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Objective: To conduct a quality improvement evaluation of the Empower Veterans Program (EVP), an interdisciplinary pain rehabilitation/functional restoration program option for functional restoration for high-impact chronic pain, offered in a large metro-area Veterans Health Administration (VHA) system. Data Sources: VHA Corporate Data Warehouse electronic medical record data for patients treated by EVP between 2015 and 2019. Evaluation Design: This retrospective design first compared EVP patients considered engaged or not engaged in completing treatment in terms of demographic characteristics and post-treatment changes in clinical measures related to opioid use and mental health. We then compared mortality risk between matched groups of treated and untreated patients with chronic pain and concurrent opioid prescriptions using propensity score matching and Cox proportional hazards methods. 'Treated' in the matched groups was defined as any level of EVP participation (i.e., both engaged and not engaged). Data Collection/Extraction Methods: We first identified 1053 EVP patients with 1 year of pre-and post-treatment follow-time and determined their engagement level. From those with chronic pain and prescription opioids, we matched 237 EVP patients to 375 untreated patients. Principal Findings: Engaged patients (57.4% of treated patients), were somewhat older than the non-engaged (mean age 57.1 vs. 53.7, Cohen's D = 0.30), and achieved lower mean PHQ9 depression scores in the post-treatment year (9.2 vs. 10.6, Cohen's D = 0.20). Participation in EVP was associated with a 65% lower mortality risk among Veterans with chronic pain and opioid use when compared to the untreated patients: (HR: 0.35, 95% CI: 0.17, 0.75). Conclusions: EVP was associated with a large reduction in mortality risk for Veterans with both chronic pain and opioid use. This result could inform the decision process in a VA station or region when considering providing or expanding access to an interdisciplinary rehabilitation/functional restoration program for chronic pain. KEYWORDS chronic pain, functional rehabilitation, functional restoration, opioid use disorder, pain management, 1 | INTRODUCTION Veterans are more likely to suffer from the related impacts of chronic pain, opioid overdose, and suicide when compared to the general population. Severe pain is reported [...]

Organizational changes often follow the cessation of hostilities as the military attempts to correct imperfections exposed by conflict, take advantage of lessons learned, and adjust to postwar conditions. Following the [...]

Enabling communications is the core mission of the Signal Corps. Commanders must have effective communications to maintain command and control over their forces without regard to physical distance--whether it is [...]

On April 1, 1920, the Office of the Chief Signal Officer published Information Bulletin No. 1. The announcement on the cover said: 'It is the belief of this office that [...]

Customized Speech--speech targeted or tailored based on knowledge of one's audience--is pervasive. It permeates our relationships, our culture, and, especially, our politics. Until recently, customization drew relatively little attention. Cambridge Analytica changed that. Since 2016, a consensus has decried Speech Customization as causing political manipulation, disunity, and destabilization. On this account, machine learning, social networks, and Big Data make political Customized Speech a threat we constitutionally can, and normatively should, curtail. That view is mistaken. In this Article, I offer the first systematic analysis of Customized Speech and the First Amendment. I reach two provocative results: Doctrinally, the First Amendment robustly protects Speech Customization. And normatively, even amidst Big Data, this protection can help society and democracy. Doctrinally, the use of audience information to customize speech is, itself, core protected speech. Further, audience-information collection, while less protected, may still only be regulated by carefully drawn, content-neutral, generally applicable laws. And unless and until the state affirmatively enacts such laws (as, overwhelmingly, it has not), it may not curtail speakers' otherwise lawful use of such information in political Speech Customization. What does this mean for democratic government? Today, Customized Speech raises fears about democratic discourse, hyper-partisan factions, and citizen autonomy. But these are less daunting than the consensus suggests, and are offset by key benefits: Modern Customized Speech activates the apathetic, empowers the marginalized, and checks government overreach. Accordingly, many current proposals to restrict such Customized Speech--from disclosure requirements to outright bans--are neither constitutionally viable nor normatively required., TABLE OF CONTENTS I. INTRODUCTION 407 II. THE LAW OF CUSTOMIZED SPEECH 413 A. Speaker Use of Audience Information 414 1. Plenary Protection for Content and Audience Choices 415 2. [...]

Preparing for a future war is the mission of the Army. Though the 'who, what, where, why, and when' are unknown, the Army must have a concept--an idea--to drive a [...]

As the Army shrank in size and millions of men returned home at the conclusion of World War II, Camp Gordon, Georgia, fell into a caretaker status with less than [...]

At about 4 a.m. on Saturday, Oct. 22, 1983, a telephone rang at the Eisenhower Cottage at Augusta National Golf Course. National Security Advisor Robert McFarland needed to speak to [...]

