Many military service members experience posttraumatic stress disorder (PTSD) and other mental health conditions following deployment; however, current methods for screening and identifying those at risk for developing mental health disorders are insufficient. The present study used archival, prospectively collected longitudinal data on risk factors to create a brief screening measure that could be used to proactively identify those most likely to develop longer-term PTSD and other mental health symptoms following deployment. Data were available for 512 military personnel, and the sample was randomly divided in half to create derivation and replication samples. Participants from all branches of the Armed Forces completed a mailed survey within 12 months of returning from deployment to Iraq or Afghanistan and were reassessed 6-9 months later. After identifying Time 1 risk factors that predicted elevated Time 2 PTSD in the derivation sample, items were trimmed to 16 that accounted for the most variance in PTSD scores. Using receiver operating characteristic curves, the most appropriate performance cut score for sufficient sensitivity and specificity was identified in the samples. Results revealed optimal performance using a cut score of ≥19, with higher sensitivity than specificity (.803 and .715), as expected for a screening measure. This 16-item Military Mental Health Risk Screen shows promise for accurately assessing post-deployment risk for PTSD and overall mental health symptoms in returning service members and guiding prevention and early intervention efforts.

OBJECTIVE:The aim of this scoping review is to map the concept of resilience and its measurement along with co-occurring theoretical constructs within nursing research using the COVID-19 pandemic as a critical date range for the current evidence. INTRODUCTION:Resilience has a wide variety of definitions in research literature and is often measured through its co-occurring theoretical constructs. Nurse resilience is a key element in interventions targeting nurse well-being and has been tied to burnout and mental health. Resilience is influential in workforce stabilization and impactful to nurse retention both within a facility and within the field of nursing. This is significant given the worldwide nursing shortage and attrition from the field. INCLUSION CRITERIA:This review will consider published and unpublished studies that investigate resilience and co-occurring theoretical constructs in nurses, excluding students. Studies published in English or Spanish will be considered for inclusion without restriction to setting or geographic location. All instruments that measure resilience will be considered for inclusion and mapped in conjunction with the co-occurring constructs. METHODS:Database searches from January 10, 2020, onwards will include CINAHL (EBSCOhost), MEDLINE (Ovid), Embase (Ovid), PsycINFO (Ovid), Scopus, and LILACS. Unpublished studies and gray literature will be searched in ProQuest Dissertations and Theses (ProQuest). The JBI methodology for scoping reviews will be followed. Extracted data will include publication details (authors, titles, year of publication), resilience measurement instruments, co-occurring theoretical constructs, participants, context, and concept. Extracted data will be presented in charts and tables supported by a narrative summary. REVIEW REGISTRATION:Open Science Framework https://osf.io/n2uge/.

Worldwide, gender equality remains a barrier for women seeking career advancement in corporations. Despite the globalization of corporate social responsibility programs, women have not achieved positional parity with men within the managerial hierarchy. The purpose of this integrative review was to investigate the breadth of the gendered organization literature, summarize the evidence, and inform future research about the career advancement of women in privately owned and publicly traded corporations. Twelve databases were searched between January 1990 and December 2023 for published evidence. Of the 1914 documents screened, 55 articles were included in this review. The gendered organization literature is slowly evolving as a critical area for management research even though fully developed substantive and formal theories are lacking. However, gendered organizations can be conceptualized for theoretical development as a constellation of metaphors embedded in the corporate culture. These metaphors include firewalls, glass ceilings, glass cliffs, glass escalators, labyrinths, queen bees and beehives, and sticky floors. Notably, few intervention studies were reported in the literature. Corporate social responsibility programs had a surprisingly limited impact on eliminating deep-seated structural attributes contributing to gendered organizations. Therefore, management scholars need to engage in theoretical development and research to advance a comprehensive theory of the gendered organization, and studies should investigate why the identified metaphors continue to adversely impact the career advancement of women despite the presence of corporate social responsibility programs. Finally, existing evidence needs to be translated into intervention recommendations for policymakers and corporate leaders.

