JKO Narcotics Order Review and Approval (NORA) Basics (FOUO)

September 10, 2022 Dwayne Morise

NORA stand for?

B. Narcotics Order Review and Approval

What information is required to check and order status?

B. contract number
C. call number
D.DEA tracking number

only registered users of NORA can check on the status of orders.

B. False

in order to retransmit an order, what conditions must be met?

A. it has been more than two hours since the original EDI 850 purchase order was sent to the prime vender

C. NORA has not received an EDI 855 acknowledgement that the prime vendor has received the original EDI 850 purchase order

D. direct coordination has been made with the prime vendor and the prime vendor is aware that the purchase order is being retransmitted

what roles is (are) allowed to approve or reject pending controlled substance purchase orders?

B. registrant/POA

NORA allows a properly privileged user to digitally sign narcotics orders made in SMLSS and TEWLS

A. true

who issues the digital certs that are uploaded into NORA?

C. Drug enforcement agency (DEA)

after the access manger approves a NORA account, what does the new account holder do next?

B. Active the account following the instruction on approval email.

what users can an access manager see when they access the view users menu?

A. all approved , rejected and pending account for the access managers services

once registered and approved, a DEA employee can unregister a user's account?

B. False

couldn't figure out 11 answers.

JKO DoD Opioid Provider Safety Training Program

September 10, 2022 Dwayne Morise

Which of the following is NOT an appropriate long-term treatment goal for chronic pain?

Increase dosage of prescription pain medications until pain is eliminated

The supplemental questions in the Defense and Veterans Pain Rating Scale (DVPRS) include a patient report of how pain is impacting all of the following EXCEPT:

Opioid Use

Which of the following is associated with opioid toxicity?

All of the above

Which one of the following patients does NOT have a clear indication for a referral for cognitive behavioral therapy for pain as part of their comprehensive treatment plan?

A patient attending a follow-up appointment for a sprained ankle

How can the Behavioral Health Consultants support the primary care pain treatment plan?

Both B and C

Which of the following is an indication to provide Naloxone to a patient who is prescribed opioids?

All of the above

The DoD Informed Consent for Long Term Opioid Therapy includes which of the following:

All of the above

After prolonged use, opioid medications change reward centers in the brain. This results in the motivation of use moving from ____ to ____.

'To feel good' to 'to avoid feeling bad'

Carefully monitored opioid taper should be considered in which of the following situations?

All of the above

Self-management strategies for pain are designed to achieve the following goals EXCEPT:

Improvement of a patient's marathon running times

The 2020 revision to DoDI 1010.16 directs that, absent a time period specified by the prescriber, controlled substance prescriptions for Active Duty Service Members expire _______

6 months after the last fill date

Which of the following tools is/are available to help assess for opioid-related risks and the indications for prescribing Naloxone?

All of the above

All patients prescribed opioid therapy are required to be enrolled in the MTF Sole Provider Program?

False

The following are DSM-5 diagnostic criteria of Opioid Use Disorder EXCEPT?

Requesting a refill for initial opioid prescription

According to the DHA-PI Pain Management and Opioid Safety, which of the following are NOT indicators for co-prescribing of Naloxone?

None of the above, all of these groups should be prescribed Naloxone

Which of the following are recommended for disposing of expired or unused prescription medications:

Mail-in envelopes distributed at MTF pharmacies
Designated collection receptacles co-located at MTF pharmacies

Which TWO of the following are part of the DoD comprehensive biopsychosocial pain assessment?

Pain Assessment Screening Tool and Outcomes Registry (PASTOR)
The Defense and Veterans Pain Rating Scale (DVPRS)

Which of the following clinician actions is recommended prior to prescribing opioid therapy for treatment of non-cancer, chronic pain? (Opioid Prescribing/Tapering Video)

Verify that non-opioid medications have been considered and optimized prior to prescribing opioids.

Which of the following should be considered for the first line of treatment for chronic pain? (Six Essentials Video)

I, II, and III

Which of the following statements regarding the prevalence of pain in Service members and Veterans is false? (Understanding Pain)

Chronic Pain is medical issue that is unique to the military and Veteran populations.

The DoD strategies and policies for Safe Medication Use, Storage, Disposal, and Take Back were developed to address: (Safe Medication Disposal/Use)

I, III and IV

I. Prescription medication diversion.
III. Use of prescription medication for conditions other than those conditions for which they were prescribed
IV. Environmental harm caused by improper disposal of medications

The first and most important element of good pain care is: (Six Essentials)

Educate the patient

Which of the following components of pain is not incorporated in the biopsychosocial model of pain?

medical

Essential components of Safe Opioid Prescribing includes which of the following: (Opioid Prescribing/Tapering Video )

All of the above

I. Do not prescribe opioids as the first line treatment for chronic pain
II. Start Low and Go Slow
III. After initiation of opioid therapy, assess, taper and discontinue opioids as indicated by ongoing assessment of effectiveness and risk of harm or misuse
IV. Be prepared to treat overdose and addiction

The following statement(s) are true regarding the use of routine drug screening as part of safe opioid prescribing: (Opioid Prescribing/Tapering Video)

I, II and IV

I. Frequency is based on risk assessment and stratification
II. Conducted prior to initiating opioid therapy
III. Routinely conducted at every patient visit
IV. Repeated at least once every 6-12 months for low risk patients

What is the first "step" in the Stepped Care Model of Pain Management? (Stepped Care Model)

Primary Care

Which of the following components of Stepped Care Model of pain management is first introduced in Step 3: (Stepped Care Model)

Advanced pain medicine diagnostics and interventions

Evidence-based treatments for patients with Opioid Use Disorder (OUD) include:

C. 1, 2, and 3

1. Medication-Assisted Treatment (MAT) with buprenorphine or methadone
2. Recovery support services
3. Behavioral therapies
4. Psychoanalytic therapy

True or False: The US Center for Disease Control (CDC) recently released 12 guidelines for prescribing opioids to reduce opioid related patient harm. One of the recommendations is to use urine drug testing before starting opioid therapy and at least annually to assess for prescribed medications as well as other controlled prescription drugs and illicit drugs.

True

There are certain standards that all providers must remember when treating any patient for any condition, even wounded war heroes. Which of the following statements is incorrect?

5. For confidentiality reasons, do not document care plan in chart.

Physical dependence is a state of adaptation that is manifested by withdrawal syndrome that can be produced by:

D. All of the above

1. Abrupt cessation
2. Rapid dose reduction
3. Decreasing blood level of the drug
4. Administration of an antagonist

True or False: The US Center for Disease Control (CDC) recently released 12 guidelines for prescribing opioids to reduce opioid related patient harm. One of the recommendations is to prescribe immediate-release opioids instead of extended-release/long acting (ER/LA) opioids.

True

According to CDC Guidelines, which of the following statements is incorrect?

C. Opioids should be prescribed based on patients' preference.

In a series of recent surveys, misusers indicated that only about 1 in 5 obtained their misused medications through a legitimate prescription. The majority obtained them through diversion from a friend or relative.

true

There have been several identified risk factors for prescription medication misuse. Which of the following statements is incorrect:

A. Older age, over sixty years old

When it comes to dosing, CDC Guidelines recommend that you carefully reassess evidence of individual benefits and risks when increasing dosage to ≥50 morphine milligram equivalents (MME)/day, and avoid increasing dosage to ≥90 MME/day or carefully justify a decision to titrate dosage to ≥90 MME/day.

True

Which option is the correct choice: Patients who have a history of substance abuse or active psychopathology should be treated as follows:

(Wrong Answer)
D. should only be managed by a multi-disciplinary team consisting of pain management physicians, addiction medicine physicians, and psychiatrists in a highly structured environment.

True or False: Risk Index for Prescription Opioid Overdose and Opioid-induced Serious Respiratory Depression (RIOSORD) is a validated risk stratification tool that defines patient risk classes and predicts probability of a significant adverse event and is helpful when deciding to prescribe Naloxone.

True

There are certain standards that all providers must remember when treating any patient for any condition, even wounded war heroes. Which of the following statements is incorrect?

For confidentiality reasons, do not document care plan in chart

Evidence-based treatments for patients with Opioid Use Disorder (OUD) include:
1. Medication-Assisted Treatment (MAT) with buprenorphine or methadone
2. Recovery support services
3. Behavioral therapies
4. Psychoanalytic therapy

NOT: all of the above

True

Which of the following statements is incorrect? Good prescribing practices by health care providers include:

Ignore aberrant behavior such as provider shopping or early refills

True

For prescribing opioids, treatment agreements with patients should have the following qualities:
1. be readable, reasonable and flexible. They should avoid using absolute terms such as "will" or "shall" and should use "may" in most cases.
2. Identify penalties for misuse or diversion - legal (police report) and medical (forced detox, forced taper, or cessation of medical treatment based on the clinical scenario)
Choose one

Both

Referring a Soldier to the local substance abuse program can be an unpopular move. You'll likely get resistance from the patient and sometimes the chain of command might object to what they feel is unnecessary meddling. Which of the following statements is correct?

2 It's important that you trust your judgment and do the right thing. It could very well be a matter of life and death?

According to CDC Guidelines, which of the following statements is incorrect?

NOT: If opioids are used, they should be combined with non-pharmacologic and non-opioid pharmacologic therapy?

True

JKO DoD Opioid Provider Safety Training Program

September 10, 2022 Dwayne Morise

Carefully monitored opioid taper should be considered in which of the following situations?

All of the above

Self-management strategies for pain are designed to achieve the following goals EXCEPT:

Improvement of a patient's marathon running times

The 2020 revision to DoDI 1010.16 directs that, absent a time period specified by the prescriber, controlled substance prescriptions for Active Duty Service Members expire _______

6 months after the last fill date

Which of the following tools is/are available to help assess for opioid-related risks and the indications for prescribing Naloxone?

All of the above

All patients prescribed opioid therapy are required to be enrolled in the MTF Sole Provider Program?

False

The following are DSM-5 diagnostic criteria of Opioid Use Disorder EXCEPT?

Requesting a refill for initial opioid prescription

According to the DHA-PI Pain Management and Opioid Safety, which of the following are NOT indicators for co-prescribing of Naloxone?

None of the above, all of these groups should be prescribed Naloxone

Which of the following are recommended for disposing of expired or unused prescription medications:

Mail-in envelopes distributed at MTF pharmacies
Designated collection receptacles co-located at MTF pharmacies

Which TWO of the following are part of the DoD comprehensive biopsychosocial pain assessment?

Pain Assessment Screening Tool and Outcomes Registry (PASTOR)
The Defense and Veterans Pain Rating Scale (DVPRS)

The objective(s) of using informed consent when prescribing opioids is to:

II, III, and IV

Which of the following components of Stepped Care Model of pain management is first introduced in Step 3

NOT: Pain severity screening and assessment

The majority of patients with chronic pain are managed in

Primary Care

Pain affects more Americans than diabetes, heart disease, and cancer combined.

True

The DoD strategies and policies for Safe Medication Use, Storage, Disposal, and Take Back were developed to address

I, III, and IV

The most important goal(s) that should guide pain management decisions by patients and their providers include(s) which of the following

II and IV

Essential components of Safe Opioid Prescribing includes which of the following

All of the above

What is the first "step" in the Stepped Care Model of Pain Management?

Self-Care and Patient Education

Which of the following should be considered for the first line of treatment for chronic pain?

NOT III and IV

The first and most important element of good pain care is

NOT Exploring non-pharmacological treatments for pain care NOT: Safe opioid use

The following statement(s) are true regarding the use of routine drug screening as part of safe opioid prescribing

NOT: I and IV; not I and III; not I, II and IV

There are 3 components of pain that providers should consider during their assessment and treatment plans? Which component does not belong

Biologic

When taken as prescribed, long term use of opioids can result in the following adverse medical and psychological outcomes

All of the above

The ultimate goal of the Stepped Care Model of pain management is to

Decrease healthcare reliance by assisting patients in adopting self care management early in the pain cycle? NOT maximize use of available resources across

Which of the following clinician actions is recommended prior to prescribing opioid therapy for treatment of non-cancer, chronic pain?

Verify that non-opioid medications have been considered and optimized prior to prescribing opioids

Which of the following components of Stepped Care Model of pain management is first introduced in Step 3

NOT Consultation between Primary Care and Pain Specialty Care

Which of the following statements regarding the prevalence of pain in Service members and Veterans is false?

NOT: As many as 75% of female Veterans suffer from chronic pain

What is the first "step" in the Stepped Care Model of Pain Management

Self-Care and Patient Education

Which of the following is a true statement regarding the use of opioids in the United States

all of the above

Which of the following components of pain is not incorporated in the biopsychosocial model of pain?

Medical

True

There are certain standards that all providers must remember when treating any patient for any condition, even wounded war heroes. Which of the following statements is incorrect?

For confidentiality reasons, do not document care plan in chart

NOT: all of the above

True

Which of the following statements is incorrect? Good prescribing practices by health care providers include:

Ignore aberrant behavior such as provider shopping or early refills

True

Both

2 It's important that you trust your judgment and do the right thing. It could very well be a matter of life and death?

According to CDC Guidelines, which of the following statements is incorrect?

NOT: If opioids are used, they should be combined with non-pharmacologic and non-opioid pharmacologic therapy?

True

JKO Navy Suicide Prevention Training for Providers

September 10, 2022 Dwayne Morise

According to DoDI 6490.08 "Healthcare providers shall follow a presumption that they are not to notify a Service member's commander when a Service member obtains mental health care or substance abuse education services unless certain conditions are met." Which of the following is a situation when a command SHOULD be notified?

The provider believes there is serious risk of a Service member harming him/herself or someone else

Which acute warning sign below would be classified as a Tier 1 warning sign based on the consensus groups developed by Rudd and colleagues in 2006?

Seeking ways to kill self

What is the name of the nomenclature developed by the Centers for Disease Control and Rocky Mountain MIRECC to describe suicidal thoughts and behaviors?

Self-Directed Violence Classification System

A history of childhood trauma and a parent who has died by suicide are examples of which of the following?

Risk Factors

Besides perceived burdensomeness and thwarted belongingness, what is the third component of the Interpersonal-Psychological Theory of Suicide Risk?

Acquired capability

What risk factor present in both military and civilian and military populations carries the highest risk for a future suicide attempt?

Previous suicide attempt

What is the theory that examines the way baseline risk interacts with acute stressors to explain the changing nature of suicide risk?

Individual Risk Theory

Accessible and available social support, life satisfaction, strong therapeutic alliance and hopefulness are examples of what?

Acute risk factors

Which statement about safety planning is correct?

A safety plan should incorporate (1) mood regulation techniques, (2) pleasant activities, and (3) emergency numbers.

When completing a risk assessment with patients, providers should ask what type of questions?

Neutral, non-judgmental and direct questions

Which of the following terms is NOT recommended for use with regard to suicide?

Suicide

What is the name of the document that provides a general guide to best practices for addressing suicide with military-connected patients?

VA/DoD Clinical Practice Guidelines for the Assessment and Management of Patients at Risk for Suicide.

Safe firearm storage should be discussed with which patients?

All suicidal patients regardless of identified means for suicide

Once a Safety Plan has been completed, what should the provider discuss with the patient?

Where to store the plan

What are some co-occurring health conditions that are identified as increasing overall risk for suicide?

Sleep problems and chronic pain

What is the term used to describe an organized response following a suicide?

Suicide Postvention

The Marine Intercept Program (MIP) and the Navy Sailor Assistance and Intercept for Life (SAIL) program offer case management and support services to individual Service members following a suicide attempt.

True

Which statement best describes a Safety Plan?

A prioritized list of coping strategies and sources developed collaboratively between patient and provider

In the Navy, the person designated by their commanding officer who organizes suicide prevention trainings and ensures suicide prevention materials are accessible at the command is called the ______?

