Veterans Returning to School

Research Posters Model System Program of Research, HSR&D Center for Innovation in Rehabilitation Outcome (Tampa & Gainesville, Florida). This material is based upon work supported in part by the Defense and Veterans Brain Injury Center, US Army Medical Research and Material Command (USAMRMC). This material is the result of work supported with resources and the use of facilities at the James A. Haley Veterans’ Hospital. The views, opinions, and/or findings contained in this article are those of the authors and should not be construed as an official Department of Defense position or any other federal agency, policy or decision unless so designated by other official documentation. Research Poster 3153 VA TBIMS Study of Mental Health and Functional Characteristics of Military/Veterans Returning to School Marc A. Silva (James A. Haley Veterans’ Hospital), Kristina M. Martinez, Margaret Schmitt, Courtney Lynn, Christina (Tina) Dillahunt-Aspillaga, Jeffrey S. Garofano, Risa NakaseRichardson Objective(s): Describe mental health symptomatology and functional independence/disability in veterans and military personnel (V/M) returning to school (RTS) 1-2 years post-TBI. Design: Cohort. Setting: Four VA Polytrauma Rehabilitation Centers. Participants: Study sample included 63 V/M who RTS at 1 and/or 2 years post injury, derived from 627 V/M enrolled in the VA-TBI Model System study. Participants were primarily male (92%), young (age MdnZ25, IQRZ22-31), with moderate-to-severe TBI (65%) based on Glasgow Coma Scale. Median posttraumatic amnesia duration was 15 days (IQR 0-31). 38% were injured while deployed. Many were pursuing a college degree prior to injury (41%). Interventions: NA. Main Outcome Measure(s): Functional Independence Measure (FIM); Generalized Anxiety Disorder Questionnaire (GAD-7), Glasgow Outcome Scale-Extended (GOS-E), Patient Health Questionnaire-Depression (PHQ9), PTSD Checklist-Civilian (PCL-C). Results: Of those with outcome data at follow up, 73% had moderate-tosevere global disability while 27% had good recovery (GOS-E); on the FIM, 23% required assistance or supervision in  1 functional domain, most commonly cognitive [e.g., problem solving (17%), memory (15%), comprehension (15%)]. Clinically elevated PTSD symptoms (PCL-C) was endorsed by 21%, while 32% and 41% endorsed some-to-extreme difficulty with functioning due to anxiety (GAD-7) and depression (PHQ-9), respectively. Conclusions: Higher education is a viable area of productivity for returning V/M whose military work may translate poorly to civilian occupations, or who have injury-related disability precluding them from returning to preinjury work. The Post 9/11 GI Bill provides generous financial support for eligible V/M, yet some V/M face challenges transitioning from military to college and completing degrees. Functional status and mental health at time of RTS may present additional barriers to college success. Study findings may inform and facilitate improved understanding of how chronic TBI affects RTS in V/M. Key Words: Brain Injuries, Veterans, Military personnel, Students Disclosure(s): Financial Disclosures: None. This research was sponsored by VHA Central Office Division of Rehabilitation Medicine and VA TBI Model System Program of Research, HSR&D Center for Innovation in Rehabilitation Outcome (Tampa & Gainesville, Florida). This material is based upon work supported in part by the Defense and Veterans Brain Injury Center (DVBIC) and US Army Medical Research and Material Command (USAMRMC). This material is the result of work supported with resources and the use of facilities at the James A. Haley Veterans’ Hospital. The views, opinions, and/or findings contained in this article are those of the authors and should not be construed as an official Department of Defense position or any other federal agency, policy or decision unless so designated by other official documentation.

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e21 Research Poster 3157 Mechanical Circulatory Support Assessment System: Measure of Functional Gains in Patients on Mechanical Circulatory Devices Nichole Mayer (Nationwide Children’s Hospital), Jennifer Meagher Lane Objective(s): The objective of this project is to describe the Mechanical Circulatory Support Assessment System (MCSAS), a tool that can measure functional progress in patients who are supported by a mechanical circulatory device such as LVAD, Berlin Heart, or EMCO. Design: This is a proposed assessment. Setting: This is being completed in an intensive care unit in a large Midwestern pediatric hospital. Participants: The MCSAS was developed for use with patients in the ICU who are over 1 year old and on a mechanical circulatory device (LVAD, berlin heart, ECMO). Patients must be neck cannulated if on ECMO and cannot be completely sedated. Interventions: Patients receive occupational and/or physical therapy sessions 6 days a week, 1-2 times per day as part of their standard care while in the ICU. Therapists administer the MCSAS during initial assessment and then weekly to track progress. Main Outcome Measure(s): The MCSAS includes baseline goniometer reading for range of motion (ROM), strength assessments, figure 8 readings for edema management, the Modified WeeFIM (mWeeFIM), the Quality of Life Inventory (PedsQL), and the Functional Status Scale (FSS). Results: The MCSAS tracks functional progress during ICU stay for children on circulatory support. Conclusions: We hypothesize that the MCSAS can be used to measure functional gains in activities of daily living and mobility while patients are supported on a mechanical circulatory device. Key Words: Ventilation, Mechanical, Rehabilitation, Patient outcome assessment Disclosure(s): None Disclosed.

Research Poster 3174 Implementation of Evidence-Based Practices in Traumatology Continuums of Care: A Multi-Site Assessment Dahlia Kairy (Universite´ de Montre´al, Center for Interdisciplinary Research in Rehabilitation of Greater Montreal - Institut de re´adaptation Gingras-Lindsay de Montre´al), Andre´ E. Bussie`res, Cynthia Gagnon, Anne-Sophie Allaire, Frederic Messier, Marie-Eve Lamontagne, Anabe`le Brie`re, Me´lanie Be´rube´, Marie-The´re`se Larame´e, Jean-Franc¸ois Lemay, Karine Pre´ville, Manon Voyer Objective(s): To identify perceived determinants of successful implementation processes of evidence-based practices (EBPs) facilitated by implementation coordinators within six clinical settings involved in trauma care. Design: Multiple case study design. A mixed methods approach using questionnaires, interviews and TRIAGE consensus groups was used over a 12-month period to identify determinants of implementation success. Intraand inter-site comparisons were conducted. Setting: Four implementation projects involving distinct EBPs took place at trauma programs within six sites: (1) an acute care hospital (ACH), (2) an inpatient rehabilitation facility (IRF), (3) an outpatient rehabilitation facility (ORF) and (4) a group of three facilities (two IRFs and one ORF). Participants: Four implementation coordinators, four program managers and 21 clinicians and managers across facilities. Interventions: Clinical evaluation (MPAI-4, ISCIPDS: B) and screening (CNST, SSA) tools implemented with the support of implementation coordinators. Main Outcome Measure(s): Customized performance indicators for each site. Results: The four projects met the majority of their respective objectives. Coordinators put in place between 19-28 implementation