Research

Prison Employee PTSD

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                    [post_date] => 2018-10-18 05:30:08
                    [post_date_gmt] => 2018-10-18 09:30:08
                    [post_content] => The prison setting is a uniquely challenging work environment, with employees facing constant exposure to threat, violence, and trauma. Previous research has shown that prison employees are at high risk for serious psychological distress leading to the development of mental illness such as depression and anxiety. Another serious concern for prison employees is post-traumatic stress disorder (PTSD). “Trauma” within the PTSD context generates from an event or series of events from which the person feels like they cannot escape. This trauma can result from direct experience of grievous injury or sexual violence. Or it could come from witnessing such events or death. Prison employees, particularly correction officers, are at high risk for both routinely witnessing trauma and potentially experiencing it themselves.

The goal of our study was to investigate the prevalence of PTSD among prison employees and explore risk and protective factors. We surveyed 355 Washington state prison employees using a comprehensive questionnaire designed to assess the physical and psychological risks of prison work. Included in the questionnaire were the PTSD checklist from the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition), the Critical Incident History Questionnaire, and the Work Environment Inventory. We estimated PTSD rates and symptoms, explored risk factors associated with higher PTSD scores, and investigated protective factors associated with lower PTSD scores.
Nineteen percent of respondents met the diagnostic criteria for PTSD—a rate six times higher than the general population, comparable to Iraq and Afghanistan war veterans.  
The majority of the sample was male (65%) and white (81%). Most participants were correction officers (65%) working in male inmate facilities (63%). Nineteen percent of respondents met the diagnostic criteria for PTSD—a rate six times higher than the general population, comparable to Iraq and Afghanistan war veterans. Symptoms that stood out were nightmares related to work events (15%), avoiding reminders of workplace trauma (14%), and disturbing flashbacks (10%). Female employees, Black employees, day-shift employees, and employees with more years of experience reported higher rates of PTSD. Significant risk factors for PTSD included being seriously injured at work and dealing with inmates who had been recently sexually assaulted. Work frustrations including feeling like the prison puts the employees in unnecessary danger and lack of clarity about job roles were also significantly associated with higher PTSD rates. Several factors, however, were found to be protective against PTSD. These included being happy with work assignments, having good relationships with supervisors, and having positive relationships with coworkers. The results of this study have several important implications. First, given the high prevalence of PTSD among prison employees, interventions for promoting resilience to trauma in this population are clearly needed. Second, given that some prison employees are at greater risk (e.g. woman), interventions need to address specific needs of certain prison employee subgroups. Third, more research is needed to understand why certain groups of prison employees are at greater risk, and what types of interventions are the most promising for addressing this critical problem. We urge researchers to focus on this critical problem, and the corrections profession to adopt trainings and interventions that promote resilience to the harmful effects of working behind the walls. Feature image: HakuNellies/iStock, used for illustrative purposes only.  [post_title] => Prison Employee PTSD [post_excerpt] => The prison setting is a uniquely challenging work environment, with employees facing constant exposure to threat, violence, and trauma. Prison employees are at high risk for post-traumatic stress disorder (PTSD). [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => prison-employee-ptsd [to_ping] => [pinged] => [post_modified] => 2018-10-18 06:55:30 [post_modified_gmt] => 2018-10-18 10:55:30 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.publichealthpost.org/?post_type=bu_research&p=5715 [menu_order] => 0 [post_type] => bu_research [post_mime_type] => [comment_count] => 0 [filter] => raw ) [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [view] => BUPHP_Post_View Object ( [multipage] => [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [extra_args] => Array ( ) [owner] => [_trigger_error:WPLib_Base:private] => 1 )

The prison setting is a uniquely challenging work environment, with employees facing constant exposure to threat, violence, and trauma. Prison employees are at high risk for post-traumatic stress disorder (PTSD).

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Research

Nurses Leading Collaborative Care

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                    [post_date] => 2018-10-17 06:25:35
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                    [post_content] => When Case Western Reserve University began building something new on their Cleveland campus, the goal was to create a collaborative space for all healthcare students. This new “mini-campus” will be finished in 2019, and will be part of an effort to train medical, dental, and nursing students together.

Similarly, the Robert Wood Johnson Foundation’s Culture of Health initiative emphasizes cross-sector collaborations, taking the effort a step further by involving non-health care organizations like businesses, schools, and the government. These collaborations are meant to not only address general health, but also housing, neighborhood, and income inequities, which can be attributed to 70% of the variation in health outcomes.

