military as a one-size-fits-all solution become so engrained that we no longer consider alternatives? Are domestic politics so intertwined with foreign affairs that the citizenry has no choice but to accept veterans to fill the ranks of the executive branch? Is there hope for the future? Can we rebalance the general orientation of our government? The outcome to all these questions can be arrived at in a favorable way if our military continues to embrace the Huntingtonian notion of objective control. If professionalism continues to guide the actions of our military’s senior leaders and ...


Multi-Domain Operations, Bad For Civil-Military Relations?, George Fust 2019 United States Military Academy

Multi-Domain Operations, Bad For Civil-Military Relations?, George Fust

West Point Research Papers

Is it possible that the U.S. military’s newest warfighting concept is bad for civil-military relations? The current lexicon for this new concept is multi-domain operations, or simply MDO.


Civ-Mil In Danger? Blame The Pundits, Not The Academies., George Fust 2019 United States Military Academy

Civ-Mil In Danger? Blame The Pundits, Not The Academies., George Fust

West Point Research Papers

I teach civil-military relations at the U.S. Military Academy at West Point. While searching for readings for an elective course taught in the spring semester, I came across a 2010 article written in the L.A. Times, “An increasingly politicized military.” One passage stood out: “By all accounts, the curricula of the service academies and the war colleges give remarkably little attention to the central importance of civilian control. They do not systematically expose up-and-coming officers to intensive case studies and simulations designed to give them a sense of the principle’s real-world implications.” So where are we now ...


Current Military Academy Service Obligation: Good For Civil-Military Relations, George Fust 2019 United States Military Academy

Current Military Academy Service Obligation: Good For Civil-Military Relations, George Fust

West Point Research Papers

Imagine receiving a free undergraduate education at one of the best colleges in the United States. The military academies provide this. Any economist, however, will tell you that there is no such thing as a free lunch. The American tax payer foots the bill for all those who are admitted to attend one of the military’s academies. In exchange, these citizens will commission as officers and serve an obligation of five years on active duty. The most recent National Defense Authorization Act (NDAA) includes a section directing the Secretary of Defense to assess if this five-year service obligation should ...


Automated Text Messaging With Patients In Department Of Veterans Affairs Specialty Clinics: Cluster Randomized Trial, Vera Yakovchenko, Timothy P. Hogan, Thomas K. Houston, Lorilei Richardson, Jessica Lipschitz, Beth Ann Petrakis, Chris Gillespie, D. Keith McInnes 2019 Department of Veterans Affairs

Automated Text Messaging With Patients In Department Of Veterans Affairs Specialty Clinics: Cluster Randomized Trial, Vera Yakovchenko, Timothy P. Hogan, Thomas K. Houston, Lorilei Richardson, Jessica Lipschitz, Beth Ann Petrakis, Chris Gillespie, D. Keith Mcinnes

Open Access Articles

BACKGROUND: Acceptability of mobile phone text messaging as a means of asynchronous communication between health care systems and patients is growing. The US Department of Veterans Affairs (VA) has adopted an automated texting system (aTS) for national rollout. The aTS allows providers to develop clinical texting protocols to promote patient self-management and allows clinical teams to monitor patient progress between in-person visits. Texting-supported hepatitis C virus (HCV) treatment has not been previously tested.

OBJECTIVE: Guided by the Practical, Robust Implementation and Sustainability Model (PRISM), we developed an aTS HCV protocol and conducted a mixed methods, hybrid type 2 effectiveness implementation ...


Factoring The Personal Profile System For Construct Validity: Three Analyses Under Different Standardization Assumptions, Thomas G. Henkel, James Noel Wilmoth 2019 Embry-Riddle Aeronautical University

Factoring The Personal Profile System For Construct Validity: Three Analyses Under Different Standardization Assumptions, Thomas G. Henkel, James Noel Wilmoth

Tom G. Henkel

Three types of data were factor analyzed using principal components extractions with orthogonal and oblique rotations to test publisher claims for construct validity of the Personal Profile System (PPS). Behavioral descriptor data from 1,045 senior non-commissioned Air Force officers were factored as raw data, mean corrected data, and standardized z-scores (correlations). The most efficacious solution was produced with standardized z-scores generating four factors accounting for 86% of the total variance. The measure of sampling adequacy for every descriptor exceeded 0.922. The first factor was general with approximately equal loadings on each of the dominance, influencing, steadiness, and compliance ...


