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Sullivan KS, Richardson S, Ross A, Cederbaum JA, Pflieger J, Abramovitz L, Bukowinski A, Stander V. Pre- and Perinatal Risk Factors for Child Maltreatment in Military Families Across the First Two Years of Life. CHILD MALTREATMENT 2023; 28:209-220. [PMID: 35427204 DOI: 10.1177/10775595221088198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Military families are exposed to a unique constellation of risk factors, which may impact maltreatment outcomes. The present study examined prospective relationships between demographic, health, birth-related, and military-specific risk factors identified prior to a child's birth on their risk for maltreatment in the first two years of life. Data from the Millennium Cohort Study, Department of Defense (DoD) operational records and Family Advocacy Program data on met-criteria maltreatment, and Birth and Infant Health Research program data on suspected maltreatment were linked for 9076 service member parents. Discrete time survival analysis showed that preterm birth increased risk of maltreatment while parents' older age, physical health, and service in the Navy or Air Force decreased risk. Building on DoD's New Parent Support Program, findings suggest the need for universal and targeted prevention efforts, beginning during pregnancy, which limit or eliminate risk factors for maltreatment in military families.
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Affiliation(s)
| | - Sabrina Richardson
- Leidos, Inc., San Diego, CA, USA
- Center for Deployment Health Research, 115252Naval Health Research Center, San Diego, CA, USA
| | - Abigail Ross
- Graduate School of Social Service, 5923Fordham University, New York, NY, USA
| | - Julie A Cederbaum
- Suzanne Dworak-Peck School of Social Work, 5116University of Southern California, Los Angeles, CA, USA
| | - Jacqueline Pflieger
- Leidos, Inc., San Diego, CA, USA
- Center for Deployment Health Research, 115252Naval Health Research Center, San Diego, CA, USA
| | - Lisa Abramovitz
- Leidos, Inc., San Diego, CA, USA
- Center for Deployment Health Research, 115252Naval Health Research Center, San Diego, CA, USA
| | - Anna Bukowinski
- Leidos, Inc., San Diego, CA, USA
- Center for Deployment Health Research, 115252Naval Health Research Center, San Diego, CA, USA
| | - Valerie Stander
- Center for Deployment Health Research, 115252Naval Health Research Center, San Diego, CA, USA
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Turner N, Deng C, Granger S, Wingate TG, Shafqat R, Dueck PM. Young workers and safety: A critical review and future research agenda. JOURNAL OF SAFETY RESEARCH 2022; 83:79-95. [PMID: 36481039 DOI: 10.1016/j.jsr.2022.08.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 12/31/2021] [Accepted: 08/08/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Research on young worker safety often relies on inconsistent definitions of young workers and poorly delineated indicators of occupational safety. This review aims to reconcile these fundamental issues by critically integrating research across disciplines and providing clear directions for future research on young worker safety. METHOD We critically review the extant research on young worker safety. RESULTS We first reconcile the inconsistent definitions of young workers and specify the indicators of occupational safety used in young worker safety research. We next describe the prevalence of workplace injuries and population-level predictors of these injuries among young workers and then outline other factors that increase young workers' susceptibility to workplace injuries. Finally, we discuss the convergence of many of these issues on family farms-a context commonly studied in young worker safety research. CONCLUSIONS Clearer definitions of young workers and indicators of occupational safety can improve the interpretation and comparability of extant research findings. Furthermore, the prevalence of workplace injuries and population-level predictors of injury among young workers are subject to the interactions among age, gender, minority status, and job characteristics. Other factors that increase young workers' susceptibility to injury include young workers' responses to hazardous work, individual differences stemming from young workers' biological and psychological development, managerial attitudes about young workers, and the limited safety training young workers are thus provided, the types of work that young workers typically perform, and the range of social influences on young workers. PRACTICAL APPLICATIONS Safety campaigns and safety training should consider interactions among young workers' age, gender, minority status, and job characteristics, rather than considering these features independently.
