There is growing concern about an alleged rise in violent behaviour amongst military personnel returning from deployment to Iraq and Afghanistan. The aims of this study were to determine the ...prevalence of violence in a sample of U.K. military personnel following homecoming from deployment in Iraq and to examine the impact of deployment-related experiences, such as combat trauma, on violence, and the role of sociodemographics and pre-enlistment antisocial behaviour.
This study used baseline data from a cohort study of a large randomly selected sample of U.K. Armed Forces personnel in service at the time of the Iraq war (2003). Regular personnel (n=4928) who had been deployed to Iraq were included. Data, collected by questionnaire, included information on deployment experiences, sociodemographic and military characteristics, pre-enlistment antisocial behaviour, post-deployment health outcomes and a self-report measure of physical violence in the weeks following return from deployment.
Prevalence of violence was 12.6%. This was strongly associated with pre-enlistment antisocial behaviour adjusted odds ratio (aOR) 3.6, 95% confidence interval (CI) 2.9-4.4. After controlling for pre-enlistment antisocial behaviour, sociodemographics and military factors, violence was still strongly associated with holding a combat role (aOR 2.0, 95% CI 1.6-2.5) and having experienced multiple traumatic events on deployment (aOR for four or more traumatic events 3.7, 95% CI 2.5-5.5). Violence on homecoming was also associated with mental health problems such as post-traumatic stress disorder (aOR 4.8, 95% CI 3.2-7.2) and alcohol misuse (aOR 3.1, 95% CI 2.5-3.9).
Experiences of combat and trauma during deployment were significantly associated with violent behaviour following homecoming in U.K. military personnel. Post-deployment mental health problems and alcohol misuse are also associated with increased violence.
Science faculty’s subtle gender biases favor male students Moss-Racusin, Corinne A; Dovidio, John F; Brescoll, Victoria L ...
Proceedings of the National Academy of Sciences - PNAS,
10/2012, Letnik:
109, Številka:
41
Journal Article
Recenzirano
Odprti dostop
Despite efforts to recruit and retain more women, a stark gender disparity persists within academic science. Abundant research has demonstrated gender bias in many demographic groups, but has yet to ...experimentally investigate whether science faculty exhibit a bias against female students that could contribute to the gender disparity in academic science. In a randomized double-blind study (n = 127), science faculty from research-intensive universities rated the application materials of a student—who was randomly assigned either a male or female name—for a laboratory manager position. Faculty participants rated the male applicant as significantly more competent and hireable than the (identical) female applicant. These participants also selected a higher starting salary and offered more career mentoring to the male applicant. The gender of the faculty participants did not affect responses, such that female and male faculty were equally likely to exhibit bias against the female student. Mediation analyses indicated that the female student was less likely to be hired because she was viewed as less competent. We also assessed faculty participants’ preexisting subtle bias against women using a standard instrument and found that preexisting subtle bias against women played a moderating role, such that subtle bias against women was associated with less support for the female student, but was unrelated to reactions to the male student. These results suggest that interventions addressing faculty gender bias might advance the goal of increasing the participation of women in science.
Abstract
Introduction
Interest in moral injury has burgeoned over the last decade as an increasing number of professionals recognize that current conceptualizations of trauma are not sufficient to ...explain some of the challenges that military service members face. The Moral Injury Events Scale (MIES) was the first instrument developed to measure exposure to military events that could produce moral injury (Nash et al., 2013). Two previously published validation studies that focused on service members still in uniform reveal some discrepancies regarding the scale’s factor structure. Bryan and colleagues (2016) documented a three-factor solution (i.e., transgressions-others, transgressions-self, and betrayal), while Nash and colleagues (2013) noted a two-factor solution (i.e., perceived transgressions and perceived betrayals).
Materials and Methods
With an interest in further scale validation, the present study utilized survey data from a group of veterans recently separated from service, to test the fitness of the two- or three-factor model and to examine the invariance of the scale across gender and branch. The investigators followed the policies governing the protection of human subjects as prescribed by ICF Institutional Review Board.
Results
Findings revealed a two-factor structure that differed from previous factor solutions (transgressions-self and transgressions-others) and was invariant across gender and branch. High intercorrelations among the MIES items that addressed exposure and reaction to events suggested that these experiences tend to co-occur. Removal of the event items did not significantly impact model fit.
Conclusions
The factor structure identified in the present study aligns with current theoretical conceptualizations of moral injury. The inability to distinguish between event and reaction items and the lack of impact on the factor structure when event items were removed from the model suggest the MIES is more accurately described as a measure of moral pain as compared to a measure of potentially morally injurious experiences (PMIEs). Given that all events associated with moral injury have impinged upon welfare, justice, rights, and fairness considerations, one could argue that little would be gained by focusing attention on the development of a measure of PMIEs. Given the lack of convergence in factor structure across samples, future directions may profit from a focus on further clarifying the temporal stability of the MIES factor structure.
Neil Greenberg and colleagues set out measures that healthcare managers need to put in place to protect the mental health of healthcare staff having to make morally challenging decisions
Health practitioners working in gray zones, or between official
and unofficial medicines, played a fundamental role in shaping
Latin America from the colonial period onward. The Gray Zones
of ...Medicine offers a human, relatable, complex examination of
the history of health and healing in Latin America across five
centuries. Contributors uncover how biographical narratives of
individual actors-outside those of hegemonic biomedical knowledge,
careers of successful doctors, public health initiatives, and
research and medical institutions-can provide a unique window into
larger social, cultural, political, and economic historical changes
and continuities in the region. They reveal the power of such
stories to illuminate intricacies and resilient features of the
history of health and disease, and they demonstrate the importance
of escaping analytical constraints posed by binary frameworks of
legality/illegality, learned/popular, and orthodoxy/heterodoxy when
writing about the past. Through an accessible and story-like
format, this book unlocks the potential of historical narratives of
healings to understand and give nuance to processes too frequently
articulated through intellectual medical histories or the lenses of
empires, nation-states, and their institutions.
