Background We evaluated the clinical outcomes, functional burden, and complications one month after COVID-19 infection in a prospective United States Military Health System (MHS) cohort of active duty, retiree, and dependent populations using serial patient-reported outcome surveys and electronic medical record (EMR) review. Methods MHS beneficiaries presenting at nine sites across the United States with a positive SARS-CoV-2 test, a COVID-19 like illness, or a high-risk SARS-CoV-2 exposure were eligible for enrollment. Medical history and clinical outcomes were collected through structured interviews and ICD-based EMR review. Risk factors associated with hospitalization were determined by multivariate logistic regression. Results A total of 1,202 participants were enrolled. There were 1,070 laboratory confirmed SARS-CoV-2 cases and 132 SARS-CoV-2 negative participants. In the first month post-symptom onset among the SARS-CoV-2 positive cases, there were 214 hospitalizations, 79% requiring oxygen, 22 ICU admissions, and 9 deaths. Risk factors for COVID-19 associated hospitalization included race (increased for Asian, Black, and Hispanic compared to non-Hispanic White), age (age 45-64 and 65+ compared to <45), and obesity (BMI>=30 compared to BMI<30). Over 2% of survey respondents reported the need for supplemental oxygen and 31% had not returned to normal daily activities at one-month post-symptom onset. Conclusions Older age, reporting Asian, Black or Hispanic race/ethnicity, and obesity are associated with SARS-CoV-2 hospitalization. A proportion of acute SARS-CoV-2 infections require long-term oxygen therapy; the impact of SARS-CoV-2 infection on short-term functional status was substantial. A significant number of MHS beneficiaries had not yet returned to normal activities by one month.

This study examined the resilience experiences of 13 sexual and gender minority persons living with disabilities, using phenomenological qualitative methodology. Researchers used in-depth, semi-structured interviews and various trustworthiness standards in the study. Participants endorsed four common resilience maximizers—self-acceptance, advocacy, social support, and a plea for recognition of humanity (an aspirational resilience maximizer)—and three common resilience minimizers—fragmentation, identity concealment, and punishment. Counseling implications and future research directions are also discussed.

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The world is facing the largest number of displaced persons in history, with many refugee persons seeking safety in the United States. Among many challenges, refugee persons may face difficulty when navigating the world of work in the United States. We conceptualize career-related barriers for refugee persons residing in the United States, including economic constraints, acculturation challenges, and health disparities. Given these challenges, we describe the relevance of psychology of working theory as a potential theoretical model from which to conceptualize career concerns in refugee persons. Finally, based on previous research, we provide implications for counselors working with refugee persons with vocational concerns, as well as suggested areas for future research.

Purpose:Reported use of and satisfaction rates of vocational rehabilitation (VR) services among a small sample of lesbian, gay, bisexual, and transgender (LGBT) persons living with various chronic illness and disability (CID) conditions in the United States were explored.Method:Data were pulled from a larger data set that was collected via the Internet. A quantitative research design using descriptive statistics and Pearson chi-square tests were used to analyze the data.Results:Sexual minorities living with various CID conditions are presenting to VR for vocational services. Sexual minority women- and bisexual-identified persons were more likely to report dissatisfaction with VR services than gay men.Conclusions:LGBT persons are experiencing an array of CID conditions and using VR services. More consideration of LGBT issues in rehabilitation counseling is necessary.