Empowerment through education : enhancing quality of life of clients on anticoagulant therapy

This particular study was a sub-study of an on-going investigation by Porter and Kazcaraba (1994) at the Veterans Administration Medical Center in Miami. While the Porter and Kazcaraba study utilizes multiple measures to determine the impact of nurse patient collaborative care on quality of life of cardiovascular patients receiving anticoagulant therapy, this study sought to find whether health education could empower similar clients to improve their quality of life. A health education program based on Freire's belief that shared collective knowledge empowers individuals to improve their lives and their community and Porter's nurse patient collaborative care model was used. Findings on a sample of thirty-eight subjects revealed strong correlations between self-esteem and life satisfaction as well as a trend towards increased power post-treatment. No group comparisons were made at posttest because the sample size was too small for meaningful statistical analysis.

Low frequency of cigarette smoking and the risk of head and neck cancer in the INHANCE consortium pooled analysis

Funding • The pooled data coordination team (PBoffetta, MH, YCAL) were supported by National Cancer Institute grant R03CA113157 and by National Institute of Dental and Craniofacial Research grant R03DE016611 • The Milan study (CLV) was supported by the Italian Association for Research on Cancer (Grant no. 10068). • The Aviano study (LDM) was supported by a grant from the Italian Association for Research on Cancer (AIRC), Italian League Against Cancer and Italian Ministry of Research • The Italy Multicenter study (DS) was supported by the Italian Association for Research on Cancer (AIRC), Italian League Against Cancer and Italian Ministry of Research. • The Study from Switzerland (FL) was supported by the Swiss League against Cancer and the Swiss Research against Cancer/Oncosuisse [KFS-700, OCS-1633]. • The central Europe study (PBoffetta, PBrenan, EF, JL, DM, PR, OS, NS-D) was supported by the World Cancer Research Fund and the European Commission INCOCOPERNICUS Program [Contract No. IC15- CT98-0332] • The New York multicentre study (JM) was supported by a grant from National Institute of Health [P01CA068384 K07CA104231]. • The study from the Fred Hutchison Cancer Research Center from Seattle (CC, SMS) was supported by a National Institute of Health grant [R01CA048996, R01DE012609]. • The Iowa study (ES) was supported by National Instituteof Health [NIDCR R01DE011979, NIDCR R01DE013110, FIRCA TW001500] and Veterans Affairs Merit Review Funds. • The North Carolina studies (AFO) were supported by National Institute of Health [R01CA061188], and in part by a grant from the National Institute of Environmental Health Sciences [P30ES010126]. • The Tampa study (PLazarus, JM) was supported by National Institute of Health grants [P01CA068384, K07CA104231, R01DE013158] • The Los Angeles study (Z-F Z, HM) was supported by grants from National Institute of Health [P50CA090388, R01DA011386, R03CA077954, T32CA009142, U01CA096134, R21ES011667] and the Alper Research Program for Environmental Genomics of the UCLA Jonsson Comprehensive Cancer Center. • The Houston study (EMS, GL) was supported by a grant from National Institute of Health [R01ES011740, R01CA100264]. • The Puerto Rico study (RBH, MPP) was supported by a grant from National Institutes of Health (NCI) US and NIDCR intramural programs. • The Latin America study (PBoffetta, PBrenan, MV, LF, MPC, AM, AWD, SK, VW-F) was supported by Fondo para la Investigacion Cientifica y Tecnologica (FONCYT) Argentina, IMIM (Barcelona), Fundaco de Amparo a‘ Pesquisa no Estado de Sao Paulo (FAPESP) [No 01/01768-2], and European Commission [IC18-CT97-0222] • The IARC multicentre study (SF, RH, XC) was supported by Fondo de Investigaciones Sanitarias (FIS) of the Spanish Government [FIS 97/ 0024, FIS 97/0662, BAE 01/5013], International Union Against Cancer (UICC), and Yamagiwa-Yoshida Memorial International Cancer Study Grant. • The Boston study (KKelsey, MMcC) was supported by a grant from National Institute of Health [R01CA078609, R01CA100679]. • The Rome study (SB, GC) was supported by AIRC (Italian Agency for Research on Cancer). • The US multicentre study (BW) was supported by The Intramural Program of the National Cancer Institute, National Institute of Health, United States. • The Sao Paolo study (V W-F) was supported by Fundacao de Ampara a Pesquisa no Estado de Sao Paulo (FAPESP No 10/51168-0) • The MSKCC study (SS, G-P Y) was supported by a grant from National Institute of Health [R01CA051845]. • The Seattle-Leo stud (FV) was supported by a grant from National Institute of Health [R01CA030022] • The western Europe Study (PBoffetta, IH, WA, PLagiou, DS, LS, FM, CH, KKjaerheim, DC, TMc, PT, AA, AZ) was supported by European Community (5th Frame work Programme) grant no QLK1-CT-2001- 00182. • The Germany Heidelberg study (HR) was supported by the grant No. 01GB9702/3 from the German Ministry of Education and Research.

