Non-fatal self-harm in Scottish military veterans: a retrospective cohort study of 57,000 veterans and 173,000 matched non-veterans

Purpose: Although suicide risk in veterans has been widely studied, there is little information on the risk of non-fatal self-harm in this population. We used data from the Scottish Veterans Health Study to conduct an epidemiological analysis of self-harm in veterans, in comparison with people who have never served. Methods: We conducted a retrospective, 30-year cohort study of 56,205 veterans born 1945–1985, and 172,741 people with no record of military service, and used Cox proportional hazard models to examine the association between veteran status and cumulative risk of non-fatal self-harm, overall and stratified by birth cohort, sex and length of service. We also examined mental and physical comorbidities, and association of suicide with prior self-harm. Results: There were 1620 (2.90%) first episodes of self-harm in veterans, compared with 4212 (2.45%) in non-veterans. The difference was statistically significant overall (unadjusted HR 1.27, 95% CI 1.21–1.35, p < 0.001). The risk was highest in the oldest veterans, and in the early service leavers who failed to complete initial training (unadjusted HR 1.69, 95% CI 1.50–1.91, p < 0.001). The risk reduced with longer service and in the intermediate birth cohorts but has increased again in the youngest cohort. Conclusions: The highest risk of non-fatal self-harm was in veterans with the shortest service, especially those who did not complete training or minimum engagement, and in the oldest birth cohorts, whilst those who had served the longest were at reduced risk. The risk has increased again in the youngest veterans, and further study of this subgroup is indicated

Lymphohaematopoietic malignancies in Scottish military veterans: Retrospective cohort study of 57,000 veterans and 173,000 non-veterans

Background: Lymphohaematopoietic malignancies are common in the general population. There have been concerns that military service may be associated with increased risk as a result of occupational exposures. To date, few studies have demonstrated an increased risk, although a disability pension is payable to veterans who were present at nuclear tests and who develop leukaemia (other than chronic lymphocytic leukaemia). The aim of the study was to utilise data from the Scottish Veterans Health Study to examine the risk of lymphohaematopoietic malignancy following military service in a large national cohort of veterans. Methods: Retrospective cohort study of 57,000 veterans and 173,000 non-veterans born between 1945 and 1985 matched for age, sex and area of residence, adjusted for areal deprivation and followed up for up to 30 years, using Cox proportional hazard models to compare the risk of lymphohaematopoietic malignancy overall, by diagnosis and by sex and birth cohort. Results: We found no statistically significant difference in risk between veterans and non-veterans either for all leukaemias (Cox proportional hazard ratio 1.03, 95% confidence intervals 0.84–1.27, p = 0.773), Hodgkin lymphoma (hazard ratio 1.19, 95% confidence intervals 0.87–1.61, p = 0.272) or for non-Hodgkin lymphoma (hazard ratio 0.86, 95% confidence intervals 0.71–1.04, p = 0.110). Conclusion: Our findings provide reassurance that service in the UK Armed Forces is not associated with increased risk of lymphohaematopoietic malignancy

The Bridge Program: Recasting Blackness, Fostering Resilience and Transformative Resistance through Narratives of Success

This article presents the results of data based on individual interviews and focus groups conducted with Black students who participated in a post-secondary student retention program called The Bridge. The program was specifically designed to address the needs of Black students and to identify the types of support programming that would enhance their engagement and graduation rates. Three of the themes that emerged from the interviews and focus groups identified the importance of developing differing frames of Blackness, engaging in transformative resistance, and the importance of providing spaces for the students to engage with and explore multiple conceptions of Blackness and narratives of success

Dementia: Shifting Mystery to Meaning and Management

Asking “Why” tries to find the logical rationale behind current behaviors. With dementia, reasoning is faulty because of the breakdown in the normal brain activity. The questions, “What does this mean?” and, “What must we do?” are catalysts to taking care of the needs and emotions of the whole person. We present our discoveries so that others in the caretaker community may more effectively help their loved ones feel better in spite of the physiological challenges that may face them. Finally, we examine our current potentially confusing habits, which our future caretakers may not understand if roles are changed. The goal in either scenario is to maintain the loving relationship through our narrative

