The AFSPP effectively prevented suicides in the US Air Force. The long-term effectiveness of this program depends upon extensive implementation and effective monitoring of implementation. Suicides can be reduced through a multilayered, overlapping approach that encompasses key prevention domains and tracks implementation of program activities.
Fatigue and hot flashes are important factors related to work productivity in breast cancer survivors even at three years post treatment. IMPLICATIONS FOR SURVIVORS: Therapy for hot flashes should be given serious consideration in breast cancer survivors who are experiencing work limitations.
People with type 2 diabetes appear to experience incremental decrements in work performance that may affect their current and future health and performance. Lower incomes of participants with diabetes suggest that both people with diabetes and their employers bear the cost of any work efficiency losses.
Objective
To develop an online suicide prevention gatekeeper training program to prepare community pharmacy staff to communicate with patients who exhibit warning signs of suicide.
Method
A convenience sample of 17 community pharmacy staff members completed a 1‐hr semi‐structured interview during which they viewed content from an existing gatekeeper training program and provided suggestions for improvement. Once thematic saturation was achieved, interviews were digitally recorded, transcribed, and analyzed by two independent coders who reached consensus on the themes present in each transcript.
Results
Participants noted barriers to communicating about suicide, including lack of time and privacy, discomfort with using the word “suicide” and limited referral options. Participants wanted gatekeeper training to include local suicide prevention referral resources, take less than 30 min to complete, and incorporate 3–4 realistic role play scenarios, including a phone interaction.
Conclusions
Many environmental, interpersonal, and individual‐level barriers complicate pharmacy staff members’ ability to act as gatekeepers and communicate about suicide with at‐risk patients. To maximize the public health impact of pharmacy staff, skills‐based training on how to identify, communicate with, and refer at‐risk patients is needed. Gatekeeper training should model brief, realistic interactions with patients and provide pharmacy staff with local referral resources.
Vitamin D deficiency has long been associated with reduced immune function that can lead to viral infection. Several studies have shown that Vitamin D deficiency is associated with increases the risk of infection with COVID-19. However, it is unknown if treatment with Vitamin D can reduce the associated risk of COVID-19 infection, which is the focus of this study. In the population of US veterans, we show that Vitamin D2 and D3 fills were associated with reductions in COVID-19 infection of 28% and 20%, respectively [(D3 Hazard Ratio (HR) = 0.80, [95% CI 0.77, 0.83]), D2 HR = 0.72, [95% CI 0.65, 0.79]]. Mortality within 30-days of COVID-19 infection was similarly 33% lower with Vitamin D3 and 25% lower with D2 (D3 HR = 0.67, [95% CI 0.59, 0.75]; D2 HR = 0.75, [95% CI 0.55, 1.04]). We also find that after controlling for vitamin D blood levels, veterans receiving higher dosages of Vitamin D obtained greater benefits from supplementation than veterans receiving lower dosages. Veterans with Vitamin D blood levels between 0 and 19 ng/ml exhibited the largest decrease in COVID-19 infection following supplementation. Black veterans received greater associated COVID-19 risk reductions with supplementation than White veterans. As a safe, widely available, and affordable treatment, Vitamin D may help to reduce the severity of the COVID-19 pandemic.
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