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Objective: Despite unique experiences that may increase eating disorder risk, U.S. military service members are an understudied population. The current study examined incidence and prevalence of eating disorder diagnoses in U.S. military personnel. Method: This retrospective cohort study utilized Military Health System Data Repository (MDR) data on eating disorder diagnoses (2016–2021). Active duty, Reserve, and National Guard U.S. military service members who received care via TRICARE Prime insurance were identified by ICD‐10 eating disorder diagnostic codes. Results: During the 6‐year surveillance period, 5189 Service members received incident eating disorders diagnoses, with a crude overall incidence rate of 6.2 cases per 10,000 person‐years. The most common diagnosis was other/unspecified specified eating disorders, followed by binge‐eating disorder, bulimia nervosa, and anorexia nervosa. There was an 18.5% overall rise in total incident cases across the surveillance period, but this trend was not statistically significant (p = 0.09). Point prevalence significantly increased across the 6‐year timeframe for total eating disorders (p < 0.001). Period prevalence for 6‐year surveillance period was 0.244% for total eating disorders, 0.149% for other/unspecified eating disorder, 0.043% for bulimia nervosa, 0.038% for binge‐eating disorder, and 0.013% for anorexia nervosa. Discussion: Overall crude incidence estimates for total eating disorders were higher than reported in prior research that included only active duty Service members and required an eating disorder diagnosis code in the first or second diagnostic position of the medical record. Comprehensive and confidential studies are needed to more thoroughly characterize the nature and scope of eating disorder symptomatology within U.S. military personnel. Public Significance: U.S. military service members are a vulnerable population with regard to eating disorder symptoms. Previously reported incidence and prevalence estimates using data from the Military Health System may have been underestimated due to overly stringent case definitions. Given personal and occupational barriers (e.g., career consequences), confidential studies of military personnel may provide more complete data on the scope of eating disorders to inform screening and clinical practice guidelines for military populations. [ABSTRACT FROM AUTHOR]

Objective: Adolescent children of US service members (i.e., military‐dependent youth) face unique stressors that increase risk for various forms of disinhibited eating, including emotional eating. Difficulties with adaptively responding to stress and aversive emotions may play an important role in emotional eating. This study examined emotion dysregulation as a potential moderator of the association between perceived stress and emotional eating in adolescent military dependents. Method: Participants were military‐dependent youth (N = 163, 57.7% female, Mage = 14.5 ± 1.6, MBMI‐z = 1.9 ± 0.4) at risk for adult binge‐eating disorder and high weight enrolled in a randomized controlled prevention trial. Prior to intervention, participants completed questionnaires assessing perceived stress and emotional eating. Parents completed a questionnaire assessing their adolescent's emotion dysregulation. Moderation analyses were conducted using the PROCESS macro in SPSS and adjusted for theoretically relevant sociodemographic covariates. Results: The interaction between adolescent perceived stress and emotion dysregulation (parent‐reported about the adolescent) in relation to adolescent emotional eating was found to be significant, such that higher emotion dysregulation magnified the association between perceived stress and emotional eating (p =.010). Examination of simple slopes indicated that associations between perceived stress and emotional eating were strongest for youth with above‐average emotion dysregulation, and non‐significant for youth with average or below‐average emotion dysregulation. Discussion: Findings suggest that greater emotion dysregulation may increase risk for emotional eating in response to stress among military‐dependent youth at risk for binge‐eating disorder or high weight. Improving emotion regulation skills may be a useful target for eating disorder prevention among youth who are at risk for emotional eating. Public Significance: Prior research has shown that adolescent military dependents are at increased risk for eating disorders and high weight. The current study found that emotion dysregulation moderated the relationship between perceived stress and emotional eating among military‐dependent youth. There may be clinical utility in intervening on emotion regulation for adolescent dependents at particular risk for emotional eating and subsequent eating disorders. [ABSTRACT FROM AUTHOR]

Objective: The offspring of US military service members may be at increased risk for eating disorders. However, no epidemiological studies to date have evaluated eating disorder incidence rates and prevalence estimates among military‐dependent youth. Method: This retrospective cohort study examined eating disorder diagnoses in the military healthcare system (MHS) from 2016 through 2021. Active duty and national guard military‐dependent youth, aged 10–17 years, who received care in the MHS via TRICARE Prime insurance, were identified by one or more ICD‐10 codes indicative of an eating disorder diagnosis (anorexia nervosa, bulimia nervosa, binge‐eating disorder, and other‐specified eating disorders). Results: During the 6‐year surveillance period, 2534 dependents received incident diagnoses of eating disorders, with a crude overall incidence rate of 1.75 cases per 10,000 person‐years. The most common diagnosis was other‐specified eating disorder, followed by anorexia nervosa, bulimia nervosa, and binge‐eating disorder. The crude annual incidence rate of all eating disorder diagnoses increased by nearly 65% from 2016 to 2021. Rates for all diagnoses were highest in 2020 and 2021. Period prevalence estimates were.08% for any eating disorder diagnosis,.01% for anorexia nervosa,.004% for bulimia nervosa,.004% for binge‐eating disorder, and.06% for other‐specified eating disorders. Discussion: The observed increase in eating disorder diagnoses during the surveillance period appeared to be driven by female dependents. More military dependents experienced a new‐onset diagnosis during the COVID‐19 pandemic compared to previous years. These findings highlight the need for eating disorder screening, identification, and treatment for dependents within the MHS. Public Significance Statement: Children of US military service members may be at increased risk for eating disorders. Results indicate new‐onset eating disorder cases increased 65% from 2016 to 2021, primarily among girls compared to boys. The most diagnosed and fastest growing diagnosis was other‐specified eating disorder. Rates of anorexia nervosa increased following the COVID‐19 pandemic. Findings highlight the need for eating disorder screening, identification, and treatment within the military healthcare system. [ABSTRACT FROM AUTHOR]

