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The purpose of this paper is to explore the reintegration process of Wounded, Injured or Sick Employees (WISE) of the Dutch Military Armed Forces.

The research method is an exploratory, qualitative case study. A purposive sampling was drawn, including 10 WISE, and 6 reintegration stakeholders. A total of 16 interviews were conducted to explore the individual, organisational and socio-environmental factors that influence reintegration of WISE.

Findings show the importance of involvement and participation of members of the social environment in the reintegration process. Findings show that the complexity of the plethora of WISEs' injuries and disabilities requires a more person-centric reintegration approach with personalized-customized provisions, rather than a policy-driven approach to the reintegration, in order to enhance the reintegration experience and to arrive at beneficial individual and organisational reintegration outcomes.

This cross-sectional study on a limited sample of WISE and reintegration stakeholders does not allow for making inferences about the long-term effects of the reintegration process on reintegration outcomes of the wider population of WISE. Future longitudinal research, encompassing a larger sample, could examine the long-term career, organisational and societal implications of reintegration of WISE within and outside the Military Armed Forces.

This paper presents a “Wounded Warrior Workplace Reintegration Program”, aimed at deriving beneficial outcomes for all stakeholders involved in the reintegration trajectory.

This paper contributes to the literature by presenting a Model of Occupational Reintegration of WISE that considers the factors at an individual, social-environmental, and institutional level as determinants of successful reintegration.

This study demonstrates how becoming a high-reliability institution in health care is a priority, given the high-risk environment in which an error can result in harm. Literature conceptually supports the need for highly reliable health care facilities but does not show a comprehensive approach to operationalizing the concept into the daily workforce to support patients. The Veterans Health Administration closes the gap by documenting a case study that not only demonstrates specific actions and functions that create a high-reliability organization (HRO) for safety and improvement but also created a learning organization by spreading the knowledge to other facilities.

The authors instituted a methodology consisting of assessments, training and educational simulations to measure, establish and operationalize activities that identified and prevented harmful events. Visual communication boards were created to facilitate team huddles and discuss improvement ideas. Improvements were then measured and analyzed for purposeful outcomes and return on investment (ROI).

HRO can be operationalized successfully in health care systems. Measurable outcomes verified that psychological safety was achieved through the identification and participation of 3,184 process improvement projects over a five-year period, which yielded a US$2.8m ROI. Documented processes and activities were used for educational teachings, which were disseminated to other Veteran Affairs Medical Center’s through the Truman HRO Academy.

This case study is limited to one hospital in the Veterans Health Administration (VHA) network. As the VHA continues to deploy the methods outlined to other hospitals, the authors will perform incremental data collection and ongoing analysis for further validation of the HRO methods and operations. Hospitalists can adapt the methods in the case study for practical application in a health care setting outside of VHA. Although the model is rooted in health care, the methods may be adapted for use in other industries.

This case study overcomes the limitations within literature regarding operationalizing HRO by providing actual activities and demonstrations that can be implemented by other health care facilities.

Black male student veterans enter postsecondary education with three intersecting identities that should be acknowledged through the academic and student support services provided by the institution they attend. The academic guidance provided by competent and compassionate advisors coupled with student affairs engagement contribute to the graduation of this unique population.

The purpose of this literature is twofold: (a) identify and highlight effective academic support methods that contribute to Black male veteran graduation and (b) identify and highlight effective Student Affairs engagement strategies that contribute to Black male veteran graduation. The literature will further inform higher education professionals in both Academic Affairs spaces and Student Affairs spaces of collaborative partnerships that can be formed to increase the graduation rates of Black male veterans. Black male student veterans are not a monolithic population nor are the institutions they are attending. Therefore, it is also important to examine how the literature addresses advising and engagement of Black male veterans at diverse types of postsecondary institutions.

This study aims to increase awareness and educate the reader about health-care fraud targeting seniors in the USA to help stakeholders better understand, recognize and prevent this type of fraud.

This paper collects statistics on the current state of health care frauds committed against seniors, and examines related cases and laws.

The authors find this type of fraud is highly prevalent and expected to increase. Current laws preventing this fraud from occurring are multifold and complex. While prevention strategies through law enforcement have been somewhat successful, a reduction in resources may put seniors at an increased risk in the years to come.

Without additional prevention strategies, the problem will likely escalate with a growing population of older adults. This study encourages further research into effective prevention strategies and methods to fight health-care fraud against seniors.

Health-care fraud and its associated costs pose a significant threat to the society and economy of the USA. Reducing this fraud will not only reduce the costs to the US economy but also improve the physical and mental well-being of senior victims, reduce their mortality and hospitalization rates and improve the public trust placed to health-care providers.

This study highlights how health-care fraud is committed against seniors. With the projected trend of an aging US population, educating stakeholders, increasing awareness and applying tools to protect seniors will be important to reduce the absolute scope of this problem in the future.

Engaging with heritage to support mental health and wellbeing has become a focus of research and policy, more recently moving towards social prescription of heritage interventions. While there are benefits to active participation, there are potential risks to those taking part and to the non-renewable historic remains and landscape that form the core of these projects. The purpose of the current research paper was to develop best practice guidelines for organisations offering heritage projects as interventions for people who live with mental health issues to protect both participants and heritage.

