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Patients managed operatively had equivalent functional outcomes compared with nonoperative treatment; however, the risk of displacement and problems with union was substantially lower in patients managed with surgery.

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The present study investigated the impact of motivational interviewing (MI) and stage of change on a self-report measure of global functioning (Outcome Questionnaire [OQ 45.2]). Participants were men mandated to attend the Responsible Choices for Men (RCM) group therapy program following an incident of domestic violence. The study design utilized a quasi-experimental between-groups comparison utilizing data collected at three time points (pregroup, first group session, and final group session). One group of mandated program attendees received two sessions of MI (n = 106), whereas the comparison group did not (n = 106). Stage of change was assessed using the URICA-G and the URICA-DV (University of Rhode Island Change Assessment--Domestic Violence). Multilevel growth modeling indicated that stage of change has a significant relationship to global functioning. Discussion focuses on the potential benefits of MI as a pregroup treatment and the importance of accounting for individual readiness to change.

BackgroundPast research on the association between insomnia and suicidal ideation (SI) has produced mixed findings. The current study explored the relationship between insomnia, SI, and past-year mental health status among a large Canadian Forces (CF) sample.MethodData was obtained from the 2013 Canadian Forces Mental Health Survey (CFMHS), and included a large representative sample of Canadian Regular Forces personnel (N = 6700). A series of univariate logistic regressions were conducted to test individual associations between past-year mental health status, insomnia, and potential confounds and SI. Mental health status included three groups: 0, 1, or two or more probable diagnoses of posttraumatic stress disorder (PTSD), major depressive disorder (MDD), generalized anxiety disorder (GAD), panic disorder (PD) and alcohol abuse/dependence. Stepwise multivariate logistic regression was used to assess the relationship between insomnia and SI with mental health status as a moderator.Results40.8% of respondents reported experiencing insomnia. Both insomnia and number of mental health conditions incrementally increased the risk of SI. However, past-year mental health status was a significant moderator of this relationship, such that for CF personnel with either no (AOR = 1.61, 1.37–1.89) or only one past-year mental health condition (AOR = 1.39, 1.12–1.73), an incremental increase in insomnia was associated with an increased likelihood of SI. However, in personnel with two or more past-year mental health disorders, insomnia was no longer significantly associated with SI (AOR = 1.04, 0.81–1.33).ConclusionsInsomnia significantly increased the odds of SI, but only among individuals with no or one mental health condition. Findings highlight the importance of assessing insomnia among CF members in order to further suicide prevention efforts.