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George S. Patton: On Guts, Glory, and Winning relies on the writings, speeches, and poems of George Patton. Included are more than 100 exquisite combat photos from the European Theater of Operations during WWII, which illuminate the text. General Patton is one of the greatest and most controversial battle commanders of the war. He was criticized by his detractors, lauded by his peers, and feared by the Nazis in North Africa, Sicily, France, and northern Europe. Even today, despite advances in weaponry and technology, military commanders still study his battle tactics

The timing and sequencing of completing education, leaving home, beginning full-time work, forming intimate relationships, and parenting are evolving rapidly worldwide. This study describes patterns of transition in a population-based longitudinal study of Australians at ages 20 and 29 ( N = 1,366). Latent class analysis and latent transition analysis identified four categories of emerging adulthood in both age-groups. At age 20, 41.8% were in the category of students living in their parents' home; at age 29, most were categorized as "established young adults" with (25.7%) or without children (51.1%). A majority of "young independents" at age 20 went on to become "established parents" at 29, and most students living independently at age 20 were "established young adults without children" at 29. Findings suggest that the directions of emerging adulthood are largely set in place by age 20. Programs and policies may be needed to support transitions into stable life partnerships and parenthood.

AbstractHomeless young adults are at increased risk for contact with the police and are overrepresented in the justice system. This study explored associations between homelessness, antisocial behaviour and violence victimisation using longitudinal panel data gathered through young adulthood. Data were drawn from a state representative population‐based sample of young adults from Victoria, Australia participating in the International Youth Development Study (IYDS; n = 2884, 54% female). Participants were surveyed at age 21 years, with follow‐up at ages 23 and 25 years. We examined changes in the prevalence of homelessness and tested hypothesised directional relationships between young adult homelessness, antisocial behaviour and violence victimisation using longitudinal cross‐lagged panel models. Multiple‐group modelling was used to test whether these relationships were moderated by gender. The prevalence of young adult homelessness was highest at age 21 (6.5%), declining at ages 23 (3.9%) and 25 years (2.5%). Results showed that young adult homelessness, antisocial behaviour and victimisation were related cross‐sectionally, but not longitudinally. Gender did not significantly moderate these associations. Findings suggest that the state of homelessness is associated with temporary vulnerability to potentially harmful and problematic situations involving antisocial behaviour and victimisation. These situations are likely to heighten risk for contact with the police and direct physical and psychological harm.

Background: Self-harm (defined here as an act of intentionally causing harm to own self, irrespective of the type, motive or suicidal intent) is one of the strongest antecedents of suicide in youth. While there have been a number of studies of youth self-harm in low- and middle-income countries (LMICs), there is currently no systematic review of studies of prevalence rates and risk and protective factors. Aim: To systematically review the evidence relating to the prevalence rates and forms of self-harm in youth in LMICs and its relationship to family economic status, family functioning, relationship with the peer group, social relationships and academic performance. Methods: Electronic searches of three databases, MEDLINE, PsycINFO and Scopus, were performed. In total, 27 school-, community- and hospital-based studies evaluating self-harm in LMICs with youth focus (with participants between 12 and 25 years) were included. Results: The self-harm was divided into suicidal and non-suicidal depending on the nature of self-harm. The 12-month prevalence rates of non-suicidal self-harm varied from 15.5% to 31.3%, and the range of suicidal behaviour rates was from 3.2% to 4.7%. Banging and hitting were the most common in the community-based studies, followed by cutting, scratching and wound picking. Self-poisoning with pesticides was most commonly reported in hospital-based studies. Risk factors for self-harm were family conflict, peer groups with members indulging in self-harm, truancy and school absenteeism. Protective factors were having an understanding family, having friends and higher school competence. Risk factors for suicidal thoughts and attempts were lack of close friends and history of suicide by a friend. Conclusion: The 12-month prevalence rates of youth self-harm in LMICs are comparable to high-income countries (HICs). The profile of risk and protective factors suggests that family-based interventions could be useful in treatment and prevention. Future studies should aim for greater consistency in assessment methods and the constructs under evaluation.

About the Series From its inception, the Disease Control Priorities series has focused attention on delivering efficacious health interventions that can result in dramatic reductions in mortality and disability at relatively modest cost. The approach has been multidisciplinary, and the recommendations have been evidence-based, scalable, and adaptable in multiple settings. Better and more equitable health care is the shared responsibility of governments and international agencies, public and private sectors, and societies and individuals, and all of these partners have been involved in the development of the series. Disease Control Priorities, third edition (DCP3) builds upon the foundation and analyses of the first and second editions of Disease Control Priorities (DCP1 and DCP2) to further inform program design and resource allocation at global and country levels by providing an up-to-date comprehensive review of the effectiveness of priority health interventions. In addition, DCP3 presents systematic and comparable economic evaluations of selected interventions, packages, delivery platforms, and policies based on newly developed economic methods. DCP3 presents its findings in nine individual volumes addressed to specific audiences. The volumes are structured around packages of conceptually related interventions, including those for maternal and child health, cardiovascular disease, infectious disease, and surgery. The volumes of DCP3 will constitute an essential resource for countries as they consider how best to improve health care, as well as for the global health policy community, technical specialists, and students.