There were two research phases; a Sandpit with World Café discussions to produce a set of research priorities, and a Delphi Consultation, using three questionnaires distributed over six months, to develop best practice guidelines. The panel in both phases comprised experts through lived experience, policy, practice and research.

The Authentic and Meaningful Participation in Heritage or Related Activities (AMPHORA) guidelines cover three stages: project development, project delivery and project follow-up, with a set of action points for each stage. Of particular importance was authentic participation and expertise to ensure appropriate management of heritage/ historic environment assets and support for participants.

The AMPHORA guidelines can assist all organisations in the delivery of safe projects that support the mental health of those involved, as well as enhancing and protecting the historic environment.

To the best of the authors’ knowledge, these are the first research-led guidelines that help heritage organisations support those living with mental health issues.

This chapter more clearly identifies the distinction between Electronic Health Record (EHR) and Electronic Medical Record (EMR), and states their value in obtaining individual-level data. Synthetic medical records may be used as a surrogate for EHR data in order to ensure digital data privacy is maintained during the development of the LHS. Synthea is an open-source simulation tool available through GitHub.¹ Extensive descriptive analysis of synthesized data is provided as a foundation for the analysis in Chapter 7.

The process of chronic pain (CP) and strategies is to improve the patient’s health and well-being. CP is a frequent medical problem that presents a major challenge to healthcare providers because of its complex natural history, imprecise aetiology, and inadequate response to pharmacological treatment. Although different definitions exist it is widely accepted that CP is an ongoing pain that lasts more than 3 months or that persists longer than the reasonably expected healing time for the involved tissues. Also, it is acknowledged that its treatment is much different than the treatment for acute pain. When addressing a person with CP, one should always keep in mind that pain is much more about the individual than the underlying medical condition. Every person is different, and healthcare providers should take a tailor-made approach to managing their pain. This is the only way to ensure good results in pain treatment. Treatment goals should be discussed and adapted to the patient profile. It is fundamental to have clear goals from the beginning and to ensure these are realistic, individualized, and measurable. Effective treatment for CP is only achieved through a holistic framework in which the patient’s well-being is the first concern and an interdisciplinary and societal approach is implemented from the first day.

The COVID-19 pandemic created a broad array of challenges for hospitals. These challenges included restrictions on admissions and procedures, patient surges, rising costs of labor and supplies, and a disparate impact on already disadvantaged populations. Many of these intersecting challenges put pressure on hospitals' finances. There was concern that financial pressure would be particularly acute for hospitals serving vulnerable populations, including safety-net (SN) hospitals and critical access hospitals (CAHs). Using data from hospitals in Washington State, we examined changes in operating margins for SN hospitals, CAHs, and other acute care hospitals in 2020 and 2021. We found that the operating margins for all three categories of hospitals fell from 2019 to 2020, with SNs and CAHs sustaining the largest declines. During 2021, operating margins improved for all three hospital categories but SN operating margins still remained negative. Both changes in revenue and changes in expenses contributed to observed changes in operating margins. Our study is one of the first to describe how the financial effects of COVID-19 differed for SNs, CAHs, and other acute care hospitals over the first two years of the pandemic. Our results highlight the continuing financial vulnerability of SNs and demonstrate how the factors that contribute to profitability can shift over time.

This study aims to assess the nature and scope of dog-based programmes in prisons, assessing critically the potential opportunities, benefits, challenges and risks of developing innovative dog-based programmes for older prisoners in England and Wales. This paper outlines the potential benefits and challenges of developing dog-based programmes for older prisoners and sets out next steps for future research and practice.

This study is based on a scoping review of published research literature on prison dog programmes (PDPs) in the USA, the UK and other countries, with particular reference to older people in prison, followed by semi-structured interviews with six members of an expert advisory group. The literature review and data from the qualitative interviews were analysed thematically.

There is a substantial body of published research literature which supports PDPs as having identifiable positive impacts for people and also dogs, and also published research which highlights the benefits to older people of dog ownership or participation in dog-based activities. However, much of this research is small-scale and qualitative, and it has been argued that there is a lack of a quantitative evidence base. This research concludes that findings from the literature review and the semi-structured interviews support further research and the creation of pilot projects to develop dog-based projects for older people in prison.

This study was small-scale, and the findings need to be approached with caution. The literature review searched a small number of databases and filtered out articles published in languages other than English, and the review of the grey literature focused on reports from the UK. The number of experts interviewed was small and there was no direct consultation with older people in prison nor with older people with recent personal lived experience of imprisonment and community resettlement. A more extensive future study would benefit from a more extensive literature review, a larger group of participants and the inclusion of service users, prison managers and government policymakers, subject to the appropriate ethical and security approvals. At the time the research took place, ongoing COVID-19 restrictions on prison research meant that research with current prisoners and prison managers would not have been approved by the HMPPS NRC.

This research provides a research-based justification for future dog projects for older prisoners, leading potentially to improved well-being for older people in prison.

This study brings together the published research literature on PDPs with the research literature on the needs and experiences of older people in prison for the first time, and identifies potential directions for future research.