Collaboration has been a trendy topic in the health space, but little research actually outlines what kind of conditions benefit from these collaborations. The role of health care providers in catalyzing these improvements and sustaining these efforts has not been studied heavily, either. A group of researchers set out to address this gap. Martsolf and colleagues assessed nurse experiences in health care systems that were modeled around effective collaboration between different sectors. The researchers focused on those who were a part of the American Academy of Nursing’s Edge Runner program. These nurses led or designed care models at their institutions that exhibited positive outcomes both clinically and financially.
These nurses led or designed care models at their institutions that exhibited positive outcomes both clinically and financially.  
Between December 2015 and March 2016, the researchers first used an online survey to gather information from these Edge Runner nurses about their care models, and then followed up with telephone interviews. According to the study results, these care models were often implemented in inpatient settings, or those in which patients stay at the facility for the duration of treatment. Four in five of the models focused on women, and about 61% of the models also heavily considered low-income populations as well as racial and ethnic minorities. Regarding cross-sector work, about 86% of the care models emphasized health care provider collaborations to some extent, and around 76% highlighted non-health care collaborations. The researchers found that specialists, hospital staff, and primary care physicians were the most effective at working together in these care models. As for non-health sectors, the strongest collaborations happened between health care providers and leaders within the community, research organizations, and faith-based groups. On the contrary, emergency room staff and the dialysis department were among the less collaborative, as were environmental organizations, child welfare agencies, and legal firms. Even though the Edge Runner nurses aimed to better understand the community to improve its overall health, there still seemed to be some disconnect.
Considering their study findings, the authors reflect that nurses are important to improving community health because they act as “bridgers” between the health care system and the people they serve.  
The successful collaborations were more likely to feature nurses and other health care providers who could at least speak another language in addition to English. The communities that had a greater sense of neighborliness and trust in their health systems also saw improved conditions through cross-sector collaborations. Additionally, the care models in which collaborating sectors shared a vision and a sense for business did better than others. Considering their study findings, the authors reflect that nurses are important to improving community health because they act as “bridgers” between the health care system and the people they serve. They can help increase a sense of trust, and their role in health care systems is becoming increasingly crucial. Feature image: monkeybusinessimages, iStock [post_title] => Nurses Leading Collaborative Care [post_excerpt] => Martsolf and colleagues assessed the role of nurses in cross-collaborative health care systems, and the ways in which nurses are important to improving community health. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => nurses-leading-collaborative-care [to_ping] => [pinged] => [post_modified] => 2018-10-17 06:29:21 [post_modified_gmt] => 2018-10-17 10:29:21 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.publichealthpost.org/?post_type=bu_research&p=5714 [menu_order] => 0 [post_type] => bu_research [post_mime_type] => [comment_count] => 0 [filter] => raw ) [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [view] => BUPHP_Post_View Object ( [multipage] => [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [extra_args] => Array ( ) [owner] => [_trigger_error:WPLib_Base:private] => 1 )

Martsolf and colleagues assessed the role of nurses in cross-collaborative health care systems, and the ways in which nurses are important to improving community health.

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Research

Catholic Hospitals and a Woman’s Right to Know

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                    [post_date] => 2018-10-15 07:00:37
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                    [post_content] => Between 2001 and 2016, the number of Catholic-owned or affiliated hospitals grew by over 20%. Catholic facilities often do not provide certain types of reproductive health care, such as sterilization or contraception. Some women have even been denied emergency gynecological procedures in life-threatening situations—for instance following a miscarriage—after being brought to a Catholic hospital.

A study published earlier this year in the American Journal of Obstetrics and Gynecology asked 1,430 women “How important is it for you to know what the hospital’s religion is when making decisions about where to get care?” The women were then asked, after being told that some hospitals restrict care related to reproductive health based on their religious affiliation, “How important is it to you to know what care is restricted before you decide where to get care?” Participants were also asked about their religious affiliation and if it was acceptable for hospitals to restrict the care they provide based on religion.
Over 80% reported that it was somewhat or very important to know what restrictions hospitals have on care. Over half of these responded with “very important.”  
Only one-third of the sample responded that it was somewhat or very important to know a hospital’s religious affiliation when deciding where to get care. Over 80% reported that it was somewhat or very important to know what restrictions hospitals have on care. Over half of these responded with “very important.” Several groups of women reported that it was important to know a hospital’s religious affiliation, including those who reported no religion, atheists and agnostics, and born-again Protestants. The researchers hypothesized that Catholic women and women with stronger religious beliefs would be more supportive of religious restrictions on care. Yet Catholic women were no more likely to respond that it was important to know a hospital’s religious affiliation or care restrictions than non-born-again Protestant women. Women with no religious affiliation and those who identified as atheist or agnostic were more likely to want to know about care restrictions. Over half of the women said that no hospital should be able to restrict care based solely on the hospital’s religious affiliation. Less than one-third said hospitals should be allowed to restrict care under some conditions. Dr. Lori Freedman, the lead author, explained the significance of their findings in an email interview: “Women want more information about how religious policies restrict their care before they decide where to seek it. Findings support policy efforts to compel more transparency from religious healthcare institutions about what they will and will not provide.” Feature image: ArisSu/iStock [post_title] => Catholic Hospitals and a Woman’s Right to Know [post_excerpt] => Catholic hospitals often do not provide certain types of reproductive health care. Freedman and colleagues conducted research on women's knowledge about hospital religious affiliation and its impact on their decisions about where to get care. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => catholic-hospitals-and-a-womans-right-to-know [to_ping] => [pinged] => [post_modified] => 2018-10-15 07:02:32 [post_modified_gmt] => 2018-10-15 11:02:32 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.publichealthpost.org/?post_type=bu_research&p=5655 [menu_order] => 0 [post_type] => bu_research [post_mime_type] => [comment_count] => 0 [filter] => raw ) [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [view] => BUPHP_Post_View Object ( [multipage] => [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [extra_args] => Array ( ) [owner] => [_trigger_error:WPLib_Base:private] => 1 )

