This paper explores the dynamics of health and health care in Cuba during a period of severe crisis by placing it within its economic, social, and political context using a comparative historical approach. It outlines Cuban achievements in health care as a consequence of the socialist transformations since 1959, noting the full commitment by the Cuban state, the planned economy, mass participation, and a self-critical, working class perspective as crucial factors. The roles of two external factors, the U.S. economic embargo and the Council of Mutual Economic Cooperation (CMEA), are explored in shaping the Cuban society and economy, including its health care system. It is argued that the former has hindered health efforts in Cuba. The role of the latter is more complex. While the CMEA was an important source for economic growth, Cuban relations with the Soviet bloc had a damaging effect on the development of socialism in Cuba. The adoption of the Soviet model of economic development fostered bureaucracy and demoralization of Cuban workers. As such, it contributed to two internal factors that have undermined further social progress including in health care: low productivity of labor and the growth of bureaucracy. While the health care system is still consistently supported by public policy and its structure is sound, economic crisis undermines its material and moral foundations and threatens its achievements. The future of the current Cuban health care system is intertwined with the potentials for its socialist development.
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Full Text Available Integrating theory and research on persuasion, moralization, and intergroup relations, the present research aims to highlight the far-reaching impact of health-related persuasion on society. I propose that governments’ health-related persuasion leads to the emergence of new social norms, and in particular moral norms. Importantly, moral norms provide strong behavioral imperatives and are seen as binding for group members. This suggests that moralized persuasion has a strong potential to divide society along the lines of citizens who conform to and citizens who deviate from health-related moral norms. Thus, departing from the traditional focus on targets of persuasion, the present research focuses on those holding a moralized view on health and lifestyle. Key aspects of social cohesion as defined by the OECD (2011 have been tested across four studies. The main hypothesis tested is that those conforming to the norm (e.g., non-smokers, normal weight people, people with healthy lifestyles will stigmatize those deviating from the norm (e.g., smokers, overweight people, people with unhealthy lifestyles. Flowing from stigmatization, less inclusion, lower solidarity with and greater endorsement of unequal treatment of those deviating from the moral norm are predicted. Four survey studies (total N = 1568 examining the proposed associations among non-smokers, normal weight people, and employees with healthy lifestyles are presented. The studies provide unanimous support for the hypothesis, with meta-analysis providing further support for the reliability of the findings. Consistent across studies, social cohesion indicators were negatively affected by health moralization through stigmatization of those deviating from health-related moral norms. Findings highlight an under-acknowledged potential of moralized health-related persuasion to divide society, thereby undermining cohesion and the achievement of important societal goals. In the discussion
Full Text Available The South African National Health Act (No. 61 of 2003 provides a legal framework for the regulation of the health system across the country. Within the Act, section 71 introduces a number of legal norms relating to research or experimentation with human subjects, including research on HIV prevention and treatment. These norms have been criticised for the negative impact they will have on research involving children. This article describes three of the new consent requirements in section 71 of the Act. It shows, using a range of case studies, how important HIV-related research will be halted or undermined if the current provisions are implemented. The article argues that the new consent requirements are out of step with other statutory provisions and ethical guidelines, and as a result they will exclude a large population group – children in diverse settings – from much-needed evidence-based healthcare interventions. The article concludes with a clarion call for support of advocacy on this issue with the Minister of Health and the Health Portfolio Committee.
... sacrifices to our country, and they face different health issues than civilians. During their service, they are ... knees There may also be a risk of health problems from exposure to environmental hazards, such as ...
balancing refers to a state's strategies or diplomatic efforts aiming to undermine a rival's power. By contrast, positive balancing means to strengthen a state's own power in world politics. I argue that a state's balancing strategies are shaped by the level of threat perception regarding its rival....... The higher the threat perception, the more likely it is for a state to choose positive balancing. The lower the threat perception, the more likely it is for a state to choose negative balancing. I suggest that the hegemon provides security as a public good to the international system in a unipolar world...... in which the relatively low-threat propensity of the system renders positive balancing strategies incompatible with state interests after the Cold War. Instead, states have employed various negative balancing strategies to undermine each other's power, especially when dealing with us primacy. China...
Malone Ruth E
threatened by the globalization of public health, sidestep competitive concerns to coordinate their activities. The global network of national and regional manufacturing associations created and nurtured by INFOTAB remains active, particularly in relation to the recently negotiated global health treaty, the Framework Convention on Tobacco Control. Policymakers should be aware that although these associations claim to represent only national or regional interests, they are allied to and coordinated with a confederation of transnational tobacco companies seeking to protect profits by undermining public health.
McDaniel, Patricia A; Intinarelli, Gina; Malone, Ruth E
concerns to coordinate their activities. The global network of national and regional manufacturing associations created and nurtured by INFOTAB remains active, particularly in relation to the recently negotiated global health treaty, the Framework Convention on Tobacco Control. Policymakers should be aware that although these associations claim to represent only national or regional interests, they are allied to and coordinated with a confederation of transnational tobacco companies seeking to protect profits by undermining public health.
McDaniel, Patricia A; Intinarelli, Gina; Malone, Ruth E
public health, sidestep competitive concerns to coordinate their activities. The global network of national and regional manufacturing associations created and nurtured by INFOTAB remains active, particularly in relation to the recently negotiated global health treaty, the Framework Convention on Tobacco Control. Policymakers should be aware that although these associations claim to represent only national or regional interests, they are allied to and coordinated with a confederation of transnational tobacco companies seeking to protect profits by undermining public health. PMID:18201375
Petrov, G M; Moretskiĭ, A A
There are discussed the problems of military treatment and prophylactic institution (TPI) functioning under conditions of market reform of Russian public health. Main marketing concepts in military health are determined and some recommendations on work improvement in TPI of the Armed Forces in the system of obligatory medical insurance are presented, granting population paid medical services. It is necessary to form a new type of director--military and medical manager.
Rudin, Robert S; Schneider, Eric C; Volk, Lynn A; Szolovits, Peter; Salzberg, Claudia A; Simon, Steven R; Bates, David W
Federal and state agencies are investing substantial resources in the creation of community health information exchanges, which are consortia that enable independent health care organizations to exchange clinical data. However, under pressure to form accountable care organizations, medical groups may merge and support private health information exchanges. Such activity could reduce the potential utility of community exchanges-that is, the exchanges' capacity to share patient data across hospitals and physician practices that are independent. Simulations of care transitions based on data from ten Massachusetts communities suggest that there would have to be many such mergers to undermine the potential utility of health information exchanges. At the same time, because hospitals and the largest medical groups account for only 10-20 percent of care transitions in a community, information exchanges will still need to recruit a large proportion of the medical groups in a given community for the exchanges to maintain their usefulness in fostering information exchange across independent providers.
Health and health care provision are one of the most important topics in public policy, and often a highly debated topic in the political arena. The importance of considering trust in the health care sector is highlighted by studies showing that trust is associated, among others, with poor self-related health, and poorer health outcomes. Similarly, corruption has shown to create economic costs and inefficiencies in the health care sector. This is particularly important for a newly democratized country such as Croatia, where a policy responsive government indicates a high level of quality of democracy (Roberts, 2009) and where a legacy of corruption in the health care sector has been carried over from the previous regime. In this study, I assess the relationship between health care corruption and trust in public health care and hypothesize that experience with health care corruption as well as perception of corruption has a negative effect on trust in public care facilities. Data were collected in two surveys, administered in 2007 and 2009 in Croatia. Experience with corruption and salience with corruption has a negative effect on trust in public health care in the 2007 survey, but not in the 2009 survey. While the results are mixed, they point to the importance of further studying this relationship. Copyright © 2013 Elsevier Ltd. All rights reserved.
Otañez, Martin G; Glantz, Stanton A
The cigarette companies and their lobbying organization used tobacco industry-produced films and videos about tobacco farming to support their political, public relations, and public policy goals. Critical discourse analysis shows how tobacco companies utilized film and video imagery and narratives of tobacco farmers and tobacco economies for lobbying politicians and influencing consumers, industry-allied groups, and retail shop owners to oppose tobacco control measures and counter publicity on the health hazards, social problems, and environmental effects of tobacco growing. Imagery and narratives of tobacco farmers, tobacco barns, and agricultural landscapes in industry videos constituted a tobacco industry strategy to construct a corporate vision of tobacco farm culture that privileges the economic benefits of tobacco. The positive discursive representations of tobacco farming ignored actual behavior of tobacco companies to promote relationships of dependency and subordination for tobacco farmers and to contribute to tobacco-related poverty, child labor, and deforestation in tobacco growing countries. While showing tobacco farming as a family and a national tradition and a source of jobs, tobacco companies portrayed tobacco as a tradition to be protected instead of an industry to be regulated and denormalized. PMID:20160936
Otañez, Martin G; Glantz, Stanton A
The cigarette companies and their lobbying organization used tobacco industry-produced films and videos about tobacco farming to support their political, public relations, and public policy goals. Critical discourse analysis shows how tobacco companies utilized film and video imagery and narratives of tobacco farmers and tobacco economies for lobbying politicians and influencing consumers, industry-allied groups, and retail shop owners to oppose tobacco control measures and counter publicity on the health hazards, social problems, and environmental effects of tobacco growing. Imagery and narratives of tobacco farmers, tobacco barns, and agricultural landscapes in industry videos constituted a tobacco industry strategy to construct a corporate vision of tobacco farm culture that privileges the economic benefits of tobacco. The positive discursive representations of tobacco farming ignored actual behavior of tobacco companies to promote relationships of dependency and subordination for tobacco farmers and to contribute to tobacco-related poverty, child labor, and deforestation in tobacco growing countries. While showing tobacco farming as a family and a national tradition and a source of jobs, tobacco companies portrayed tobacco as a tradition to be protected instead of an industry to be regulated and denormalized.
Neufeld, Maria; Lachenmeier, Dirk W.; Walch, Stephan G.; Rehm, Jürgen
Counterfeit alcohol belongs to the category of unrecorded alcohol not reflected in official statistics. The internet trade of alcoholic beverages has been prohibited by the Russian Federation since 2007, but various sellers still offer counterfeit spirits (i.e., forged brand spirits) over the internet to Russian consumers, mostly in a non-deceptive fashion at prices up to 15 times lower than in regular sale. The public health issues arising from this unregulated trade include potential harm to underage drinkers, hazards due to toxic ingredients such as methanol, but most importantly alcohol harms due to potentially increased drinking volumes due to low prices and high availability on the internet. The internet sale also undermines existing alcohol policies such as restrictions of sale locations, sale times and minimum pricing. The need to enforce measures against counterfeiting of spirits, but specifically their internet trade should be implemented as key elements of alcohol policies to reduce unrecorded alcohol consumption, which is currently about 33 % of total consumption in Russia. PMID:28663784
Neufeld, Maria; Lachenmeier, Dirk W; Walch, Stephan G; Rehm, Jürgen
Counterfeit alcohol belongs to the category of unrecorded alcohol not reflected in official statistics. The internet trade of alcoholic beverages has been prohibited by the Russian Federation since 2007, but various sellers still offer counterfeit spirits (i.e., forged brand spirits) over the internet to Russian consumers, mostly in a non-deceptive fashion at prices up to 15 times lower than in regular sale. The public health issues arising from this unregulated trade include potential harm to underage drinkers, hazards due to toxic ingredients such as methanol, but most importantly alcohol harms due to potentially increased drinking volumes due to low prices and high availability on the internet. The internet sale also undermines existing alcohol policies such as restrictions of sale locations, sale times and minimum pricing. The need to enforce measures against counterfeiting of spirits, but specifically their internet trade should be implemented as key elements of alcohol policies to reduce unrecorded alcohol consumption, which is currently about 33 % of total consumption in Russia.
Smith, EA; Malone, RE
Smoking impairs the readiness and performance of military personnel, yet congressional opposition has thwarted military tobacco control initiatives. Involvement of civilian organizations might alter this political dynamic. We interviewed 13 leaders of national civilian public health and tobacco control organizations to explore their perspectives on military tobacco control, inductively analyzing data for themes. Leaders believed that military tobacco use was problematic but lacked specific kn...
With the recent passage of the National Defense Authorization Act for Fiscal Year 2017, Congress has triggered groundbreaking Military Health System organizational restructuring with the Defense Health Agency assuming responsibility for managing all hospitals and clinics owned by the Army, Navy, and Air Force. This is a major shift toward a modern value-based managed care system, which will require much greater military-civilian health care delivery integration to be in place by October 2018. Just before the National Defense Authorization Act for Fiscal Year 2017 passage, the Department of Defense had already begun a seismic shift and awarded a contract for the new Military Health System-wide electronic health record system. In this perspective, we discuss the implications of the intersection of two large-scope and large-scale initiatives, health system transformation, and information technology modernization, being rolled out in the largest and most complex federal agency and potential risk mitigating steps. The Military Health System will require an expanded unified clinical leadership to spearhead short-term transformation; furthermore, developing, organizing, and growing a cadre of informatics expertise to expand the use and diffusion of novel solutions such as health information exchanges, data analytics, and others to transcend organizational barriers are still needed to achieve the long-term aim of health system reform as envisioned by the National Defense Authorization Act for Fiscal Year 2017.
Waitzkin, Howard; Cruz, Mario; Shuey, Bryant; Smithers, Daniel; Muncy, Laura; Noble, Marylou
Although research conducted within the military has assessed the health and mental health problems of military personnel, little information exists about personnel who seek care outside the military. The purpose of this study is to clarify the personal characteristics, mental health diagnoses, and experiences of active duty U.S. military personnel who sought civilian sector services due to unmet needs for care. This prospective, multi-method study included 233 clients, based in the United States, Afghanistan, South Korea, and Germany, who obtained care between 2013 and 2016 from a nationwide network of volunteer civilian practitioners. A hotline organized by faith-based and peace organizations received calls from clients and referred them to the network when the clients described unmet needs for physical or mental health services. Intake and follow-up interviews at 2 wk and 2 mo after intake captured demographic characteristics, mental health diagnoses, and reasons for seeking civilian rather than military care. Non-parametric bootstrap regression analyses identified predictors of psychiatric disorders, suicidality, and absence without leave (AWOL). Qualitative analyses of clients' narratives clarified their experiences and reasons for seeking care. The research protocol has been reviewed and approved annually by the Institutional Review Board at the University of New Mexico. Depression (72%), post-traumatic stress disorder (62%), alcohol use disorder (27%), and panic disorder (25%) were the most common diagnoses. Forty-eight percent of clients reported suicidal ideation. Twenty percent were absence without leave. Combat trauma predicted post-traumatic stress disorder (odds ratio [OR] = 8.84, 95% confidence interval [CI] 1.66, 47.12, p = 0.01) and absence without leave (OR = x3.85, 95% CI 1.14, 12.94, p = 0.03). Non-combat trauma predicted panic disorder (OR = 3.64, 95% CI 1.29, 10.23, p = 0.01). Geographical region was associated with generalized anxiety disorder
The Department of Defense's military health care system, entitled TRICARE, brings together the direct health care resources of the Department of Defense and supplements this capability through the use...
Bermann, S; Escudero, J C
The socioeconomic policies of Argentina's Military Junta, in power since March 1976, have led to a sharp impoverishment of the vast majority of the population. In the health sector, facilities which previously were public are being transferred to the private sector, and public hospitals formerly providing free services to the population now charge patients for the care received. As a necessary counterpart to these unpopular measures, a regime of terror has been waged against members of the health team--both those politically active and those considered potentially subversive, particularly the psychiatrists and workers in community health. Differences between the Argentinian situation and previous European fascist patterns are noted, and the possibility of use of the "Argentinian model" in other capitalist countries in crisis is discussed.
Lewy, Colleen S; Oliver, Celina M; McFarland, Bentson H
An Internet-based survey sought information about barriers to mental health services for military wives. On the basis of qualitative work, an Internet-based program was created to identify military wives who may have major depressive disorder. Women (N=569, ages 18 to 56) were recruited from 45 states and eight foreign countries. Most participants (78%) reported mild to severe depression. Many (44%) reported unaddressed mental health needs. Barriers included inability to attend daytime appointments (38%), inability to find a counselor who understands the needs of military spouses (35%), inability to find a counselor the participant could trust (29%), concerns about confidentiality (26%), and lack of knowledge about where to get services (25%). The barriers reported differed markedly from those described by distressed women in the general population. Military wives are an underserved population. Knowledge of military culture is essential for civilian mental health providers working with military wives.
Himmerich, Hubertus; Willmund, G D; Wesemann, U; Jones, N; Fear, N T
Despite joint participation in international military operations, few collaborative military mental health research projects have been undertaken by European countries. From a common perspective of military mental health researchers from Germany and the UK, the lack of shared research might be related not only to the use of different languages but also the different ways in which the two militaries provide mental health and medical support to operations and differences in military institutions. One area that is suitable for military health research collaboration within UK and German forces is mental health and well-being among military personnel. This could include the study of resilience factors, the prevention of mental disorder, mental health awareness, stigma reduction and the treatment of mental disorder. Military mental health research topics, interests and the studies that have been conducted to date in the UK and Germany have considerable overlap and commonality of purpose. To undertake the investigation of the long-term consequences of operational deployment, the specific burdens placed on military families and to further the understanding of the role of factors such as biomarkers for use in military mental health research, it seems advisable to forge international research alliances across European nations, which would allow for researchers to draw transcultural and generalisable conclusions from their work. Such an enterprise is probably worthwhile given the shared research interests of Germany and the UK and the common perspectives on military mental health in particular. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Gibbons, Susanne W; Barnett, Scott D; Hickling, Edward J
This study uses data from the 2005 Department of Defense Survey of Health-Related Behaviors Among Military Personnel to examine relationships between family stress and posttraumatic stress symptoms across 4 subgroups of Operation Iraqi Freedom-deployed (i.e., war in Iraq) or Operation Enduring Freedom-deployed (i.e., war in Afghanistan) active-duty military service members. Results suggest the following: (a) the greatest positive correlation of family stressors with posttraumatic stress symptoms was found within the military health care officer group, and (b) these military health care officers differed in family stressors mediating posttraumatic stress with divorce and financial problems accounting for significant and unique portions of the variance. Implications for care of service members and their families are discussed. Published by Elsevier Inc.
Agazio, Janice Griffin; Buckley, Kathleen M
In this study, we explored what may determine, or predict, United States military women's health promotion behaviors. Using a descriptive correlational design grounded in Pender's Health Promotion model, 491 military women completed instruments measuring their demographic variables, perception of health, definition of health, self-efficacy, and interpersonal influences to determine the significant factors affecting participation in health promotion activities. The outcome indicated that self-efficacy and interpersonal influences were the most influential in determining health promotion. This research illuminates some of the challenges working women face in meeting health promotion activities and how best to support their ability to participate in healthy behaviors.
The study of Health Status of Military Women and Men in the Total Force will obtain comprehensive probability-based epidemiological data for women and men across all pay grades for active-duty Army...
.... As pan of the Defense Women's Health Research Program, a new report from the Committee on Body Composition, Nutrition, and Health of Military Women of the Institute of the Institute of Medicine examines issues of body composition, fitness, and appearance standards and their impact on the health, nutritional status, and performance of active-duty women.
Delahaye, R P
Between June 1871 and December 1872, about five thousand prisoners were kept in Versailles among some places of detention. This high death rate was indebted for worst hygienic states (individual or collective) and food wretched quality during first weeks. Military Health Service, under Hippolyte Larrey's management with Adolphe Thiers and staff assent involved living conditions owing to tubs and toilets not forgiving accurate clothes and well-balanced food. In every prison was fitted and infirmary managed by a military physician. Sick people were sent into hospital. Versailles city's archives show that, during 1871, 154 insurgent people died in the military hospital while the number dropped to 55 during 1872.
Lyk-Jensen, Stéphanie; Weatherall, Cecilie Dohlmann; W. Jepsen, Peter
for the non-deployed eligible men, and our results hold to various robustness checks. Our administrative records provide objective measures of mental health service use in the form of psychiatric diagnoses and purchase of mental health-related medication. The very rich data makes it possible to control......In this paper we estimate the causal effect of military deployment on soldiers’ mental health. To handle the selection bias problem, we use longitudinal data for deployed and non-deployed eligible men in a difference-in-differences setting. Using pair-wise matching, we impute deployment dates...... for important variables like intelligence tests and family background. We find significant adverse effects of military deployment on soldiers’ mental health service use. Highlights: - Causal effect of military deployment on soldiers’ use of mental health service - Using a difference-in-differences approach...
Zeliff, Barbara Hundley.
The Department of Defense's military health care system, entitled TRICARE, brings together the direct health care resources of the Department of Defense and supplements this capability through the use of managed care support services contracts and purchased care. This blended system is charged with providing a comprehensive health benefit to approximately 8.9 million beneficiaries, including active duty and retired uniformed services members, their families, and survivors, while also providin...
Williamson, Randall B
.... DOD oversees the military services compliance with PDHRA requirements through its deployment health assessment quality assurance program and is required to report on the quality assurance program...
Wilson, Candy; Trego, Lori; Rychnovsky, Jacqueline; Steele, Nancy; Foradori, Megan
In 2008, four doctorate military nurse scientists representing the triservices (Army, Navy, and Air Force) identified a common interest in the health and care of all women in the armed forces. For 7 years, the team's shared vision to improve servicewomen's health inspired them to commit to a rigorous schedule of planning, developing, and implementing an innovative program that has the capability of advancing scientific knowledge and influencing health policy and practice through research. The ultimate goal of the Military Women's Health Research Interest Group (MWHRIG) is to support military clinicians and leaders in making evidence-based practice and policy decisions. They developed a 4-pronged approach to cultivate the science of military women's healthcare: evaluate the existing evidence, develop a research agenda that addresses gaps in knowledge, facilitate the collaboration of multidisciplinary research, and build the bench of future researchers. The MWHRIG has been a resource to key leaders; its value has been validated by multiservice and multidisciplinary consultations. However, the journey to goal attainment has only been achieved by the enduring commitment of these MWHRIG leaders and their passion to ensure the health and wellbeing of the many women who serve in the United States military. This article describes their journey of dedication.
Langenberg, J.P.; Polhuijs, M.; Sijbranda, T.
Participation in military operations is accompanied by health hazards resulting from exposure to chemical substances from natural and anthropogenic sources. Historically, focus on toxicological risks has been on the health effects of exposure to chemical warfare agents (CW A). In recent years the
Schneider, Eric C.; Volk, Lynn A.; Szolovits, Peter; Salzberg, Claudia A.; Simon, Steven R.; Bates, David W.
Substantial resources are being invested in health information exchanges (HIE), community-based consortia that enable independent health-care organizations to exchange clinical data. However, under pressure to form accountable care organizations, medical groups may merge and support private HIE, reducing the potential utility of community HIEs. Simulations of “care transitions” based on data from 10 Massachusetts communities suggest that mergers would have to be considerable to substantially reduce the potential utility of an HIE. Nonetheless, simulations also suggest that HIEs will need to recruit a large proportion of the medical groups in a community, as hospitals and the largest groups account for only 10 to 20% of care transitions in communities. PMID:22392665
Freeman, Becky; Chapman, Simon
Background The World Health Organization Framework Convention on Tobacco Control (WHO FCTC) bans all forms of tobacco advertising, promotion and sponsorship. The comprehensiveness of this ban has yet to be tested by online social networking media such as Facebook. In this paper, the activities of employees of the transnational tobacco company, British American Tobacco, (BAT) on Facebook and the type of content associated with two globally popular BAT brands (Dunhill and Lucky Strike) are mapp...
Lawrence, Mark A; Dickie, Sarah; Woods, Julie L
Food-based Dietary Guidelines (FBDGs) promote healthy dietary patterns. Nutrient-based Front-of-Pack Labelling (NBFOPL) schemes rate the 'healthiness' of individual foods. This study aimed to investigate whether the Australian Health Star Rating (HSR) system aligns with the Australian Dietary Guidelines (ADGs). The Mintel Global New Products Database was searched for every new food product displaying a HSR entering the Australian marketplace from 27 June 2014 (HSR system endorsement) until 30 June 2017. Foods were categorised as either a five food group (FFG) food or 'discretionary' food in accordance with ADG recommendations. Ten percent (1269/12,108) of new food products displayed a HSR, of which 57% were FFG foods. The median number of 'health' stars displayed on discretionary foods (2.5; range: 0.5-5) was significantly lower ( p stars across the two food categories was observed, with 56.7% of discretionary foods displaying ≥2.5 stars. The HSR system is undermining the ADG recommendations through facilitating the marketing of discretionary foods. Adjusting the HSR's algorithm might correct certain technical flaws. However, supporting the ADGs requires reform of the HSR's design to demarcate the food source (FFG versus discretionary food) of a nutrient.
.... Military retirement health benefits are post-retirement benefits that DoD provides to military retirees and other eligible beneficiaries through the Civilian Health and Medical Program of the Uniformed Services (Purchased Care...
Freeman, Becky; Chapman, Simon
The World Health Organization Framework Convention on Tobacco Control (WHO FCTC) bans all forms of tobacco advertising, promotion and sponsorship. The comprehensiveness of this ban has yet to be tested by online social networking media such as Facebook. In this paper, the activities of employees of the transnational tobacco company, British American Tobacco, (BAT) on Facebook and the type of content associated with two globally popular BAT brands (Dunhill and Lucky Strike) are mapped. BAT employees on Facebook were identified and then the term 'British American Tobacco' was searched for in the Facebook search engine and results recorded, including titles, descriptions, names and the number of Facebook participants involved for each search result. To further detail any potential promotional activities, a search for two of BAT's global brands, 'Dunhill' and 'Lucky Strike', was conducted. Each of the 3 search terms generated more than 500 items across a variety of Facebook subsections. Some BAT employees are energetically promoting BAT and BAT brands on Facebook through joining and administrating groups, joining pages as fans and posting photographs of BAT events, products and promotional items. BAT employees undertaking these actions are from countries that have ratified the WHO FCTC, which requires signatories to ban all forms of tobacco advertising, including online and crossborder exposure from countries that are not enforcing advertising restrictions. The results of the present research could be used to test the comprehensiveness of the advertising ban by requesting that governments mandate the removal of this promotional material from Facebook.
Background The World Health Organization Framework Convention on Tobacco Control (WHO FCTC) bans all forms of tobacco advertising, promotion and sponsorship. The comprehensiveness of this ban has yet to be tested by online social networking media such as Facebook. In this paper, the activities of employees of the transnational tobacco company, British American Tobacco, (BAT) on Facebook and the type of content associated with two globally popular BAT brands (Dunhill and Lucky Strike) are mapped. Methods BAT employees on Facebook were identified and then the term ‘British American Tobacco’ was searched for in the Facebook search engine and results recorded, including titles, descriptions, names and the number of Facebook participants involved for each search result. To further detail any potential promotional activities, a search for two of BAT's global brands, ‘Dunhill’ and ‘Lucky Strike’, was conducted. Results Each of the 3 search terms generated more than 500 items across a variety of Facebook subsections. Discussion Some BAT employees are energetically promoting BAT and BAT brands on Facebook through joining and administrating groups, joining pages as fans and posting photographs of BAT events, products and promotional items. BAT employees undertaking these actions are from countries that have ratified the WHO FCTC, which requires signatories to ban all forms of tobacco advertising, including online and crossborder exposure from countries that are not enforcing advertising restrictions. The results of the present research could be used to test the comprehensiveness of the advertising ban by requesting that governments mandate the removal of this promotional material from Facebook. PMID:20395406
Full Text Available Background: Ingestion of excess fluoride can cause fluorosis which adversely affects teeth and bones. Fluorosis is a major public health problem in the state of Rajasthan with all its 32 districts having variable fluoride contamination, and many initiatives are currently implemented in this region to mitigate the fluorosis burden. Objective: The objective of this study was to assess fluorosis, its risk factors, and the awareness among school students and teachers in endemic villages of Jodhpur district, Rajasthan. Materials and Methods: A representative sample of 300 students of age 12–15 years were enrolled for cross-sectional study in selected villages. Data were collected regarding awareness, behavioral and preventive practices about fluorosis and clinical assessment and fluoride estimation in water and urine samples was done. Results: Dental fluorosis through Dean's index was observed in 24.5% of students. The awareness and practices for fluorosis prevention and its risk factors were poor among both students and teachers. Intake of piped water supply was reported by majority of students (95.8%. High fluoride concentration was found in 35 (81.3% out of 43 urine samples. Conclusion: Improvement in drinking water supply in the endemic village of Rajasthan has decreased the burden of fluorosis, but low level of awareness and prevailing dietary and behavioral practices still pose them at risk of high fluoride intake. This signifies the need to address nonconventional sources of fluoride intake (diet and toothpaste and early screening of disease by involving teachers and family physicians in fluoride mitigation efforts.
Vincent, Stéphanie; Weatherall, Cecilie Dohlmann; W. Jepsen, Peter
Public concern about soldiers’ mental health has increased over the last decade. Yet the large literature on the mental health problems of returning soldiers relies primarily on self-reported measures that may suffer from non-response bias, usually refers to older conflicts, and focuses mainly...... on specific diagnoses such as PTSD. Another challenge is that the differences between soldiers and non-soldiers are not necessarily causal, instead possibly reflecting an underlying propensity towards active military service. Using the objective measures of hospitalizations and the purchase of mental health...... medication, this paper is the first to investigate the effect of recent military deployments on a broader measure of mental health, for a full population of Danish soldiers and a comparison group of eligible men. We exploit a panel of Danish health administrative records and use propensity score matching...
Full Text Available Counterfeit alcohol belongs to the category of unrecorded alcohol not reflected in official statistics. The internet trade of alcoholic beverages has been prohibited by the Russian Federation since 2007, but various sellers still offer counterfeit spirits (i.e., forged brand spirits over the internet to Russian consumers, mostly in a non-deceptive fashion at prices up to 15 times lower than in regular sale. The public health issues arising from this unregulated trade include potential harm to underage drinkers, hazards due to toxic ingredients such as methanol, but most importantly alcohol harms due to potentially increased drinking volumes due to low prices and high availability on the internet. The internet sale also undermines existing alcohol policies such as restrictions of sale locations, sale times and minimum pricing. The need to enforce measures against counterfeiting of spirits, but specifically their internet trade should be implemented as key elements of alcohol policies to reduce unrecorded alcohol consumption, which is currently about 33 % of total consumption in Russia.
Full Text Available Counterfeit alcohol belongs to the category of unrecorded alcohol not reflected in official statistics. The internet trade of alcoholic beverages has been prohibited by the Russian Federation since 2007, but various sellers still offer counterfeit spirits (i.e., forged brand spirits over the internet to Russian consumers, mostly in a non-deceptive fashion at prices up to 15 times lower than in regular sale. The public health issues arising from this unregulated trade include potential harm to underage drinkers, hazards due to toxic ingredients such as methanol, but most importantly alcohol harms due to potentially increased drinking volumes due to low prices and high availability on the internet. The internet sale also undermines existing alcohol policies such as restrictions of sale locations, sale times and minimum pricing. The need to enforce measures against counterfeiting of spirits, but specifically their internet trade should be implemented as key elements of alcohol policies to reduce unrecorded alcohol consumption, which is currently about 33 % of total consumption in Russia.
Khachatrian, R G
The mission of human rights protection encompasses the protection of the rights of the military. The article attempts to study the fulfillment of the right of military servicemen to health protection and work security in Republic of Armenia. The military servicemen right to health is defined on the basis of analysis of current system of law, military legislation, regulations and rules. Corrective actions limiting dangerous factors of military service are recommended to contribute to the protection of human rights, to ensure protection of the life and health of servicemen and to create healthy conditions of military service.
Foran, Heather M; Garber, Bryan G; Zamorski, Mark A; Wray, Mariane; Mulligan, Kathleen; Greenberg, Neil; Castro, Carl Andrew; Adler, Amy B
Deployments increase risk for adjustment problems in service members. To mitigate this increased risk, mental health training programs have been developed and implemented in several nations. As part of a coordinated effort, three nations adapted a U.S. mental health training program that had been validated by a series of group randomized trials demonstrating improvement in postdeployment adjustment. Implementation of evidence-based programs in a new context is challenging: How much of the original program needs to remain intact in order to retain its utility? User satisfaction rates can provide essential data to assess how well a program is accepted. This article summarizes service member ratings of postdeployment mental health training and compares ratings from service members across four nations. The participating nations (Canada, New Zealand, United Kingdom, and the United States) administered mental health training to active duty military personnel in their respective nations. Following the training, military personnel completed an evaluation of the training. Overall, across the four nations, more than 70% of military personnel agreed or strongly agreed that they were satisfied with the mental health training. Although some differences in evaluations were observed across nations, components of training that were most important to overall satisfaction with the training were strikingly similar across nations. Fundamentally, it appears feasible that despite cultural and organizational differences, a mental health training program developed in one nation can be successfully adapted for use in other nations. PsycINFO Database Record (c) 2013 APA, all rights reserved.
Pavalanathan, Umashanthi; Datla, Vivek V.; Volkova, Svitlana; Charles-Smith, Lauren E.; Pirrung, Megan A.; Harrison, Joshua J.; Chappell, Alan R.; Corley, Courtney D.
Social media can provide a resource for characterizing communities and targeted populations through activities and content shared online. For instance, studying the armed forces‚Äô use of social media may provide insights into their health and wellbeing. In this paper, we address three broad research questions: (1) How do military populations use social media? (2) What topics do military users discuss in social media? (3) Do military users talk about health and well-being differently than civilians? Military Twitter users were identified through keywords in the profile description of users who posted geotagged tweets at military installations. These military tweets were compared with the tweets from remaining population. Our analysis indicate that military users talk more about military related responsibilities and events, whereas non-military users talk more about school, work, and leisure activities. A significant difference in online content generated by both populations was identified, involving sentiment, health, language, and social media features.
Poston, Walker S.C.; Haddock, Christopher K.; Jahnke, Sara A.; Hyder, Melissa L.; Jitnarin, Nattinee
Military installation newspapers are a primary means used by military commanders to communicate information about topics important to military personnel including leadership, training issues, installation events, safety concerns, and vital health issues. We conducted a content analysis of military commanders’ messages about health issues that were published in online military installation newspapers/newsfeeds. We identified a total of 75 publicly accessible installation newspapers/newsfeeds with commanders’ messages (n=39 Air Force, n=19 Army, n=7 Navy, n=1 Marine, and n=9 Joint Bases). Commander messages published between January 2012–December 2012 were collected, screened, and coded. Coder inter-rater reliability was 98.9%. Among the 2,479 coded commanders’ messages, 132 (5.3%) addressed a health topic as the primary focus. There were no significant differences between service branches in the percentage of health-oriented messages (χ2=5.019, p=0.285). The most commonly addressed health topics were exercise/fitness (23.5%), other mental health concerns (19.7%), alcohol/DUI (13.6%), and suicide (12.1%). Tobacco use was directly addressed as a primary health aim in only two commanders’ messages (1.5%). Health topics, and particularly tobacco-related content, are rarely written about by military commanders. The absence of tobacco-related health messages from line leadership contributes to the perception that tobacco control is a low priority. PMID:26032388
A healthy, well-fed, educated populace is synonymous with a prospering economy. Yet, when planning their budgets, governments tend to emphasize infrastructural/industrial projects and defence rather than investing in health, education and other social programmes to eliminate the widespread poverty and high mortality of its population, which would assure a more promising future in the long-term. As citizens, nurses are responsible for initiating and supporting action to meet the health and social needs of the public. And in keeping with ICN's 1989 resolution on nuclear war, INR presents some facts on social and defence spending to show how health needs are often being deprived by emphasis on others sectors, particularly defence. The aim is "to encourage nurses to critically appraise expenditure on health and welfare at a national and global level in relation to that spent on conventional and nuclear arms and to assist nurses to develop strategies of action to contribute to international peace."
Greene-Shortridge, Tiffany M; Britt, Thomas W; Castro, Carl Andrew
The present review addresses the perceived stigma associated with admitting a mental health problem and seeking help for that problem in the military. Evidence regarding the public stigma associated with mental disorders is reviewed, indicating that the public generally holds negative stereotypes toward individuals with psychological problems, leading to potential discrimination toward these individuals. The internalization of these negative beliefs results in self-stigma, leading to reduced self-esteem and motivation to seek help. Even if soldiers form an intention to seek help for their psychological difficulty, barriers to mental health care may prevent the soldier from receiving the help they need. An overall model is proposed to illustrate how the stigma associated with psychological problems can prevent soldiers getting needed help for psychological difficulties and proposed interventions for reducing stigma in a civilian context are considered for military personnel.
