scholarly journals Risk factors for positive depression screening across a shipboard deployment cycle

BJPsych Open ◽  
2019 ◽  
Vol 5 (5) ◽  
Author(s):  
Alice E. Arcury-Quandt ◽  
Judith Harbertson ◽  
Lauretta Ziajko ◽  
Braden R. Hale

Background Depression is a leading cause of healthcare use and risk for suicide among US military personnel. Depression is not well characterised over the shipboard deployment cycle, and personnel undergo less screening than with land-based deployments, making early identification less likely. Aims To determine the demographic and behavioural risk factors associated with screening positive for risk of depression (ROD) across the shipboard deployment cycle. Method Active-duty ship assigned personnel completed an anonymous assessment using the Center for Epidemiologic Studies Depression Scale (CES-D) in the year prior to deployment, during deployment and in the months following deployment. Longitudinal models were used to determine risk factors. Results In total, 598 people were included in the analysis. Over 50% of the study population screened positive for ROD (CES-D score ≥16) and over 25% screened positive for risk of major depressive disorder (CES-D score ≥22) at all time points. Lower age, female gender, alcohol use, stress and prior mental health diagnoses were all associated with greater odds of screening positive for ROD in multivariable models. Conclusions Although the risk factors associated with screening positive for ROD are similar to those in other military and civilian populations, the proportion screening positive exceeds previously reported prevalence. This suggests that shipboard deployment or factors associated with shipboard deployment may present particular stressors or increase the likelihood of depressive symptoms. Declaration of interest The authors are military service members (or employees of the US Government). This work was prepared as part of the authors' official duties. Title 17, U.S.C. §105 provides the ‘Copyright protection under this title is not available for any work of the United States Government.’ Title 17, USC, §101 defines a US Government work as work prepared by a military service member or employee of the US Government as part of that person's official duties. The views expressed in this research are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of the Army, Department of the Air Force, Department of Veterans Affairs, Department of Defense, or the US Government. Approved for public release; distribution unlimited. Material has been reviewed by the Walter Reed Army Institute of Research. There is no objection to its presentation and/or publication. The opinions or assertions contained herein are the private views of the authors, and are not to be construed as official, or as reflecting true views of the Department of the Army or the Department of Defense.

2020 ◽  
pp. e1-e5
Author(s):  
Eva H. Clark ◽  
Karla Fredricks ◽  
Laila Woc-Colburn ◽  
Maria Elena Bottazzi ◽  
Jill Weatherhead

Widely administered efficacious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines are the safest and most efficient way to achieve individual- and population-level immunity, making SARS-CoV-2 vaccination the most viable strategy for controlling the coronavirus disease 2019 (COVID-19) pandemic in the United States. To this end, the US government has invested more than $10 billion in “Operation Warp Speed,” a public-private partnership including the Centers for Disease Control and Prevention (CDC), the US Food and Drug Administration (FDA), and the US Department of Defense. Operation Warp Speed funded the development of several SARS-CoV-2 vaccines and aimed to deliver 300 million doses of a vaccine by the ambitious date of January 2021. (Am J Public Health. Published online ahead of print December 22, 2020: e1–e5. https://doi.org/10.2105/AJPH.2020.306047 )


Author(s):  
Azad Kabir ◽  
Raeed Kabir ◽  
Jebun Nahar ◽  
Ritesh Sengar

The objective of the study was to evaluate the risk factors associated with lower COVID-19 vaccination rates in the United States. The study evaluated the effect of red-blue political affiliation and the effect of the US state's average educational aptitude score and per capita income on states' vaccination rates. The study found that states with concomitantly lower income along with lower educational aptitude scores are less vaccinated while the states with higher income have higher vaccination rates even among those with lower educational aptitude scores. These findings stayed significant after adjusting for red-blue political affiliation where states with red political affiliation have lower vaccination rates. Further study is needed to evaluate how to stop online misinformation among states with low income and low educational aptitude scores; and whether such an effort will increase overall vaccination rates in the United States.