ABSTRACTThe proliferation of entrepreneurship education in business schools suggests that it is commonly believed to foster venture creation. At the same time, research on entrepreneurship education is growing. However, further studies are needed to determine the effectiveness of compulsory entrepreneurship education (CEE) by providing evidence on the specific type of entrepreneurial behavior it elicits and when these effects occur. To address this gap, this study evaluates different behavioral outcomes of CEE over time while building on social cognitive career theory to account for mediating effects of entrepreneurial intentions and entrepreneurial self-efficacy. We conduct a field quasi-experiment by following university business students (1,387 observations for 450 individuals) over 24 months post-treatment. Our findings reveal that CEE effectively increases entrepreneurial behavior in the short term but does not extend much beyond that. A follow-up study (N = 395) adds confidence to the generalizability of the results. We contribute to research on entrepreneurship education and policy.

Vulnerability. A word well known to all Signaleers who install, operate, maintain and defend the cyberspace domain. Recognizing a threat, identifying the target of the threat, and reducing or eliminating [...]

Say or read the word 'bikini' and an image is evoked in one's mind. However, what is that image of? Is it the small pieces of cloth that make up [...]

Throughout its history, the Signal Corps has trained its officers and soldiers at several locations during peacetime and wartime. Some of those locations were permanent in terms of decades and [...]

UNTIL THE 1600S, the average annual rate of economic growth in human history was approximately zero, on a per capita basis. Economies developed haltingly and, by today's standards, minimally. Politics [...]

Enabling communications has been the core mission of the US Army Signal Corps for over 160 years. To ensure reliable communications, the Signal Corps Warrant Officer cohort has continually adapted [...]

During early morning darkness on Sept. 9, 1943, approximately 450 Allied ships carrying 125,000 troops assembled off the coast of Salerno, Italy, to execute Operation Avalanche. The amphibious landings were [...]

Enabling During the Civil War, the U.S. Army employed the unique capabilities of the Signal Corps to facilitate timely and secure information for battlefield commanders. Signal officers and Soldiers were [...]

Reinfection after successful treatment with direct-acting antivirals is hypothesised to undermine efforts to eliminate hepatitis C virus (HCV) infection among people with HIV. We aimed to assess changes in incidence of HCV reinfection among people with HIV following the introduction of direct-acting antivirals, and the proportion of all incident cases attributable to reinfection.

The Allied invasion of Normandy stands as one of the most famous military operations in history for its magnitude, complexity, individual daring and decisive leadership. Over 2,700 ships--from battleships to [...]

The war was over. In the early 1920s, the US Army faced the predicable challenge of drawing down, downsizing, or whatever contemporary name applied to the post-war process and actions [...]

The COVID-19 pandemic is a poignant example of a rapidly changing operational environment (OE). The virus's spread has caused chaos in almost every personal and public sector throughout the world. [...]

Editor's note: This article originally ran in the April 2020 edition of the Army Communicator and is being republished upon request In 1859, the War Department provided Albert J. Myer [...]

Brown cartons whisk by at breakneck speeds as the sound of pneumatic triggers divert the cartons onto a separate path or down a chute. Red laser light beams sparkle and [...]

During the past few years there has been much interest and excitement about the establishment of the newest military service--the US Space Force. The concept of domains of warfare--land, sea, [...]

It is unknown whether decompressive craniectomy improves clinical outcome for people with spontaneous severe deep intracerebral haemorrhage. The SWITCH trial aimed to assess whether decompressive craniectomy plus best medical treatment in these patients improves outcome at 6 months compared to best medical treatment alone.

Mit der rasch fortschreitenden Digitalisierung von Patientendaten haben sich Chancen zur Verbesserung von Gesundheitsprävention und zur Therapieforschung entwickelt, die noch vor wenigen Jahren kaum vorstellbar waren. Diese Möglichkeiten führen zu einem Zielkonflikt, bei dem nicht weniger als ein Interessenausgleich zwischen den Rechten des Individuums (nämlich dem Grundrecht auf informationelle Selbstbestimmung) und andererseits fundamentalen Interessen der Allgemeinheit (u.a. dem Recht aller auf Leben und körperliche Unversehrtheit aus Art. 2 Abs. 2 GG) zu verhandeln ist (BVerfG, Urt. v. 20.7.1954 - 1 BvR 459/52 u.w., BVerfGE 4, 7 - Menschenbild des Grundgesetzes). Mit dem Gesetz zur verbesserten Nutzung von Gesundheitsdaten, einschließlich dem Gesundheitsdatennutzungsgesetz (GDNG) wird auf der Grundlage der entsprechenden Regelungen in der DSGVO und dem BDSG der Versuch eines sachgerechten Interessensausgleichs unternommen. Der Aufsatz ordnet diesen Versuch in Bezug auf die tatsächlichen Datennutzungsmöglichkeiten ein und stellt ihn in den Kontext des Datenschutzrechts, der Datenschutzpraxis und der Informationssicherheit.