Since the publication of Unequal Treatment in 2003,1 the number of studies investigating the implicit bias of health-care providers and its troubling consequences has increased exponentially. ...Literature on health disparities focuses primarily on implicit prejudice and few studies have systematically investigated the role of implicit stereotyping in patient care.5 Consequently, implicit bias in previous research generally refers to implicit prejudice. ...we specify whether we mean implicit prejudice or implicit stereotyping, particularly when we review findings from previous studies. ...several candidates for the 2020 US presidential election acknowledged the role of health-care providers' implicit bias in racial or ethnic health disparities and have demanded remediation.8 On Oct 2, 2019, California assembly bill no 241 was signed into law,9 mandating implicit bias training for health-care providers, and thereby making it probable that other US medical schools and health organisations will follow suit. A programme that taught college students about five evidence-based strategies for reducing implicit bias (ie, stereotype replacement, counter-stereotypical imaging, individuating, perspective taking, and contact) resulted in lower implicit racial prejudice, as measured by an implicit association test, 8 weeks after the intervention.20 These findings suggest that implicit bias training should also provide health-care providers with concrete strategies to reduce their implicit bias.
History at the intersection of healthcare, labor, and civil rights.The union of hospital workers usually referred to as the 1199 sits at the intersection of three of the most important topics in US ...history: organized labor, health care, and civil rights. John Hennen's book explores the union's history in Appalachia, a region that is generally associated with extractive industries but has seen health care grow as a share of the overall economy.With a multiracial, largely female, and notably militant membership, 1199 was at labor's vanguard in the 1970s, and Hennen traces its efforts in hospitals, nursing homes, and healthcare centers in West Virginia, eastern Kentucky, and Appalachian Ohio. He places these stories of mainly low-wage women workers within the framework of shake-ups in the late industrial and early postindustrial United States, relying in part on the words of Local 1199 workers and organizers themselves. Both a sophisticated account of an overlooked aspect of Appalachia's labor history and a key piece of context for Americans' current concern with the status of "essential workers," Hennen's book is a timely contribution to the fields of history and Appalachian studies and to the study of social movements.
Recent evidence indicates a high prevalence of child abuse exposure in modern US veterans, which may explain in part their higher likelihood of suicide relative to civilians. However, the ...relationship between child abuse exposure and suicide-related outcomes in military personnel relative to civilians is unknown. Furthermore, the associations among deployment-related trauma, child abuse exposure, and suicide-related outcomes in military personnel have not been examined.
To determine whether child abuse exposure is more prevalent in Canadian Armed Forces (CAF) personnel compared with the Canadian general population (CGP); to compare the association between child abuse exposure and suicidal ideation, suicide plans, and suicide attempts among the CAF and CGP; and to determine whether child abuse exposure has an additive or interaction effect on the association of deployment-related trauma and past-year suicidal ideation and suicide plans among Regular Forces personnel.
Data were collected from the following 2 nationally representative data sets: the 2013 Canadian Forces Mental Health Survey (CFMHS) for the CAF (8161 respondents; response rate, 79.8%) and the 2012 Canadian Community Health Survey-Mental Health (CCHS-MH) for the CGP (23,395 respondents; response rate, 68.9% of these, 15,981 age-matched participants were drawn). Data were collected from April 15 to August 31, 2013, for the CFMHS and January 2 to December 31, 2012, for the CCHS-MH. Data were analyzed from October 2014 to October 22, 2015. Statistical weights were applied to both data sets.
Child abuse exposure, including physical abuse, sexual abuse, and exposure to intimate partner violence, and deployment-related trauma were assessed in relation to suicide-related outcomes.
Data were analyzed from 24 142 respondents aged 18 to 60 years (Regular Forces, 86.1% male and 13.9% female; Reserve Forces, 90.6% male and 8.9% female; and CGP, 49.9% male and 50.1% female). Any child abuse exposure was higher in the Regular Forces (47.7%; 95% CI, 46.4%-49.1%) and Afghanistan mission-deployed Reserve Forces (49.4%; 95% CI, 46.3%-51.5%) compared with the CGP (33.1%; 95% CI, 31.8%-34.4%). All types of child abuse exposures were associated with increased odds of suicidal ideation, suicide plans, and suicide attempts in the CGP (range of adjusted odds ratios AORs, 3.0 95% CI, 2.3-3.9 to 7.7 95% CI, 5.7-10.3; P < .05) and CAF (range of AORs, 1.7 95% CI, 1.0-2.9 to 6.3 95% CI, 4.2-9.5; P < .05), with many associations significantly weaker in military personnel relative to civilians. Additive effects for past-year suicide ideation (AOR, 2.7; 95% CI, 1.8-4.2) and past-year suicide plans (AOR, 4.6; 95% CI, 2.3-9.2) but not interactive effects for past-year suicide ideation (AOR, 1.2; 95% CI, 0.7-2.2) and past-year suicide plans (AOR, 0.8; 95% CI, 0.3-2.2) were noted between deployment-related trauma and child abuse exposure among Regular Forces personnel.
Individuals with a child abuse history may be more likely to enter the military, and child abuse exposure may increase the likelihood of suicide-related outcomes. Prevention efforts targeting child abuse may reduce suicide-related outcomes.
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