Factor Analysis Of The Personal Profile System, Thomas G. Henkel, James Noel Wilmoth 2019 Embry-Riddle Aeronautical University

Factor Analysis Of The Personal Profile System, Thomas G. Henkel, James Noel Wilmoth

Tom G. Henkel

Principal components extraction with orthogonal and oblique rotations tested construct validity for the Personal Profile System. MOST-LIKE endorsements of 96 behavioral descriptors were coded with 4, LEAST-LIKE with 1, and unendorsed with 2.5. Descriptor data from 1,045 senior noncommissioned Air Force officers were normalized. Four factors accounted for 85% of total variance, with 19 descriptors loading significantly on two factors and the remaining 77 on just one factor. The measure of sampling adequacy for every descriptor exceeded .94. One factor for the varimax-rotated (best) analysis was bi-scalar, loading on Steadiness and Compliance descriptors; a second resembled Influencing, a ...


A Field Study: An Examination Of Managers’ Situational Leadership Styles, Thomas G. Henkel, Debra T. Bourdeau 2019 Embry-Riddle Aeronautical University

A Field Study: An Examination Of Managers’ Situational Leadership Styles, Thomas G. Henkel, Debra T. Bourdeau

Tom G. Henkel

The present study explored the applicable situational leadership styles of experienced military managers attending an advanced leadership educational program. While attending this program, these managers were requested to reveal the results of their situational leadership self-assessment in which they participated. A total of 620 managers agreed to reveal their results, and descriptive statistics were conducted to determine the findings of their situational leadership self-assessments. The study research results revealed two situational leadership styles were predominating: (Telling and Participating). The findings of research study have significant implications for managers when leading individuals and teams for organizational success. These findings also may ...


What Every Boss Wants: Forecasting, George Fust 2019 United States Military Academy

What Every Boss Wants: Forecasting, George Fust

West Point Research Papers

It was the first day at my new unit. As a staff officer I wasn’t surprised when the Battalion Executive Officer (XO), my new boss, motioned me into his office for a chat. What he said next left me speechless. I anticipated the normal “welcome to the unit” speech, but instead he offered one sentence worth of guidance and sent me on my way: “forecast my needs and that of the unit and you will succeed here.” What exactly did he mean by this? How does one forecast without additional information? Where should I start? What should the priority ...


You Can’T Surge Trust: Lessons On Working With Allies And Partners, George Fust 2019 United States Military Academy

You Can’T Surge Trust: Lessons On Working With Allies And Partners, George Fust

West Point Research Papers

Today’s increasingly complex global operating environment can change at the speed of a tweet or viral video. It is therefore imperative for US forces to have the relationships that offer flexibility and options for any contingency—relationships established in advance of unforeseeable events. The world’s interconnectedness and US defense requirements demand partners and allies with whom we work effectively to bridge cultural gaps. Those relationships increase interoperability by creating realistic expectations and combating what can at times emerge as negative stereotypes. Further, shared experiences can help overcome misunderstandings and foster friendships that will be critical in times of ...


Army Schools… Go To Them, George Fust 2019 United States Military Academy

Army Schools… Go To Them, George Fust

West Point Research Papers

Besides looking cool on your chest or sleeve, Army schools should be sought after. They provide opportunities, they demonstrate your technical or tactical proficiency, and the act of preparing to complete them will make you stronger and faster. As a junior officer you should actively seek every opportunity to invest in your education. Rarely will the slot be handed to you. You must make the effort to be ready when the tryouts come along, or circumstances align to allow you to attend.


Recommendations For The Evaluation Of Cross-System Care Coordination From The Va State-Of-The-Art Working Group On Va/Non-Va Care, Kristin M. Mattocks, Kristin Cunningham, A. Rani Elwy, Erin P. Finley, Clinton Greenstone, Michelle A. Mengeling, Steven D. Pizer, Megan E. Vanneman, Michael Weiner, Lori A. Bastian 2019 University of Massachusetts Medical School

Recommendations For The Evaluation Of Cross-System Care Coordination From The Va State-Of-The-Art Working Group On Va/Non-Va Care, Kristin M. Mattocks, Kristin Cunningham, A. Rani Elwy, Erin P. Finley, Clinton Greenstone, Michelle A. Mengeling, Steven D. Pizer, Megan E. Vanneman, Michael Weiner, Lori A. Bastian

Kristin M. Mattocks

In response to widespread concerns regarding Veterans' access to VA care, Congress enacted the Veterans Access, Choice and Accountability Act of 2014, which required VA to establish the Veterans Choice Program (VCP). Since the inception of VCP, more than two million Veterans have received care from community providers, representing approximately 25% of Veterans enrolled in VA care. However, expanded access to non-VA care has created challenges in care coordination between VA and community health systems. In March 2018, the VA Health Services Research and Development Service hosted a VA State of the Art conference (SOTA) focused on care coordination. The ...