Command Prevention Representative

How should the Patient Health Questionnaire and the Columbia-Suicide Severity Rating Scale be used?

As suicide screening tools

Warning signs of suicide

suicide

the voluntary or intentional act of causing one's own death

suicidal ideation

thinking about and planning one's own death

suicide attempt

nonfatal, del-inflicted destructive act with an intent to die as a result of behavior

resilience

capacity to withstand, recover, grow, and adapt in the force of stressors and changing demands.

What do you do if someone is a risk of suicide?

Ask Care Treat (ACT)

Identify an individual who is part of the suicide prevention program (SPP) resources

Chaplain, Medical professional

What is the purpose of the Navy Suicide Prevention Program?

Implement support, Promote sailor resilience, Reduce risk of suicide

JKO Sim 101: Simulation Operator-Basic Course

September 10, 2022 Dwayne Morise

FAATDS

Advanced Field Artillery Tactical Data System

AMDWS

Air and Missile Defense Workstation

ARFORGEN

Army Force Generation

BCS3

Battle Command Sustainment Support System

BCT

Brigade Combat Team

CETRIXS

Combined Enterprise Regional Information Exchange System

CIDNE

Combined Information Data Network Exchange

CJTF

Combined Joint Task Force

COS

Chief of Staff

CPOF

Command Post of the Future

DCO

Defense Connect Online

DCGS-A

Distributed Common Ground System - Army

DoD

Department of Defense

Field Manual

G-1

Personnel

G-2

Intelligence

G-3

Operations

G-4

Logistics

G-5

Plans

G-6

Signal

JCR

Joint Capabilities Release

JADOCS

Joint Automated Deep Operations Coordination System

MISO

Military Information Support Operations

NATO

North Atlantic Treaty Organization

SIGACT

Significant Activities Report

SITREP

Situational Report

SOP

Standard Operating Procedure

TAIS

Tactical Airspace Integration System

TIGR

Tactical Ground Reporting System

Executive Officer

Battle Rhythm

A deliberate daily cycle of command, staff, and unit activities intended to synchronize current and future operations.

Explicit Knowledge

Codified or formally documented knowledge organized and transferred to others through digital or non-digital means.

Knowledge Management

The process of enabling knowledge flow to enhance shared understanding, learning and decision making.

Measure of Effectiveness

A criterion used to asses changes in system behavior, capability, or operational environment that is tied to measuring the attainment of an end state, achievement of an objective or creation of an effect.

Measure of Performance

A criterion used to assess friendly actions that is tied to measuring task accomplishment.

Military Decision Making Process (MDMP)

An iterative planning methodology to understand the situation and mission, develop a course of action, and produce and operations plan or order.

Risk Management

The Process of identifying, assessing, and controlling risks arising from operational factors and making decisions that balance risk cost with mission benefits.

Tacit Knowledge

What individuals know, a unique, personal store of knowledge gained from life experiences, training, and networks of friends, acquaintances, and professional colleagues.

Troop Leading Procedures

A dynamic process used by small-unit leaders to analyze mission, develop a plan and prepare for an operation.

The steps
of knowledge management include:

Assess.
Design.
Develop.
Pilot.
Implement.

The four
components of knowledge management include:

People.
Processes.
Tools.
Organization.

Organization

An organization is a matrix where people, processes, and tools function to integrate individual and
organizational knowledge and learning strategies.

Culture

The culture of an organization provides the perspective by which information, goals, and
motivations are viewed.

Knowledge management enables the mission command warfighting function by:

Supporting the commander's decisionmaking throughout operations.

Facilitating dialogue and interaction required for successful mission command through
collaborative tools and processes.

Facilitating the capture and transfer of tacit knowledge shared in the organization.

Facilitating the transfer of explicit knowledge shared in the organization.

Helping the staff provide timely and relevant information and knowledge.

Enabling adaptive learning organizations.

Supporting mission command warfighting function tasks.

Commanders drive operations through execution
of their tasks

...of understand, visualize, describe, direct, lead, and assess.

Knowledge Brokering

As knowledge brokers, knowledge management representatives link their colleagues to knowledge
and information sources outside their immediate context.

Assessment

Assessment is the first step of knowledge management.

Assessment is the determination of the progress toward accomplishing a task, creating a condition, or
achieving an objective (JP 3-0).

Deliberate

A deliberate knowledge management assessment identifies all people, process, and tools and places
them in their context for entire organization.

Abbreviated

Abbreviated knowledge management assessments are focused on needs or identified problems.

Knowledge management assessment has four steps:

Step 1: Define the organization and its environment; people, processes, tools, and organization.

Step 2: Describe the organization's internal and external linkages and dependencies.

Step 3: Analyze the organization and evaluate its knowledge and performance and the gaps in its
knowledge and performance.

Step 4: Depict the connectivity and alignment of the organization's knowledge management
components in easily understood graphical representations.

Knowledge management map

Knowledge management maps are a graphic representation or map of the organization.

Concept Maps

A concept map shows information or knowledge created.

Situational understanding

Situational understanding is the product of applying analysis and judgment to relevant
information to determine the relationships among the operational and mission variables to facilitate
decision making (ADP 5-0).

Data

Data consist of unprocessed signals communicated between any nodes in an information system,

Information

Information is the meaning that a human assigns to data by means of the known conventions used in
their representation.

Knowledge

Knowledge is information that has been analyzed to provide meaning or value or evaluated as to
implications for the operation.

Understanding

Understanding is knowledge that has been synthesized and had judgment applied to it to comprehend
the situation's inner relationships.

Knowledge transfer

Knowledge transfer is the movement of knowledge—including knowledge based on expertise or
skilled judgment—from one person to another (FM 6-01.1).

Information management

Information management is the science of using procedures and information systems to collect,
process, store, display, disseminate, and protect data, information, and knowledge products (ADRP 6-0).

relevance of information based on the following characteristics:

Accurate—conveys the true situation.

Timely—is available in time to make decisions.

Useable—is portrayed in common, easily understood formats and displays.

Complete—provides all necessary data.

Precise—has the required level of detail.

Secure—affords required protection.

Core Competencies

1. Mission Command Integration
2. Simulation Operations
3. Knowledge Management

Knowledge

Knowledge is information that has been analyzed to provide meaning or value.

Knowledge Management Functions

1. Creating Knowledge
2. Organizing Knowledge
3. Applying Knowledge
4. Transferring Knowledge

KM Components

1. People
2. Processes
3. Tools
4. Organizations

KM Principles

1. Understand
2. Share
3. Integrate
4. Connect
5. Learn
6. Trust

KM Core Competencies

1. Knowledge flow and capture
2. Collaboration
3. Standardization

Principles of Mission Command

1. Build cohesive teams through mutual trust
2. Create shared understanding
3. Provide a clear commander's intent
4. Exercise disciplined initiative
5. Use mission orders
6. Accept prudent risk

Focus Areas for KM Assessment

•Standards Analysis
•Time Management
•Meeting Analysis
•Report Analysis
•Technical Systems Analysis
•Content Management Analysis

Standards Analysis

Standards analysis helps a unit determine the degree to which the unit follows standard knowledge management practices and what needs improvement

Time Management Analysis

The purpose of time management analysis is to determine if an organization is using time efficiently, how it can reduce wasted time, and make the best use of available time. This analysis focuses on the unit's battle rhythm

Meeting Analysis

Meeting analysis helps determine the efficiency of the meetings conducted from the perspective of efficient use of time and whether the meetings serve the purpose intended

Report Analysis

Report analysis examines how reports are created, organized, and transferred

Technical Analysis

Digital dashboards to display key KM performance indicators

Content Management Analysis

Consideration of how the visibility and accessibility of digital and non digital knowledge products within and outside the organization affect mission accomplishment

KM Assessment Steps

Define, Describe, Analyze and Depict

Analysis Step

Heart of the assessment process

Gap Analysis

Identifies shortfalls in knowledge and shortfalls in unit performance, analyzes the linkage, and determines how knowledge-based solutions help fill the gaps.

Types of Constraints

Physical and Logical

KM Design Steps

Conceptualize, Refine, Prepare

KM Action Plan

Includes actions, actors, timeframe, resources, measures of effectiveness, and key performance indicators

KM Develop Steps

Confirm, Outline, Build

4 Types of Data
Collection

1.Automatic
2.External
3.Subjective
4.Environmental

What is the definition of a model?

A model is a simplification of reality.

The definition of live simulation is:

Simulation involving real people operating real systems.

The definition of a virtual simulation is:

A simulation involving real people operating simulated systems

The definition of constructive simulation is:

Simulations that involve simulated people operating simulated systems.

A________________ is a "picture element," that refers to the smallest visual unit in an image on a computer display.

pixel

What is the reason for process mapping?

Process models are used to represent steps of a task, event or activity.

The earliest known use of M&S to enhance military training was the Prussian Army's use of mobilization models to plan for WW I.

False

A model airplane is a good example of a process model.

False

A _______________ is a set of simulations, a common federation object model, and supporting RTI, that are used together achieve some specific objective.

federation

What is the capstone document for all of the Services for the development, acquisition, integration, and use of models and simulation?

Chairman Of The Joint Chiefs Of Staff Instruction CJCSI
3170.01I , Joint Capabilities Integration And Development
System (JCIDS)

The Mission Training Complex (MTC) includes the full array of available mission command systems and training support system
enablers/capabilities networked, integrated and interoperable to provide the most effective capability to meet the unit's training needs while at home station and when deployed.

True

The desired endstate for any simulation supported training event is to
successfully achieve the selected commander's training objectives
required to support the mission.

True

What is the purpose of an operational needs statement (ONS)?

An ONS (Operational Needs Statement) is a request for a materiel
solution to an operational requirement.

A computer program is a set of instructions that tells a computer exactly what to do.

True

What are the two methods of time progression used in model and simulation design?

event driven and time increment

A database is the organization of data, while programming is the ability to access it in a logical sequence.

True

The process of determining the degree to which a model is an accurate representation of the real world from the perspective of the intended users of the model, is the definition of?

Fidelity

Some of the more important considerations for the use of game engine simulations are:

A. Games enhance soldier engagement and retention.

B. Games are adaptable, highly motivating, and can be fun.

C. Games can be used to create a variety of scenarios not easily

replicated in a live environment.

D. All of the above.

An effective LVCG strategy supports which of the following training environments?

A. Units at Home Station.

B. Individuals in Institutional Training.

C. Deployed Units.

D. All of the Above.

The four phases of the training development process within Unit
Training Management (UTM) are plan, prepare, execute, and _______

Assess

Who is the primary staff agent that supports the Commander in the production of the Unit's Training Guidance?

G-3/S-3

System TADSS:

A. Support training on a specific weapon system.

B. Are funded and documented as part of the weapon

system.

C. Are provided by the weapon system Program Manager

(PM).

D. All of the above

What is the purpose of EXCIS in a constructive simulation federation?

The ExCIS is the translator between the Distributed Interactive
Simulation (DIS) environment, and FIRESIM in particular,
and the Advanced Field Artillery Tactical Data System
(AFATDS).

The two current members of the Combined Arms Tactical Training (CATT) family of virtual, distributed interactive simulations for collective training are:

AVCATT and CCTT

Which of the following is the best description of training with constructive simulations?

Training with constructive simulations is training that uses computer
models and simulations to exercise the command and staff functions of units from platoon through echelons above corps.

Aggregate level simulation events normally have some key aspects that define their supporting requirements or fidelity of play. In general terms, aggregate level simulation events typically have a ____________ level of Abstraction, ________________ overhead, and typically _______________ fidelity than a comparable entity level simulation supported event.

Higher, moderate, lower

In spite of the complex technical nature of planning Simulation supported training events the Plan, Prepare, Execute, Assess steps of the operational Process in ADRP 7-0 is compatible with the Event Life Cycle found in CJCSM 3500 03D.

True

In exercise planning which person / position: Supports the Exercise Director; Coordinates all planning activities, Operational Environment, exercise directive, exercise control, cell structure, Observer/Control Plan, manning document and operator training?

Lead Exercise Planner

AR 5-11, Management of Army Modeling and Simulation, 15 May 2014 requires that planning for every exercise includes the following events: Concept Development, Initial Planning, Main Planning, Final Planning and MSEL Work session(s). Excluding any of these requires approval from an organization's next higher headquarters.

False

What is metadata?

Data about data.

Which of the below could you use to create a unit's Order of Battle (ORBAT) or Task Organization for a JCATS supported exercise?

JTDS

What is the function of the EXCON in a Constructive Simulation exercise?

Control the exercise to meet training objectives.

What function do Interfaces devices, like SIMPLE, perform?

Interface devices translate model data into specific message formats
that are transmitted to the unit MCIS.

A Mini-Ex is:

A full up rehearsal prior to Start-Ex.

When developing the After Action Review collection control plan for a constructive exercise what should be your starting point?

Training Objectives

What is a map

A representation usually on a flat surface of the whole or part of an area.

There is a lot of knowledge management information in Joint Doctrine. True/False?

FALSE

1. Explain how Mission Command related to Unified Action. Short Answer.

-Knowledge Sharing
-Shared Understanding
-Collaboration

List the Staff Tasks.

Conduct Knowledge Management and Information Management

Where does the KM "Big Ideas" reside (which FM and Chapter).

Chapter 3, FM 6-0

ATP 6-01.1 replaced FM 6-01.1. True/False?

TRUE

Which Army publication first defines Knowledge Management?

ADP and ADRP 3.0 - Unified Land Operations.

Define Mission Command.

Commanders use the warfighting functions to help them exercise command and to help them and their staffs exercise control.

Which chapter of the ATP 6-01.1 covers the assessment phase of the KM Process

Ch. 2

Future versions of the ATP will likely include discussions on "Change Management" and KM Maturity.

TRUE

The higher HQ battle rhythm and reporting requirements is a factor that shapes a battle Rhythm. True/False.

TRUE

What is the 7 Minute Drill Process?

Why are we having this meeting? What inputs are necessary? What outputs will it achieve relative to the CCIRs?

Define Battle Rhythm.

Battle rhythm integrates the decision cycle and staff events across the three event horizons (current operations, future operations, and future plans)

What tools does the KMO and the KMWG need to manage the Battle Rhythm?

· 7 minute drill summary roll up
· Information Flow Diagram
· Staff event participation matrix
· Event location & sequencing matrix

Understanding the commander's touch point requirements and preferences begins the process of creating an effective battle rhythm.

TRUE

Define Working Groups?

A Working Group is an enduring or ad hoc organization within the JFC's HQ formed around a specific function whose purpose is to provide analysis to users. >

The following are Battle Rhythm insights and best practices?

· Identify the commander's decision-making preferences and touch point requirements early to underpin the staff battle rhythm.
· Ensure the staff battle rhythm has the flexibility to handle changes in mission requirements and HHQ demands. At the same time, ensure it has a structure and foundation for staff and unit level interaction, planning and prioritization.
· The CoS should manage and discipline the battle rhythm, including vetting and approval of battle rhythm events through some form of a seven minute drill.
· When creating a battle rhythm, identify manpower limitations of key SMEs and ensure they are utilized effectively.
· Nest the battle rhythm with other HQ's - both HHQ and adjacent HQ, while best accommodating the needs of subordinates.
· Provide as much predictability as possible in the battle rhythm and maintain sufficient white space in the battle rhythm for circulation, work, and personal time.

The G3 coordinating and maintaining the battle rhythm. True/False

FALSE

Who is responsible for the Battle Rhythm?

CoS

Informal Leadership is granted to individuals by virtue of assignment to a position. True/False

FALSE

What is Change Management?

1. Change management is the discipline that guides how we prepare, equip and support individuals to successfully adopt change in order to drive organizational success and outcomes.