Reproductive coercion (RC) can be conceptualized as any behavior that limits one's ability to make decisions about their reproductive health. Here, we broaden this definition to consider the impact of systemic and sociocultural factors on RC using an ecological model. Specifically, we use Bronfenbrenner's model as a framework for organizing the multilevel factors that influence reproductive coercion (RC) and its impacts on individual health. This paper is intended to offer a primer to historical, sociocultural, community, interpersonal, and individual processes that may interact to shape reproductive decision-making and its effect on individual health outcomes. We emphasize the importance of conceptualizing RC within the broader sociocultural and community context, and the potential implications for reproductive and sexual health research, clinical care, and policy in the United States. [ABSTRACT FROM AUTHOR]

Objective: The COVID‐19 pandemic and public health mitigation measures have negatively impacted individuals with eating disorders (ED). We evaluated changes in and predictors of ED symptoms, pandemic‐related ED concerns, and anxiety symptoms across the first 12 months of the COVID‐19 pandemic among individuals with self‐reported EDs in the United States (US), Sweden (SE), and the Netherlands (NL). Method: Participants in the US (N = 510), SE (N = 982), and NL (N = 510) completed an online survey assessing ED symptoms (binge eating, restriction, compensatory behaviors, and anxiety about being unable to exercise), general anxiety symptoms, and pandemic‐related ED concerns about accessing food, lack of structure and social support, being in a triggering environment, and food and treatment costs. In the US and NL, respondents completed surveys beginning April 2020 and continuing monthly for a year. In SE, respondents completed baseline surveys in May 2020, a six‐month follow‐up around December 2020, and a 12‐month follow‐up in May 2021. Results: Three patterns emerged: (1) a curvilinear course with the highest level of symptoms at baseline, declining through November 2020, and increasing through the rest of the year; (2) a linear declining course over time; and (3) a stable course with no changes. Worries about COVID‐19 infection, lockdown, concerns about lack of structure and social support, and concerns about accessing food consistent with one's recovery meal plan predicted increases in ED symptoms. Discussion: ED symptoms tracked with pandemic‐related concerns in people with EDs. Conceptualizing predictors of symptoms may inform therapy and public health resources that reduce the impact of pandemics on mental health. Public Significance: Our findings suggest that the COVID‐19 pandemic had negative impacts on people with eating disorders, including amplification of mental health symptoms and stressors around peak periods of infection and COVID‐19 restrictions. These findings inform medical providers, policy‐makers, and community‐based supports about the information and resource needs of this group to ensure efficient dissemination in future public health emergencies and during the ongoing COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Many ongoing programs compute response rates for usage both as performance measures and as quality indicators. There is extensive literature on the computation and analysis of response rates for demographic surveys, which are generally characterized by multistage designs with heterogeneous populations within selected clusters. In contrast, business surveys are characterized by singlestage designs with highly skewed populations. Consequently, business surveys in the Economic Directorate of the U.S. Census Bureau compute two "flavors" of response rates: the unit response rate (URR), defined as the rate of the total unweighted number of "responding" units to the total number of sampled units eligible for tabulation; and a total quantity response rate (TQRR), which is the weighted proportion of a key estimate reported by responding units or obtained from equivalent quality sources (Lineback and Thompson 2010). Thus, for each statistical period, a survey produces one unit response rate and several total quantity response rates - one per key item. In this article, we describe how these two rates are computed, then introduce a statistical process control analysis perspective for monitoring them. We illustrate this approach with examples from ongoing economic programs conducted by the U.S. Census Bureau. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine the perceptions of issues related to off-highway vehicle (OHV) use and management tactics among US Forest Service District Rangers on National Forests in the Appalachian region. We determined the differences in perceptions of District Rangers based on different concentrations of OHV managed trails on Ranger Districts. We surveyed 42 District Rangers on 14 National Forests using a modified Dillman mail-back method that resulted in a response rate of 69.1%. The questionnaire was modified from a previous study. Managers with high levels of OHV trail concentrations reported using more varied and additional management tactics to deal with ecological impacts and social issues. Unauthorized trail creation was reported consistently across both levels of OHV trail concentrations. When we compared our findings to earlier results, there were some differences in what managers reported. For example, closing or limiting use was more frequently reported as a management tactic in this study, whereas use of personal contacts was more often selected in the California study. [ABSTRACT FROM AUTHOR]

Outdoor recreation has emerged as on important way in which forests contribute to national public health and prosperity. This article builds a case for strengthening science and education-based programs to address outdoor recreation management challenges and train the next generation of natural resource leaders. We describe a national-level effort to develop a 5-year strategic plan for outdoor recreation research and education. Outcomes from this strategic plan are elaborated and a call to action is issued. The forestry community needs to seize this political opportunity to bring about real change on the ground-change that builds a healthier and more prosperous America. [ABSTRACT FROM AUTHOR]

The article discusses the testimonies of middle school teachers on the proposed educational standards and curriculum integration in the U.S. Many private foundations, companies, and organizations have also developed standards in addition to state-developed standards. In each testimony, the curriculum was challenging, integrative, and exploratory. Students engaged in activities that helped them understand themselves and the world around them. It has been observed that learning was rigorous, and students constructed knowledge rather than just consuming knowledge.

The article focuses on the role of pediatric primary care providers (PCPs) in addressing firearm safety and counseling patients and families on strategies to prevent firearm-related injuries and deaths among children and adolescents. It discusses the challenges faced by PCPs in initiating discussions about firearm safety, outlines recommendations from pediatric professional organizations, and provides practical examples of firearm anticipatory guidance in practice.