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Acute and chronic pain affects more Americans than heart disease, diabetes, and cancer combined. Conservative estimates suggest the total economic cost of pain in the United States is $600 billion, and more than half of this cost is due to lost productivity, such as absenteeism, presenteeism, and turnover. In addition, an escalating opioid epidemic in the United States and abroad spurred by a lack of safe and effective pain management has magnified challenges to address pain in the workforce, particularly the military. Thus, it is imperative to investigate the organizational antecedents and consequences of pain and prescription opioid misuse (POM). This chapter provides a brief introduction to pain processing and the biopsychosocial model of pain, emphasizing the relationship between stress, emotional well-being, and pain in the military workforce. We review personal and organizational risk and protective factors for pain, such as post-traumatic stress disorder, optimism, perceived organizational support, and job strain. Further, we discuss the potential adverse impact of pain on organizational outcomes, the rise of POM in military personnel, and risk factors for POM in civilian and military populations. Lastly, we propose potential organizational interventions to mitigate pain and provide the future directions for work, stress, and pain research.

To better understand contributing factors and mediating mechanisms related to team dynamics in isolated, confined, and extreme (ICE) environments.

Literature review.

Our primary focus is on cohesion and adaptation – two critical aspects of team performance in ICE environments that have received increased attention in both the literature and funding initiatives. We begin by describing the conditions that define ICE environments and review relevant individual biological, neuropsychiatric, and environmental factors that interact with team dynamics. We then outline a unifying team cohesion framework for long-duration missions and discuss several environmental, operational, organizational, and psychosocial factors that can impact team dynamics. Finally, we end with a discussion of directions for future research and countermeasure development, emphasizing the importance of temporal dynamics, multidisciplinary integration, and novel conceptual frameworks for the inherently mixed work and social setting of long-duration missions in ICE environments.

A better understanding of team dynamics over time can contribute to success in a variety of organizational settings, including space exploration, defense and security, business, education, athletics, and social relationships.

We promote a multidisciplinary approach to team dynamics in ICE environments that incorporates dynamic biological, behavioral, psychological, and organizational factors over time.

The overall objective of this research was to elucidate the ecosystem of women’s health social enterprises (WHSEs) based in the United States. The Aim I was to conduct a secondary data analysis of a random national sample of non-profit WHSEs based in the United States regarding their characteristics and areas of intervention. Aim II was to conduct a qualitative assessment of a sample of WHSEs based in the United States regarding their perspectives on the ecosystem of WHSEs. Aim I utilized the GuideStar database and assessed enterprise size, geographic location, financial distress, health intervention area, and health activity category using descriptive statistics, statistical tests, and multivariable regression analysis via SPSS. Aim II utilized in-depth interviewing and grounded theory analysis via MAXQDA 2018 to identify novel themes and core categories while using an established framework for mapping social enterprise ecosystems as a scaffold.

Aim I findings suggest that WHSE activity is more predominant in the south region of the United States but not geographically concentrated around cities previously identified as social enterprise hubs. WHSEs take a comprehensive approach to women’s health, often simultaneously focusing on multiple areas of health interventions. Although most WHSEs demonstrate a risk for financial distress, very few exhibited severe risk. Risk for financial distress was not significantly associated with any of the measured enterprise characteristics. Aim II generated four core categories of findings that describe the ecosystem of WHSE: (1) comprehensive, community-based, and culturally adaptive care; (2) interdependent innovation in systems, finances, and communication; (3) interdisciplinary, cross-enterprise collaboration; and (4) women’s health as the foundation for family and population health. These findings are consistent with the three-failures theory for non-profit organizations, particularly that WHSEs address government failure by focusing on the unmet women’s health needs of the underserved populations (in contrast to the supply of services supported by the median voter) and address the market failure of over exclusion through strategies such as cross-subsidization and price discrimination. While WHSEs operate with levels of financial risk and are subject to the voluntary sector failure of philanthropic insufficiency, the data also show that they act to remediate other threats of voluntary failure.

Aim I findings highlight the importance of understanding financial performance of WHSEs. Also, lack of significant associations between our assessed enterprise characteristics and their financial risk suggests need for additional research to identify factors that influence financial performance of WHSE. Aim II findings show that WHSEs are currently engaged in complex care coordination and comprehensive biopsychosocial care for women and their families, suggesting that these enterprises may serve as a model for improving women’s health and health care. The community-oriented and interdisciplinary nature of WHSE as highlighted by our study may also serve as a unique approach for research and education purposes. Additional research on the ecosystem of WHSE is needed in order to better inform generalizability of our findings and to elucidate how WHSE interventions may be integrated into policies and practices to improve women’s health.

