Family military leave—A growing national trend for employees with active‐duty family members

2008 ◽  
Vol 35 (2) ◽  
pp. 69-74
Author(s):  
William C. Martucci ◽  
Katherine R. Sinatra
Keyword(s):  
Family Members ◽  
Active Duty ◽  
National Trend

Shared Decision-Making During Labor and Birth Among Low-Risk, Active Duty Women in the U.S. Military

2021 ◽  
Author(s):  
Stacey E Iobst ◽  
Angela K Phillips ◽  
Candy Wilson
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Family Members ◽  
Hospital Setting ◽  
Active Duty ◽  
Theory Approach ◽  
Labor And Delivery ◽  
Shared Decision ◽  
Cesarean Birth ◽  
The U.S

ABSTRACT Introduction The cesarean birth rate of 24.7% in the Military Health System (MHS) is lower than the national rate of 31.7%. However, the MHS rate remains higher than the 15-19% threshold associated with optimal maternal and neonatal outcomes. For active duty servicewomen, increased morbidity associated with cesarean birth is likely to affect the ability to meet the demands of assigned missions. Several decision-points occur during pregnancy and after the onset of labor that can affect the likelihood of cesarean birth including choice of provider, choice of hospital, timing of admission, and type of fetal monitoring. Evidence suggests the overuse of labor interventions may be associated with cesarean birth. Shared decision-making (SDM) is a strategy that can be used to carefully consider the risks, benefits, and alternatives of each labor intervention and is shown to be associated with positive patient outcomes. Most existing evidence explores SDM as an interaction that occurs between women and their providers. Few studies have explored the role of stakeholders such as spouses, family members, friends, labor and delivery nurses, and doulas. Furthermore, little is known about the process of SDM during labor and childbirth in the hospital setting, particularly for active duty women in the U.S. military. The purpose of this study was to propose a framework that explains the process of SDM during labor and childbirth in the hospital setting for active duty women in the U.S. military. Materials and Methods A qualitatively driven mixed-methods approach was conducted to propose a framework that explains the process of SDM during labor and childbirth in the hospital setting for active duty women in the U.S. military. Servicewomen were recruited from September 2019 to April 2020. Semi-structured interviews were analyzed using a constructivist grounded theory approach. Participants also completed the SDM Questionnaire (SDM-Q-9). Results Interviews were conducted with 14 participants. The sample included servicewomen from the Air Force (n = 7), Army (n = 4), and Navy (n = 3). Two participants were enlisted and the remainder were officers. Ten births occurred at military treatment facilities (MTFs) and six births took place at civilian facilities. The mean score on the SDM Questionnaire was 86.7 (±11.6), indicating a high level of SDM. Various stakeholders (e.g., providers, labor and delivery nurses, doulas, spouses, family members, and friends) were involved in SDM at different points during labor and birth. The four stages of SDM included gathering information, identifying preferences, discussing options, and making decisions. Events that most often involved SDM were deciding when to travel to the hospital, deciding when to be admitted, and selecting a strategy for pain management. Military factors involved in SDM included sources of information, selecting and working with civilian providers, and delaying labor interventions to allow time for an active duty spouse to travel to the hospital. Conclusions SDM during labor and birth in the hospital setting is a multi-stage process that involves a variety of stakeholders, including the woman, members of her social and support network, and healthcare professionals. Future research is needed to explore perspectives of other stakeholders involved in SDM.

scholarly journals Civilian-military Collaboration: Department of Defense data in the BioSense Platform

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Jessica Deerin ◽  
Jean-Paul Chretien ◽  
Paul E. Lewis
Keyword(s):  
Department Of Defense ◽  
Family Members ◽  
Active Duty ◽  
Surveillance Program ◽  
Age Group ◽  
Diagnosis Codes ◽  
Time Period ◽  
Control And Prevention ◽  
Military Treatment Facility ◽  
Clinic Visits