Guideline-based decision support has a small, non-sustained effect on transthoracic echocardiography ordering frequency.

BACKGROUND: Guidance for appropriate utilisation of transthoracic echocardiograms (TTEs) can be incorporated into ordering prompts, potentially affecting the number of requests. METHODS: We incorporated data from the 2011 Appropriate Use Criteria for Echocardiography, the 2010 National Institute for Clinical Excellence Guideline on Chronic Heart Failure, and American College of Cardiology Choosing Wisely list on TTE use for dyspnoea, oedema and valvular disease into electronic ordering systems at Durham Veterans Affairs Medical Center. Our primary outcome was TTE orders per month. Secondary outcomes included rates of outpatient TTE ordering per 100 visits and frequency of brain natriuretic peptide (BNP) ordering prior to TTE. Outcomes were measured for 20 months before and 12 months after the intervention. RESULTS: The number of TTEs ordered did not decrease (338±32 TTEs/month prior vs 320±33 afterwards, p=0.12). Rates of outpatient TTE ordering decreased minimally post intervention (2.28 per 100 primary care/cardiology visits prior vs 1.99 afterwards, p<0.01). Effects on TTE ordering and ordering rate significantly interacted with time from intervention (p<0.02 for both), as the small initial effects waned after 6 months. The percentage of TTE orders with preceding BNP increased (36.5% prior vs 42.2% after for inpatients, p=0.01; 10.8% prior vs 14.5% after for outpatients, p<0.01). CONCLUSIONS: Ordering prompts for TTEs initially minimally reduced the number of TTEs ordered and increased BNP measurement at a single institution, but the effect on TTEs ordered was likely insignificant from a utilisation standpoint and decayed over time.

Operational Stress Injuries: Impact on Family Mental Health and Well-being

This study was part of a larger scoping review and environmental scan conducted for Veterans Affairs Canada on the effects of operational stress injuries (OSIs) on the mental health and wellbeing of Veterans’ families. This paper focuses broadly on the relationships between combat (and/or deployment more generally), OSIs (primarily post-traumatic stress disorder (PTSD)), and the family. Based on the scoping review, the paper finds that existing research investigates the impacts of a Veteran’s OSI on the family, but also how various aspects of the family (such as family functioning, family support, etc.) can impact a Veteran living with an OSI.

"Paseo por una guerra antigua" (Juan Antonio Bardem, 1948-49): una contramemoria de la Guerra Civil

Este artículo pretende demostrar en qué medida Paseo por una guerra antigua (1948-1949), la práctica de segundo curso del Instituto de Investigaciones y Experiencias Cinematográficas (IIEC) en la que Juan Antonio Bardem rueda a un joven mutilado caminando por las ruinas de la Ciudad Universitaria de Madrid, constituye un intento pionero de desmontar los relatos oficiales de la Guerra Civil Española y rescatar la memoria de los vencidos. Filmar las ruinas del campus madrileño en aquellos años era un acto sub­versivo, puesto que el Régimen había emprendido su reconstrucción para borrar las huellas del Madrid republicano y de la Guerra Civil, resignificando por completo el recinto universitario. Por tanto, en Paseo por una guerra antigua, Bardem intenta reapropiarse de un espacio que en la época iba imponiéndose como uno de los “lugares de memoria” del franquismo. Esta película se vale de la función documental del cine para inmortalizar unas ruinas que simbolizan la República y la guerra, para preservarlas de la muerte simbólica que representa su reconstrucción. Mostrar esas ruinas en 1948-1949 equivale a “materializar” el pasado, a traerlo al presente de la posguerra, en un proceso que recuerda a los planteamientos sobre la Historia de Walter Benjamin, para proponer una visión alternativa de la contienda. Se trata de una visión teñida de una memoria íntima, ya que la película es un paseo no solo por las ruinas sino también por los recuerdos de este joven mutilado. En suma, Bardem propone una contramemoria de la Guerra Civil.