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Affiliation(s)
- Nick Turner
- Haskayne School of Business, University of Calgary, Canada.
| | - Connie Deng
- Haskayne School of Business, University of Calgary, Canada
| | - Steve Granger
- Haskayne School of Business, University of Calgary, Canada
| | - Timothy G Wingate
- Haskayne School of Business, University of Calgary, Canada; Department of Psychology, University of Calgary, Canada
| | - Rabeel Shafqat
- Haskayne School of Business, University of Calgary, Canada
| | - Paul M Dueck
- Asper School of Business, University of Manitoba, Canada
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Brickell TA, French LM, Wright MM, Lange RT. Aggression in Military Members With Mild Traumatic Brain Injury and Post-Traumatic Stress Disorder Is Associated With Intimate Partner Health-Related Quality of Life. Womens Health Issues 2022; 32:526-533. [PMID: 35643836 DOI: 10.1016/j.whi.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 02/08/2022] [Accepted: 04/11/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVE We aimed to examine the relationship between service member/veteran (SMV) aggression and health-related quality of life (HRQOL) in their intimate partners. METHODS This prospective cohort study included 201 female intimate partner caregivers of post-9/11 male SMVs with a diagnosis of uncomplicated mild traumatic brain injury and post-traumatic stress disorder from a military treatment facility. Caregivers completed 17 HRQOL measures and rated the level the SMV experiences problems with verbal or physical expressions of irritability, anger, or aggression on the Mayo-Portland Adaptability Inventory, 4th edition. Caregivers were classified into three SMV Aggression groups: i) none or very mild (n = 53); ii) mild (n = 47); and iii) moderate or severe (n = 101). HRQOL scores were classified as clinically elevated using a cutoff of 60T or higher. RESULTS Using χ2 analysis, the moderate or severe group had a significantly higher proportion of clinically elevated scores on 15 HRQOL measures compared with the none or very mild group, and six measures compared with the mild group. The mild group had higher scores on two measures compared with the none or very mild group. Using analysis of covariance (and controlling for caregiver strain), the moderate or severe group had significantly higher scores on 11 HRQOL measures compared with the none or very mild group, and two measures compared with the mild group. The mild group had higher scores on five measures compared with the none or very mild group. CONCLUSIONS Many caregivers who report moderate to severe SMV aggression after a traumatic brain injury, report poor HRQOL beyond the strain of care provision. Traumatic brain injury and post-traumatic stress disorder programs should screen for and treat SMV aggression, and attend to the health needs of their caregivers.
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Affiliation(s)
- Tracey A Brickell
- Department of Research, Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland; Department of Research, National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland; F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland; Department of Research, General Dynamics Information Technology, Silver Spring, Maryland.
| | - Louis M French
- Department of Research, Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland; Department of Research, National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland; F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Megan M Wright
- Department of Research, Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland; Department of Research, National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland; Department of Research, General Dynamics Information Technology, Silver Spring, Maryland
| | - Rael T Lange
- Department of Research, Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland; Department of Research, National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland; Department of Research, General Dynamics Information Technology, Silver Spring, Maryland; Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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Short P, Burklow CS, Nylund CM, Susi A, Hisle-Gorman E. Impact of Parental Illness and Injury on Pediatric Disorders of Gut-Brain Interaction. J Pediatr 2021; 236:148-156.e3. [PMID: 33991543 DOI: 10.1016/j.jpeds.2021.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 04/02/2021] [Accepted: 05/07/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate the relationship between parental injury and illness and disorders of gut-brain interaction (DGBI) in children. STUDY DESIGN A self-controlled case series using data from the Military Health System Data Repository compared International Classification of Diseases, Ninth Revision-identified DGBI-related outpatient visits and prescriptions in 442 651 children aged 3-16 years in the 2 years before and the 2 years after the injury and/or illness of their military parent. Negative binomial regression was used to compare visit rates for constipation, fecal incontinence, abdominal pain, irritable bowel syndrome, and a composite of these before and after parental injury and/or illness. Logistic regression, clustered by child, compared the odds of stooling agent and antispasmodic prescription before and after parental injury and/or illness. RESULTS In the 2 years following parental injury and/or illness, children had increased visits for DGBIs (adjusted incidence rate ratio [aIRR] 1.09; 95% CI 1.07-1.10), constipation (aIRR 1.07; 95% CI 1.04-1.10), abdominal pain (aIRR 1.09; 95% CI 1.07-1.12), and irritable bowel syndrome (aIRR 1.37; 95% CI 1.19-1.58). Following parental injury and/or illness, the odds of stooling agent prescription decreased (aOR 0.95; 95% CI 0.93-0.97) and the odds of antispasmodic prescription increased (aOR 1.26; 95% CI 1.18-1.36). CONCLUSIONS Parental injury and/or illness is associated with increased healthcare use for DGBIs. Parental health should be considered by clinicians when assessing DGBIs, counseling patients, and formulating treatment plans.