ObjectiveThe Department of Defense data is available to NationalSyndromic Surveillance Program (NSSP) users to conduct syndromicsurveillance. This report summarizes the demographic characteristicsof DoD health encounter visits.IntroductionThe DoD provides daily outpatient and emergency room data feedsto the BioSense Platform within NSSP, maintained by the Centersfor Disease Control and Prevention. This data includes demographiccharacteristics and diagnosis codes for health encounter visits ofMilitary Health System beneficiaries, including active duty, activeduty family members, retirees, and retiree family members. NSSPfunctions through collaboration with local, state, and federal publichealth partners utilizing the BioSense Platform, an electronic healthinformation system.MethodsDoD data was pulled from the BioSense Platform through aRStudio server on October 11, 2016, querying data from November1, 2015 to September 30, 2016. Appointment type and beneficiarycategory data was not available in BioSense until November 1, 2015.Appointment type was categorized into clinic visits and telephoneconsults. Demographic characteristics (age group, gender, beneficiarycategory) are stratified by appointment type.ResultsDuring the time period of November 1, 2015 to September 30, 2016,data were received from 452 clinics. There is a military treatmentfacility located in 45 states and a military treatment facility mayhave one to 12 clinics. There were a total of 86,840,632 healthcareencounter records. The age group, 25-44 years, accounted for 39.4%of the medical encounters; the mean age was 33.9 (SD=19.1). Malesaccounted for 55.6% of the medical encounters. For the time periodfrom November 1, 2015 to September 30, 2016, 78.9% of medicalencounters were clinic visits. The remaining medical encounterswere telephone consults. Of the clinic visits, 53.7% of the medicalencounters were for active duty personnel.ConclusionsThis report highlights the DoD data available to NSSP users forcollaborative syndromic surveillance efforts, promoting a communityof practice. It is important to understand the population demographicsand limitations to the DoD data when conducting syndromicsurveillance.

Effective Clinical Interviewing

1978 ◽  
Vol 9 (4) ◽  
pp. 265-271 ◽  
Author(s):  
Pauline T. Flynn
Keyword(s):  
Family Members ◽  
Essential Elements ◽  
Speech Language Pathologist ◽  
Lay Persons ◽  
Clinical Interviewing ◽  
Client Management

Speech, language, and hearing professionals rely on many individuals to provide information about a client. Management programs, in part, are devised, modified, and evaluated according to responses obtained from the client, family members, educators, and other professional and lay persons who have contact with the client. The speech-language pathologist has the responsibility of obtaining pertinent, complete, unbiased information about clients. This article provides an overview of the essential elements of an interview.

Much Ado About Fried Chicken: Abetting Aspiration or Respecting Autonomy?

2019 ◽  
Vol 28 (3) ◽  
pp. 1356-1362
Author(s):  
Laurence Tan Lean Chin ◽  
Yu Jun Lim ◽  
Wan Ling Choo
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Multidisciplinary Team ◽  
Biopsychosocial Model ◽  
Family Members ◽  
Clinical Decisions ◽  
Goals Of Care ◽  
Complex Needs ◽  
Aspiration Risk ◽  
Patient Centric

Purpose Palliative care is a philosophy of care that encompasses holistic, patient-centric care involving patients and their family members and loved ones. Palliative care patients often have complex needs. A common challenge in managing patients near their end of life is the complexity of navigating clinical decisions and finding achievable and realistic goals of care that are in line with the values and wishes of patients. This often results in differing opinions and conflicts within the multidisciplinary team. Conclusion This article describes a tool derived from the biopsychosocial model and the 4-quadrant ethical model. The authors describe the use of this tool in managing a patient who wishes to have fried chicken despite aspiration risk and how this tool was used to encourage discussions and reduce conflict and distress within the multidisciplinary team.

A Strengths-Based Approach to Autism: Neurodiversity and Partnering With the Autism Community

2017 ◽  
Vol 2 (1) ◽  
pp. 56-68 ◽  
Author(s):  
Amy L. Donaldson ◽  
Karen Krejcha ◽  
Andy McMillin
Keyword(s):  
Broad Spectrum ◽  
First Language ◽  
Family Members ◽  
Community Identity ◽  
Speech Language Pathologists

The autism community represents a broad spectrum of individuals, including those experiencing autism, their parents and/or caregivers, friends and family members, professionals serving these individuals, and other allies and advocates. Beliefs, experiences, and values across the community can be quite varied. As such, it is important for the professionals serving the autism community to be well-informed about current discussions occurring within the community related to neurodiversity, a strengths-based approach to partnering with autism community, identity-first language, and concepts such as presumed competence. Given the frequency with which speech-language pathologists (SLPs) serve the autism community, the aim of this article is to introduce and briefly discuss these topics.

Dermatophytes Tracked Among Family Members

2006 ◽  
Vol 39 (23) ◽  
pp. 11
Author(s):  
Timothy F. Kirn
Keyword(s):  
Family Members
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