Smoking-related cancer in military veterans: retrospective cohort study of 57,000 veterans and 173,000 matched non-veterans

Background: Serving military personnel are more likely to smoke, and to smoke more heavily, than civilians. The aim of our study was to examine whether veterans have an increased risk of a range of smoking-related cancers compared with non-veterans, using a large, national cohort of veterans. Methods: We conducted a retrospective cohort study of 57,000 veterans resident in Scotland and 173,000 age, sex and area of residence matched civilians. We used Cox proportional hazard models to compare the risk of any cancer, lung cancer and other smoking-related cancers overall, by sex and by birth cohort, adjusting for the potential confounding effect of socioeconomic deprivation. Results: Over a mean of 29 years follow-up, 445 (0.79 %) veterans developed lung cancer compared with 1106 (0.64 %) non-veterans (adjusted hazard ratio 1.16, 95 % confidence intervals 1.04–1.30, p = 0.008). Other smoking-related cancers occurred in 737 (1.31 %) veterans compared with 1883 (1.09 %) non-veterans (adjusted hazard ratio 1.18, 95 % confidence intervals 1.08–1.29, p < 0.001). A significantly increased risk was observed among veterans born 1950–1954 for lung cancer and 1945–1954 for other smoking-related cancers. The risk of lung cancer was decreased among veterans born 1960 onwards. In comparison, there was no difference in the risk of any cancer overall (adjusted hazard ratio 0.98, 95 % confidence intervals 0.94–1.01, p = 0.171), whilst younger veterans were at reduced risk of any cancer (adjusted hazard ratio 0.88, 95 % confidence intervals 0.81–0.97, p = 0.006). Conclusions: Military veterans living in Scotland who were born before 1955 are at increased risk of smoking-related cancer compared with non-veterans, but younger veterans are not. The differences may reflect changing patterns of smoking behaviour over time in military personnel which may, in turn, be linked to developments in military health promotion policy and a changing military operational environment, as well as to wider societal factors

The Elephant and the Four Blind Men: The Burger Court and its Federal Tax Decisions

All the federal tax decisions of the Burger Court are reviewed in order to demonstrate that widely held beliefs about statutory interpretation in tax cases are misleading. For example, although the literature asserts that courts do not distinguish between legislative and interpretive regulations, the Burger Court did give greater deference to legislative regulations. Further, despite some Justices antipathy to legislative history, the Burger Court relied heavily on legislative histories in making its decisions. In addition, the widely held view that the Court eschews tax controversies was found false when compared to other business areas

Furthering the quality agenda in Aboriginal community controlled health services: understanding the relationship between accreditation, continuous quality improvement and national key performance indicator reporting

A rapidly expanding interest in quality in the Aboriginal-community-controlled health sector has led to widespread uptake of accreditation using more than one set of standards, a proliferation of continuous quality improvement programs and the introduction of key performance indicators. As yet, there has been no overarching logic that shows how they relate to each other, with consequent confusion within and outside the sector. We map the three approaches to the Framework for Performance Assessment in Primary Health Care, demonstrating their key differences and complementarity. There needs to be greater attention in both policy and practice to the purposes and alignment of the three approaches if they are to embed a system-wide focus that supports quality improvement at the service level

But, I don’t believe it’s about race’: Challenging fallacies of race and racism amongst early childhood educators in Ontario

There is the continued belief that children do not see race and that they are racially innocent. This belief is evidenced in early childhood environments and influences the practices of the instructors in these settings. However, research continues to show that children do see and react to varying markers of race. This research project focused on early childhood educators’ interpretations of children’s racially coded behaviours and interactions. The results revealed four central themes: racial evasiveness; racial dis-ease; parental role in promoting racism; and limited educational preparation. This study contributes to the growing body of research on children, race, and early childhood by examining how Canadian early childhood educators address race and racism in the classroom