Catholic hospitals often do not provide certain types of reproductive health care. Freedman and colleagues conducted research on women’s knowledge about hospital religious affiliation and its impact on their decisions about where to get care.

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Research

Hacking Public Health

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                    [post_content] => Everyone loves a hackathon, it seems. Yet, do hackathons really contribute to solving public health problems? Are they a meaningful new tool—or simply the latest fad?

The theory is that hackathons—multi-day, energy-charged events often described as “brainstorming on steroids”—spark exciting new thinking by fostering cognitive diversity, teamwork, and an atmosphere that is competitive yet “safe-to-fail.” A typical hackathon brings people with diverse backgrounds together in a new environment to address a particular problem or challenge. Participants break into teams to design innovative new solutions. They pitch their ideas, rapidly discard or refine them, and often compete for prize money or access to ongoing expert guidance at the end of an action-packed few days. Hackathons can be a fun way to spend a weekend, and they raise the visibility of tricky or overlooked problems. They also hold out the promise of producing the next big breakthrough idea.

The Opioid Epidemic Challenge Summit and Hackathon, hosted in Boston in September 2016, featured the key elements that define hackathons. Initiated by the GE Foundation with the nonprofit, CAMTech, the three-day event convened approximately 265 participants to take on Massachusetts’ opioid crisis. The first day was dedicated to expert presentations that laid out the state’s opioid challenge from prevention to treatment to recovery. From there, hackathon participants—a group that included clinicians, community members, and others—threw out two-minute pitches of problems and proposed solutions.

Seventy ideas were pitched, recalled GE Foundation director, Jennifer Edwards. Of those, teams formed to develop seventeen ideas—including ideas for overcoming stigma, managing medications, and creating community among individuals in recovery—into full-fledged projects.
...numerous ideas had made significant progress by twelve months post-event on measures such as funds raised, pilot projects initiated, patents filed, and new companies formed.  
Early research on public health hackathons has primarily focused on whether they yield actual products. A 2017 article by Olson et al., for example, examined hackathons aimed at seeding new global health tools. The authors found that numerous ideas had made significant progress by twelve months post-event on measures such as funds raised, pilot projects initiated, patents filed, and new companies formed. Importantly, the study also documented broader hackathon impacts on health innovation activities in local communities. For example, over 30% of teams reported that at least one team member went on to work with people they met at the hackathon on other health innovation initiatives. In Boston, two ideas from the 2016 hackathon gained traction. The first, a product called GEMS Boxes—public boxes stocked with naloxone that can be unlocked by 911 dispatch—ran a successful feasibility trial in May 2017. Its founders are now in discussions with potential buyers. The second, a mobile health van called CareZONE, is being piloted in Boston neighborhoods with frequent fatal overdoses. More broadly, the Boston hackathon inspired the Empire State Opioid Innovation Challenge, which CAMTech and partners hosted in New York State last month. And, according to Edwards, the 2016 event also catalyzed private-sector investment in the addressing the opiod crisis in Massachusetts. In March 2017, groups like Partners HealthCare, Blue Cross Blue Shield, and SEIU1199, along with GE Foundation and others, launched RIZE Massachusetts, an innovation fund aimed at ending the state’s opioid epidemic. The high profile organization, which awarded its first “design grants” to community-based providers in June 2018, intends to fuel promising new solutions to opioid addiction. Its grant making, expected to land in the multiple millions, will ensure that local energy remains focused on one of the toughest public health challenges of recent times. GEMS boxes mockup, internal and external locations Feature image: Participants co-creating solutions to curb the local and national opioid epidemic at the 2016 Opioid Epidemic Challenge Summit and Hackathon, hosted by CAMTech in partnership with the GE Foundation in Boston in September 2016. Photo courtesy of CAMTech.  Image in article: Mockup of indoor and outdoor models of GEMS Boxes, $10K grand prize winner of the 2016 Opioid Epidemic Challenge Summit and Hackathon, hosted by CAMTech in partnership with the GE Foundation in Boston in September 2016. A GEMs Box is a solar-powered, remotely-unlockable supply kiosk that communicates with 911, and is stocked with critical first-aid supplies that can be administered with no medical training, such as Naloxone (an opioid antidote), tourniquets/gauze, epi-pens, and AEDs. Photo courtesy of CAMTech.  [post_title] => Hacking Public Health [post_excerpt] => Everyone loves a hackathon, it seems. How much do hackathons really contribute to solving public health problems? Are they a meaningful new tool, or simply the latest fad? [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => hacking-public-health [to_ping] => [pinged] => [post_modified] => 2018-10-12 05:51:29 [post_modified_gmt] => 2018-10-12 09:51:29 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.publichealthpost.org/?post_type=bu_research&p=5686 [menu_order] => 0 [post_type] => bu_research [post_mime_type] => [comment_count] => 0 [filter] => raw ) [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [view] => BUPHP_Post_View Object ( [multipage] => [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [extra_args] => Array ( ) [owner] => [_trigger_error:WPLib_Base:private] => 1 )

