Suchergebnisse

Women who serve in the military benefit from unique opportunities but face strains as a minority population and, compared to men, report greater dissatisfaction with their service and have shorter military careers. We interviewed 35 U.S. women veterans about their decisions to enter and leave military service. Premature separation—leaving military service before one plans, expects, or wants to—was a prominent theme and was often precipitated by gender-based experiences, including interpersonal violence, harassment, and caregiving needs. Findings can inform efforts to improve the length and quality of women's military careers and support women during and after service.

The quest for making social work a discipline based entirely on empirical research findings is not new. In this article, the authors briefly review the field of social work in the United States during the past 100 years and discuss how the quest for the status of a profession forced the emphasis on empirical research. However, the authors claim that now and in the past, social work is a most complex field and that many of its basic ingredients are inherently difficult to study. They conclude this article, with a call for social work to continue stressing the "science" side by enhancing careful evidence-based practice, does not hamper the field from evolving and from practitioners using the "art" side of social care.

BACKGROUND: The federal government and other organizations have recommended that healthcare institutions collect and document patient sexual orientation and gender identity (SO/GI) information in order to advance the understanding of the health of sexual and gender minority populations and to combat existing health disparities. Little is known, however, about provider perception of the clinical relevance of, or how they might use, patient SO/GI information in individual care. OBJECTIVE: To explore providers' perspectives on and experiences with collection of patient SO/GI information and how the knowledge of this information may impact clinical care. DESIGN: Qualitative study using in-depth individual interviews of healthcare providers. PARTICIPANTS: Twenty-five healthcare providers, including physicians, physician assistants, and nurse practitioners, from the fields of family medicine, internal medicine, gynecology, and urology within a single healthcare system in an east coast city. APPROACH: Interviews were recorded and transcribed verbatim. Transcripts were coded and analyzed using principles of grounded theory and thematic analysis to identify themes emerging from the data. KEY RESULTS: Providers recognized the importance of collecting patient SO/GI information for understanding population-level public health concerns and disparities, as well as understanding and respecting the context of patients' lives. However, providers also emphasized the importance of knowing patients' sexual behaviors and physical anatomy for addressing health risk and preventive care needs—and noted the distinction between these characteristics and patient SO/GI. Providers cautioned that assumptions based on knowledge of patient SO/GI may unintentionally obscure accurate profiles of patient behavior and anatomy. CONCLUSIONS: Along with the potential benefits of routine collection of patient SO/GI, it is important that providers continue to inquire about patient behaviors and anatomy to inform individual risk and needs assessments. ...

IMPORTANCE: Adverse childhood experiences (ACE) are associated with several adulthood health problems, such as self-directed violence. For some individuals, enlistment in the military may be an instrumental act to escape adverse household environments, however prevalence of ACE among persons with military service histories has not been documented in the U.S. using population-based data. OBJECTIVE: To compare the prevalence of ACE among individuals with and without histories of military service. We hypothesized that ACE differences between military and non-military groups will be more pronounced during the era when the military became all-volunteer (enlisted on or after 1973) versus the draft era (pre-1973). DESIGN, SETTING & PARTICIPANTS: Data are from the 2010 Behavioral Risk Factor Surveillance System. Computer-assisted telephone interviews were conducted with population-based samples of non-institutionalized U.S. adults during January-December 2010. Analyses were limited to respondents who received the ACE module (n=60,598). Participants were categorized by military service history and whether a respondent was 18 years of age in 1973. MAIN OUTCOMES: Military service history was defined by active duty service, veteran status, or training for the Reserves or National Guard. The ACE inventory assessed 11 negative experiences before the age of 18. Weighted chi-square and multiple logistic regression analyses were used to examine differences in ACE by military service history, era of service, and gender. RESULTS: Any difference in prevalence of ACE showed greater odds for those with military experience. In the All-volunteer Era, men with military service had higher prevalence of all eleven ACE items than men without military service; in the Draft Era there were only two differences. Notably, in the All-volunteer Era, men with military service had twice the odds of reporting forced sex before the age of 18 (OR=2.19, 95%CI: 1.34–3.57) compared to men without military service. Fewer differences were observed ...