AND+third. 15 Ibid. 16 Ibid. 17 32 C.F.R. §199.17(p)(5)(ii) (2005). 18 See http://mytoc.tma.osd.mil/AccessToCare/ TOC /ATC.htm. 19 File name...responsible sexual behavior; mental health; injury and violence; environmental quality; immunization; and access to care.11 Responsibility The Assistant
Kaikkonen, Noora M; Laukkala, Tanja
Volunteering in international military missions has been scrutinized for its effects on mental health. Different kinds of exposures to traumatic events are associated with a variety of mental disorders, mainly heightened rates of post-traumatic stress disorder (PTSD) and alcohol abuse. Based on the literature we discuss risk and protective factors concerning the psychological well-being of soldiers attending to international military operations. A systematic literature search was carried out using relevant search terms to identify the articles for this review. The ability to recognize and treat acute stress reactions during deployments is important. Post-deployment psychosocial support and services have a role in lowering barriers to care, diminishing stigma and also in recognizing individuals who suffer from psychological distress or psychiatric symptoms, to connect them with appropriate care. Further investigation of gender differences and the role of stigmatization is warranted. Most of those participating in international military operations are repatriated without problems, but repeated exposure to combat situations and other stressors may affect mental health in various ways. Stigmatization is still a barrier to care.
websites, campaign videos in cinemas , leaflets for the public and health care professionals, and reading materials for young people for use in school...Psychiatric Services, Vol. 59, No. 1, January 2008, pp. 105–108. Okumura, Y., and S. Sakamoto, “Depression Treatment Preferences Among Japanese ... Japanese Undergraduates: Using Conjoint Analysis,” International Journal of Social Psychiatry, Vol. 58, No. 2, March 2012, pp. 195–203. Oliver, Michael
Full Text Available Providing effective health interventions and achieving equity in health need to apply the community-based approaches such as social determinants of health. In the military organizations, these determinants have received less attention from the military health researchers and policymakers. Therefore, this study aimed to identify and explain the social determinants affecting the health of military forces in Iran. This was a qualitative study which was conducted in 2014. The required data were collected through semistructured interviews and analyzed through Conventional Content Analysis. The studied sample consisted of 22 military health experts, policymakers, and senior managers selected using purposeful sampling method with maximum variation sampling. MAXQDA.2007 was used to analyze the collected data. After analyzing the collected data, two main contents, that is, “general social determinants of health” and “military social determinants of health,” with 22 themes and 90 subthemes were identified as the social determinants of military forces’ health. Main themes were religious rule, spirituality promotion policies, international military factors, military command, and so forth. Given the role and importance of social factors determining the military forces’ health, it can be recommended that the military organizations should pay more attention to these determinants in making policies and creating social, economic, and cultural structures for their forces.
Sanaeinasab, Hormoz; Ghanei, Mostafa; Mehrabi Tavana, Ali; Ravangard, Ramin; Karamali, Mazyar
Providing effective health interventions and achieving equity in health need to apply the community-based approaches such as social determinants of health. In the military organizations, these determinants have received less attention from the military health researchers and policymakers. Therefore, this study aimed to identify and explain the social determinants affecting the health of military forces in Iran. This was a qualitative study which was conducted in 2014. The required data were collected through semistructured interviews and analyzed through Conventional Content Analysis. The studied sample consisted of 22 military health experts, policymakers, and senior managers selected using purposeful sampling method with maximum variation sampling. MAXQDA.2007 was used to analyze the collected data. After analyzing the collected data, two main contents, that is, “general social determinants of health” and “military social determinants of health,” with 22 themes and 90 subthemes were identified as the social determinants of military forces' health. Main themes were religious rule, spirituality promotion policies, international military factors, military command, and so forth. Given the role and importance of social factors determining the military forces' health, it can be recommended that the military organizations should pay more attention to these determinants in making policies and creating social, economic, and cultural structures for their forces. PMID:26379716
De Pedro, Kris Tunac; Astor, Ron Avi; Gilreath, Tamika D.; Benbenishty, Rami; Berkowitz, Ruth
Research has found that when compared with civilian students, military-connected students in the United States have more negative mental health outcomes, stemming from the stress of military life events (i.e., deployment). To date, studies on military-connected youth have not examined the role of protective factors within the school environment,…
Herman, Patricia M; Sorbero, Melony E; Sims-Columbia, Ann C
Surveys of military personnel indicate substantial use of complementary and alternative medicine (CAM) that possibly exceeds use in the general U.S. Although military treatment facilities (MTFs) are known to offer CAM, surveys do not indicate where service members receive this care. This study offers a comprehensive system-wide accounting of the types of CAM offered across the military health system (MHS), the conditions for which it is used, and its level of use. These data will help MHS policymakers better support their population's healthcare needs. A census survey of MTFs across the MHS on all CAM use, supplemented where possible by MHS utilization data. Types of CAM offered by each MTF, reasons given for offering CAM, health conditions for which CAM is used, and number of patient visits for each CAM type. Of the 142 MTFs in the MHS, 133 (94%) responded. Of these, 110 (83%) offer at least one type of CAM and 5 more plan to offer CAM services in the future. Larger MTFs (those reporting ≥25,000 beneficiaries enrolled) are both more likely to offer CAM services (p 10) of different types of CAM (p = 0.010) than smaller MTFs. Three-fourths of MTFs offering CAM provide stress management/relaxation therapy, two-thirds provide acupuncture, and at least half provide progressive muscle relaxation, guided imagery, chiropractic, and mindfulness meditation. MTFs most commonly report CAM use for pain and mental health conditions. Acupuncture and chiropractic are most commonly used for pain, and stress management/relaxation therapy and mind-body medicine combinations are most often used for mental health-related conditions. We estimate 76,000 CAM patient encounters per month across the MHS. The availability of CAM services in the MHS is widespread and is being used to address a range of challenging pain and mental health conditions.
Do, Nhan V; Barnhill, Rick; Heermann-Do, Kimberly A; Salzman, Keith L; Gimbel, Ronald W
To design, build, implement, and evaluate a personal health record (PHR), tethered to the Military Health System, that leverages Microsoft® HealthVault and Google® Health infrastructure based on user preference. A pilot project was conducted in 2008-2009 at Madigan Army Medical Center in Tacoma, Washington. Our PHR was architected to a flexible platform that incorporated standards-based models of Continuity of Document and Continuity of Care Record to map Department of Defense-sourced health data, via a secure Veterans Administration data broker, to Microsoft® HealthVault and Google® Health based on user preference. The project design and implementation were guided by provider and patient advisory panels with formal user evaluation. The pilot project included 250 beneficiary users. Approximately 73.2% of users were Microsoft® HealthVault, and 81 (32.4%) selected Google® Health as their PHR of preference. Sample evaluation of users reflected 100% (n = 60) satisfied with convenience of record access and 91.7% (n = 55) satisfied with overall functionality of PHR. Key lessons learned related to data-transfer decisions (push vs pull), purposeful delays in reporting sensitive information, understanding and mapping PHR use and clinical workflow, and decisions on information patients may choose to share with their provider. Currently PHRs are being viewed as empowering tools for patient activation. Design and implementation issues (eg, technical, organizational, information security) are substantial and must be thoughtfully approached. Adopting standards into design can enhance the national goal of portability and interoperability.
Becker, Sara J.; Swenson, Rebecca; Esposito-Smythers, Christianne; Cataldo, Andrea; Spirito, Anthony
Military families with adolescents experience high levels of stress associated with parental deployment, but many of these families do not seek or utilize mental health services. The current qualitative study was designed to better understand barriers to mental health treatment experienced by adolescents in military families. Focus groups and individual interviews were conducted with military adolescents (n = 13), military (non-enlisted) parents (n = 12), and mental health service providers who treat adolescents in military families (n = 20). Discussions primarily explored barriers to seeking treatment, with supplemental questions assessing the ideal elements of mental health services for this population. Seven barriers to engaging in mental health services were identified: four internal (confidentiality concerns, stigma, ethic of self-reliance, lack of perceived relevance) and three external (time and effort concerns, logistical concerns, financial concerns). Challenges engaging military adolescents in mental health services are discussed and several recommendations are offered for service providers attempting to work with this population. PMID:25574070
JPC-1b Joint Program Committee-1b on Health Information Technology and Medical Informatics MAeHC Massachusetts eHealth Collaborative MHS Military...efficiency of care. The second study, by the eHealth Initiative (2011), surveyed communities across the United States with initiatives to share health...Simon et al. (2009) conducted focus groups involving 64 participants in several rural towns participating in the Massachusetts eHealth Collaborative
support stateside as a resource for information, supplies, and emotional support. Implications for Military Nursing: Though as health care professionals...a resource for information, supplies, and emotional support. Implications for Military Nursing: Though as health care professionals we pride...order one year’s supply of oral contraceptives , support menstrual suppression, and be available to answer questions; however, this support did not
Jai, Tun-Min; McCool, Barent N; Reed, Debra B
U.S. military families are experiencing high obesity rates similar to the civilian population. The Department of Defense's Military Health System (MHS) is one of the largest healthcare providers in the United States, serving approximately 9.2 million active duty service members, retirees, spouses, and children. The annual cost to the MHS for morbidities associated with being overweight exceeds $1 billion. The preschool age has been suggested as an opportune time to intervene for the prevention of obesity. Thus, this study investigated the current level of technology usage by military service member families and assessed their needs and interests in health/nutrition information. This needs assessment is crucial for researchers/educators to design further studies and intervention programs for obesity prevention in military families with young children. In total, 288 military parents (233 Army and 55 Air Force) at two military bases whose children were enrolled in military childcare centers in the southwestern United States participated in a Technology Usage in Military Family (TUMF) survey in 2013. Overall, both bases presented similar technology usage patterns in terms of computer and mobile device usage on the Internet. Air Force base parents had a slightly higher knowledge level of nutrition/health information than Army base parents. The TUMF survey suggested practical ways such as mobile applications/Web sites, social networks, games, etc., that health educators can use to disseminate nutrition/health information for obesity prevention among military families with young children.
Chu, Carol; Stanley, Ian H; Hom, Melanie A; Lim, Ingrid C; Joiner, Thomas E
Following deployment, soldiers may struggle to cope with the after-effects of combat service and experience increased suicidality. Therefore, connection to mental health services is vital. Research regarding the relationship between deployment, suicidality, and mental health connections has been equivocal, with some studies finding a link between deployment history and mental health outcomes, and others not. The purpose of this study was to examine the effects of military deployment on mental health and service utilization outcomes using a longitudinal design. Deployment history, mental health visits, symptoms of suicidality, and various mental health outcomes were assessed in a sample of 1,566 Army recruiters at study entry and 18-months follow-up. Deployment history was positively associated with mental health visits, number of major depressive episodes, and acquired capability for suicide at baseline; however, no significant relationship between deployment, mental health visits, and any other suicide or mental health-related outcomes emerged at baseline or follow-up. Findings suggest a disconnection from mental health services among military personnel. Implications for treatment and suicide prevention efforts among military personnel are discussed.
Full Text Available This paper highlights the impact of raid, rescue, and rehabilitation schemes on HIV programmes. It uses a case study of Veshya Anyay Mukti Parishad (VAMP, a sex workers collective in Sangli, India, to explore the impact of anti-trafficking efforts on HIV prevention programmes. The paper begins with an overview of the anti-trafficking movement emerging out of the United States. This U.S. based anti- trafficking movement works in partnership with domestic Indian anti- trafficking organisations to raid brothels to “rescue and rehabilitate” sex workers. Contrary to the purported goal of assisting women, the anti-trafficking projects that employ a raid, rescue, and rehabilitate model often undermine HIV projects at the local level, in turn causing harm to women and girls. We examine the experience of one peer educator in Sangli to demonstrate and highlight some of the negative consequences of these anti-trafficking efforts on HIV prevention programmes.
Sailliol, A; Ausset, S; Peytel, E
Blood transfusion is required in a number of emergency settings and the French military health service (FMHS) has issued specific guidelines for the treatment of war casualties. These guidelines take into account European standards and laws, NATO standards, and also public sentiment regarding transfusion. These guidelines reflect a determination to control the process and to avoid the improvisation frequently associated with wartime transfusion. The evolution in warfare (terrorism and bombing more frequent than gunshot) and the wide use of body armor have deeply changed the clinical presentation of war injuries. These now involve the extremities in 80% of cases, with extensive tissue damage and heavy blood loss. The FMHS recommends that war casualties with hemorrhagic shock be brought quickly to a medical treatment facility (MTF) after first-line treatment applied through buddy aid or by medics. In the MTF, before an early Medevac, a damage control surgery will be performed, with resuscitation using freeze-dried plasma, red blood cells and fresh whole blood. The French military blood bank is responsible for blood product supply, training and medical advice regarding transfusion therapy during wartime, as well as hemovigilance. All transfusion therapy practices are periodically assessed but research on whole blood pathogen reduction is being conducted in order to reduce the residual infectious risk associated with this product. Copyright © 2010 Elsevier Masson SAS. All rights reserved.
Pavalanathan, Umashanthi; Datla, Vivek V.; Volkova, Svitlana; Charles-Smith, Lauren E.; Pirrung, Megan A.; Harrison, Joshua J.; Chappell, Alan R.; Corley, Courtney D.
Social media can provide a resource for characterizing communities and small populations through activities and content shared online. For instance, studying the language use in social media within military populations may provide insights into their health and wellbeing. In this paper, we address three research questions: (1) How do military populations use social media? (2) What do military users discuss in social media? And (3) Do military users talk about health and well-being differently than civilians? Military Twitter users were identified through keywords in the profile description of users who posted geo-tagged tweets at military installations. The data was anonymized for the analysis. User profiles that belong to military population were compared to the nonmilitary population. Our results indicate that military users talk more about events in their military life, whereas nonmilitary users talk more about school, work, and leisure activities. We also found that the online content generated by both populations is significantly different, including health-related language and communication behavior.
Szayna, Thomas S; McCarthy, Kevin F; Sollinger, Jerry m; Demaine, Linda J; Marquis, Jefferson P; Steele, Brett
.... Specifically, there is a potential for a civil-military gap to undermine military effectiveness by reducing support for defense budgets, increasing the difficulties of recruiting quality people...
.... Specifically, a thorough knowledge of the language, terminology, and acronyms is fundamental to understanding today s health care delivery processes both in the civilian sector and the military health system...
Engel Charles C
Full Text Available Abstract Background: The US military is currently involved in large, lengthy, and complex combat operations around the world. Effective military operations require optimal health of deployed service members, and both mental and physical health can be affected by military operations. Methods: Baseline data were collected from 77,047 US service members during 2001–2003 as part of a large, longitudinal, population-based military health study (the Millennium Cohort Study. The authors calculated unadjusted, adjusted, and weighted means for the Medical Outcomes Study Short Form 36-item Survey for Veterans physical (PCS and mental component summary (MCS scores over a variety of demographic and military characteristics at baseline. Results: The unadjusted mean PCS and MCS scores for this study were 53.4 (95% confidence interval: 53.3–53.4 and 52.8 (95% confidence interval: 52.7–52.9. Average PCS and MCS scores were slightly more favorable in this military sample compared to those of the US general population of the same age and sex. Factors independently associated with more favorable health status included male gender, being married, higher educational attainment, higher military rank, and Air Force service. Combat specialists had similar health status compared to other military occupations. Having been deployed to Southwest Asia, Bosnia, or Kosovo between 1998 and 2000 was not associated with diminished health status. Conclusion: The baseline health status of this large population-based military cohort is better than that of the US general population of the same age and sex distribution over the same time period, especially in older age groups. Deployment experiences during the period of 1998–2001 were not associated with decreased health status. These data will serve as a useful reference for other military health studies and for future longitudinal analyses.
Shrader, Angela; Casero, Kellie; Casper, Bethany; Kelley, Mary; Lewis, Laura; Calohan, Jess
Lesbian, gay, bisexual, and transgender (LGBT) individuals serving within the U.S. military and their beneficiaries have unique health care requirements. Department of Defense Directive 1304.26 "Don't Ask, Don't Tell" created a barrier for service members to speak candidly with their health care providers, which left specific health care needs unaddressed. There are no standardized cultural education programs to assist Military Health System (MHS) health care providers in delivering care to LGBT patients and their beneficiaries. The purpose of this project was to develop, implement, and evaluate the effectiveness of an LGBT educational program for health care providers within the MHS to increase cultural awareness in caring for this special population. This multisite educational program was conducted at Travis Air Force Base and Joint Base Lewis-McChord from November 15, 2014, to January 30, 2015. A 15-question multiple-choice questionnaire was developed based on the education program and was administered before and after the education program. A total of 51 individuals completed the program. Overall posttest scores improved compared to pretest scores. This program was designed to begin the process of educating health care providers about the unique health care issues of military LGBT Service Members and their beneficiaries. This program was the first to address the disparities in LGBT health care needs within the Department of Defense. It also provided a platform for facilitating open communication among providers regarding LGBT population health needs in the military.
of the research is to establish what the model of governance of the Military Health System should be. That, with other recommendations, should be the...foundation for the impending transformation. The research found that the model of governance should be a single service model with regional health...commands that support the geographic combatant commander (GCC). With an organization based on the presented model of governance , the Military Health
Sharp, Marie-Louise; Fear, Nicola T; Rona, Roberto J; Wessely, Simon; Greenberg, Neil; Jones, Norman; Goodwin, Laura
Approximately 60% of military personnel who experience mental health problems do not seek help, yet many of them could benefit from professional treatment. Across military studies, one of the most frequently reported barriers to help-seeking for mental health problems is concerns about stigma. It is, however, less clear how stigma influences mental health service utilization. This review will synthesize existing research on stigma, focusing on those in the military with mental health problems. We conducted a systematic review and meta-analysis of studies between 2001 and 2014 to examine the prevalence of stigma for seeking help for a mental health problem and its association with help-seeking intentions/mental health service utilization. Twenty papers met the search criteria. Weighted prevalence estimates for the 2 most endorsed stigma concerns were 44.2% (95% confidence interval: 37.1, 51.4) for "My unit leadership might treat me differently" and 42.9% (95% confidence interval: 36.8, 49.0) for "I would be seen as weak." Nine studies found no association between anticipated stigma and help-seeking intentions/mental health service use and 4 studies found a positive association. One study found a negative association between self-stigma and intentions to seek help. Counterintuitively, those that endorsed high anticipated stigma still utilized mental health services or were interested in seeking help. We propose that these findings may be related to intention-behavior gaps or methodological issues in the measurement of stigma. Positive associations may be influenced by modified labeling theory. Additionally, other factors such as self-stigma and negative attitudes toward mental health care may be worth further attention in future investigation. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Full Text Available Objective To investigate the time feature of Chinese military personnel's suicide ideation and its relationship with psychosomatic health to provide scientific basis for formulation of mental health policy and intervention of related psychological crisis. Methods By random cluster sampling, a total of 11 362 military personnel including army, navy and air-force (1100 in 1980s, 8000 in 1990s, 2262 in year 2000 were tested by Chinese Psychosomatic Health Scale (CPSHS. SPSS statistic 17.0 program was used for data analysis, i.e., χ2-test, T-test and stepwise regression analysis. Results The incidence rate of military personnel's suicide ideation in the three decades from 1980 to 2000 was 10.27%, 7.09% and 2.83% respectively, which revealed a decreasing trend (P 0.05. Suicide ideation was selected into the regression equation of mental health, physical health, and total psychosomatic health scores, which could positively predict the level of military personnel's psychosomatic health (P=0.05 or 0.01. Conclusions Military personnel's suicide ideation presents a decreasing trend; the psychosomatic health of military personnel who have suicide ideation is worse than that of personnel without suicide ideation.
Sigrist, Lori D; Anderson, Jennifer E; Auld, Garry W
The increasing trend of overweight in the military, the high cost of health care associated with overweight, and the failure to meet some Healthy People 2000 objectives related to diet identify the need for more appropriate nutrition and fitness education for military personnel. The purpose of this study was to assess senior military officers' concerns on various health topics, educational preferences for nutrition and health topics, eating habits, and barriers and motivators for eating healthfully and exercising regularly. The survey was completed by 52 resident students at the U.S. Army War College. Fitness, weight, and blood cholesterol were top health concerns, and respondents wanted to know more about eating healthfully on the run. The primary barrier to eating healthfully and exercising regularly was lack of time, whereas health and appearance were top motivators. Health interventions for this population should include their topics of concern and should address perceived barriers and motivators.
Sigrist, Lori D; Anderson, Jennifer E; Auld, Garry W
The increasing trend of military personnel being overweight, the high cost of health care associated with being overweight, and the failure to meet some Healthy People 2000 objectives related to diet...
The objective of the study was to compare the prevalence of intimate partner violence and health consequences in civilian and active duty military women in the same geographic area using telephone survey and a case...
.... In this study a qualitative descriptive design using the active duty primigravada as the population of interest was used to explore perceptions of and satisfaction with prenatal care in the military health care system...
prescription practices, and antimicrobial resistance for the following infections among Military Health System (MHS) beneficiaries for calendar year...Frequently Prescribed Drug - Percent Susceptibility Proportion of Healthcare- (HA) and Community- Associated (CA) Cases Acinetobacter spp.b 18
Sparrow, Katherine; Kwan, Jamie; Howard, Louise; Fear, Nicola; MacManus, Deirdre
There is growing awareness of the problem of intimate partner violence (IPV) among military populations. IPV victimisation has been shown to be associated with mental disorder. A better understanding of the link between IPV and mental disorder is needed to inform service development to meet the needs of military families. We aimed to systematically review the literature on the association between IPV victimisation and mental health disorders among military personnel. Searches of four electronic databases (Embase, Medline, PsycINFO, and Web of Science) were supplemented by reference list screening. Heterogeneity among studies precluded a meta-analysis. Thirteen studies were included. There was stronger evidence for an association between IPV and depression/alcohol problems than between IPV and PTSD. An association between IPV and mental health problems was more frequently found among veterans compared to active duty personnel. However, the link between IPV and alcohol misuse was more consistently found among active duty samples. Finally, among active duty personnel psychological IPV was more consistently associated with depression/alcohol problems than physical/sexual IPV. The review highlighted the lack of research on male IPV victimisation in the military. There is evidence that the burden of mental health need may be significant among military personnel who are victims of IPV. The influence of attitudes towards gender in the military on research in this area is discussed. Further research is needed to inform development of services and policy to reduce IPV victimisation and the mental health consequences among military personnel.
Post Traumatic Stress Disorder among Military Health Care Workers: A Systematic Review Christopher A. Orsello, MD Resident, Aerospace Medicine...00-00-2012 to 00-00-2012 4. TITLE AND SUBTITLE Prevention of Post Traumatic Stress Disorder among Military Health Care Workers: A Systematic Review...analysis of risk factors for post - traumatic stress disorder in trauma-exposed adults. Journal of Consulting and Clinical Psychology, 68(5), 748–66
... (chewing tobacco and snuff) has not been a focus of medical services or research, Epidemiological data suggest that while smoking has continued to decline both in the general population and within the military, the use...
program and optional dental plans. Active-duty military members are automatically enrolled into TRICARE Prime and are assigned to a military treatment...registers as a cost consideration in the calculus of the majority of employers in the U.S. who provide health insurance to their employees. Military
Jones, Norman; Whybrow, D; Coetzee, R
Studies suggest that medical doctors can suffer from substantial levels of mental ill-health. Little is known about military doctors' mental health and well-being; we therefore assessed attitudes to mental health, self-stigma, psychological distress and help-seeking among UK Armed Forces doctors. Six hundred and seventy-eight military doctors (response rate 59%) completed an anonymous online survey. Comparisons were made with serving and ex-military personnel (n=1448, response rate 84.5%) participating in a mental health-related help-seeking survey. Basic sociodemographic data were gathered, and participants completed measures of mental health-related stigmatisation, perceived barriers to care and the 12-Item General Health Questionnaire. All participants were asked if in the last three years they had experienced stress, emotional, mental health, alcohol, family or relationship problems, and whether they had sought help from formal sources. Military doctors reported fewer mental disorder symptoms than the comparison groups. They endorsed higher levels of stigmatising beliefs, negative attitudes to mental healthcare, desire to self-manage and self-stigmatisation than each of the comparison groups. They were most concerned about potential negative effects of and peer perceptions about receiving a mental disorder diagnosis. Military doctors reporting historical and current relationship, and alcohol or mental health problems were significantly and substantially less likely to seek help than the comparison groups. Although there are a number of study limitations, outcomes suggest that UK military doctors report lower levels of mental disorder symptoms, higher levels of stigmatising beliefs and a lower propensity to seek formal support than other military reference groups. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Esposito-Smythers, Christianne; Wolff, Jennifer; Lemmon, Keith M; Bodzy, Mary; Swenson, Rebecca R; Spirito, Anthony
The United States military force includes over 2.2 million volunteer service members. Three out of five service members who are deployed or are preparing for deployment have spouses and/or children. Stressors associated with the deployment cycle can lead to depression, anxiety, and behavior problems in children, as well as psychological distress in the military spouse. Further, the emotional and behavioral health of family members can affect the psychological functioning of the military service member during the deployment and reintegration periods. Despite widespread acknowledgment of the need for emotional and behavioral health services for youth from military families, many professionals in a position to serve them struggle with how to best respond and select appropriate interventions. The purpose of this paper is to provide an empirically based and theoretically informed review to guide service provision and the development of evidence based treatments for military youth in particular. This review includes an overview of stressors associated with the deployment cycle, emotional and behavioral health consequences of deployment on youth and their caretaking parent, and existing preventative and treatment services for youth from military families. It concludes with treatment recommendations for older children and adolescents experiencing emotional and behavioral health symptoms associated with the deployment cycle.
Ragel, Brian T; Klimo, Paul; Grant, Gerald A; Taggard, Derek A; Nute, David; McCafferty, Randall R; Ellenbogen, Richard G
The 4-year military Health Professions Scholarship Program (HPSP) provides funds for medical school tuition, books, and a monthly stipend in exchange for a 4-year military commitment (to receive all physician bonuses, an additional 3 months must be served). To analyze the economics of the HPSP for students with an interest in neurosurgery by comparing medical school debt and salaries of military, academic, and private practice neurosurgeons. Salary and medical school debt values from the American Association of Medical Colleges, salary data from the Medical Group Management Association, and 2009 military pay tables were obtained. Annual cash flow diagrams were created to encompass 14.25 years that spanned 4 years (medical school), 6 years (neurosurgical residency), and the first 4.25 years of practice for military, academic, and private practice neurosurgeons. A present value economic model was applied. Mean medical school loan debt was $154,607. Mean military (adjusted for tax-free portions), academic, and private practice salaries were $160,318, $451,068, and $721,458, respectively. After 14.25 years, the cumulative present value cash flow for military, academic, and private practice neurosurgeons was $1 193 323, $2 372 582, and $3 639 276, respectively. After 14.25 years, surgeons with medical student loans still owed $208 761. The difference in cumulative annual present value cash flow between military and academic and between military and private practice neurosurgeons was $1,179,259 and $2,445,953, respectively. The military neurosurgeon will have little to no medical school debt, whereas the calculated medical school debt of a nonmilitary surgeon was approximately $208,000.
Unal Demirtas; Gultekin Ozturk; Aslan Ozden
During the Crimean War freezing cold and contagious diseases was more important than the Russian soldiers for the allied armies. Typhus, scorbut, cholera and malaria prepare the dead of a large number of soldiers. According to the resources, the contagious diseases led to death more than ten times of the military actions. That and #8217;s why, The European armies understood the importance of the treatment diseases in the war and the Crimean War became the beginning point in military health co...
Pierre-Louis, Bosny J; Moore, Angelo D; Hamilton, Jill B
The existence of health disparities in military populations has become an important topic of research. However, to our knowledge, this is the first study to examine health disparities, as related to access to care and health status, among active duty soldiers and their families. Specifically, the purpose of this analysis was to evaluate whether health disparities exist in access to care and health outcomes of patient satisfaction, physical health status, and mental health status according to race, gender, and sponsor rank in the population of active duty soldiers and their family members. In this cross-sectional study, active duty army soldiers and family members were recruited from either one particular army health clinic where they received their health care or from an adjacent shopping center frequented by eligible participants. Data were collected using validated measures to assess concepts of access to care and health status. Statistical analysis, including one-way analysis of variance (ANOVA) was performed to investigate differences in study outcome measures across four key demographic subgroups: race, gender, sponsor rank, and component (active soldier or family member). A total of 200 participants completed the study questionnaires. The sample consisted of 45.5 % soldiers and 54.5 % family members, with 88.5 % reporting a sponsor rank in the category of junior or senior enlisted rank. Mean scores for access to care did not differ significantly for the groups race/ethnicity (p = 0.53), gender (p = 0.14), and sponsor rank (p = 0.10). Furthermore, no significant differences were observed whether respondents were active soldiers or their family members (p = 0.36). Similarly, there were no statistically significant subgroup (race/ethnicity, gender, sponsor rank, or component) differences in mean patient satisfaction, physical health, and mental health scores. In a health equity system of care such as the military health care system, active duty
Maria Neufeld; Dirk W. Lachenmeier; Stephan G. Walch; Jürgen Rehm
Counterfeit alcohol belongs to the category of unrecorded alcohol not reflected in official statistics. The internet trade of alcoholic beverages has been prohibited by the Russian Federation since 2007, but various sellers still offer counterfeit spirits (i.e., forged brand spirits) over the internet to Russian consumers, mostly in a non-deceptive fashion at prices up to 15 times lower than in regular sale. The public health issues arising from this unregulated trade include potential harm t...
Maria Neufeld; Dirk W. Lachenmeier; Stephan G. Walch; Jürgen Rehm
Counterfeit alcohol belongs to the category of unrecorded alcohol not reflected in official statistics. The internet trade of alcoholic beverages has been prohibited by the Russian Federation since 2007, but various sellers still offer counterfeit spirits (i.e., forged brand spirits) over the internet to Russian consumers, mostly in a non-deceptive fashion at prices up to 15 times lower than in regular sale. The public health issues arising from this unregulated trade include potential harm t...
REPORT TR-HFM-175 Medically Unexplained Physical Symptoms in Military Health (Symptômes physiques médicalement inexpliqués dans la santé militaire...STO TECHNICAL REPORT TR-HFM-175 Medically Unexplained Physical Symptoms in Military Health (Symptômes physiques médicalement inexpliqués dans...The General Internist 10-7 10.5.1 The Health Psychologist 10-8 10.5.2 Medical Specialists 10-8 10.5.3 The Physiatrist 10-9 10.5.4 The Physical
Jitnarin, Nattinee; Poston, Walker S C; Haddock, Christopher K; Jahnke, Sara
The purpose of this study was to conduct a content analysis of Veterans and Military Service Organizations (VMSOs) magazines to determine what health-related topics VMSOs target and how they inform their constituencies about health issues. Health-related topics in 288 VMSOs' magazines from 21 VMSOs published in 2011 and 2012 were coded by trained raters using a standardized manual. The top three most addressed health topics were Health Services (Health care, Insurance), Disability and Disability benefits, and post-traumatic stress disorder. Topics least frequently covered were Tobacco and Smoking cessation, Illegal drugs, Alcohol, Gulf War Syndrome, and Weight and Body composition. VMSOs are concerned about the health and well-being of their members given the considerable amount of content devoted to certain health topics such as health insurance concerns, disability, and post-traumatic stress disorder. However, other health concerns that affect a considerable number of both current military personnel and veterans and cost both the Department of Veterans Affairs and the Department of Defense millions annually, such as drug and alcohol problems, and tobacco use and smoking cessation, are infrequently covered. The results of this study improve our understanding of the health-related information that reaches the military and veteran populations through this important media outlet. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.
syndrome (15 items) • Other anxiety syndrome (6 items) • Eating disorders (4 items; binge and bulimia nervosa) Has your doctor or other health...The Millennium Cohort: a 21-Year Contribution to the Understanding of Military and Veterans’ Health Second Annual Trauma Stress Disorders ...AVAILABILITY STATEMENT Approved for public release; distribution unlimited 13. SUPPLEMENTARY NOTES Presented at The Second Annual Trauma Spectrum Disorders
Kennedy, I.; Jones, N.; Sharpley, J.; Greenberg, N.
Background The UK military runs a comprehensive mental health service ordinarily accessed via primary care referrals. Aims To evaluate the feasibility of self-referral to mental health services within a military environment. Methods Three pilot sites were identified; one from each service (Royal Navy, Army, Air Force). Socio-demographic information included age, rank, service and career duration. Clinical data included prior contact with general practitioner (GP), provisional diagnosis and assessment outcome. Results Of the 57 self-referrals, 69% (n = 39) had not previously accessed primary care for their current difficulties. After their mental health assessment, 47 (82%) were found to have a formal mental health problem and 41 (72%) were offered a further mental health clinician appointment. The data compared favourably with a large military mental health department that reported 87% of primary care referrals had a formal mental health condition. Conclusions The majority of self-referrals had formal mental health conditions for which they had not previously sought help from primary care; most were offered further clinical input. This supports the view that self-referral may be a useful option to encourage military personnel to seek professional care over and above the usual route of accessing care through their GP. PMID:27121634
Kennedy, I; Whybrow, D; Jones, N; Sharpley, J; Greenberg, N
The UK military runs a comprehensive mental health service ordinarily accessed via primary care referrals. To evaluate the feasibility of self-referral to mental health services within a military environment. Three pilot sites were identified; one from each service (Royal Navy, Army, Air Force). Socio-demographic information included age, rank, service and career duration. Clinical data included prior contact with general practitioner (GP), provisional diagnosis and assessment outcome. Of the 57 self-referrals, 69% (n = 39) had not previously accessed primary care for their current difficulties. After their mental health assessment, 47 (82%) were found to have a formal mental health problem and 41 (72%) were offered a further mental health clinician appointment. The data compared favourably with a large military mental health department that reported 87% of primary care referrals had a formal mental health condition. The majority of self-referrals had formal mental health conditions for which they had not previously sought help from primary care; most were offered further clinical input. This supports the view that self-referral may be a useful option to encourage military personnel to seek professional care over and above the usual route of accessing care through their GP. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: email@example.com.
DoD health care managers should read this report. Military health care data is used for a variety of critical purposes, including managing patient care, determining the optimal health care system, and for financial management...
Street, Amy E; Stafford, Jane; Mahan, Clare M; Hendricks, Ann
The current investigation identified the gender-specific prevalence of sexual harassment and assault experienced during U.S. military service and the negative mental and physical health correlates of these experiences in a sample of former reservists. We surveyed a stratified random sample of 3,946 former reservists about their experiences during military service and their current health, including depression, posttraumatic stress disorder, somatic symptoms, and medical conditions. Prevalence estimates and confidence intervals of sexual harassment and assault were calculated. A series of logistic regressions identified associations with health symptoms and conditions. Both men and women had a substantial prevalence of military sexual harassment and assault. As expected, higher proportions of female reservists reported sexual harassment (60.0% vs 27.2% for males) and sexual assault (13.1% vs 1.6% for males). For both men and women, these experiences were associated with deleterious mental and physical health conditions, with sexual assault demonstrating stronger associations than other types of sexual harassment in most cases. This investigation is the first to document high instances of these experiences among reservists. These data provide further evidence that experiences of sexual harassment and assault during military service have significant implications for the healthcare needs of military veterans.
Razum, Oliver; Wenner, Judith; Bozorgmehr, Kayvan
Recourse to a purported ideal of societal homogeneity has become common in the context of the refugee reception crisis - not only in Japan, as Leppold et al report, but also throughout Europe. Calls for societal homogeneity in Europe originate from populist movements as well as from some governments. Often, they go along with reduced social support for refugees and asylum seekers, for example in healthcare provision. The fundamental right to health is then reduced to a citizens' right, granted fully only to nationals. Germany, in spite of welcoming many refugees in 2015, is a case in point: entitlement and access to healthcare for asylum seekers are restricted during the first 15 months of their stay. We show that arguments brought forward to defend such restrictions do not hold, particularly not those which relate to maintaining societal homogeneity. European societies are not homogeneous, irrespective of migration. But as migration will continue, societies need to invest in what we call "globalization within." Removing entitlement restrictions and access barriers to healthcare for refugees and asylum seekers is one important element thereof. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Zheng, Wu Yi; Kanesarajah, Jeeva; Waller, Michael; McGuire, Annabel C; Treloar, Susan A; Dobson, Annette J
To examine whether the relationship between traumatic exposure on deployment and poor mental health varies by the reported level of childhood adversity experienced in Australian military veterans deployed to the Bougainville or East Timor military operations. Cross-sectional self-reported survey data were collected in 2008 from 3,564 Australian military veterans who deployed to East Timor or Bougainville on their deployment experiences, health and recall of childhood events. Multivariable logistic regression was used to investigate the association between childhood adversity, deployment exposures and mental health. The most common childhood adversity reported was 'not having a special teacher, youth worker or family friend who looked out for them while growing up'. On average, responders reported experiencing 3.5 adverse childhood experiences (SD 2.7) and averaged 5.3 (SD 4.9) traumatic exposures on deployment. Both childhood adversity and traumatic exposures on deployment were associated with higher odds of poorer mental health. However, there was no evidence that level of childhood adversity modified the association between traumatic exposure and mental health. These findings suggest that military personnel who recalled a higher level of childhood adversity may need to be monitored for poor mental health and, if required, provided with appropriate support. © 2015 Public Health Association of Australia.
Booth, Brenda M; Davis, Teri D; Cheney, Ann M; Mengeling, Michelle A; Torner, James C; Sadler, Anne G
The aim of this study was to determine whether current physical health status in female veterans is associated with rape during military service and same-sex partnership. Retrospective computer-assisted telephone interviews of 1004 Midwestern US female veterans identified from Veterans Affairs electronic records were conducted. Data included rape history including rape in military, sex partnership history, demographics, and medical history including chronic pain, mental health (depression and posttraumatic stress disorder [PTSD]), and the physical health component of the Short-Form 12-item interview (PCS-12). Physical health in this sample was lower than norm values [PCS-12: mean (standard deviation) = 43 ; norm: mean (standard deviation) = 50 ). Fifty-one percent of the participants reported rape in their lifetime, 25% reported rape in military, 11% reported history of women as sex partners, and 71% reported history of chronic pain. Multiple regression analysis indicated that physical health (PCS-12) was associated with chronic pain history (β = -.40, p rape in military (β = -.09, p = .002), and current PTSD (β = .07, p = .03), adjusting for demographic data. Mediational analysis indicated that chronic pain history significantly mediated relationships of women who have sex with women, childhood rape, PTSD, depression, and current substance use disorder with PCS-12. Both rape and sex partnership are adversely associated with lower physical functioning in female veterans. Clinicians evaluating the physical health of this population should therefore consider obtaining detailed sexual histories, and a multidisciplinary team is needed to address mental health issues in female veterans.
