The goal of this study was to investigate and identify risk factors for suicide among all active duty members of the US military during 2005 or 2007.
The study used a cross-sectional design and ...included the entire active duty military population. Study sample sizes were 2,064,183 for 2005 and 1,981,810 for 2007. Logistic regression models were used.
Suicide rates for all services increased during this period. Mental health diagnoses, mental health visits, selective serotonin reuptake inhibitors (SSRIs), sleep prescriptions, reduction in rank, enlisted rank, and separation or divorce were associated with suicides. Deployments to Operation Enduring Freedom or Operation Iraqi Freedom were also associated with elevated odds ratios for all services in the 2007 population and for the Army in 2005.
Additional research needs to address the increasing rates of suicide in active duty personnel. This should include careful evaluation of suicide prevention programs and the possible increase in risk associated with SSRIs and other mental health drugs, as well as the possible impact of shorter deployments, age, mental health diagnoses, and relationship problems.
The recent COVID-19 pandemic has raised the visibility of health care workers to the level of public heroes. We study this phenomenon by exploring how nonphysician health care workers, who ...traditionally believed they were invisible and undervalued, perceive their newfound elevated status during the pandemic. Drawing from a qualitative study of 164 health care workers, we find that participants interpreted the sudden visibility and social valorization of their work as temporary and treated it with skepticism, incredulity, and as devoid of genuinely transformative power. We seek to contribute to the recent call to develop novel approaches to understanding the contours of the paradoxical nature of invisibility in the workplace by offering insights into what makes "invisible" workers accept or reject publicly driven elevation in their sudden social valorization.
Effectiveness of evidence-based psychotherapy (EBP) for PTSD can vary based on gender and trauma type, with poorer outcomes for men and sexual traumas. Among veterans receiving EBPs for PTSD, the ...effects of the interaction between gender and military sexual trauma (MST) on treatment outcome are unclear. This study examined how gender and MST impact PTSD symptoms following cognitive processing therapy (CPT) and prolonged exposure (PE).
We conducted a national, retrospective cohort study of all post 9/11 veterans who had a PTSD diagnosis from 10/2001-9/2017 at VHA facilities and >1 psychotherapy visit. Inclusion criteria included completion of ≥8 CPT/PE sessions and pre- and post-treatment PCL (N = 9711). Mixed-effects linear regression models were conducted, separately by treatment, to examine associations between changes in PTSD symptoms and gender, MST, and their interactions with time.
For both treatments, there were no significant differences in pre-treatment PCL by gender or MST, and PCL decreased significantly over time. In adjusted models, only the gender by time interaction on pre-to-post-CPT change was significant (p < .001); the decrease in women's PCL was 2.67 points greater, compared to men.
Women veterans demonstrated greater reductions in PTSD symptoms from CPT. There were no differences by gender for PE, suggesting men and women veterans benefit similarly. Results suggest outcomes may be impacted by gender socialization when utilizing certain cognitive behavioral techniques. MST, regardless of gender, did not impact PTSD outcomes for either treatment. Both CPT and PE may thus be effective for veterans irrespective of MST history.
•Women had larger PTSD reductions from Cognitive Processing Therapy than men.•No gender differences in PTSD outcomes from Prolonged Exposure.•No differences in PTSD outcomes based on MST history for either treatment.•Gender differences in treatment effectiveness do not vary by MST history.
Where They Need Me examines
the work of Haitian health professionals in humanitarian aid
encounters. Haiti is the target of an overwhelming number
of internationally funded health projects. While ...religious
institutions sponsor a number of these initiatives, many are
implemented within the secular framework of global health. Pierre
Minn illustrates the divergent criteria that actors involved in
global health use to evaluate interventions' efficacy.
