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Miguel CastilloProf. M. HaysRHET 1058 May 2016The Poor Treatment of Veterans within the Department of Veterans’ AffairsThe United State’s Department of Veterans Affairs is not suitably equipped to handle the issues that Veterans have, and they do not provide the proper level of care needed for their patients. There needs to be reform that cuts down on patient wait times and a better system for scheduling must be implemented in order for veterans to be properly cared for. Bronstein, Scott, and Drew Griffin. “A fatal wait: Veterans languish and die on a VA hospital's secret list.” . Cable News Network and Turner Broadcasting System, Inc. 23 April 2014. Web. 24 April 2016 CNN’s report on the Phoenix Scandal was what prompted me to write my paper. They covered a story in which a Veteran’s Affairs Hospital in Phoenix Arizona created two lists for veterans who signed up for benefits. One list was a secret list that was a backlog of veterans who have not yet received care, and the other was a list that they sent off to the government to look like they were keeping up with appointments in a timely manner. They would move patients from the secret list to the official list at certain times in order to keep with their own regulations. This practice lead to the deaths “of at least forty veterans”, since they were placed on the secret list and never received their N is a news network and thus a popular source. It is likely biased. Bruner, Victoria, and Pamela Woll. The Battle Within: Understanding The Physiology Of War-Zone Stress Exposure."?Social Work In Health Care?50.1 (2011): 19-33. Web. 9 Mar. 2016.This source was an article which detailed the stresses the body occurs when in war. It explained how the nervous system works and how combat related stress affects it, and it also explained how different parts of the brain react to stress. The article went into detail about how the body’s autonomic nervous system has two parts to it, the sympathetic and the parasympathetic. This relates to the “fight or flight” response people have. The sympathetic is what causes chemicals in the body to aid in the fight or flight. The parasympathetic is what causes the body to freeze up near danger. It was explained in the article that in the battlefield the sympathetic nervous system is always active. Thus when someone returns to civilian life one’s body is still hard wired in the “fight or flight” response, making it difficult for the parasympathetic system to calm them down. The article also went into detail on the brains amygdala and hippocampus. The amygdala is what sets the nervous system into motion, it stores emotional memories and activates when under stress. The hippocampus is what stores narrative memory. The article explained that blackouts were caused by the hippocampus ceasing to function when under extreme stress. The article lastly goes on to explain what can be done to minimize the effects of war trauma, it lists various ways the veteran and their community can help to bring the soldier back to normal.This article was a scholarly source published five years ago. It is relevant to my research. Since my topic is mostly going to refer to Iraq and Afghanistan war veterans, I’m able to reach a decade back if necessary. This article was peer reviewed and belongs to a healthcare journal, so its trustworthy and is not biased. The writing is slightly less formal than what I’ve seen from other articles, yet it is detailed and focuses on the topic at hand. This source goes into the background information on how war affects a veteran. This will be useful for my paper, since I will need to explain how war physiologically affects a person.Demers, Anne. “When Veterans Return: The Role of Community in Reintegration.” Journal of Loss and Trauma. 16. (2011): 160-179. Web. 29 Feb. 2016This Journal Excerpt covered the topic of reintegration and its difficulties for soldiers who return home. In this study Demers conducted a series of focus group discussions where she asked the subjects to answer a series of simple questions. Her questions were about how the deployment impacted their lives and their social interactions, and what kind of support they sought out and received after returning home. The study found that when soldiers went out to boot camp, their identities and live were changed. They transformed from civilians into soldiers, and as soldiers they learned a new way to live. They lived with the knowledge that they could die at any second out in the field. They learned to cope with this fact, and adopted attitudes to deal with the stress that came from it. The military lifestyle became a stark contrast to the civilian life they started with. When at home, they found that they had difficulty connecting with civilians. They were disconnected from their families and loved ones. When they came back home, they saw that they weren’t the same people that they used to be. The change from a civilian to a soldier created a crisis of identity