Hill, Neil; Fallowfield, Joanne; Price, Susan; Wilson, Duncan
Food and nutrition are fundamental to military capability. Historical examples demonstrate that a failure to supply adequate nutrition to armies inevitably leads to disaster; however, innovative measures to overcome difficulties in feeding reap benefits, and save lives. In barracks, UK Armed Forces are currently fed according to the relatively new Pay As You Dine policy, which has attracted criticism from some quarters. The recently introduced Multi-Climate Ration has been developed specifically to deal with issues arising from Iraq and the current conflict in Afghanistan. Severely wounded military personnel are likely to lose a significant amount of their muscle mass, in spite of the best medical care. Nutritional support is unable to prevent this, but can ameliorate the effects of the catabolic process. Measuring and quantifying nutritional status during critical illness is difficult. A consensus is beginning to emerge from studies investigating the effects of nutritional interventions on how, what and when to feed patients with critical illness. The Ministry of Defence is currently undertaking research to address specific concerns related to nutrition as well as seeking to promote healthy eating in military personnel. PMID:21149358
Chu, Nain-Feng; Lin, Fu-Huang; Wu, Yi-Chang
The purpose of this study is to evaluate the prevalence and trends of cigarette smoking among young military conscripts, military officers, and military university students during recently 10 years in Taiwan. Repeated cross-sectional surveys were conducted annually among young military conscripts and military university students from 2006 to 2014. All the young conscripts were reviewed within 1 month at the military training center and before retiring after 1 year of military services. The military officers were included using purposive sampling from 2004 to 2008 and 2013 to 2014 in different military services. Military university students were included in this study. Freshman and senior students were random sampled as the study subjects. Participants completed a structured questionnaire that included questions on general demographics and health-related behaviors. Current smokers is defined as subjects who smoked ≥1 cigarette/day during the past 30 days or had smoked ≥100 cigarettes in their lifetime or still have the habit of smoking during study. We used a χ 2 test to examine the difference between the prevalence of cigarette smoking among different groups. The Cochran-Armitage test for trend was applied to examine the change of prevalence of smoking after repeated cross-sectional surveys among populations. The prevalence of cigarette smoking within military training center and after 1-year military services was 48.6% and 48.1% on 2006, which became 39.2% and 38.6% on 2010, and then further declined to 31.0% and 30.1% on 2014. For military officers, the trends of prevalence of smoking among different military services showed slight decline from 2004 to 2008, but decreased significantly between 2013 and 2014. The prevalence of smoking in 2014 was 32.1%, 32.8%, and 32.4% for the Army, Navy, and Air Force, respectively. More interestingly, the prevalence of smoking of freshman and senior students increased during the first 5 years (2007-2011) of survey and then
D'Angelo, Matthew R; Saperstein, Adam K; Seibert, Diane C; Durning, Steven J; Varpio, Lara
Despite efforts to increase patient safety, hundreds of thousands of lives are lost each year to preventable health care errors. The Institute of Medicine and other organizations have recommended that facilitating effective interprofessional health care team work can help address this problem. While the concept of interprofessional health care teams is known, understanding and organizing effective team performance have proven to be elusive goals. Although considerable research has been conducted in the civilian sector, scholars have yet to extend research to the military context. Indeed, delivering the highest caliber of health care to our service men and women is vitally important. This commentary describes a new initiative as the Uniformed Services University of the Health Sciences aimed at researching the characteristics of successful military interprofessional teams and why those characteristics are important. It also describes the interprofessional education initiative that Uniformed Services University is launching to help optimize U.S. military health care. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.
Hamilton, Alison B; Williams, Lindsay; Washington, Donna L
The unemployment rate is currently higher among women Veterans than among male Veterans and civilian women. Employment is a key social determinant of health, with unemployment being strongly associated with adverse health. To identify military-related and health-related characteristics associated with unemployment in women Veterans. Secondary analysis of workforce participants (n=1605) in the National Survey of Women Veterans telephone survey. Demographics, mental health conditions, health care utilization, and military experiences and effects. Unemployment was defined as being in the labor force but unemployed and looking for work. The χ analyses to identify characteristics of unemployed women Veterans; logistic regression to identify independent factors associated with unemployment. Ten percent of women Veterans were unemployed. Independent correlates of unemployment were screening positive for depression [odds ratio (OR)=4.7; 95% confidence interval [CI], 1.8-12.4], military service during wartime (OR=2.9; 95%, CI 1.1-7.3), and service in the regular military (vs. in the National Guards/Reserves only) (OR=6.8; 95% CI, 2.2-20.5). Two postactive duty perceptions related to not being respected and understood as a Veteran were each independently associated with unemployment. Whether depression underlies unemployment, is exacerbated by unemployment, or both, it is critical to identify and treat depression among women Veterans, and also to investigate women Veterans' experiences and identities in civilian life. Community-based employers may need education regarding women Veterans' unique histories and strengths. Women who served in the regular military and during wartime may benefit from job assistance before and after they leave the military. Gender-specific adaptation of employment services may be warranted.
Petri, Richard P
Background: The field of integrative health and healing (IH 2 ) is emerging out of the dark recesses of "voodoo" stereotypes and into the light as a new and much needed health care paradigm. It is a philosophy of health and healing that seeks to place patients as the preeminent players in health management, disease prevention, and injury recovery. There is an emphasis of patient responsibility, which includes a holistic approach that merges allopathic with complementary medicine. Objective: The aim of this article is to explore the historical origins of integrative medicine and investigate the future role of the IH 2 paradigm. Methods: This article reviews current available data and information regarding complementary and alternative medicine utilized in civilian and military populations as the basis for a new paradigm for a system of care-a system that empowers patients. Conclusions: The current U.S. health care system is reactive and disease-based, with a focus on reductionism. This system is not serving us well. IH 2 is a new model of cost-effective patient-centered health care.
Full Text Available Musculoskeletal disorders represent a major issue in the military setting. Musculoskeletal disorders and mental disorders (MSD are a major cause of disability in the working population. Musculoskeletal disorders and premature tiredness caused by work are arisen from incompatible individual work capacity and job demands. Physical and psychology condition may lead to the generation, amplification musculoskeletal disorders. Musculoskeletal disorders and mental health disorders are high in military personnel. The purpose of this study was Assessment Mental Health and musculoskeletal disorders in military personnel. In this cross-sectional study 70 personnel military participated in May 2016. Cornell Questionnaire and Mental health inventory (MHI-28 were used for data gathering. Finally, Statistical analysis was performed using SPSS version 20, descriptive statistics, Pearson correlation test and One Way Anova test. The findings of the current study showed that personnel situation of mental health were in moderate condition (56.01±13.3. Results Cornell Questionnaire showed that the most of musculoskeletal disorders were respectively in the back (46%, shoulder (34% and wrist (31%. Also Pearson correlation test showed significantly associated between musculoskeletal disorders and mental health (r=0.72 (p-value=0.001. One Way Anova test showed that with increase age (p
experiences and attitudes may reduce stigma associated with seeking help for mental health con- cerns in a military population, although results from...Hurtado et al. SpringerPlus (2015) 4:606 DOI 10.1186/s40064-015-1402-z RESEARCH Acceptability of mental health stigma -reduction training and...purpose of this paper is to report on the development of a mental health stigma reduction toolkit and training, and the acceptability and level of stigma
HEALTH Gynecological Care SOCIAL RELATIONSHIPS Sexual Assault Physical Assault OBSTETRICS AND GYNECOLOGY (OB/Gyn) Contraception Uterine...Energy/Weight Career Outcomes Physical Fitness Healthcare Utilization Mortality Health Behaviors Work Environment Training 0 50 100 150 200 250 N um be r... Physical Assault 0 10 20 30 40 50 60 N um be r o f C at eo gi rz ed A rt ic le s Social Relationships Subtopics MILITARY WOMEN’S HEALTH
Ghahramanlou-Holloway, Marjan; LaCroix, Jessica M; Koss, Kari; Perera, Kanchana U; Rowan, Anderson; VanSickle, Marcus R; Novak, Laura A; Trieu, Theresa H
Service members (SM) are at increased risk of psychiatric conditions, including suicide, yet research indicates SMs believe seeking mental health treatment may negatively impact their military careers, despite a paucity of research examining actual career impacts. This study examined the link between seeking outpatient mental health (MH) treatment and military career impacts within the United States Marine Corps. In Phase 1, a retrospective medical record review of outpatient MH treatment-seeking Marines ( N = 38) was conducted. In Phase 2, a sample of outpatient MH treatment-seeking Marines ( N = 40) was matched to a non-treatment-seeking sample of Marines ( N = 138) to compare career-progression. In Phase 1, there were no significant links between demographic, military, and clinical characteristics and referral source or receipt of career-affecting treatment recommendations. In Phase 2, MH treatment-seeking Marines in outpatient settings were more likely than matched controls to be separated from the military (95.0% versus 63.0%, p = 0.002), but no more likely to experience involuntary separation. MH treatment-seeking Marines were more likely to have documented legal action (45.0% versus 23.9%, p = 0.008) and had a shorter time of military service following the index MH encounter than matched controls ( p < 0.001). Clinical, anti-stigma, and suicide prevention policy implications are discussed.
Rodriguez, Aubrey J; Margolin, Gayla
Although military service, and particularly absence due to deployment, has been linked to risk for depression and anxiety among some spouses and children of active duty service members, there is limited research to explain the heterogeneity in family members' reactions to military service stressors. The current investigation introduces the Timeline Followback Military Family Interview (TFMFI) as a clinically useful strategy to collect detailed time-linked information about the service member's absences. Two dimensions of parent absence--the extent to which absences coincide with important family events and cumulative time absent--were tested as potential risks to family members' mental health. Data from 70 mother-adolescent pairs revealed that the number of important family events missed by the service member was linked to elevated youth symptoms of depression, even when accounting for the number of deployments and cumulative duration of the service member's absence. However, youth who reported more frequent contact with the service member during absences were buffered from the effects of extensive absence. Mothers' symptoms were associated with the cumulative duration of the service members' time away, but not with family events missed by the service member. These results identify circumstances that increase the risk for mental health symptoms associated with military family life. The TFMFI provides an interview-based strategy for clinicians wishing to understand military family members' lived experience during periods of service-member absence. (c) 2015 APA, all rights reserved).
The military requirements of NATO Enlargement should be tied to NATO's overall goal of seeking stability in all of Europe such that it does not undermine political and economic success in new member countries...
Lv, Yipeng; Xue, Chen; Ge, Yang; Ye, Feng; Liu, Xu; Liu, Yuan; Zhang, Lulu
Relatively few articles have focused on exploring factors influencing soldiers' overall satisfaction and differences between inpatients' and outpatients' satisfaction, particularly in the Chinese army. Elucidating factors influencing military inpatient and outpatient care separately and analyzing their differences may provide more information for the health system. The Revised China National Health Service Survey questionnaire was used in the survey. The questionnaire included 5 sections and 32 items concerning demographic, inpatient, and outpatient characteristics and perception variables for both inpatients and outpatients. Bivariate and multivariate techniques were used to reveal relationships between satisfaction and the variables assessed. Outpatients' and inpatients' overall satisfaction rates were 19.0% and 18.5%, respectively. The strongest determinant of outpatients' satisfaction was satisfaction with doctor's communication regarding therapeutic regimen followed by length of military service, level of trust in medical staff, and disease severity. Determinants of inpatients' satisfaction included staff categories, satisfaction with environment, and satisfaction with medical quality. The factors influencing military outpatients' satisfaction differed from those of inpatients. Exploring the causes of satisfaction and dissatisfaction with military health institutions is important in their fulfillment of their responsibility to maintain soldiers' health.
Full Text Available Relatively few articles have focused on exploring factors influencing soldiers' overall satisfaction and differences between inpatients' and outpatients' satisfaction, particularly in the Chinese army. Elucidating factors influencing military inpatient and outpatient care separately and analyzing their differences may provide more information for the health system.The Revised China National Health Service Survey questionnaire was used in the survey. The questionnaire included 5 sections and 32 items concerning demographic, inpatient, and outpatient characteristics and perception variables for both inpatients and outpatients. Bivariate and multivariate techniques were used to reveal relationships between satisfaction and the variables assessed.Outpatients' and inpatients' overall satisfaction rates were 19.0% and 18.5%, respectively. The strongest determinant of outpatients' satisfaction was satisfaction with doctor's communication regarding therapeutic regimen followed by length of military service, level of trust in medical staff, and disease severity. Determinants of inpatients' satisfaction included staff categories, satisfaction with environment, and satisfaction with medical quality.The factors influencing military outpatients' satisfaction differed from those of inpatients. Exploring the causes of satisfaction and dissatisfaction with military health institutions is important in their fulfillment of their responsibility to maintain soldiers' health.
da Silva, Franciele Cascaes; Hernandez, Salma Stéphany Soleman; Arancibia, Beatriz Angélica Valdivia; Castro, Thiago Luis da Silva; Filho, Paulo José Barbosa Gutierres; da Silva, Rudney
The present study aimed to determine the effect of demographic characteristics, occupation, anthropometric indices, and leisure-time physical activity levels on coronary risk and health-related quality of life among military police officers from the State of Santa Catarina, Brazil. The sample included 165 military police officers who fulfilled the study’s inclusion criteria. The International Physical Activity Questionnaire and the Short Form Health Survey were used, in addition to a spreadsheet of socio-demographic, occupational and anthropometric data. Statistical analyses were performed using descriptive analysis followed by Spearman Correlation and multiple linear regression analysis using the backward method. The waist-to-height ratio was identified as a risk factor low health-related quality of life. In addition, the conicity index, fat percentage, years of service in the military police, minutes of work per day and leisure-time physical activity levels were identified as risk factors for coronary disease among police officers. These findings suggest that the Military Police Department should adopt an institutional policy that allows police officers to practice regular physical activity in order to maintain and improve their physical fitness, health, job performance, and quality of life.
Schure, Marc B; Katon, Jodie G; Wong, Edwin; Liu, Chuan-Fen
Food and housing insecurity may contribute to poorer mental and physical health. It is unclear as to whether those with prior military service, compared to those without, are more vulnerable to these current stressors. The objective of this study was to use U.S. population-based data to determine whether prior military service moderates the association of food and housing insecurity with poor mental and physical health. We analyzed data from nine states administering the Social Context module from the 2011 and 2012 Behavioral Risk Factor Surveillance System. Multivariable logistic regression was used to examine the associations of housing and food insecurity with poor mental and physical health and potential modification by military service. Compared with those with a history of military service, those without had higher prevalence of food insecurity (23.1% versus 13.7%) and housing insecurity (36.0% versus 22.5%). Food insecurity was associated with poor mental and physical health (mental health: odds ratio (OR)=3.47, 95% confidence interval (CI)=[3.18-3.77]; physical health: OR=3.21, 95% CI=[2.92-3.53]). Similar associations were observed between housing insecurity and poor mental and physical health. Prior military service was significantly associated with poor physical health. Interaction terms of prior military service with food and housing were not statistically significant. Food and housing insecurity does not appear to differentially impact mental and physical health among those with and without military service.
Pomeranz, Jennifer L
The Patient Protection and Affordable Care Act revised the law related to workplace wellness programs, which have become part of the nation's broader health strategy. Health-contingent programs are required to be reasonably designed. However, the regulatory requirements are lax and might undermine program efficacy in terms of both health gains and financial return. I propose a method for the government to support a best-practices approach by considering an accreditation or certification process. Additionally I discuss the need for program evaluation and the potential for employers to be subject to litigation if programs are not carefully implemented.
Arnett, Michael V; Lim, Julia T
Ciguatera toxin is a marine neurotoxin produced by microorganisms that becomes concentrated in predatory fish. Toxicity in humans results from the ingestion of contaminated fish harvested in tropical waters. Clinical manifestations of illness include the rapid onset of gastrointestinal symptoms and neurological abnormalities. Because of the rapid onset of symptoms and the potential for case clusters from a common source ingestion of contaminated fish, there is the potential that ciguatera poisoning may initially mimic illnesses caused by antipersonnel biological and chemical agents. We present data on an active duty soldier who presented to sick call for evaluation of new onset paresthesias and was diagnosed with ciguatera toxin poisoning. We also present a review of ciguatera poisoning literature with emphasis on the distinguishing features between ciguatoxin and other neurotoxins of military significance.
Maloney, J P; Anderson, F D; Gladd, D L; Brown, D L; Hardy, M A
The purpose of this study was to describe health care providers' perceptions of their work environment at a large U.S. Army medical center, and to compare the findings to other military medical centers. The sample (N = 112) consisted of the professional nursing staff working on the nine inpatient units. The Work Environmental Scale (WES) was used to measure perceptions of the workplace relative to gender, position (head nurses, staff nurses, and agency nurses), specialty nursing (intensive care unit [ICU] versus non-ICU), education (MSN, BSN, and ADN), and patterns of differences between the WES subscales of four military medical centers. Results of the study indicate that there were no significant gender differences. Head nurses, non-ICU nurses, and MSN nurses perceived their environment more positively. There were significant differences in the WES subscales between the military hospitals. Implications for nursing using the WES were recommended.
sion was similar among recent divorcees and those who were single. Understanding the temporal proximity of the association between a recent divorce ...Shapiro E. Alcohol consumption and divorce : Which causes which? J Divorce . 1988;12(1):127–36. 60. Lee MR, Chassin L, Mackinnon D. The effect of marriage...Naval Health Research Center Associations of Military Divorce With Mental, Behavioral, and Physical Health Outcomes Lawrence Wang Amber Seelig
Wooten, Nikki R; Brittingham, Jordan A; Pitner, Ronald O; Tavakoli, Abbas S; Jeffery, Diana D; Haddock, K Sue
Behavioral health conditions are a significant concern for the U.S. military and the Military Health System (MHS) because of decreased military readiness and increased health care utilization. Although MHS beneficiaries receive direct care in military treatment facilities, a disproportionate majority of behavioral health treatment is purchased care received in civilian facilities. Yet, limited evidence exists about purchased behavioral health care received by MHS beneficiaries. This longitudinal study (1) estimated the prevalence of purchased behavioral health care and (2) identified patient and visit characteristics predicting receipt of purchased behavioral health care in acute care facilities from 2000 to 2014. Medical claims with Major Diagnostic Code 19 (mental disorders/diseases) or 20 (alcohol/drug disorders) as primary diagnoses and TRICARE as the primary/secondary payer were analyzed for MHS beneficiaries (n = 17,943) receiving behavioral health care in civilian acute care facilities from January 1, 2000, to December 31, 2014. The primary dependent variable, receipt of purchased behavioral health care, was modeled for select mental health and substance use disorders from 2000 to 2014 using generalized estimating equations. Patient characteristics included time, age, sex, and race/ethnicity. Visit types included inpatient hospitalization and emergency department (ED). Time was measured in days and visits were assumed to be correlated over time. Behavioral health care was described by both frequency of patients and visit type. The University of South Carolina Institutional Review Board approved this study. From 2000 to 2014, purchased care visits increased significantly for post-traumatic stress disorder, adjustment, anxiety, mood, bipolar, tobacco use, opioid/combination opioid dependence, nondependent cocaine abuse, psychosocial problems, and suicidal ideation among MHS beneficiaries. The majority of care was received for mental health disorders (78
Jones, Norman; Campion, Ben; Keeling, Mary; Greenberg, Neil
Military research suggests a significant association between leadership, cohesion, mental health stigmatisation and perceived barriers to care (stigma/BTC). Most studies are cross sectional, therefore longitudinal data were used to examine the association of leadership and cohesion with stigma/BTC. Military personnel provided measures of leadership, cohesion, stigma/BTC, mental health awareness and willingness to discuss mental health following deployment (n = 2510) and 4-6 months later (n = 1636). At follow-up, baseline leadership and cohesion were significantly associated with stigma/BTC; baseline cohesion alone was significantly associated with awareness of and willingness to discuss mental health at follow-up. Over time, changes in perceived leadership and cohesion were significantly associated with corresponding changes in stigma/BTC levels. Stigma/BTC content was similar in both surveys; fear of being viewed as weak and being treated differently by leaders was most frequently endorsed while thinking less of a help-seeking team member and unawareness of potential help sources were least common. Effective leadership and cohesion building may help to reduce stigma/BTC in military personnel. Mental health awareness and promoting the discussion of mental health matters may represent core elements of supportive leader behaviour. Perceptions of weakness and fears of being treated differently represent a focus for stigma/BTC reduction.
Weeks, Murray; Zamorski, Mark A; Rusu, Corneliu; Colman, Ian
This study sought to compare the prevalence and impacts of mental illness-related stigma among Canadian Armed Forces personnel and Canadian civilians. Data were from two highly comparable, population-based, cross-sectional surveys of Canadian military personnel and Canadian civilians: the 2013 Canadian Forces Mental Health Survey (N=6,696) and the 2012 Canadian Community Health Survey-Mental Health (N=25,113), respectively. Perceived stigma was assessed among those who reported care seeking for a mental health problem in the past 12 months. Follow-up questions assessed the impact of stigma in various domains. Modified Poisson regression and linear regression were used to examine population differences (military versus civilian) in terms of care seeking, stigma, and stigma impact, with adjustments for sociodemographic characteristics and the need for care. Military personnel were significantly more likely than civilians to have perceived stigma (adjusted prevalence ratio [PR]=1.70, 95% confidence interval [CI]=1.11-2.60). Stigma had a greater impact on military personnel, particularly in terms of work or school life (b=1.01, CI=.57-1.47). However, military personnel were also significantly more likely than civilians to have sought care (PR=1.86, CI=1.53-2.25). Military personnel reported a disproportionate amount of mental illness-related stigma, compared with Canadian civilians, and a greater impact of stigma. Nevertheless, military personnel were more likely to seek care, pointing to a complex relationship between stigma and care seeking in the military.
.... This audit topic was the result of a coordinated effort by the Joint Audit Planning Group for Health Care and representatives from the Office of the Assistant Secretary of Defense (Health Affairs) (OASD(HA...
Cardona, Robert Andrew; Ritchie, Elspeth Cameron
Through the stimulus of war and concerns about neuropsychiatric disability, the U.S. military developed methods to rapidly screen the mental health of World War I and II draftees. Intelligence testing and brief psychiatric screening expanded the accession physical examination and underwent revision to identify only gross mental health disability. Supplemental psychiatric evaluations and written psychological screening tools were abandoned after postwar assessments; they demonstrated poor predictive power in evaluating recruit service capacity for combat environments. Currently, only three mental health accession tools are used to screen applicants before their entrance into military service, namely, educational achievement, cognitive testing, and a cursory psychiatric evaluation. The Navy and Air Force use a fourth screening measure during entry-level training. Educational attainment with high school graduation has been the strongest predictor of finishing a service term. The purpose of this article is to provide both a historical review and a review of testing efforts.
Wang, Lawrence; Seelig, Amber; Wadsworth, Shelley MacDermid; McMaster, Hope; Alcaraz, John E; Crum-Cianflone, Nancy F
Divorce has been linked with poor physical and mental health outcomes among civilians. Given the unique stressors experienced by U.S. service members, including lengthy and/or multiple deployments, this study aimed to examine the associations of recent divorce on health and military outcomes among a cohort of U.S. service members. Millennium Cohort participants from the first enrollment panel, married at baseline (2001-2003), and married or divorced at follow-up (2004-2006), (N = 29,314). Those divorced were compared to those who remained married for mental, behavioral, physical health, and military outcomes using logistic regression models. Compared to those who remained married, recently divorced participants were significantly more likely to screen positive for new-onset posttraumatic stress disorder, depression, smoking initiation, binge drinking, alcohol-related problems, and experience moderate weight gain. However, they were also more likely be in the highest 15(th) percentile of physical functioning, and be able to deploy within the subsequent 3-year period after divorce. Recent divorce among military members was associated with adverse mental health outcomes and risky behaviors, but was also associated with higher odds of subsequent deployment. Attention should be given to those recently divorced regarding mental health and substance abuse treatment and prevention strategies.
Kratz, Mary; Thomas, Anne; Hora, Ricardo; Vera, Delphis; Lutz, Mickey; Johnson, Mark D
As the Joint United Nations Programme on HIV/AIDS, the Global Fund, and the US President's Emergency Plan for AIDS Relief focus on reaching 90-90-90 goals, military health systems are scaling up to meet the data demands of these ambitious objectives. Since 2008, the US Department of Defense HIV/AIDS Prevention Program (DHAPP) has been working with military partners in 14 countries on implementation and adoption of a Military eHealth Information Network (MeHIN). Each country implementation plan followed a structured process using international eHealth standards. DHAPP worked with the private sector to develop a commercial-off-the-shelf (COTS) electronic medical record (EMR) for the collection of data, including patient demographic information, clinical notes for general medical care, HIV encounters, voluntary medical male circumcision, and tuberculosis screening information. The COTS software approach provided a zero-dollar software license and focused on sharing a single version of the EMR across countries, so that all countries could benefit from software enhancements and new features over time. DHAPP also worked with the public sector to modify open source disease surveillance tools and open access of HIV training materials. Important lessons highlight challenges to eHealth implementation, including a paucity of technology infrastructure, military leadership rotations, and the need for basic computer skills building. While not simple, eHealth systems can be built and maintained with requisite security, flexibility, and reporting capabilities that provide critical information to improve the health of individuals and organizations. Copyright© Bentham Science Publishers; For any queries, please email at firstname.lastname@example.org.
Full Text Available Since 1972 CDC has sponsored the annual National Health Interview Survey (NHIS. The survey collects data from a large sample of US households, a sample of adults in each household, and a sample of children in each household. But unfortunately county level data on health status are not available as readily and consistently as compared to the national level. This paper describes a telephone-based survey of health on one county to overcome the gaps in the national samples. It is concluded that phone surveys are a cost-effective way to provide for local information on the health status the population. Sample questions are included in the article.
Mangelsdorff, A David; Rogers, Jody; Finstuen, Kenn; Pryor, Rene
The purpose of this research is to assess the impact of an educational program on the Military Health System on some of the evidence-based educational outcomes for the Individual (student) and the Society (all Army Medical Treatment Facilities). The U.S. Army-Baylor University HCA program provides a unique opportunity to assess the impact of an educational program on the Military Health System (MHS). Since the majority of the graduate students are military officers who serve in military medical treatment facilities (MTFs), tracking their career progression allows assessing the value added of the U.S. Army-Baylor University HCA experience from 1951 to 2001 (n = 2234). The context of Society outcomes includes all the Army MTFs where U.S. Army-Baylor University HCA graduates execute their leadership skills. During the time from 1994 to 2001, all of the Army MTFs in the MHS (n = 38) were examined by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). In a similar but shorter time frame (1997-2001), DoD patient satisfaction assessments were conducted. The Individual outcomes (career advancement, increase in status, higher professional association membership) demonstrate that the selection criteria used for program admission appear to be successful. The Society outcomes showed higher JCAHO scores and satisfied consumers in Army facilities with Baylor graduates as the Deputy Commander for Administration (DCA). Continued internal program assessments (curriculum reviews) and external reviews (Accrediting Commission on Education for Health Services Administration accreditations of 5 years in 1987, 8 years in 1993 and 7 years in 2001, and 7 ACHE student chapter awards) attest to the strengths of the U.S. Army-Baylor University HCA program. Educating the MHS shareholders (patients, beneficiaries, professional and support staff, senior leaders) and leveraging technology to. share best practices for all administrators (including non-Baylor graduates) will
attended by skilled health personnel (%) - Contraceptive prevalence - Adolescent fertility rate (per 1000 girls aged 15–19 years) - Antenatal...were based in part on the following health metrics: maternal mortality ratio, under-five mortality rate, modern contraceptive prevalence rate, HIV...essential drugs -Modern Contraceptive Prevalence Rate -Rural Sanitation Coverage -Life expectancy rate -Birth rate -Death rate -Infant
Military chemical warfare agent testing from World War I to 1975 produced thousands of veterans with concerns about how their participation affected their health. A companion article describes the history of these experiments, and how the lack of clinical data hampers evaluation of long-term health consequences. Conversely, much information is available about specific agents tested and their long-term health effects in other populations, which may be invaluable for helping clinicians respond effectively to the health care and other needs of affected veterans. The following review describes tested agents and their known long-term health consequences. Although hundreds of chemicals were tested, they fall into only about a half-dozen pharmaceutical classes, including common pharmaceuticals; anticholinesterase agents including military nerve agents and pesticides; anticholinergic glycolic acid esters such as atropine; acetylcholine reactivators such as 2-PAM; psychoactive compounds including cannabinoids, phencyclidine, and LSD; and irritants including tear gas and riot control agents.
Full Text Available Background: Military personnel are confronted with physiological and psychological changes caused by stress and exposure to trauma. Although resilience may be protective against psychopathology, very few studies have explored the relationships between the resilience and coping strategies. The study aims to assess how different coping strategies affect resilience, psychological well-being (PWB, and perceived health among military personnel.Subjects and Methods: This study was a cross-sectional survey. Nuclear, biological, and chemical (NBC soldiers and nurses in the military medical center were recruited in Taiwan in November 2015. The survey comprised the Brief COPE Scale, Ryff's PWB Scale, and the Resilience Scale for Adults, which examined the relationships among coping strategies, PWB, resilience, and perceived health. Path analysis was applied.Results: We recruited 200 participants (145 male and 177 single aged 24.6 ± 4.7 years (range, 18–46 years. Resilience (coefficient = 0.60, P < 0.001 and PWB (coefficient = 0.33, P < 0.001 were better when using more approach-oriented coping strategies and fewer avoidant coping strategies, whereas the opposite pattern was seen when using avoidant coping (coefficient = −0.31, P < 0.001 for resilience and coefficient = −.20, P < 0.1 for PWB. PWB significantly predicted perceived health (coefficient = 0.45, P < 0.001.Conclusions: Resilience is higher when positive approach-oriented coping strategies are used, which directly affects PWB, and in turn, predicts better-perceived health. Our conceptual model indicates that interventions designed to promote approach-oriented coping strategies may help military personnel develop improved resilience, PWB, and perceived health status.
Sayers, Steven L; Farrow, Victoria A; Ross, Jennifer; Oslin, David W
Existing evidence suggests that military veterans with mental health disorders have poorer family functioning, although little research has focused on this topic. To test whether psychiatric symptoms are associated with family reintegration problems in recently returned military veterans. Cross-sectional survey of a clinical population. Respondents who were referred to behavioral health evaluation from April 2006 through August 2007 were considered for the survey. Philadelphia Veterans Affairs Medical Center, Pa. 199 military veterans who served in Iraq or Afghanistan after 2001 and were referred for behavioral health evaluation from primary care (mean age = 32.7 years, SD = 9.1). Measures included the Mini-International Neuropsychiatric Interview for psychiatric diagnoses, the 9-item Patient Health Questionnaire for depression diagnosis and severity, and screening measures of alcohol abuse and illicit substance use. A measure of military family readjustment problems and a screening measure of domestic abuse were developed for this study. Three fourths of the married/cohabiting veterans reported some type of family problem in the past week, such as feeling like a guest in their household (40.7%), reporting their children acting afraid or not being warm toward them (25.0%), or being unsure about their family role (37.2%). Among veterans with current or recently separated partners, 53.7% reported conflicts involving "shouting, pushing, or shoving," and 27.6% reported that this partner was "afraid of them." Depression and posttraumatic stress disorder symptoms were both associated with higher rates of family reintegration problems. Mental health problems may complicate veterans' readjustment and reintegration into family life. The findings suggest an opportunity to improve the treatment of psychiatric disorders by addressing family problems. Copyright 2009 Physicians Postgraduate Press, Inc.
Edwards-Stewart, Amanda; Smolenski, Derek J; Reger, Greg M; Bush, Nigel; Workman, Don E
Personal technology use is ubiquitous in the United States today and technology, in general, continues to change the face of health care. However, little is known about the personal technology use of military service members and the behavioral health care providers that treat them. This study reports the technology use of 1,101 active duty service members and 45 behavioral health care providers at a large military installation. Participants reported Internet usage; ownership of smartphones, tablets, and e-readers; usage of mobile applications (apps); and basic demographic information. Compared with providers, service members reported higher rates of smartphone ownership, were more likely to own Android smartphones than iPhones, and spent more time gaming. Both groups spent a comparable amount of time using social media. With the exception of gaming, however, differences between service members and providers were not statistically significant when demographics were matched and controlled. Among service members, younger respondents (18-34) were statistically more likely than older respondents (35-58) to own smartphones, spend time gaming, and engage in social media. Our findings can help inform provider's technology-based education and intervention of their patients and guide the development of new technologies to support the psychological health of service members. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.
Monteith, Lindsey L; Bahraini, Nazanin H; Matarazzo, Bridget B; Gerber, Holly R; Soberay, Kelly A; Forster, Jeri E
No studies have examined whether military sexual trauma, as measured and defined within the Veterans Health Administration (VHA), is associated with suicidal ideation among Veterans in VHA care, when taking prior suicide attempts into account. Research regarding the role of gender in this association is also limited. The present study examined: (1) whether military sexual trauma was associated with the presence of past-week suicidal ideation among 354 Veterans in VHA (310 men, 44 women); (2) whether gender moderated the association between military sexual trauma and suicidal ideation. Information regarding military sexual trauma, suicidal ideation, suicide attempt, and psychiatric diagnoses was obtained from self-report instruments and medical records. Adjusting for age, gender, combat, posttraumatic stress disorder, depressive disorders, negative affect, and lifetime suicide attempt, Veterans with military sexual trauma were significantly more likely to report suicidal ideation, compared to Veterans without military sexual trauma. Furthermore, the association between military sexual trauma and suicidal ideation was stronger for men compared to women. These results contribute to a growing literature identifying military sexual trauma as a risk factor for suicidal thoughts and behaviors among Veterans in VHA care and emphasize the importance of screening for suicidal ideation among survivors of military sexual trauma. Published by Elsevier Ireland Ltd.
..., Air Force, and Guard/Reserve components. These data will be combined with comparable data from a Naval Health Research Center survey of active-duty Navy and Marine Corps personnel to form a comprehensive dataset for the Total Force...
Charles, Marie-Jocelyne; Harmon, Bart J; Jordan, Pamela S
The United States Department of Defense (DoD) has transformed health care delivery in its use of information technology to automate patient data documentation, leading to improvements in patient safety...
medical school, the Uniformed Services University of the Health Sciences (USUHS), while expanding the number of scholarships provided to students... actuaries esti- 8. Department of Defense, Evaluation of the TRICARE Program— Access, Cost and Quality: Fiscal Year 2013 Report to Congress (February...DoD’s Uniformed Services University of the Health Sciences —would be closed. 4. See Congressional Budget Office, Lessons from Medicare’s Demonstration
Consolidated Health Informatics (CHI) project, one of the 24 electronic government ( eGov ) Internet- based technology initiatives supporting the president’s...United States Department of Defense (DoD) has transformed health care delivery in its use of information technology to automate patient data...use throughout the Federal Government . The importance of standards in EHR systems was further recognized in an IOM report, which stated, “Electronic
Ollivier, Lénaïck; Decam, Christophe; de Santi, Vincent Pommier; Darar, Houssein Y.; Dia, Aïssata; Nevin, Remington L.; Romand, Olivier; Bougère, Jacques; Deparis, Xavier; Boutin, Jean-Paul
Despite an increase in foreign tourism and in the numbers of foreign military personnel deployed to Djibouti, little is known about the risk of gastrointestinal illness in this country in eastern Africa. To assess risk and to describe common features of gastrointestinal illnesses, reports of illness derived from military health surveillance data collected during 2005–2009 among French service members deployed to Djibouti were reviewed. Diarrhea was the most common problem; it had an annual incidence ranging from 260 to 349 cases per 1,000 person-years. The risk was higher among soldiers deployed short-term (four months) than among soldiers deployed long-term (two years). This five-year review of French health surveillance data documents a significant burden of diarrhea among French soldiers in Djibouti. The identification of factors associated with risk may permit efficient targeting of interventions to reduce morbidity from gastrointestinal illness. PMID:20889897
Ollivier, Lénaïck; Decam, Christophe; Pommier de Santi, Vincent; Darar, Houssein Y; Dia, Aïssata; Nevin, Remington L; Romand, Olivier; Bougère, Jacques; Deparis, Xavier; Boutin, Jean-Paul
Despite an increase in foreign tourism and in the numbers of foreign military personnel deployed to Djibouti, little is known about the risk of gastrointestinal illness in this country in eastern Africa. To assess risk and to describe common features of gastrointestinal illnesses, reports of illness derived from military health surveillance data collected during 2005-2009 among French service members deployed to Djibouti were reviewed. Diarrhea was the most common problem; it had an annual incidence ranging from 260 to 349 cases per 1,000 person-years. The risk was higher among soldiers deployed short-term (four months) than among soldiers deployed long-term (two years). This five-year review of French health surveillance data documents a significant burden of diarrhea among French soldiers in Djibouti. The identification of factors associated with risk may permit efficient targeting of interventions to reduce morbidity from gastrointestinal illness.
Foote, Frederick O; Bulger, Roger J; Frampton, Susan B; Pellegrino, Edmund D
This article describes the history and findings of the Epidaurus Project, a Uniformed Services University-affiliated project to bring holistic care and evidence-based design into the Military Health System (MHS). A distinguished group of civilian thought leaders contributed. The 2005 Base Realignment and Closure process offered a chance to implement the Epidaurus agenda. A new integrated healthcare delivery system, centered around the Walter Reed National Military Medical Center at Bethesda, Maryland, was the result. These facilities will be templates for a new generation of MHS "healing environments" and a model for innovative systems of healthcare nationwide. The Epidaurus Project represents a significant collaboration between civilian medicine and the military in times of war.
Bulger, Roger J.; Frampton, Susan B.; Pellegrino, Edmund D.