Everyone loves a hackathon, it seems. How much do hackathons really contribute to solving public health problems? Are they a meaningful new tool, or simply the latest fad?

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Research

Fieldnotes, Good Guys, and the Culture of HIV Care

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                    [post_content] => As an anthropologist and health services researcher who is interested in patient-provider communication, I (GF) observe clinical encounters. I get to see the diverse ways conversations between patients and their providers unfold. In particular, I‘m interested in the “patient-centeredness” of conversations. Did the provider demonstrate empathy? Was the patient treated like a unique person? Did the patient and provider collaboratively develop a personalized care plan?

I’ve been struck by how different conversations can be, ranging from highly patient-centered and attuned to broader socio-cultural contexts to highly biomedical and focused almost exclusively on whether patients take their medications or follow other recommendations.  In the latter scenario, patients are not asked about their unique contexts. Thus, care plans are unlikely to match their lives, reducing the likelihood recommendations are followed.

In our recent work examining conversations between patients and their providers, we noticed variation across eight HIV clinics. The clinics fell into two types: “socio-culturally attuned” or “individually responsible.”  At socio-culturally attuned clinics, providers thought about patients’ contexts. We heard a provider talk with a patient with HIV about strategies to conceive, a potentially sensitive topic. Another provider asked about a patient’s gambling.  And still others were attuned to patients’ challenges getting to medical appointments because of unreliable transportation or unstable housing.
One provider asked a patient about taking his medications by saying, “I know you’re a good guy, so no problems with your meds?”  
In contrast, at the individually responsible clinics, we observed providers effectively stop patients from talking about their health or their lives. These providers focused the conversations on whether patients took their medications. One provider asked a patient about taking his medications by saying, “I know you’re a good guy, so no problems with your meds?” This left the patient with only one answer. Good patients (and good people) take their medications. A provider at another clinic asked a patient if he was “behaving,” implying that good patients are like good children and do what they are told. They take their medication. Notably, we saw consistency within each clinic, indicative of the clinic’s overall culture. In the clinics where we observed socio-culturally oriented appointments, we heard about patients’ housing, transportation and relationships, across our interview and observation data. At the clinics where we observed appointments focused on medication adherence and little or no conversation about patients’ lives, we found a broader culture in which providers perceived their patients as individually responsible for their health behaviors. In our interviews with these providers, we heard them describe patients who were perceived of as not taking their medications as “flakes” or “disasters.” These patients were seen as personally culpable and morally fallible. This perspective can prevent further conversations about how to plan care and diminishes the important role patients can and should play.
In the clinics where patients were seen as individually responsible for their health, providers’ judgmental approaches may be a defense mechanism to stave off uncomfortable conversations.  
Most importantly, we found a relationship between the clinic culture and the composition of the care team. Clinics that included social workers and mental health providers—professions commonly attuned to patients’ non-biomedical needs—were more attuned to patients’ life contexts. In the clinics where providers functioned independently, with limited access to social workers or mental health providers, patients were perceived as either good or bad individuals based on their abilities to adhere to their medications. In the clinics where patients were seen as individually responsible for their health, providers’ judgmental approaches may be a defense mechanism to stave off uncomfortable conversations. If you hear a patient has problems with housing, relationships, or substance use, but feel ill-equipped to address these challenges, having this conversation may simply raise a sense of inadequacy or powerlessness. It would have been easy, as researchers, to document the judgmental language we heard and conclude that these were “bad” providers. However, our ethnographic approach allowed us to instead think about the culture of HIV care. Just as it is critical for providers to recognize and address challenges patients face in their daily lives, we need to think about providers in the context within which they work. If we want providers to have more patient-centered conversations with their patients, we need to provide them with resources to which they can refer patients when life challenges inevitably arise. Feature image: Sarah, Point, used under CC BY 2.0 [post_title] => Fieldnotes, Good Guys, and the Culture of HIV Care [post_excerpt] => Conversations between patients and providers that treat patients as unique individuals can help providers develop care plans to better match their patients' lives. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => fieldnotes-good-guys-and-the-culture-of-hiv-care [to_ping] => [pinged] => [post_modified] => 2018-10-10 06:54:56 [post_modified_gmt] => 2018-10-10 10:54:56 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.publichealthpost.org/?post_type=bu_research&p=5684 [menu_order] => 0 [post_type] => bu_research [post_mime_type] => [comment_count] => 0 [filter] => raw ) [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [view] => BUPHP_Post_View Object ( [multipage] => [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [extra_args] => Array ( ) [owner] => [_trigger_error:WPLib_Base:private] => 1 )

