Veteran-nonveteran differences in alcohol and drug misuse by tobacco use status in Alabama SBIRT

ABSTRACT

Alcohol and substance use can challenge military veterans who live in rural communities. In 2016, the screening, brief intervention, and referral to treatment in Alabama (AL-SBIRT) program was implemented in west Alabama. The primary aim of this study was to determine whether current tobacco use modified the relationship between veteran status and substance misuse. Self-reported wellness data was collected regarding substance, alcohol, or tobacco consumption. Risk levels for alcohol and drug use were measured using the United States Alcohol Use Disorders Identification Test (US-AUDIT) and the Drug Abuse Screening Test (DAST)-10. Substance and tobacco use were significantly and positively correlated. Veterans had a higher US-AUDIT and DAST score than nonveterans, and tobacco appeared to be an exacerbating factor. Effective evidence-based interventions are needed in rural settings. Technology based programs and motivational interviewing with trained clinicians may serve as beneficial and cost-effective interventions for tobacco use prevention and cessation efforts.     

From Hospital to Home with NDIS Funded Support: Examining Participant Pathway Timeframes Against Discharge Expectations

ABSTRACT

For patients with disability who require funded supports to leave hospital, the introduction of the National Disability Insurance Scheme (NDIS) represents opportunity and challenges. At a time of major reform, timely and supported discharge is reliant on overcoming interface complexities. The purpose of this study was to examine the NDIS participant pathway timeframes against discharge expectations for hospitalised adults with spinal cord injury (SCI) or acquired brain injury (ABI) and interrogate delays for the two groups. Administrative data on 54 participants (ABI?=?18 and SCI?=?36) were analysed. Both groups experienced delays to discharge and significant variability in timeframes between NDIS pathway processes and extent of delays. Group differences were identified regarding inefficiencies across the continuum, with type of support a factor to investigate further. This study has uncovered critical points in the NDIS pathway that could impact discharge of participants and where collaboration and adaptive strategies could be targeted to improve processes.

IMPLICATIONS

• Ensuring the National Disability Insurance Scheme (NDIS) pathway operates effectively in the hospital setting is critical to the timely discharge of people with complex needs who require funded supports.

• Monitoring implementation of the NDIS in the health setting is important to avert interface problems that impede timely discharge and access.

     

L’évolution démographique et l’automatisation,deux enjeux mondiaux pour l’avenir du travail

Les auteurs s'interrogent sur le nombre des emplois qu'il conviendra de créer demain pour répondre aux besoins engendrés par l'évolution démographique, économique et technologique. Ils font le calcul pour la période 2020-2030, en se fondant sur des projections de croissance démographique et de taux d'activité et en fixant des taux de chômage cibles. Les résultats sont ventilés par âge et par sexe. Les auteurs tiennent compte également de l'influence du niveau de revenu du pays et de l'automatisation. D'après leurs projections, les besoins de création d'emplois atteindront 340 millions en 2020-2030, et ils seront imputables à l'évolution démographique bien plus qu'à l'automatisation.     

Circular economy and the city: an urban political economy agenda

ABSTRACT

The circular economy (CE) has become a matter of urban development. A literature review shows that the CE debate is biased toward technology-driven industrial change, while bracketing broader socio-political interests. We address this gap by exploring the political economy of scale of the CE. Looking into the case of Brussels (Belgium), a city that has recently adopted the CE as part of its socio-economic strategy, we explore how the anticipated transition to a ‘circular city’ chimes with long-standing urban development agendas. While there is little evidence of stable growth coalitions between corporate and political elites, we argue that the CE provides an ‘urban sustainability fix’ by selectively incorporating ecological goals in urban governance strategies. We further scrutinise the landscape of diverse and heterogenous CE practices in food and transport, highlighting how they are regulated and organised, what labour conditions they offer, and how they are anchored in urban space.     

The Digital Divide: Couple and Family Therapy Programs’ Integration of Teletherapy Training and Education

The mental health field is increasingly integrating and growing a teletherapy presence, and couple and family therapists are uniquely situated to offer these services based on our history of innovative approaches to therapeutic services. To do so successfully, careful consideration of training and education must occur. To evaluate current teletherapy training and education opportunities of COAMFTE accredited couple, marriage, and family therapy programs, an inductive qualitative content analysis was conducted on the responses of 95 faculty at COAMFTE accredited programs. Findings indicate that more than two thirds of the participants were in favor of teletherapy integration in training programs; however, most programs currently do not offer such opportunities. Barriers that prevent such integration were highlighted as well as existing concerns to training graduate students in teletherapy. Implications for training programs, policies, and regulations are discussed.     

Oral health among student veterans: Effects on mental and physical health

Abstract

Objective: The purpose of this study was to explore differences in oral health among students by military service status in postsecondary settings. Participants: Secondary data were obtained from the American College Health Association’s 2011–2014 National College Health Assessment II. Method: Demographic characteristics of the study sample were explored by calculating frequencies and percentages by military service status. Research questions were explored with maximum likelihood multiple logistic regression. Results: Service member and veteran students are at greater risk for neglecting health behaviors associated with positive oral health, including that they were less likely to get dental exams and that those who deployed in the past were the least likely to be practicing good oral health. Conclusions: The results suggest that improving oral health will contribute to improving health and mental health outcomes in this population, and provide important information for health specialists working with service members and veterans on college campuses.     

Toward General Principles for Resilience Engineering

Maintaining the performance of infrastructure-dependent systems in the face of surprises and unknowable risks is a grand challenge. Addressing this issue requires a better understanding of enabling conditions or principles that promote system resilience in a universal way. In this study, a set of such principles is interpreted as a group of interrelated conditions or organizational qualities that, taken together, engender system resilience. The field of resilience engineering identifies basic system or organizational qualities (e.g., abilities for learning) that are associated with enhanced general resilience and has packaged them into a set of principles that should be fostered. However, supporting conditions that give rise to such first-order system qualities remain elusive in the field. An integrative understanding of how such conditions co-occur and fit together to bring about resilience, therefore, has been less clear. This article contributes to addressing this gap by identifying a potentially more comprehensive set of principles for building general resilience in infrastructure-dependent systems. In approaching this aim, we organize scattered notions from across the literature. To reflect the partly self-organizing nature of infrastructure-dependent systems, we compare and synthesize two lines of research on resilience: resilience engineering and social-ecological system resilience. Although some of the principles discussed within the two fields overlap, there are some nuanced differences. By comparing and synthesizing the knowledge developed in them, we recommend an updated set of resilience-enhancing principles for infrastructure-dependent systems. In addition to proposing an expanded list of principles, we illustrate how these principles can co-occur and their interdependencies.