This article describes the history and findings of the Epidaurus Project, a Uniformed Services University–affiliated project to bring holistic care and evidence-based design into the Military Health System (MHS). A distinguished group of civilian thought leaders contributed. The 2005 Base Realignment and Closure process offered a chance to implement the Epidaurus agenda. A new integrated healthcare delivery system, centered around the Walter Reed National Military Medical Center at Bethesda, Maryland, was the result. These facilities will be templates for a new generation of MHS “healing environments” and a model for innovative systems of healthcare nationwide. The Epidaurus Project represents a significant collaboration between civilian medicine and the military in times of war. PMID:24278818
Annual Surveillance Summary: Escherichia coli ( E . coli ) Infections in the Military Health System (MHS...or position of the Department of the Navy, Department of Defense, nor the U.S. Government. i i E . coli in the MHS: Annual Summary 2015 Prepared...March 2017 EpiData Center Department NMCPHC-EDC-TR-187-2017 ii ii E . coli in the MHS: Annual Summary 2015 Prepared March 2017 EpiData
Webb-Murphy, Jennifer A; De La Rosa, Gabriel M; Schmitz, Kimberly J; Vishnyak, Elizabeth J; Raducha, Stephanie C; Roesch, Scott C; Johnston, Scott L
Military personnel deployed to Joint Task Force Guantanamo Bay (JTF-GTMO) faced numerous occupational stressors. As part of a program evaluation, personnel working at JTF-GTMO completed several validated self-report measures. Personnel were at the beginning, middle, or end of their deployment phase. This study presents data regarding symptoms of posttraumatic stress disorder, alcohol abuse, depression, and resilience among 498 U.S. military personnel deployed to JTF-GTMO in 2009. We also investigated individual and organizational correlates of mental health among these personnel. Findings indicated that tenure at JTF-GTMO was positively related to adverse mental health outcomes. Regression models including these variables had R2 values ranging from .02 to .11. Occupation at JTF-GTMO also related to mental health such that guards reported poorer mental health than medical staff. Reluctance to seek out mental health care was also related to mental health outcomes. Those who reported being most reluctant to seek out care tended to report poorer mental health than those who were more willing to seek out care. Results suggested that the JTF-GTMO deployment was associated with significant psychological stress, and that both job-related and attitude-related variables were important to understanding mental health symptoms in this sample. Copyright © 2015 International Society for Traumatic Stress Studies.
Kim, Tae Kyung; Lee, H-C; Lee, S G; Han, K-T; Park, E-C
Introduction Reports of sexual harassment are becoming more frequent in Republic of Korea (ROK) Armed Forces. This study aimed to analyse the impact of sexual harassment on mental health among female military personnel of the ROK Armed Forces. Methods Data from the 2014 Military Health Survey were used. Instances of sexual harassment were recorded as ?yes? or ?no?. Analysis of variance (ANOVA) was carried out to compare Kessler Psychological Distress Scale 10 (K-10) scores. Multiple logistic ...
Hochman, Eldar; Shelef, Leah; Mann, J John; Portugese, Shirly; Krivoy, Amir; Shoval, Gal; Weiser, Mark; Fruchter, Eyal
About 45% of civilians who died by suicide had contact with a doctor within 1 month of death. Thus, educating primary care physicians (PCP) to detect and mitigate depression is an important suicide-prevention strategy. However, the PCP consulting rate before suicide has not been examined in a military population. We investigated the utilization of primary health care and mental health services by active-duty military personnel suicide cases prior to death in comparison to matched military controls. All suicides (N = 170) were extracted from a cohort of all active-duty Israeli military male personnel between 2002 and 2012. Applying a retrospective, nested case-control design, we compared primary care services utilization by suicide cases with demographic and occupationally matched military controls (N = 500). Whereas 38.3% of suicide cases contacted a PCP within the last month before death, only 27.6% of suicide cases contacted a mental health specialist during their entire service time. The PCP contact rate within 1 month before death or index day did not differ between suicide cases and military controls (38.3% vs. 33.8%, χ²₁ = 1.05, P = .3). More suicide cases contacted a mental health specialist within service time than did military controls (27.6% vs. 13.6%, χ²₁ = 10.85, P = .001). Even though PCP contact rate by military personnel who died by suicide is slightly lower than that reported for civilians who died by suicide prior to their death, it is higher than mental health specialist contact rate and higher than that by age-matched civilians who died by suicide. These results imply that PCPs education is a viable approach to suicide prevention in a military setting. © Copyright 2014 Physicians Postgraduate Press, Inc.
Bacillus anthracis Bacterial Endotoxin Biological Weapons Candida species Clostridium difficile Chlamydia trachomatis Cholera ( Vibrio cholerae ...to characterize the AChE variability of workers at a pesticide formulation plant in Mexico . They discovered the AChE coefficient of variation (CV...communities in Mexico ; their results suggested that the poorest communities were at greater risk of health effects from pesticide exposures. While the
Ibid. 17 32 C.F.R. §199.17(p)(5)(ii) (2005). 18 See http://mytoc.tma.osd.mil/AccessToCare/ TOC /ATC.htm. 19 File name “AccessToCareSummary_MHS.xls...on Healthy People’s leading health indicators: physical activity; overweight and obesity; tobacco use; substance abuse; responsible sexual behavior
Skabelund, Andrew J; Rawlins, Frederic A; McCann, Edward T; Lospinoso, Joshua A; Burroughs, Lorraine; Gallup, Roger A; Morris, Michael J
Significant concern exists regarding the respiratory health of military personnel deployed to Southwest Asia, given their exposures to numerous environmental hazards. Although the deployed military force is generally assumed to be fit, the pre-deployment respiratory health of these individuals is largely unknown. Soldiers deploying to Southwest Asia were recruited from the pre-deployment processing center at Fort Hood, Texas. Participants completed a general and respiratory health questionnaire and performed baseline spirometry. One thousand six hundred ninety-three pre-deployment evaluations were completed. The average age of the participants was 32.2 y, and 83.1% were male. More than one third of surveyed solders had a smoking history, 73% were overweight or obese, and 6.2% reported a history of asthma. Abnormal spirometry was found in 22.3% of participants. Soldiers with abnormal spirometry reported more asthma (10.1% vs 5.1%, P military personnel that delineates factors potentially associated with the development of pulmonary symptoms and/or disease. This study suggests that deploying soldiers are older, heavier, frequently smoke, and may have undiagnosed pre-deployment lung disease. Abnormal spirometry is common but may not represent underlying disease. Self-reported asthma, wheezing, and slower 2-mile run times were predictive of abnormal spirometry. Pre-deployment evaluation of military personnel identified numerous soldiers with active pulmonary symptoms and abnormal spirometry. When combined with questions regarding asthma history, wheezing and exercise intolerance, spirometry may identify individuals at risk for deployment-related respiratory complaints. Copyright © 2017 by Daedalus Enterprises.
Facility (SW) 02500 90841 Advice/Health Instruction 02502 90801 Assessment, Behavioral 02505 90841 Crisis Intervention 02506 90889 Diagnostic Formulation...Sed/Hyp Withdrawal Delerium 32704 29283 Barb Sim Act Sed/Hyp Amnestic Disorder 32710 30550 Opioid Intoxication 32711 2920 Opioid Withdrawal 32720 30560...Disturbance 78092 7809 Pain, Chronic 78094 7809 Amnesia, Transient Global 78095 7809 Amnesia, Koo 78096 7809 Pain, Secondary to Malignancy 781 7819 Nervous
instrument and sampling procedures) and a secondary analysis of MHS utili- zation administrative data to identify CAM procedures used in the MHS...allergies or intolerance and not part of the U.S. Department of Agriculture’s dietary guidelines (e.g., blood type diet, raw food diet, etc.), which...disease (73 percent), and hypertension (70 percent). It is also commonly used for weight loss (70 percent) and general health, well- ness, and
determining a patient’s preference in a provider rather than gender (Buck & Littleton, 2014). Medics, particularly male medics, were keenly aware of...KS, Littleton HL. (2014). Stereotyped beliefs about male and female OB-GYNS: relationship to provider choice and patient satisfaction. Journal of...health care resource during deployment. Male and female IDCs felt obligated to educate women about how to conduct themselves on ship. In a
mellitus □ 4. Heart disease □ 5. Hypertension □ 6. Obesity □ 7. Other 7a. If other, please specify: Mental Health □ 8. Anxiety disorder □ 9...disease Hypertension Obesity Other chronic disease management Anxiety disorder Depression Posttraumatic stress disorder & acute stress disorder...3,223,967 Professional Counselor (Licensed) GS--‐10 $53,693 42.9 10.9 53.8 $ 2,300,745 $ 585,254 $ 2,885,999 Psychology and Psychiatry
Bell, Margret E; Reardon, Annemarie
Given the frequent occurrence and significant health impact of sexual harassment and sexual assault in the military, it is important that for health care providers working with Veterans to have at least some basic knowledge in this area. Targeting providers addressing mental health and psychosocial issues, but also applicable to clinicians working with survivors in a variety of capacities, this article provides an overview of clinical care with survivors of sexual trauma in the military, particularly those who are OEF/OIF Veterans. We cover basic background information, focusing primarily on the impact of sexual trauma in the military, how survivor's reactions are shaped by various aspects of the military context, and general principles to assist clinicians in working effectively with survivors, whatever their role.
abdollah vosoughi niri
Full Text Available Introduction: Health related measures in emergencies are of the issues that, if taken properly, can reduce damages of a disaster effectively. To have this situation happened knowledge of health personnel, crisis staff, and military and other related groups has to improve. This study aimed to determine military staffs’ attitude and knowledge about health measures in emergencies. Methods: This descriptive and cross-sectional study was conducted through a self-administrated questionnaire. Validity and reliability of the questionnaire was previously proven. The questionnaire included items on personal information and knowledge and attitude about health measures in emergencies. Using a multi-stage sampling, 190 soldiers of Malek Ashtar Military Garrison in Arak were selected. ANOVA, Kruskal- Wallis, Chi Square, Spearman rho’s coefficient correlation and T-test were used to analyze that data. Results: Findings showed that 43 percent of soldiers had good knowledge of health measures in emergencies. About 11 percent of staff had poor knowledge. Half of staff had an average attitude toward emergency health measures. Concerning the degree of knowledge, no significant difference was observed between soldiers with different levels of education. Regarding knowledge and attitude, there was no statistically significant difference between different age groups. Conclusion: Having a basic knowledge of health measures in emergencies is of salient importance. Considering lack of such basic knowledge among some military staff, provision of training on health related measures for those staff is recommended. Keywords: knowledge, attitude, health measures, military staff, crisis
Porter, Ben; Long, Kyna; Rull, Rudolph P; Dursa, Erin K
This research describes Gulf War and era veterans enrolled in the Millennium Cohort Study, who were sampled from US military personnel serving in 2000, and compares health characteristics of this sample to a Department of Veterans Affairs study sampled from the complete population. Demographics characteristics of this sample were described. Self-reported health characteristics were compared between the two studies. Gulf War and era veterans in the Millennium Cohort were generally healthier than in the VA study; they had fewer medical conditions and mental health disorders and better self-reported health. In both studies, Gulf War veterans had poorer health outcomes than era veterans. The Millennium Cohort Study is a unique resource for examining the long-term health effects of Gulf War deployment, particularly comparing deployed and nondeployed personnel and examining illnesses with long latencies.
Sutthavong, Sirikarn; Ukritchon, Supak; Rangsin, Ram
Dental problems are some of the major health problems of deployed miilitaly personnel. There have been no systematically reports of oral health information survey among the deployed military personnel in Thailand. The present study was to determine the oral health problems of the deployed military personnel and effects on personnel fitness. A cross-sectional study and a cluster sampling were conducted during April 2011 and March 2013. The Royal Thai Army (RTA) personnel 12 out of21 task forces in southern most provinces were invited to participate in the study. A standardized questionnaire was used. In total, 2,884 RTA deployed personnel voluntarily participated and completed the questionnaire infonnrmation. Their mean age was 27.8 +/- 9.4 years old. Fifty percent admitted that they had oral problems during the past six months and the most common ones were toothache/hypersensitivity (32.4%), and dental caries (21.5%). The majority of the participants (60.7%) reported that they experienced oral health problems less than 3 times and 2.8% reported sick leave during deployment because of oral conditions. 64.4% reported that their oral problems affected their quality of life and disturbed their duties. A relatively high prevalence oforal health problems was reported by the deployed RTA personnel. The problems affected their quality of life and assigned duties. Most ofthe problems were neglected. In order to keep the RTApersonnel fit for deployment, an effective dental health program should be developed.
Sargent, Paul; Millegan, Jeffrey; Delaney, Eileen; Roesch, Scott; Sanders, Martha; Mak, Heather; Mallahan, Leonard; Raducha, Stephanie; Webb-Murphy, Jennifer
Provider burnout can impact efficiency, empathy, and medical errors. Our study examines burnout in a military medical center during a period of war. A survey including the Maslach Burnout Inventory (MBI), deployment history, and work variables was distributed to health care providers. MBI subscale means were calculated and associations between variables were analyzed. Approximately 60% of 523 respondents were active duty and 34% had deployed. MBI subscale means were 19.99 emotional exhaustion, 4.84 depersonalization, and 40.56 personal accomplishment. Frustration over administrative support was associated with high emotional exhaustion and depersonalization; frustration over life/work balance was associated with high emotional exhaustion. Levels of burnout in our sample were similar to civilian medical centers. Sources of frustration were related to administrative support and life/work balance. Deployment had no effect on burnout levels. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.
Miller, Laurence; Miller, Halle B; Bjorklund, David
Military deployment of a parent carries with it a number of stresses for children, all centering around uncertainty, instability and unpredictability. This article conceptualizes military deployment and relocation stress in the context of attachment theory, and describes the types of adverse outcomes that can occur as the result of impaired attachment. It then presents a set of practical recommendations for mental health clinicians and counselors for helping children and families cope productively and negotiate the developmental hurdles associated with maintaining healthy attachment and family stability in the face of military deployment.
Full Text Available Background and purpose:Consumption of baking soda, as a primary material for preparation of bread dough, has been banned due to its health complications in Iran. So bread production in our country faced difficulties and one part of them is related to health issues which are bread production. Also, in some cases, baking soda is used in the bread production. This study was done to study the environmental health status and consumption of baking soda in the military and urban Lavash bakeries of Tehran in 2012. Materials and methods:This is a descriptive comparative study done on Lavash bread production of 14 military bakeries and 14 corresponding urban bakeries near them. PH in the samples was tested based on Institute of Standards and Industrial Research of Iran No. 2628. To check the status of environmental health and personal hygiene of bakeries, the check list of Cereal Research Center was used. Results:In terms of environmental health status,28.6% military bakeries and7.1% urban bakeries were at good level. In terms of personal hygiene, all bakeries were in the poor category. Also,42.9% of military Lavash bakeries and 14.3% of urban Lavash bakeries used baking soda in their bread production. Conclusion:Environment health and personal hygiene status in military bakeries are better than the urban bakeries however, hygiene status was not desirable in military bakeries. Also, baking soda consumption in military bakeries was more common than the urban bakeries. According to the results of this study, control of health status and avoiding baking soda consumption in the bakeries are necessary.
Hourani, Laurel L; Williams, Thomas V; Kress, Amii M
This study examined the extent to which high levels of occupational and family stress were associated with mental health problems and productivity loss among active duty military personnel. We analyzed data from the 2002 Department of Defense Survey of Health-Related Behaviors among Military Personnel, which provided extensive population-based information on 12,756 active duty personnel in all branches of the military worldwide. Military personnel reported higher levels of stress at work than in their family life. The personnel reporting the highest levels of occupational stress were those 25 or younger, those who were married with spouses not present, and women. Personnel with high levels of stress had significantly higher rates of mental health problems and productivity loss than those with less stress. We recommend that prevention and intervention efforts geared toward personnel reporting the highest levels of stress be given priority for resources in this population.
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psychology , family, military, epidemiology, mental health, deployments Correspondence Nancy Crum-Cianflone, Deployment Health Research Department...American Psychological Association, 2007; Siegel et al., 2013; US Army Medical Research and Materiel Command, 2013). Although studies on military...functional health Modules on common types of mental disorders: depression, anxiety, panic syndrome, somatoform symptoms, alcohol abuse, bulimia nervosa
Beauvais, Brad; Richter, Jason; Brezinski, Paul
The 2014 Military Health System Review calls for healthcare system leaders to implement effective strategies used by other high-performing organizations. The authors state, " the [military health system] MHS can create an optimal healthcare environment that focuses on continuous quality improvement where every patient receives safe, high-quality care at all times" (Military Health System, 2014, p. 1). Although aspirational, the document does not specify how a highly reliable health system is developed or what systemic factors are necessary to sustain highly reliable performance. Our work seeks to address this gap and provide guidance to MHS leaders regarding how high-performing organizations develop exceptional levels of performance.The authors' expectation is that military medicine will draw on these lessons to enhance leadership, develop exceptional organizational cultures, onboard and engage employees, build customer loyalty, and improve quality of care. Leaders from other segments of the healthcare field likely will find this study valuable given the size of the military healthcare system (9.6 million beneficiaries), the United States' steady progression toward population-based health, and the increasing need for highly reliable systems and performance.
Bareis, Natalie; Mezuk, Briana
Childhood poverty has been associated with depression in adulthood, but whether this relationship extends to later life major depression (MD) or is modified by military service is unclear. Data come from the Health and Retirement Study (HRS) 2010 wave, a longitudinal, nationally representative study of older adults. Men with data on military service and childhood poverty were included (N=6330). Childhood poverty was assessed by four indicators (i.e., parental unemployment, residential instability) experienced before age 16. Military service was categorized as veteran versus civilian, and during draft versus all-volunteer (after 1973) eras. Past year MD was defined by the Composite International Diagnostic Inventory. Four in ten men ever served, with 13.7% in the all-volunteer military. Approximately 12% of civilians, 8% draft era and 24% all-volunteer era veterans had MD. Childhood poverty was associated with higher odds of MD (Odds Ratio (OR): 2.38, 95% Confidence Interval (CI): 1.32-4.32) and higher odds of military service (OR: 2.58, 95% CI: 1.58-4.21). Military service was marginally associated with MD (OR: 1.28, 95% CI: 0.98-1.68) and did not moderate the association between childhood poverty and MD. Self-report data is subject to recall bias. The HRS did not assess childhood physical and emotional abuse, or military combat exposure. Men raised in poverty had greater odds of draft and all-volunteer military service. Early-life experiences, independent of military service, appear associated with greater odds of MD. Assessing childhood poverty in service members may identify risk for depression in later life. Copyright © 2016 Elsevier B.V. All rights reserved.
Plat, M. J.; Frings-Dresen, M. H. W.; Sluiter, J. K.
Some occupations have tasks and activities that require monitoring safety and health aspects of the job; examples of such occupations are emergency services personnel and military personnel. The two objectives of this systematic review were to describe (1) the existing job-specific workers' health
Patterson, Steven L; Dancy, Blair C R; Ippolito, Danielle L; Stallings, Jonathan D
: This paper presents environmental health risks which are prevalent in dense urban environments.We review the current literature and recommendations proposed by environmental medicine experts in a 2-day symposium sponsored by the Department of Defense and supported by the Johns Hopkins University Applied Physics Laboratory.Key hazards in the dense urban operational environment include toxic industrial chemicals and materials, water pollution and sewage, and air pollution. Four critical gaps in environmental medicine were identified: prioritizing chemical and environmental concerns, developing mobile decision aids, personalized health assessments, and better real-time health biomonitoring.As populations continue to concentrate in cities, civilian and military leaders will need to meet emerging environmental health concerns by developing and delivering adequate technology and policy solutions.
Blosnich, John R; Gordon, Adam J; Fine, Michael J
To assess the associations of self-identified lesbian, gay, bisexual, and questioning sexual orientation or transgender status (LGBTQ) and military experience with health indicators. We used data from the Fall 2012 National College Health Assessment. The survey included self-identified sociodemographic characteristics, mental (e.g., depression) and physical (e.g., human immunodeficiency virus) conditions, health risk behaviors (e.g., smoking), and social stressors (e.g., victimization). We used modified Poisson regression models, stratified by self-reported military service, to examine LGBTQ-related differences in health indicators, whereas adjusting for sociodemographic characteristics. Of 27,176 in the sample, among the military-experienced group, LGBTQ individuals had increased adjusted risks of reporting a past-year suicide attempt (adjusted risk ratio [aRR] = 4.37; 95% confidence interval [CI] = 1.39-13.67), human immunodeficiency virus (aRR = 9.90; 95% CI = 1.04-79.67), and discrimination (aRR = 4.67; 95% CI = 2.05-10.66) than their non-LGBTQ peers. Among LGBTQ individuals, military experience was associated with a nearly four-fold increased risk of reporting a past-year suicide attempt (aRR = 3.61; 95% CI = 1.46-8.91) adjusting for age, sex, race and ethnicity, marital status, depression, and other psychiatric diagnoses. Military experience may moderate health indicators among LGBTQ populations, and likewise, LGBTQ status likely modifies health conditions among military-experienced populations. Results suggest that agencies serving military populations should assess how and if the health needs of LGBTQ individuals are met. Published by Elsevier Inc.
Ladlow, Peter; Phillip, Rhodri; Etherington, John; Coppack, Russell; Bilzon, James; McGuigan, M Polly; Bennett, Alexander N
To evaluate the functional and mental health status of severely injured traumatic amputees from the United Kingdom military at the completion of their rehabilitation pathway and to compare these data with the published normative data. Retrospective independent group comparison of descriptive rehabilitation data recorded postrehabilitation. A military complex trauma rehabilitation center. Amputees (N=65; mean age, 29±6 y) were evaluated at the completion of their rehabilitation pathway; of these, 54 were operationally (combat) injured (23 unilateral, 23 bilateral, 8 triple) and 11 nonoperationally injured (all unilateral). Continuous ∼4-week inpatient, physician-led, interdisciplinary rehabilitation followed by ∼4-weeks of patient-led, home-based rehabilitation. The New Injury Severity Score at the point of injury was used as the baseline reference. The 6-minute walk test, Amputee Mobility Predictor with Prosthesis, Special Interest Group in Amputee Medicine, Defence Medical Rehabilitation Centre mobility and activity of daily living scores as well as depression (Patient Health Questionnaire-9), anxiety (General Anxiety Disorder Scale-7), mental health support, and pain scores were recorded at discharge and compared with the published normative data. The mean New Injury Severity Score was 40±15. After 34±14 months of rehabilitation, amputees achieved a mean 6-minute walk distance of 489±117 m compared with age-matched normative distances of 459 to 738 m. The 2 unilateral groups walked (544 m) significantly further (P>.05) than did the bilateral amputee (445±104 m) and triple amputee (387±99 m) groups. All groups demonstrated mean functional mobility scores consistent with scores of either active adults or community ambulators with limb loss. In total, 85% could walk/run independently and 95% could walk and perform activities of daily living independently with an aid/adaptation. No significant difference in mental health outcome was reported between the
Cederbaum, Julie A; Wilcox, Sherrie L; Sullivan, Kathrine; Lucas, Carrie; Schuyler, Ashley
Although many service members successfully cope with exposure to stress and traumatic experiences, others have symptoms of depression, posttraumatic stress disorder (PTSD), and anxiety; contextual factors may account for the variability in outcomes from these experiences. This work sought to understand mechanisms through which social support influences the mental health of service members and whether dyadic functioning mediates this relationship. We collected cross-sectional data as part of a larger study conducted in 2013; 321 military personnel who had at least 1 deployment were included in these analyses. Surveys were completed online; we collected data on demographic characteristics, social support, mental health measures (depression, PTSD, and anxiety), and dyadic functioning. We performed process modeling through mediation analysis. The direct effects of social support on the mental health of military personnel were limited; however, across all types of support networks, greater social support was significantly associated with better dyadic functioning. Dyadic functioning mediated the relationships between social support and depression/PTSD only when social support came from nonmilitary friends or family; dyadic functioning mediated social support and anxiety only when support came from family. We found no indirect effects of support from military peers or military leaders. Findings here highlight the need to continue to explore ways in which social support, particularly from family and nonmilitary-connected peers, can bolster healthy intimate partner relationships and, in turn, improve the well-being of military service members who are deployed.
Wilcox, Sherrie L.; Sullivan, Kathrine; Lucas, Carrie; Schuyler, Ashley
Objectives: Although many service members successfully cope with exposure to stress and traumatic experiences, others have symptoms of depression, posttraumatic stress disorder (PTSD), and anxiety; contextual factors may account for the variability in outcomes from these experiences. This work sought to understand mechanisms through which social support influences the mental health of service members and whether dyadic functioning mediates this relationship. Methods: We collected cross-sectional data as part of a larger study conducted in 2013; 321 military personnel who had at least 1 deployment were included in these analyses. Surveys were completed online; we collected data on demographic characteristics, social support, mental health measures (depression, PTSD, and anxiety), and dyadic functioning. We performed process modeling through mediation analysis. Results: The direct effects of social support on the mental health of military personnel were limited; however, across all types of support networks, greater social support was significantly associated with better dyadic functioning. Dyadic functioning mediated the relationships between social support and depression/PTSD only when social support came from nonmilitary friends or family; dyadic functioning mediated social support and anxiety only when support came from family. We found no indirect effects of support from military peers or military leaders. Conclusion: Findings here highlight the need to continue to explore ways in which social support, particularly from family and nonmilitary-connected peers, can bolster healthy intimate partner relationships and, in turn, improve the well-being of military service members who are deployed. PMID:28005474
The "Lysenko affair", which lasted roughly from the mid-1930s to the mid-1960s, was the big scandal of 20th-century science: a classic example of how politics can corrupt and undermine its rational basis. Under Stalin's leadership the Soviet Government suppressed genuine genetics and other sound biology, with devastating consequences for agriculture and health. The worst example of this occurred in August 1948 when the Politburo outlawed the teaching of and research into classical Mendelian genetics. There is broad agreement that this case offers a stark warning against politicians interfering with science. But what, precisely, is this interference that we are being warned about? Whereas the fate of genetics in Soviet Russia was a clear-cut example of direct suppression, there were also other less obvious ways in which politics subverted the scientific process. This indirect interference with science is a persistent feature of modern politics that we need to be on the lookout for.
Victoria A. Osborne
Full Text Available Women involved in all aspects of the United States Armed Forces face mental health needs that are unique from women in the general population. Because the most recent wars in Iraq and Afghanistan are involving more women in combat situations, social workers encounter female clients who are increasingly experiencing post-traumatic stress disorder, substance misuse, and sexual violence. Special attention must be paid particularly to women who serve in the National Guard or Reserves, as they have different concerns than enlisted active duty women. These concerns include less social support and fewer resources upon return from deployment. Thus, it is imperative for social workers in the community to be aware of these military women’s experiences and unique mental health challenges in order to effectively treat their needs.
Bravo, Adrian J; Pearson, Matthew R; Kelley, Michelle L
Previous research on trait mindfulness facets using person-centered analyses (e.g., latent profile analysis [LPA]) has identified four distinct mindfulness profiles among college students: a high mindfulness group (high on all facets of the Five-Factor Mindfulness Questionnaire [FFMQ]), a judgmentally observing group (highest on observing, but low on non-judging of inner experience and acting with awareness), a non-judgmentally aware group (high on non-judging of inner experience and acting with awareness, but very low on observing), and a low mindfulness group (low on all facets of the FFMQ). In the present study, we used LPA to identify distinct mindfulness profiles in a community based sample of U.S. military personnel (majority veterans; n = 407) and non-military college students ( n = 310) and compare these profiles on symptoms of psychological health outcomes (e.g., suicidality, PTSD, anxiety, rumination) and percentage of participants exceeding clinically significant cut-offs for depressive symptoms, substance use, and alcohol use. In the subsample of college students, we replicated previous research and found four distinct mindfulness profiles; however, in the military subsample we found three distinct mindfulness profiles (a combined low mindfulness/judgmentally observing class). In both subsamples, we found that the most adaptive profile was the "high mindfulness" profile (i.e., demonstrated the lowest scores on all psychological symptoms and the lowest probability of exceeding clinical cut-offs). Based on these findings, we purport that the comprehensive examination of an individual's mindfulness profile could help clinicians tailor interventions/treatments that capitalize on individual's specific strengths and work to address their specific deficits.
Hurtado, Suzanne L; Simon-Arndt, Cynthia M; McAnany, Jennifer; Crain, Jenny A
The purpose of this paper is to report on the development of a mental health stigma reduction toolkit and training, and the acceptability and level of stigma awareness following the stigma-reduction training for military personnel. The overall aims of the training were to provide discussion tools highlighting the experiences of Marines seeking help for stress concerns, improve communication between leaders and their Marines around the issue of help seeking, and familiarize Marines with behavioral health treatment. Senior enlisted leaders and officers (N = 52) from a Marine Corps battalion participated in a pretest, 2-h stigma-reduction training and immediate posttest. Acceptability of the training was measured by querying participants about the usefulness and helpfulness of the training among other factors, and stigma awareness was measured with 10 items about mental health stigma. The stigma-reduction training and materials were well accepted by participants. In addition, there was a significant improvement in four of ten stigma-reduction awareness concepts measured before and immediately after the training, which included an increase in agreement that mental health treatments are usually effective in reducing stress reactions [t(51) = -3.35, p = 0.002], and an increase in disagreement that seeking counseling after a deployment will jeopardize future deployments [t(51) = -3.05, p = 0.004]. Level of agreement with several statements including those regarding perceptions of invincibility, and malingering, among others, did not change significantly after the training. The stigma-reduction training containing educational and contact strategies was highly acceptable to the leaders and may have promise for initially dispelling myths associated with seeking help for stress concerns among military service members; however, results indicate that there is clearly more work to be done in combatting stigma.
Bonar, Ted C.
This chapter provides an overview of common challenges faced by military-connected students on university campuses. The characteristics, culture, and experiences of service members and veterans are described through vignettes based on military-connected students.
MILITARY FORCES(FOREIGN), *MILITARY ORGANIZATIONS, MILITARY ENGINEERING , INFANTRY, AMPHIBIOUS OPERATIONS, MINELAYING, ARMORED VEHICLES, NUCLEAR...RADIATION, DOSIMETERS, CHEMICAL WARFARE, PROTECTIVE CLOTHING, DECONTAMINATION, HEALTH PHYSICS.
Cogan, Alison M
More than 2 million U.S. military servicemembers have deployed to Afghanistan or Iraq since September 11, 2001. Unlike during prior conflicts, many servicemembers leave spouses and children behind. Long, multiple deployments cause strain on family at home, with new challenges arising when servicemembers return from combat and reintegrate into family and civilian life. In World Wars I and II, occupational therapy practitioners played a significant role in supporting servicemember reintegration. However, their presence in program delivery in this practice area is limited. Occupational therapy researchers and practitioners can make a valuable contribution by helping families tailor daily activities and routines to address challenges and optimize health and wellness. However, barriers such as reimbursement for services, workforce availability, and access to military families have limited the profession's full engagement. Advocacy is needed to help establish occupational therapy as a key component of the mental and preventive health care teams serving military servicemembers. Copyright © 2014 by the American Occupational Therapy Association, Inc.
Vincent-Johnson, Nancy A
Even though privately-owned pet care is a lower priority mission than military working dog care, food inspection,and the public health mission, it is still very important,and the one that many Veterinary Corps officers, civil-ian veterinarians, and technicians enjoy the most. The vast majority of veterinarians and technicians went into veterinary medicine because of a love for animals. It is fulfilling to offer guidance to a client with a new puppy or kitten, see a sick pet improve after treatment, and interact with dozens of animals and clients in a day. The services provided by the Army Veterinary Corps in car-ing for pets has expanded over the years and the standard of care has improved as well. It is truly a privilege to serve those who dedicate themselves to the protection of our Nation. The Army Veterinary Corps is indeed proud to provide care to the pets of Warfighters of the Army,Navy, Marine Corps, Air Force, and Coast Guard; their family members; and our military retirees.
Full Text Available During the Crimean War freezing cold and contagious diseases was more important than the Russian soldiers for the allied armies. Typhus, scorbut, cholera and malaria prepare the dead of a large number of soldiers. According to the resources, the contagious diseases led to death more than ten times of the military actions. That and #8217;s why, The European armies understood the importance of the treatment diseases in the war and the Crimean War became the beginning point in military health concept development. Florence Nightingale and a staff of 38 volunteers provide clean bedding, improve ventilation and sewage disposal, and reorganize everyday sanitary procedures at British barracks in Istanbul. She was an early theorist of sanitation and one of the founders of the modern nursing profession. Nightingale worked to improve sanitation, nutrition, and activity of patients at hospitals. Death rates were reduced dramatically with the introduction of such measures. [TAF Prev Med Bull 2014; 13(1.000: 1-6
Bos, Marcel J. [Dept. of Gas Turbines and Structural Integrity, National Aerospace Laboratory NLR, Amsterdam (Netherlands)
An important trend in the sustainment of military aircraft is the transition from preventative maintenance to condition based maintenance (CBM). For CBM, it is essential that the actual system condition can be measured and the measured condition can be reliably extrapolated to a convenient moment in the future in order to facilitate the planning process while maintaining flight safety. Much research effort is currently being made for the development of technologies that enable CBM, including structural health monitoring (SHM) systems. Great progress has already been made in sensors, sensor networks, data acquisition, models and algorithms, data fusion/mining techniques, etc. However, the transition of these technologies into service is very slow. This is because business cases are difficult to define and the certification of the SHM systems is very challenging. This paper describes a possibility for fielding a SHM system on legacy military aircraft with a minimum amount of certification issues and with a good prospect of a positive return on investment. For appropriate areas in the airframe the application of SHM will reconcile the fail-safety and slow crack growth damage tolerance approaches that can be used for safeguarding the continuing airworthiness of these areas, combining the benefits of both approaches and eliminating the drawbacks.
Bos, Marcel J.
An important trend in the sustainment of military aircraft is the transition from preventative maintenance to condition based maintenance (CBM). For CBM, it is essential that the actual system condition can be measured and the measured condition can be reliably extrapolated to a convenient moment in the future in order to facilitate the planning process while maintaining flight safety. Much research effort is currently being made for the development of technologies that enable CBM, including structural health monitoring (SHM) systems. Great progress has already been made in sensors, sensor networks, data acquisition, models and algorithms, data fusion/mining techniques, etc. However, the transition of these technologies into service is very slow. This is because business cases are difficult to define and the certification of the SHM systems is very challenging. This paper describes a possibility for fielding a SHM system on legacy military aircraft with a minimum amount of certification issues and with a good prospect of a positive return on investment. For appropriate areas in the airframe the application of SHM will reconcile the fail-safety and slow crack growth damage tolerance approaches that can be used for safeguarding the continuing airworthiness of these areas, combining the benefits of both approaches and eliminating the drawbacks
Browne, Tamara Kayali
Non-medical sex selection is premised on the notion that the sexes are not interchangeable. Studies of individuals who undergo sex selection for non-medical reasons, or who have a preference for a son or daughter, show that they assume their child will conform to the stereotypical roles and norms associated with their sex. However, the evidence currently available has not succeeded in showing that the gender traits and inclinations sought are caused by a "male brain" or a "female brain". Therefore, as far as we know, there is no biological reason why parents cannot have the kind of parenting experience they seek with a child of any sex. Yet gender essentialism, a set of unfounded assumptions about the sexes which pervade society and underpin sexism, prevents parents from realising this freedom. In other words, unfounded assumptions about gender constrain not only a child's autonomy, but also the parent's. To date, reproductive autonomy in relation to sex selection has predominantly been regarded merely as the freedom to choose the sex of one's child. This paper points to at least two interpretations of reproductive autonomy and argues that sex selection, by being premised on gender essentialism and/or the social pressure on parents to ensure their children conform to gender norms, undermines reproductive autonomy on both accounts.
Armsworth, Paul R; Daily, Gretchen C; Kareiva, Peter; Sanchirico, James N
The full or partial purchase of land has become a cornerstone of efforts to conserve biodiversity in countries with strong private property rights. Methods used to target areas for acquisition typically ignore land market dynamics. We show how conservation purchases affect land prices and generate feedbacks that can undermine conservation goals, either by displacing development toward biologically valuable areas or by accelerating its pace. The impact of these market feedbacks on the effectiveness of conservation depends on the ecological value of land outside nature reserves. Traditional, noneconomic approaches to site prioritization should perform adequately in places where land outside reserves supports little biodiversity. However, these approaches will perform poorly in locations where the countryside surrounding reserves is important for species' persistence. Conservation investments can sometimes even be counterproductive, condemning more species than they save. Conservation is most likely to be compromised in the absence of accurate information on species distributions, which provides a strong argument for improving inventories of biodiversity. Accounting for land market dynamics in conservation planning is crucial for making smart investment decisions.