Explain General Stanley McChrystal's "Team of Team" concept.

Scalable Adaptability knowledge sharing

Where on the "Tipping Point of Change" Graph should you focus your effort?

15-18%

As middle managers in the Army, we should focus on "Leading Change" from the bottom?

False

What are the sequential steps in Kotter's 8 Step Change Model?

a. Create
b. Build
c. Form
d. Enlist
e. Enable
f. Generate
g. Sustain
h. institute

Explain Nickerson's 3 Sequential Strategies.

a. Identify all relevant stakeholders and partition them into four categories:
i. superordinates
ii. subordinates
iii. customers
b. complementors/blockers (those who control needed resources but over whom the leaders have no authority).
i. For each stakeholder category, identify the CoSTS to "Win them over":
ii. Communications
iii. Strategies
iv. Tactics
c. Don't stimulate negative emotions that make people DEAF—Disrespect, Envy, Anger, and Fear—to efforts to produce change.

What are the 4 components of Nickerson's Stakeholder Landscape?

a. Buy-in
b. Be-in
c. Allow-in
d. Agree-in

The first step of Kotter's Change Model is "Create a sense of urgency". True/False.

TRUE

According to Nickerson, who are the "Buy-ins" on his Stakeholder Landscape ?

Staff Principals & Primary Staff

What is DIS

Distributed Interactive Simulation

state information

such as position and orientation from the host controlling the entity to one or more other hosts participating in the simulation

TENA

Test and Training Enabling Architecture

HLA

High Level Architecture

LVCS

Live-Virtual-Constructive simulations

ALSP

Aggregate-Level Simulation Protocol

The objectives of the HLA are to:

Establish a common development and execution architecture

an application that may be, or is coupled with other software applications under a Federation Object Model Document Data (FDD) and a runtime infrastructure (RTI)

A federate

a named set of federate applications and a common Federation Object Model that are used as a whole to achieve some specific objective

A Federation

a specification of the types of information that an individual federate could provide to HLA federations as well as the information a federate could receive from other federates in HLA federations.

A Simulation Object Model (SOM)

A Federation Object Model (FOM)

a specification defining the information exchanged at runtime to achieve a given set of federation objectives.

a standardised format , rules and terminology used for describing HLA object models

Object Model Template

The software that provides common interface services during a HLA federation execution for synchronization and data exchange.

Run Time Infrastructure (RTI)

TENA

The Test and Training Enabling Architecture

Live

real, physical assets, including soldiers, aircraft, tanks, ships, and weapon systems.

Virtual

simulators of physical assets that provide real-world operator interfaces and humans in the loop, such as aircraft simulators, tank simulators, etc.

Constructive

Pure simulations either controlled by human beings (called "semiautomated forces"), or run entirely without human intervention (called "closed simulations").

JKO Military Acute Concussion Evaluation Version 2 (MACE 2)

September 10, 2022 Dwayne Morise

Which of the following statements regarding the MACE 2 are correct? Select ALL that apply.

-The MACE 2 should be administered as close to the time of injury as possible.
-The MACE 2 is used in deployed and non-deployed environments.

It might be difficult for a Service Member to get all of the questions correct in the Orientation part of the Cognitive Exam. Which of the following is the correct procedure if a Service Member is having trouble answering any of the questions? Select the correct answer.

Mark the question as incorrect.

When administering the MACE 2, which one of the following factors should NOT be considered in the results of the MACE 2? Select the correct answer.

Gender of the Service Member

You have just evaluated Captain Ramsey for a potential concussion. The Service Member told you that he banged his head really hard on an open cabinet in his kitchen and he saw stars for a few seconds. Which of the following statements regarding this encounter is correct? Select the correct answer.

This would be a concussion because Captain Ramsey hit his head and experienced an alteration of consciousness.

Which of the following are common concussion symptoms? Select ALL that apply.

-Nausea/vomiting
-Memory problems
-Headache

Major Vega has just completed the MACE 2 with a Service Member. She will now document this encounter in the electronic medical records using the appropriate concussion codes. Why is it important that she completes this step after evaluating the Service Member? Select ALL that apply.

-The information can be used by other healthcare providers during the Service Member's follow-up visits.
-The data from accurate documentation and coding is used when making decisions regarding manpower.

Immediate memory is tested through the recall of a word list. There are six color-coded word lists to choose from. Which of the following statements about the word lists are correct? Select ALL that apply.

-Choose one color-coded list for immediate memory testing, and the same color-coded list for delayed recall testing.
-There are six color-coded lists to choose from to avoid memorization.

The Neurological Exam consists of a series of tests which assess eyes, speech, motor skills, and balance. Which statements below about the Neurological Exam are FALSE? Select the option that is False.

When testing grip strength, the medical provider should allow for differences in grip strength for dominant and non-dominant hands, which should be considered normal.

You are assessing a Service Member for a potential concussion using the MACE 2. You are now assessing concentration using the Cognitive Exam15A, Reverse Digits. Which of the following statements about Reverse Digits is correct? Select the correct answer.

Use the same color-coded list you used for Immediate Memory testing

If the Service Member has previously been given List A: Jacket, Arrow, Pepper, Cotton, Movie in Question 6: Immediate Memory, what score would you give them if they responded Arrow, Coat, Film, Nylon, Pepper for the Delayed Recall test? The maximum score that can be earned on the delayed recall test is 5. Select the correct answer.

2, since they matched two words exactly.

When administering the Convergence test as part of the Vestibular/Ocular-Motor Screening (VOMS), what distance, as a near point of convergence from the tip of the nose, would be considered normal? Select the correct answer.

4 centimeters

Why is it important for medical personnel to use the MACE 2 to identify concussion as soon as possible after a potentially concussive event occurs? Select the correct answer.

Early diagnosis and treatment can shorten the time it takes for a Service Member to return to duty.

When scoring the Service Member's orientation, which of the following is true? Select the correct answer.

To score Orientation, award one point for each correctly answered question. There are a possible 5 points.

When screening a Service Member for concussion using the MACE 2, which of the following statements is correct? Select the correct answer.

If Concussion Screening is negative, the MACE 2 evaluation can be stopped.

Which of the following statements about calculating the MACE 2 final score is correct? Select the correct answer.

Total score highlighting abnormal results should be documented in the Service Member's medical record.

JKO Concussion Training for Medical Personnel

September 10, 2022 Dwayne Morise

Following diagnosis of concussion, Seaman McKenzie's headaches were aggravated when she tried to increase her levels of physical and cognitive activity. After attempts to manage the headaches with medication and therapy, her medical provider referred her to a neurologist. Why did the medical provider refer the Service Member to a neurologist? Select the correct answer.

Patient treatment is targeted based on her persistent symptom of headache.
Seaman McKenzie may need an exercise and strengthening protocol.
All Service Members who have a concussion will be referred to neurology.
Seaman McKenzie does not have a concussion; she has migraines.

Which of the following are signs that a person may have sustained a concussion? Select ALL that apply.

Leg cramps
Blank or vacant look
Inability to respond appropriately to questions
Drinking excessive amounts of water
Slow labored movements
Lying motionless on the ground
difficulty raising arm above head

not B C E
not b c e

Four Airmen are involved in a football collision during downtime. They all received a blow to the head. Airman A and Airman B appear uninjured. However, Airman C hits the ground hard, quickly becoming dazed and confused. Airman D experiences some dizziness. Which of the Airmen should receive a medical examination? Select the correct answer.

All of the Airmen because they were all involved in a potentially concussive event

None of the Airmen because they were not participating in a training event or mission

Airmen C and D because they were both injured

Airman D because he feels dizzy

While deployed and working out in her free time, Captain Jackson hit her head. She was disoriented right after the event and felt a little nauseous. What could have happened had Captain Jackson sustained a concussion but did not get checked out? Select ALL that apply.

She could be commended for her dedication to mission.
She could affect the ability to accomplish the mission at hand.
She could compromise the safety of other Service Members.
She could make critical mistakes that could impact mission success.

B C D

Match each tool in Column 2 with its description in Column 1.

a) Offers guidance to medical providers on a progressive approach for Service Members who have sustained a concussion to return to duty
b) Multimodal guidance that assists providers in the assessment and diagnosis of concussion

MACE 2 or A PRA

not
a mace
b pra

In order to be diagnosed with a concussion, two criteria must be met. 1) An injury event such as a direct blow or jolt to the head, exposure to a blast, or other head injury and 2) at least one of three other criteria. Which of the following is an accurate description of one of the three other criteria? Select the correct answer.

Headache lasting longer than 1 hour

Post-traumatic amnesia (for example you can't remember anything) greater than 24 hours

An alteration of consciousness (feeling dazed and confused) for less than 24 hours

A loss of consciousness (blacking out) for more than 30 minutes

not d

Which of the following statements is the most accurate? Select the correct answer.

All Service Members who sustain a concussion will experience one or more symptoms.
Some Service Members with a concussion will experience no symptoms.
If a Service Member reports a headache, it is most likely that they recently sustained a head injury.
There are some symptoms that are only associated with concussion.

not d

Captain Rosario has just completed a follow-up visit for a Service Member experiencing headache and tinnitus following an accident in which the Service Member sustained a concussion. Which of the following statements about documenting this patient encounter is correct? Select the correct answer.

It is important for Captain Rosario to document this patient encounter to ensure that the Service Member knows when his follow-up visit is scheduled.
Captain Rosario does not need to document the patient encounter, but he should provide an update to the Service Member's leader.
Since this is a follow-up visit, Captain Rosario does not need to document the patient encounter.
It is important for Captain Rosario to document this patient encounter because information can be used by other healthcare providers during the Service Member's follow-up visits.

In which of the following ways can a concussion impact a Service Member's performance? Select ALL that apply.

The Service Member may feel more hungry than usual.
The Service Member may trip and fall more often.
The Service Member may make mistakes they wouldn't usually make.
The Service Member may feel irritable.

b c d

Captain Hernandez has been progressing through the six stages of a progressive return to activity (PRA). Today he has been told he can return to unrestricted activity. Which stage of the PRA has Captain Hernandez reached?

Stage 2
Stage 4
Stage 6
Stage 5

not b

Lieutenant Colonel Karlsson asked her patient about his medical history and his family's medical history during the MACE 2 assessment. Why is the patient's medical history of interest to Lieutenant Colonel Karlsson? Select ALL that apply.

Recovery time from concussion could be longer if there is a family history of concussion.
Personal and family history may be risk factors for delayed recovery following concussion.
Personal and family history may contribute to which symptom cluster is most prominent after a concussion.
Family medical history is not relevant to the presentation of symptom clusters related to concussion.

not a b

As a medical provider you have a responsibility to identify and treat concussions as soon after the potentially concussive event as possible. Which of the following best explains why this is important? Select the correct answer.

Early treatment can shorten the time it takes for a Service Member to return to duty.

Most Service Members take concussions less seriously if they are not diagnosed immediately after sustaining a concussion.

Concussions are not treatable if not addressed within the first 24 hours.

Symptoms of concussion will be less evident the longer you wait.

Staff Sergeant Morrison hits his head hard on the tailgate of his truck while working in his driveway. He is evaluated for concussion and is told that he did not sustain a concussion. Why did he not sustain a concussion if he received a sharp blow to the head? Select the correct answer.

Concussions usually occur on the battlefield and not in a driveway.
The Service Member was not involved in a blast event.
Not all blows to the head result in a concussion.
The Service Member did not black out.

While evaluating a Service Member for concussion, the medical provider learns that the Service Member has a headache and that she also has a history of migraines. Why is the Service Member's medical history of migraines relevant to her headache today? Select ALL that apply.

This information may help guide prioritization of treatments and further assessments.
The headache is probably not the result of the concussion.
Her recovery time from concussion could be longer because of the history of migraines.
This patient could be at a greater risk of sustaining another concussion.

a c

Which of the following is a symptom of concussion? Select the correct answer.

Irritability
Cough
Increased appetite
Diarrhea

Lieutenant Walsh was diagnosed with a concussion a week ago. He has been progressing through a progressive return to activity (PRA) and increasing his activity levels each day. He has been back in his office for the last few days with a reduced shift time. Today he reported that he felt fine and has no symptoms of concussion. Which of the following will the medical provider recommend? Select the correct answer.

Start engaging in some light physical and cognitive activity as tolerated.
Start engaging in some light aerobic exercise, and more complex cognitive tasks.
Take it easy for the next twenty-four-hours. Get some rest and limit your activity to cognitively familiar activities.
You can return to pre-injury activity.

not a

Which of the following best describes the role of the MACE 2 and a progressive return to activity (PRA) in the treatment and management of concussion? Select the correct answer.

They assist with the treatment of concussion symptoms.
The MACE 2 outlines the activities that are recommended when a patient is moving through the stages in a progressive return to activity.
The MACE 2 and a PRA integrate advances in clinical management to aid with concussion diagnosis, treatment, and return to duty determinations.
They are driven by clinical management of concussion guidelines which help determine when a patient may be ready to move to subsequent stages in the progressive return to activity.

not d

Which of the following best describes the relationship between the MACE 2 and a progressive return to activity (PRA)? Select the correct answer.

The MACE 2 provides guidance to medical providers on a progressive approach to returning Service Members to duty following a concussion.
The MACE 2 and a PRA integrate advances in clinical management to aid with concussion diagnosis, treatment, and return to duty determinations.
The MACE 2 outlines the activities that are recommended when a patient is moving through the stages in a progressive return to activity.
A PRA assists providers in the assessment of concussion following initial diagnosis using the MACE 2.

Senior Airman Patrick was diagnosed with a concussion a few days ago. His symptoms were headache and nausea. He has been progressing through a progressive return to activity and increasing his activity levels each day. Today his medical provider recommended engaging in some light aerobic exercise and more complex cognitive tasks. Senior Airman Patrick went for a short run. Following the run, his headache returned. Which of the following will the medical provider recommend? Select the correct answer.

Start engaging in some light aerobic exercise, and more complex cognitive tasks.
Take it easy for the next twenty-four-hours. Get some rest and limit your activity to cognitively familiar activities.
Since only your headache returned but you are not nauseous, you can return to work on lighter duty.
Start engaging in some light physical and cognitive activity as tolerated.

Which of the following are signs that a person may have sustained a concussion? Select ALL that apply.

Heavy breathing
Stumbling
Difficultly bending
Confusion
Facial injury after head trauma
Broken arm

not b c d

Not all blows to the head result in a concussion.

Which of the following statements about concussion are correct? Select ALL that apply.

Being involved in a vehicle crash is one of the common causes of concussion.

Being near a blast does not always result in a concussion.

Which of the following are signs that a person may have sustained a concussion? Select ALL that apply.

Slow to get up after a direct or indirect blow to the head

Blank or vacant look

Lying motionless on the ground

Disorientation

Which of the following best describes the role of the MACE 2 and a PRA in the treatment and management of concussion? Select the correct answer.

It is important for Captain Rosario to document this patient encounter because information can be used by other healthcare providers during the Service Member's follow-up visits.

Which of the following are associated with sustaining multiple concussions? Select ALL that apply

You may experience more severe symptoms with multiple concussions.

You will be at greater risk of sustaining another concussion after the first concussion.

Recovery may take longer for a second or third concussion.

After being involved in an accident during a training event, Corporal Morales hit her head and was dazed and confused for a couple of seconds. Corporal Morales brushed off her injury and was reluctant to go to the medical center to get checked out. If Corporal Morales did not get checked out and had sustained a concussion, which of the following could happen? Select ALL that apply

Corporal Morales would be putting her unit and the mission in danger.

Corporal Morales would be at risk for worsening or lingering concussion symptoms

During a follow-up appointment for concussion, Sergeant Harris reports that he has a constant headache and feels nauseous. The medical provider asks Sergeant Harris how he has been sleeping. Why is the Service Member's sleep of interest to the Medical Provider? Select the correct answer.