Conversations between patients and providers that treat patients as unique individuals can help providers develop care plans to better match their patients’ lives.

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Research

Spillover Effects: Police Killings and Black Americans’ Mental Health

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                    [post_content] => Black Americans are three times more likely to be killed by police than White Americans, and five times more likely to be killed unarmed. Although the media and small-area studies have reported the consequences of unarmed shootings on mental health, scholars have yet to quantify the national impact. In July of this year, Dr. Jacob Bor and colleagues conducted a nationally representative study to measure the impact of these police shootings on Black Americans’ mental health.

Bor and his team analyzed data from two sources. First, mental health data within each state were obtained from the Behavioral Risk Factor Surveillance System (BRFSS), a large, population-based survey conducted by the Center for Disease Control which measures health behaviors of state residents via random-digit-dial surveys. Respondents reported how many days of “poor” mental health they experienced in the past month, based on stress, depression, and emotional problems. Second, to obtain information on police killings, the research team used data from the Mapping Police Violence research collaborative, which has collected and compiled the date and location police killings since 2013.
On average, Black Americans are exposed to four police killings of other unarmed Black Americans in the same state each year.  
On average, Black Americans are exposed to four police killings of other unarmed Black Americans in the same state each year. Police killings affected mental health the most within the first two months of the incident. The researchers estimate that these killings cause an additional 1.7 poor mental health days per person every year, or an additional 55 million poor mental health days per year in the general Black US population. By comparison, diabetes is one of the most common chronic diseases in the US, and causes 75 million poor mental health days annually among Black Americans. The contrast between Black and White respondents is stark. Killings of unarmed White Americans did not effect the mental health of other Whites. “Just because it’s intuitive that racism is bad for health, doesn’t mean we don’t need evidence to quantify the impacts on health,” Bor explained. “It’s not that people are different, but that people have different exposures to racism, which causes real harm when it comes to health.” Although the impact on Black American’s mental health will vary between individuals within each state (from people who experienced a close exposure and were impacted directly to others who may not have heard of the event) the effects were estimated at a population-level. “The important thing about the analysis,” explained Bor, “[is that] exposure here is simply defined based on what state you live in, and whether the date of your interview was within three months of a police killing of an unarmed Black American.” Bor emphasized, “There are lots of open questions – [but] the fundamental one is how do we reduce police violence and the disproportionate police force in Black communities?” Feature image: Screenshot of interactive Police Violence Map created by Samuel Sinyangwe Samuel Sinyangwe [post_title] => Spillover Effects: Police Killings and Black Americans' Mental Health [post_excerpt] => Black Americans are three times more likely to be killed by police than White Americans, and five times more likely to be killed unarmed. Jacob Bor and colleagues conducted research to measure the mental health impact of police shootings. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => spillover-effects-police-killings-and-black-americans-mental-health [to_ping] => [pinged] => [post_modified] => 2018-10-10 06:51:03 [post_modified_gmt] => 2018-10-10 10:51:03 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.publichealthpost.org/?post_type=bu_research&p=5678 [menu_order] => 0 [post_type] => bu_research [post_mime_type] => [comment_count] => 0 [filter] => raw ) [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [view] => BUPHP_Post_View Object ( [multipage] => [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [extra_args] => Array ( ) [owner] => [_trigger_error:WPLib_Base:private] => 1 )

Black Americans are three times more likely to be killed by police than White Americans, and five times more likely to be killed unarmed. Jacob Bor and colleagues conducted research to measure the mental health impact of police shootings.

