Suchergebnisse

This paper examines the class position of 156 Birmingham first-line supervisors, and how the supervisors perceive that position. It concludes that they occupy a class position which is only marginally superior to that of manual workers. In their perceptions, however, they range from ascribing a middle class position for themselves to a working class one. These perceptions are assessed in terms of six indicators. The less that supervisors see their role and standing in the firm falling short of what they believe to be appropriate, and the closer they identify themselves with senior management, the higher tends to be the class position they see themselves occupying. It would be an oversimplification, the paper suggests, to conclude that the supervisors studied belong in a straightforward manner either to a proletarianized middle class or to a working class group which has adopted middle class characteristics.

Introduction: Despite limited research on the topic, it has been observed that military members face unique challenges with social support. Methods: The current study used data provided by treatment-seeking Veterans and Canadian Armed Forces (CAF) members ( N=666) to: (1) determine whether symptomatology of posttraumatic stress disorder (PTSD), depression (MDD), anxiety, and suicidal ideation (SI) increased as level of perceived social support decreased; and (2) identify if the level of perceived social support is associated with PTSD, MDD, and anxiety symptom distress and SI frequency; this was done while controlling for demographic factors. Social support was measured using a single item grouped according to "low," "medium," and "high" levels of perceived support. Results: Overall, adequate social support was low with less than one-third (29%) of participants reporting a high level. There was an inverse association between social support and symptom distress for all mental health conditions, whereby those who perceived low social support had significantly greater symptom distress than those who perceived medium social support, who in turn reported significantly greater symptom distress than those perceiving high social support. Social support was significantly associated with all mental health conditions when controlling for demographic variables. The effect of social support on PTSD and SI affected Veterans and CAF members differently. Discussion: Our study highlights the difficulty this population faces in maintaining adequate social support alongside military-related mental health disorders. More research is required to fully understand the role of social support in military populations.

"Focusing on the importance of discussions of sovereignty and of the diversity of American Indian communities, Survivance, Sovereignty, and Story offers a variety of ways to teach and write about Indigenous North American rhetorics. These essays introduce Indigenous rhetorics as they frame both how and why they would be taught in an American university writing classroom"--Provided by publisher

Introduction: Limited research has investigated gender differences among treatment-seeking Veterans and serving military personnel, despite important implications for treatment provision. In order to better serve the needs of women with military service, the authors sought to address this gap by examining the clinical presentation of men and women requesting services for military-related operational stress injuries (OSIs). Methods: Using a sample of 648 treatment-seeking male ( n = 550) and female ( n = 99) Veterans and Canadian Armed Forces (CAF) personnel, the authors compared prevalence of childhood sexual and physical abuse, probable mental health diagnoses (posttraumatic stress disorder [PTSD], depression, and generalized anxiety disorder [GAD]), and severity of pain and somatic symptoms. Results were rerun to control for sociodemographic variables that significantly differed by gender. Results: Rates of probable PTSD were higher for women ( p < 0.05), and women reported significantly more somatic symptoms ( p < 0.001), pain severity ( p < 0.01), and childhood sexual abuse (47% of the sample; p < 0.001). Both men and women reported equally high rates of childhood physical abuse (71% for both genders). Discussion: Women in this study had a higher prevalence of probable PTSD and childhood sexual abuse, and reported higher severity of pain and somatic symptoms. The study highlights the diverse range of issues that are clinically relevant for – and may complicate the treatment of – women with military service who have OSIs.

Introduction: The present study examines the relationship between feeling responsible for the death of another and suicidal ideation (SI) while controlling for post-traumatic stress disorder (PTSD), major depressive disorder (MDD), and general adverse deployment experiences. Methods: Participants were current and former Canadian Armed Forces personnel ( N=276) seeking treatment at a hospital-based operational stress injury clinic. Data was collected as part of a standard intake protocol. Results: Although 43.5% of the sample reported feeling responsible for the death of another in at least one instance, this variable did not emerge as a significant predictor of SI. Instead, MDD and PTSD severity were the only significant predictors of SI in our model. Discussion: Consistent with previous research, MDD emerged as the strongest predictor of SI. Results emphasize the influence of psychiatric conditions on suicidal behaviour over and above other combat-related variables.

Previous research studies have focused on patient outcomes related to healthcare interventions, but there is little research available regarding nurses' involvement in activities that would advance the profession. Advanced Practice Registered Nurses' (APRN) contributions to the healthcare system lead to direct improvement of patient outcomes through research, mentoring new professionals, and participating in professional organizations. The theoretical motivation behind the study is Ray's Theory of Bureaucratic Caring that proposed healthcare personnel consider incorporation of the business aspects of healthcare to propel nursing into the future. Ray dared nurses to become leaders in the field, understand the corporate aspects of health care, evolve bedside nursing through research activity, and build future nurse leaders with political and mentorship works. The study considers characteristics Ray demanded nurses take to control the future of the profession and advance the nurse's role in healthcare. The study will assess current level of involvement of APRNs in three activities that directly advance the profession. Survey questions will address demographic information and the degree of participation in the three specific activities. The study will use a quantitative approach through randomized surveys distributed through face-to-face encounters, Survey Monkey, social media, and email. Inclusion criteria is limited to practicing APRNs within any specialty with a master's level education or higher.