Background Parkinson’s disease is a progressive neurodegenerative disorder. The majority of the nearly 9 million people living with Parkinson’s disease are men. As such, caregiving is often assumed by wives as the disease progresses. However, there is little research about the lived experience of wives as they transition to caregivers. Objective To describe the lived experience of wife caregivers of male spouses living at home with Parkinson’s disease. Methods A descriptive phenomenological study. Semi-structured interviews were recorded and transcribed for analysis in Atlas.ti using Colaizzi’s method. Results Thirteen women, aged 50 to 83 years, were interviewed. Five themes emerged from the analysis, (1) caregiver who? (2) taking it day by day, (3) not sure what to do next, (4) just too much, and (5) caring is your soul’s growth, to support the central theme “there is no cure for caregiving.” Conclusion Transitioning from wife to caregiver was a gradual but difficult process. Although the wife caregivers wanted to be part of the health care team, they remained outsiders. Clinicians need to recognize the wives as care coordinators linking medical management with home care. Policy makers need to develop reimbursement models that provide wife caregivers with support groups, education programs, and telemental health services.

ObjectivesDispositional mindfulness has been associated with lower posttraumatic stress disorder (PTSD) and other negative health symptoms in the police population. Of the various mindfulness facets (i.e., non-judging, observing, describing, acting with awareness), non-judging has been demonstrated to be the strongest predictor of lower PTSD symptoms in police academy cadets. The mechanisms by which non-judging may lead to enhanced health outcomes in police officers are poorly understood and require further investigation.MethodThe purpose of the current study was to test a model involving a pathway from pre-trauma mindful non-judging to PTSD symptoms and ultimately posttraumatic growth (PTG) that is mediated by worldviews in a sample of police academy cadets (n = 379). Data were collected via a survey packet distributed at a police academy located in a Southern state of the United States. We examined the relationships among demographic factors, adverse child events, negative life events, mindful non-judgment, world assumptions, PTSD, and PTG using path analysis.ResultsThe results indicated that positive worldviews served as a mediator between dispositional mindful non-judging and lower PTSD symptoms, which ultimately led to lower PTG.ConclusionsThese findings have important implications for the selection and training of police academy cadets with the goal of increasing resilience to occupational trauma exposure. Additionally, these results have clinical implications regarding the treatment of officers experiencing symptoms of PTSD.PreregistrationThis study is not preregistered.

Background Patients admitted to hospitals after emergency care for injury or acute illness are at risk for later mental health problems. The American College of Surgeons Committee on Trauma Standards for care of injured patients call for mental health risk screening, and the Hospital Mental Health Risk Screen (HMHRS) accurately identified at-risk patients in a developmental study that included patients from five ethnoracial groups. Replication of these findings is essential, because initial positive results for predictive screens can fail to replicate if the items were strongly related to outcomes in the development sample but not in a new sample from the population the screen was intended for. Study design Replication of the predictive performance of the 10-item HMHRS was studied prospectively in ethnoracially diverse patients admitted after emergency care for acute illness or injury in three hospitals across the U.S. Results Risk screen scores and follow-up mental health outcomes were obtained for 452 of 631 patients enrolled (72%). A cut score of 10 on the HMHRS correctly identified 79% of the patients who reported elevated levels of depression, anxiety, and PTSD symptoms two months post-admission (sensitivity) and 72% of the patients whose symptoms were not elevated (specificity). HMHRS scores also predicted well for patients with acute illness, for patients with injuries, and for patients who reported an Asian American/Pacific Islander, Black, Latinx, Multirace, or White identity. Conclusions Predictive performance of the HMHRS was strong overall and within all five ethnoracial subgroups. Routine screening could reduce suffering and health care costs, increase health and mental health equity, and foster preventive care research and implementation. The performance of the HMHRS should be studied in other countries and in other populations of recent trauma survivors, such as survivors of disaster or mass violence.