Haitian physicians, nurses, and administrative staff are hired
to carry out these global health programs, distribute or withhold
resources, and produce accounts of interventions' outcomes. In
their roles as intermediaries, Haitian clinicians are expected not
only to embody the humanitarian projects of foreign funders and
care for their impoverished patients but also to act as sources of
support for their own kin networks, while negotiating their future
prospects in a climate of pronounced scarcity and insecurity. In
Where They Need Me , Minn argues that a serious
consideration of these local health care providers in the context
of global health is essential to counter simplistic depictions of
clinicians and patients as heroes, villains, or victims as well as
to move beyond the donor-recipient dyad that has dominated
theoretical work on humanitarianism and the gift.
In management, decisions are expected to be based on rational analytics rather than intuition. But intuition, as a human evolutionary achievement, offers wisdom that, despite all the advances in ...rational analytics and AI, should be used constructively when recruiting and winning personnel. Integrating these inner experiential competencies with rational-analytical procedures leads to smart recruiting decisions.
Although much has been written about tank losses during the fighting near Prokhorovka as part of the battle for the Kursk salient in July 1943, little has been written about losses in personnel. This ...research note addresses the issue of Soviet personnel losses during the battle.
In the article, from the standpoint of theory and methodology, a competent approach to the evaluation of company personnel is described. The models for assessing the company's personnel from ...different approaches are presented. The methods used by modern companies for the personnel assessment procedure are highlighted. The meaning of the competence concept and approaches to understanding the essence of the competence concept are given. The concept of competency model is formulated and a variant of this competence model is presented. Deficient moments in the formation of competence models for the evaluation of company personnel were identified.
Objective
This study aimed to examine the effectiveness of cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD) when administered on a daily basis during a 2‐week period of ...time.
Method
In an open‐label, prospective cohort pilot trial, 20 U.S. military personnel and veterans diagnosed with PTSD or subthreshold PTSD participated in 12 daily sessions of CPT. Primary outcomes included Clinician Administered PTSD Scale for DSM‐5 and PTSD Checklist for DSM‐5 scores. Secondary outcomes included Patient Health Questionnaire‐8 and Beck Scale for Suicide Ideation (BSSI) scores. Interviews and self‐report scales were completed at pretreatment, posttreatment, and 6 months after the treatment.
Results
Relative to baseline, PTSD symptom severity and rates of PTSD diagnosis were significantly reduced at posttreatment and 6‐month follow‐up. Depression symptom severity did not significantly improve, but suicide ideation significantly decreased at 6‐month follow‐up.
Conclusions
Daily administration of CPT is associated with significant reductions in PTSD and suicide ideation.
Objective To describe new onset and persistence of self reported post-traumatic stress disorder symptoms in a large population based military cohort, many of whom were deployed in support of the wars ...in Iraq and Afghanistan.Design Prospective cohort analysis.Setting and participants Survey enrolment data from the millennium cohort (July 2001 to June 2003) obtained before the wars in Iraq and Afghanistan. Follow-up (June 2004 to February 2006) data on health outcomes collected from 50 184 participants.Main outcome measures Self reported post-traumatic stress disorder as measured by the posttraumatic stress disorder checklist—civilian version using Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria.Results More than 40% of the cohort were deployed between 2001 and 2006; between baseline and follow-up, 24% deployed for the first time in support of the wars in Iraq and Afghanistan. New incidence rates of 10-13 cases of post-traumatic stress disorder per 1000 person years occurred in the millennium cohort. New onset self reported post-traumatic stress disorder symptoms or diagnosis were identified in 7.6-8.7% of deployers who reported combat exposures, 1.4-2.1% of deployers who did not report combat exposures, and 2.3-3.0% of non-deployers. Among those with self reported symptoms of post-traumatic stress disorder at baseline, deployment did not affect persistence of symptoms.Conclusions After adjustment for baseline characteristics, these prospective data indicate a threefold increase in new onset self reported post-traumatic stress disorder symptoms or diagnosis among deployed military personnel who reported combat exposures. The findings define the importance of post-traumatic stress disorder in this population and emphasise that specific combat exposures, rather than deployment itself, significantly affect the onset of symptoms of post-traumatic stress disorder after deployment.
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