Background Little is known about the long-term psychosocial outcomes associated with self-harm during adolescence. We aimed to determine whether adolescents who self-harm are at increased risk of adverse psychosocial outcomes in the fourth decade of life, using data from the Victorian Adolescent Health Cohort Study. Methods We recruited a stratified, random sample of 1943 adolescents from 44 schools across the state of Victoria, Australia. The study started on Aug 20, 1992, and finished on March 4, 2014. We obtained data relating to self-harm from questionnaires and telephone interviews at eight waves of follow-up, commencing at mean age 15·9 years (SD 0·5; waves 3–6 during adolescence, 6 months apart) and ending at mean age 35·1 years (SD 0·6; wave 10). The outcome measures at age 35 years were social disadvantage (divorced or separated, not in a relationship, not earning money, receipt of government welfare, and experiencing financial hardship), common mental disorders such as depression and anxiety, and substance use. We assessed the associations between self-harm during adolescence and the outcome measures at 35 years (wave 10) using logistic regression models, with progressive adjustment: (1) adjustment for sex and age; (2) further adjustment for background social factors; (3) additional adjustment for common mental disorder in adolescence; and (4) final additional adjustment for adolescent antisocial behaviour and substance use measures. Findings From the total cohort of 1943 participants, 1802 participants were assessed for self-harm during adolescence (between waves 3 and 6). Of these, 1671 were included in the analysis sample. 135 (8%) reported having self-harmed at least once during adolescence. At 35 years (wave 10), mental health problems, daily tobacco smoking, illicit drug use, and dependence were all more common in participants who had reported self-harm during the adolescent phase of the study (n=135) than in those who had not (n=1536): for social disadvantage odds ratios [ORs] ranged from 1·34 (95% CI 1·25–1·43) for unemployment to 1·88 (1·78–1·98) for financial hardship; for mental health they ranged from 1·61 (1·51–1·72) for depression to 1·92 (1·79–2·04) for anxiety; for illicit drug use they ranged from 1·36 (1·25–1·49) for any amphetamine use to 3·39 (3·12–3·67) for weekly cannabis use; for dependence syndrome they were 1·72 (1·57–1·87) for nicotine dependence, 2·67 (2·38–2·99) for cannabis dependence, and 1·74 (1·62–1·86) for any dependence; and the OR for daily smoking was 2·00 (1·89–2·12). Adjustment for socio-demographic factors made little difference to these associations but a further adjustment for adolescent common mental disorders substantially attenuated most associations, with the exception of daily tobacco smoking (adjusted OR 1·74, 95% CI 1·08–2·81), any illicit drug use (1·72, 1·07–2·79) and weekly cannabis use (3·18, 1·58–6·42). Further adjustment for adolescent risky substance use and antisocial behaviour attenuated the remaining associations, with the exception of weekly cannabis use at age 35 years, which remained independently associated with self-harm during adolescence (2·27, 1·09–4·69). Interpretation Adolescents who self-harm are more likely to experience a wide range of psychosocial problems later in life. With the notable exception of heavy cannabis use, these problems appear to be largely accounted for by concurrent adolescent mental health disorders and substance use. Complex interventions addressing the domains of mental state, behaviour, and substance use are likely to be most successful in helping this susceptible group adjust to adult life.

Housing insecurity is concerning at any age, but the prevalence and predictors of young adult housing insecurity are poorly described. Multivariable regression analyses using cross-national longitudinal data from a population-based sample tested prospective associations between various adolescent predictors and young adult housing insecurity. Participants from Washington State (United States) and Victoria (Australia) were surveyed at ages 13, 14 and 15 (2002–2004) and 25 and 29 years (2014–15, 2018–19; N = 1945; 46% female). The prevalence of housing insecurity was 9%. Multivariable predictors of housing insecurity included living in Washington State, antisocial behavior, a history of school suspension, and academic underachievement. School suspension was more strongly related to insecure housing in Washington State than in Victoria. Future analyses should explore state policy differences and risk and protective processes within social-ecological contexts to identify population-level modifiable upstream risk factors for housing insecurity that can be targeted earlier in the life course.

BACKGROUND: Schools can play an important role in health promotion by improving students' health literacy, attitudes, health-related behaviours, social connection and self-efficacy. These interventions can be particularly valuable in low- and middle-income countries with low health literacy and high burden of disease. However, the existing literature provides poor guidance for the implementation of school-based interventions in low-resource settings. This paper describes the development and pilot testing of a multicomponent school-based health promotion intervention for adolescents in 75 government-run secondary schools in Bihar, India. METHOD: The intervention was developed in three stages: evidence review of the content and delivery of effective school health interventions; formative research to contextualize the proposed content and delivery, involving intervention development workshops with experts, teachers and students and content analysis of intervention manuals; and pilot testing in situ to optimize its feasibility and acceptability. RESULTS: The three-stage process defined the intervention elements, refining their content and format of delivery. This intervention focused on promoting social skills among adolescents, engaging adolescents in school decision making, providing factual information, and enhancing their problem-solving skills. Specific intervention strategies were delivered at three levels (whole school, student group, and individual counselling) by either a trained teacher or a lay counsellor. The pilot study, in 50 schools, demonstrated generally good acceptability and feasibility of the intervention, though the coverage of intervention activities was lower in the teacher delivery schools due to competing teaching commitments, the participation of male students was lower than that of females, and one school dropped out because of concerns regarding the reproductive and sexual health content of the intervention. CONCLUSION: This SEHER approach provides a framework for adolescent health promotion in secondary schools in low-resource settings. We are now using a cluster-randomized trial to evaluate its effectiveness and cost-effectiveness.