Author(s):  
Stacy D. Fahrenthold

This chapter examines the clandestine recruitment of ten thousand Syrian migrants into the militaries of the Entente powers. As conditions deteriorated in Ottoman Syria and Mount Lebanon, Syrian migrant organizations shifted from providing humanitarian relief toward military resistance against the Ottoman state. Activists from competing Syrianist, Lebanist, and Arab nationalist movements produced propaganda in support of the war against Istanbul, conducted espionage for the Entente powers, and recruited Arab men from across the mahjar into Entente military service. The chapter tracks migrant networks between Syrians in Brazil, Argentina, and the United States who worked to deliver migrant troops to the army, where the US government granted recruits passports and a post-Ottoman nationality status to facilitate their service. Syrians joined up under a patriotic rhetoric promising the war would deliver Syria’s liberation, but they also resented nationalists’ attempts to claim them as symbols for competing homeland projects.


Author(s):  
Ana Elizabeth Rosas

In the 1940s, curbing undocumented Mexican immigrant entry into the United States became a US government priority because of an alleged immigration surge, which was blamed for the unemployment of an estimated 252,000 US domestic agricultural laborers. Publicly committed to asserting its control of undocumented Mexican immigrant entry, the US government used Operation Wetback, a binational INS border-enforcement operation, to strike a delicate balance between satisfying US growers’ unending demands for surplus Mexican immigrant labor and responding to the jobs lost by US domestic agricultural laborers. Yet Operation Wetback would also unintentionally and unexpectedly fuel a distinctly transnational pathway to legalization, marriage, and extended family formation for some Mexican immigrants.On July 12, 1951, US president Harry S. Truman’s signing of Public Law 78 initiated such a pathway for an estimated 125,000 undocumented Mexican immigrant laborers throughout the United States. This law was an extension the Bracero Program, a labor agreement between the Mexican and US governments that authorized the temporary contracting of braceros (male Mexican contract laborers) for labor in agricultural production and railroad maintenance. It was formative to undocumented Mexican immigrant laborers’ transnational pursuit of decisively personal goals in both Mexico and the United States.Section 501 of this law, which allowed employers to sponsor certain undocumented laborers, became a transnational pathway toward formalizing extended family relationships between braceros and Mexican American women. This article seeks to begin a discussion on how Operation Wetback unwittingly inspired a distinctly transnational approach to personal extended family relationships in Mexico and the United States among individuals of Mexican descent and varying legal statuses, a social matrix that remains relatively unexplored.


Author(s):  
Danylo Kravets

The aim of the Ukrainian Bureau in Washington was propaganda of Ukrainian question among US government and American publicity in general. Functioning of the Bureau is not represented non in Ukrainian neither in foreign historiographies, so that’s why the main goal of presented paper is to investigate its activity. The research is based on personal papers of Ukrainian diaspora representatives (O. Granovskyi, E. Skotzko, E. Onatskyi) and articles from American and Ukrainian newspapers. The second mass immigration of Ukrainians to the US (1914‒1930s) has often been called the «military» immigration and what it lacked in numbers, it made up in quality. Most immigrants were educated, some with college degrees. The founder of the Ukrainian Bureau Eugene Skotzko was born near Western Ukrainian town of Zoloczhiv and immigrated to the United States in late 1920s after graduating from Lviv Polytechnic University. In New York he began to collaborate with OUN member O. Senyk-Hrabivskyi who gave E. Skotzko task to create informational bureau for propaganda of Ukrainian case. On March 23 1939 the Bureau was founded in Washington D. C. E. Skotzko was an editor of its Informational Bulletins. The Bureau biggest problem was lack of financial support. It was the main reason why it stopped functioning in May 1940. During 14 months of functioning Ukrainian Bureau in Washington posted dozens of informational bulletins and send it to hundreds of addressees; E. Skotzko, as a director, personally wrote to American governmental institutions and foreign diplomats informing about Ukrainian problem in Europe. Ukrainian Bureau activity is an inspiring example for those who care for informational policy of modern Ukraine.Keywords: Ukrainian small encyclopedia, Yevhen Onatsky, journalism, worldview, Ukrainian state. Keywords: Ukrainian Bureau in Washington, Eugene Skotzko, public opinion, history of journalism, diaspora.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 458.2-458
Author(s):  
G. Singh ◽  
M. Sehgal ◽  
A. Mithal