Compensating Irish female revolutionaries, 1916-1923

The newly released Irish Military Service Pensions Collection offers the most comprehensive opportunity to examine the role of women in the Irish revolution (1916-1923) or in any comparable nationalist revolution. It is also an extremely useful source of evidence for an emerging historiographical trend of tracing the post-revolutionary lives of female veterans by examining the award of service pensions to them by that state. This article will examine the role played by gender in the award of such pensions, the economic and financial significance of them in a state that had under-developed welfare provision and the importance of them as a symbolic recognition of women’s roles in helping to achieve Irish independence. It also compares the post-conflict experience of Irish female revolutionary veterans with women who were involved in comparable international military conflicts.

Experiências de Combate e a sua Relação com a Sintomatologia Associada à Perturbação Pós-Stress Traumático em Veteranos da Guerra Colonial Portuguesa

Objectivos: O presente estudo avaliou a relação entre diversos aspectos objectivos e subjectivos inerentes às experiências de combate/guerra e sintomatologia associada à Perturbação Pós-Stress Traumático. Os instrumentos de auto-resposta utilizados na colheita dos dados foram analisados quanto às suas principais propriedades psicométricas. Métodos: A amostra foi composta por 105 combatentes da Guerra Colonial Portuguesa. Foram utilizados os seguintes instrumentos de avaliação: um questionário sóciodemográfico de auto-resposta para a caracterização da amostra, o Posttraumatic Stress Disorder Checklist (para militares), o Peritraumatic Dissociative Experiences Questionnaire, o Questionário de Experiências de Combate e duas escalas do Deployment Risk and Resilience Inventory, nomeadamente a Difficult Livings and Working Environment Scale e a Perceived Threat Scale. Resultados: O estudo das qualidades psicométricas dos instrumentos apresenta uma consistência interna superior a .86 e uma estabilidade temporal superior a .79. A análise factorial do Peritraumatic Dissociative Experiences Questionnaire apresenta bons valores na medida de Kaiser-Meyer-Olkin e no teste de esfericidade de Bartlett. Na rotação de Varimax é extraído um factor, predizendo a sua unidimensionalidade, que explica cerca de 70% da variância total do questionário. Os resultados relativos à validade divergentediscriminante indicam, por si só, que esta se apresenta de forma clara entre os instrumentos estudados (PCL-M, PDEQ, DLWES e PTS) no subgrupo com PTSD, com excepção da verificada entre o PCL-M e o PDEQ.. Quanto à validade de critério, constatam-se diferenças entre os subgrupos com e sem PTSD. Através do método da regressão linear múltipla, duas das seis variáveis têm, isoladamente, um peso preditivo significativo para a PTSD, nomeadamente a frequência de exposição a situações típicas e objectivas de combate/ guerra e os desconfortos diários durante a(s) comissão(ões). Ao considerarmos as variáveis no seu conjunto, aquelas que mais contribuem são a dissociação peritraumática e os desconfortos diários durante a(s) comissão(ões). Conclusão: Constata-se que os factores peritraumáticos em estudo desempenham um importante papel no desenvolvimento da sintomatologia inerente à PTSD. /

Vivências de Esposas de Ex-combatentes Diagnosticados com Stress Pós-traumático: uma abordagem fenomenológica

A Guerra Colonial assombrou a sociedade Portuguesa, durante mais de 10 anos. Durante esse tempo, milhares de jovens soldados foram obrigados fazer parte dessa Luta. Grande parte deles desenvolvera a Perturbação de Stress Pós-Traumático, com a qual ainda hoje vivem. A presente Investigação pretendeu descrever e compreender as Vivências das Esposas de Ex-Combatentes diagnosticados com a Perturbação de Stress Pós-Traumático, utilizando uma abordagem Qualitativa de Orientação Fenomenológica. Através deste Método, pretendeu-se conhecer a globalidade do Fenómeno, de uma forma compreensiva. Foram entrevistadas quatro Esposas que vivem de perto com este problema, as quais revelaram informações importantes para a Investigação. Desta maneira, foram recolhidos dados acerca da Infância e Adolescência, Casamento, Doença do Marido e Perspectivas de Futuro, destas Mulheres. Entre outras conclusões, destacamos a emergência de significações existenciais para estas Mulheres e o facto de esta doença ter influência a nível social, pessoal, familiar e económico. Além disso, as inúmeras estratégias de coping relatadas, demonstraram ser uma mais-valia na forma como estas esposas lidam com a doença dos Maridos. Desta maneira compreendeu-se o fenómeno de uma forma holística, o que forneceu dados importantes para entender o que estas Mulheres vivenciam diariamente, tal como uma melhor compreensão do estado Psicológico destas Esposas e dos Maridos. / The Colonial War haunted the Portuguese society, for over 10 years. During that time, thousands of young soldiers were forced to be part of that fight. Most of them developed Post-Traumatic Stress Disorder, which they still live with. This research aims to describe and understand the Experiences of War Veterans’ Wives, whose husbands were diagnosed with the Post-Traumatic Stress Disorder, using the qualitative method and phenomenological orientation. Through this method, we meant to understand the whole phenomenon in a comprehensive manner. We interviewed four Wives who live closely with this problem, which revealed important information for the investigation. Therefore, we collected data on Childhood and Adolescence, Marriage, Husband’s Disease and Future Prospects, of those Women’s. Among other findings, we highlight the emergence of existential meaning for these Women’s and the fact that this disease influences their lives on social, personal, familial and financial issues. Moreover, the many coping strategies reported, have proven an asset in the way this Wives deal with their husbands illness. Thus it was understood the phenomenon in a holistic way, which provided important information to understand what these Women’s live daily as a better understanding of the psychological state of Husbands and Wives.