Sleep disturbances can exacerbate or modify symptom presentation.

Chief Petty Officer Jackson was diagnosed with a concussion 24 hours ago. Today she has returned for a follow-up examination with her medical provider. Chief Petty Officer Jackson's symptoms were dizziness and nausea. Today the Service Member reports that her symptoms have resolved. Which of the following will the medical provider recommend to return Chief Petty Officer Jackson to pre-concussion activity?

Start engaging in some light physical and cognitive activity as tolerated.

Which of the following are symptoms of concussion? Select ALL that apply.

Memory difficulty

Visual disturbances

Balance difficulty

JKO Concussion Training for Service Members

September 10, 2022 Dwayne Morise

Corporal Morales would be putting her unit and the mission in danger.

Corporal Morales would be putting herself at risk for worsening or lingering concussion symptoms

You are looking for guidance on the management of concussion prior to a deployment. Where would be the best place to locate this information? Select the correct answer

Visit the DVBIC (TBI Center of Excellence) website.

Which of the following are signs that a person may have sustained a concussion? Select ALL that apply.

Blank or vacant look

Heavy Breathing

Disorientation

Slow to get up after a direct or indirect blow to the head

Which of the following statements about concussion is the most accurate? Select the best answer.

A concussion may occur with or without loss of consciousness.

Private Sanchez just got diagnosed with a concussion. Which of the following statements is the most accurate? Select the correct answer.

All Service Members who sustain a concussion will experience one or more symptoms.

In which of the following ways can a concussion impact your performance? Select ALL that apply.

You may make mistakes that you wouldn't usually make.

You may trip and fall more often.

You may feel irritable.

Master Sergeant Newton collided with another Service Member during a football game. Master Sergeant Newton was diagnosed with a concussion. Which of the following activities should he AVOID for the next 24 hours? Select ALL that apply

Drinking alcohol

Doing crossword puzzles

Downhill skiing

Catching up on reports

Your buddy, Staff Sergeant Grayson, is involved in a potentially concussive event while you and some friends are relaxing and enjoying a game of basketball. Staff Sergeant Grayson hits his head against the wall of the gym. He has no visible injuries but seems to be slightly dazed and appears to be a little off for the next couple of hours. You ask him if he wants to get checked out, but he says no. What should you do in this situation? Select the correct answer.

Encourage Staff Sergeant Grayson to go and get a medical evaluation right away.

Is the following statement true or false? After sustaining one concussion, you are at a higher risk of sustaining a second concussion.

True

Lieutenant Bennet was diagnosed with a concussion. He is to attend a training event next week that he does not want to miss. He has been following medical recommendations for a week and today he feels like he is ready to return to duty. When should Lieutenant Bennet return to duty? Select the correct answer.

He should return to duty when his medical provider clears him to return to duty.

In a deployed environment, which of the following Service Members should be evaluated for concussion and have mandatory 24 hours of rest? Select ALL that apply.

Petty Officer Lopez hit her head hard when running up the stairs, and she seems confused and disoriented.

Lieutenant Williams was involved in a vehicle crash but
has no visible injuries.

Sergeant Lawrence was 40 meters away from an IED blast. Sergeant Lawrence has no visible injuries and he feels fine.
Question 12.

Which of the following statement(s) about concussion are correct? Select ALL that apply.

A direct blow to the head or the head striking an object always causes a concussion.

Being involved in a vehicle crash is one of the common causes of concussion.

Falls are not a common cause of concussion.

What is true about concussions? Select the correct answer.

With early diagnosis and treatment, most Service Members can return to duty quickly following a concussion.

Is the following statement true or false? If a Service Member has a concussion, he/she will definitely have one or more of the following symptoms such as a headache, ringing in the ears, or dizziness. Select the correct answer.

False

Which of the following is NOT a common cause of concussion? Select the correct answer.

Swimming

JKO Section 508 Accessibility Standards

September 10, 2022 Dwayne Morise

Accessibility

Technology that can be used just as effectively by people with
disabilities as it can
by those without.

People with disabilities are the

largest and fastest growing minority group in the world

debunk myth: accessible web pages are dull

30% of users don't load images, search engines use textual information

debunk myth: accessible web pages are too time consuming and expensive

-Accessibility is "built-in" to HTML
-Cost-effective to factor accessibility in the
design phase

what phase should accessibility be factored in?

during the design phase

debunk myth: accessible web authoring is too hard to learn

Accessible Web design requires limited
working knowledge of HTML

debunk myth: Web is graphical and cannot/
should not be adapted for auditory or
text-only users

-Style sheets can add visual flare
-Use alternate text with multimedia

debunk myth: Assistive technology (AT) can
solve the problem

AT can only interpret information that is
formatted to the same standards

accessibility testing process

phase 1: assessment
-discovery
-test and eval
phase 2: dev support
-remediation
-validation

Types of Disabilities

◦ Blindness and visual limitations
◦ Deafness and hearing limitations
◦ Speech limitations
◦ Mobility limitations
◦ Cognitive limitations
◦ Multiple limitations

in addition to the disabled, accessibility also aids

-An active aging population
-Users to whom English is a second language
-Users operating with low-bandwidth or
environmental limitations

Statistics point to

an increasing population of people with functional limitations as the population ages

Americans with Disabilities Act, Title II

Communications must be as effective for
those with disabilities as for those without

Rehabilitation Act, Section 504

Establishes requirement to make programs,
services and activities accessible

Rehabilitation Act, Section 508

Provides standards to use in evaluating the
accessibility of web pages and other electronic communication

Section 508 requires
that

electronic and information technology that is developed or purchased by the
Federal Government is accessible by people with disabilities

Section 508 was enacted to

-eliminate barriers
-new available opportunities
-encourage tech dev for this
-bring ADA to harmony

Section 508 does NOT require

◦ Agencies to provide AT to the general public.
◦ All workstations to be fitted with AT.
◦ Retrofitting of E&IT (e.g., Web pages)

by making tech accessible you make it

more usable for everyone, enhance every user's experience

benefits of these laws?

-productivity/ participation of disabled employees
-reduced employment barriers for disabled

Federal, State, and Local Governments who address accessibility discover that

they serve their stakeholders more efficiently, meet legal obligations, and save money

Accessibility =

Barrier free as possible

Usability =

Easy to use for all

Goals of Accessible Design

web-based info and service available to disabled and the widest audience

how visually impaired use the web

◦ Screen readers
◦ Screen magnifiers
◦ Text browser
◦ Braille display

how hearing impaired use the web

◦ Braille display
◦ Direct connection to hearing aid
◦ Turn up the volume

how mobility impaired use the web

◦ Speech control
◦ Keyboard guards & overlays
◦ Slow keys & on-screen keyboards
◦ Replacement mice & switches

how those with cognitive disabilities use the web

◦ Most neglected disability
◦ Require clear and simple content
◦ Alternate presentations of data

how do web sites use design techniques, scripts, images and graphics in ways that make the content inaccessible or difficult to use?

-graphics w/out alt text
-complex nav
-video/audio w/out text
-require specific browser
-not user centric

solution to non accessible web?

define standards for web accessibility
-create tools to support it
-author sites to comply

Adaptive technologies are designed to

interpret websites designed to the standards

Authoring tools are designed to

integrate the standards into web designs

Validation tools are designed to

help determine standards compliance

pros of using accessibility standards

author doesn't need to know what adaptive tech client uses or test pages using that tech

cons of using accessibility standards

standards are not specific enough, so they are subject to interpretation
-No tool can fully automatically test or create accessible web pages

standard: W3C's Web Accessibility Initiative

Published guidelines, implementation methods, and priority checkpoints under the Web Content Accessibility Guidelines

reasons to follow accessibility standards

-Compliance with regulatory and legal
requirements
-Produces better web design and
implementation
-Funding issues

how to follow accessibility standards

pick a standard, author sites compliant to them, check and maintain them

types of standards

section 508, W3C

508 Standards: every non-text element shall provide

a text equivalent

508 Standards: multimedia presentation shall

have an equivalent alternative that is synched with the presentation

508 standards: audio

at least provide transcript, if possible video descriptions

508 standards: design web pages with color so that

all information conveyed with color is
also available without color; use contrast in b/w

508 standards: to convey meaning don't

rely only on color(Ex. red text is important)

508 standards: Documents shall be organized so

they are readable without requiring an
associated style sheet

508 standards: for each active region of a
server-side image map

Redundant text links shall be provided

best never to use

-server-side image maps, there is no way to make them accessible
-frames

508 standards: instead of server-side image
maps

Client-side image maps shall be provided except where the regions cannot be
defined with an available geometric shape

508 standards: for data tables

Row and column headers shall be
identified

to further enhance table accessibility...

use the <CAPTION> tag and "summary"
attribute

508 standards: Markup shall be used to associate data cells and header cells for

data tables that have two or more logical levels of row or column headers

508 standards: <TD> and <TH> purpose

Data cells (<TD>) must be associated with appropriate column and row headers cells (<TH>) to give them meaning

508 standards: Frames shall be titled with text that

facilitates frame identification and
navigation

508 standards: Pages shall be designed to avoid

causing the screen to flicker with a frequency greater than 2 Hz and lower than 55 Hz

508 standards: when
compliance cannot be accomplished in
any other way

A text-only page, with equivalent info or functionality, shall be
provided and updated as needed

Providing a text-only alternative

-only solution if no others
-requires the maintenance of two sets of content

508 standards: info provided by a scripting language

shall be identified with functional text that can be read by assistive technology

to identify that clicking
on an image will run a JavaScript

use "alt" attribute

508 standards: When a web page requires that an application be
present on the client system to interpret
page content

the page must provide a link to a plug-in or applet

508 standards: When electronic forms are designed to be completed on-line, the form shall

allow people using assistive technology to
access the information, field elements, and
functionality required for completion/
submission of the form, including all
directions and cues

Forms pose accessibility issues when

form element is separated from its
associated label

to tag labels

use the <LABEL> tag and associated "for"
attribute

how to use <label> tag and "for" attribute

-Identify exact words to use as label in <label> tag
-use the "for" attribute to uniquely identify the
form element associated with the label

Use the "id" attribute in the associated
form element

to associate it with the
label

508 standards: A method shall be provided that permits

users to skip repetitive navigation links

there must be a
mechanism for users to skip

repetitive navigational links

508 standards: When a timed response is required,
the user shall

be alerted and given
sufficient time to indicate more time is
required

Someone's disability can limit the speed with which

they can read, move around, or fill in a
web form

how to make timed form more accessible?

notify user it page is about to time out, provide prompt asking if additional time is needed

If IT proves functional and adaptable
according to users' skills and needs, then

individuals with disabilities become
more independent and more productive
members of society

usable and accessible
design also moves firmly into supporting the needs of

all people

Accessibility

Technology that can be used just as effectively by people with disabilities as it can by those without.

What phase should accessibility be factored in?

During the design phase

Assistive technology (AT)

Technology used to assist people with disabilities access/use a computer. Note: AT can only interpret information that is formatted to be accessible

In addition to people with disabilities, accessibility also aids

-An active aging population
-Users to whom English is a second language
-Users operating with low-bandwidth or environmental limitations

Americans with Disabilities Act, Title II

Communications must be as effective for
those with disabilities as for those without

Rehabilitation Act, Section 504

Establishes requirement to make programs,
services and activities accessible

Rehabilitation Act, Section 508

Provides standards to use in evaluating the
accessibility of web pages and other electronic communication

Section 508 requires that

Electronic and information technology that is developed or purchased by the Federal Government is accessible by people with disabilities

Section 508 was enacted to

-eliminate barriers
-new available opportunities
-encourage tech dev for this
-bring ADA to harmony

Section 508 does NOT require

◦ Agencies to provide AT to the general public.
◦ All workstations to be fitted with AT.
◦ Retrofitting of E&IT (e.g., Web pages)

Accessibility =

Barrier free as possible

Usability =

Easy to use for all

Goals of Accessible Design

Web-based info and service available to disabled and the widest audience

How blind people or people with low vision use the web

◦ Screen readers
◦ Screen magnifiers
◦ Text browser
◦ Braille display

How Deaf and people that are hard of hearing use the web

◦ Braille display
◦ Direct connection to hearing aid
◦ Turn up the volume

How people with limited mobility use the web

◦ Speech control
◦ Keyboard guards & overlays
◦ Slow keys & on-screen keyboards
◦ Replacement mice & switches

How people with cognitive disabilities use the web

◦ Most neglected disability
◦ Require clear and simple content
◦ Alternate presentations of data

JKO DMLSS: Joint Medical Asset Repository (JMAR) Basics (FOUO)

September 10, 2022 Dwayne Morise

Acronym JMAR stand for?

C. Joint Medical Asset Repository

JMAR does not create or modify date; it captures and consolidates exiting data from disparate medical logistics applications?

A. True

to register for a JAMR account you must :

A. State why you need the account
B. State what specific areas you need access to
C. Operate from a .mil network

what areas could you access to find data on item receipts?

A. asset visibility
C. KPI

under asset visibility, you can find all of the following modules except:

D. key performance indicators

where would you go to perform an unrestricted inventory search for any item across the services?

wrong answer C. inventory/reports

what area modules would provide equipment maintenance data?

A. Equipment/ equipment dashboards

what modules would you use to find due-in/due-out metrics?

C. KPI

the online help feature can be accessed form anywhere on the JAMAR website.

A. True

reporting site errors to the MHS help desk can be accomplished via:

A. DHA global service center link on the main header bar

B. emailing dhagsc@mail.mil

C. calling them directly

JKO DMLSS: Navy Disbursement Reconciliation Process (FOUO)

September 10, 2022 Dwayne Morise

in which tab would you find data that could indicate a weakness in your receipt control process?

A. Tab 4

DRT pending action should be processed once a month.

B. False

where could you find order and receipt transaction related to a pending DRT document number?

A. Transaction history

which tab displays DRT's that have transmitted to DMLSS but have not been receipted in DMLSS?

A. Tab 4

which tab displays errors between disbursement records and the data in DMLSS?

A. Tab 3

which tab do DRT's for purchase card buys post?

A. None

processing DRT pending action is not mandatory.

B. False

pending disbursement record data can assist accounting with obligation validation?

A. True

customer funds are adjusted when DRT's are processed by a user?

A. True

DRT's do not occur for purchase card buys?

A. True

JKO DMLSS: Purchase Card Reconciliation

September 10, 2022 Dwayne Morise

match the decriptions of privileges next to purchase card roles
1._purchase card admin
2._purchase card approving
3._purchase card holder

1.C
2.A
3.B

if you do not have the appropriate roles and privileges assigned to you in DMLSS, you should contact you local DMLSS system Admin.

A. Ture

what displays on the transaction history?

B. transactions linked to the highlighted buy within the purchase.

DMLSS order status is intended to represent the status of the purchase card procurement on your bank statement.

A. Ture

which purchase card reconciliation code can an order have that you have only partially received?

A. D- dispute
B. P- partial
E. N- new

when selectin the customer id and expense center for purchase card adjustments(PCAs), choose those tied to the customer order.

A. True

for PCA transactions, charges for an order cannon be distributed to multiple customers IDs and expense centers.

B. False

assuming a reconciliation is processed judiciously by card holder:

A. the statement month equals the current bank statement month

the approving official has oversight and access to purchase card register, but card holders are responsible for daily reconciliation.

A. True

if you have received all the items in an order, what reconciliation coeds can you choose?

A. D - dispute
B. P - partial
C. Y - complete
D. C- credit

you can access you purchase card register even though your purchase card id reconciled and the current calendar month matches the purchase card register.

A. True

what reconciliation code can be followed with a code of C- Credit?

C. D- dispute

JKO Typhoid Course

September 10, 2022 Dwayne Morise

What is the usual incubation period for typhoid fever?

