Quetiapine monotherapy was efficacious in the treatment of PTSD. These findings suggest quetiapine as a single agent is effective in treating military PTSD.
This study confirmed previous research and identified factors that can be targeted for the development of more effective shiftwork adaptation programmes in a health care setting (sleep timing and duration, exercise and optimal health and organizational satisfaction).
Objective To evaluate a theoretical model for mortality after spinal cord injury (SCI) by sequentially analyzing 4 sets of risk factors in relation to mortality (i.e., adding 1 set of factors to the regression equation at a time). Design Prospective cohort study of data collected in late 1997 and early 1998 with mortality status ascertained in December 2005. We evaluated the significance of 4 successive sets of predictors (biographic and injury, psychologic and environmental, behavioral, health and secondary conditions) using Cox proportional hazards modeling and built a full model based on the optimal predictors. Setting A specialty hospital. Participants 1,386 adults with traumatic SCI, at least 1 year post-injury, participated. There were 224 deaths. After eliminating cases with missing data, there were 1,209 participants, with 179 deceased at follow-up. Interventions N/A. Main Outcome Measures Mortality status was determined using the National Death Index and the Social Security Death Index. Results The final model included one environmental variable (poverty), 2 behavioral factors (prescription medication use, binge drinking), and 4 health factors or secondary conditions (hospitalizations, fractures/amputations, surgeries for pressure ulcers, probable major depression). Conclusions The results supported the major premise of the theoretical model that risk factors are more important the more proximal they are in a theoretical chain of events leading to mortality. According to this model, mortality results from declining health, precipitated by high-risk behaviors. These findings may be used to target individuals who are at high risk for early mortality as well as directing interventions to the particular risk factor.
Introduction: Staying home when sick can reduce the spread of influenza. The objectives of this study were to quantify the percentage of workers who had paid sick leave (PSL) benefits, examine sociodemographic characteristics that may be associated with having these benefits, and examine the association between having PSL benefits and use of sick days and influenza vaccination status. Methods: The public-use dataset from the 2009 National H1N1 Flu Survey (NHFS) were analyzed in 2017. Wald chi-square tests and t-tests were used to test for associations between having PSL benefits and sociodemographic characteristics and industry and occupation groups, the associations between having PSL benefits and seeking treatment when sick with influenza-like illness (ILI), and taking days off work when sick with ILI. Logistic regression was used to determine variables associated with having PSL benefits and the association between having PSL benefits and influenza vaccination status. Results: Sixty-one percent of employed adults reported having PSL benefits during the 2009–10 influenza season. Being younger, female, Hispanic, less educated, or a farm/blue collar worker were associated with reduced likelihood of having PSL benefits. Not having PSL benefits was associated with a lower likelihood of receiving an influenza vaccination and visiting a health professional when sick with ILI. Conclusions: The percentage of workers who have PSL benefits differs by sociodemographic characteristics and industry/occupation groups. Offering PSL benefits along with promoting influenza vaccination and encouraging employees with ILI to stay home can increase influenza vaccination coverage and help control the spread of influenza.
Objective Our objective was to identify the association of 2 distinct psychological constructs, personality and purpose in life (PIL), with risk of early mortality among persons with spinal cord injury (SCI). Design Prospective cohort study with health data collected in late 1997 and early 1998 and mortality status ascertained in December 2005. Setting A large rehabilitation hospital in the Southeastern United States. Participants Adults (N=1386) with traumatic SCI, at least 1 year post-injury. Interventions Not applicable. Main Outcome Measures We first evaluated the significance of a single psychological predictor (a total of 6 scales) while controlling for biographic and injury predictors using Cox proportional hazards modeling and subsequently built a comprehensive model based on an optimal group of psychological variables. Results There were a total of 224 (16.2%) observed deaths in the full sample. The total number of deaths was reduced to 164 in the final statistical model (out of 1128 participants) due to missing data. All 6 psychological factors were statistically significant in the model that was adjusted for biographic and injury factors, whereas only 3 psychological factors were retained in the final comprehensive model, including 2 personality scales (Sensation Seeking, Neuroticism-Anxiety) and the PIL scale. The final comprehensive model only modestly improved the overall prediction of survival compared to the model with only biographic and injury variables, as the pseudo-R2 increased from 0.121 to 0.129 and the concordance increased from 0.730 to 0.747. Conclusion The results affirm the importance of psychological factors in relation to survival after SCI.
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