for them when they returned.The study had an abundance of male participants and was conducted on soldiers who lived in California. There were forty-five men and three women taking part in the study. All the participants were veterans from the Iraq and Afghanistan wars. They were put into focus groups and asked to discuss three “open ended” questions. The questions what were asked were about “the ways in which their deployments impacted their lives, the ways in which their deployments affected their interactions with family members and friends, and the types of support they sought out and received” The first two questions were well covered, the third was not answered. As for the Journal Excerpt itself, it is a peer reviewed scholarly source from five years ago. It is recent enough to be considered useful. There does not seem to be any bias within this study. Draper, Debra. VA HEALTH CARE Actions Needed to Improve Access to Primary Care for Newly Enrolled Veterans Accessible Version. 2016. U.S. Government Accountability Office. PDF File. < source is from the United States’ Government Accountability Office (GAO). This organization is involved in collecting information about government practice and publishing reports for both Government and Journalist use. This source is a review of the Veterans’ Affairs’ Veteran Health Administration (VHA) and its practices. Through interviewing one-hundred and eighty veterans who signed up for benefits, GAO was able to get a picture of how Veteran Healthcare works in America. They found that the VHA had a large issue with scheduling. Many veterans were not able to see providers due to poor scheduling practices. GAO also found that those veterans who did meet with providers did so after having waited for a significantly longer period of time than they should have. GAO lastly found out that there was a discrepancy with how they and the VHA measured wait times. The VHA measured time by how long the veteran waited from their requested appointment date, to the actual date they received care. GAO measured wait times by how long it had been since the veteran signed up for benefits. This lead to a massive difference in wait times. The GAO measured that many veterans waited above a month. The VHA measurements showed no such issue. This is GAO’s main issue with the VHA, the discrepancy between the wait times. This is an issue that GAO brought up to officials in order them to seek reform. This is an official document from an accredited source. It will be useful since it outlines the VA’s issue with wait time and scheduling. It can be considered as a scholarly source due to the fact it provides various citations for its claims. Debra Draper is the director of healthcare issues within GAO, thus she is well qualified to report on the issues at hand.Grim, Ryan, and Jennifer Bendery. “Leaked Document: Nearly One-Third Of 847,000 Vets With Pending Applications For VA Health Care Already Died.” . , Inc. 13 July. 2015. Web. 24 April. 2016.This is an article by the Huffington Post that addresses the issue that the Department of Veterans Affairs faces concerning their Application backlog. The statistic shown in the title, the “one-third of 847,000… dead” is misleading, since it does not account for veterans who were never taken off the list upon death, as well as veterans who may have moved on to a different provider. Regardless, this shows a massive flaw in the VA’s system, one that shall be addressed when I cover it in my research paper. The Huffington Post is a popular source; it is a news site with a left wing bias. It claims that the statistics they got were from a source of theirs, a man called Scott Davis. Huffington Post linked Davis’ report in the article. Although the report looks official, it lacks citations and could easily have been forged. Since the authenticity of the report is questionable, one would have to rely on the Huffington Post to back it up. Thus this source is unquestionably a popular source.Kime, Patrica. “Despite what the VA says, veterans still wait weeks to see a doctor.” . The Military Times and Sightline Media Group. 19 April. 2016. Web. 24 April. 2016.This article from the Military Times was an explanation of the GAO report on the Department of Veterans’ Affairs. This article went into detail on how the VA and GAO measured veteran wait times differently and how the VA is going to reform itself to try to eliminate this issue.The Military Times is a news site operated by the Sightline Media Group, a company that publishes information on military affairs. Thus is it biased to military views and seeks to spread information within the military’s interest. Because of this, and the fact that it is a news source and not a scholarly source, it is a popular source.Krumholz, Harlan. “3 Things To Know Before You Judge VA Health System.” . LLC, 23 May. 2014. Web. 11 March. 