Objective:This scoping review aims to identify, catalogue, and characterize previously reported tools, techniques, methods, and processes that have been recommended or used by evidence synthesizers to detect fraudulent or erroneous data and mitigate its impact.Introduction:Decision-making for policy and practice should always be underpinned by the best available evidence-typically peer-reviewed scientific literature. Evidence synthesis literature should be collated and organized using the appropriate evidence synthesis methodology, best exemplified by the role systematic reviews play in evidence-based health care. However, with the rise of "predatory journals," fraudulent or erroneous data may be invading this literature, which may negatively affect evidence syntheses that use this data. This, in turn, may compromise decision-making processes.Inclusion criteria:This review will include peer-reviewed articles, commentaries, books, and editorials that describe at least 1 tool, technique, method, or process with the explicit purpose of identifying or mitigating the impact of fraudulent or erroneous data for any evidence synthesis, in any topic area. Manuals, handbooks, and guidance from major organizations, universities, and libraries will also be considered.Methods:This review will be conducted using the JBI methodology for scoping reviews and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Databases and relevant organizational websites will be searched for eligible studies. Title and abstract, and, subsequently, full-text screening will be conducted in duplicate. Data from identified full texts will be extracted using a pre-determined checklist, while the findings will be summarized descriptively and presented in tables.Review registration:Open Science Framework https://osf.io/u8yrn

Introduction: Globalization has increased the importance of multicultural research to address health disparities and improve healthcare outcomes for underrepresented communities. The International Nursing Network for HIV Research (The Network) serves as a platform for researchers to collaborate on cross-cultural and cross-national HIV studies. This article discusses the Network's approach to overcoming barriers in multicultural and multinational research in a qualitative context.Methods: The network created a protocol to guide decision-making throughout the translation process of qualitative data collected from participants in their native languages. The protocol includes aspects of why, when, what, who, how, where, and by what means the translation is completed.Results: The protocol has allowed researchers to enhance the validity, reliability, and cultural sensitivity of translation process, ensuring the clarity and impact of their research findings.Discussion: Rigorous translation practices promote cross-cultural understanding and respect for participants' perspectives, fostering global collaborations and knowledge exchange.

Distress tolerance, or the perceived ability to tolerate negative emotional states, is often associated with posttraumatic stress disorder (PTSD) such that higher distress tolerance is generally associated with less severe PTSD symptom levels. As distress tolerance is often considered a risk and maintenance factor in distress disorders, examining the association between changes in distress tolerance and changes in PTSD symptoms may have clinical relevance. The present study examined the associations between PTSD symptom severity and distress tolerance across three assessment points over 12 weeks among 212 patients receiving outpatient psychotherapy services. Using random-intercept cross-lagged panel modeling (RI-CLPM), concurrent and prospective associations between PTSD and distress tolerance were examined. PTSD symptoms at Time 1 and Time 2 significantly predicted distress tolerance at Time 2, β = -.296, and Time 3, β = -.395, respectively. Distress tolerance did not predict subsequent PTSD symptom severity. Exploratory analyses examined distress tolerance and four PTSD symptom clusters over time. Patterns of results differed across clusters, though it was consistent that only PTSD symptom clusters predicted subsequent distress tolerance and not vice versa. The results support the interrelationship of changes in psychopathology and emotional distress tolerance and indicate that distress tolerance may be an important factor in symptom remission during PTSD treatment.

Abstract As the COVID-19 pandemic spread across the world, immunocompromised individuals such as people with HIV (PWH) may have faced a disproportionate impact on their health and HIV outcomes, both from COVID-19 and from the strategies enacted to contain it. Based on the SPIRIT guidelines, we describe the protocol for an international multisite observational study being conducted by The International Nursing Network for HIV Research, with the Coordinating Center based at the University of California, San Francisco (UCSF) School of Nursing. Site Principal Investigators implement a standardized protocol to recruit PWH to complete the study online or in-person. Questions address demographics; HIV continuum of care indicators; mental and social health; COVID-19 and vaccination knowledge, attitudes, behaviors, and fears; and overall outcomes. Results of this study will contribute to knowledge that can inform responses to future public health crises to minimize their impacts on vulnerable populations such as PWH.