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Research

Are Post-9/11 Veterans Experiencing a New Version of Gulf War Illness?

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                    [post_content] => Gulf War illness (also known as Gulf War syndrome, Gulf War veterans’ illnesses, and chronic multi-symptom illness) is a collection of chronic symptoms that affects a substantial minority of veterans deployed to the Persian Gulf in 1990-1991. Studies have found these symptoms typically include headache, widespread pain, mood disturbances, respiratory problems, persistent and unexplained fatigue, memory and other cognitive difficulties, gastrointestinal disturbances, and skin rashes.

These symptoms lack a clear medical explanation, but the current understanding points to toxic exposures: for example, pyridostigmine bromide, nerve agents, chemical weapons, and pesticides. These exposures may have led to excess health problems in approximately 34% of Gulf War veterans.

Now, veterans of the recent conflicts in Iraq and Afghanistan are reporting a similar constellation of symptoms. My colleagues and I have begun investigating a potential link between toxic exposures during deployment and chronic multi-symptom illness (CMI).

Participants in our study were veterans who served in the Iraq or Afghanistan war after September 11, 2001. Veterans who also served in prior conflicts like the Vietnam War or the Gulf War were excluded. This ensured that the results represented only veterans exposed to hazardous substances during post-9/11 deployments.
In our sample of 224 veterans, 97.2% reported experiencing one or more potentially toxic exposures during their Iraq or Afghanistan deployment(s).  
In our sample of 224 veterans, 97.2% reported experiencing one or more potentially toxic exposures during their Iraq or Afghanistan deployment(s). The most commonly reported experiences were inhaling smoke/air pollution (83.5%), being exposed to burning trash/feces (83.5%), and inhaling fumes/exhaust from heaters or generators (80.0%). Other exposures included, but were not limited to, pesticides, insect repellents, diesel or other petrochemical fuel, and chemical or biological weapons. We found an association between toxic exposures and CMI symptoms. Of the nine CMI symptoms defined by the Centers for Disease Control, the veterans in our study reported fatigue, sleep problems, difficulty concentrating, irritability, anxiety or depression, and musculoskeletal pain. These six symptoms are further grouped into three “clusters” of symptoms: 1) fatigue, 2) mood and cognition, and 3) musculoskeletal pain. Nearly three-fourths (71.4%) experienced at least one of these six symptoms. Moreover, 37.1% met criteria for a diagnosis of CMI (two of the three symptom clusters) and 10.3% reported experiencing all three clusters of symptoms.
Pesticide exposure predicted CMI symptoms after controlling for the previously mentioned variables, but exposure to smoke inhalation did not.  
Toxic exposures were significantly associated with CMI symptoms, even after accounting for demographic variables (e.g., age, gender, and years of education), combat exposure, smoking status, and post-traumatic stress disorder symptoms that do not overlap with CMI. We did additional analyses to determine whether certain types of toxic exposures were more strongly associated with CMI symptoms than others. We focused on pesticide-type exposure (i.e., environmental pesticide, pesticide in uniforms or flea collars, DEET insect repellants) and smoke inhalation (i.e., smoke/air pollution, fumes/exhaust from heaters or generators, and burning trash/feces). Pesticide exposure predicted CMI symptoms after controlling for the previously mentioned variables, but exposure to smoke inhalation did not. This is the first empirical study to provide evidence that post-9-11 veterans were exposed to toxic substances similar to Gulf War veterans and are experiencing similar CMI symptoms. Further research is needed to examine toxic exposures in real time during deployment, as exposures vary significantly, and some soldiers may not be aware that they have been exposed. This type of data collection could examine the severity and chronicity of the exposure, both of which were not examined in this study. Further, prevalence studies of CMI symptoms in this population and treatment to reduce CMI symptoms are also needed. Feature image: The U.S. Army, U.S. Army Soldiers put their gas masks on for a simulated chemical attack during a training mission near Camp Ramadi, Iraq, Sept. 25, 2007. U.S. Marine Corps photo by Sgt. Andrew D. Pendracki. www.army.mil. Used under CC BY 2.0.  [post_title] => Are Post-9/11 Veterans Experiencing a New Version of Gulf War Illness? [post_excerpt] => Veterans of Iraq and Afghanistan are reporting a similar constellation of symptoms that affect veterans deployed to the Persian Gulf in 1990-1991. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => post-9-11-iraq-afghanistan-veterans-experience-gulf-war-illness [to_ping] => [pinged] => [post_modified] => 2018-10-09 07:34:40 [post_modified_gmt] => 2018-10-09 11:34:40 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.publichealthpost.org/?post_type=bu_research&p=5634 [menu_order] => 0 [post_type] => bu_research [post_mime_type] => [comment_count] => 0 [filter] => raw ) [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [view] => BUPHP_Post_View Object ( [multipage] => [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [extra_args] => Array ( ) [owner] => [_trigger_error:WPLib_Base:private] => 1 )

Veterans of Iraq and Afghanistan are reporting a similar constellation of symptoms that affect veterans deployed to the Persian Gulf in 1990-1991.