2016.In this news story by Forbes, Krumholz suggests that people aught to not react harshly to the news of the Department of Veterans’ Affair’s failings, and that they should consider his points before judging the group. He states that the VA “has consistently out-performed the non-VA/ private sector in quality of care and patient safety.” His second point was that the VA is an accountable group; the only reason that we know of how bad wait times for veterans are is because the VA was accountable enough to measure it themselves. Krumholz’ last point was that negative reactions to the VA’s failings may cause them to be dishonest and hide future failure from the public.This is the required source that does not support my my thesis. This source is new enough to be considered relevant. This is not a peer reviewed article, nor is it scholarly source. It is a popular source, thus its likely to come with bias. Krumholz only reports on science and medicine for Forbes, so he is within his area of expertise. Yet he is still writing for Forbes, which is likely biased since the owner of the site has a political alignment and has run for office in the past. Krumholz uses multiple sources for his article. He used two news sources to show the reader what the controversy was about, and he used three sources to prove his point. Of the three sources that support him two are from scholarly sources (journals of medicine) and one is from a popular source (National Public Radio). Although Krumholz has these sources, he uses them for only the first of his points, the other points are unsupported. He states that the VA is accountable, but doesn’t bring up a source for that. He states that focusing on the VA’s faults will make them less willing to admit further issues, this is also unsupported. In general, save for his first point about VA quality, he is not a reliable source.Landrum, Sam. "Enhancing Recovery from Trauma: Facilitating a Mindfulness Skills Group On a Department Of Veterans Affairs Inpatient PTSD Unit."?Social Work with Groups?39.1 (2016): 35-47.?Web. 11 Mar. 2016.This article describes how a skill called “mindfulness” was being used on a group of PTSD victims being treated in a Veterans’ Affairs medical clinic. Mindfulness can be described as “attentive non judgmental listening”; It is supposed to help a person accept their “internal experience” in life and “[reduce] avoidance” in order to help that person change. The Veterans were put into groups and taught mindfulness skills; they were also told to focus on three key points when practicing these skills. First off, the veterans were told that they need to focus on the present. The veterans’ issues with PTSD come from being stuck in the past (where the war was at) while being in the present. Focusing on the present will take them out of that war mentality. Secondly, Veterans were told they needed to have “inner awareness.” As soldiers they became so used to having an outer awareness; they needed to know their surroundings at all times in order to survive. Now these Veterans must learn to recognize their “thoughts, emotions, and bodily sensations” in order to have an inner awareness. They need to learn to “recognize combat mode” and “disengage it.” Lastly, the Veterans were told that they needed to use focused breathing in order to promote their recovery.This is an unbiased scholarly source from a peer reviewed social work journal. Its not written as professionally as a scientific journal, and there was no methodical lab testing being done. This was simply a report on the usefulness of the mindfulness technique on veterans. This is useful to me as it lets me see what the VA is doing for veterans.Lawhorne, Cheryl, and Don Philpott. Combat-Related Traumatic Brian Injury and PTSD. Plymouth: Government Institutes, 2010. Print.Lawhorne and Philpott’s book details PTSD from a medical standpoint. It has an overview of definitions for PTSD and various types of Traumatic Brian Injuries and lists various ways of treatment. Its written in a clear cut tone with the author not allowing any of their own personality in the writing. Often times paragraphs simply aren’t used and the authors go for using bullet points to go about defining treatments.This is a scholarly source with a small but respectable fifty-nine sources. Its not as many sources as the book below has, but it is enough to be considered a scholarly source. This book is part of a series called “Military Life” which is written primarily for families of service members with the purpose of helping them understand the nature of what their loved one is going though. As a result, it isn’t a difficult book to read, it lacks all the jargon and technicality of a medical journal. Also, there is no visible bias, this is just an informative collection of information for families of war veterans. I will find this useful in case any of my other sources doesn’t have the information I’m looking for. Paulson, Daryl, and Stanley Krippner. Haunted by Combat. Plymouth: Rowman and Littlefield Publishers Inc. 2007. PrintThis book goes into detail on PTSD, its treatment, and personal stories from veterans who have PTSD, from a more social