BACKGROUND: Patients hospitalized after emergency care are at risk for later mental health problems such as depression, anxiety, and posttraumatic stress disorder symptoms. The American College of Surgeons Committee on Trauma standards for verification require Level I and II trauma centers to screen patients at high risk for mental health problems. This study aimed to develop and examine the performance of a novel mental health risk screen for hospitalized patients based on samples that reflect the diversity of the US population. STUDY DESIGN: We studied patients admitted after emergency care to 3 hospitals that serve ethnically, racially, and socioeconomically diverse populations. We assessed risk factors during hospitalization and mental health symptoms at follow-up. We conducted analyses to identify the most predictive risk factors, selected items to assess each risk, and determined the fewest items needed to predict mental health symptoms at follow-up. Analyses were conducted for the entire sample and within 5 ethnic and racial subgroups. RESULTS: Among 1,320 patients, 10 items accurately identified 75% of patients who later had elevated levels of mental health symptoms and 71% of those who did not. Screen performance was good to excellent within each of the ethnic and racial groups studied. CONCLUSIONs: The Hospital Mental Health Risk Screen accurately predicted mental health outcomes overall and within ethnic and racial subgroups. If performance is replicated in a new sample, the screen could be used to screen patients hospitalized after emergency care for mental health risk. Routine screening could increase health and mental health equity and foster preventive care research and implementation.

The third annual Health Watch USA(sm) webinar conference assembled 16 speakers from 4 continents who shared information regarding frontline worker safety in the age of COVID-19. The U.S. Bureau of Labor Statistics reported a nearly 4000% increase in workplace illness in 2020 compared with 2019. It is estimated that 2% of the U.S. workforce is not working because of long COVID. In addition, the impact is growing with each surge. After the acute illness, patients are often described as recovered, when in fact many have only survived and are coping with the multisystem impacts of long COVID. Long COVID, including its late cognitive, cardiovascular, embolic, and diabetic complications, disproportionately impacts frontline workers, many of whom are of lower socioeconomic status and represented by ethnic minorities.Natural infection and current vaccines do not provide durable protection for reinfection. Herd immunity is not possible at this time. Although SARS-CoV-2 is unlikely to be eliminated, decreasing spread is imperative to slow the rate of mutations, decrease the number of reinfections, and lower the chances of developing long COVID. The primary mode of spread is through aerosolization. Both routine breathing and talking aerosolizes the virus. With the extremely high infectivity of SARS-CoV-2, it is unlikely that central building ventilation alone will be enough to satisfactorily mitigate spread. Additional safe active air cleaning technology, such as upper-room germicidal UV-C lighting, needs to be deployed.Misinformation and disinformation have inhibited response effectiveness. Examples include downplaying the benefit of well-fitted masks and the risks that COVID-19 and long COVID pose to children, along with believing children cannot spread the disease. The engagement of local community leaders is essential to educate the community and drive social change to accept vaccinations and other public health interventions. Vaccinations and natural immunity alone are unlikely to adequately prevent community spread and do not provide durable protection against the risk of long COVID.Frontline workers must keep their immunity as high as possible and work in settings with clean air, along with wearing N95 masks when they are in contact with the public. Finally, there needs to be a financial safety net for frontline workers and their families in the event of incapacitation or death from COVID-19.

