•The relationships between health-promoting behaviors, such as maintaining a healthy weight, exercising, and not smoking, and psychological disorders have been widely studied in civilian ...populations.•Often, but not universally, higher adherence to healthy behaviors is associated with lower risk of psychological disorders. Similarly, those with these disorders often, but not always, benefit from higher adherence to healthy behaviors.•Military personnel are at higher risk than civilian populations for certain psychological disorders, notably post-traumatic stress disorder. However, they are also generally more physically healthy owing largely to the military culture of fitness.•We answered the question of whether, in an already fit and healthy, but psychologically at-risk population, such as military personnel, relationships between health behaviors and mental health are similar to those in civilian populations.•We found that certain behaviors, notably maintaining a healthy weight and obtaining adequate sleep, are related to better mental health, across the disorders studied.•Additionally, certain psychological disorders may benefit from a concurrent treatment approach that targets specific health behaviors, for example, cigarette smoking in anxiety.
Background Military personnel are at greater risk of psychological disorders and related symptoms than civilians. Limited participation in health-promoting behaviors may increase presence of these disorders. Alternatively, these symptoms may limit engagement in health-promoting behaviors.
Methods Self-reported data from the 2015 Department of Defense Health Related Behaviors Survey were used to assess bi-directional relationships between health-related behaviors (obesity, physical activity PA, alcohol, smoking, sleep) and self-reported psychological disorders (generalized anxiety disorder GAD, depression, post-traumatic disorder PTSD) in U.S. military personnel.
Outcomes Among 12 708 respondents (14.7% female; 28.2% 17−24 y; 13.7% obese), self-reported depression was reported by 9.2%, GAD by 13.9%, and PTSD by 8.2%. Obesity and short sleep were associated with self-reported depression, GAD, and PTSD; current smoking was associated with higher odds of GAD; higher levels of vigorous PA were associated with lower odds of GAD; higher levels of moderate PA associated with lower odds of PTSD; and higher alcohol intake associated with higher odds of depression and PTSD. Self-reported depression, GAD, and PTSD were associated with higher odds of short sleep, obesity, and low levels of PA.
Interpretation Obesity, short sleep, and limited engagement in health-promoting behaviors are associated with higher likelihood of self-reported psychological disorders, and vice-versa. Encouraging and improving health-promoting behaviors may contribute to positive mental health in military personnel.
This impressive and original study is one of the first books to combine mainstream sociology with feminism in exploring the subject of the professions and power.This is an important addition to the ...corpus of feminist scholarship... It provides fresh insights into the way in which male power has been used to limit the employment aspirations of women in the middle classes. - Rosemary Crompton, University of Kent
The suicide rate among US Army soldiers has increased substantially in recent years.
To estimate the lifetime prevalence and sociodemographic, Army career, and psychiatric predictors of suicidal ...behaviors among nondeployed US Army soldiers.
A representative cross-sectional survey of 5428 nondeployed soldiers participating in a group self-administered survey.
Lifetime suicidal ideation, suicide plans, and suicide attempts.
The lifetime prevalence estimates of suicidal ideation, suicide plans, and suicide attempts are 13.9%, 5.3%, and 2.4%. Most reported cases (47.0%-58.2%) had pre-enlistment onsets. Pre-enlistment onset rates were lower than in a prior national civilian survey (with imputed/simulated age at enlistment), whereas post-enlistment onsets of ideation and plans were higher, and post-enlistment first attempts were equivalent to civilian rates. Most reported onsets of plans and attempts among ideators (58.3%-63.3%) occur within the year of onset of ideation. Post-enlistment attempts are positively related to being a woman (with an odds ratio OR of 3.3 95% CI, 1.5-7.5), lower rank (OR = 5.8 95% CI, 1.8-18.1), and previously deployed (OR = 2.4-3.7) and are negatively related to being unmarried (OR = 0.1-0.8) and assigned to Special Operations Command (OR = 0.0 95% CI, 0.0-0.0). Five mental disorders predict post-enlistment first suicide attempts in multivariate analysis: pre-enlistment panic disorder (OR = 0.1 95% CI, 0.0-0.8), pre-enlistment posttraumatic stress disorder (OR = 0.1 95% CI, 0.0-0.7), post-enlistment depression (OR = 3.8 95% CI, 1.2-11.6), and both pre- and post-enlistment intermittent explosive disorder (OR = 3.7-3.8). Four of these 5 ORs (posttraumatic stress disorder is the exception) predict ideation, whereas only post-enlistment intermittent explosive disorder predicts attempts among ideators. The population-attributable risk proportions of lifetime mental disorders predicting post-enlistment suicide attempts are 31.3% for pre-enlistment onset disorders, 41.2% for post-enlistment onset disorders, and 59.9% for all disorders.
The fact that approximately one-third of post-enlistment suicide attempts are associated with pre-enlistment mental disorders suggests that pre-enlistment mental disorders might be targets for early screening and intervention. The possibility of higher fatality rates among Army suicide attempts than among civilian suicide attempts highlights the potential importance of means control (ie, restricting access to lethal means such as firearms) as a suicide prevention strategy.
<!CDATAFor years, opponents of outsourcing have argued that offshoring American jobs destroys our local industries, lays waste to American job creation, and gives foreigners the good jobs and income ...that would otherwise remain on our shores. Yet few Americans realize that a parallel dynamic is occurring in the healthcare sector--previously one of the most consistent sources of stable, dependable living-wage jobs in the entire nation.