Stochastic Modeling of Reversible Biochemical Reaction-Diffusion Systems and High-Resolution Shock-Capturing Methods for Fluid Interfaces

Thesis (Ph.D.)--University of Washington, 2016-08

The Co-Adapted Community: A New Vision for the Parks at Walter Reed

The human-canine bond is one that has existed for thousands of years, yet not until more recently has it gained serious attention in the military medical field. The following thesis will use architecture as a way to explore the physical and psychological rehabilitative relationship between veterans and rescued canines. As soldiers return home from deployment, many struggle with reintegration into civilian life. The therapeutic potential of service dogs, however, has become a widely recognized recovery tool. Meanwhile, there are thousands of non-service dogs suffering extended periods in animal shelters with adverse psychological effects. In a society primarily centered on the typical human experience, the built environment often demonstrates a narrow perspective that lacks sensitivity towards the atypical user. Soldiers and dogs alike perceive and experience the world uniquely, and a further exploration of their distinct relationship can begin to inform how we might develop a new type of shared healing environment or co-adapted community.

The Amplifier - v. 12, no. 2

In this issue...Library Building, Mineral Museum, Daylight Savings Time, Pete Knudson, Finlen Hotel, Homecoming, Vending Machines, Veterans' Day

The Amplifier - v. 15, no. 5

In this issue...Coach Charlie Armey, Veterans, Marcus Daly, Campus Pollution, Satellites, Campus Parking, Elks National Foundation, Kieth Strom, International Club

Veteranness : Representations of Combat-related PTSD in U.S. Popular Visual Media

Posttraumatic stress and PTSD are becoming familiar terms to refer to what we often call the invisible wounds of war, yet these are recent additions to a popular discourse in which images of and ideas about combat-affected veterans have long circulated. A legacy of ideas about combat veterans and war trauma thus intersects with more recent clinical information about PTSD to become part of a discourse of visual media that has defined and continues to redefine veteran for popular audiences. In this dissertation I examine realist combat veteran representations in selected films and other visual media from three periods: during and after World Wars I and II (James Allen from I Am a Fugitive from a Chain Gang, Fred Derry and Al Stephenson from The Best Years of Our Lives); after the Vietnam War (Michael from The Deer Hunter, Eriksson from Casualties of War), and post 9/11 (Will James from The Hurt Locker, a collection of veterans from Wartorn: 1861-2010.) Employing a theoretical framework informed by visual media studies, Barthes’ concept of myth, and Foucault’s concept ofdiscursive unity, I analyze how these veteran representations are endowed with PTSD symptom-like behaviors and responses that seem reasonable and natural within the narrative arc. I contend that veteran myths appear through each veteran representation as the narrative develops and resolves. I argue that these veteran myths are many and varied but that they crystallize in a dominant veteran discourse, a discursive unity that I term veteranness. I further argue that veteranness entangles discrete categories such as veteran, combat veteran, and PTSD with veteran myths, often tying dominant discourse about combat-related PTSD to outdated or outmoded notions that significantly affect our attitudes about and treatment of veterans. A basic premise of my research is that unless and until we learn about the lasting effects of the trauma inherent to combat, we hinder our ability to fulfill our responsibilities to war veterans. A society that limits its understanding of posttraumatic stress, PTSD and post-war experiences of actual veterans affected by war trauma to veteranness or veteran myths risks normalizing or naturalizing an unexamined set of sociocultural expectations of all veterans, rendering them voice-less, invisible, and, ultimately disposable.