Lester, Patricia; Stein, Judith A; Saltzman, William; Woodward, Kirsten; MacDermid, Shelley W; Milburn, Norweeta; Mogil, Catherine; Beardslee, William
Family-centered preventive interventions have been proposed as relevant to mitigating psychological health risk and promoting resilience in military families facing wartime deployment and reintegration. This study evaluates the impact of a family-centered prevention program, Families OverComing Under Stress Family Resilience Training (FOCUS), on the psychological adjustment of military children. Two primary goals include (1) understanding the relationships of distress among family members using a longitudinal path model to assess relations at the child and family level and (2) determining pathways of program impact on child adjustment. Multilevel data analysis using structural equation modeling was conducted with deidentified service delivery data from 280 families (505 children aged 3-17) in two follow-up assessments. Standardized measures included service member and civilian parental distress (Brief Symptom Inventory, PTSD Checklist-Military), child adjustment (Strengths and Difficulties Questionnaire), and family functioning (McMaster Family Assessment Device). Distress was significantly related among the service member parent, civilian parent, and children. FOCUS improved family functioning, which in turn significantly reduced child distress at follow-up. Salient components of improved family functioning in reducing child distress mirrored resilience processes targeted by FOCUS. These findings underscore the public health potential of family-centered prevention for military families and suggest areas for future research. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.
workplaces, restaurants , grocery stores, and day care facilities could have been fre- quented by both military personnel and the local German...guidance and aid in prevention of disease transmission as well as mitigate possible operational impacts. Author affiliations: Armed Forces Health...Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway
Jones, Norman; Fear, Nicola T; Jones, Margaret; Wessely, Simon; Greenberg, Neil
little is known about longer term military work outcomes in UK military personnel who develop mental health problems when operationally deployed. Deployed Field Mental Health Teams (FMHTs) who support them follow the principles of "Forward Psychiatry," aiming to treat psychiatric casualties close to the front line to maximize operational effectiveness and occupational retention. to examine the short- and long-term military work outcomes in soldiers deployed to Iraq between 2003 and 2007 who were referred to the FMHT. FMHT clinical records were linked to occupational records with 825 resulting matches. 71.6% of the referred soldiers with a documented short-term military work outcome returned to their operational unit, and 73.5% of those who had a documented long-term military work outcome served on for a period in excess of two years. Adjusting for potential confounders, a shorter service length and removal from the operational theatre were both strongly associated with premature discharge; however, it was not possible to determine the severity of the presenting mental health problem and assess whether this impacted outcome. the results of this study support the use of the Forward Psychiatry principles in achieving good short-term military work outcomes. Utilizing these principles, three-quarters of those referred to the FMHT were returned to their deployed unit and approximately three-quarters of those assessed by the FMHT remained in service two years after referral. We suggest that these are positive work outcomes; however, being evacuated out of the operational environment and having a short service length were both associated with premature discharge, though we were unable to examine the role of illness severity.
Snihs, J.O.; Aakerblom, G.
There has been concern regarding the possible environmental impacts of depleted uranium (DU) and its possible health effects on both military personnel and on civilians following the Gulf War 1991. These issues have been raised by several non-governmental organizations, some scientists and by a number of press reports. Since DU could also have been used in the Balkan conflict 1999, there has been a concern about the possible consequences of its use for the people and for the environment of this region. Because of this concern it was considered necessary to review existing information on DU and give appropriate recommendations in the aftermath of the Balkans conflict. This was made in October 1999. In November 2000 a Mission to Kosovo was undertaken on basis of new information from NATO
Full Text Available The influence of military service on self-assessed hearing symptoms and measured auditory function was studied as well as the efficacy of the Hearing Conservation Program (HCP of the Swedish Armed Forces. 839 conscripts were recruited for the study at reporting to military service. They were all exposed to noise over the risk-limits from weapons and vehicles and used earmuffs and/or earplugs. Questionnaires and pure tone screening audiometry were studied at the start and the end of the military service. Retrospective information regarding audiometry at conscription before military service was included as control. The prevalence values of tinnitus were 23% before and 32% after the service and of sensitivity to noise 16% and 19% respectively. The prevalence values of hearing impairment were 6.3% at conscription, 14.5% at reporting to military service, and 24% after the training period. The incidence values of hearing decline were 3.7% during the period with no military noise exposure and 6.6% during the military service. Acoustic accident increased the risk of worsened tinnitus and sensitivity to noise four times and for a high frequency hearing decline six times. We observed elevated prevalence values of tinnitus, sensitivity to noise and hearing impairment at discharge compared to before military service. We observed an elevated risk of hearing decline during military service. Acoustic accident increased the risk of tinnitus, noise sensitivity and hearing decline. We suggest improvements regarding inclusion criteria for military service, and for education regarding the HCP.
Cigrang, J A; Todd, S L; Carbone, E G
A significant proportion of people entering the military are discharged within the first 6 months of enlistment. Mental health related problems are often cited as the cause of discharge. This study evaluated the utility of stress inoculation training in helping reduce the attrition of a sample of Air Force trainees at risk for discharge from basic military training. Participants were 178 trainees referred for a psychological evaluation from basic training. Participants were randomly assigned to a 2-session stress management group or a usual-care control condition. Compared with past studies that used less rigorous methodology, this study did not find that exposure to stress management information increased the probability of graduating basic military training. Results are discussed in terms of possible reasons for the lack of treatment effects and directions for future research.
ABSTRACT The Military Health System (MHS) uses a variety of systems and processes to manage its most important asset ???its people. Chief among the...Health System (MHS) uses a variety of systems and processes to manage its most important asset …its people. Chief among the systems employed to do...enhanced multi-service market FTE full-time equivalent HRM human -resource management LCA labor cost assignment MEPRS Medical Expense
Sargent, James D; Hanewinkel, Reiner
effect). Viewing smoking in movies not only has a direct association with adolescent smoking, it may also undermine parental attempts to prevent this behavior.
Jansen, Don J
.... Known as Tricare, this system of military and private health care offers benefits to active duty personnel and other beneficiaries, including dependents of active duty personnel, military retirees...
Hudak, Ronald P; Russell, Rebecca; Toland, P Paul
The evolution of governance models for the Military Health System's (MHS) large hospitals, called medical treatment facilities (MTFs), has culminated with the effort to implement Enhanced Multi-Service Markets (eMSM). The term eMSM refers to two separate concepts. First, MSM refers to those geographic areas, that is, markets, which have the following characteristics: they have MTFs that are operated by two or more Department of Defense (DoD) Services, that is, Army, Navy, or Air Force; there is a large beneficiary population; there is a substantial amount of direct care (i.e., beneficiaries are treated at MTFs instead of TRICARE's purchased care from civilian providers); and there is a substantial readiness and training platform. Second, the term "enhanced" refers to an increase in management authority over clinical and business operations, readiness, and MTF workload. A retrospective review was conducted to study the evolution of military and civilian health care delivery models for the purpose of understanding how governance models have changed since the 1980s to design and manage MTFs with overlapping catchments areas. Primary and secondary data sources were analyzed through a comprehensive literature review. Since the 1980s, the MHS governance models have evolved from testing various managed care models to a regionally focused TRICARE model and culminating with an overlapping catchment area model entitled eMSMs. The eMSM model partially fulfills the original vision because the eMSM leaders have limited budgetary and resource allocation authority. The various models sought to improve governance of overlapping catchment areas with the intent to enhance medical readiness, community health, and individual health care while reducing costs. However, the success of the current model, that is, eMSMs, cannot be fully assessed because the eMSM model was not fully implemented as originally envisioned. Instead, the current eMSM model partially implements the eMSM model. As
Dave, Ajal; Cagniart, Kendra; Holtkamp, Matthew D
The development of primary stroke centers has improved outcomes for stroke patients. Telestroke networks have expanded the reach of stroke experts to underserved, geographically remote areas. This study illustrates the outcome and cost differences between neurology and primary care ischemic stroke admissions to demonstrate a need for telestroke networks within the Military Health System (MHS). All adult admissions with a primary diagnosis of ischemic stroke in the MHS Military Mart database from calendar years 2010 to 2015 were reviewed. Neurology, primary care, and intensive care unit (ICU) admissions were compared across primary outcomes of (1) disposition status and (2) intravenous tissue plasminogen activator administration and for secondary outcomes of (1) total cost of hospitalization and (2) length of stay (LOS). A total of 3623 admissions met the study's parameters. The composition was neurology 462 (12.8%), primary care 2324 (64.1%), ICU 677 (18.7%), and other/unknown 160 (4.4%). Almost all neurology admissions (97%) were at the 3 neurology training programs, whereas a strong majority of primary care admissions (80%) were at hospitals without a neurology admitting service. Hospitals without a neurology admitting service had more discharges to rehabilitation facilities and higher rates of in-hospital mortality. LOS was also longer in primary care admissions. Ischemic stroke admissions to neurology had better outcomes and decreased LOS when compared to primary care within the MHS. This demonstrates a possible gap in care. Implementation of a hub and spoke telestroke model is a potential solution. Published by Elsevier Inc.
Ashida, Sato; Lynn, Freda B; Williams, Natalie A; Schafer, Ellen J
To identify the social contextual factors, specifically the presence of information that supports v. undermines clinical recommendations, associated with infant feeding behaviours among mothers in low-income areas. Cross-sectional survey evaluating social support networks and social relationships involved in providing care to the infant along with feeding beliefs and practices. Out-patient paediatric and government-funded (Women, Infants, and Children) clinics in an urban, low-income area of the south-eastern USA. Eighty-one low-income mothers of infants between 0 and 12 months old. Most mothers reported receiving both supportive and undermining advice. The presence of breast-feeding advice that supports clinical recommendations was associated with two infant feeding practices that are considered beneficial to infant health: ever breast-feeding (OR=6·7; 95% CI 1·2, 38·1) and not adding cereal in the infant's bottle (OR=15·9; 95% CI 1·1, 227·4). Advice that undermines clinical recommendations to breast-feed and advice about solid foods were not associated with these behaviours. Efforts to facilitate optimal infant feeding practices may focus on increasing information supportive of clinical recommendations while concentrating less on reducing the presence of undermining information within mothers' networks. Cultural norms around breast-feeding may be stronger than the cultural norms around the introduction of solid foods in mothers' social environments; thus, additional efforts to increase information regarding introduction of solid foods earlier in mothers' infant care career may be beneficial.
Otgaar, Henry; Cleere, Colleen; Merckelbach, Harald; Peters, Maarten; Jelicic, Marko; Lynn, Steven Jay
In three experiments, we examined the memory-undermining effects of daydreaming for (un)related stimuli. In Experiments 1 and 2, we tested whether daydreaming fosters forgetting of semantically interrelated material and hence, catalyzes false memory production. In Experiment 3, we examined the memory effects of different daydreaming instructions. In Experiment 1, daydreaming did not undermine correct recall of semantically interrelated words, nor did it affect false memories. In Experiment 2, we again failed to find that daydreaming exerted memory-undermining effects a. In Experiment 3, no memory effects were obtained using different daydreaming instructions. Together, our studies fail to show appreciable memory-undermining effects of daydreaming. Copyright © 2015 Elsevier Inc. All rights reserved.
Inefficient procurement processes undermine access to medicines in the Western ... chronic infectious and non-communicable diseases in the public sector. ... (ii) absence of contracts for certain medicines appearing on provincial code lists; ...
responses revealed major themes of need for additional training in leadership /communication, austere/realistic training environment, interoperability...casualties. Since the military is best equipped to manage global operations, medical military members of the Indo-Asia Pacific nations initiated efforts...three previously separate medical, nursing, and leadership information exchanges into a single event. APHME was developed to foster information and
electronic inpa- tient and outpatient medical records from the following sources: Standard Inpatient Data Record, which contains one record for each...Deployment dates to military opera- tions between September 2001 and March 2008 were determined using military electronic data from the Defense... plasms requiring hospitalization in the first year of life among this cohort. Although multivariable statistical modeling was not performed for
Evans, Elizabeth A; Glover, Dawn L; Washington, Donna L; Hamilton, Alison B
Women Veterans who use the Veterans Health Administration (VA) have high rates of substance abuse and poorer health than non-Veteran women. Less is known about the psychosocial needs of women Veterans who seek care in non-VA settings. We provide a grounded description of factors that impact substance abuse, mental health, and related quality of life of women Veterans who use non-VA community-based health and social services. Utilizing a mixed methods design, we conducted semi-structured in-person interviews with 22 women Veterans in Los Angeles in 2013-2015. The current health of these women Veterans was shaped by substance abuse and several other factors, including: histories of trauma (in childhood, during military service) and discrimination, and associated mental health conditions; post-military socio-economic stressors; shifting social roles and adverse social support; and lost personal identity after military service. Psychosocial factors collectively underscore areas in which delivery of health and social services to women Veterans being treated in non-VA settings could be improved: (1) diffuse, implement, and sustain evidence-based gender-sensitive substance abuse treatment; (2) address traumas contributing to poor health; (3) recognize stress proliferation processes erode women's capacity to access healthcare or cope with stressors in healthy ways; (4) champion women Veterans who embody resilience and thereby can help others to form empowered personal identities of health and wellness. Findings can inform interventions and services that ameliorate vulnerability to substance abuse and other health risks among women Veterans.
Kim, Tae Kyung; Lee, H-C; Lee, S G; Han, K-T; Park, E-C
Reports of sexual harassment are becoming more frequent in Republic of Korea (ROK) Armed Forces. This study aimed to analyse the impact of sexual harassment on mental health among female military personnel of the ROK Armed Forces. Data from the 2014 Military Health Survey were used. Instances of sexual harassment were recorded as 'yes' or 'no'. Analysis of variance (ANOVA) was carried out to compare Kessler Psychological Distress Scale 10 (K-10) scores. Multiple logistic regression analysis was performed to identify associations between sexual harassment and K-10 scores. Among 228 female military personnel, 13 (5.7%) individuals experienced sexual harassment. Multiple logistic regression analysis revealed that sexual harassment had a significantly negative impact on K-10 scores (3.486, psexual harassment were identified in the unmarried (including never-married) group (6.761, pSexual harassment has a negative impact on mental health. Factors associated with worse mental health scores included service classification and length of service. The results provide helpful information with which to develop measures for minimising the negative psychological effects from sexual harassment and promoting sexual harassment prevention policy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Holmes, Samuel L; Lee, Daniel J; Charny, Grigory; Guthrie, Jeff A; Knight, John G
Recent strategies employed in response to military physician recruitment shortfalls have consisted of increasing financial incentives for students in the Health Professions Scholarship Program (HPSP) while offering no increased incentive for attendance at the Uniformed Services University of the Health Sciences (USUHS). To gauge the impact of these incentive increases on the decision of medical students to attend USUHS, a prospective e-mail survey of current USUHS medical students was conducted. The survey was distributed to 674 USUHS medical students from all four class years, of which 41% responded. Students were asked to prioritize incentives and disincentives for military service and USUHS, as well as respond to whether recent incentives applied solely to the HPSP would have affected their decision to attend USUHS. Data were assessed using a weighted scale with responses ranked highest receiving a score of 3, responses ranked second receiving a weighted score of 2, and those ranked third receiving a weighted score of 1. The total weighted sum for each question response across the respondent population was then tallied in aggregate and assigned a weighted score to identify factors consistently ranked highest among the students. Patriotic duty and serving uniformed personnel were ranked most appealing about military service. Combat and deployment considerations were ranked least appealing about military service. Also of note, numerous survey comment box responses highlighted the perceived advantages of pooling resources between the two programs to benefit military medical student recruitment and training. Survey results suggested that current enhanced financial incentives and shorter service obligation offered by the HPSP make attendance of USUHS less appealing for current USUHS students and may negatively impact recruitment and retention of USUHS medical officers. Commensurate incentives such as promotion and credit for time in service while attending USUHS were
An Analysis of Alternatives for Reducing Outpatient Military Health Care Costs for Active Duty Members and their Families: Implementing a Recommended Savings Strategy Using Defense Acquisition Principles
Jaime, Richardo; Rupert, Joshua W
.... In efforts to reduce or contain the costs of the military health care system, this project will propose two cost savings alternatives for providing outpatient care to active duty personnel and their dependents...
Castagnet, X.; Amabile, J.C.; Laroche, P.; Carbonnieres, H. de [Service de Protection Radiologique des Armees, 92 - Clamart (France); Pennacino, A. [Direction Centrale du Service de Sante des Armees, 75 - Paris (France)
The French armed forces health service has set up in France specialized installation only designed and used to take care of radio contaminated patients. These installations can be used for the military and for the civilians, e.g. in case of an accident in a civilian nuclear installation or in case of terrorist attack with a few injured. The main principles of the medical management of a radio contaminated wounded are: - Trauma care is the first priority, - External decontamination has to be treated as fast and reasonably as possible, - Medical treatment for internal contamination is more efficiency that is given earlier (stable iodine, DTPA). Three type of installations have been developed to take charge of contaminated patient or with a suspicion of contamination: - The hasty decontamination post, to take into account the involved victims physically fit, - The advance post for radio-contaminated wounded (P.A.B.R.C.), for the relative emergency whom evacuation can be delayed after medical examination, - The center for the treatment of radio-contaminated wounded(C.T.B.R.C.), in an hospital area, for the absolute emergencies (needing some resuscitation and emergency surgery for saving life, like stopping an hemorrhage). Each military hospital in France has is own C.T.B.R.C. These structures are dedicated to the decontamination, that means that all type of decontamination would be conducted here: skin decontamination, internal decontamination by specific de-contaminant if needed, and decontamination of a contaminated wound by surgical means. This type of surgery might be associated with a precise detection. At his arrival, in a first time, the victim is examined by an emergency physician who is in charge of the structure. Secondly, he makes a triage concerning the medical emergency to identify the type of emergency, life threatening emergency or not. - If the patient is a critical case then the medical treatment takes precedence over contamination - If the patient is
Castagnet, X.; Amabile, J.C.; Laroche, P.; Carbonnieres, H. de; Pennacino, A.
The French armed forces health service has set up in France specialized installation only designed and used to take care of radio contaminated patients. These installations can be used for the military and for the civilians, e.g. in case of an accident in a civilian nuclear installation or in case of terrorist attack with a few injured. The main principles of the medical management of a radio contaminated wounded are: - Trauma care is the first priority, - External decontamination has to be treated as fast and reasonably as possible, - Medical treatment for internal contamination is more efficiency that is given earlier (stable iodine, DTPA). Three type of installations have been developed to take charge of contaminated patient or with a suspicion of contamination: - The hasty decontamination post, to take into account the involved victims physically fit, - The advance post for radio-contaminated wounded (P.A.B.R.C.), for the relative emergency whom evacuation can be delayed after medical examination, - The center for the treatment of radio-contaminated wounded(C.T.B.R.C.), in an hospital area, for the absolute emergencies (needing some resuscitation and emergency surgery for saving life, like stopping an hemorrhage). Each military hospital in France has is own C.T.B.R.C. These structures are dedicated to the decontamination, that means that all type of decontamination would be conducted here: skin decontamination, internal decontamination by specific de-contaminant if needed, and decontamination of a contaminated wound by surgical means. This type of surgery might be associated with a precise detection. At his arrival, in a first time, the victim is examined by an emergency physician who is in charge of the structure. Secondly, he makes a triage concerning the medical emergency to identify the type of emergency, life threatening emergency or not. - If the patient is a critical case then the medical treatment takes precedence over contamination - If the patient is
Using a Resource-Based Theory/View of the firm, this study examined if increased inpatient staffing levels at military hospitals can generate a competitive advantage based on better patient quality outcomes...
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theory of human motivation . Psychological Review, 50(4), 370-396. McGeary, D. D. (2011). Making sense of resilience. Military Medicine, 176(4), 1-2...essential role in developing and supporting resiliency. A model for resilience patterned after Maslows Hierarchy of Needs is proposed. Gaps in our...actualization in Maslow’s Hierarch of Needs ( Maslow , 1943). The progressive requirements for military resiliency might be physiological, psychological
Dichter, Melissa E; Wagner, Clara; True, Gala
Women who have served in the military in the United States experience high rates of intimate partner violence (IPV) and non-partner sexual assault (SA). The military setting presents challenges and opportunities not experienced in other employment contexts that may compound the negative impacts of IPV/SA on women's lives. The purpose of this study was to explore the intersection of women's experiences of IPV/SA and military service through analysis of women veterans' narrative accounts. We conducted in-depth face-to-face qualitative interviews with 25 women veterans receiving primary care at a U.S. Veterans Affairs Medical Center. We draw upon Adler and Castro's (2013) Military Occupational Mental Health Model to frame our understanding of the impact of IPV/SA as a stressor in the military cultural context and to inform efforts to prevent, and support women service members who have experienced, these forms of violence. Our findings highlight the impact of IPV/SA on women's military careers, including options for entering and leaving military service, job performance, and opportunities for advancement. Women's narratives also reveal ways in which the military context constrains their options for responding to and coping with experiences of IPV/SA. These findings have implications for prevention of, and response to, intimate partner or sexual violence experienced by women serving in the military and underscore the need for both military and civilian communities to recognize and address the negative impact of such violence on women service members before, during, and after military service.
footprint in the partner nation • expertise working with partner SOFs • advanced language and transcultural skills • inculcation of a “BPC mindset” in...these relationships have led to critical support for U.S. opera- tions during times of crisis or conflict. Details of these instances are not...United States with access and support in times of crisis and conflict.21 AFSOC health advisors could likewise enable the United States to benefit in
Ayo-Yusuf, Olalekan A; Olutola, Bukola G; Agaku, Israel T
School personnel, who are respected members of the community, may exert significant influence on policy adoption. This study assessed the impact of school personnel's permissiveness toward tobacco industry sponsorship activities on their support for complete bans on tobacco advertisements, comprehensive smoke-free laws and increased tobacco prices. Representative data were obtained from the Global School Personnel Survey for 29 African countries (n = 17 929). Adjusted prevalence ratios (aPR) were calculated using multi-variable Poisson regression models to assess the impact of permissiveness toward tobacco sponsorship activities on support for tobacco control policies (p industry should be allowed to sponsor school events were significantly less likely to support complete bans on tobacco advertisements [aPR = 0.89; 95% confidence interval (CI) 0.84-0.95] and comprehensive smoke-free laws (aPR = 0.95; 95% CI 0.92-0.98). In contrast, support for complete tobacco advertisement bans was more likely among those who believed that the tobacco industry encourages youths to smoke (aPR = 1.27; 95% CI 1.17-1.37), and among those who taught about health sometimes (aPR = 1.06; 95% CI 1.01-1.11) or a lot (aPR = 1.05; 95% CI 1.01-1.10) compared with those who did not teach about health at all. These findings underscore the need to educate school personnel on tobacco industry's strategies to undermine tobacco control policies. This may help to build school personnel support for laws intended to reduce youth susceptibility, experimentation and established use of tobacco products. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: email@example.com.
Takahashi, Yoshiko; Isogai, Zenzo; Mizokami, Fumihiro; Furuta, Katsunori; Nemoto, Tetsuya; Kanoh, Hiroyuki; Yoneda, Masahiko
We examined the location-specific properties of pressure ulcers, focusing on depth and undermining formation, which are often unfavorable factors for ulcer healing. We conducted a retrospective observational study of 2 independent databases on pressure ulcers. Databases from a 200-bed hospital (database A) and a 300-bed hospital (database B) were collected during different time periods. Relationships between ulcer location, ulcer depth, and undermining formation were analyzed. All pressure ulcers were accurately diagnosed and classified according to their locations. A total of 282 pressure ulcers in 189 patients from database A and 232 pressure ulcers in 154 patients from database B were analyzed. It was found that pressure ulcers primarily developed over the sacrum. Ratio of stages III and IV pressure ulcers was high in pressure ulcers of the foot, ankle, and crus on the lower leg. Among the deep pressure ulcers, undermining formation was frequently observed on the greater trochanter, ilium, and sacrum. In contrast, pressure ulcers of the foot, ankle, and crus did not exhibit undermining formation. Our results revealed marked differences in pressure ulcer properties depending on their location. Factors affecting depth and undermining of pressure ulcers appear to be related to anatomical and physical properties of the bone and subcutaneous tissue. Copyright © 2013 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.
Mohatt, Nathaniel Vincent; Boeckmann, Robert; Winkel, Nicola; Mohatt, Dennis F; Shore, Jay
Persistent stigma, lack of knowledge about mental health, and negative attitudes toward treatment are among the most significant barriers to military service members and veterans seeking behavioral health care. With the high rates of untreated behavioral health needs among service members and veterans, identifying effective programs for reducing barriers to care is a national priority. This study adapted Mental Health First Aid (MHFA), an evidence-based program for increasing mental health knowledge, decreasing stigma, and increasing laypeople's confidence in helping and frequency of referring people in need, for military and veteran populations and pilot tested the adapted training program with 4 Army National Guard armories. A total of 176 community first responders (CFRs) participated in a comparative outcomes study, with 69 receiving the training and 107 participating in the control group. CFRs were individuals in natural positions within the Armory or home communities of Guard members to identify and help service members in mental health crisis. Surveys assessing confidence in helping, attitudes toward help seeking, knowledge of resources, use of MHFA practices, and stigma were completed before the training, immediately post-training, at 4 months post-training, and at 8 months post-training. Analyses included repeated measures analysis of variances on data from CFRs who received the training and mixed between-within subjects analysis of variances comparing the intervention and control group longitudinally at three time points. Institutional review board approval for this study was received from Montana State University and the U.S. Army Medical Department, Medical Research and Materiel Command, Human Research Protection Office. Significant and meaningful improvements in confidence (p stigma (p stigma (η 2 = 0.02), with a significant and meaningful difference observed for practice behaviors (p mental health support. In addition, there were positive growth
Best Jr, Richard A
... carry out their military missions, and to be prepared to deliver health care during wartime. The military health system also provides, where space is available, health care services in Department of Defense (DOD...
M. S. Zaitsev
Full Text Available The article analyzes the evolution of military strategy of the Republic of India and key factors that influences its development. New Delhi keeps an eye on the balance of power in South Asia to create favorable conditions for its economic and social development, yet the remaining threats and new challenges still undermine the security and stability in India. The ambitions of China aspiring to power in Asia-Pacific region, combined with its immense military build-up and territorial disputes, cause disturbance in New Delhi. The remaining tensions between India and Pakistan also cause often border skirmishes and medium-scale conflicts. Close relations between China and Pakistan, labeled as “all-weather friendship”, are a source of major concern for India. The fact that both Beijing and Islamabad wield nuclear weapons means that without effective mechanisms of nuclear deterrence any military conflict may turn into a full-scale nuclear war. Terrorist activities and insurgency in the Indian state of Jammu and Kashmir and in the North-Eastern regions of the country, along with maritime piracy and illicit drug trafficking contribute to the complicated nature of the challenges to the Indian security. Indian military strategy is considered as a combination of the army doctrine, maritime doctrine and nuclear doctrine. The Indian political and military leadership wants to meet the challenges of changing geopolitical environment and thus continuously adapts its strategy. However, there is still a gap between theory and practice: Indian armed forces lack the capacity to implement the declared goals because of bulky bureaucratic system, outdated military equipment and insufficient level of command and control. The government needs to mobilize political will and administrative resources to upgrade its defense sector to counter its security threats and challenges.
Sareen, Jitender; Belik, Shay-Lee; Afifi, Tracie O; Asmundson, Gordon J G; Cox, Brian J; Stein, Murray B
We investigated mental disorders, suicidal ideation, self-perceived need for treatment, and mental health service utilization attributable to exposure to peacekeeping and combat operations among Canadian military personnel. With data from the Canadian Community Health Survey Cycle 1.2 Canadian Forces Supplement, a cross-sectional population-based survey of active Canadian military personnel (N = 8441), we estimated population attributable fractions (PAFs) of adverse mental health outcomes. Exposure to either combat or peacekeeping operations was associated with posttraumatic stress disorder (men: PAF = 46.6%; 95% confidence interval [CI] = 27.3, 62.7; women: PAF = 23.6%; 95% CI = 9.2, 40.1), 1 or more mental disorder assessed in the survey (men: PAF = 9.3%; 95% CI = 0.4, 18.1; women: PAF = 6.1%; 95% CI = 0.0, 13.4), and a perceived need for information (men: PAF = 12.3%; 95% CI = 4.1, 20.6; women: PAF = 7.9%; 95% CI = 1.3, 15.5). A substantial proportion, but not the majority, of mental health-related outcomes were attributable to combat or peacekeeping deployment. Future studies should assess traumatic events and their association with physical injury during deployment, premilitary factors, and postdeployment psychosocial factors that may influence soldiers' mental health.
Full Text Available Recourse to a purported ideal of societal homogeneity has become common in the context of the refugee reception crisis – not only in Japan, as Leppold et al report, but also throughout Europe. Calls for societal homogeneity in Europe originate from populist movements as well as from some governments. Often, they go along with reduced social support for refugees and asylum seekers, for example in healthcare provision. The fundamental right to health is then reduced to a citizens’ right, granted fully only to nationals. Germany, in spite of welcoming many refugees in 2015, is a case in point: entitlement and access to healthcare for asylum seekers are restricted during the first 15 months of their stay. We show that arguments brought forward to defend such restrictions do not hold, particularly not those which relate to maintaining societal homogeneity. European societies are not homogeneous, irrespective of migration. But as migration will continue, societies need to invest in what we call “globalization within.” Removing entitlement restrictions and access barriers to healthcare for refugees and asylum seekers is one important element thereof.
Gwack, Jin; Lee, Ju Hyung; Kang, Young Ah; Chang, Kyu-jin; Lee, Moo Sik; Hong, Jee Young
Objectives This study was conducted to investigate acute health effects and its related factors among military personnel participating in the cleanup of the 2007 Hebei Spirit oil spill accident in Taean county, Korea. Methods We collected data on acute symptoms during the cleanup and their predictors using a self-administered questionnaire to 2624 military personnel. Selfreported symptoms included six neurologic symptoms, five respiratory symptoms, two dermatologic symptoms, three ophthalmic ...
Roskes, M.; Elliot, A.J.; Nijstad, B.A.; de Dreu, C.K.W.
Four experiments were designed to test the hypothesis that performance is particularly undermined by time pressure when people are avoidance motivated. The results supported this hypothesis across three different types of tasks, including those well suited and those ill suited to the type of
Data analysis showed that: racial desegregation was achieved at student and level one staff level and lacking at management and administrative staff level; staffing ... These regularities point to a discursive formation (Foucault, 1977) that undermine integration and would reproduce previous racialised inequalities. Finally ...
Kajzar, Vlastimil; Doležalová, Hana
Roč. 59, č. 4 (2013), s. 1-10 ISSN 1802-5420 R&D Projects: GA MŠk ED2.1.00/03.0082 Institutional support: RVO:68145535 Keywords : undermining * surface changes * surveying methods Subject RIV: DH - Mining, incl. Coal Mining http://gse.vsb.cz/2013/LIX-2013-4-1-10.pdf
Roskes, Marieke; Elliot, Andrew J.; Nijstad, Bernard A.; De Dreu, Carsten K. W.
Four experiments were designed to test the hypothesis that performance is particularly undermined by time pressure when people are avoidance motivated. The results supported this hypothesis across three different types of tasks, including those well suited and those ill suited to the type of
Zhang, Xuan-Ming; Zhang, Xuan; Luo, Xu; Guo, Hai-Tao; Zhang, Li-Qun; Guo, Ji-Wei
Military medicine is a research field that seeks to solve the medical problems that occur in modern war conditions based on public medicine theory. We explore the main research topics of military health and medical research in the web of science™ core collection (WoSCC) from 2007 to 2016, and the goal of this work is to serve as a reference for orientation and development in military health and medicine. Based on CiteSpace III, a reference co-citation analysis is performed for 7921 papers published in the WoSCC from 2007 to 2016. In addition, a cluster analysis of research topics is performed with a comprehensive analysis of high-yield authors, outstanding research institutions and their cooperative networks. Currently, the research topics in military health and medicine mainly focus on the following seven aspects: mental health diagnoses and interventions, an army study to assess risk and resilience in service members (STARRS), large-scale military action, brain science, veterans, soldier parents and children of wartime, and wound infection. We also observed that the annual publication rate increased with time. Wessely S, Greenberg N, Fear NT, Smith TC, Smith B, Jones N, Ryan MAK, Boyko EJ, Hull L, and Rona RJ were the top 10 authors in military health and medicine research. The top 10 institutes were the Uniformed Services University of the Health Sciences, the United States Army, the United States Navy, Kings College London, Walter Reed National Military Medical Center, Boston University, Walter Reed Army Institute of Research, Walter Reed Army Medical Center, Naval Health Research Center, and the VA Boston Healthcare System. We are able to perform a comprehensive analysis of studies in military health and medicine research and summarize the current research climate and the developmental trends in the WoSCC. However, further studies and collaborations are needed worldwide. Overall, our findings provide valuable information and new perspectives and shape
desensitizes these receptors, resulting in the user becoming dependent and eventually addicted to the nicotine (Ref 12). Studies have shown the average...cultural ties between tobacco usage and military service dating back to the early 20th century. Newspaper advertisements depicted and glamorized
CUil:RENITL Y IN UBE CAN BE VS-ED BENZODIAZEPINE USE AMONG LOW BACK PAIN PATIENTS CONCURRENn Y PRESCRJBED OPIOIDS IN THE MILITARY HEAL TH SYSTEM BETWEEN...increases in the amount of opiotds p.rescrtl>ed for chronic non-cancer pain , particularly low back pain , exist amoog those served by the milit:a ry health...be11ZOdiazepine prescribing practices among active duty service members with low back pain . It is important to understand factors associated with
Kristensen, Pål; Heir, Trond; Herlofsen, Pål H; Langsrud, Øyvind; Weisæth, Lars
We prospectively studied parental mental health after suddenly losing a son in a military training accident. Parents (N = 32) were interviewed at 1, 2 and 23 years after the death of their son. The General Health Questionnaire and Expanded Texas Inventory of Grief were self-reported at 1, 2, 5, and 23 years; the Inventory of Complicated Grief was self-reported at 23 years. We observed a high prevalence of psychiatric disorders at 1- and 2-year follow-ups (57% and 45%, respectively), particularly major depression (43% and 31%, respectively). Only one mental disorder was diagnosed at the 23-year follow-up. Grief and psychological distress were highest at 1- and 2-year follow-ups. Spouses exhibited a high concordance of psychological distress. Mothers reported more intense grief reactions than did fathers. The loss of a son during military service may have a substantial impact on parental mental health particularly during the first 2 years after death. Spouses' grief can be interrelated and may contribute to their psychological distress.
Searle, Amelia K; Van Hooff, Miranda; McFarlane, Alexander C; Davies, Christopher E; Fairweather-Schmidt, A Kate; Hodson, Stephanie E; Benassi, Helen; Steele, Nicole
Depression, alcohol use disorders and post-traumatic stress disorder (PTSD) are serious issues among military personnel due to their impact on operational capability and individual well-being. Several military forces screen for these disorders using scales including the Kessler Psychological Distress Scale (K10), Alcohol Use Disorders Identification Test (AUDIT), and Post-traumatic Stress Disorder Checklist (PCL). However, it is unknown whether established cutoffs apply to military populations. This study is the first to test the diagnostic accuracy of these three scales in a population-based military cohort. A large sample of currently-serving Australian Defence Force (ADF) Navy, Army and Air Force personnel (n = 24,481) completed the K10, AUDIT and PCL-C (civilian version). Then, a stratified sub-sample (n = 1798) completed a structured diagnostic interview detecting 30-day disorder. Data were weighted to represent the ADF population (n = 50,049). Receiver operating characteristic (ROC) analyses suggested all three scales had acceptable sensitivity and specificity, with areas under the curve from 0.75 to 0.93. AUDIT and K10 screening cutoffs closely paralleled established cutoffs, whereas the PCL-C screening cutoff resembled that recommended for US military personnel. These self-report scales represent a cost-effective and clinically-useful means of screening personnel for disorder. Military populations may need lower cutoffs than civilians to screen for PTSD. Copyright © 2014 John Wiley & Sons, Ltd.
the variance in regards to overall satisfaction. 15. SUBJECT TERMS Dentistry, Patient Satisfaction, Military, Consumer Satisfaction, Dental... patient satisfaction in military dental treatment facilities. Dental health is extremely important for the military as dental assets are not always... customer satisfaction is an important component of military dental care. Quarterly patient satisfaction reports are generated for each dental treatment
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Luxton, David D; Pruitt, Larry D; O'Brien, Karen; Stanfill, Katherine; Jenkins-Guarnieri, Michael A; Johnson, Kristine; Wagner, Amy; Thomas, Elissa; Gahm, Gregory A
Home-based telemental health (TMH) treatments have the potential to address current and future health needs of military service members, veterans, and their families, especially for those who live in rural or underserved areas. The use of home-based TMH treatments to address the behavioral health care needs of U.S. military healthcare beneficiaries is not presently considered standard of care in the Military Health System. The feasibility, safety, and clinical efficacy of home-based TMH treatments must be established before broad dissemination of home-based treatment programs can be implemented. This paper describes the design, methodology, and protocol of a clinical trial that compares in-office to home-based Behavioral Activation for Depression (BATD) treatment delivered via web-based video technology for service members and veterans with depression. This grant funded three-year randomized clinical trial is being conducted at the National Center for Telehealth and Technology at Joint-base Lewis-McChord and at the Portland VA Medical Center. Best practice recommendations regarding the implementation of in-home telehealth in the military setting as well as the cultural and contextual factors of providing in-home care to active duty and veteran military populations are also discussed. Published by Elsevier Inc.
Full Text Available Background: After military deployment, soldiers are at an increased risk of developing posttraumatic psychiatric disorders. The correlation of personal values with symptoms, however, has not yet been examined within a military context. Method: Schwartz's Portrait Values Questionnaire (PVQ, the Posttraumatic Stress Diagnostic Scale (PDS, and the 11-item version of the Resilience Scale (RS-11 were completed by 117 soldiers of the German Armed Forces who had recently been deployed to Afghanistan (n=40 undergoing initial psychiatric treatment, n=77 untreated. Results: Logistic regression showed that the value types of hedonism (−, power (−, tradition (+, and universalism (+ were significantly correlated with the probability and severity of PTSD and whether the participant was in treatment or not. The effects were partially mediated by the RS-11 scale values. Conclusions: Value types seem to be associated with psychiatric symptoms in soldiers after deployment. These results could contribute to the further development of therapeutic approaches.