Introduction: Using a treatment-seeking sample of military personnel and Veterans ( n = 736), the objectives were to determine the prevalence of somatic symptoms in the sample and investigate whether the mean severity of somatic symptoms differed between common probable psychiatric conditions and comorbidity. Methods: The Patient Health Questionnaire–15 was used to determine somatic symptom severity. One-way analyses of variance and Tukey post hoc tests determined whether the severity of somatic symptom categories (musculoskeletal pain, neurological, cardiovascular, gastrointestinal, sleep, and lethargy) and total somatic symptom severity differed significantly between groups. Results: Most participants (80%) reported moderate to high levels of somatic symptoms, and more than half the sample had probable comorbid post-traumatic stress disorder (PTSD) and major depressive disorder (MDD). Mean total somatic symptom severity for the comorbid PTSD–MDD group was high and differed significantly from that of the PTSD- and MDD-only groups (medium severity) and the group with neither condition (mild severity). Severity of most mean somatic symptom categories differed significantly between comorbid PTSD and MDD for all other groups. Discussion: Results suggest that the presentation of comorbid PTSD and MDD is more detrimental in terms of somatic symptom severity than that of either disorder separately. Although there were some differences in the severity of specific somatic symptom types between the PTSD-only and the MDD-only groups, overall severity did not differ. After diagnosis of a mental health condition, military personnel and Veterans should be screened for somatic symptoms.

Introduction: DSM-5 diagnostic criteria revisions for post-traumatic stress disorder (PTSD) have raised concerns about PTSD prevalence – particularly the new requirement of one avoidance symptom. We examined the frequency of positive screening results for probable PTSD in treatment-seeking Canadian Armed Forces (CAF) personnel and Veterans when both DSM-5 and DSM-IV-TR symptom cluster criteria were applied. Methods: Previously collected data from 382 CAF personnel and Veterans were used to identify the frequency of positive screens using both sets of diagnostic criteria. Results: 71.2% ( n=272) of participants screened positively for probable PTSD using DSM-5 symptom cluster criteria, compared to 77.7% ( n=297) using DSM-IV-TR symptom cluster criteria. Percent agreement analyses found that negative percent agreement was 100.0%, positive percent agreement was 91.6%, and overall percent agreement was 93.5%. Discussion: The number of individuals who screened positively for probable PTSD using DSM-IV-TR criteria was higher than those who screened positively using DSM-5 criteria. The requirement of at least one avoidance symptom appears to have a noticeable impact on the frequency of positive screens for probable PTSD among treatment-seeking military personnel. This has important implications for pension adjudication and treatment entitlement.

LAY SUMMARY Military personnel and Veterans receiving psychotherapy for mental health diagnoses such as posttraumatic stress disorder (PTSD) often have only modest symptom improvement. The authors wondered whether participating in a therapeutic recreation and creative arts group along with psychotherapy would aid recovery. A 12-week program called the my Social life, Expression, Leisure and Food (mySELF) group was created that offered therapeutic recreation, art, and music therapy. A total of 36 clients, most with PTSD, who had been receiving psychotherapy for an average of three years completed the program and submitted pre- and post-group questionnaires. The authors examined leisure attitudes, quality of life, and mental health symptoms before, immediately after, and four months after the group. Results showed significant improvements in leisure attitudes, environmental quality of life and depression, anxiety, stress, and PTSD symptoms. These preliminary results suggest that therapeutic recreation, art, and music therapy are beneficial for military personnel, Veterans, and Royal Canadian Mounted Police receiving psychotherapy.

LAY SUMMARY The Montreal Cognitive Assessment (MoCA) is a test of mild cognitive impairment that is commonly administered to military personnel seeking mental health treatment. However, there is little research on the average MoCA score for military Veterans. This study looked at MoCA scores provided by Canadian Armed Forces members and Veterans receiving services for an operational-related mental health condition. Scores below the cut-off for mild cognitive impairment were not uncommon and were related to education level, as well as to severity of posttraumatic stress disorder and depression. These findings will help clinicians better contextualize score variation among clients.

OBJECTIVE: Posttraumatic stress disorder (PTSD) is often accompanied by other mental health conditions, including major depressive disorder (MDD), substance misuse disorders, and anxiety disorders. The objective of the current study is to delineate classes of comorbidity and investigate predictors of comorbidity classes amongst a sample of Canadian Armed Forces (CAF) Regular Force personnel. METHODS: Latent class analyses (LCAs) were applied to cross-sectional data obtained between April and August 2013 from a nationally representative random sample of 6700 CAF Regular Force personnel who deployed to the mission in Afghanistan. RESULTS: MDD was the most common diagnosis (8.0%), followed by PTSD (5.3%) and generalized anxiety disorder (4.7%). Of those with a mental health condition, LCA revealed 3 classes of comorbidity: a highly comorbid class (8.3%), a depressed-only class (4.6%), and an alcohol use–only class (3.1%). Multinomial logit regression showed that women (adjusted relative risk ratio [ARRR] = 2.77; 95% CI, 2.13 to 3.60; P < 0.01) and personnel reporting higher trauma exposure (ARRR = 4.18; 95% CI, 3.13 to 5.57; P < 0.01) were at increased risk of membership in the comorbid class compared to those without a mental health condition. When compared to those with no mental health condition, experiencing childhood abuse increased the risk of being in any comorbidity class. CONCLUSIONS: Results provide further evidence to support screening for and treatment of comorbid mental health conditions. The role of sex, childhood abuse, and combat deployment in determining class membership may also prove valuable for clinicians treating military-related mental health conditions.