1 to 3 weeks

In the United States, most cases of typhoid fever occur in people who

Have recently traveled internationally

On average, about how many cases of typhoid fever occur each year in the United States?

400

How is typhoid fever most commonly spread from one person to another?

In contaminated food or water

How do most people in the United States become ill with typhoid fever? They are infected:

During international travel

By what route do S. typhi infect the body?

Mouth

Fever in typhoid fever

is sustained and high

Which person presenting for treatment in an emergency department in the United States is most likely to have typhoid fever? The person who has:

A high fever, headache, and abdominal pain, and who states she returned from Peru a week ago

A diagnosis of typhoid fever is confirmed when:

S. typhi is found in blood or stool cultures

Which is the treatment used to eliminate S. typhi from the body and cure typhoid fever?

Antibiotics

Which instruction given to a person who is recovering from typhoid fever would be LEAST important in preventing possible spread of the infection to others?

Drink only boiled or bottled water

For which person would ViCPS be the preferred type of typhoid vaccine? One who:

Is taking an antibiotic

What type of vaccine is Ty21a?

A live attenuated bacterial vaccine

For which person would typhoid fever vaccine be indicated?

A person traveling to the Indian subcontinent

Which person should NOT be given Ty21a today? Assume that all are susceptible to typhoid fever and are traveling to a typhoid-endemic area.

A woman with abdominal pain and persistent diarrhea

Which person should NOT receive ViCPS today? Assume that all are susceptible to typhoid fever and are traveling to a typhoid-endemic area.

A person who is a chronic carrier of S. typhi

Which statement is correct and included in the VIS for typhoid vaccine?

A booster dose is needed for people who remain at risk

What is the correct dose, schedule, and route of administration for Ty21a?

Four capsules taken by mouth on alternate days, each dose taken one hour before a meal

What is the correct dose, schedule, and route of administration for ViCPS vaccine?

One 0.5 mL dose administered intramuscularly

A person receives Ty21a vaccine because he is traveling to a country in which typhoid fever is endemic. If he plans to continue this type of travel in the future, when is it recommended that he be revaccinated against typhoid fever?

In five years

Which adverse reactions are most common following vaccination with ViCPS?

Pain and swelling at the injection site

Which statement is true about typhoid fever illness?

Typhoid fever is diagnosed by finding S. typhi in the blood, urine, or feces

Typhoid fever is characterized by a sudden onset of a sustained fever as high as 39.4 degrees Celsius to 40 degrees Celsius (103 degrees Fahrenheit to 104 degrees Fahrenheit). Which are other common initial symptoms of typhoid fever?

Myalgia and abdominal pain

Which is the only natural host for S. typhi?

Humans

JKO Rotavirus Course

September 10, 2022 Dwayne Morise

Which statement about rotavirus is correct?

Rotavirus is the most common cause of diarrhea in children (correct)

Rotavirus vaccine is indicated for all children older than 6 weeks of age.

False (correct)

What is the most common adverse reaction to RotaTeq vaccine?

elevated temperature (correct)

What kind of vaccines are RotaTeq and Rotarix?

Live, oral vaccine (correct)

What is the recommended dose for RotaTeq vaccine?

2 ml

What is the recommended schedule for RotaTeq vaccine?

2, 4, and 6 months of age (correct)

You have given a 12 week old his first dose of rotavirus vaccine. When is the earliest he can receive the second dose?

In 4 weeks (correct)

What is the main treatment for rotavirus infection?

Supportive care with fluid replacement (correct)

JKO Varicella and Herpes Zoster (shingles) Course

September 10, 2022 Dwayne Morise

Choose the true statement about varicella vaccine.

Previously unvaccinated people 13 years of age and older need only one dose of varicella vaccine.

Choose the true statement about varicella vaccine.

It is recommended that varicella be administered subcutaneously.

Which person should have varicella vaccination delayed?

A 40 year old who received a blood transfusion 10 days ago.

Which person should not receive zoster vaccine today?

48-year-old woman who will be undergoing chemotherapy in two weeks

A healthy, 35-year-old woman was exposed to VZV 16 days ago. Today, she notices maculopapular lesions at her hairline. She is not pregnant. What action is recommended?

Refer her to a healthcare provider to discuss administration of acyclovir.

A susceptible person is infected with VZV. Typically, during which days after exposure could this person be considered infectious?

From day 12 until the day the lesions are crusted

Choose the true statement about varicella vaccine.

Varicella vaccine is a live attenuated vaccine

T/F A healthy adult, born in 1968, who works as a kindergarten teacher lacks written documentation of varicella vaccination, but reports that he had a typical case of chickenpox as a child. This person should be given two doses of Varicella vaccine separated by 4 to 8 weeks.

True

Y/N You have three persons to vaccinate. Click on Yes if varicella vaccine should be administered today, on No if varicella vaccine should not be administered today, or on It Depends if it would depend on the situation. Assume in all cases that the person is susceptible to varicella. An 8-year-old boy with a documented allergy to gelatin.

Y/N You have three persons to vaccinate. Click on Yes if varicella vaccine should be administered today, on No if varicella vaccine should not be administered today, or on It Depends if it would depend on the situation. Assume in all cases that the person is susceptible to varicella. A 34-year-old nurse who is trying to become pregnant.

It Depends

Y/N You have three persons to vaccinate. Click on Yes if varicella vaccine should be administered today, on No if varicella vaccine should not be administered today, or on It Depends if it would depend on the situation. Assume in all cases that the person is susceptible to varicella. A 26-year-old daycare worker with leukemia for which she completed her first round of chemotherapy 4 months ago.

It depends

Which person has a valid contraindication to receiving varicella vaccine today?

An HIV-infected 2 year old with a very low CD4+ T-lymphocyte count

Which person listed should be considered immune to VZV?

A woman born in 1969 who has medical records documenting a case of varicella in 1971, with no documentation of serologic testing or varicella vaccination

An 18-year-old Armed Forces recruit needs varicella vaccination and a PPD. What is a correct way to administer these injections?

Administer the PPD and varicella vaccine simultaneously

A healthy, 40-year-old man who is susceptible to varicella was exposed to VZV 3 days ago. What action is recommended to prevent or reduce the severity of varicella illness if this man is infected with VZV?

Administer a dose of varicella vaccine today, followed by a second dose in 4 to 8 weeks

Choose the true statement about varicella vaccine.

Adults account for approximately 35% of varicella-associated mortality

Varivax is given to adults in two doses, separated by 4 to 8 weeks. What is the recommended amount of vaccine in each dose of Varivax?

0.5mL

Which statement accurately represents information contained in the varicella VIS?

Mild problems after vaccination include soreness or swelling where the shot was given, fever, and mild rash.

A healthy, 18-year-old pregnant woman was exposed to VZV yesterday. She does not know whether she has ever had varicella or varicella vaccine. What action is recommended?

Refer her to a healthcare provider for serologic testing to determine if she has antibodies against VZV.

Varicella Zoster

Herpes virus that causes varicella (chicken pox) Acute

The virus lies dormant in the nerve root ganglia causing Herpes Zoster (shingles)

Communication of Herpes Zoster

A very contagious virus is communicable for 1-2 days before the onset through 4-5 days after characteristic rash

Respiratory transmission or Contact with lesions

Clinical features of Varicella

Generalized rash, consisting of more than a thousand pruritic vesicles

Highest concentration is on the trunk

Lesions appear on the face, scalp, extremities, and mucous membranes

Contain a clear fluid and often rupture. or drain before they dry and develop a crust

Complications of Varicella

Secondary infections with group A Strep. spp. or Staph spp.

Secondary infections are serious leading to clinic visits, hospitalizations, and death

Cerebral ataxia, Encephalitis, pneumonia

Varicella vaccines on the market

Live attenuated virus

Variax
Zostavax (Mayb)
Shingrix (MayB)

Varicella abbreviation

VAR

Target groups for varicella zoster

All Children older than age 12 months of age

Susceptible adolescent and adults

People who do not need to be vaccinated for varicella zoster

Lab evidence of immunity and confirmation of disease

Birth in US before 1980, except women and those that are immunocompromised

Vacerella zoster recommenations

First dose at 12-15 months of age
Second dose at. 4-6. months of age

All. 13 and younger should receive second dose at least 3 months after the first.

All susceptible 13 and older adolescence and adults should receive 2 doses at least 4 weeks apart

Women should be vaccinated at least. one month before conception

Vacerella Zoster Contraindications

People who are immune suppressed should be referred to an allergist

Do not give vaccine to anyone that has had a blood transfusion recently

Can still develop Shingles after vaccination

Herpes Zoster

Reactivation of chicken pox causes nerve pain and a rash on one side of the body
Postherpetic neuralgia (PHN)

PHN

Pain lasting 90 days after injury

Development of more neurological conditions

Shingles/Zoster vaccine abréviation

HZV

Shingles/Zoster vaccine on the market

Zostavax (Live)

Target group for Zoster/Shingles

All adults 60 years or older

Doses of Zoster vaccine

HPV vaccine abbreviation

9vHPV (inactivated)

HPV target groups for vaccination

Children, Adolescence, and adults 9-26, ideally at 11 or 12

HPV doses given for children <15

2 doses given 6 to 12 months apart

HPV doses given for children older that 15

3 doses given where the second dose is given 1-2 months from the first. The third given 6 months after the first

Measles

Contagious virus that is communicable 4 days before and 4 days after the rash appears

-Cough, runny nose, conjunctivitis, koplik spots, maculopapolar rash

Young children and young adults are at higher risk of disease

Paromoxyvirus family

Mumps

Spread by respiratory route but not as contagious as measles
Communicable 3-4 days of onset symptoms
Some people may experience symtoms while some may experience nonspecific symptoms

Most common symtom of mumps is parotitis- inflammation of parotid glands

Member of paromoxyvirus

Rubella

The rubella virus is transported via respiratory route and is communicable 7 days before and 5-7 days after rash appears

Mild and causes few complications

Maculopapular rash appears 2 weeks after exposure

Congenital rubella syndrome (CRS)

If a pregnant women is infected with rubella, fetal harm can occur

Measles, Mumps, Rubella vaccine abbreviation

MMR

MMR vaccine type

Live attenuated

Target groups for MMR

All individuals 12 months and older

Timing of administration for MMR

First dose at 12 to 15 months and second dose at 4 to 6 years

For catch up, 2 doses 4 weeks apart

Pneumococcal vaccine abbreviations

PCV13 and PPSV23

Pneumococcal vaccine type

Inactivated

Timing of PCV13 for children

Children should receive a dose at months:
2, 4, 6, 12 to 15

Pneumococcal vaccine for high risk children

PPSV23 should be given at least 8 weeks after last dose of PCV13 to children 2 and older

Spacing of PPSV23

At least 5 years apart

Pneumococcal vaccine in adults 65 or older

Should receive PCV13 first and wait a year for the next shot of PPSV23
Give 8 weeks apart if immunocompromised
PCV13 only given once in this series
PPSV23 can be given up to 3 times

Meningitis vaccine abbreviations

MenACWY and MenB

Meningitis vaccine type

Inactivated`

Timing of MenACWY

Should be given at age 11-12 and a booster at 16 to 18 years. Must wait at least 8 weeks between doses
For high risk conditions, one dose followed by revaccination every 5 years

Timing of MeB Bexsero vaccinations

MenB given at age 16 to 18 based on clinical discretion
Give second dose at least one month later

Timing of MenB Trumenba vaccinations

Given as 2 doses: Second dose given after 6 months
Given as 3 doses: Second dose given at 1-2 months, Third dose given at 6 months

Hepatitis A vaccine abbreviation

HepA

HepA vaccine type

Inactivated

Timing of administration for HepA

2 doses: The first dose should be given at 1 month of age, and a booster should be given 6-12 months later

Hepatitis B vaccination

HepB

HepB vaccination type

Inactivated

HepB timing of administration for children

3 doses: Given at birth, 1-2 months, 6-18 months

HepB timing for older patients

3 doses: Given at 1 month and 6 months apart

Rotovirus vaccinations

RV1 (Rotarix) and RV5 (RotaTeq)

RV vaccination type

Live

Rotavirus schedule

3 doses total: One dose at 2 months, 4 months, 6 months
or
2 doses: One dose at 2 months of age and 4 months of age

Haemophilus type B abbreviaton

Hib

Dosing schedule for Hib

4 doses (ActHIB, MenHibrix, Hiberix, Pentacel): 2 months of age, 4 months, 6 months, and booster at 12-15 months

3 doses (PedvaxHIB): 2 months of age, 4 months of age, 12-15 months of age

Hib vaccine type

Innactivated

Polio vaccine abbreviation

IPV

Polio vaccine type

Inactivated

Poliovirus vaccination schedule

4 doses: 2 months, 4 months, 6-18 months, 4-6 years

JKO Polio: The Disease and Vaccines that Prevent Disease Course

September 10, 2022 Dwayne Morise

Which statement regarding poliovirus infection is true?

All of the above

A 20-year-old man is a new recruit in Army basic training. The current recommendation of the US military to protect him from polio is...

One dose

Which statement regarding polio transmission is true?

All of the above

Most children (greater than 70 percent) infected with poliovirus will develop...

No symptoms

Which statement regarding polio incidence is true?

All of the above

Which statement regarding outcomes of polio infection is true?

All of the above

Which statement regarding polio vaccines is true?

All of the above

Vaccine Associated Paralytic Polio (VAPP) is a rare complication of receipt of oral polio vaccine (OPV).

True

Which statement regarding inactivated polio vaccine (IPV) is true?

IPV is a component of some combination vaccine products that have been licensed to also protect children from diphtheria, tetanus, and pertussis (DTaP).

A 20-year-old woman presents for a wellness exam. She has lived all her life in the United States and she has no plans for overseas travel. Should she receive polio vaccine today?

A 30-year-old man has just immigrated to the United States from Africa. He has no history of prior polio immunization. He plans to continue worldwide travel. What polio vaccine regimen is recommended?

Three doses

A 40-year-old woman is planning travel to a country where wild poliovirus is still a threat. She has a documented record of two prior doses of IPV, spaced by an appropriate interval. What polio vaccine regimen is recommended?

One dose

The current recommendation to protect children in the United States from polio is...

At least three doses of IPV, with the final dose of the series given after age 4-years

Administering IPV at intervals shorter than the recommended timing between doses may result in lower vaccine effectiveness.

True

When vaccinating children or adults with IPV, the minimum interval between the final dose of IPV and the previous dose of IPV is 6 months.

True

Polioviruses are transmitted by...

Person-to-person via the fecal-oral route

Polioviruses are transmitted by...

Person-to-person via the fecal-oral route

One dose of IPV

A 20-year-old man is a new recruit in Army basic training. The current recommendation of the US military to protect him from polio is...

One dose of IPV

Three doses of IPV

The current recommendation to protect children in the United States from polio is...

At least three doses of IPV, with the final dose of the series given after age 4-years

Which statement regarding polio incidence is true?

All of the above.

Which statement regarding inactivated polio vaccine (IPV) is true?

IPV is a component of some combination vaccine products that have been licensed to also protect children from diphtheria, tetanus, and pertussis (DTaP).

A 20-year-old woman presents for a wellness exam. She has lived all her life in the United States and she has no plans for overseas travel. Should she receive polio vaccine today?

Which statement regarding outcomes of polio infection is true?

All of the above.

Administering IPV at intervals shorter than the recommended timing between doses may result in lower vaccine effectiveness.

True

Which statement regarding polio vaccines is true?

All of the above.

Most children (greater than 70 percent) infected with poliovirus will develop...

No symptoms

Which statement regarding polio transmission is true?

All of the above.

Which statement regarding poliovirus infection is true?

All of the above.