Background:Heart failure (HF) is the eighth leading cause of death in the US, with a 38% increase in the number of deaths due to HF from 2011 to 2017 (1). Gout and hyperuricemia have previously been recognized as significant risk factors for heart failure (2), but there is little nationwide data on the clinical and economic consequences of these comorbidities.Objectives:To study heart failure hospitalizations in patients with gout in the United States (US) and estimate their clinical and economic impact.Methods:The Nationwide Inpatient Sample (NIS) is a stratified random sample of all US community hospitals. It is the only US national hospital database with information on all patients, regardless of payer, including persons covered by Medicare, Medicaid, private insurance, and the uninsured. We examined all inpatient hospitalizations in the NIS in 2017, the most recent year of available data, with a primary or secondary diagnosis of gout and heart failure. Over 69,800 ICD 10 diagnoses were collapsed into a smaller number of clinically meaningful categories, consistent with the CDC Clinical Classification Software.Results:There were 35.8 million all-cause hospitalizations in patients in the US in 2017. Of these, 351,735 hospitalizations occurred for acute and/or chronic heart failure in patients with gout. These patients had a mean age of 73.3 years (95% confidence intervals 73.1 – 73.5 years) and were more likely to be male (63.4%). The average length of hospitalization was 6.1 days (95% confidence intervals 6.0 to 6.2 days) with a case fatality rate of 3.5% (95% confidence intervals 3.4% – 3.7%). The average cost of each hospitalization was $63,992 (95% confidence intervals $61,908 - $66,075), with a total annual national cost estimate of $22.8 billion (95% confidence intervals $21.7 billion - $24.0 billion).Conclusion:While gout and hyperuricemia have long been recognized as potential risk factors for heart failure, the aging of the US population is projected to significantly increase the burden of illness and costs of care of these comorbidities (1). This calls for an increased awareness and management of serious co-morbid conditions in patients with gout.References:[1]Sidney, S., Go, A. S., Jaffe, M. G., Solomon, M. D., Ambrosy, A. P., & Rana, J. S. (2019). Association Between Aging of the US Population and Heart Disease Mortality From 2011 to 2017. JAMA Cardiology. doi:10.1001/jamacardio.2019.4187[2]Krishnan E. Gout and the risk for incident heart failure and systolic dysfunction. BMJ Open 2012;2:e000282.doi:10.1136/bmjopen-2011-000282Disclosure of Interests: :Gurkirpal Singh Grant/research support from: Horizon Therapeutics, Maanek Sehgal: None declared, Alka Mithal: None declared


2021 ◽  
Vol 12 ◽  
pp. 215145932098769
Author(s):  
Jaclyn Kapilow ◽  
Junho Ahn ◽  
Kathryn Gallaway ◽  
Megan Sorich