Improving Care Coordination For Veterans Within Va And Across Healthcare Systems, Kristina M. Cordasco, Denise M. Hynes, Kristin M. Mattocks, Lori A. Bastian, Hayden B. Bosworth, David Atkins 2019 University of California, Los Angeles

Improving Care Coordination For Veterans Within Va And Across Healthcare Systems, Kristina M. Cordasco, Denise M. Hynes, Kristin M. Mattocks, Lori A. Bastian, Hayden B. Bosworth, David Atkins

Kristin M. Mattocks

The VA faces a plethora of care coordination challenges. Many Veterans have multiple conditions and providers, and many get a portion of their care in the community, a number that will only grow as recent legislation expands options for private care. These challenges have spawned new VA initiatives for redesigning care to meet them, described in this supplement in an editorial by Hosenfeld and colleagues. The VA Health Services Research and Development (HSR&D) service, in partnership with VA’s Office of Primary Care, and Office of Community Care, sponsored a State of the Art (SOTA) conference with the goals of (a) summarizing what is known about care coordination relevant to Veterans’ care; (b) identifying care coordination approaches ready for wider dissemination and implementation within VA; and (c) identifying a research agenda and recommendations, as appropriate, for increasing VA’s ...


Understanding Maternity Care Coordination For Women Veterans Using An Integrated Care Model Approach, Kristin M. Mattocks, Aimee Kroll-Desrosiers, Rebecca L. Kinney, Sara Singer 2019 University of Massachusetts Medical School

Understanding Maternity Care Coordination For Women Veterans Using An Integrated Care Model Approach, Kristin M. Mattocks, Aimee Kroll-Desrosiers, Rebecca L. Kinney, Sara Singer

Kristin M. Mattocks

BACKGROUND: An increasing number of women veterans are using VA maternity benefits for their pregnancies. However, because the VA does not offer obstetrical care, women must seek maternity care from non-VA providers. The growing number of women using non-VA care has increased the importance of understanding how this care is integrated with ongoing VA medical and mental health services and how perceptions of care integration impact healthcare utilization. Therefore, we sought to understand these relationships among a sample of postpartum veterans utilizing VA maternity benefits.

METHODS: We fielded a modified version of the Patient Perceptions of Integrated Care survey among ...


A Permethrin Metabolite Is Associated With Adaptive Immune Responses In Gulf War Illness, Utsav Joshi, Lawrence J. Stern, Laila Abdullah 2019 The Open University

A Permethrin Metabolite Is Associated With Adaptive Immune Responses In Gulf War Illness, Utsav Joshi, Lawrence J. Stern, Laila Abdullah

Open Access Articles

Gulf War Illness (GWI), affecting 30% of veterans from the 1991 Gulf War (GW), is a multi-symptom illness with features similar to those of patients with autoimmune diseases. The objective of the current work is to determine if exposure to GW-related pesticides, such as permethrin (PER), activates peripheral and central nervous system (CNS) adaptive immune responses. In the current study, we focused on a PER metabolite, 3-phenoxybenzoic acid (3-PBA), as this is a common metabolite previously shown to form adducts with endogenous proteins. We observed the presence of 3-PBA and 3-PBA modified lysine of protein peptides in the brain, blood ...


An Alternative Perspective Of Veteran Disapproval Of Recent Wars: The Civil-Military Health Of The Nation Is Strong, George Fust 2019 United States Military Academy

An Alternative Perspective Of Veteran Disapproval Of Recent Wars: The Civil-Military Health Of The Nation Is Strong, George Fust

West Point Research Papers

A Pew Research Center report published on July 10 suggests that most veterans of the conflicts in Iraq and Afghanistan believe these wars are “not worth fighting.” What are the implications of these findings? What can they reveal about the health of U.S. civil-military relations? Is it dangerous for the guardians to be opposed to the mission they are directed to accomplish?


Highland Falls Is America, George Fust 2019 United States Military Academy

Highland Falls Is America, George Fust

West Point Research Papers

In 1957 Samuel Huntington published a highly influential book called the Soldier and the State. In the last paragraph he famously wrote “Highland Falls [represents] the American spirit at its most commonplace…today America can learn more from West Point than West Point from America.” This passage was controversial at the time and even cost Huntington tenure at Harvard. The book would go on to influence generations of civil-military relations scholars. While the sentiment may have been accurate in the 1950s, today’s Highland Falls represents everything America should be.


A Study Of The Diffusion Of Innovations And Hurricane Response Communication In The U.S. Coast Guard, Melissa L. Leake 2019 Old Dominion University

A Study Of The Diffusion Of Innovations And Hurricane Response Communication In The U.S. Coast Guard, Melissa L. Leake

Communication & Theatre Arts Theses

Hurricane Harvey (HH) is considered to be the first natural disaster where social-network applications to request help surpassed already overloaded 911 systems (Seetharaman & Wells, 2017). Increasing interpersonal connectivity via Facebook, Twitter, and other social media sites correspond to an increasing need for researchers and responders to recognize how people use social media platforms to connect, share, and receive information especially during times of crisis such as natural disasters. Heightened public perceptions and expectations of response efforts in the digital era make it especially important for first responders to evaluate, monitor, and adapt to these shifts in communication. Disaster-relief groups and ...


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