Background Racial/ethnic differences in mental health outcomes after a traumatic event have been reported. Less is known about factors that explain these differences. We examined whether pre-, peri-, and post-trauma risk factors explained racial/ethnic differences in acute and longer-term posttraumatic stress disorder (PTSD), depression, and anxiety symptoms in patients hospitalized following traumatic injury or illness. Methods PTSD, depression, and anxiety symptoms were assessed during hospitalization and 2 and 6 months later among 1310 adult patients (6.95% Asian, 14.96% Latinx, 23.66% Black, 4.58% multiracial, and 49.85% White). Individual growth curve models examined racial/ethnic differences in PTSD, depression, and anxiety symptoms at each time point and in their rate of change over time, and whether pre-, peri-, and post-trauma risk factors explained these differences. Results Latinx, Black, and multiracial patients had higher acute PTSD symptoms than White patients, which remained higher 2 and 6 months post-hospitalization for Black and multiracial patients. PTSD symptoms were also found to improve faster among Latinx than White patients. Risk factors accounted for most racial/ethnic differences, although Latinx patients showed lower 6-month PTSD symptoms and Black patients lower acute and 2-month depression and anxiety symptoms after accounting for risk factors. Everyday discrimination, financial stress, past mental health problems, and social constraints were related to these differences. Conclusion Racial/ethnic differences in risk factors explained most differences in acute and longer-term PTSD, depression, and anxiety symptoms. Understanding how these risk factors relate to posttraumatic symptoms could help reduce disparities by facilitating early identification of patients at risk for mental health problems.

BACKGROUND:High rates of mental health symptoms such as depression, anxiety, and posttraumatic stress disorder (PTSD) have been found in patients hospitalized with traumatic injuries, but little is known about these problems in patients hospitalized with acute illnesses. A similarly high prevalence of mental health problems in patients hospitalized with acute illness would have significant public health implications because acute illness and injury are both common, and mental health problems of depression, anxiety, and PTSD are highly debilitating. METHODS AND FINDINGS:In patients admitted after emergency care for Acute Illness (N = 656) or Injury (N = 661) to three hospitals across the United States, symptoms of depression, anxiety, and posttraumatic stress were compared acutely (Acute Stress Disorder) and two months post-admission (PTSD). Patients were ethnically/racially diverse and 54% female. No differences were found between the Acute Illness and Injury groups in levels of any symptoms acutely or two months post-admission. At two months post-admission, at least one symptom type was elevated for 37% of the Acute Illness group and 39% of the Injury group. Within racial/ethnic groups, PTSD symptoms were higher in Black patients with injuries than for Black patients with acute illness. A disproportionate number of Black patients had been assaulted. CONCLUSIONS:This study found comparable levels of mental health sequelae in patients hospitalized after emergency care for acute illness as in patients hospitalized after emergency care for injury. Findings of significantly higher symptoms and interpersonal violence injuries in Black patients with injury suggest that there may be important and actionable differences in mental health sequelae across ethnic/racial identities and/or mechanisms of injury or illness. Routine screening for mental health risk for all patients admitted after emergency care could foster preventive care and reduce ethnic/racial disparities in mental health responses to acute illness or injury.

Medical laboratory professionals (MLPs) perform clinical diagnostic testing on human specimens. Due to the COVID-19 pandemic, MLPs were at risk for viral exposure due to occupational hazards. As MLPs typically work behind the scenes, hidden in hospital laboratories, their needs are often overlooked by management. This phenomenological study describes the lived experience of MLPs working in hospital laboratories during the COVID-19 pandemic. MLPs were purposively recruited from hospitals in the Middle Atlantic and Midwestern regions of the United States. Semi-structured interviews were conducted via Zoom until saturation was achieved with 12 participants. Data were analyzed using Colaizzi’s (1978) seven-step method in Atlas.ti. The central theme “nobody cares about us” emerged from the 232 codes organized into 16 subthemes and consolidated into five themes. The themes included: (1) Who is responsible for our safety? (2) What is causing our fear? (3) Why work so much? (4) Where are our managers? and, (5) Where is our emergency plan? This study provides the first known qualitative findings to describe the unique experiences of MLPs working in hospital laboratories during the COVID-19 pandemic. Unmitigated occupational hazards and unresponsive management resulted in increased fear and viral exposure in laboratories. Misinformation from social and broadcast medias and inadequate hospital communication increased anxiety and concerns. Deficiencies in hospital disaster response plans may have resulted from inadequate review by accreditors and poor regulatory oversight. The findings provide an opportunity for professional organizations to take a proactive role in improving laboratory safety.