Zimmermann, Peter; Firnkes, Susanne; Kowalski, Jens T; Backus, Johannes; Siegel, Stefan; Willmund, Gerd; Maercker, Andreas
After military deployment, soldiers are at an increased risk of developing posttraumatic psychiatric disorders. The correlation of personal values with symptoms, however, has not yet been examined within a military context. Schwartz's Portrait Values Questionnaire (PVQ), the Posttraumatic Stress Diagnostic Scale (PDS), and the 11-item version of the Resilience Scale (RS-11) were completed by 117 soldiers of the German Armed Forces who had recently been deployed to Afghanistan (n=40 undergoing initial psychiatric treatment, n=77 untreated). Logistic regression showed that the value types of hedonism (-), power (-), tradition (+), and universalism (+) were significantly correlated with the probability and severity of PTSD and whether the participant was in treatment or not. The effects were partially mediated by the RS-11 scale values. Value types seem to be associated with psychiatric symptoms in soldiers after deployment. These results could contribute to the further development of therapeutic approaches.
Korenev, N M; Bulaga, L P; Komlik, P V; Nemirova, O A; Kalmykov, K K; Sidorenko, T P
Submitted in the article are medical causes of unfitness of those men called up for military service in peace-time. These include psychic dysfunctions (22%), traumata (18.5%), disorders of the nervous system and sensory organs (14.5%), of the osteomuscular system and connective tissue (13.3%), digestive diseases (8.6%). Mental disorders, those of the nervous system and sensory organs, the endocrine system and digestive organs rank first among causes of striking the serviceman off the register, coming up to 40.9%, 31.2%, and 6.8% respectively. Age has been established at which disease manifestations causing unfitness for military service come to reveal themselves: in 58.4 percent of registrants the above manifestations were first diagnosed in childhood, in 5.4 percent--at 16 to 17 years of age, in 36.2 percent--at call-up age.
Cantaluppi, C.; Degetto, S.
Depleted uranium is a by-product of the process of enrichment of natural uranium and is classified as a toxic and radioactive waste; it has a very high density (approximately 19 g cm - 3), a remarkable ductility and a cost low enough to be attractive for some particular technical applications. Civilian uses are essentially related to its high density, but the prevailing use is however military (production of projectiles). From the radioactive point of view, the exposure to depleted uranium can result from both external irradiation as well as internal contamination. The associated risks are however mainly of chemical-toxicological kind and the target organ is the kidney. In the present note the recent military uses and the possible effects of its environmental diffusion are discussed [it
active military personnel and veterans, are affected by three major blinding diseases of the retina and optic nerve: diabetic retinopathy , age-related...disease is detected early. New advanced detection methods are available, but are only interpretable by very experienced specialists. The goal of this...consist of several steps [1-3]: feature detection ; transform model estimation; optimization function design; and optimization strategies. We do not
tissue disorders were the predominant illness and injury- related category for ambulatory visits in military clinics and facilities in 2008, accounting...tobacco use, high bone turnover rates, and family history of osteoporosis all contribute to a higher risk of osteoporosis .23 During the physical...Soldiers reported they did not consume large quantities of milk in Baghdad because of its unpleasant taste. Increased skin pigmen- tation, obesity , and
Hesham I Al-Khashan
Full Text Available Background and Aim: Health reforms that tend to increase the participation of clients in decision-making requires them to be health-literate; hence, the importance of health education. However, not much research has been done to investigate the differences in health education needs according to demographic characteristics of the clients. The aim of this study was to find out any possible gender differences there may be in health education needs and preferences. Subjects and Methods : This cross-sectional study was conducted at Riyadh Military Hospital, Saudi Arabia, on a convenience sample of adult Saudis attending its clinics. Data was collected from April 2009 to May 2010 using a self-administered questionnaire covering demographic data, history and needs of health education, methods, and preferred educator. Results: Of the 1300 forms distributed, 977 were returned completed (75.2% response. Most men (74.0% and women (77.9% had had health education, but more women reported that it had been helpful (P = 0.014. More men mentioned health education needs relating to primary prevention (P = 0.027, and unhealthy practices (P = 0.003, and considered the different language a barrier (P = 0.002 even after adjustment for age and education. The one-to-one method was the most preferred health education method for men (72.7% and women (67.9%. More women preferred group health education (P = 0.02 after adjustment for age and education. Significantly more men preferred pharmacists and dietitians as health educators. Conclusion: The results point to a few significant differences between men and women regarding their health education needs, barriers, and preferences. These must be taken into consideration when planning health education programs.
Pasupathi, Monisha; Rich, Ben
Two studies explore the narrative construction of self-perceptions in conversational storytelling among pairs of same-sex friends. Specifically, the studies examined how listener behavior can support or undermine attempts to self-verify in personal storytelling. In two studies (n=100 dyads), speakers told attentive, distracted, or disagreeable (Study 1 only) friends about a recent experience. Distracted, but not disagreeable, friends tended to undermine participants' attempts to verify their self-perception of being interested in an activity (Study 1) or their self-perception that an event was typical for them (Study 2). These results support the notion that friends can be an important source of influence on self-perceptions and, perhaps surprisingly, suggest that responsiveness from friends, rather than agreement per se, may be crucial for supporting self-verification processes.
Korinek, Kim; Teerawichitchainan, Bussarawan
We sought to better understand the association between early life exposure to war and trauma and older adult health status in a developing setting. We analyzed data of 405 Vietnamese men and women in 1 northern Vietnam commune who entered early adulthood during the Vietnam War and who are now entering late adulthood (i.e., ages 55 years and older in 2010). The toll of war's trauma in the aging northern Vietnamese population was perceptible in the association between exposure to war trauma and various measures of physical health, including negative self-reported health and somatic symptoms. Killing another person and being exposed to toxic substances in warfare was especially detrimental to health in older adulthood. War traumas were likely implicated more strongly as determinants of late adulthood health in men than in women. The weak association between trauma exposure and reported depressive symptoms raised questions about measuring mental health. Military service and war trauma were important determinants of older adult health beyond the US context, given the widespread waging of war and concentration of recent armed conflicts within developing societies.
A form of elitism undermines much writing on voter competence. The elitist move occurs when an author uses a self-serving worldview as the basis for evaluating voters. Such elitism is apparent in widely cited measures of “political knowledge” and in common claims about what voters should know. The elitist move typically limits the credibility and practical relevance of the analysis by leading writers to draw unreliable conclusions about voter competence. I propose a more constructive way of t...
Sunstein, Cass Robert
Some people believe that nudges undermine human agency, but with appropriate nudges, neither agency nor consumer freedom is at risk. On the contrary, nudges can promote both goals. In some contexts, they are indispensable. There is no opposition between education on the one hand and nudges on the other. Many nudges are educative. Even when they are not, they can complement, and not displace, consumer education.
Prominent thinkers such as Jurgen Habermas and Michael Sandel are warning that biomedical enhancements will undermine fundamental political values. Yet, whether biomedical enhancements will undermine such values depends on how biomedical enhancements will function, how they will be administered and to whom. Since only few enhancements are obtainable, it is difficult to tell whether their predictions are sound. Nevertheless, such warnings are extremely valuable. As a society we must, at the very least, be aware of developments that could have harmful consequences. Indeed, if important values would be jeopardized, we should take appropriate measures to protect them. This paper focuses on four central values: solidarity, personal responsibility, equality and autonomy. It delineates the conditions under which biomedical enhancements would undermine these values. It also details the circumstances under which these values would be unaffected by enhancements as well as those under which they would be promoted. Specifying these conditions is valuable; it would enable society to prepare appropriate ethical guidelines and policy responses in advance. PMID:20002073
Bergeron, Michael F; Nindl, Bradley C; Deuster, Patricia A; Baumgartner, Neal; Kane, Shawn F; Kraemer, William J; Sexauer, Lisa R; Thompson, Walter R; O'Connor, Francis G
A potential emerging problem associated with increasingly popularized extreme conditioning programs (ECPs) has been identified by the military and civilian communities. That is, there is an apparent disproportionate musculoskeletal injury risk from these demanding programs, particularly for novice participants, resulting in lost duty time, medical treatment, and extensive rehabilitation. This is a significant and costly concern for the military with regard to effectively maintaining operational readiness of the Force. While there are certain recognized positive aspects of ECPs that address a perceived and/or actual unfulfilled conditioning need for many individuals and military units, these programs have limitations and should be considered carefully. Moreover, certain distinctive characteristics of ECPs appear to violate recognized accepted standards for safely and appropriately developing muscular fitness and are not uniformly aligned with established and accepted training doctrine. Accordingly, practical solutions to improve ECP prescription and implementation and reduce injury risk are of paramount importance.
Jeffery, Diana D; Bulathsinhala, Lakmini; Kroc, Michelle; Dorris, Joseph
We compared prevalence, health care utilization, and costs over time for nonelderly adults diagnosed with fibromyalgia syndrome (FMS), irritable bowel syndrome (IBS), and chronic fatigue syndrome (CFS) in relation to timing of federal approvals for FMS drugs. We used military health care claims from October 2006 to September 2010. Retrospective, multiple-year comparisons were conducted using trend analyses, and time series regression-based generalized linear models. Over 5 years, FMS prevalence rates increased from 0.307% to 0.522%, whereas IBS and CFS prevalence rates remained stable. The largest increase in FMS prevalence occurred between 2007 and 2008. Health care utilization was higher for FMS cases compared to IBS and CFS cases. Over 5 years, the total cost for FMS-related care increased $163.2 million, whereas IBS costs increased $14.9 million and CFS cost increased $3.7 million. Between 2006 and 2010, total pharmacy cost for FMS cases increased from $55 million ($3,641/person) to $96.3 million ($3,557/person). Although cause and effect cannot be established, the advent of federally approved drugs for FMS in concert with pharmaceutical industry marketing of these drugs coincide with the observed changes in prevalence, health care utilization, and costs of FMS relative to IBS and CFS. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.
José A. Centeno
Full Text Available Background: The majority of modern war wounds are characterized by high-energy blast injuries containing a wide range of retained foreign materials of a metallic or composite nature. Health effects of retained fragments range from local or systemic toxicities to foreign body reactions or malignancies, and dependent on the chemical composition and corrosiveness of the fragments in vivo. Information obtained by chemical analysis of excised fragments can be used to guide clinical decisions regarding the need for fragment removal, to develop therapeutic interventions, and to better anticipate future medical problems from retained fragment related injuries. In response to this need, a new U.S Department of Defense (DoD directive has been issued requiring characterization of all removed fragments to provide a database of fragment types occurring in combat injuries. Objectives: The objective of this study is to determine the chemical composition of retained embedded fragments removed from injured military personnel, and to relate results to histological findings in tissue adjacent to fragment material. Methods: We describe an approach for the chemical analysis and characterization of retained fragments and adjacent tissues, and include case examples describing fragments containing depleted uranium (DU, tungsten (W, lead (Pb, and non-metal foreign bodies composed of natural and composite materials. Fragments obtained from four patients with penetrating blast wounds to the limbs were studied employing a wide range of chemical and microscopy techniques. Available adjacent tissues from three of the cases were histologically, microscopically, and chemically examined. The physical and compositional properties of the removed foreign material surfaces were examined with energy dispersive x-ray fluorescence spectrometry (EDXRF, scanning electron microscopy (SEM, laser ablation inductively-coupled plasma mass-spectrometry (LA-ICP-MS, and confocal laser Raman
professional military. It simultaneously undermines a military’s commitment to protect the country and its citizens. Plato noted some 2,400 years ago...stepping down from his post as Senior Advisor to the President on Defence and Security.42 He procured not only spoiled food rations for the Ugandan... Plato , The Republic, tr. G.M.A. Grube (Hacket, 1992), 417b and 434a-b. 17 “Above the State: The Officers’ Republic in Egypt,” Carnegie Middle East Center
Runge, Catherine E.; Waller, Michael; MacKenzie, Alison; McGuire, Annabel C. L.
Introduction There are few studies on the experiences of spouses of military members, with most focused on adverse impacts of deployment. Responses to an open-ended question in a survey of spouses' health and wellbeing enabled access to perceptions and insights on a broad range of topics. The objective of this investigation was to examine how respondents used the open-ended question and what they discussed, in aim of informing support service agencies and spouses of military members. Methods Thematic analysis was conducted on responses to the open-ended question. Descriptive analysis was performed on the demographics, military member characteristics and self-reported health of respondents and non-respondents to the open-ended question. Findings Over a quarter (28.5%) of the 1,332 survey participants answered the open-ended question, with respondents having a significantly higher level of education than non–respondents. Respondents expressed negative and positive experiences and insights on military life, provided personal information, commented on the survey, and qualified their responses to closed-ended questions. Topics included ‘inadequate support’, ‘deployment impacts’, ‘suggestions for supporting agencies’, ‘appraisal of experiences’ and ‘coping strategies’. Conclusions This investigation uncovered issues of importance to spouses of military members that were not included or identified in a quantitative study. The findings provide a platform from which to explore these issues further, particularly the impact of military life on the non-serving spouse's career. The findings also provide support agencies with evidence to strengthen their services and they give spouses an opportunity to reflect on their own and others' feelings and evaluations of military life. PMID:25479135
caregivers have been actively and productively engaged long before the attacks of 9/11, having provided mental health and spiritual care to military...Secondary Traumatic Stress or Simply Burnout ? Effect of Trauma Therapy on Mental Health Professionals,” Australian and New Zealand Journal of Psychiatry...24. 77 Ibid., 24. 78 Ben-Zeev et al., “DSM-V and the Stigma of Mental Illness ,” 319. 79 Britt et al., “The Stigma of Mental Health Problems in
Fogarty, Gerard P
Following 9/11, the U.S. Administration invoked extraordinary wartime powers to establish a new forward-leaning system of military justice that it hoped would match a very different type of conflict...
Plat, M J; Frings-Dresen, M H W; Sluiter, J K
Some occupations have tasks and activities that require monitoring safety and health aspects of the job; examples of such occupations are emergency services personnel and military personnel. The two objectives of this systematic review were to describe (1) the existing job-specific workers' health surveillance (WHS) activities and (2) the effectiveness of job-specific WHS interventions with respect to work functioning, for selected jobs. The search strategy systematically searched the PubMed, PsycINFO and OSH-update databases. The search strategy consisted of several synonyms of the job titles of interest, combined with synonyms for workers' health surveillance. The methodological quality was checked. At least one study was found for each of the following occupations fire fighters, ambulance personnel, police personnel and military personnel. For the first objective, 24 studies described several job-specific WHS activities aimed at aspects of psychological, 'physical' (energetic, biomechanical and balance), sense-related, environmental exposure or cardiovascular requirements. The seven studies found for the second objective measured different outcomes related to work functioning. The methodological quality of the interventions varied, but with the exception of one study, all scored over 55% of the maximum score. Six studies showed effectiveness on at least some of the defined outcomes. The studies described several job-specific interventions: a trauma resilience training, healthy lifestyle promotion, physical readiness training, respiratory muscle training, endurance and resistance training, a physical exercise programme and comparing vaccines. Several examples of job-specific WHS activities were found for the four occupations. Compared to studies focusing on physical tasks, a few studies were found that focus on psychological tasks. Effectiveness studies for job-specific WHS interventions were scarce, although their results were promising. We recommend studying
Fischer, A; Muller, M
The process of transformation in the South African Military Health Services, has influenced the nursing service managers' level of motivation and the following research question is applicable: what are the perceptions of the nursing service managers within the South African Military Health Services on their level of motivation? The purpose with this study was to explore and describe the perceptions of nursing service managers on their level of motivation within these health services. A qualitative research design was utilized and four focus group interviews were conducted with 33 nursing service managers country wide. The transcribed interviews were exposed to a content analysis. The results confirm that the level of motivation amongst these nursing service managers is low. The demotivators relate mainly to the following: inadequate acknowledgement, job insecurity in relation to the future, problems with the process of integration, transformation and rationalization, problems with management, many labour related issues, poor/inadequate communication, inadequate support, increased work load, poor physical environment, negative publicity and poor self motivation. Although there were a few motivators identified, they were of less importance. These results were interpreted within Herzberg's motivation theory to identify the hygiene/maintenance factors and to assess whether the important motivators were in place. During any process of change, and/or when the level of motivation amongst employees is low, it is important to adequately manage the environment (hygiene/maintenance factors within the Herzberg theory). But it is even more important to ensure that the motivators are in place or to intensify them. It is therefore recommended that a motivation strategy, based on the Herzberg theory as well as the Hackman-Oldham job enrichment model, be developed, implemented and evaluated.
Full Text Available Sport and physical activity is important and compulsory for military staff. They determine the execution of service duties and tasks. Respondents with low level of physical activity have difficulties achieving required fitness level and pass the annual physical tests. Staff officers aged 28 to 40 years completed questionnaires in 2009 (n=22, 2010 (n=30 and 2012 (n=39. Each questionnaire included twenty one questions which were then evaluated in points. The answers allowed us to collect information regarding their physical activity during service hours as well as after the working day. Questionnaires included also issues on harmful habits – sleep duration, smoking and use of alcohol; self-esteem of body mass as well. The respondents were divided into four groups according to the level of physical activity: low, moderate, good, high. The percentage of respondents with a high and good level of physical activity has increased from 22.7% to 68.9% during the analysed time period. Morning exercises and hardening (fitness procedures were not popular for military personnel. However, physical activities during the working hours have slightly increased: 31.8%, 43.3% and 48.9.3% respectively. In study years, it was found that respondents try to follow healthy eating habits and sleep regime. There is a slight decrease of respondents with obese and there is a slight increase of 22.7% to 27.6% of the respondents who are regular smokers .
This paper discusses four main theses concerning the military use of depleted uranium (DU) weapons by NATO in the Nineties. The first thesis is that DU is harmful and dangerous, not only as a chemically toxic agent, but also from the radiological viewpoint. We also demonstrate the strict connection between DU exposure and certain illnesses, such as leukaemia and Hodgkin lymphoma. The second thesis is that western political and military authorities could not be uninformed of the dangers of DU and of its use in wars of the last decade; it is incorrect to say that DU weapons are not forbidden at the international level. The third thesis, based on an estimate of the cases expected to occur in the general population as well as in the armed forces, states that we can reasonably expect soldiers and population to develop tumours caused by DU. The estimate is made by means of population dose codes and dispersion models for atmospheric pollutants. Collective doses are determined, and data are discussed. The fourth thesis shows that the presence of DU is difficult to determine experimentally by field research. Better ways to determine DU pollution are discussed. In addition, we focus on a point that broadens the perspective of the D U problem : DU is only the tip of an iceberg as regards the consequences of what amounts to a chemical, radiological and environmentally destructive war conducted by NATO against the entire environmental system in the Balkans
Wu, Mae; Henne, Melinda; Propst, Anthony
The FAMILY Act, an income tax credit for infertility treatments, was introduced into the U.S. Senate on May 12, 2011. We estimated the costs and utilization of in vitro fertilization (IVF) in the military if infertility treatment became a tax credit or TRICARE benefit. We surveyed 7 military treatment facilities (MTFs) that offer IVF, with a 100% response rate. We first modeled the impact of the FAMILY Act on the MTFs. We then assessed the impact and costs of a TRICARE benefit for IVF. In 2009, MTFs performed 810 IVF cycles with average patient charges of $4961 and estimated pharmacy costs of $2K per cycle. With implementation of the FAMILY Act, we estimate an increase in IVF demand at the MTFs to 1165 annual cycles. With a TRICARE benefit, estimated demand would increase to 6,924 annual IVF cycles. MTF pharmacy costs would increase to $7.3 annually. TRICARE medical and pharmacy costs would exceed $24.4 million and $6.5 million, respectively. In conclusion, if the FAMILY Act becomes law, demand for IVF at MTFs will increase 29%, with a 50% decrease in patient medical expenses after tax credits. MTF pharmacy costs will rise, and additional staffing will be required to meet the demand. If IVF becomes a TRICARE benefit, demand for IVF will increase at least 2-fold. Current MTFs would be unable to absorb the increased demand, leading to increased TRICARE treatment costs at civilian centers.
Frilander, Heikki; Lallukka, Tea; Viikari-Juntura, Eira; Heliövaara, Markku; Solovieva, Svetlana
Disability retirement causes a significant burden on the society and affects the well-being of individuals. Early health problems as determinants of disability retirement have received little attention. The objective was to study, whether interrupting compulsory military service is an early indicator of disability retirement among Finnish men and whether seeking medical advice during military service increases the risk of all-cause disability retirement and disability retirement due to mental disorders and musculoskeletal diseases. We also looked at secular trends in these associations. We examined a nationally representative sample of 2069 men, who had entered military service during 1967-1996. We linked military service health records with cause-specific register data on disability retirement from 1968 to 2008. Secular trends were explored in three service time strata. We used the Cox regression model to estimate proportional hazard ratios and their 95% confidence intervals. During the follow-up time altogether 140 (6.8%) men retired due to disability, mental disorders being the most common cause. The men who interrupted service had a remarkably higher cumulative incidence of disability retirement (18.9%). The associations between seeking medical advice during military service and all-cause disability retirement were similar across the three service time cohorts (overall hazard ratio 1.40 per one standard deviation of the number of visits; 95% confidence interval 1.26-1.56). Visits due to mental problems predicted disability retirement due to mental disorders in the men who served between 1987 and 1996 and a tendency for a similar cause-specific association was seen for musculoskeletal diseases in the men who served in 1967-1976. In conclusion, health problems-in particular mental problems-during late adolescence are strong determinants of disability retirement. Call-up examinations and military service provide access to the entire age cohort of men, where
Sareen, Jitender; Cox, Brian J; Afifi, Tracie O; Stein, Murray B; Belik, Shay-Lee; Meadows, Graham; Asmundson, Gordon J G
Although military personnel are trained for combat and peacekeeping operations, accumulating evidence indicates that deployment-related exposure to traumatic events is associated with mental health problems and mental health service use. To examine the relationships between combat and peacekeeping operations and the prevalence of mental disorders, self-perceived need for mental health care, mental health service use, and suicidality. Cross-sectional, population-based survey. Canadian military. A total of 8441 currently active military personnel (aged 16-54 years). The DSM-IV mental disorders (major depressive disorder, posttraumatic stress disorder, generalized anxiety disorder, panic disorder, social phobia, and alcohol dependence) were assessed using the World Mental Health version of the World Health Organization Composite International Diagnostic Interview, a fully structured lay-administered psychiatric interview. The survey included validated measures of self-perceived need for mental health treatment, mental health service use, and suicidal ideation. Lifetime exposure to peacekeeping and combat operations and witnessing atrocities or massacres (ie, mutilated bodies or mass killings) were assessed. The prevalences of any past-year mental disorder assessed in the survey and self-perceived need for care were 14.9% and 23.2%, respectively. Most individuals meeting the criteria for a mental disorder diagnosis did not use any mental health services. Deployment to combat operations and witnessing atrocities were associated with increased prevalence of mental disorders and perceived need for care. After adjusting for the effects of exposure to combat and witnessing atrocities, deployment to peacekeeping operations was not associated with increased prevalence of mental disorders. This is the first study to use a representative sample of active military personnel to examine the relationship between deployment-related experiences and mental health problems. It provides
Moller, Arlen C.; McFadden, H. Gene; Hedeker, Donald; Spring, Bonnie
Financial incentives are widely used in health behavior interventions. However, self-determination theory posits that emphasizing financial incentives can have negative consequences if experienced as controlling. Feeling controlled into performing a behavior tends to reduce enjoyment and undermine maintenance after financial contingencies are removed (the undermining effect). We assessed participants' context-specific financial motivation to participate in the Make Better Choices trial—a trial testing four different strategies for improving four health risk behaviors: low fruit and vegetable intake, high saturated fat intake, low physical activity, and high sedentary screen time. The primary outcome was overall healthy lifestyle change; weight loss was a secondary outcome. Financial incentives were contingent upon meeting behavior goals for 3 weeks and became contingent upon merely providing data during the 4.5-month maintenance period. Financial motivation for participation was assessed at baseline using a 7-item scale (α = .97). Across conditions, a main effect of financial motivation predicted a steeper rate of weight regained during the maintenance period, t(165) = 2.15, P = .04. Furthermore, financial motivation and gender interacted significantly in predicting maintenance of healthy diet and activity changes, t(160) = 2.42, P = .016, such that financial motivation had a more deleterious influence among men. Implications for practice and future research on incentivized lifestyle and weight interventions are discussed. PMID:22548152
Arlen C. Moller
Full Text Available Financial incentives are widely used in health behavior interventions. However, self-determination theory posits that emphasizing financial incentives can have negative consequences if experienced as controlling. Feeling controlled into performing a behavior tends to reduce enjoyment and undermine maintenance after financial contingencies are removed (the undermining effect. We assessed participants’ context-specific financial motivation to participate in the Make Better Choices trial—a trial testing four different strategies for improving four health risk behaviors: low fruit and vegetable intake, high saturated fat intake, low physical activity, and high sedentary screen time. The primary outcome was overall healthy lifestyle change; weight loss was a secondary outcome. Financial incentives were contingent upon meeting behavior goals for 3 weeks and became contingent upon merely providing data during the 4.5-month maintenance period. Financial motivation for participation was assessed at baseline using a 7-item scale (=.97. Across conditions, a main effect of financial motivation predicted a steeper rate of weight regained during the maintenance period, (165=2.15, =.04. Furthermore, financial motivation and gender interacted significantly in predicting maintenance of healthy diet and activity changes, (160=2.42, =.016, such that financial motivation had a more deleterious influence among men. Implications for practice and future research on incentivized lifestyle and weight interventions are discussed.
Warneken, Felix; Tomasello, Michael
The current study investigated the influence of rewards on very young children's helping behavior. After 20-month-old infants received a material reward during a treatment phase, they subsequently were less likely to engage in further helping during a test phase as compared with infants who had previously received social praise or no reward at all. This so-called overjustification effect suggests that even the earliest helping behaviors of young children are intrinsically motivated and that socialization practices involving extrinsic rewards can undermine this tendency.
King, Heidi B; Kesling, Kimberly; Birk, Carmen; Walker, Theodore; Taylor, Heather; Datena, Michael; Burgess, Brittany; Bower, Lyndsay
Partnership for Patients (PfP) was a national initiative sponsored by the Department of Health and Human Services, Centers for Medicare and Medicaid Services, to reduce preventable hospital acquired conditions (HACs) by 40% and readmissions (within 30 days) by 20%, by the end of 2013 (as compared to the baseline of CY2010). Along with partners across the nation, the Assistant Secretary of Defense for Health Affairs, Dr. Jonathan Woodson, pledged to support PfP in June 2011. Participation of the Military Health System (MHS) in PfP marked the implementation of the first enterprise-wide patient safety initiative. Three phases of the MHS initiative were developed to meet the aims of the national PfP initiative: (1) Planning and Design, (2) Implementation, and (3) Monitoring and Sustainment. The Planning and Design phase focused on the identification of evidence-based practices (Table III); the development of implementation guides; the implementation of various communication, education, and improvement strategies; and the development of methods by which to track progress and share successes. The implementation phase focused on identifying roles and responsibilities across all levels of care; creating, disseminating, and implementing evidence-based practices at participating military treatment facilities; and establishing a structured learning action network. Finally, during the monitoring and sustainment phase, per the guidance of the Agency for Healthcare Research and Quality, an overall HAC rate was developed for quarterly analysis. The HAC rate per 1,000 dispositions (i.e., discharges) was an aggregate of all PfP HACs. Using the HAC rate, the improvement rate was calculated by comparing the current quarter's HAC rate to the baseline (CY2010). This allowed the MHS to track the overall progress across the enterprise. The MHS achieved a number of accomplishments, including a 15.8% cumulative reduction in HACs by the end of 2013, an 11.1% reduction in readmissions
Edwards, Ryan D.
There is a large and robust correlation between adult health and education, part of which likely reflects causality running from education into health. Less clear is whether education obtained later in life is as valuable for health as are earlier years of schooling, or whether education raises health directly or through income or wealth. In this…
Bingham, Clarissa M L; Lahti-Koski, Marjaana; Absetz, Pilvikki; Puukka, Pauli; Kinnunen, Marja; Pihlajamäki, Harri; Sahi, Timo; Uutela, Antti; Jallinoja, Piia
To analyse changes in food choices, diet-related risk factors and their association during 6 months of military service. Longitudinal cohort study in Finland, where all men are liable to military service and a clear majority of each age group completes service. Dietary intake data were collected by self-administered questionnaire before and at 6 months of service. Three dietary indices based on food frequencies were developed to characterize the diet: Sugar Index, Fibre Index and Fat Index. Thirteen diet-related risk factors were measured at the beginning and at 6 months of service. Military environment, two geographically distinct garrisons. Male conscripts aged 18-21 years (n 256) performing military service. During 6 months of service, positive changes concerned more frequent use of fibre-rich foods (P = 0·011), improved body composition (BMI, waist circumference, muscle mass, fat mass and percentage body fat, P ≤ 0·003 for all), decreased systolic blood pressure and increased HDL cholesterol (P foods and increased total cholesterol, TAG and blood glucose (P foods was inversely associated with anthropometric risk factors at baseline and with sugar-rich foods at both time points. Despite more frequent consumption of sweet foods, military service with a unified, nutritionally planned diet, a controlled environment and high physical load has a positive effect on conscripts' health risk factors. The negative changes in blood lipids and glucose may reflect more varied free-time eating.
Hiilamo, Heikki; Glantz, Stanton A
To analyse how local tobacco companies in the Nordic countries, individually and through National Manufacturers' Associations, cooperated with British American Tobacco and Philip Morris in denying the health hazards of smoking and undermining tobacco control. Analysis of tobacco control policies in the Nordic countries and tobacco industry documents. Nordic countries were early adopters of tobacco control policies. The multinational tobacco companies recognised this fact and mobilised to oppose these policies, in part because of fear that they would set unfavourable precedents. Since at least 1972, the Nordic tobacco companies were well informed about and willing to participate in the multinational companies activities to obscure the health dangers of smoking and secondhand smoke and to oppose tobacco control policies. Cooperation between multinational companies, Nordic national manufacturer associations and local companies ensured a united front on smoking and health issues in the Nordic area that was consistent with the positions that the multinational companies were taking. This cooperation delayed smoke-free laws and undermined other tobacco control measures. Local tobacco companies worked with multinational companies to undermine tobacco control in distant and small Nordic markets because of concern that pioneering policies initiated in Nordic countries would spread to bigger market areas. Claims by the local Nordic companies that they were not actively involved with the multinationals are not supported by the facts. These results also demonstrate that the industry appreciates the global importance of both positive and negative public health precedents in tobacco control.
Hiilamo, Heikki; Glantz, Stanton A
Objective To analyse how local tobacco companies in the Nordic countries, individually and through National Manufacturers’ Associations, cooperated with British American Tobacco and Philip Morris in denying the health hazards of smoking and undermining tobacco control. Methods Analysis of tobacco control policies in the Nordic countries and tobacco industry documents. Results Nordic countries were early adopters of tobacco control policies. The multinational tobacco companies recognised this fact and mobilised to oppose these policies, in part because of fear that they would set unfavourable precedents. Since at least 1972, the Nordic tobacco companies were well informed about and willing to participate in the multinational companies activities to obscure the health dangers of smoking and secondhand smoke and to oppose tobacco control policies. Cooperation between multinational companies, Nordic national manufacturer associations and local companies ensured a united front on smoking and health issues in the Nordic area that was consistent with the positions that the multinational companies were taking. This cooperation delayed smoke-free laws and undermined other tobacco control measures. Conclusions Local tobacco companies worked with multinational companies to undermine tobacco control in distant and small Nordic markets because of concern that pioneering policies initiated in Nordic countries would spread to bigger market areas. Claims by the local Nordic companies that they were not actively involved with the multinationals are not supported by the facts. These results also demonstrate that the industry appreciates the global importance of both positive and negative public health precedents in tobacco control. PMID:22199013
Arad, V. [Petrosani Univ., Petrosani (Romania). Dept. of Mining Engineering; Arad, S. [Petrosani Univ., Petrosani (Romania). Dept of Electrical Engineering
The Romanian mining industry has been in a serious decline and is undergoing ample restructuring. Analyses of reliability and risk are most important during the early stages of a project in guiding the decision as to whether or not to proceed and in helping to establish design criteria. A technical accident occurred in 2008 at the Petrila coal mine involving an explosion during the exploitation of a coal seam. Over time a series of technical accidents, such as explosions and ignitions of methane gas, roof blowing phenomena or self-ignition of coal and hazard combustions have occurred. This paper presented an analysis of factors that led to this accident as well an analysis of factors related to the mining method. Specifically, the paper discussed the geomechanical characteristics of rocks and coal; the geodynamic phenomenon from working face 431; the spontaneous combustion phenomenon; gas accumulation; and the pressure and the height of the undermined coal bed. It was concluded that for the specific conditions encountered in Petrila colliery, the undermined bed height should be between 5 and 7 metres, depending on the geomechanic characteristics of coal and surrounding rocks. 8 refs., 1 tab., 3 figs.
Woodruff, Susan I; Galarneau, Michael R; McCabe, Cameron T; Sack, Daniel I; Clouser, Mary C
Little is known about the long-term, health-related quality of life (HRQOL) of those wounded in combat during Operations Enduring Freedom, Iraqi Freedom, and New Dawn. The present study described the overall HRQOL for a large group of US service members experiencing mild-to-severe combat-related injuries, and assessed the unique contribution of demographics, service- and injury-related characteristics, and mental health factors on long-term HRQOL. The Wounded Warrior Recovery Project examines patient-reported outcomes in a cohort of US military personnel wounded in combat. Participants were identified from the Expeditionary Medical Encounter Database, a US Navy-maintained deployment health database, and invited to complete a web-based survey. At the time of this study, 3245 service members consented and completed the survey. Hierarchical linear regression analyses were conducted to assess the unique contribution of each set of antecedents on HRQOL scores. HRQOL was uniquely associated with a number of demographics, and service- and injury-related characteristics. Nevertheless, screening positive for posttraumatic stress disorder (B = - .09; P < .001), depression (B = - .10; P < .001), or both as a set (B = - .19; P < .001) were the strongest predictors of lower long-term HRQOL. Postinjury HRQOL among service members wounded in combat was associated with service and injury experience, and demographic factors, but was most strongly linked with current mental health status. These findings underscore the significance of mental health issues long after injury. Further, findings reinforce that long-term mental health screening, services, and treatment are needed for those injured in combat.
... develops formal arrangements with community-based providers, such as community mental health clinics... effectiveness of community partnerships in helping to meet the mental health needs of veterans in a timely way... networks that supports the use of community mental health services, including telehealth services and...
Full Text Available Overexposure to high levels of noise can cause permanent hearing disorders, which have a significant adverse effect on the quality of life of those affected. Injury due to noise can affect people in a variety of careers including construction workers, factory workers, and members of the armed forces. By monitoring the noise exposure of workers, overexposure can be avoided and suitable protective equipment can be provided. This work focused on the creation of a noise dosimeter suitable for use by members of the armed forces, where a discrete dosimeter was integrated into a textile helmet cover. In this way the sensing elements could be incorporated very close to the ears, providing a highly representative indication of the sound level entering the body, and also creating a device that would not interfere with military activities. This was achieved by utilising commercial microelectromechanical system microphones integrated within the fibres of yarn to create an acoustic sensing yarn. The acoustic sensing yarns were fully characterised over a range of relevant sound levels and frequencies at each stage in the yarn production process. The yarns were ultimately integrated into a knitted helmet cover to create a functional acoustic sensing helmet cover prototype.
Minayo, Maria Cecília de Souza; de Assis, Simone Gonçalves; de Oliveira, Raquel Vasconcellos Carvalhaes
In this article, we analyze the physical and mental stress and illness of military and civil police force officers in the State of Rio de Janeiro (Brazil) due to their working conditions and professional activities. The same methodology was used for the study of two categories, namely a quantitative approach (simple random sampling by conglomerates, involving a total of 1,458 civil police officers and 1,108 military police officers, who answered questionnaires anonymously) and a qualitative approach (focal groups involving 143 professionals and 18 interviews with managers of both police forces). The data presented here are all original. Disorders identified were: overweight and obesity in both forces but mainly in the Military Police; low frequency of physical exercise and high levels of cholesterol, especially in the Civil Police. The main health complaints are neck, back or spinal cord pain, eyesight complaints and headaches/ migraines. Sixteen point two per cent of officers of both forces reported physical lesions that were more prevalent in the Military Police, among whom psychic suffering was also more frequent (SRQ20). The need for changes in the individual and professional dimensions and in institutional aspects regarding the conditions and organization of work and of health services is emphasized.
Sheean, Andrew J; Foster, James N; Aden, James K; Tubb, Creighton C; Johnson, Anthony E; Stinner, Daniel J
multimedia campaign resulted in significant improvements among indices of orthopaedic patient satisfaction. We believe this model could be used at other military or nonmilitary treatment facilities as a means to engender patients' familiarity with their surgeon and prompt an appreciation for his/her expertise and enhance overall patient perceptions of department-wide health care quality. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.
Manjelievskaia, Janna; Brown, Derek; Shriver, Craig D; Zhu, Kangmin
Chronic hepatitis C virus (HCV) is the most common blood-borne infection in the United States, with an estimated 2.7 to 3.9 million cases as of 2014. In August 2012, the Centers for Disease Control and Prevention (CDC) recommended 1-time HCV testing of all baby boomers. The objectives of this study were to (1) determine the proportion of people screened for HCV in the US Department of Defense Military Health System before and after the CDC screening recommendation for baby boomers and (2) assess whether certain patient or system factors were associated with screening for HCV before and after August 2012. We used a dataset containing 5% of beneficiaries randomly selected from the Military Health System Data Repository medical claims database for the period July 2011 through September 2013. Of 108 223 people eligible for HCV screening during the first period (July 2011 through July 2012), 1812 (1.7%) were screened. Of 109 768 people eligible during the second period (September 2012 through September 2013), 2599 (2.4%) were screened. HCV screening receipt was related to benefit type (Prime before August 2012: adjusted odds ratio [aOR] = 2.16; 95% confidence interval [CI], 1.89-2.46; Prime after August 2012: aOR = 1.93; 95% CI, 1.73-2.16) and care source (direct care before August 2012: aOR = 1.80; 95% CI, 1.57-2.07; direct care after August 2012: aOR = 2.45; 95% CI, 2.18-2.75); male sex (aOR = 1.17; 95% CI, 1.06-1.29) and black race (aOR = 1.20; 95% CI, 1.05-1.37) were associated with HCV testing only before August 2012. Interventions should be implemented to increase awareness and knowledge of the current national HCV testing recommendation among baby boomers to seek out testing and health care providers to perform screening.