Since 1985, Advances in Special Education has aspired to advance theories and best practices essential to understanding, treating, and instructing students with disabilities. At times, advancement involves vision and innovation. At other times, new technologies, cutting edge medical procedures, or innovate pedagogical practices capture the attention of special education professionals globally and substantial changes can result in the way students with special needs are instructed. This volume in Special Education International Perspectives invites a call for common ground and global commonalities in all schools. The main theme of this chapter is that teachers matter. The chapter reviews two decade of scientific evidence that supports this theme. The scientific evidence comes from neuroscience and social cognition findings related to the importance of the teacher–student interaction. Environmental influences are not only the physical world but the all-important social world. The chapter begins with an overview of the “social” brain relative to teaching. A practical guide for teacher use of evidence-based educational practices concludes the chapter.

To examine how clinicians navigate providing treatment to Borderline Personality Disorder (BPD) in the context of the DSM 5, deinstitutionalization, and the biomedical model.

We conducted 39 interviews with mental health providers in the United States in a two-year period preceding and following the release of the DSM 5. Using Constructivist Grounded Theory, we analyzed the data for themes that emerged.

Clinicians faced pressures from insurance companies, the DSM categories, and their professional training to focus on biomedical treatments. These treatments, which emphasized pharmaceuticals and short courses of care, were ill-suited to BPD, which has a strong evidence base recommending long-term therapeutic interventions. We term this contradiction a “biomedical mismatch” and use Gidden’s concept of structuration to better understand how clinicians navigate the system of care. Providers ranged in their responses to the mismatch: some championed biomedicine, others were complicit, and a final group behaved as activists, challenging the paradigm. The sum of the strategies had downstream effects which included crisis reinstitutionalization and a discourse of untreatability. Ultimately, we discuss how social factors such as gender bias, stigma, and trauma are insufficiently represented in the biomedical model of care for BPD.

BPD fits poorly within the biomedical underpinnings of the current system. Accordingly, it illuminates the structuration of health care and where the rules of care break down. More precisely, deinstitutionalization was designed to remove patients from long courses of inpatient care. Many patients with BPD have failed to experience this outcome, with some patients now cycling through long courses of short-term crisis reinstitutionalization instead of having effective outpatient care over long periods. This unintended consequence of deinstitutionalization calls for a more biopsychosocial response to BPD.

The process of chronic pain (CP) and strategies is to improve the patient’s health and well-being. CP is a frequent medical problem that presents a major challenge to healthcare providers because of its complex natural history, imprecise aetiology, and inadequate response to pharmacological treatment. Although different definitions exist it is widely accepted that CP is an ongoing pain that lasts more than 3 months or that persists longer than the reasonably expected healing time for the involved tissues. Also, it is acknowledged that its treatment is much different than the treatment for acute pain. When addressing a person with CP, one should always keep in mind that pain is much more about the individual than the underlying medical condition. Every person is different, and healthcare providers should take a tailor-made approach to managing their pain. This is the only way to ensure good results in pain treatment. Treatment goals should be discussed and adapted to the patient profile. It is fundamental to have clear goals from the beginning and to ensure these are realistic, individualized, and measurable. Effective treatment for CP is only achieved through a holistic framework in which the patient’s well-being is the first concern and an interdisciplinary and societal approach is implemented from the first day.

Heritability studies attempt to estimate the contribution of genes (vs. environments) to variation in phenotypes (or outcomes of interest) in a given population at a given time. This chapter scrutinizes heritability studies of adverse health phenotypes, emphasizing flaws that have become more glaring in light of recent advances in the life sciences and manifest most visibly in epigenetics.

Drawing on a diverse body of research and critical scholarship, this chapter examines the veracity of methodological and conceptual assumptions of heritability studies.

The chapter argues that heritability studies are futile for two reasons: (1) heritability studies suffer from serious methodological flaws with the overall effect of making estimates inaccurate and likely biased toward inflated heritability, and, more importantly (2) the conceptual (biological) model on which heritability studies depend – that of identifiably separate effects of genes versus the environment on phenotype variance – is unsound. As discussed, contemporary bioscientific work indicates that genes and environments are enmeshed in a complex (bidirectional, interactional), dynamic relationship that defies any attempt to demarcate separate contributions to phenotype variance. Thus, heritability studies attempt the biologically impossible. The emerging research on the importance of microbiota is also discussed, including how the commensal relationship between microbial and human cells further stymies heritability studies.

Understandably, few sociologists have the time or interest to be informed about the methodological and theoretical underpinnings of heritability studies or to keep pace with the incredible advances in genetics and epigenetics over the last several years. The present chapter aims to provide interested scholars with information about heritability and heritability estimates of adverse health outcomes in light of recent advances in the biosciences.