The research study protocol is a roadmap for conducting research systematically, efficiently, and ethically. While protocols have standard components, a classic grounded theory protocol differs in its methods, including processes and procedures, because of the uniqueness of the methodology. A classic grounded theory protocol commonly contains the following: (1) introduction to the topic; (2) purpose of the study with the research question; (3) detailed description of the research methods, including data collection and analysis; and (4) procedures to demonstrate the ethical conduct of human participant research. Based on a review of grounded theory methodological literature, the current article describes an approach for developing a research protocol that maintains grounded theory research integrity while adhering to institutional and funding requirements. A properly written study protocol is essential for maintaining methodological fi-delity, avoiding method slurring, and unintended remodeling in classic grounded theory.

The Dissociative Symptoms Scale (DSS) was developed to assess moderately severe types of dissociation (depersonalization, derealization, gaps in awareness and memory, and dissociative reexperiencing) that would be relevant to a range of clinical populations, including those experiencing trauma-related dissociation. The current study used data from 10 ethnically and racially diverse clinical and community samples ( N = 3,879) to develop a brief version of the DSS (DSS-B). Item information curves were examined to identify items with the most precision in measuring above average levels of the latent trait within each subscale. Analyses revealed that the DSS-B preserved the factor structure and content domains of the full scale, and its scores had strong reliability and validity that were comparable to those of scores on the full measure. DSS-B scores showed high levels of measurement invariance across ethnoracial groups. Results indicate that DSS-B scores are reliable and valid in the populations studied.

Posttraumatic stress disorder (PTSD) consists of four main components in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5): intrusions (INT), avoidance (AV), negative alterations in cognition and mood (NACM), and arousal and reactivity (AAR); however, studies do not always support this four-factor model. A sample of 348 treatment-seeking adults was assessed for PTSD symptoms at baseline (Time 1) and then 12 weeks later (Time 2). Confirmatory factor analysis (CFA) was used to examine the model fit of the DSM-5 four-factor model of PTSD with and without a general factor at both time points, and structural equation modeling allowed for examination of these associations between time points. The four-factor model did not meet the criteria for excellent model fit, and the bifactor model provided improved model fit. The NACM specific factor did not meet the criteria for unique variance above and beyond the general factor. The bifactor model of PTSD symptoms was reliable over time, and both the general factor and the AAR factor significantly predicted subsequent symptom severity.

BACKGROUND:VA primary care patients are routinely screened for current symptoms of PTSD, depression, and alcohol disorders, but many who screen positive do not engage in care. In addition to stigma about mental disorders and a high value on autonomy, some veterans may not seek care because of uncertainty about whether they need treatment to recover. A screen for mental health risk could provide an alternative motivation for patients to engage in care.METHOD:Data from samples of veterans and traumatic injury survivors were analyzed to identify mental health risk factors that are characteristics of individuals or stressors or of post-trauma, post-deployment, or post-military service resources, experiences, or responses. Twelve risk factors were strongly related to PTSD (r > .50): current PTSD, depression, dissociation, negative thinking, and emotional lability symptoms, life stress, relationship stress, social constraints, and deployment experiences of a difficult environment, concerns about life and family, perceived threat, and moral injury. Items assessing each of these risk factors were selected and their validity to prospectively predict PTSD and/or depression 6 months later was assessed in a new sample of 232 VA primary care patients.RESULTS:Twelve items assessing dissociation, emotional lability, life stress, and moral injury correctly classified 86% of those who later had elevated PTSD and/or depression symptoms (sensitivity) and 75% of those whose later symptoms were not elevated (specificity). Performance was also very good for 110 veterans who identified as members of ethnic/racial minorities.CONCLUSIONS:Mental health status was prospectively predicted in VA primary care patients with high accuracy using a screen that is brief, easy to administer, score, and interpret, and fits well into VA's integrated primary care. When care is readily accessible, appealing to veterans, and not perceived as stigmatizing, information about mental health risk may result in higher rates of engagement than information about current mental disorder status.