Cieslak, Roman; Anderson, Valerie; Bock, Judith; Moore, Bret A; Peterson, Alan L; Benight, Charles C
Our research assessed the prevalence of secondary traumatic stress (STS) among mental health providers working with military patients. We also investigated personal, work-related, and exposure-related correlates of STS. Finally, using meta-analysis, the mean level of STS symptoms in this population was compared with the mean level of these symptoms in other groups. Participants (N = 224) completed measures of indirect exposure to trauma (i.e., diversity, volume, frequency, ratio), appraisal of secondary exposure impact, direct exposure to trauma, STS, and work characteristics. The prevalence of STS was 19.2%. Personal history of trauma, complaints about having too many patients, and more negative appraisals of the impact caused by an indirect exposure to trauma were associated with higher frequency of STS symptoms. A meta-analysis showed that the severity of intrusion, avoidance, and arousal symptoms of STS was similar across various groups of professionals indirectly exposed to trauma (e.g., mental health providers, rescue workers, social workers).
combat exposures were significantly more likely to have a history of psychiatric health issues, to have been engaged in physical altercation with spouse...perspective because of the focus on daily functioning and the subjective experience of the physical , mental and social health . Among soldiers seize experiences... physical , and mental health , . The personality trait neuroticism would be a good predictor of physical and psychological symptoms following
The article argues that while doctrine represents the more scientific side of warfare, strategy represents the artistic side. Existing doctrine will almost never meet the requirements for winning the next war; it is through the artistic application of generic peacetime doctrine to the specific st...... strategic and operational context, using doctrine as building blocks for a context specific military strategy, that the military commander outwits and defeats or coerces the adversary and achieves the military objectives....
Lorenz, Jan; Rauhut, Heiko; Schweitzer, Frank; Helbing, Dirk
Social groups can be remarkably smart and knowledgeable when their averaged judgements are compared with the judgements of individuals. Already Galton [Galton F (1907) Nature 75:7] found evidence that the median estimate of a group can be more accurate than estimates of experts. This wisdom of crowd effect was recently supported by examples from stock markets, political elections, and quiz shows [Surowiecki J (2004) The Wisdom of Crowds]. In contrast, we demonstrate by experimental evidence (N = 144) that even mild social influence can undermine the wisdom of crowd effect in simple estimation tasks. In the experiment, subjects could reconsider their response to factual questions after having received average or full information of the responses of other subjects. We compare subjects’ convergence of estimates and improvements in accuracy over five consecutive estimation periods with a control condition, in which no information about others’ responses was provided. Although groups are initially “wise,” knowledge about estimates of others narrows the diversity of opinions to such an extent that it undermines the wisdom of crowd effect in three different ways. The “social influence effect” diminishes the diversity of the crowd without improvements of its collective error. The “range reduction effect” moves the position of the truth to peripheral regions of the range of estimates so that the crowd becomes less reliable in providing expertise for external observers. The “confidence effect” boosts individuals’ confidence after convergence of their estimates despite lack of improved accuracy. Examples of the revealed mechanism range from misled elites to the recent global financial crisis. PMID:21576485
Millegan, Jeffrey; Wang, Lawrence; LeardMann, Cynthia A; Miletich, Derek; Street, Amy E
Although absolute counts of U.S. service men who experience sexual trauma are comparable to service women, little is known about the impact of sexual trauma on men. The association of recent sexual trauma (last 3 years) with health and occupational outcomes was investigated using longitudinal data (2004-2013) from the Millennium Cohort Study. Of 37,711 service men, 391 (1.0%) reported recent sexual harassment and 76 (0.2%) sexual assault. In multivariable models, sexual harassment or assault, respectively, was associated with poorer mental health: AOR = 1.60, 95% CI [1.22, 2.12], AOR = 4.39, 95% CI [2.40, 8.05]; posttraumatic stress disorder: AOR = 2.50, 95% CI [1.87, 3.33], AOR = 6.63, 95% CI [3.65, 12.06]; depression: AOR = 2.37, 95% CI [1.69, 3.33], AOR = 5.60, 95% CI [2.83, 11.09]; and multiple physical symptoms: AOR = 2.22, 95% CI [1.69, 2.92]; AOR = 3.57, 95% CI [1.98, 6.42], after adjustment for relevant covariates. Sexual harassment was also associated with poorer physical health: AOR = 1.68, 95% CI [1.27, 2.22]. Men who reported sexual trauma were more likely to have left military service: AOR = 1.60, 95% CI [1.14, 2.24], and be disabled/unemployed postservice: AOR = 1.76, 95% CI [1.02, 3.02]. Results suggest that sexual trauma was significantly associated with adverse health and functionality extending to postmilitary life. Findings support the need for developing better prevention strategies and services to reduce the burden of sexual trauma on service men. Copyright © 2016 International Society for Traumatic Stress Studies.
Kutschera, P. C.; Caputi, Marie A.; Pelayo, Jose Maria G., III
Virtually no formal treatment protocol exists for the health/mental health care of biracial Filipino Amerasians in the Philippines. Today this large group comprises a mostly socioeconomically at risk diaspora. A recent 3-year study found depression, elevated anxiety, joblessness, social isolation, substance and alcohol abuse, and housing…
Smith, Marshall H; Brady, Patrick J
A critical incident stress debriefing (CISD) was conducted with two U.S. Army military police officers (MPs) and 11 Iraqi detainees who experienced the untimely death of a detainee. The CISD was conducted by a psychiatrist and a psychologist, who used the seven-step debriefing model created by Jeffrey Mitchell in 1983. A primary goal of CISD is to diminish the impact of a traumatic event and ultimately to prevent the onset of post-traumatic stress disorder. An unexpected finding was that the debriefing provided an opportunity for the MPs and detainees to clear preconceived notions about each other, enhancing mutual collaboration. The purpose of this article is to describe how a mental health team used a CISD as an intervention in treating MPs and detainees who experienced a common tragic event.
Military Court of Appeals ruled in United States v. Beeker that “the use or possession of marihuana was service connected because the use or...possession . . . of marihuana and narcotics has a special military significance since their use has ‘disastrous effects on the health, morale and fitness
Romaní-Romaní, Franco; Curisinche-Rojas, Maricela; Arteaga, Norka Rojas; Lopez, Pedro Riega; Cabezas, César
There is a gap between human resources and technical-operational education that limits the Peruvian health system's ability to implement public health interventions. The Peruvian Ministry of Health, through the National Health Institute and the Ministry of Defense, implemented a Public Health Training Program addressed to young full-time military servicemen, on the basis of the competency profile of a public health technician. The program consists of seven thematic units given in 390 hours, 200 of which correspond to classroom and field practices. Between July 2014 and December 2015, the program has been carried out in 10 venues of the three armed forces, training and certifying 405 young servicemen. The intervention provides the military service with an additional educational benefit, making it more appealing as a chance for development and opens up a line of work in the public health sector for young people in more remote areas. This experience seeks to increase public health-trained human resources to a technical-operational level. In collaboration with regional governments, graduates are expected to be welcomed and included in the public health system.
.... COHORT is a series of relevant databases that have been consolidated into a datamart that allow for the continuous monitoring, analysis and early detection of epidemics, disease trends, and health...
...% of the screened women reported lifetime emotional abuse. Analyses of the cases and controls are currently underway to explore the health consequences of partner abuse and preferences for partner abuse screening...
Bray, Robert M; Hourani, Laurel L; Rae Olmsted, Kristine L; Witt, Michael; Brown, Janice M; Pemberton, Michael R; Marsden, Mary Ellen; Marriott, Bernadette; Scheffler, Scott; Vandermaas-Peeler, Russ
... Secretary of Defense (Health Affairs). All of the surveys investigated the prevalence of alcohol use, illicit drug use, and tobacco use, as well as negative consequences associated with substance use...
Jeffery, Diana D; Mattiko, Mark
Numerous studies document higher substance use among military men after deployment; similar studies focused on military women are limited. This study examines alcohol use of active duty women and deployment factors, social/environmental/attitudinal factors, and psychological/intrapersonal factors. Secondary data analysis of the 2011 Survey of Health-Related Behavior of active duty military personnel was conducted using bivariate statistics and multiple regression analyses with Alcohol Use Disorders Identification Test scores as the dependent variable. Nearly 94% had low risk for alcohol use disorders. Length of combat experience and extent of combat exposure were unrelated to Alcohol Use Disorders Identification Test scores; noncombat deployment was unrelated after controlling for marital status, age of first drink, pay grade, and branch of service. Significant motivators (p risk propensity, lifetime prevalence of suicidal ideation, and depressed mood were significant predictors in the regression model after controlling for covariates. Findings suggest that some active duty women use alcohol to cope with adverse emotional states, whereas others use alcohol consistent with propensity for high-risk behaviors. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.
Cardile, Anthony P; Murray, Clinton K; Littell, Christopher T; Shah, Neel J; Fandre, Matthew N; Drinkwater, Dennis C; Markelz, Brian P; Vento, Todd J
In response to the unprecedented Ebola virus disease (Ebola) outbreak in West Africa, the U.S. government deployed approximately 2,500 military personnel to support the government of Liberia. Their primary missions were to construct Ebola treatment units (ETUs), train health care workers to staff ETUs, and provide laboratory testing capacity for Ebola. Service members were explicitly prohibited from engaging in activities that could result in close contact with an Ebola-infected patient or coming in contact with the remains of persons who had died from unknown causes. Military units performed twice-daily monitoring of temperature and review of exposures and symptoms ("unit monitoring") on all persons throughout deployment, exit screening at the time of departure from Liberia, and post-deployment monitoring for 21 days at segregated, controlled monitoring areas on U.S. military installations. A total of 32 persons developed a fever during deployment from October 25, 2014, through February 27, 2015; none had a known Ebola exposure or developed Ebola infection. Monitoring of all deployed service members revealed no Ebola exposures or infections. Given their activity restrictions and comprehensive monitoring while deployed to Liberia, U.S. military personnel constitute a unique population with a lower risk for Ebola exposure compared with those working in the country without such measures.
Richer, Isabelle; Lee, Jennifer E C; Born, Jennifer
Heavy drinking increases the risk of injury, adverse physical and mental health outcomes, and loss of productivity. Nonetheless, patterns of alcohol use and related symptomatology among military personnel remain poorly understood. A latent class analysis (LCA) was used to explore the presence of subgroups of alcohol users among Canadian Armed Forces (CAF) Regular Forces members. Correlates of empirically derived subgroups were further explored. Analyses were performed on a subsample of alcohol users who participated in a 2008/09 cross-sectional survey of a stratified random sample of currently serving CAF Regular Force members (N = 1980). Multinomial logistic regression models were conducted to verify physical and mental health differences across subgroups of alcohol users. All analyses were adjusted for complex survey design. A 4-class solution was considered the best fit for the data. Subgroups were labeled as follows: Class 1 - Infrequent drinkers (27.2%); Class 2 - Moderate drinkers (41.5%); Class 3 - Regular binge drinkers with minimal problems (14.8%); and Class 4 - Problem drinkers (16.6%). Significant differences by age, sex, marital status, element, rank, recent serious injuries, chronic conditions, psychological distress, posttraumatic stress disorder, and depression symptoms were found across the subgroups. Problem drinkers demonstrated the most degraded physical and mental health. Findings highlight the heterogeneity of alcohol users and heavy drinkers among CAF members and the need for tailored interventions addressing high-risk alcohol use. Results have the potential to inform prevention strategies and screening efforts. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Kevin M. Beaver
Full Text Available Given that enlistment in the U.S. military is completely voluntary, there has been a great deal of interest in identifying the various factors that might explain why some people join the military, whereas others do not. The current study expanded on this line of literature by estimating the extent to which genetic and environmental factors explained variance in the liability for lifetime participation in the military. Analysis of twin pairs drawn from the National Longitudinal Study of Adolescent to Adult Health (Add Health revealed that 82% of the variance was the result of genetic factors, 18% of the variance was the result of nonshared environmental factors, and none of the variance was accounted for by shared environmental factors. In light of a number of limitations, replication studies are needed to determine the robustness of these findings and whether they are generalizable to other samples and populations.
Burkle, Frederick M
For decades, military humanitarian assistance programs have avoided empirical scrutiny, leaving researchers, the humanitarian community and decision makers without proof of outcome. This Editorial highlights the findings of three major studies that disclose deficits in the quality of the performance and reporting of humanitarian missions, and offer guidance for change. The author suggests that, contrary to current plans to limit the military's role in humanitarian assistance, emerging crises actually increase civilian security risks and that it is time for a new partnership of military and civilian humanitarian resources to evolve in the interest of human security.
Magadzire, Bvudzai P; Ward, Kim; Leng, Henry M J; Sanders, David
South Africa (SA) has experienced several stock-outs of life-saving medicines for the treatment of major chronic infectious and non-communicable diseases in the public sector. To identify the causes of stock-outs and to illustrate how they undermine access to medicines (ATM) in the Western Cape Province, SA. This qualitative study was conducted with a sample of over 70 key informants (frontline health workers, sub-structure and provincial health service managers). We employed the critical incident technique to identify significant occurrences in our context, the consequences of which impacted on access to medicines during a defined period. Stock-outs were identified as one such incident, and we explored when, where and why they occurred, in order to inform policy and practice. Medicines procurement is a centralised function in SA. Health service managers unanimously agreed that stock-outs resulted from the following inefficiencies at the central level: (i) delays in awarding of pharmaceutical tenders; (ii) absence of contracts for certain medicines appearing on provincial code lists; and (iii) suppliers' inability to satisfy contractual agreements. The recurrence of stock-outs had implications at multiple levels: (i) health facility operations; (ii) the Chronic Dispensing Unit (CDU), which prepacks medicines for over 300 000 public sector patients; and (iii) community-based medicines distribution systems, which deliver the CDU's prepacked medicines to non-health facilities nearer to patient homes. For instance, stock-outs resulted in omission of certain medicines from CDU parcels that were delivered to health facilities. This increased workload and caused frustration for frontline health workers who were expected to dispense omitted medicines manually. According to frontline health workers, this translated into longer waiting times for patients and associated dissatisfaction. In some instances, patients were asked to return for undispensed medication at a later
Bvudzai P Magadzire
Full Text Available Background. South Africa (SA has experienced several stock-outs of life-saving medicines for the treatment of major chronic infectious and non-communicable diseases in the public sector. Objective. To identify the causes of stock-outs and to illustrate how they undermine access to medicines (ATM in the Western Cape Province, SA. Methods. This qualitative study was conducted with a sample of over 70 key informants (frontline health workers, sub-structure and provincial health service managers. We employed the critical incident technique to identify significant occurrences in our context, the consequences of which impacted on access to medicines during a defined period. Stock-outs were identified as one such incident, and we explored when, where and why they occurred, in order to inform policy and practice. Results. Medicines procurement is a centralised function in SA. Health service managers unanimously agreed that stock-outs resulted from the following inefficiencies at the central level: (i delays in awarding of pharmaceutical tenders; (ii absence of contracts for certain medicines appearing on provincial code lists; and (iii suppliers’ inability to satisfy contractual agreements. The recurrence of stock-outs had implications at multiple levels: (i health facility operations; (ii the Chronic Dispensing Unit (CDU, which prepacks medicines for over 300 000 public sector patients; and (iii community-based medicines distribution systems, which deliver the CDU’s prepacked medicines to non-health facilities nearer to patient homes. For instance, stock-outs resulted in omission of certain medicines from CDU parcels that were delivered to health facilities. This increased workload and caused frustration for frontline health workers who were expected to dispense omitted medicines manually. According to frontline health workers, this translated into longer waiting times for patients and associated dissatisfaction. In some instances, patients were
Shmueli, Amir; Israeli, Avi
Compared to OECD countries, Israel has a remarkably low percentage of GDP and of government expenditure spent on health, which are not reflected in worse national outcomes. Israel is also characterized by a relatively high share of GDP spent on security expenses and payment of public debt. To determine to what extent differences between Israel and the OECD countries in security expenses and payment of the public debt might account for the gaps in the percentage of GDP and of government expenditures spent on health. We compare the percentages of GDP and of government expenditures spent on health in the OECD countries with the respective percentages when using primary civilian GDP and government expenditures (i.e., when security expenses and interest payment are deducted). We compared Israel with the OECD average and examined the ranking of the OECD countries under the two measures over time. While as a percentage of GDP, the national expenditure on health in Israel was well below the average of the OECD countries, as a percentage of primary civilian GDP it was above the average until 2003 and below the average thereafter. When the OECD countries were ranked according to decreasing percent of GDP and of government expenditure spent on health, adjusting for security and debt payment expenditures changed the Israeli rank from 23rd to 17th and from 27th to 25th, respectively. Adjusting for security expenditures and interest payment, Israel's low spending on health as a percentage of GDP and as a percentage of government's spending increases and is closer to the OECD average. Further analysis should explore the effect of additional population and macroeconomic differences on the remaining gaps.
Full Text Available Abstract Background Compared to OECD countries, Israel has a remarkably low percentage of GDP and of government expenditure spent on health, which are not reflected in worse national outcomes. Israel is also characterized by a relatively high share of GDP spent on security expenses and payment of public debt. Objectives To determine to what extent differences between Israel and the OECD countries in security expenses and payment of the public debt might account for the gaps in the percentage of GDP and of government expenditures spent on health. Methods We compare the percentages of GDP and of government expenditures spent on health in the OECD countries with the respective percentages when using primary civilian GDP and government expenditures (i.e., when security expenses and interest payment are deducted. We compared Israel with the OECD average and examined the ranking of the OECD countries under the two measures over time. Results While as a percentage of GDP, the national expenditure on health in Israel was well below the average of the OECD countries, as a percentage of primary civilian GDP it was above the average until 2003 and below the average thereafter. When the OECD countries were ranked according to decreasing percent of GDP and of government expenditure spent on health, adjusting for security and debt payment expenditures changed the Israeli rank from 23rd to 17th and from 27th to 25th, respectively. Conclusions Adjusting for security expenditures and interest payment, Israel's low spending on health as a percentage of GDP and as a percentage of government's spending increases and is closer to the OECD average. Further analysis should explore the effect of additional population and macroeconomic differences on the remaining gaps.
psychological testing, while other testing and assessment methods, including neuropsychological testing and health and behavior assessment, were uti - lized with...Resident/Intern Without License 750 Pharmacist , General Practice 227 Physician/Pathology/Hematology 117 Plastic Surgery Resident/Intern Without License
Beverly Sheppard, Katherine Snell, Steven Speigle, Kari Sausedo, Jennifer Walstrom, Martin White, James Whitmer, and Char- lene Wong; Madigan Army Medical...what physicians should know. J Gen Intern Med. 2006; 21(suppl 3):S5–S10. 13. Lindstrom KE, Smith TC, Wells TS, et al. The mental health of U.S
Infection Classifications .................................................................. 7 Section B – Antimicrobial Resistance and Use... Antimicrobial Resistance and Use Regional Multidrug Resistance In 2016, the IR of Acinetobacter species infection was 5.34 infections per 100,000 persons...et al. Antimicrobial - resistant pathogens associated with health-associated infections: annual summary of data reported to the National Healthcare
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Randall C. Nedegaard
Full Text Available America has been at war for almost 10 years. Because of this, continuing missions in the Middle East require the support and cooperation of our allied North Atlantic Treaty Organization (NATO forces from around the world. In this paper we provide an overview of the mission at Kandahar Air Field (KAF and the Multi-National Role 3 hospital located at KAF. Next, we explain the mental health capabilities and unique perspectives among our teammates from Canada, Great Britain, and the United States to include a discussion of the relevant cross-cultural differences between us. Within this framework we also provide an overview of the mental health clientele seen at KAF during the period of April 2009 through September 2009. Finally, we discuss the successes, limitations, and lessons learned during our deployment to Kandahar, Afghanistan.
Lucchetti, Giancarlo; Lucchetti, Alessandra L G; Peres, Mario F P; Moreira-Almeida, Alexander; Koenig, Harold G
This study aims to analyze the association between religious attendance, self-reported religiousness, depression, and several health factors in 170 older adults from a Brazilian outpatient setting. A comprehensive assessment was conducted including sociodemographic characteristics, religious attendance, self-reported religiousness, functional status, depression, pain, hospitalization, and mental status. After adjusting for sociodemographics, (a) higher self-reported religiousness was associated with lower prevalence of smoking, less depressive symptoms, and less hospitalization and (b) higher religious attendance was only associated with less depressive symptoms. Religiousness seems to play a role in depression, smoking, and hospitalization in older adults from a Brazilian outpatient setting. Self-reported religiousness was associated with more health characteristics than religious attendance.
University of Texas T and operational at the University of Texas at Dallas Center for BrainHealth located at 2200 W. Mockingbird Lane, Dallas, Texas...cells), and the targeted cells have been efficiently killed with NIR. This work is now published (Chakravarty et al., 2008) (Appendix B...mononuclear cells bound only to the CNTs coupled to the anti-CD25 mAb. Most importantly, only the specifically targeted cells were killed after exposure to
costs and benefits of disclosure and made an informed deci- sion that it was not in their personal best interest. The emotional trauma of forensic...forensic services, (3) advocacy and emotional support, and (4) mental health and psy- chiatric care. In each subsection, the review focuses primarily...al., 1996). The WHO guidelines recommend that victims who present for services within five days of the assault be offered emergency contraception
Mommersteeg, P.M.C.; Denollet, J.; Kavelaars, A.; Geuze, E.; Vermetten, E.; Heijnen, C.J.
Background The Type D (distressed) personality refers to a general propensity to psychological distress defined by the combination of negative affectivity and social inhibition. Type D personality predicts poor mental and physical health in cardiac patients, but it has been argued that its assessment is affected by the state of illness. Therefore, validation of the Type D construct in healthy adults remains essential. Purpose The objectives of this study were (1) to validate Type D personalit...
Meyer, Eric G; Hall-Clark, Brittany N; Hamaoka, Derrick; Peterson, Alan L
Cultural competence is widely considered a cornerstone of patient care. Efforts to improve military cultural competency have recently gained national attention. Assessment of cultural competence is a critical component to this effort, but no assessment of military cultural competence currently exists. An assessment of military cultural competence (AMCC) was created through broad input and consensus. Careful review of previous cultural competency assessment designs and analysis techniques was considered. The AMCC was organized into three sections: skills, attitudes, and knowledge. In addition to gathering data to determine absolute responses from groups with different exposure levels to the military (direct, indirect, and none), paired questions were utilized to assess relative competencies between military culture and culture in general. Piloting of the AMCC revealed significant differences between military exposure groups. Specifically, those with personal military exposure were more likely to be in absolute agreement that the military is a culture, were more likely to screen for military culture, and had increased knowledge of military culture compared to those with no military exposure. Relative differences were more informative. For example, all groups were less likely to agree that their personal culture could be at odds with military culture as compared to other cultures. Such perceptions could hinder asking difficult questions and thus undermine care. The AMCC is a model for the measurement of the skills, attitudes, and knowledge related to military cultural competence. With further validity testing, the AMCC will be helpful in the critical task of measuring outcomes in ongoing efforts to improve military cultural competence. The novel approach of assessing variance appears to reduce bias and may also be helpful in the design of other cultural competency assessments.
Rand, David G; Kraft-Todd, Gordon T
The cognitive basis of prosocial behavior has received considerable recent attention. Previous work using economic games has found that in social dilemmas, intuitive decisions are more prosocial on average. The Social Heuristics Hypothesis (SHH) explains this result by contending that strategies which are successful in daily life become automatized as intuitions. Deliberation then causes participants to adjust to the self-interested strategy in the specific setting at hand. Here we provide further evidence for the SHH by confirming several predictions regarding when and for whom time pressure/delay will and will not alter contributions in a Public Goods Game (PGG). First, we replicate and extend previous results showing that (as predicted by the SHH) trust of daily-life interaction partners and previous experience with economic games moderate the effect of time pressure/delay in social dilemmas. We then confirm a novel prediction of the SHH: that deliberation should not undermine the decision to benefit others when doing so is also individually payoff-maximizing. Our results lend further support to the SHH, and shed light on the role that deliberation plays in social dilemmas.
Chad R Wells
Full Text Available Theoretical models of infection spread on networks predict that targeting vaccination at individuals with a very large number of contacts (superspreaders can reduce infection incidence by a significant margin. These models generally assume that superspreaders will always agree to be vaccinated. Hence, they cannot capture unintended consequences such as policy resistance, where the behavioral response induced by a new vaccine policy tends to reduce the expected benefits of the policy. Here, we couple a model of influenza transmission on an empirically-based contact network with a psychologically structured model of influenza vaccinating behavior, where individual vaccinating decisions depend on social learning and past experiences of perceived infections, vaccine complications and vaccine failures. We find that policy resistance almost completely undermines the effectiveness of superspreader strategies: the most commonly explored approaches that target a randomly chosen neighbor of an individual, or that preferentially choose neighbors with many contacts, provide at best a 2% relative improvement over their non-targeted counterpart as compared to 12% when behavioral feedbacks are ignored. Increased vaccine coverage in super spreaders is offset by decreased coverage in non-superspreaders, and superspreaders also have a higher rate of perceived vaccine failures on account of being infected more often. Including incentives for vaccination provides modest improvements in outcomes. We conclude that the design of influenza vaccine strategies involving widespread incentive use and/or targeting of superspreaders should account for policy resistance, and mitigate it whenever possible.
Full Text Available Health literacy (HL has become an important public health issue and is receiving growing attention. However, the HL levels of military college students in China have never been analyzed. This study aimed to investigate the HL and related associate factors in military college students in Chongqing, China. Data was obtained with the "Chinese Citizen Health Literacy Questionnaire (2012 edition" from 3183 military college students aged 16-28 years at Chongqing in December 2015. A total score of ≥80 points determined adequate HL, and HL level was defined as the proportion of students who had adequate HL out of the total number of participants. Multiple logistic regression analysis with a stepwise forward likelihood ratio (LR method was used to determine the effects of sociodemographic characteristics, health-related behaviors, and family-related factors on HL level. The mean score of HL was 68.56, and the HL level of military college students was 21.05%; the overall knowledge rate was 71.33%. The independent factors that were associated with HL level were years in college, educational system, time playing online games, annual household income and father's education level. Senior (odds ratio [OR] = 1.229, 95% confidence interval [CI] 1.018∼1.484, undergraduate (OR = 1.509, 95% CI 1.151∼1.978, time played games more than 5 hours each week (OR = 0.638, 95% CI 0.486∼0.837, annual household incomes more than 50,000 yuan (OR = 1.231, 95% CI 1.027∼1.476 and father's education level (high school: OR = 2.327, 95% CI 1.186∼4.565; university: OR = 2.450, 95% CI 1.244∼4.825, were independently associated with higher HL level. HL levels of military college students in Chongqing need to be improved across the board. Our data suggests that special emphasis should be placed on students in junior and those in the specialist educational system. School departments may also benefit from incorporating health literacy into their curricula and helping
Gillies, J. A; Etyemezian, V; Kuhns, H; Moosmueller, H; Engelbrecht, J; King, J; Uppapalli, S; Nikolich, G; McAlpine, J. D; Gillette, D. A; Allwine, K. J
...). PM emitted during DoD testing and training activities threatens the safety and respiratory health of military personnel and can impact the health of urban populations encroaching on military installations...
PENs) within the military health service. The purpose of the research was to explore and describe the learning experiences of PENs within the Military health clinical learning environment. An explorative, descriptive, contextual design which is ...
the relation of religion and politics to seventeenth-century English military history. Frederick II, King of Prussia. Frederick the Great on the Art...Beginning with the reign of King Henry VIII, Barnett’s work explores the history of the British Army as an institution and fighting force. The volume...native clans led by Shaka , to its fall under the guns of the British Army by 1878. The Zulus produced a formidable military force, and this excellent
Cragun, Joshua N; April, Michael D; Thaxton, Robert E
Compassion fatigue is a problem for many health care providers manifesting as physical, mental, and spiritual exhaustion. Our objective was to evaluate the association between prior combat deployment and compassion fatigue among military emergency medicine providers. We conducted a nonexperimental cross-sectional survey of health care providers assigned to the San Antonio Military Medical Center, Department of Emergency Medicine. We used the Professional Quality of Life Scale V survey instrument that evaluates provider burnout, secondary traumatic stress, and compassion satisfaction. Outcomes included burnout, secondary traumatic stress, and compassion satisfaction raw scores. Scores were compared between providers based on previous combat deployments using two-tailed independent sample t tests and multiple regression models. Surveys were completed by 105 respondents: 42 nurses (20 previously deployed), 30 technicians (11 previously deployed), and 33 physicians (16 previously deployed). No statistically significant differences in burnout, secondary traumatic stress, or compassion satisfaction scores were detected between previously deployed providers versus providers not previously deployed. There was no association between previous combat deployment and emergency department provider burnout, secondary traumatic stress, or compassion satisfaction scores. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.
Rafferty, L A; Cawkill, P E; Stevelink, S A M; Greenberg, K; Greenberg, N
Dementia is currently incurable, irreversible and a major cause of disability for the world's older population. The association between mental health difficulties, such as post-traumatic stress disorder (PTSD) and major depressive disorder (MDD), and dementia has a long history within the civilian population. Despite the increased importance of this link within the military veteran population, who suffer a greater propensity of mental health difficulties and consist largely of over 65s, attention is only recently being paid to the salience of such an association for this group. This paper aims to explore the relationship between PTSD and MDD with dementia within the military veteran population. A systematic review was conducted on articles from 1990 to July 2016 on MEDLINE, EMBASE, EBSCO and Web of Science electronic databases with an update conducted in February 2017. Six empirical studies were identified from the review, the majority of which originated from the USA. Five of the studies asserted that veterans with a diagnosis of either PTSD or MDD are at a significantly greater risk of developing dementia than 'healthy' controls. The final study, conducted in Australia, found only a small, but non-significant, correlation between earlier MDD and future dementia, but no concurrent correlation. While causality cannot be determined, it is likely that PTSD and depressive disorders are related to an increased risk of dementia in military veterans. Potential pathological explanations and risk factors are reviewed and the clinical and neuroscience implications of these findings are explored.
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Taherpour, Fatima; Rajaeepour, Saeed; Siadat, Ali; Kazemi, Iraj
Understanding the social undermining is increasing important in organizational literature both because of its relation with job performance and because of its collective cost to individuals and organizations. This article argued that social undermining can effect on co-creation among faculty members. The study adopted a descriptive-correlational…
Nee, Robert; Fisher, Evan; Yuan, Christina M; Agodoa, Lawrence Y; Abbott, Kevin C
Previous reports showed an increased early mortality after chronic dialysis initiation among the end-stage renal disease (ESRD) population. We hypothesized that ESRD patients in the Military Health System (MHS) would have greater access to pre-ESRD care and hence better survival rates during this early high-risk period. In this retrospective cohort study, using the US Renal Data System database, we identified 1,256,640 patients initiated on chronic dialysis from January 2, 2004 through December 31, 2014, from which a bootstrap sample of 3,984 non-MHS incident dialysis patients were compared with 996 MHS patients. We assessed care by a nephrologist and dietitian, erythropoietin administration, and vascular access use at dialysis initiation as well as all-cause mortality as outcome variables. MHS patients were significantly more likely to have had pre-ESRD nephrology care (adjusted OR [aOR] 2.9; 95% CI 2.3-3.7) and arteriovenous fistula used at dialysis initiation (aOR 2.2; 95% CI 1.7-2.7). Crude mortality rates peaked between the 4th and the 8th week for both cohorts but were reduced among MHS patients. The baseline adjusted Cox model showed significantly lower death rates among MHS vs. non-MHS patients at 6, 9, and 12 months. This survival advantage among MHS patients was attenuated after further adjustment for pre-ESRD nephrology care and dialysis vascular access. MHS patients had improved survival within the first 12 months compared to the general ESRD population, which may be explained in part by differences in pre-ESRD nephrology care and vascular access types. © 2017 S. Karger AG, Basel.
Crofoot, Margaret Chatham; Gilby, Ian C
In many social animals, group-mates cooperate to defend their range against intrusion by neighboring groups. Because group size tends to be highly variable, such conflicts are often asymmetric. Although numerical superiority is assumed to provide a competitive advantage, small groups can generally defend their ranges, even when greatly outnumbered. The prevailing explanation for this puzzling phenomenon is that individuals in relatively large groups experience a greater temptation to flee from conflicts, in effect leveling the balance of power. Using playback experiments simulating territorial intrusions by wild capuchin monkey (Cebus capucinus) groups, we show that such a collective action problem does indeed undermine the competitive ability of large groups. Focal capuchins were more likely to run away from territorial intrusions when their group had a numeric advantage; each one-individual increase in relative group size raised the odds of flight by 25%. However, interaction location had a more important impact on individuals' reactions, creating a strong home-field advantage. After controlling for relative group size, the odds that a focal animal fled were 91% lower in experiments that occurred in the center compared with on the edge of its group's range, whereas the odds that it rushed toward the speaker were more than sixfold higher. These location-dependent patterns of defection and cooperation create a competitive advantage for residents over intruders across a wide range of relative group sizes, which may stabilize range boundaries and provide a general explanation for how groups of widely divergent sizes can coexist, even in the face of intense intergroup competition.
Ramchand, Rajeev; Rudavsky, Rena; Grant, Sean; Tanielian, Terri; Jaycox, Lisa
This review summarizes the epidemiology of posttraumatic stress disorder (PTSD) and related mental health problems among persons who served in the armed forces during the Iraq and Afghanistan conflicts, as reflected in the literature published between 2009 and 2014. One-hundred and sixteen research studies are reviewed, most of which are among non-treatment-seeking US service members or treatment-seeking US veterans. Evidence is provided for demographic, military, and deployment-related risk factors for PTSD, though most derive from cross-sectional studies and few control for combat exposure, which is a primary risk factor for mental health problems in this cohort. Evidence is also provided linking PTSD with outcomes in the following domains: physical health, suicide, housing and homelessness, employment and economic well-being, social well-being, and aggression, violence, and criminality. Also included is evidence about the prevalence of mental health service use in this cohort. In many instances, the current suite of studies replicates findings observed in civilian samples, but new findings emerge of relevance to both military and civilian populations, such as the link between PTSD and suicide. Future research should make effort to control for combat exposure and use longitudinal study designs; promising areas for investigation are in non-treatment-seeking samples of US veterans and the role of social support in preventing or mitigating mental health problems in this group.
Gwack, Jin; Lee, Ju Hyung; Kang, Young Ah; Chang, Kyu-jin; Lee, Moo Sik; Hong, Jee Young
Objectives This study was conducted to investigate acute health effects and its related factors among military personnel participating in the cleanup of the 2007 Hebei Spirit oil spill accident in Taean county, Korea. Methods We collected data on acute symptoms during the cleanup and their predictors using a self-administered questionnaire to 2624 military personnel. Selfreported symptoms included six neurologic symptoms, five respiratory symptoms, two dermatologic symptoms, three ophthalmic symptoms, and three general symptoms. Independent variables were demographic factors (gender, age, education level, and rank), health behavioral factors (smoking history and usage of the personal protective equipment such as masks and gloves), and occupational history such as where and for how long individuals participated in cleanup. Results The duration of work days was significantly associated with 17 acute symptoms except for itchiness and red skin.Working in Taean county also increased the risk of most acute symptoms except headache and back pain. In regard to personal protective equipment, wearing masks was mainly related to the development of respiratory symptoms such as sore throat and wearing other protective equipment was related to the development of sore throat, back pain, headache, and cough. Military personnel younger than 25 years reported 4.66 times more hot flushing and 5.39 times more itchiness than those older than 25 years. Conclusion It should be emphasized that for early-stage cleanup the number of workers should be minimized, sufficient personal protective equipment with approved quality for blocking noxious gas should be supplied, and systematic health care for the workers should be provided. Health effects could be diminished by providing adequate education regarding the appropriate use of protective equipment, especially to nonprofessionals such as residents and volunteers. To make disaster response expeditious, a national and regional preparedness
Burke-Shyne, Naomi; Csete, Joanne; Wilson, Duncan; Fox, Edward; Wolfe, Daniel; Rasanathan, Jennifer J K
Drug conventions serve as the cornerstone for domestic drug laws and impose a dual obligation upon states to prevent the misuse of controlled substances while ensuring their adequate availability for medical and scientific purposes. Despite the mandate that these obligations be enforced equally, the dominant paradigm enshrined in the drug conventions is an enforcement-heavy criminal justice response to controlled substances that prohibits and penalizes their misuse. Prioritizing restrictive control is to the detriment of ensuring adequate availability of and access to controlled medicines, thereby violating the rights of people who need them. This paper argues that the drug conventions' prioritization of criminal justice measures-including efforts to prevent non-medical use of controlled substances-undermines access to medicines and infringes upon the right to health and the right to enjoy the benefits of scientific progress. While the effects of criminalization under drug policy limit the right to health in multiple ways, we draw on research and documented examples to highlight the impact of drug control and criminalization on access to medicines. The prioritization and protection of human rights-specifically the right to health and the right to enjoy the benefits of scientific progress-are critical to rebalancing drug policy.