When vaccinating children or adults with IPV, the minimum interval between the final dose of IPV and the previous dose of IPV is 6 months.

True

Vaccine Associated Paralytic Polio (VAPP) is a rare complication of receipt of oral polio vaccine (OPV).

True

JKO HIPAA Privacy and Security Officer Training

September 10, 2022 Dwayne Morise

Privacy Officer

Patti Bushnell

Security Officer

Patti Bushnell

Protected Health Information (PHI)

Information that must be protected whether in written, oral, or electronic format.

Minimum Necessary Standard

Workforce uses only the minimum amount of PHI necessary to get the job done.

Patient Privacy Rights

HIPAA provided rights of patients.

Notice of Privacy Practices (NOPP/NPP)

Notification to patients that includes a description of patient's privacy rights, how EVO may use a patient's PHI, what family members the medical staff may interact with and how, information on how to file a complaint with HHS.

Privacy Policies

Policies regarding how EVO is allowed to use and disclose PHI.

HIPAA Security

Refers to portion of HIPAA that addresses physical, technical, and administrative safeguards that are put in place to protect confidentiality of information.

Electronic Protected Health Information (ePHI)

Refers to the integrity, confidentiality, and availability of patient health information stored in electronic formats.

User Identity

Unique User ID and Password.

Password Management

Selecting strong passwords, protecting those passwords, and changing passwords regularly.

Security Policies

Written policies that address how EVO will implement appropriate safeguards to ensure the confidentiality, integrity, and availability of ePHI.

WHY WAS THE HIPAA RULE ENACTED

BOTH A AND B

WHICH OF THE FOLLOWING IS A GOAL OF HIPPA

ALL OF THE ABOVE

FACILITY ACCESS CONTROLS IS AN EXPAMPLE OF WHICH HIPAA SAFEGUARD

PHYSICAL

CONTINGENCY PLANS ARE AN EXAMPLE OF WHICH SAFEGUARD

ADMINISTRATIVE

TRANSMISSION SECURITY IS AN EXAMPLE OF WHICH SAFEGUARD

TECHNICAL

PHI STANDS FOR WHICH OF THE FOLLOWING

PROTECTED HEALTH INFORMATION

True or False:
HEALTH INFORMATION TRANSMITTED RALLY IS NOT CONSIDERED PHI

FALSE

WHICH OF THE FOLLOWING WOULD BE AN EXAMPLE OF THE "MINIMUM NECESSARY" STANDARD

CREATING ROLE SPECIFIC USER ACCOUNTS BASED ON THE DATA NEEDED TO PERFORM

WHICH DATA ELEMENTS ARE CLASSIFIED AS BOTH PHI AND PII

ALL OF THE ABOVE

PII IS DEFINED AS

B & C ONLY

PER HIPAA WHICH OF THE FOLLOWING IS A PERMITTED USE/ DISCLOSURE OF PHI

BUSINESS MANAGEMENT AND ADMINISTRATIVE ACTIVITES

WITHIN WHAT TIME FRAME ARE YOU REQUIRED TO REPORT A BREACH TO ONE CALL

WITHIN 20 DAYS OF THE DISCOVERY OF THE BREACH

oNE CALL RESTRICTS ACCESS TO ONLY THOSE WITH A TRUE NEED- TO-KNOW FOR WHICH OF THE FOLLOWING

ALL OF THE ABOVE

WHICH OF THE FOLLOWING ARE THINGS YOU CAN DO TO SECURE PHI AND PII

ALL OF THE ABOVE

True or False:
LOSING YOU JOB OR NETWORK STATUS IS THE ONLY POSSIBLE DISCIPLINARY ACTION FOR VIOLATING THE INFORMATION SECURITY POLICY

FALSE

HIPAA

As a result, the federal government decided that privacy legislation must be enacted. In the 1970's, Congress began working to reform many aspects of the health care industry. By 1996, the Health Insurance Portability and Accountability Act (HIPAA) was passed in the House and Senate and was signed by the President. HIPAA became law, and many rules were set in place to protect patients and their personal health information.

The Purposes of HIPAA

-Privacy of Health Information
-Security of Electronic Records
-Administrative Simplification
-Insurance Portability

Privacy of Health Information

-According to HIPAA, a patient's health information is private. Before a patient's information is released to anyone, such as a family member or another physician, the patient must give written authorization.

-The privacy regulations are outlined in a section of HIPAA called the Privacy Rule. The Privacy Rule provides detailed instructions for handling and protecting a patient's personal health information.

Security of Electronic Records

-In recent years, there has been a trend in health care facilities to convert all medical records from paper form to electronic form.
-Electronic medical records (EMR) help the health care industry to operate more efficiently. However, EMR creates many security and privacy issues. As a result, HIPAA provides regulations to make sure that confidential records are kept secure. This is called the -Security Rule.

Security Rule Safeguards

-According to the Security Rule, health care facilities must provide three types of safeguards when using electronic records.

Physical Safeguards

-include rules for providing a safe and hazard-free environment in which to store medical records.

For example:
-Doors should be locked.
-Computer server rooms should be locked and accessed by authorized personnel only.
-Any paper records should be stored in locked, fireproof cabinets.

Technical Safeguards

include rules for protecting electronic information.

For example:
-All medical records should be password-protected, and passwords should be updated regularly.
-Information that is transmitted electronically should be encrypted.
-All computer systems must have effective anti-virus software.

Administrative Safeguards

include rules for managing employees who have access to protected health records. For example:
-Policies must be in place regarding which employees are allowed to access information.
-All employees should complete security awareness training.

Administrative Simplification

-Because most health care agencies have adopted an electronic records system, there was a need for national standards for health transactions. These standards are created in HIPAA in the Transaction and Code Set Rule. As a result of this rule, all medical transactions and codes have become the same nationwide. For example, a medical office assistant will be able to submit an insurance claim in the same format for any insurance plan and any insurance company.

-By standardizing these transactions, the health care industry has simplified its claims process. The process for transmitting data has also become more efficient. Standard, electronic claims are filed faster. And they are typically more accurate than the old paper forms.

Health Insurance Access, Portability, and Renewability

-section of HIPAA was created to provide continuous insurance coverage for people when they change or lose a job. A change in jobs usually results in a change in health insurance. HIPAA prevents health insurance companies from denying or limiting coverage for people who have pre-existing conditions.

Insurance Portability

For example, suppose that Rose Wilson had health insurance through her employer. After several years of employment, Rose developed a heart condition. She decided to quit her job and begin her own business working from home. When Rose applies for a new health insurance policy, it is illegal for the insurance company to deny coverage on the basis of her pre-existing heart condition.

Privileged Communication

information that is shared within a protected relationship. Such relationships include physician and patient, attorney and client, and clergy and counselee. The confidentiality, or privacy, of privileged communication is protected by law. In other words, under most circumstances, privileged communication cannot be disclosed. For example, an employee has taken a lot of sick days. The employer knows the employee's physician and asks the physician why the employee has taken so many sick days. The physician cannot answer the employer's question without the patient's permission.

The Privacy Rule

-established nationwide standards that are used to protect private patient information. For example, personal health information may only be shared among the members of a patient's health care team. Under most circumstances, it may not be disclosed to anyone else without the patient's permission. Violations of the Privacy Rule may include civil and criminal penalties, such as fines and loss of license.
-The Privacy Rule was not intended to slow down health care or to make health care more complicated. Rather, the rule was created to protect private health information while still allowing the flow of necessary information. As a result, patients should feel confident that their information is being treated properly and respectfully.

Protected health information (PHI)

is any individually identifiable health information about a patient. This is information about a patient's health status, provision of health care, and payment for health care that also identifies the patient's name, social security number, address, telephone number, date of birth, etc. PHI can be oral-, paper-, or electronic-based.

privacy

defined as a patient's right to control the use of protected health information.

Confidentiality

using discretion when handling protected health information. So then, patients have the right to the privacy of their health information, and health care employees have the responsibility to keep a patient's health information confidential.

Disclosure

release, transfer, or provision of access to protected health information. Patients must give permission for their health information to be disclosed to other people, including other doctors, family members, friends, health insurance companies, employers, and attorneys.

Authorization

the permission that patients give in order to disclose protected health information. Several elements must be included in formal authorization.

Authorization must be in writing and in plain language.

Authorization must name the entities that are allowed to receive health information. Entities include health care providers, health insurance providers, and health care clearinghouses, who handle insurance claims.

Authorization must state the people that are allowed to view health information, such as a spouse or other relatives.

Authorization must state the extent of health information that approved entities and people are allowed to access.

Authorization must include a statement that patients have the right to refuse authorization. As a result, health care providers have the right to limit treatment to that patient.

Authorization must have an expiration date.

Authorization must be signed and dated by the patient.

Patient Rights under the Privacy Rule

At a patient's first visit to a health care facility, the patient must be given a written copy of the facility's rules and the patient's rights regarding protected health information.

Right to request restrictions on certain uses of protected health information

Patients may select which items in their medical records should not be disclosed. For example, a patient may restrict an item in the medical record if the previous health condition is no longer applicable or if the patient feels that it will cause embarrassment.

Right to request confidential communications

Patients may request reasonable, alternative forms of communication. For example, a patient may ask to be contacted at a work phone number instead of a home phone number.

Right to access a copy of protected health information

With the exception of psychotherapy notes, patients may access, inspect, and obtain a copy of their medical records. Typically, the request must be made in writing and acted on within 30 days. Most facilities will charge a fee to patients to obtain copies of their medical records.

Right to request an amendment of protected health information

Patients may request a change to their medical record if they feel that something is incorrect. The requests must be made in writing. Facilities must respond in a timely fashion. In some cases, the requests may be denied.

Right to receive an accounting of disclosures of protected health information

Patients may request a record of all the instances in which their personal information was disclosed. Each item in the record must include the date of disclosure, the name of the entity or person to which information was disclosed, a description of the information that was disclosed, and the reason for disclosure.

Medical Facility Responsibilities

Medical facilities must abide by HIPAA and Privacy Rule regulations. Each facility must have a written policy for adhering to these rules. The policy must be recorded in electronic and paper form.

Medical Facility Responsibilities

When patients come to a medical facility for the first time, they must receive a copy of the facility's privacy policy. This is called the Notice of Privacy Practice form. All patients must read and sign the form. In addition, patients must sign a Release of Information form to allow the facility to disclose medical information to authorized entities or people.

Disclosure without Authorization

When a patient requests to see his or her own personal information: Patients may have access to their own medical record at any time.

When permission to disclose is obtained: If a patient is admitted to the hospital, the patient will be asked if his or her name may be listed in the directory. Then, if any guests request to see the patient by name, the guests can be directed to the correct room.

When information is used for treatment, payment, and health care operations: If a patient is referred from one doctor to another doctor, these two doctors may share the patient's health information.

When disclosures are obtained incidentally: Incidental information is information that is obtained accidentally, even when privacy precautions are taken. For example, if a doctor discusses a medical condition with a patient behind closed doors and someone outside the door overhears, this is considered incidental.

When information is needed for research: Some health data may be released to researchers or for public health purposes. In these cases, identifying information, such as names, social security numbers, and addresses, has been removed from the data.

The final situation for when disclosure of protected health information is allowed without authorization occurs when there are legal or public interest issues involved. Some examples of legal or public interest issues include:

When information in a medical record must be provided to a court of law.

When law enforcement needs medical records to identify a suspect or missing person.

When reporting cases of abuse, neglect, or domestic violence.

When births and deaths occur.

When a patient contracts a serious communicable disease, such as tuberculosis.

When information is needed to facilitate organ transplants from deceased donors.

Emotional abuse

includes excessive demands. It includes insults and humiliation. It also includes jealousy, control, and isolation. Emotional abuse includes stalking and threats. And it includes lack of affection and support.

Physical abuse

includes hitting, kicking, pushing, shaking, pulling hair, pinching, choking, biting, burning, scalding, and threatening with a weapon. It also includes inappropriate restraint. And physical abuse includes withholding food and water, not providing physical care, and abandonment.

Sexual abuse

includes using sexual gestures, suggesting sexual behavior, and unwanted sexual touching or acts.

Signs of Abuse

-Patient statements
-Unexplained injuries, such as bruises, abrasions, fractures, bite marks, and burns
-Unreasonable explanations for injuries
-Malnutrition and dehydration
-Poor personal hygiene
-Pain or bruising in the genital area
-Unexplained genital infections
-Emotional problems, such as anxiety, depression, aggressiveness, -

changes in appetite, problems at school or work

Medical Records

-Personal information, such as full name, phone number, address, work number and address, birth date, social security number, and marital status
-Medical history
-Description of symptoms
-Diagnoses
-Treatments
-Prescriptions and refills
-Records of patient's telephone calls
-Name of legal guardian
-Name of power of attorney
-Notes about copies of medical records

Ownership of Medical Records

Medical records belong to health care providers, but patients have the right to see and obtain a copy of their records. The exception to this is patients with mental illness. This is because knowledge of their medical information may make such patients' condition worse. In addition, if a patient's employer or prospective employer pays for a job-related physical examination, the employer, not the patient, has the right to see and obtain a copy of the records. In this case, the employer must give permission for the patient to see and obtain a copy of the records.

Proper Maintenance

Medical records are legal documents. Therefore, they must be properly maintained. Specifically, medical records must be complete, legible, and timely. In addition, all information in records must be objective and the information must be initialed and dated. Subjective observations made by health care workers should never be included. On the other hand, subjective statements made by patients may be included. These should be recorded in patients' exact words and quotation marks should surround them.

-Furthermore, errors should never be erased or covered with correction fluid. Instead, a single line should be drawn through an error so that the error is still readable. And the word "error" should be written and initialed. An explanation of the error may be included. Then, correct information may be inserted, initialed, and dated.

-Records should also be kept for at least two to seven years, according to federal and state laws. When records are destroyed, they should be shredded.

Electronic Medical Records
advantages

-Instant access
-Remote access to up-to-date information
-Simultaneous access
-Decreased time to record information
-Legible
-Better organization
-Flexible data layout
-Automated checks and reminders
-Increased privacy and decreased tampering, destruction, and loss due to required authorization

disadvantages of electronic medical records

-Additional hardware, software, and licensing costs
-Resistance to giving up paper records
-Difficult data entry
-Training
-Computer downtime, such as unexpected failure or routine servicing
-Confidentiality and security concerns, such access of information to unauthorized individuals

Confidentiality of Electronic Records

-Limit individuals who have access to records by using passwords, fingerprints, voice recognition, and eye patterns.
-Require codes to access specific information.
-Place monitors in areas where others cannot see the screen.
-Do not leave monitors unattended while confidential information is on the screen.
-Do not send confidential information by e-mail.
-Back up data.
Constantly monitor and evaluate the use of electronic medical records.

Printers

-Do not leave printers unattended while printing confidential information.
-Do not print confidential information on printers that are shared by unauthorized individuals.
-Do not print confidential information on wrong printers.
Make sure to collect printouts of confidential information from printers.
-Do not throw unneeded printouts of confidential information in trash cans. Instead, these should be shredded.

Copiers

-Do not copy confidential information if unauthorized individuals are in the area and can see the information.
-Do not leave copiers unattended while copying confidential information.
-If a paper jam occurs, be sure to remove the copies that caused the jam from the copier.
-Make sure to collect all copies of confidential information as well as the original from the copier.
-Do not throw unneeded copies of confidential information in trash cans. Instead, these should be shredded.

Fax machines

-Contact the receiver and verify the fax number of the receiving location before faxing confidential information.
-Do not fax confidential information to unauthorized individuals.
-Attach a cover sheet that contains a confidentiality statement.
-Do not fax confidential information if unauthorized individuals are in the area and can see the information.
-Do not leave fax machines unattended while faxing confidential information.
--Make sure to collect confidential information from fax machines.
-Do not throw unneeded faxes of confidential information in trash cans. Instead, this should be shredded.
-Contact the receiver after faxing confidential information.