and psychological standpoint than the book above. In the Introduction we are given an interesting insight as to how PTSD is currently perceived by the medical community. Often times doctors just try to remedy the symptoms of PTSD, but that doesn’t address the actual condition. PTSD is a complicated issue whose heart lies at the experience the solder had. The experience of the war is the cause of the illness and the main issue, it is not something that can be taken away with a simple pill. In the introduction there was a metaphor that summed this up very well. “Combatants who come home to PTSD are hobbled by a psychic fragment that is the psychological equivalent of shrapnel, less important as a remnant of the event… than it is as a presence at every moment.”The two authors have personal experiences with war. Paulson grew up during World War Two and had a cousin who became traumatized after becoming a POW after her capture by the Japanese. Krippner was a Vietnam war veteran who saw fighting first hand and knows what its like returning from war. As for the book, it is a scholarly source. It has nearly twenty pages of citations and has been thoroughly researched. I will use this source when needing to describe PTSD and its effects on postwar life.Sayer, Nina, Robert J. Orazem, Siamak Noorbaloochi, Amy Gravely, Patricia Frazier, Kathleen F. Carlson, Paula P. Schnurr and Heather Oleson. "Iraq And Afghanistan War Veterans With Reintegration Problems: Differences By Veterans Affairs Healthcare User Status."?Administration & Policy In Mental Health & Mental Health Services Research?42.4 (2015): 493-503. Web. 7 Mar. 2016.This original article covered a randomized clinical trial which compared veterans who use veteran’s affairs with those who do not. The US department of Veterans Affairs is the department responsible for taking care of veterans and their dependents in the united states. Recently, they have been the subject of many scandals and thus they don’t have the best reputation. This article “estimate[s] the prevalence of perceived reintegration difficulty” among veterans and to produces data that shows correlations between mental and physical problems between the two groups and to find predictors for VA status (meaning that the study tried to find what factors can be used to predict if a person will use veterans’ affairs or not.) More than anything, this source is a collection of numbers and statistics that show correlation, not causation, between different groups and VA status.This article was peer reviewed. It is a scholarly source. It is a quantitative source; a collection of data. The article used “a clinical trail of expressive writing” in order to gather its data. Those in charge of research had a large pool of fifteen-thousand possible participants and they narrowed it down to a study sample of one-thousand two-hundred ninety-two. To narrow it down, they eliminated subjects that did not have difficulty reintegrating into society, as well as subjects that suffered depression and subjects that were not interested nor able to participate. They came out with around two thirds of the subjects being VA users and one third being VA non users. They oversampled women in this study, they made it so that women constituted thirty percent of the possible participants in the study, even though women only constituted twelve percent of veterans. The data from this article was organized in three large tables that show correlations between various factors (age, race, gender, financial status) along with VA user status and perceived integration difficulty. There were also small sections where they mentioned how often they saw evidence for “probable PTSD” and “probable traumatic brain injury” among participants. They analyzed the writings from the veterans and used various sources to cross check and see if there were widespread problems with these issues among veterans. They quantified the data and put the information in the tables. This will all be useful to me later on, since I’ll be able to back up my claims with numerical evidence.Worthen, Miranda, Rudolf Moos, and Jennifer Ahern. “Iraq and Afghanistan Veterans’ Experiences Living with their Parents after Separation from the Military.” Contemporary Family Therapy: An International Journal. 34. (2012): 362–375. Web. 29 Feb. 2016.This article is a report on the lives of military veterans and how they responded to reintegration to society while living with their parents. This also covered topics such as survivors of sexual assault, and those who suffer from PTSD, and went into detail on the issues they went through after returning home.This article is a scholarly source that was peer reviewed. It does not seem to be biased, it is written very professionally and was published recently (2012). It will prove useful to me for it shows the kinds of stresses soldiers have after coming home from war. This is a point that I will have to address in my paper ................
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