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Affiliation(s)
- Patrick Short
- Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, MD; Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Carolyn Sullivan Burklow
- Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, MD; Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Cade M Nylund
- Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, MD; Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Apryl Susi
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Elizabeth Hisle-Gorman
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD
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Ahmed S, Gorman GH, Susi A, Robertson BD, Collen JF, Hisle-Gorman EJ. Impact of parental injury on adolescent sleep. J Clin Sleep Med 2021; 16:1437-1444. [PMID: 32336323 DOI: 10.5664/jcsm.8514] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES The aim of this study was to determine the impact of serious parental injury on adolescent sleep disorder diagnoses, outpatient care, and medication use. METHODS U.S. military personnel who sustained a serious injury and were parents of adolescents aged 10-18 years were identified. Included adolescents were enrolled in the Military Health System for 2 years before their parent's injury and 2 years after the injury. We used logistic regression clustered by adolescents to compare the odds of having a sleep diagnosis and negative binomial regression analysis clustered by adolescents to compare outpatient sleep disorder visits and sleep medication days before and after parental injury. RESULTS There were 96,318 parents seriously injured during 2004-2014 who had 117,577 children aged 10-18 years in 2002-2016. Approximately 2% of adolescents had a sleep disorder diagnosis, both before and after their parent's injury or illness. Outpatient sleep disorder visits increased 36% after a parent's injury (incidence rate ratio 1.36 [1.24-1.50]), with a twofold increase in insomnia visits (incidence rate ratio 2.35 [2.08-2.64]). Increases in sleep visits were most pronounced in adolescents of parents with traumatic brain injury, comorbid traumatic brain injury and posttraumatic stress disorder, battle injury, and those who were medically discharged from the military. The number of adolescents using sleep medications increased, but sleep medication days did not increase. CONCLUSIONS Adolescents in our study used more outpatient medical care for sleep disorders; sleep medication use increased after parental injury. Sleep disorders should be considered in the care of adolescents with injured parents.
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Affiliation(s)
- Saira Ahmed
- Division of Adolescent Medicine, Department of Pediatrics, Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, Texas
| | | | - Apryl Susi
- Department of Pediatrics, Uniformed Services University, Bethesda, Maryland
| | - Brian D Robertson
- Department of Pulmonary, Critical Care and Sleep Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Jacob F Collen
- Department of Pulmonary, Critical Care and Sleep Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland.,Department of Medicine, Uniformed Services University, Bethesda, Maryland
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Turner N, Granger S, Tucker S, Deng C, Kelloway EK. Parents' work injuries and children's mental health: The moderating role of children's work centrality. JOURNAL OF SAFETY RESEARCH 2021; 77:61-66. [PMID: 34092329 DOI: 10.1016/j.jsr.2021.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 09/17/2020] [Accepted: 02/03/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION The purpose of this study is to explore the relationship between parents' work-related injuries and their children's mental health, and whether children's work centrality - the extent to which a child believes work will play an important part in their life - exacerbates or buffers this relationship. METHOD We argue that high work centrality can exacerbate the relationship between parental work injuries and children's mental health, with parental work injuries acting as identity-threatening stressors; in contrast, high work centrality may buffer this relationship, with parental work injuries acting as identity-confirming stressors. We test this relationship with a sample of Canadian children (N = 4,884, 46.2% female, M age = 13.67 years). RESULTS Children whose parents had experienced more frequent lost-time work-related injuries reported worse mental health with high work centrality buffering this negative relationship. CONCLUSIONS Our study highlights the vicarious effects of work injuries on salient others, specifically parental work injuries on children's mental health, as well as the role of work centrality in shaping children's sense-making and expectations about the consequences of work.
