Build it Together and They will Come: The Case for Community-based Participatory Research with Military Populations

In this article, we describe the methodology broadly known as community-based participatory research (CBPR) and identify its relevance to social work intervention research with families serving in Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF). Since the inception of OEF/OIF, much has been written about low rates of service utilization among military service members and families to address deployment and combat-related concerns. Barriers to participation include difficulty accessing programs, mistrust of clinicians/researchers, concerns about confidentiality, stigma, and career implications, and perceptions of program effectiveness. Because CBPR values the community’s inherent resilience and expertise about its own needs, this method can be important for the development of feasible, culturally-relevant and evidence-based prevention and intervention models for military populations. To illustrate, we provide an overview of our implementation of CBPR to develop and test a home-based reintegration program for military families with very young children. Implications for social work practice and research are discussed

The Characteristics of Disclosure among Children Who May have been Sexually Abused

Seventy-six children (5 to 10 years old), who were referred because of concerns about sexual abuse, were interviewed as part of a larger study testing the efficacy of a computerassisted interview in sexual abuse evaluations. Data from initial interviews were coded according to the presence of disclosure and the details revealed about sexual abuse. The presence and amount of corroboration were coded through case review. Although 56 children were coded as having disclosed prior to evaluation, only 44 subjects disclosed during the initial interview. Only 1 child disclosed spontaneously. An additional 8 children (11%) disclosed possible sexual abuse in a second or later interview. Although girls disclosed at a higher rate than boys, children did not differ in the amount or types of information they provided about alleged sexual abuse. Findings are discussed in terms of the conceptualization of disclosure as a process. Implications for interviewing strategies are addressed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66798/2/10.1177_1077559599004003003.pd

Examining Rates of Postpartum Depression in Active Duty U.S. Military Servicewomen

Background: Postpartum depression (PPD) is understudied in military populations. The present descriptive transversal study evaluated the incidence of PPD diagnoses in U.S. military electronic health records, based on International Classification of Diseases, Ninth Revision (ICD-9) and ICD-10 codes, among active duty military servicewomen between 2001 and 2018. Methods: Data on 3,724 active duty military servicewomen who served between 2001 and 2018 were drawn from the Defense Medical Epidemiological Database and stratified by race, age, marital status, service branch, and military pay grade. Single sample chi squares were used to examine observed versus expected differences in diagnosis rates. Results: The incidence rate of PPD among all U.S. military servicewomen was the lowest in 2001 (1.96 per 1,000) and the highest in 2018 (29.95 per 1,000). Servicewomen most often diagnosed with PPD were white (60%), married (74%), in the enlisted pay grades of E-1 to E-4 (60%), in the Army (43%), and were between 20 and 24 years old (46%). Statistically significant differences (p \u3c 0.001) were found between observed and expected counts across all five demographic variables. Conclusions: This is the first population-based study to assess the incidence rates of PPD among all active duty military servicewomen. Findings that some groups were over- and underdiagnosed within each demographic category, and that PPD incidence rates have increased between 2001 and 2018, underscore the importance of further research to inform policies and interventions supporting this vulnerable population

Organoid profiling identifies common responders to chemotherapy in pancreatic cancer

Pancreatic cancer is the most lethal common solid malignancy. Systemic therapies are often ineffective, and predictive biomarkers to guide treatment are urgently needed. We generated a pancreatic cancer patient–derived organoid (PDO) library that recapitulates the mutational spectrum and transcriptional subtypes of primary pancreatic cancer. New driver oncogenes were nominated and transcriptomic analyses revealed unique clusters. PDOs exhibited heterogeneous responses to standard-of-care chemotherapeutics and investigational agents. In a case study manner, we found that PDO therapeutic profiles paralleled patient outcomes and that PDOs enabled longitudinal assessment of chemosensitivity and evaluation of synchronous metastases. We derived organoid-based gene expression signatures of chemosensitivity that predicted improved responses for many patients to chemotherapy in both the adjuvant and advanced disease settings. Finally, we nominated alternative treatment strategies for chemorefractory PDOs using targeted agent therapeutic profiling. We propose that combined molecular and therapeutic profiling of PDOs may predict clinical response and enable prospective therapeutic selection. SIGNIfICANCE: New approaches to prioritize treatment strategies are urgently needed to improve survival and quality of life for patients with pancreatic cancer. Combined genomic, transcriptomic, and therapeutic profiling of PDOs can identify molecular and functional subtypes of pancreatic cancer, predict therapeutic responses, and facilitate precision medicine for patients with pancreatic cancer