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Research

Sports Specialization and Overuse Injuries

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                    [post_date] => 2018-10-03 07:00:41
                    [post_date_gmt] => 2018-10-03 11:00:41
                    [post_content] => Sports participation in younger athletes has evolved over the years from child-driven activities for fun to intense, specialized training, often driven by parents and coaches, with a goal of competing at the collegiate, elite, or professional level. Specialized training is defined by intense, year-round training in a single sport at the exclusion of other sports.

In a study of more than 1200 young athletes across all sports, Jayanthi et al. demonstrated an association between overuse injury and sports specialization. The authors also documented a dose-dependent increase in injury risk for those who have higher degrees of specialization. Moreover, there was an increase in overuse injury for those who train more hours/week than their age (7 hours a week for a seven-year-old), and in those who exceed a 2:1 sports training-to-free play ratio.

More recent data has shown a relationship between socioeconomic status (SES) and overuse injury. Children of parents who have a higher level of education and total household income are more likely to be more highly specialized. As a result, as SES increased, there was proportional increase in overuse injuries. This is thought to be a result of the greater intensity of training and higher degree specialization among the athletes with higher SES status. Further, athletes from higher income families were more likely to participate in individual sports (tennis, swimming), had a ratio of organized sport to free play of greater than 2:1, and spent more months per year in sports.

Young athletes from lower SES families participate in more weekly hours of physical activity than those of higher SES overall, but have lower rates of serious overuse injuries. One speculation is that higher amounts of self-directed free play may play a protective role in preventing overuse injuries. Furthermore, the adult-driven nature of organized sports may foster an environment in which athletes are less likely to report injuries and remove themselves from play out of fear of disappointing parents and coaches.

The opportunity to specialize in youth sports is more readily accessible to athletes who come from higher income families. But these young athletes are at greater risk of developing overuse injuries as a result of the demands associated with specialized training. While there is less access to sports for children of lower SES, those young athletes who do participate seem to exhibit healthier patterns of play. Increasing opportunities to lower SES children in sports may have widespread implications in healthy sports-related physical activity.

Photo by Marcus Ng on Unsplash
                    [post_title] => Sports Specialization and Overuse Injuries
                    [post_excerpt] => Sports participation in younger athletes has evolved from activities for fun to intense, specialized training. Recent data shows a relationship between socioeconomic status and overuse injury. 
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Sports participation in younger athletes has evolved from activities for fun to intense, specialized training. Recent data shows a relationship between socioeconomic status and overuse injury. 

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Research

Contraception Deception by Crisis Pregnancy Centers

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                    [post_date] => 2018-10-02 05:30:53
                    [post_date_gmt] => 2018-10-02 09:30:53
                    [post_content] => Crisis pregnancy centers (also called pregnancy resource centers) made headlines during the first half of 2018 in the Supreme Court case, National Institute of Family and Life Advocates v. Becerra. Crisis pregnancy centers are known for their anti-abortion work, but some also focus on preventing women from accessing contraceptives.

A recent study analyzed the information that crisis pregnancy centers in Georgia provided about contraception on their websites. Twenty of the 64 websites reviewed contained information on contraceptives and 90% of those contained information on emergency contraception. About one-third contained information on “highly” or “moderately” effective forms of birth control such as intrauterine devices and implants, contraceptives pills, patches, shots, and vaginal rings. Less than half of the websites (40%) contained information on condoms.