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Hisle-Gorman E, Susi A. The Impact of Parental Injury on Children's Mental Health Diagnoses and Classes of Psychotropic Medication by Child Age. Mil Med 2021; 186:222-229. [PMID: 33499532 DOI: 10.1093/milmed/usaa466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 09/21/2020] [Accepted: 10/23/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Civilian and military research has linked parental illness and injury with increased overall mental health care and psychiatric medication use in children. Care for specific mental health conditions and medications by child age have not been reported. OBJECTIVE We sought to quantify the effect of parental illness and injury on child mental health care and psychiatric medication use in children overall and stratified by age. METHODS A self-controlled case series analyzed the impact of parental illness/injury on mental health and psychiatric medication use of military dependent children. Children were aged 2-16 years (51% male) when their parents were injured and received care in the Military Health System for 2 years before and 2 years after their parent's illness/injury. We used International Classification of Diseases 9th edition codes to identify outpatient mental healthcare visits. Outpatient care for 14 specific mental health diagnoses was classified using the Agency for Healthcare Research and Quality clinical classification system. Outpatient pharmacy records identified psychiatric medication prescriptions by therapeutic class. Parental illness/injury was identified by inclusion in the Military Health System Ill, Injured, and Wounded Warrior database. Adjusted negative binomial regression analysis compared rates of outpatient visits and medication days in the 2 years following parental illness/injury to the 2 years before the parent's illness/injury overall. Secondary analyses were stratified by age groups of 2-5 years (n = 158,620), 6-12 years (n = 239,614), and 13-16 years n = 86,768) and adjusted for parental pre-injury/illness deployment and child sex. Additional secondary analysis compared post-parental injury/illness care of children whose parents had post-traumatic stress disorder or traumatic brain injury to children of parents with physical/mental health injury/illness. RESULTS There were 485,002 children of 272,211 parents injured during the study period. After adjustment for child sex, years of pre-injury/illness parental deployment, and child age, parental illness/injury was associated with increased mental visits across all categories of care except developmental diagnoses. Post-parental injury visits for suicidal ideation, alcohol abuse, mood, and anxiety disorders were all doubled. For children aged 2-5 years at parental illness/injury, the largest increases in care were in psychotic, anxiety, attention deficit, and mood disorders. In children aged 6-12 years, the largest increases were in psychotic conditions, suicidal ideation, and personality disorders. In adolescents aged 13-16 years, the largest increases were for alcohol and substance abuse disorders, with visits increasing by 4-5 times. For children of all ages, parental injury was associated with increased use of all therapeutic classes of psychiatric medications; use of stimulant medications was increased in younger children and decreased in older children following parental injury (P < .001). CONCLUSION Parental illness/injury is associated with increased mental health care and days of psychiatric medication use in dependent children. Practitioners who care for families impacted by parental illness/injury should be cognizant of children's mental health risk. Early identification and treatment of child-related mental health issues can improve family functioning and increase military family readiness.
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Affiliation(s)
| | - Apryl Susi
- Department of Pediatrics, Uniformed Services University, Bethesda, MD 20814, USA
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