Purpose: The severity of bleeding events is heterogeneously defined during peripheral veno-arterial extracorporeal membrane oxygenation (pVA-ECMO). We studied three bleeding definitions in pVA-ECMO: the Extracorporeal Life Support Organization (ELSO)-serious bleeding, the Bleeding Academic Research Consortium (BARC), and the universal definition of postoperative bleeding (UPDB) classifications. Methods: We included consecutive adult patients supported by pVA-ECMO for refractory cardiogenic shock admitted to Lille academic hospitals between January 2013 and December 2019. We assessed the association of bleeding definitions with the primary endpoint of 28-day all-cause mortality with the use of multivariate models accounting for time-dependent and competing variables. We compared models’ performances using the Harrell’s C-Index and the Akaike information criteria. Results: Twenty-eight-day mortality occurred in 128/308 (42%) 308 patients. The ELSO-serious bleeding (hazard ratio [HR], 1.67; 95% confidence interval [CI], 1.09 to 2.56) and BARC ≥ type 2 (HR, 1.55; 95% CI, 1.01 to 2.37) were associated with 28-day mortality (Harrell’s C-index, 0.69; 95% CI, 0.63 to 0.74 for both). Predictors of ELSO-serious bleeding were postcardiotomy, body mass index, baseline platelets count, fibrinogen, and hemoglobin levels. Conclusion: Extracorporeal Life Support Organization-serious bleeding and BARC ≥ type 2 are relevant definitions of major bleeding regarding their association with mortality in critically ill patients who survived the first 24 hr while supported with pVA-ECMO for cardiogenic shock. Study registration: CERAR (IRB 00010254-2022-050, Paris, France); first submitted on 18 April 2022.

On December 15, 1880, William B. Hazen was appointed to the position of Chief Signal Officer with the regular army rank of Brigadier General. Hazen had served in the US [...]

To the Marin Independent Journal, Feb. 22, 2023 I want to congratulate authors David N. Myers and Daniel Sokatch for having the courage to write the recently published commentary that [...]

The idea of preparing for a future war is not new. It is the mission of the Army, especially when not engaged in conflict, to prepare for a war in [...]

At the beginning of the 1980s, Army Chief of Staff General Edward C. Meyer directed a study to devise a method to transfer specialty proponency from the Army Staff to [...]

Fifty years ago on July 23, 1970 soldiers of the 101st Airborne Division evacuated from and abandoned the hill known as Fire Support Base (FSB) Ripcord located about 25 miles [...]

A New Century--A New War The unthinkable occurred when terrorists attacked the United States on September 11, 2001. One of the lessons learned from the response to this attack was [...]

Rapid advances in computer technology brought forth the Information Age during the 1990s. When the US went to war with Iraq in 1990-1991 instead of miles of wire, arrays of [...]

Following World War II the Signal Corps shrank from 350,000 personnel to an active strength of about 50,000. However increasing tensions with the Soviet Union and Communist China gave rise [...]

Throughout the 1930s, the world situation grew unstable due to the rise of Nazism in Germany, Fascism in Italy, and Japanese military aggression in the Far East. When war began [...]

For years the US had managed to avoid involvement in the European war that began in 1914. However, its status as a world power and trading giant brought it into [...]

Since its beginning, the Signal Corps found that its scope of missions included any technology that enabled an extended line of sight, such as a signal tower. A technology that [...]

In 1859, the War Department provided Albert J. Myer the resources to test his proposed wigwag visual signaling system. Myer and a few assistants arrived at Fort Monroe, Virginia in [...]

On April 1, 1920 the Office of the Chief Signal Officer published Information Bulletin No. 1, an 18 page newsletter reproduced in mimeograph format. The announcement on the front cover [...]

When most people think of WWII Pacific Theater of Operations, they usually associate the epic battles and campaigns with the Sailors and Marines of the Naval service. In fact, the [...]

Seventy-five years ago, the largest concentration of warships and naval assault craft ever assembled in the Pacific Ocean sailed into Leyte Gulf. Located in the heart of the Philippine archipelago, [...]

In 1921, Maj. Gen. George O. Squire, the Chief Signal Officer, wrote to Sgt. Henry T. Rowbottom, through the commanding officer of the Washington-Alaska Military Cable and Telegraph System (WAMCATS), [...]

Every signal Soldier knows June 21, 1860, is the official birthday of the Signal Corps as an Army branch. However, from then until March 3, 1863, there was only one [...]

The month of February 2023 marks the anniversary of the constitution of three historical Signal Corps units, each of which happens to belong to one of the three different Army [...]

On Nov. 4, 1982, Maj. Gen. Archibald Birtwistle, a British military signal officer, rededicated a 7-foot, 900-pound, bronze statue of the ancient Roman god Mercury, to the U.S. Army Signal [...]