Instead of outsourcing high-paying jobs overseas--as the manufacturing and service sectors do--hospitals and other healthcare companies insource healthcare labor from developing countries, giving the jobs to people who are willing to accept lower pay and worse working conditions than U.S. healthcare workers. As Dr. Tulenko shows, insourcing has caused tens of thousands of high-paying local jobs in the healthcare sector to effectively vanish from the reach of U.S. citizens, weakened the healthcare systems of developing nations, and constricted the U.S. health professional education system. She warns Americans about what she's seeing--a stunning story they're scarcely aware of, which impacts all of us directly and measurably--and describes how to create better American health professional education, more high-paying healthcare jobs, and improved health for the poor in the developing world.>
In October and November 2020, we conducted a survey of 2,678 healthcare workers (HCWs) involved in general population immunisation in France, French-speaking Belgium and Quebec, Canada to assess ...acceptance of future COVID-19 vaccines (i.e. willingness to receive or recommend these) and its determinants. Of the HCWs, 48.6% (n = 1,302) showed high acceptance, 23.0% (n = 616) moderate acceptance and 28.4% (n = 760) hesitancy/reluctance. Hesitancy was mostly driven by vaccine safety concerns. These must be addressed before/during upcoming vaccination campaigns.
Providing practical, hands-on approaches to connect data to HR policies and practices to help influence overall business performance, this book is an essential resource for aspiring, new and ...experienced HR professionals across a wide range of industrial contexts.
US military suicides have increased substantially over the past decade and currently account for almost 20% of all military deaths. We investigated the associations of a comprehensive set of ...time-varying risk factors with suicides among current and former military service members.
We did a retrospective multivariate analysis of all US military personnel between 2001 and 2011 (n=110 035 573 person-quarter-years, representing 3 795 823 service members). Outcome was death by suicide, either during service or post-separation. We used Cox proportional hazard models at the person-quarter level to examine associations of deployment, mental disorders, history of unlawful activity, stressful life events, and other demographic and service factors with death by suicide.
The strongest predictors of death by suicide were current and past diagnoses of self-inflicted injuries, major depression, bipolar disorder, substance use disorder, and other mental health conditions (compared with service members with no history of diagnoses, the hazard ratio HR ranged from 1·4 95% CI 1·14-1·72 to 8·34 6·71-10·37). Compared with service members who were never deployed, hazard rates of suicide (which represent the probability of death by suicide in a specific quarter given that the individual was alive in the previous quarter) were lower among the currently deployed (HR 0·50, 95% CI 0·40-0·61) but significantly higher in the quarters following first deployment (HR 1·51 1·17-1·96 if deployed in the previous three quarters; 1·14 1·06-1·23 if deployed four or more quarters ago). The hazard rate of suicide increased within the first year of separation from the military (HR 2·49, 95% CI 2·12-2·91), and remained high for those who had separated from the military 6 or more years ago (HR 1·63, 1·45-1·82).
The increased hazard rate of death by suicide for military personnel varies by time since exposure to deployment, mental health diagnoses, and other stressful life events. Continued monitoring is especially needed for these high-risk individuals. Additional information should be gathered to address the persistently raised risk of suicide among service members after separation.
Partly funded by the Naval Research Program.
The Challenges of Minoritized Faculty in Higher Education offers a probing and unvarnished look at the employment challenges of these faculty members in four-year institutions. With dramatic shifts ...in the faculty workforce and nearly three-quarters of instructional positions in United States institutions now off the tenure track, contingent faculty have become the essential, frontline workers of higher education. Remarkably little research attention has focused on the experiences of minoritized contingent faculty in this new academic underclass. Based on in-depth interviews coupled with extensive research, the book highlights the double marginalization that can occur due to secondary employment status in the academic hierarchy, and the exclusion resulting from the intersectionality of nondominant social identities including race and ethnicity, gender, sexual orientation, gender identity, and disability. As the first-person narratives reveal, these faculty often struggle for acceptance, recognition, and rewards in the day-to-day academic environment, and they can face devaluation of their contributions. As a pragmatic and concrete resource, this book offers proactive workforce strategies and key structural and policy recommendations that will assist academic and administrative leaders, including presidents, provosts, department chairs, and chief diversity officers, in building more inclusive working conditions for contingent faculty.
Posttraumatic stress disorder (PTSD) affects approximately 8% of the general population. The prevalence of PTSD is twice as high in active duty service members and military veterans. Few studies have ...investigated the incidence rates of PTSD in active duty military personnel. The present study evaluated the incidence of PTSD diagnoses and the differences between demographic factors for service members between 2001 and 2017. Data on 182,400 active duty service members between 2001 and 2017 were drawn from the Defense Medical Epidemiological Database and examined by sex, age, service branch, military pay grade, marital status, and race. From 2001 to 2017, the incidence rates of PTSD in the active force (per 1,000 service members) steadily climbed, with a low of 1.24 in 2002 to a high of 12.94 in 2016. Service members most often diagnosed with PTSD were in the U.S. Army, with the enlisted pay grades of E‐5–E‐9, White, married, male, and between 20 and 24 years old. Statistically significant differences, ps < .001, were found between observed and expected counts across all examined demographic variables. The present study is the first to our knowledge to provide a comprehensive examination of PTSD incidence rates in an active duty military population.
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