Telephones

-Do not use patients' names if unauthorized individuals are in the area and can overhear.
-When leaving messages, simply ask patients to return the call. Do not speak about any confidential information.

Which of the following is not among HIPAA's primary purposes?

advising patient on which health screenings they need to monitor their health

XYZ Ltd., a business associate of a healthcare provider, was responsible for handling all accounting services for the provider. While performing an audit, Brooke, one of XYZ's employees, shared confidential patient information on social media in violation of HIPAA. What penalties may XYZ face?

XYZ faces potential audits and penalties from HHS

Under which of the following conditions could Meredith show the patient's records to Caitlin?

If Caitlin needed to view the chart for purposes of treatment, payment, or operations.

what's the worst thing that could happen to Meredith if she shows Caitlin the patient's records without the patient's prior consent?

She could be fined or even imprisoned.

As Tracy prepared to leave work for the day, she put documents containing PHI in a folder on her desk, shut off her computer and left her office without locking the door. Which of Tracy's actions put PHI at risk?

Leaving PHI in a folder on her desk and not locking her office door

Assuming the files and thumb drive contained unencrypted PHI, did Claire mishandle PHI here?

Yes, because she told Juan to throw the files and thumb drives in the dumpster

If Juan later took the thumb drives home with him, would this be a security breach?

Yes, because Juan was not authorized to take the thumb drives home.

What should Sam have done to protect the PHI on the flash drive?

Nothing. Sam should not have taken the PHI out of the office at all.

Assuming that the person who picked up the lost flash drive was a stranger unknown to Sam, would this be considered a "security breach" involving PHI under HIPAA

Yes, unless Sam's employer can prove it's unlikely the PHI has been compromised

Health

The "H" in HIPAA

Insurance

The "I" in HIPAA

Portability

The "P" in HIPAA

Accountability

The first "A" in HIPAA

Act

The second "A" in HIPAA

PHI

HIPAA acronym for confidential health information

Protected

The "P" in PHI

Information

The "I" in PHI

Harry owns a medical billing services company. In order to save money, Harry decides to eliminate HIPAA training for his employees. As a result, one of Harry's employees accidentally disclosed PHI. Which of the following statements is the most accurate?

Harry may be subject to significant civil and criminal penalties

Which of the following is not protected health information (PHI) under HIPAA

A pamphlet explaining the risks of smoking

Which of the following guidelines should you follow when handling PHI

Destroy PHI once it is no longer needed in accordance with the company's record management policies

Which of the following guidelines should you follow when handling PHI

Maintain strong passwords on electronic systems

which of the following is not a reasonable privacy safeguard required by HIPAA

Talking about PHI in Pig Latin

Which of the following is the best summary of one of HIPAA's primary purposes

Standardizing healthcare data

Which of these is the best reason to be sure you understand how HIPAA affects your day-to-day job responsibilities

Both of the above:
-violations of HIPAA can incur substantial penalties, including large fines and imprisonment
-Protecting the privacy of personal healthcare information aids the integrity of our healthcare system

When must a covered entity provide a Notice of Privacy Practices (NPP)

Whenever someone requests a copy of the NPP

Gayle recently had hip replacement surgery and has been visiting an outpatient rehabilitation center. Her medical costs are covered by Medicare. The rehabilitation center has sent Gayle a letter asking for certain information to resolve a billing problem. Is Gayle's personal health information protected by HIPAA in this situation?

Yes, because both Medicare and the rehabilitation center are subject to HIPAA

Ben just started a new job at a company that handles PHI. In exploring the layout of the office, Ben entered a room that houses hard copies of files that care being converted into an electronic format. Curious, Ben reviewed certain files, many of which contained PHI. What HIPAA security measure could have prevented Ben's unauthorized access to PHI?

Facility access controls

Which of the following is a physical safeguard required by HIPAA?

Developing procedures for the proper disposal of old laptops

Which of the following is an example of a technical safeguard required by HIPAA?

Using person or entity authentication to control access to PHI

Jenny's children go to school with the children of a pharmacist who works at her local drugstore. Jenny learned that the pharmacist disclosed Jenny's drug prescriptions to a teacher at the school to dissuade her from allowing Jenny to chaperone an overnight field trip. What action can Jenny take?

file a complaint with OCR

Which of the following is the most accurate summary of the possible penalties for a HIPAA violation?

All of the above:
-Civil fines of up to $1.65 million annually
-Criminal fines of up to $250,000
-Imprisonment for up to 10 years

In which of the following situations may we not use or disclose an individual's PHI without written authorization?

To discuss the patient's condition with family members

Affordable Health Plan Inc. posts its NPP on its website. Recently, the company made a material revision to the NPP. As a result, they mailed a new copy of the NPP and an explanation of the revisions to all of the individuals covered by their health plan. Did Affordable Health Plan Inc. act correctly?

No, the company also needs to post the material revisions on its website

Julia recently moved across the country and started seeing a new doctor. She never contacted her former doctor for her medical records. Six years before she moved, Julia was treated for depression. Is this information protected by HIPAA?

Yes, medical records never lose HIPAA protection

Which of the following situations present(s) potential violations of HIPAA

All of the above:
-The sale of a list of patient names and phone numbers to a marketing company
-The theft of a laptop containing unencrypted PHI
-A nurse sharing PHI with her husband to assist him in a lawsuit against a patient

JKO Introduction to the Disability Evaluation System (DES) for PEBLOs

September 9, 2022 Dwayne Morise

Why was the Integrated Disability Evaluation System created?

To determine whether a wounded, ill or injured service members are able to continue to serve

What are some reasons a member could be medically separated or retired?

- Have a disqualifying medical diagnosis
- Condition prohibits or limits the individual from completing his or her duties
-Condition routinely interferes with their ability to deploy
- Condition restricts worldwide duty reassignment
-Imposes unreasonable requirements on the military to either maintain or protect the member

Why does the AF have the two-step evaluation process?

To ensure proper referral to the IDES

When a provider identifies a diagnosis that could be disqualifying for a member to continue active duty, what must the member undergo?

A fitness for duty(FFD) evaluation

Once the deployment availability working group reviews the case, whom is it sent to?

HQ AFPCDPANM

What is the purpose of the deployment availability working group(DAWG)?

to review patients with medical records with a duty limiting condition(DLC) that impacts mobility, retention, or long term physical fitness of an airman. They also identify personnel not deployment eligible, and tracks progress of the medical condition

What is a trigger event?

It is a condition or occurrence which may indicate a member has a health condition that is inconsistent with retention standards or deployability

Purpose of disability evaluation system

-To maintain a fit military organization with max use of manpower
-To provide benefits for service connected disability
-To provide prompt disability processing while ensuring the rights of the Government and soldier are protected

Purpose of physical profile serial system

To provide an index to overall functional capacity that starts with the physical profile. Consists of both alphabetical and numerical designations.

Physical capacity or stamina. Heart; respiratory system; GI system; GU system; nervous system; blood diseases; dental conditions

Upper extremities. Hands, arms, shoulder girdle, and spine in regard to strength, ROM, and general efficiency

Lower extremities. Feet, legs, pelvic girdle, lower back and spine in regard to strength, ROM, and general efficiency

Hearing and ears. Concerns auditory acuity and disease and defects of the ear

Eyes. Concerns visual acuity and diseases and defects of the eye.

Psychiatric. Concerns personality, emotional, stability, and psychiatric diseases.

Numerical Components: 1

Indicates a high level of medical fitness

Numerical Components: 2

Indicates some medical condition or physical defect which may require some activity limitations

Numerical Components: 3

Indicates 1 or more medical conditions or physical defects which may require significant limitations. The individual should receive assignments commensurate with his/her physical capability for military duty

Numerical Components: 4

Indicates 1 or more medical conditions or physical defects of such severity that performance of military duty must be drastically limited

Temporary Profiles (DD Form 689 and DA Form 3349)

DD Form 689, Individual Sick Slip (not to exceed 7 days)
DA Form 3349, Physical Profile (Reevaluated every 3 months. Cannot exceed 12 months.)

DA Form 3349 (Permanent Profile)

Permanent Profile
-original and one copy to unit commander
-MILPO
-Health record
-Inpatient record, if applicable
-Patient, if pseudofoliculitis of the beard

Distribute Temporary profile

-original and one copy to unit commander
-health record
-patient, if pseudofoliculitis of the beard

Purpose of Physical Performance Evaluation System (PPES)

to evaluate soldiers with permanent medical conditions to determine if they can perform in their PMOS/AOC in a worldwide field environment

MOS/Administration Retention Review (MAR2)

-Evaluates a soldier's physical ability to reasonably perform in PMOS/AOC - Specialty
-Determines if soldier can perform under worldwide field environment and conditions
-Permanent 3/4 profiles must be referred for evaluation by MAR2/MEB

MAR2 Proceedings

Not a "medical board" - Human Resources Command administrative review process, duty standards, Commanders input, and soldier's statement to determine capacity to serve in current MOS/AOC under worldwide deployable conditions

MAR2 Recommendations

1. Retain a soldier in PMOS or AOC specialty code
2. Reclassified
3. Referral to the Disability Evaluation System

Components of Disability Evaluation System

-Medical Evaluation Board (MEB)
-Physical Evaluation Board (PEB)
-US Army Physical Disability Agency (USAPDA)

Medical Evaluation Board (MEB)

-Documents a soldier's medical status and duty limitations
-Refers soldiers to Physical Evaluation Board if necessary
-DA Form 3947, Medical Evaluation Board Proceedings

Composition of MEB

-2 or more physicians, 1 senior
-recorder
-board style
-informal
-clinical, health records reviewed
-the patient may appear

MEB Recommendations

-return to duty
-return to duty with limitations
-referral to Physical Evaluation Board

Physical Evaluation Board Liaison Officer (PEBLO)

-appointed by the MTF Commander
-Responsible for counseling soldiers undergoing physical disability processing
-ensures MEB proceedings referred to the PEB are complete, accurate and fully documented

Roles and Responsibilities of the PEBLO

-Counselor
-Advisor
-Editor
-Supervisor
-Mediator
-Chaplain
-First Sergeant

Physical Evaluation Board

A fact finding board established to evaluate all cases of physical disability equitably for the soldier and the Army

Voting members of PEB

-president - field grade officer
-personnel officer - field grade medical officer

Non-voting Members of PEB

-army attorney (for soldier)
-recorder/reporter

Informal PEB

-reviews soldier's case file
-determines whether the soldier is physically fit or unfit to perform the duties of the soldier's office, grade, rank, or rating
-determines whether the disability meets the criteria established by law for compensation
-VA assigns a disability percentages

Formal PEB

-convened when a soldier demands it after electing not to accept the findings and recommendations of an informal board
-when the case file has been forwarded to PERSCOM for issuance of retirement orders and the soldier demands a formal hearing before PERSCOM action is final

Separation without benefits (SWOB)

-soldier is unfit and did not occur in Line of Duty
-existed prior to service and not service aggravated

Separation with Severance Pay (SWSP)

-soldier is unfit
-soldier is eligible for compensation
-soldier has less than 20 years service and less than a 30% disability rating

Permanent Disability Retirement (PDR)

-unfit
-eligible for compensation
-has either 20 years active service or a disability rating of at least 30%

Temporary Disability Retirement List (TDRL)

-PDR eligible AND the disability is not stable for rating
-3 year tenure max
-periodic re-exams 96-18 months)
-soldiers placed on TDRL receive a min of 50% of their base pay

Retirement Pay

Method A (% Method)
-% of disability x monthly base pay

Method B
-2.5 x years service x monthly base pay

Severance Pay

Years of service x monthly base pay x 2
(years of service cannot exceed 19)

Army Physical Disability Appeal Board (APDAB)

reviews cases that are forwarded by USAPDA

Army Disability Rating Review Board (ADRRB)

reviews disability % ratings on request of a soldier who was retired because of physical disability

Army Board for Correction of Military Records (ABCMR)

corrects errors or injustices in a soldier's military records

VA benefits

-VA may rate any service-connected disability and their ratings may fluctuate depending on the future severity of the disability
-VA compensation is exempt from income tax

How can leaders help improve the process?

-get soldiers into medical treatment ASAP
-document the problem with a detailed commander's letter
-stay involved and maintain contact with PEBLO

JKO Organizational Socialization

September 9, 2022 Dwayne Morise

Of the following, what is the most important ethical duty of healthcare organizations and their leaders?

Upholding the rights of patients

What are the ethical guidelines that are established by professional societies usually called?

Codes of Ethics

What makes Mayo Clinic's value statement particularly effective?

The definition of each organizational value

When developing and communicating clear standards of conduct, the code should:

Provide illustrations and guidelines, particularly in "gray" areas

How should the joint commission (TJC) standards on organizational ethics be viewed?

As a minimum set of ethical responsibilities

True or false: standards and procedures to guide behavior is a structural component of an ethics program.

True

What statement sets an ethical tone and best represents the "soul" of the organization?

Values statement

True or false: "act with an entrepreneurial mindset" is one of the four basic principles of organizational ethics.

False

What defines the organizations basic philosophy, principles, and ideals?

Values or guiding principles statement

True or false: random evaluations of program effectiveness is a recommended structural component for an ethics program

False

What is the most important cultural/leadership component in an ethics program?

Refine management systems to support the ethics program

True or false: the stakeholder that would benefit from implementation of the principle "provide care with compassion" is the employee.

False

Organizational Socialization

Three phases: Anticipatory socialization, Encounter, Change & Acquisition. Where you mov e from an outsider to becoming a socialized insider

Anticipatory Socialization

Managing expectations the "getting in". Phase 1.

Encounter

Facing reality. "breaking in" Phase 2

Change & Acquisition

taking on the role . "settling in" Phase 2 the third socialization stage, in which the newcomer begins to master the demands of the job

Socialization Tactics

Collective vs Individual
Formal vs Informal
Sequential vs Random
Fixed vs Variable
Serial vs Disjunctive
Investiture vs Divestiture

Mentoring

a work relationship that encourages development and career enhancement for people moving through the career cycle

Better to pair mentors together based on interests not similar backgrounds

Organizational socialization

The process by which individuals learn the values and expected behaviors necessary to assume their roles in the organization

2 functions of organizational socialization

- Support organizational culture
- Helps newcomers adjust to coworkers and work procedures

Psychological contract

The individual's beliefs about the terms and conditions of a reciprocal exchange agreement between that person and their employer

2 types of psychological contracts

- Transactional
- Relational

Transactional contracts

Primarily short-term economic exchanges with well-defined and unchanging responsibilities and obligations

Relational contracts

Long-term attachments that encompass a broad array of subjective mutual obligations

3 stages of organizational socialization

- Preemployment socialization
- Encounter
- Role management

Preemployment socialization

Learning about the organization and the job, doing web searches

Main probems with preemployment socialization

- Outsiders rely on indirect information about what it's like to work at the company

- Applicants engage in impression management

- Employers are sometimes reluctant to ask certain questions as they don't want to scare off applicants

When does the "encounter" stage start?

First day on the job

Reality shock

The stress that results when employees perceive discrepancies between their preemployment expectations and on-the-job reality

Examples of role management

- Practice new role behaviours
- Adopt attitudes and values consistent with their new position and organization

Realistic Job Preview (RJP)

A method of improving organizational socialization in which job applicants are given a balance of positive and negative information about the job and work context

Benefits of RJPs

- Reduce turnover
- Increase job performance
- Increase affective organizational commitment

Socialization agents

Those who help with the organizational socialization process.

Can be boss or coworkers

When is newcomer socialization most successful?