The study’s authors found much of the information on these sites was misleading or false. One website referred to IUDs as abortifacients whereas IUDs actually prevent fertilization. They do not cause fertilized eggs to abort.
Many sites tried to equate emergency contraception with abortion when in fact emergency contraception prevents or delays ovulation.  
Many sites tried to equate emergency contraception with abortion when in fact emergency contraception prevents or delays ovulation. Some websites had information on emergency contraception listed under the heading “Abortion,” and others labelled it as an abortifacient. The researchers cited examples of misinformation including: “Abortion options range from the morning after pill to various surgical procedures.” Further, many crisis pregnancy center websites incorrectly stated that women who take emergency contraception are at risk for dependence, overdose, and ectopic pregnancy, which occurs when a fertilized egg implants outside of the uterus. Over half of the websites analyzed did not include citations from the medical literature supporting such assertions. When citations were provided, the links were often broken or the information was outdated or incomplete.
Swartzendruber added, “Furthermore, crisis pregnancy centers are increasingly attracting public funding..."  
When asked why it’s important to highlight the misinformation crisis pregnancy centers have on their websites, Andrea Swartzendruber, the lead author of the study, wrote in an email, “Studies show that the internet is an important source of health information for many people. In addition, studies show that pregnant women often use online information to support pregnancy-related decision-making. However, many people aren't critical consumers of online health information and don't consider the source or date of online health content to assess its credibility.” Swartzendruber added, “Furthermore, crisis pregnancy centers are increasingly attracting public funding. Governments have a responsibility to protect public health and should ensure that public funding does not support inaccurate and misleading health information.” Feature image: EdnaM/iStock [post_title] => Contraception Deception by Crisis Pregnancy Centers [post_excerpt] => Crisis pregnancy centers are known for their anti-abortion work, but some also focus on preventing women from accessing contraceptives. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => contraception-deception-by-crisis-pregnancy-centers [to_ping] => [pinged] => [post_modified] => 2018-10-02 12:04:38 [post_modified_gmt] => 2018-10-02 16:04:38 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.publichealthpost.org/?post_type=bu_research&p=5644 [menu_order] => 0 [post_type] => bu_research [post_mime_type] => [comment_count] => 0 [filter] => raw ) [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [view] => BUPHP_Post_View Object ( [multipage] => [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [extra_args] => Array ( ) [owner] => [_trigger_error:WPLib_Base:private] => 1 )

Crisis pregnancy centers are known for their anti-abortion work, but some also focus on preventing women from accessing contraceptives.

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Research

Body Image and Bullying

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                    [post_date] => 2018-10-01 06:00:35
                    [post_date_gmt] => 2018-10-01 10:00:35
                    [post_content] => When children are bullied in school, the effects carry into adulthood. According to a recent UNICEF report, 150 million teenagers around the world say they experienced some form of bullying in the past month or were involved in physical altercations in the past year. In the US, the 2011 Youth Risk Behavior Survey found that 20% of participants reported being bullied in the past year, and a 2014 meta-analysis found that up to 35% of school children experienced bullying in some form.

Weight plays a major role, as children with larger bodies tend to be bullied more than their thinner peers. Most of the prior research on weight and bullying, however, focuses on how others view a person’s body. There is a lack of research assessing both self-perceived body image and actual appearance, and how they relate to bullying.

Yi-Ching Lin and colleagues aimed to fill that gap by analyzing data from the 2009-2010 Health Behavior of School-Aged Children study. They focused on answers from 8,303 US students in grades seven through ten to questions about perceptions of their weight status, frustration with appearance, and experiences of being bullied.

The survey measured self-perceived weight status through questions like “what are your thoughts on your body?”, and participants chose from “much too fat,” “about the right size,” and “much too thin.” Participants were also asked to rate how strongly they agreed with items related to frustrations with their looks, and to indicate how often they were bullied by peers in the past few months.
Participants’ frustrations with their body images was also found to play a key role in the experience of bullying.  
Self-perceived weight was more related to bullying than actual weight, particularly among female students. Participants’ frustrations with their body images was also found to play a key role in the experience of bullying. The researchers speculate that lower self-esteem associated with poor self-perception may make someone more likely to withdraw socially, potentially increasing their chances of being targeted by bullies. Further, self-perception of weight had stronger association with health outcomes than did actual weight. Frustrations with body image also had a greater impact on health than actual body weight. The researchers suggest that efforts to prevent bullying should change in approach. Instead of solely discussing weight loss or maintenance, anti-bullying programs should also emphasize self-esteem and self-confidence about one’s body. Feature image: Benjamin Watson, Anorexia, used under CC BY 2.0  [post_title] => Body Image and Bullying [post_excerpt] => Yi-Ching Lin and colleagues found that self-perceived weight and frustration with body image were more related to bullying than actual weight, particularly among female students. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => body-image-and-bullying [to_ping] => [pinged] => [post_modified] => 2018-10-01 06:01:02 [post_modified_gmt] => 2018-10-01 10:01:02 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.publichealthpost.org/?post_type=bu_research&p=5630 [menu_order] => 0 [post_type] => bu_research [post_mime_type] => [comment_count] => 0 [filter] => raw ) [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [view] => BUPHP_Post_View Object ( [multipage] => [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [extra_args] => Array ( ) [owner] => [_trigger_error:WPLib_Base:private] => 1 )

Yi-Ching Lin and colleagues found that self-perceived weight and frustration with body image were more related to bullying than actual weight, particularly among female students.

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