Navigating the Demands of Tenure-Track Positions.

Navigating a tenure-track position can sometimes feel like walking the high wire, teetering from side to side wondering when that next overload course, research paper, or service project will topple you from your scholarly perch. Many of these positions lack significant formalized mentorship and guidance to help navigate and balance the workload of academia. Even with experience, the tenure and promotion process can be ambiguous. Workload balance is imperative to achieve tenure and promotion. Once you are in a tenure-track position, it is important to balance and understand the tenure and promotion process and its value. We provide a roadmap for early career academic professionals on how to balance their teaching, research, and service to obtain tenure and promotion. We inform the next generation of academicians about how researchers address public health problems through teaching, scholarship, and service. Finally, we explore five critical areas relevant to successful tenure and promotion: (a) classification and organizational culture, (b) the "Big Three" (teaching, research, and service), (c) professional development and network, (d) mentorship, and (e) work-life balance.

Improving Military Medical Retention Through Growth Counseling: A Cross-sectional Retention Survey of U.S. Army Physician Assistants.

INTRODUCTION: Although compensation is often the only factor considered with military medical retention, retention has been shown to have many other important factors. Maximizing the retention of military medical personnel not only decreases the cost of recruiting them but also maintains the institutional knowledge of military medicine needed to conduct military medical operations. This study used a recent retention survey of U.S. Army physician assistants (PAs) to understand military medical retention needs. MATERIALS AND METHODS: The study analyzed a survey created, implemented, and collected by the Statistical Cell at the U.S. Army Center of Excellence. In September 2020, all 864 active duty PAs were sent a link to the survey and 290 completed the survey, with a participation rate of 34%. The study used cross-tabulation, Pearson's chi-square, and multivariate logistical regression to analyze the results. Institutional review board approval was obtained through the Army Medical Center of Excellence and University of the Incarnate Word. RESULTS: Pearson's chi-square found that 18 questions in the survey were answered significantly different (P < .05) among those who intended to stay for 20 years in the Army. Binomial logistical regression found that each point higher on a 5-point Likert scale of the belief a PA could accomplish their career goals in Army medicine increased probability of likelihood to stay for 20 years by 74% (95% CI [0.57-0.98]). Each point higher on a 5-point Likert scale of perception Defense Health Agency control of Army medicine affected retention increased probability of likelihood to stay by 54% (95% CI [0.39-0.75]). Every decade older of age increased probability of increased likelihood to stay for 20 years by 63% (95% CI [0.40-0.98]). CONCLUSIONS: The belief a service member can reach their career goals in the military is critical for retention. Using Army Techniques Publication 6-22.1 as a guide, leaders can help subordinates meet their career goals, and this may be the most important task a leader can accomplish to improve their unit's retention. Strengths of this study include the high response rate of 33.6% and results demonstrating the importance of growth counseling which is already part of Army doctrine. Weaknesses include the use of secondary cross-sectional data which impair the ability to derive conclusions from the data. Future studies should explore how training programs for military leaders in growth counseling can help subordinates find their career goals in the military and the effect on military retention.

Considering Needle Phobia among Adult Patients During Mass COVID-19 Vaccinations.

As mass vaccination is underway to combat the COVID-19 pandemic and achieve herd immunity, healthcare professionals need to recognize the fear and phobia of needles among their patients. Approximately 11.5 to 66 million U.S. adults may suffer from this condition. This population often avoids seeking medical care including vaccinations. The exact number of people suffering from this phobia is unknown, and the potential years of life lost in the American health care system cannot be estimated accurately. The resistance to vaccinations among this population may delay achieving herd immunity to end this current pandemic. An overview of needle phobia, vaccinations, and current treatments are explored. The use of telemedicine could prove critical for reaching this population as well as those who are hesitant about vaccinations. Providing education to healthcare providers to identify and manage these patients during the pandemic is necessary.

Anxiety Disorders in Primary Care Settings.

Although anxiety disorders are extremely prevalent in primary care settings, barriers such as a lack of knowledge, time constraints, and lack of common presentation can lead to misdiagnosis and ineffective treatment. Optimal treatment of anxiety disorders includes both pharmacologic and behavioral interventions. The purpose of this article is to assist primary care providers in quick identification of anxiety disorders so that proper treatment can be initiated and appropriate referrals can be made.

Impact of antidepressant use on gastric bypass surgery patients' weight loss and health-related quality-of-life outcomes.

BACKGROUND: Psychological factors may be predictive of post-surgical adjustment and successful outcomes in obesity-surgery populations. OBJECTIVE: The authors compared post-gastric bypass surgery (GBS) outcomes of patients being given active psychotropic treatment for depression, with those of patients without treatment or identifiable need for treatment at enrollment. METHOD: Outcome measures included weight and repeated administration of the Medical Outcome Survey Short Form-36 (SF-36). RESULTS: There was no impact of antidepressant treatment on GBS patients' weight loss or SF-36 outcomes. CONCLUSION: Therefore, patients with actively treated depression should be expected to have GBS outcomes equivalent to those of patients without identifiable psychiatric illness or treatment.

Ethnic identity and risky health behaviors in school-age Mexican-American children.

The study examined the relationship between ethnic identity and risky health behaviors in 1,892 Mexican-American students (M age= 14.6, SD= 1.35; 50.3% male) in South Texas. The Ethnic Identity Scale assessed ethnic identity and questions from the Youth Risk Behavior Survey measured risky health behaviors (mixed use of alcohol and drugs, heavy drinking, driving under the influence, regular marijuana use, regular cigarette smoking, lack of regular exercise, not eating breakfast regularly, and carrying a gun or knife to school). Logistic regression tested the relationships between ethnic identity and report of risky health behaviors controlling for potential confounders (sex, free school lunch status, grade, and self-reported school grade). Adjusted odds ratio (AOR) and confidence intervals were calculated. Results indicated that being associated with Mexican-American cultural identity was significantly associated with a decreased mixed use of alcohol and drugs (AOR= .97), heavy drinking (AOR= .98), and regular marijuana use (AOR= .97). A stronger ethnic identity was protective against engaging in risky health behaviors among these Mexican-American adolescents.