When companies help to strengthen social bonds between the new hires and current employees.

phases of socialization

-anticipatory/pre arrival: before entry into the org

-encounter/entry: sense making stage when new employee enters the org and must let go of old roles; can be intense experience

-metamorphosis/role management: reached at completion of the process and new employee now accepted as org insider; turning point

jablin's model of socialization

same 3 phases plus exit (either voluntary or involuntary)

this is inevitable

anticipatory socialization

period before joining an organization

two types of anticipatory socialization

vocational anticipatory socialization: what field of work, choosing what to do with life

organizational anticipatory socialization: deals with a specific organization

uncertainty management

newcomers experience high uncertainty which explains info seeking behaviors among newcomers (passive, active, interactive)

sense making

how individuals understand or assign meaning to experiences
-retrospectively creating meaning to understand experiences
-interactive subjetive (meaning negotiated through comm)

identity cretaed by committing to particular interpretations

Recruitment

Attempts to attract prospective members to an organization.

Socialization

Ways in which newcomers learn about and make sense of an organization.

Role Expectations

How others believe a person should act in a given situation. Socialization impacts this.

Roles

Internalized formal (developed) or informal (selected) expectations for a job or position.

Role +/-

When met, more satisfaction and commitment.
When unmet, more turnover.

Role Conflict

The tension caused by competing demands between two or more roles pertaining to different statuses. You have multiple bosses.

Role Ambiguity

Uncertainty about what the organization expects from the employee in terms of what to do or how to do it. How do I know I am succeeding?

Role Overload

A job situation that places so many requirements or demands on workers that it becomes impossible to do a good job. Performance suffers.

Role Development

Who sends the message? How can the worker react? Workers can conform or not, negotiate message back.

Role Negotiation

Expand role: You want me to push papers but I can fix your leadership issues. You want me to work every day but I can only do three.

Reciprocal Influence Model

Dynamic model describing the passage of ID's through groups, beginning with socialization.

Stages of members through groups

Investigation, Socialization, Maintenance, Resocialization, Remembrance.

Group Perspective

Investigation: Recruitment, establish criteria to enter.
Socialization: Produce pressure to conform for assimilation of new members.
Maintenance: Max ID input to group, minimize costs to group.
Resocialization: Try to force assimilation.
Remembrance: Reach consensus about ID past contributions.

Member Perspective

Investigation: Reconnaissance, consider joining groups.
Socialization: Persuasion/leverage to pressure accommodation.
Maintenance: Max ID gains, minimize costs to ID.
Resocialization: Attempt to force accommodation.
Remembrance: Reminisce about how group fulfilled needs.

Role Transition

If commitment exists or not. Evaluation: Of member by group to determine if they are committed to member. By member of group to determine if benefitting. Commitment both ways. If yes then transition to role as new member/partial etc. If no then transition to ex-member.

Evaluation

Group and ID.....each other based on expectations, behavior, and the discrepancy between both.

Member Status

Full member, marginal member, non-member.

Recruitment Success

Production
Viability
Well/being satisfaction

Developable worker

Consider personality, resume. Attract using developmental language: saying things like new experiences await, possibly scouting. Interview past bosses, then design a structured interview.

Recruitment Process

Recruitment planning: Strategic planning, Asses desired KSA's. Anticipate supply/demand/turnover. Job market.
Recruitment methods: Costs, Yield Ratios, Time Lapse.

What People Learn During Socialization

History, language, politics, people, org goals and values, performance proficiency.

Org Structures Affecting Socialization

Recruitment: Strategy, job preview, Salary/benefits, fit.
Socialization: Group norms, climate, management practices.
Maintenance: Performance eval, feedback, goals.
Resocialization: Education and training. Org change initiatives Pressure, expectations.
Remembrance: Lessons learned, hiring committee considerations. New KSA's?

Content of Socialization

Collective vs Individual
Formal vs Informal
Sequential vs Random
Fixed vs Variable
Serial vs Disjunctive
Investiture vs Divestiture

Responses to Socialization

Custodianship
Content Innovation
Role Innovation
Rebellion

JKO Conflict Management

September 9, 2022 Dwayne Morise

Definition of Conflict

Interaction of interdependent people who perceive incompatibility and the possibility of interference from others as a result of this incompatibility.

4 Arenas of Conflict (interpersonal, organizational, group, intergroup)

1) Conflict is constitutes and sustained by moves and countermoves during interaction.
2) Patterns of behavior in conflict tend to perpetuate themselves.
3) Conflict interaction is influenced by and in turn affects relationships.
4) Conflict interaction is influenced by the context in which it occurs.

Aggressive Impulses & Reactions

Due to unf. Suppression and displacementuldilled needs or desires

Anxiety Impulses & Reactions

results from fear. Causes rigid and inflexibility

Emotions in conflict

Primary and secondary appraisal. Hurt, guilt, hop, energy

Primary Appraisals

Our initial understanding of the emotion
Positive or Negative

Emotional Flooding

an overwhelming response to another's suppression of emotion

Emotional Contagion

Spreading emotion from one party to the other

Pondy's Model of Conflict (organizational context)

• Latent Conflict
• Perceived Conflict
• Felt Conflict
• Manifest Conflict
• Conflict Aftermath

Four Horseman Stages

Criticism, Defensiveness, Contempt and Stonewalling.

Interdependent:

Both agents rely on each to accomplish a relationship, work, goals, tasks, etc.

Perceive Incompatibility:

One or more agents sees that both cannot get what they want.

Possibility of Interference:

One or more agents see the other person as thwarting, preventing, or inhibiting one's plans to reach his/her goals.

Conflict is a process of moves and countermoves among individuals.

Communication makes the unknown know, Verbal and nonverbal communication, Miscommunication

Communication

makes the unknown know

Nonverbal communication

Demeanor Changes, Tension, Anger, Sadness

Miscommunication

can create conflict

Harsh communication style

Blaming, shaming, or verbally assaulting others

Realistic:

Conflicts are based on a disagreement over the means to an end or the ends in themselves.

Unrealistic:

Conflicts are expressions of aggression in which the sole end is to defeat or hurt the other person. (link) (link)

What makes productive conflict different from destructive conflict?

Flexibility is present more than rigidity, All parties believe they can attain important goals. The parties are competitive in reaching their goals.

DIFFERENTIATION

People propose their differing ideas and beliefs. People give reasoning behind the difference of beliefs. People acknowledge the differences.

INTEGRATION

People acknowledge common ground. People discuss possible options. People discuss moving towards a solution. People settle on a solution.

Secondary Appraisal

Identifying and categorizing what the emotion is, We also determine who/what was responsible for the emotion.

Conflict

between two interdependent parties who perceive incompatible goals and interference from the other party in achieving their goals.

Interdependent parties

captures the notion that people in a conflict are dependent upon each other. Win-win, win-lose

Perceived incompatibility

it seems as if the goals of those involved are mutually exclusive, but that is not always the case, as mutually satisfying answers can be agreed upon.

Conflict styles

are the default styles people have for handing conflict.

Avoidance Conflict Style

(lose-lose) occurs when people ignore or stay away from conflict either physically or conversationally.

Accommodation Conflict Style

(lose-win) occurs when we allow others to have their own way rather than asserting our own point of view.

Competition Conflict Style

is a win/lose approach to conflict that involves high concern for self and low concern for others and can result in aggression.

Passive aggression Conflict Style

occurs when a communicator expresses dissatisfaction in a disguised manner.

Direct aggression Conflict Style

occurs when a communicator attacks the source of displeasure.

Compromise Conflict Style

(negotiated lose-lose) gives both people at least some of what they want, though both sacrifice part of their goals.

Collaboration Conflict Style

seeks to apply win/win problem solving to conflict and involves a high degree of concern for both self and others; the goal is to find a solution that satisfies the needs of everyone involved. The style to use depends upon several factors such as the situation, the other person, and your goals.

Definition of Power

something the strong have that the weak lack

Contrient

(competitive). Parties cannot trust each other if their interests differ, it may not be safe to open up or express feelings openly because they may be used against us.

Assertiveness

is our need and concern to meet our own needs and cooperation is our desire and concern that the other person has their needs met.

We are concerned with creating or fixing face because

1) It affects a relationship 2) It affects our identity or the acceptance of our identity by others

Chinese Definition of Face

Lien: What our integrity is based on OTHERS judgments and Mien-Tzu: What our reputation or social standing is

Lim & Bowers's Face Needs:

1) Fellowship face (inclusion) 2) Competence face (acknowledgement of ability) 3) Autonomy face (the desire to not be imposed upon)

Politeness Theory

Face is something that can be lost, maintained, or enhanced and must constantly be attended to in all interactions.

Positive Face:

A desire to acquire the approval of others

Negative Face:

A desire for autonomy

Threat:

A request can become a face threat. It depends upon: 1) Social distance between the parties, 2) The relative power of the parties and 3) The intrusiveness of the request or act

Negative Politeness:

Gives the person autonomy

Positive Politeness:

The focus is on the positive face or need for approval

Strategies of Face Threatening Acts

1) Avoid (do not perform) 2) Going off-record 3) Negative Politeness 4) Positive Politeness 5) Bald on-record

Climate is a culmination of factors:

Culture and Interaction

Culture:

Boleman and Deal came up with four workplace times including bet your company and work hard play hard.

Interaction:

Climates are established via interactions with others. It's not one person creating a climate.

Uncertainty can have a huge impact on climates

People will seek cues from the the climate in order to figure out how to respond.

Promotive:

When everyone is responsible for success, the results are: Information is shared among individuals, True feelings can be expressed safely, Power is less likely to be employed, and Everyone is aware of the group's goals and where the group is headed. Ex: Nonprofit Organizations, Start-ups

Shifting Climate

1) Make small changes that will eventually add up and change the climate. 2) Openly discuss parts of the climate. 3) Create a critical incident that will change the climate

Four functions of apology

1) As a Social Nicety 2) As a correction for a minor interaction offense 3) As an expression of sympathy (no responsibility taken) 4) As an expression acknowledging an offense and accepting responsibility for it.

Scher & Darley's Five strategies

1) The initial statement (I'm sorry, I apologize, excuse me, etc.) 2) An explanation of the cause 3) An expression of the speaker's responsibility 4) An offer of repair 5) A promise of forbearance (it will never occur again)

Communication Mediums

can serve as a shield to prevent reactions to communication . It's just as much about the behavior with the medium than it is about the affect the medium has.

Flamming:

The flamer writes content that will invoke certain emotions and responses such as rage, sadness, humiliation, self-doubt and more.

Falsification

(Creating a fiction)

Concealment

(Hiding a secret)

Equivocation

(Dodging an issue)

Framing Problems - Superordinate Goals

Develop a common goal that everyone can agrees to and values.

Framing Problems - Collaborative Attitude Regarding Conflict

Conflict is healthy and Conflict can lead to better outcomes

Differentiation to Integration

1) Issue Identification 2) Vision 3) Solution Generation 4) Solution Evaluation & Selection 5) Implementation

Superiority

A belief that a person or group is better than another in special ways.

Injustice

A belief that the individual has been treated by specific others or the world at large. This mistreatment becomes a frame for sensemaking.

Distrust

A belief that others are truly out to get an individual or group and intend to do harm.

Vulnerability

A belief that the welfare or position of a group is in the hands of a powerful other. Dangers lurk around every corner.

Helplessness

A belief that even carefully crafted plans will result in a demise. Groups tend to feel powerless. Ex. Groups of individuals with a victim mentality

Path Toward Forgiveness

■ Empathy for the offender
■ Fear of Isolation
■ The need to relieve hurt and resentment
■ Desire to restore the relationship
■ Desire to recognize conciliatory behavior
■ Relieve guilt
■ Likeability of the offender

Path Away From Forgiveness

■ Lack of Truthfulness
■ Self Protection
■ Justice
■ Desire for Revenge
■ Social Pressure
■ Seriousness of the Offense
■ Attraction to Being a Victim

Deep Transgression

Serious actions/behaviors that jeopardizes the relationship and breaks down communication.

Mediation

Process through which a neutral party facilitates communication between disputing parties and works to help the parties reach a mutually agreed upon solution.

About the Third Party

Must account for the actions and communication of another individual.

The power of the third party determines how much they can influence the situation.

Formal Endorsements vs. Informal Endorsements

Process Control

3rd party establishes the way in which the discussion will proceed. Includes time limits and turn taking.

Content Control

3rd party establishes what information will be discussed. And 3rd party also has a level of control over the outcomes.

Arbitrators:

Have control to make a final decision (Judge Judy)

Mediators:

The final resolution rests with the parties, but mediators are present to allow parties to clarify their choices, resources, and decisions.

Evaluative Mediation:

Court-referred mediation are Expertise on legal matters. Some mediators are arbitrators in that they can enforce a judgment

Facilitative Mediation:

Community Mediation Programs

Motivational Control

The degree to which the third party can induce parties to perform the desired action.

Reward & Coercive Power

Sanctions on Cuba or Demoting an employee

Referential power

(likeability) Pastors, Friends, Teachers and Parents

Facilitators & Conciliators

The situation must be one in which the two parties involved are rather amicable and just need someone to help with the process.

Facilitators:

A person who intervenes in ongoing decision-making groups such as boards, management teams, or department staff.

Conciliator:

A person who intervenes in in multiparty disputes among recognizable adversaries like public policy disputes or race-relations

Deal-makers:

Take an active role in making the deal happen

Orchestrators:

Set up processes to keep individuals talking

Bargaining

Try to encourage the interaction and encourage less direct discussion.

Therapeutic

Try to increase understanding between parties

Advisory Role

Consults with parties and suggests moves they can make

Investigator

Collects information and assesses the source of the problem.

Restructurer

Focuses on changing the structure of the organization.

Mediative

Guides communication and attempts creative problem solving.

Compensate:

persuade one or more of the parties to move or reach settlement by some reward or incentive offering by a third party (offering a perk in exchange for accepting some outcome in the conflict with a co worker.

Integrate:

Attempt to solve the conflict by encouraging negotiations

Press:

Pressure disputants to change their goals or willingness to settle. Persuasion via information

Inaction:

Not do anything and let the disputants handle it themselves.

3rd party frames

1. Right-Wrong Frame
• The conflict is occurring because someone violated a rule or expectation.
2. Underlying Conflict Frame
• The present conflict is due to previous issues that have not been explicitly discussed.
3. Stop Frame
• The goal is to stop the conflict. This means the issues may not be dealt with. Instead they may remain underneath the surface only to be brought up at a later date.

Kozan's Harmony Model

- Emphasizes smooth relationships
- Avoid Open expression of conflict
- Reliance on cooperativeness and connection
- Lack of self assertion
- Emphasis on the use of third parties
- Restriction on Negative emotional displays
- Strives for long-term, stable outcomes to a conflict

Kozan's Confrontational Model

- Emphasizes the aggressive pursuit of individual goals
- Conflicts are valued because they can address the needs of individuals
- Less emphasis on relationship or group preservation
- Tendency to open up conflict and to engage in negotiations
- Emotions are experienced intensely and expressed openly
- Use of third parties to help facilitate the negotiation between parties
- Interventions strive for short-term goals

Kozan's Regulative Model

- Emphasizes settling conflict through application of principles
- Reliance on codes, rules, and laws to address differences or issues
- Personal aspects of the conflicts tend to be underplayed or ignored
- Emotions are underplayed and are seen as less relevant to the conflict resolution process
- Third parties are usually people in ascribed roles who have the power to apply rules to specific conflict situations
- Procedural justice is an important element of conflict resolution process
- Short-term resolutions are valued over long-term concerns

Interdependent:

Both agents rely on each to accomplish a relationship, work, goals, tasks, etc.

Perceive Incompatibility:

One or more agents sees that both cannot get what they want.

Possibility of Interference:

One or more agents see the other person as thwarting, preventing, or inhibiting one's plans to reach his/her goals.