Objectives: To report the incidence and risk factors for prolonged hospitalization, discharge to a facility, and postoperative complications in geriatric patients who underwent surgery for patella fracture. Design: Retrospective database review. Setting: The American College of Surgeons—National Surgical Quality Improvement Program (NSQIP) collects data from 600 hospitals across the United States. Patients/Participants: NSQIP patients over 65 years of age with patella fractures. Intervention: Surgical fixation of patella fracture including extensor mechanism repair. Main Outcome Measurements: Prolonged hospitalization, discharge to a facility, and 30-day post-operative complications. Results: 1721 patients were included in the study. The average age was 74.9 years. 358 (20.8%) patients were male. 122 (7.1%) patients had a length of stay greater than 7 days. Factors associated with prolonged length of stay include pre-existing renal failure, need for emergent surgery, and time to surgery greater than 24 hours from admission. 640 patients (37.2%) of patients were discharged to a facility after surgery. Discharge to facility was associated with age >77 years, obesity, anemia, thrombocytopenia, pre-operative SIRS, and CCI > 0.5. Admission from home decreased the odds of discharge to a facility. The most common postoperative complications in this population were unplanned readmission (3.4%), unplanned reoperation (2.7%), surgical site infection (1.1%), mortality (1.0%), venous thromboembolism (0.8%), and wound dehiscence (0.2%). Complication rates increased with anemia and ASA class IV-V. Conclusions: Geriatric patients undergoing operative intervention for patella fractures are at high risk for prolonged hospitalization, discharge to facility, unplanned readmission or reoperation, and surgical site complications in the first 30 days following surgery. This study highlights modifiable and non-modifiable risk factors associated with adverse events. Early recognition of these factors can allow for close monitoring and multidisciplinary intervention in the perioperative period to improve outcomes. Level of Evidence: Prognostic level III.


Author(s):  
Mary Hannan ◽  
Sajid Ansari ◽  
Natalie Meza ◽  
Amanda H. Anderson ◽  
Anand Srivastava ◽  
...  

The Chronic Renal Insufficiency Cohort (CRIC) Study is an ongoing, multicenter, longitudinal study of nearly 5500 adults with CKD in the United States. Over the past 10 years, the CRIC Study has made significant contributions to the understanding of factors associated with CKD progression. This review summarizes findings from longitudinal studies evaluating risk factors associated with CKD progression in the CRIC Study, grouped into the following six thematic categories: (1) sociodemographic and economic (sex, race/ethnicity, and nephrology care); (2) behavioral (healthy lifestyle, diet, and sleep); (3) genetic (apoL1, genome-wide association study, and renin-angiotensin-aldosterone system pathway genes); (4) cardiovascular (atrial fibrillation, hypertension, and vascular stiffness); (5) metabolic (fibroblast growth factor 23 and urinary oxalate); and (6) novel factors (AKI and biomarkers of kidney injury). Additionally, we highlight areas where future research is needed, and opportunities for interdisciplinary collaboration.


Author(s):  
Sarah Raifman ◽  
M. Antonia Biggs ◽  
Lauren Ralph ◽  
Katherine Ehrenreich ◽  
Daniel Grossman

Abstract Introduction Twenty-four states have at least one law in place that could be used to prosecute people for self-managed abortion (SMA), or the termination of a pregnancy outside of the formal healthcare system. We investigated factors associated with public attitudes about SMA legality and legal access to abortion more generally. Methods In August 2017, we surveyed a nationally representative sample of English- and Spanish-speaking women ages 18–49 years in the United States (US) using Ipsos Public Affairs’ KnowledgePanel. Unadjusted and adjusted multinomial logistic regression estimates identify characteristics associated with believing that SMA should not be against the law, compared to should be against the law, with weighting to account for sampling into the panel. Results Overall, 76% (95% CI: 74.3%-77.1%) and 59% (95% CI: 57.3%-60.4%) of participants (n = 7,022, completion rate 50%) reported that abortion and SMA, respectively, should not be against the law; 1% and 19% were unsure. Among those living in a state with at least one law that could be used to prosecute an individual for SMA, the majority (55%, 95% CI: 52.7%-57.9%) believed SMA should not be against the law. Factors associated with believing SMA should not be against the law, compared to should be against the law, included prior abortion experience and higher levels of education and income. Conclusion Most reproductive age women in the US believe that SMA should not be criminalized. There is more uncertainty about SMA legality than about the legality of abortion more generally. Policy Implications US laws that criminalize SMA are not supported by the majority of the people living in their jurisdictions.


Sign in / Sign up

Export Citation Format

Share Document