Zweifel, Peter; Janus, Katharina
coming from the case studies. As to physicians working in hospital or group practice, the prediction is again that a transition in hospital payment from FFS to PP weakens their ethical orientation. However, this prediction could not be tested because the one hospital study found relates to a transition to P4P, suggesting that this mode of payment may actually enhance medical ethics of healthcare providers working in a hospital or group practice. The claim that moving away from FFS undermines medical ethics is far too sweeping. It can only in part be justified by observed relationships, which even may suggest that a transition to P4P strengthens medical ethics.
Ford, Shannon; Schnitzlein, Carla
With the announcement that members of the military who identify as transgender are allowed to serve openly, the need for Department of Defense behavioral health providers to be comfortable in the assessment, diagnosis, and treatment of this population becomes quickly evident. This population has been seeking care in the community and standards have been developed to help guide decision-making, but a comparable document does not exist for the military population. Previously published papers were written in anticipation of the policy allowing for open service. The civilian sector has treatment guidelines and evidence supporting the same for reference. There is no similar document for the military population, likely due to the recent change and ongoing development. This paper attempts to provide an overview of the recent Department of Defense policy and walks the reader through key considerations when providing care to a transgender member of the military as it relates to those who are currently serving in the military through the use of a case example. The military transgender population faces some unique challenges due to the need to balance readiness and deployability with medically necessary health care. Also complicating patient care is that policy development is ongoing-as of this publication, the decision has not yet been made regarding how people who identify as transgender will access into the military nor is there final approval regarding coverage for surgical procedures. Unique circumstances of this population are brought up to generate more discussion and encourage further evaluation and refinement of the process.
Jones, Norman; Burdett, Howard; Green, Kevin; Greenberg, Neil
Trauma Risk Management (TRiM) is a peer-led, occupational mental health support process that aims to identify and assist U.K. military personnel with persistent mental ill health related to potentially traumatic events (PTEs). This study compared help seeking, mental disorder symptoms, and alcohol use between TRiM recipients and personnel experiencing similar combat events who did not receive TRiM; an unexposed group provided context. Records of TRiM activity during a U.K. military deployment in Afghanistan were linked to contemporaneous survey data assessing mental health and combat experiences. The resulting deployment data set was amalgamated with mental health, alcohol use, and help-seeking data collected within 12 weeks of homecoming and again one to two years later. Mental health and help-seeking outcomes were compared between a nonexposed, non-TRiM sample (n = 161), an exposed, non-TRiM sample (n = 149), and an exposed, TRiM-recipient sample (n = 328) using logistic regression analyses. At follow-up, TRiM recipients were significantly more likely to seek help from mental health services than exposed, non-TRiM personnel. At baseline, TRiM recipients had significantly greater adjusted odds of reporting possible posttraumatic stress disorder (PTSD) symptoms than exposed non-TRiM personnel; the difference was not significant at follow-up. TRiM recipients were significantly more likely to report persistent mental disorder and alcohol misuse caseness over the follow-up period. TRiM recipients were significantly more likely to seek help from mental health services than a similar PTE-exposed group that did not receive TRiM; however, TRiM recipients experienced more persistent mental ill-health symptoms and hazardous alcohol use over the period of follow-up despite seeking help.
Lin, Jie; Carter, Corey A; McGlynn, Katherine A; Zahm, Shelia H; Nations, Joel A; Anderson, William F; Shriver, Craig D; Zhu, Kangmin
Accurate prognosis assessment after non-small-cell lung cancer (NSCLC) diagnosis is an essential step for making effective clinical decisions. This study is aimed to develop a prediction model with routinely available variables to assess prognosis in patients with NSCLC in the U.S. Military Health System. We used the linked database from the Department of Defense's Central Cancer Registry and the Military Health System Data Repository. The data set was randomly and equally split into a training set to guide model development and a testing set to validate the model prediction. Stepwise Cox regression was used to identify predictors of survival. Model performance was assessed by calculating area under the receiver operating curves and construction of calibration plots. A simple risk scoring system was developed to aid quick risk score calculation and risk estimation for NSCLC clinical management. The study subjects were 5054 patients diagnosed with NSCLC between 1998 and 2007. Age, sex, tobacco use, tumor stage, histology, surgery, chemotherapy, peripheral vascular disease, cerebrovascular disease, and diabetes mellitus were identified as significant predictors of survival. Calibration showed high agreement between predicted and observed event rates. The area under the receiver operating curves reached 0.841, 0.849, 0.848, and 0.838 during 1, 2, 3, and 5 years, respectively. This is the first NSCLC prognosis model for quick risk assessment within the Military Health System. After external validation, the model can be translated into clinical use both as a web-based tool and through mobile applications easily accessible to physicians, patients, and researchers.
Classifications .................................................................. 7 Section B – Antimicrobial Resistance and Use...368-2017 Section B – Antimicrobial Resistance and Use Regional Multidrug Resistance The 2016 annual incidence rate of MRSA among all MHS...Annual Surveillance Summary: Methicillin- Resistant Staphylococcus aureus (MRSA) Infections in the Military
this article are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of... Article history: Accepted 25 July 2011 Keywords: Mild traumatic brain injury Self-rated health Military Combat casualty A B S T R A C T Introduction: Mild...throat 9 (3.2) 14 (3.9) .662 Eye 5 (1.8) 13 (3.6) .170 Family problems 2 (0.7) 1 (0.3) Fatigue 13 (4.7) 24 (6.7) .286 Audiology 40 (14.4) 41 (11.4
It is often said that international humanitarian law (IHL) “accounts for” military necessity, but its meaning and normative consequences have remained obscure. This thesis develops a theory that offers a coherent explanation of the process through which IHL generates its rules. To
Historic military uses of radiography are discussed in this chapter: Battle of Adowa in 1986 was the first. Besides describing the early campaigns in which radiography was used, the author discusses the problems faced: a reliable source of electricity; the problems of extreme heat; moving and breakage of equipment. Numerous historical photographs are included. 9 refs
Frost, J.H.; Finkel, E.J.; Norton, M.I.; Ariely, D.; Caprariello, P.A.; Eastwick, P.W.
This article began as an adversarial collaboration between two groups of researchers with competing views on a longstanding question: Does familiarity promote or undermine interpersonal attraction? As we explored our respective positions, it became clear that the limitations of our
Breland, Jessica Y; Donalson, Rosemary; Nevedal, Andrea; Dinh, Julie V; Maguen, Shira
Disordered eating, ranging from occasional binge eating or restriction to behaviors associated with eating disorder diagnoses, is common among military personnel and veterans. However, there is little information on how military service affects eating habits. To describe possible pathways between military service and disordered eating among women veterans, a high risk group. Twenty women veterans who reported changing eating habits in response to stress participated in audio-recorded focus groups or dyadic interviews between April 2013 and October 2014. We used thematic analysis of transcripts to identify and understand women's self-reported eating habits before, during, and after military service. Participants reported entering the military with varied eating habits, but little disordered eating. Participants described several ways military environments affected eating habits, for example, by promoting fast, irregular, binge-like eating and disrupting the reward value of food. Participants believed military-related stressors, which were often related to gender, also affected eating habits. Such stressors included military sexual trauma and the need to meet military weight requirements in general and after giving birth. Participants also reported that poor eating habits continued after military service, often because they remained under stress. For some women, military service can result in socialization to poor eating habits, which when combined with exposure to stressors can lead to disordered eating. Additional research is needed, including work to understand possible benefits associated with providing support in relation to military weight requirements and the transition out of military service. Given the unique experiences of women in the military, future work could also focus on health services surrounding pregnancy-related weight change and the stress associated with being a woman in predominantly male military environments. Published by Elsevier Ltd.
Murayama, Kou; Matsumoto, Madoka; Izuma, Keise; Matsumoto, Kenji
Contrary to the widespread belief that people are positively motivated by reward incentives, some studies have shown that performance-based extrinsic reward can actually undermine a person's intrinsic motivation to engage in a task. This "undermining effect" has timely practical implications, given the burgeoning of performance-based incentive systems in contemporary society. It also presents a theoretical challenge for economic and reinforcement learning theories, which tend to assume that monetary incentives monotonically increase motivation. Despite the practical and theoretical importance of this provocative phenomenon, however, little is known about its neural basis. Herein we induced the behavioral undermining effect using a newly developed task, and we tracked its neural correlates using functional MRI. Our results show that performance-based monetary reward indeed undermines intrinsic motivation, as assessed by the number of voluntary engagements in the task. We found that activity in the anterior striatum and the prefrontal areas decreased along with this behavioral undermining effect. These findings suggest that the corticobasal ganglia valuation system underlies the undermining effect through the integration of extrinsic reward value and intrinsic task value.
Eickhoff, Erin; Yung, Kathryn; Davis, Diane L; Bishop, Frank; Klam, Warren P; Doan, Andrew P
Excessive use of video games may be associated with sleep deprivation, resulting in poor job performance and atypical mood disorders. Three active duty service members in the U.S. Marine Corps were offered mental health evaluation for sleep disturbance and symptoms of blunted affect, low mood, poor concentration, inability to focus, irritability, and drowsiness. All three patients reported insomnia as their primary complaint. When asked about online video games and sleep hygiene practices, all three patients reported playing video games from 30 hours to more than 60 hours per week in addition to maintaining a 40-hour or more workweek. Our patients endorsed sacrificing sleep to maintain their video gaming schedules without insight into the subsequent sleep deprivation. During the initial interviews, they exhibited blunted affects and depressed moods, but appeared to be activated with enthusiasm and joy when discussing their video gaming with the clinical provider. Our article illustrates the importance of asking about online video gaming in patients presenting with sleep disturbances, poor work performance, and depressive symptoms. Because excessive video gaming is becoming more prevalent worldwide, military mental health providers should ask about video gaming when patients report problems with sleep. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.
Champagne , 2012). The 14 study, which is still currently ongoing with a completion date of 2020, consists of 72 men and women from age 18–40...leads to improved cognitive response, satiety, and fitness levels ( Champagne , 2012). F. SUMMARY For every article published saying omega-3 is...optimal warrior performance. Military Medicine, 179(11), 176–180. Retrieved from publications.amsus.org Champagne , C. (2012). The Optimum Omega-3 (003
Lü, Wei; Hughes, Brian M; Howard, Siobhán; James, Jack E
Sleep loss is associated with increased cardiovascular disease, but physiological mechanisms accounting for this relationship are largely unknown. One possible mechanism is that sleep restriction exerts effects on cardiovascular stress responses, and that these effects vary between individuals. Emotional stability (ES) is a personality trait pertinent to sleep restriction and stress responding. However, no study to date has explored how ES and sleep-restriction interactively affect cardiovascular stress responses or processes of adaptation during stress. The present study sought to investigate the association between ES and impact of sleep restriction on cardiovascular function during stress, with particular regard to the trajectory of cardiovascular function change across time. Ninety female university students completed a laboratory vigilance stress task while undergoing continuous cardiovascular (SBP, DBP, HR, SV, CO, TPR) monitoring, after either a night of partial sleep restriction (40% of habitual sleep duration) or a full night's rest. Individuals high in ES showed stable and adaptive cardiovascular (SBP, SV, CO) responses throughout stress exposure, regardless of sleep. In contrast, individuals low in ES exhibited cardiovascular adaptation during stress exposure while rested, but disrupted adaption while sleep-restricted. These findings suggest that sleep-restriction undermines healthful cardiovascular adaptation to stress for individuals low in ES. Copyright © 2017 Elsevier B.V. All rights reserved.
Sun, Yong; Shao, Yani; Zhang, Zhiguo; Wang, Lianfen; Mariga, Alfred M.; Pang, Guangchang; Geng, Chaoyu; Ho, Chi-Tang; Hu, Qiuhui; Zhao, Liyan
Cordyceps (Cordyceps militaris) exhibits many biological activities including antioxidant, inhibition of inflammation, cancer prevention, hypoglycemic, and antiaging properties, etc. However, a majority of studies involving C. militaris have focused only on in vitro and animal models, and there is a lack of direct translation and application of study results to clinical practice (e.g., health benefits). In this study, we investigated the regulatory effects of C. militaris micron powder (3 dos...
O'Toole, Brian I; Catts, Stanley V; Outram, Sue; Pierse, Katherine R; Cockburn, Jill
The long-term health consequences of war service remain unclear, despite burgeoning scientific interest. A longitudinal cohort study of a random sample of Australian Vietnam veterans was designed to assess veterans' postwar physical and mental health 36 years after the war (2005-2006) and to examine its relation to Army service, combat, and post-traumatic stress disorder (PTSD) assessed 14 years previously (1990-1993). Prevalences in veterans (n = 450) were compared with those in the Australian general population. Veterans' Army service and data from the first assessments were evaluated using multivariate logistic regression prediction modeling. Veterans' general health and some health risk factors were poorer and medical consultation rates were higher than Australian population expectations. Of 67 long-term conditions, the prevalences of 47 were higher and the prevalences of 4 were lower when compared with population expectations. Half of all veterans took some form of medication for mental well-being. The prevalence of psychiatric diagnoses exceeded Australian population expectations. Military and war service characteristics and age were the most frequent predictors of physical health endpoints, while PTSD was most strongly associated with psychiatric diagnoses. Draftees had better physical health than regular enlistees but no better mental health. Army service and war-related PTSD are associated with risk of illness in later life among Australian Vietnam veterans.
Barr, Taura; Livingston, Whitney; Guardado, Pedro; Baxter, Tristin; Mysliwiec, Vincent; Gill, Jessica
Up to one-third of deployed military personnel sustain a traumatic brain injury (TBI). TBIs and the stress of deployment contribute to the vulnerability for chronic sleep disturbance, resulting in high rates of insomnia diagnoses as well as symptoms of posttraumatic stress disorder (PTSD), depression, and declines in health-related quality of life (HRQOL). Inflammation is associated with insomnia; however, the impact of sleep changes on comorbid symptoms and inflammation in this population is unknown. In this study, we examined the relationship between reported sleep changes and the provision of the standard of care, which could include one or more of the following: cognitive behavioral therapy (CBT), medications, and continuous positive airway pressure (CPAP). We compared the following: (a) the group with a decrease in the Pittsburgh Sleep Quality Index (PSQI; restorative sleep) and (b) the group with no change or increase in PSQI (no change). Independent t tests and chi-square tests were used to compare the groups on demographic and clinical characteristics, and mixed between-within subjects analysis of variance tests were used to determine the effect of group differences on changes in comorbid symptoms. Linear regression models were used to examine the role of inflammation in changes in symptoms and HRQOL. The sample included 70 recently deployed military personnel with TBI, seeking care for sleep disturbances. Thirty-seven participants reported restorative sleep and 33 reported no sleep changes or worse sleep. The two groups did not differ in demographic characteristics or clinical symptoms at baseline. The TBI+restored sleep group had significant reductions in PTSD and depression over the 3-month period, whereas the TBI+no change group had a slight increase in both PTSD and depression. The TBI+restored sleep group also had significant changes in HRQOL, including the following HRQOL subcomponents: physical functioning, role limitations in physical health
Smith, Brian N; Shipherd, Jillian C; Schuster, Jennifer L; Vogt, Dawne S; King, Lynda A; King, Daniel W
This study examined posttraumatic stress symptomatology (PSS) as a mediator of the association between military sexual trauma and post-deployment physical health. Relationships were examined in a sample of 83 female veterans of the first Gulf War (1990-1991) approximately 10 years post-deployment. Participants reported on the frequency of sexual harassment and sexual assault experienced during deployment. Physical health was measured using participants' self-reports of pre-deployment and post-deployment symptoms within 7 body systems. Sexual harassment exposure was not found to be associated with PSS-mediated associations with physical health symptoms. However, sexual assault during deployment was found to be associated with PSS and 4 of the 7 health symptom clusters assessed: gastrointestinal, genitourinary, musculoskeletal, and neurological symptoms. Furthermore, PSS was found to be a significant mediator of the sexual assault-physical health relationship in each of these domains, with the indirect path accounting for 74% to 100% of the relationship. The findings from the current study indicate that sexual assault has detrimental associations with physical health and that PSS plays a primary role in that relationship.
Childs, John D; Wu, Samuel S; Teyhen, Deydre S; Robinson, Michael E; George, Steven Z
Effective strategies for preventing low back pain (LBP) have remained elusive, despite annual direct health care costs exceeding $85 billion dollars annually. In our recently completed Prevention of Low Back Pain in the Military (POLM) trial, a brief psychosocial education program (PSEP) that reduced fear and threat of LBP reduced the incidence of health care-seeking for LBP. The purpose of this cost analysis was to determine if soldiers who received psychosocial education experienced lower health care costs compared with soldiers who did not receive psychosocial education. The POLM trial was a cluster randomized trial with four intervention arms and a 2-year follow-up. Consecutive subjects (n=4,295) entering a 16-week training program at Fort Sam Houston, TX, to become a combat medic in the U.S. Army were considered for participation. In addition to an assigned exercise program, soldiers were cluster randomized to receive or not receive a brief psychosocial education program delivered in a group setting. The Military Health System Management Analysis and Reporting Tool was used to extract total and LBP-related health care costs associated with LBP incidence over a 2-year follow-up period. After adjusting for postrandomization differences between the groups, the median total LBP-related health care costs for soldiers who received PSEP and incurred LBP-related costs during the 2-year follow-up period were $26 per soldier lower than for those who did not receive PSEP ($60 vs. $86, respectively, p=.034). The adjusted median total health care costs for soldiers who received PSEP and incurred at least some health care costs during the 2-year follow-up period were estimated at $2 per soldier lower than for those who did not receive PSEP ($2,439 vs. $2,441, respectively, p=.242). The results from this analysis demonstrate that a brief psychosocial education program was only marginally effective in reducing LBP-related health care costs and was not effective in reducing
Alexey I. Podberyozkin
Military-political issues is an important area of research work at MGIMO. The difference in this direction from the classical international specialization is that it is at the intersection of several disciplines: military science, military-technical and military-industrial as well as International Relations. A specialist in military and political issues should not only be an expert in the field of international relations and diplomacy, but also have a deep knowledge of military-technical issu...
The CDU, a model for centralised ... changes or strategic service delivery decisions that led to increased ... impact on their production planning – and we must remember ... the unplanned production upscaling and the associated risk of .... The National Health Care Facilities Baseline Audit: National Summary Report.
Balandiz, Huseyin; Bolu, Abdullah
The definition of psychological trauma has been rephrased with the DSM-5. From now on, witnessing someone else's traumatic event is also accepted as a traumatic life event. Therefore, the psychiatric examination of forensic cases gains importance for not overlooking a psychiatric trauma. This research aims to discuss the psychiatric examinations of military personnel who had a traumatic life event and to reveal psychiatric states of soldiers after trauma. The forensic reports prepared at Gulhane Military Medical Academy (GMMA), Forensic Medicine polyclinic between January 1, 2011 and November 30, 2014 were examined, and among them the cases sent to GMMA Psychiatry polyclinic for psychiatric examination were analyzed retrospectively. There were a total of 2408 cases who applied for the arrangement of a judicial report and 167 of them required a psychological examination. Among 167 cases, 165 were male and 2 were female, and the mean age was 25.6 years. Anxiety disorder (53.9%) was the most common diagnosis as a result of the psychiatric examination, following posttraumatic stress disorder (PTSD) (18.6%), and 3.6% had no psychopathology. It was determined that injuries caused by firearms (38.3%) and explosive materials (26.3%) had caused psychological trauma the most. On the other hand, 11 (6.6%) cases were determined to have undergone a psychological trauma on account of being a witness to their friends' injuries during the conflict without experiencing any physical injury. There were not any statistically significant relationships between the severity of physical injury and being PTSD or anxiety disorder. Development of PTSD risk is directly correlated with the nature of trauma. The trauma types of the cases in our study were in the high-risk group because of the military population. Our study is of importance in terms of putting forward the psychiatric disorders seen in the military population with traumatic life history associated with war (combat-related). In
Full Text Available This paper views America's 'drones-first' counter-insurgency effort in Pakistan through the lens of Merton's theory of the unintended consequences of purposive action. It also references Beck’s Risk Society thesis, America’s Revolution in Military Affairs doctrine, Toft’s theory of isomorphic learning, Langer’s theory of mindfulness, Highly Reliable Organisations theory and the social construction of technology (SCOT argument. With reference to Merton’s theory, the CIA-directed armed Remotely Piloted Vehicle (RPV campaign has manifest functions, latent functions and latent dysfunctions. Measured against numbers of suspected insurgents killed, the campaign can be judged a success. Measured against the level of collateral damage or the state of US-Pakistan relations, the campaign can be judged a failure. Values determine the choice of metrics. Because RPV operations eliminate risk to American service personnel, and because this is popular with both US citizens and politicians, collateral damage (the killing of civilians is not considered a policy-changing dysfunction. However, the latent dysfunctions of America's drones-first policy may be so great as to undermine that policy's intended manifest function – to make a net contribution to the War on Terror. In Vietnam the latent dysfunctions of Westmoreland’s attritional war undermined America’s policy of containment. Vietnam holds a lesson for the Obama administration.
Apgar, Mahlon; Keane, John M
A $200 billion market has appeared on your business horizon, but you may not have noticed it. It's the U.S. military--the new U.S. military. Virtually all aspects of the military are changing to ensure it can fight unpredictable threats while sustaining the infrastructure needed to support and train forces. The military is turning to non-traditional business partners to meet a wide range of needs, from health care to housing to information technology. The Defense Department is yielding its monopoly on every aspect of national security and adopting a more businesslike model in which the military's warfighting capabilities are supported through outsourcing and business alliances. Civilians are replacing military personnel in many noncombat roles. Military functions with corporate equivalents are candidates for outsourcing and privatization. Market standards are replacing the heavy customization that has locked many companies out of this marketplace. The authors have participated in the transformation process from different perspectives--one civilian, the other military. Together, they highlight the prospects that transformation is creating for companies outside the traditional defense industry and reveal paths to success in this complex market. They also present six principles for doing business with the military that require persistence, integrity, and a willingness to master the intricacies of a distinctive culture. By understanding the logic of military transformation, executives can identify and create vast new business opportunities. And by mastering the six principles, they can build profitable long-term relationships.
AlAteeq, Mohammed; Alrashoud, Abdulaziz M; Khair, Mohammed; Salam, Mahmoud
Brief advice on smoking cessation from primary health care (PHC) physicians reduces smoking prevalence. However, few studies have investigated the provision of such advice by PHC physicians providing services to military communities. The aim of this study was to evaluate PHC physicians' attitudes toward and practice of delivering smoking cessation advice to smokers in a military community in central Saudi Arabia. A self-reported survey of PHC physicians was conducted in 2015 using a previously validated tool. The age, sex, educational level, job title, experience and previous smoking cessation training of each physician was recorded. Attitude (ten statements) and practice (six statements) were evaluated on a five-point Likert scale. Scoring system was applied and percentage mean scores (PMS) were calculated. Descriptive/statistical analyses were applied to identify factors that were significantly associated with a positive attitude and favorable practice (PMS >65 each). P-values smoking cessation educational program in the previous year. Approximately 75% of physicians had a positive attitude (PMS =72.4±11.2), while 64.4% reported favorable practice (PMS =65.3±27.7). Higher education levels were significantly more associated with positive attitude than lower education levels (adj. odds ratio [OR] 95% confidence interval [CI] =17.9 [1.3-242.3]; adj. P=0.03). More experienced physicians (adj. OR [95% CI] =9.5 [1.6-54.6]) and those with positive attitude (adj. OR [95% CI] =6.1 [1.6-23.3]) were more likely to report a favorable practice, compared to the less experienced (adj. P=0.012) and physicians with a negative attitude (adj. P=0.008). Provision of smoking cessation advice by primary health care physicians serving a military community is significantly associated with their attitude and years of experience. Patients who are seeking smoking cessation advice should be referred to physicians with higher levels of education. Routinely scheduled training on proper
Briggs, C. W.; Bissonnette, M. C.; Edwards, M.; Shjegstad, S. M.
Thousands of 100-lb M47A series bombs containing sulfur mustard were disposed in the ocean following World War II yet few studies have been conducted at sites in excess of 250 m, the depth where most discarded military munitions (DMM) were disposed. The Hawai`i Undersea Military Munitions Assessment (HUMMA) project was conducted to evaluate the risk from chemical warfare materiel (CWM) in DMM to human health, measuring ecological differences between the disposal area and nearby but otherwise similar areas, and evaluating the most efficient platforms for surveying DMM sea-disposal sites located at depths between 400-650 m. During the 2014 HUMMA Sampling Survey, the Jason 2 remotely operated vehicle was used to collect data. Shrimp were collected and analyzed to assess the potential for bioaccumulation of CWM, energetics and metals from munitions. No CWM was detected in H. ensifer tissue samples, indicating bioaccumulation is not occurring. Low levels of 2,4,6-trinitrotoluene, 4-amino-2,6-dinitrotoluene, 1,3,5-trinitrobenzene, nitrobenzene, arsenic, copper, and lead were detected and the concentrations were not significantly different at DMM and control sites. No visible deformities, eroded fins, lesions, or tumors were observed on the shrimp living in the vicinity of M47A bombs. Given these results and under current and potential future uses of the HUMMA study area, health risks to likely receptors are within EPA acceptable levels. Photographic data and benthic infauna analysis were used to study benthic organisms that lived on or near munitions. There was no statistically distinguishable difference between organism distributions in dense and sparse munitions fields. Conventional munitions were found to have the greatest number of benthic infauna individuals, with control sites generally having the least number of individuals. This is consistent with the benthic macro-fauna analysis, which shows that munitions provide habitat.
such as primary care practices, therapist 2 offices, prisons, schools , and community organizations. Providers working in these various settings have...ment, follow-up care for children prescribed attention deficit hyperactivity disorder ( ADHD ) medication, and mental health utilization (among other
Chattopadhyay, Subrata; Myser, Catherine; Moxham, Tiffany; De Vries, Raymond
We identify the ways the policies of leading international bioethics journals limit the participation of researchers working in the resource-constrained settings of low- and middle-income countries (LMICs) in the development of the field of bioethics. Lack of access to essential scholarly resources makes it extremely difficult, if not impossible, for many LMIC bioethicists to learn from, meaningfully engage in, and further contribute to the global bioethics discourse. Underrepresentation of LMIC perspectives in leading journals sustains the hegemony of Western bioethics, limits the presentation of diverse moral visions of life, health, and medicine, and undermines aspirations to create a truly "global" bioethics. Limited attention to this problem indicates a lack of empathy and moral imagination on the part of bioethicists in high-income countries, raises questions about the ethics of bioethics, and highlights the urgent need to find ways to remedy this social injustice.
Buckman, Joshua E J; Sundin, Josefin; Greene, Talya; Fear, Nicola T; Dandeker, Christopher; Greenberg, Neil; Wessely, Simon
To determine the current state of knowledge regarding the effects of deployment length and a 'mismatch' between the expected and actual length of deployments on the health and well-being of military personnel in order to draw relevant conclusions for all organisations that deploy personnel to conflict zones. A systematic review was conducted of studies measuring deployment length to theatres of operations and the issue of 'mismatch' between expected and actual tour lengths. The nine studies included were rated for quality. Of the nine studies reviewed, six were rated as high quality, two as moderate quality and one as low quality. Seven of these studies found adverse effects of longer deployments on health and well-being. The two studies that measured 'mismatch' found adverse effects on mental health and well-being when deployments lasted longer than personnel expected. There are a limited number of studies which have assessed the effects of deployment length and very few that have assessed the effects of 'mismatch' on health and well-being. However, this review suggests that, as deployment length increases, the potential for personnel to suffer adverse health effects also increases. Further research is required to investigate the effects of spending prolonged periods of time away from family and friends, especially when deployment lasts longer than expected by personnel. These results are important not only for the Armed Forces, but also for other organisations that place employees in similar working conditions. Taking account of these findings may allow better preparation for the potentially harmful effects that deployments can have on employees' health and well-being.
Lim, S.; Prakash, A.
Do economic downturns in the Global North undermine worker safety in the Global South? Literature suggests that bilateral trade linkages lead to the diffusion of “good” labor standards from importing countries of the Global North to exporting countries of the Global South. The crucial mechanism is
This article shows how patronage politics affects a popular international education model: community-managed schools (CMS). Focusing on Honduras's CMS initiative, PROHECO (Programa Hondureno de Educacion Comunitaria), I demonstrate how patronage can undermine CMS accountability. Whereas supporters argue that CMS increases accountability, partisan…
Ufkes, Elze Gooitzen; Calcagno, Justine; Glasford, Demis; Dovidio, John F.
Past research has consistently demonstrated that creating a sense of a common ingroup identity can be beneficial for reducing intergroup tensions and creating intergroup harmony. At the same time, however, creating a strong sense of a common ingroup identity has elements that may undermine
...) provides many factors needed in the assessment of human health risk that were derived from general population studies or studies involving relatively small groups that may not be representative of military populations...
Dr. Joel Gaydos, science advisor for the Armed Forces Health Surveillance Center, and Dr. Robert Potter, a research associate for the Armed Forces Medical Examiner System, discuss deaths from adenovirus in the US military.
Patton, Christina L; McNally, Matthew R; Fremouw, William J
Previous studies have implicated significant differences between military members and civilians with regard to violent behavior, including suicide, domestic violence, and harm to others, but none have examined military murder-suicide. This study sought to determine whether there were meaningful differences between military and civilian murder-suicide perpetrators. Using data from the Center for Disease Control's (CDC) National Violent Death Reporting System (NVDRS), military (n = 259) and civilian (n = 259) murder-suicide perpetrators were compared on a number of demographic, psychological, and contextual factors using chi-square analyses. Logistic regression was used to determine which variables predicted membership to the military or civilian perpetrator groups. Military murder-suicide perpetrators were more likely to be older, have physical health problems, be currently or formerly married, less likely to abuse substances, and to exhibit significantly different motives than civilian perpetrators. Logistic regression revealed that membership to the military, rather than the civilian, perpetrator group was predicted by age, physical health problems, and declining heath motive-reflecting the significance of a more than 15-year difference in mean age between the two groups. Findings point to the need to tailor suicide risk assessments to include questions specific to murder-suicide, to assess attitudes toward murder-suicide, and to the importance of assessing suicide and violence risk in older adult military populations. © The Author(s) 2015.
... (peacekeeping, humanitarian, disaster relief, etc.). Most of these missions are performed by multinational forces, which requires the cooperation of all military services including the medical support systems...
Currier, Joseph M; Holland, Jason M; Drescher, Kent; Foy, David
Moral injury is an emerging construct related to negative consequences associated with war-zone stressors that transgress military veterans' deeply held values/beliefs. Given the newness of the construct, there is a need for instrumentation that might assess morally injurious experiences (MIEs) in this population. Drawing on a community sample of 131 Iraq and/or Afghanistan Veterans and clinical sample of 82 returning Veterans, we conducted an initial psychometric evaluation of the newly developed Moral Injury Questionnaire-Military version (MIQ-M)-a 20-item self-report measure for assessing MIEs. Possibly due to low rates of reporting, an item assessing sexual trauma did not yield favourable psychometric properties and was excluded from analyses. Veterans in the clinical sample endorsed significantly higher scores across MIQ-M items. Factor analytic results for the final 19 items supported a unidimensional structure, and convergent validity analyses revealed that higher scores (indicative of more MIEs) were correlated with greater general combat exposure, impairments in work/social functioning, posttraumatic stress and depression in the community sample. In addition, when controlling for demographics, deployment-related factors and exposure to life threat stressors associated with combat, tests of incremental validity indicated that MIQ-M scores were also uniquely linked with suicide risk and other mental health outcomes. These findings provide preliminary evidence for the validity of the MIQ-M and support the applicability of this measure for further research and clinical work with Veterans. Military service can confront service members with experiences that undermine their core sense of humanity and violate global values and beliefs. These types of experiences increase the risk for posttraumatic maladjustment in this population, even when accounting for rates of exposure to life threat traumas. Moral injury is an emerging construct to more fully capture the many
47. New York, NY: Springer Science + Business Media. Luvaas, Jay. 1986. Frederick the Great: The education of a great captain. In The John Biggs ...based on individual assignments undermines the nature of mixed agency related tensions that dual professionals experience. John Lunsroth suggests...Lunsroth, John . 2008. Torture and the regulation of the health care professions. In Physicians at War: The Dual-Loyalties Challenge, ed. Fritz Allhoff, 127
behaviors, for exam- ple, adherence to medical regiments, proper exercise, and diet. Social cognitive theory was developed by Albert Bandura and...and Health Education: Theory, Research and Practtce.3rd ed. San Francisco, CA. Jossey-Bass; 2002:214-245. 19. Bandura A. Social cognitive theory: an...SoclaLCognitlve_Theory_Overview. htm. Accessed April 2006. 21. Bandura A. Health promotion by social cogni- tive means. Health Educ Bebav. 2004;31(2):143- 164. 318
or the veracity of, but not the existence of. This article critically examines the concept of ‘data’ within larger questions of research method and frameworks for scientific inquiry. The current dominance of the term ‘data’ and ‘big data’ in discussions of scientific inquiry as well as everyday advertising...... focuses our attention on only certain aspects of the research process. The author suggests deliberately decentering the term, to explore nuanced frames for describing the materials, processes, and goals of inquiry....
Swann, Thomas; Husted, Emil
Drawing on concepts rooted in cybernetics and anarchist political theory, this article argues that the shift in Occupy Wall Street from being a physical protest camp in late 2011 to an online movement in 2012 coincided with a shift in social media activity. Analysis of Facebook activity suggests...
White, Richard; Barber, Catherine; Azrael, Deb; Mukamal, Kenneth J.; Miller, Matthew
Studies of completed suicide by history of military service have produced inconsistent findings; no representative population-based study has compared the risk of nonfatal suicidal behavior among veterans with risk among nonveterans. The objective of this study was to examine whether male veterans of the U.S. military are at heightened risk of…
Maurivan Batista da Silva
relate it to mental health. We tried to contextualize the purposes of public safety services through a brief history of the state police, its division and how it has been used against daily violence. Based on labor psychology view, we made use of techniques and concepts based on the Ergonomics of the Activity and on Labor Psychodynamics; observing the work process, document research, individual and collective interviews. Qualitative analysis demonstrated that military officers are in the center of a link of forces coming from work organization, the precariousness of the work and, finally, from the contemporary society. The ways these relationships of forces are joined contribute to harmful implications to the mental health of professionals, favoring the increase in psychological suffering and it can lead to alcoholism, depression, and even suicide. Data from Medical Council of João Pessoa, (2003 to 2005, show an average of 489 military officers who retired from work on medical grounds. These are worrisome figures in an area of public service that is essential to the population. These figures would be higher if the leaves granted in the workplace were also included. Procedures for granting internal leaves occur in an attempt to mediate the possible long period of health treatment.
8217, Psychological Medicine, vol. 38, no. 4, pp. 511-522. Jacobson IG, Ryan MAK, Hooper TI, Smith TC, Amoroso PJ, Boyko EJ, Gackstetter GD, Wells TS...Instruments Embedded within the Survey Construct Inventory Physical, mental, and functional health Short-Form 36 Psychological assessment...including symptoms of Patient Health Questionnaire depression, anxiety, panic syndrome, binge-eating, bulimia (PHQ) nervosa, and alcohol abuse Post
The People's Republic of China (PRC) is seen by many as an economic powerhouse with the world's largest standing military that has the potential to translate economic power into the military sphere...
Bernasconi, Jeffrey J
.... Two divergent theories cover the ground of military effectiveness. One looks at the interaction of social structures, whereas the other looks at the effect organization has on military effectiveness...
The theoretical results about optimum strategy of use of military uranium confirmed by systems approach accounts are received. The numerical value of the system approach price of the highly enriched military uranium also is given
... MilitaryFamily.org © 2017 - National Military Family Association Twitter Facebook Pinterest Instagram Charity Navigator Four Star Charity GuideStar Exchange Better Business Bureau Charity Watch Independent Charity of America nonprofit ...
assault or harassment, violence , death of a loved one, or illness or injury (Holmes & Rahe, 1967). After assigning a score to each life stress item, the...PRIME-MD patient health questionnaire in assessment of 3000 obstetric -gynecologic patients: The PRIME-MD Patient Health Questionnaire Obstetrics ...Gynecology Study. American Journal of Obstetrics & Gynecology, 183, 759–769. doi:10.1067/mob.2000.106580 Spitzer, R. L., Williams, J. B., Kroenke, K
Health Policy Research taps RAND expertise in both defense and health policy to conduct research for the Department of Defense, the Department of...Program EFT emotional freedom technique EMM Emergency Medical Ministry FAMOPS Family Optimization Systems FAP Family Advocacy Program FIRP Federal...Assistance Advisor TAMC Tripler Army Medical Center TAPS Tragedy Assistance Program for Survivors TAU treatment as usual TBI traumatic brain injury
Lazecky, Milan; Kacmarik, Michal; Rapant, Petr
A part of czech highway D1 connecting Ostrava with Prague and Poland, is built over an undermined area of Ostrava-Svinov. Since the end of 2010, this part of the highway is fully operational. Because of undermining, a subsidence can be expected, however with a very slow rate since the mines are no more active in this area. Several TerraSAR-X images from 2011 are investigated interferometrically in order to estimate a precise deformation model. Subjects of interest are movements of newly built highway bridges, banks and close neighbourhood. Existing C-band multitemporal InSAR processing results of ERS and Envisat are available from an earlier period that reveil a slow trend of residual subsidence. In this project, InSAR will be investigated as a tool for an early warning for highway stability.
Full Text Available CONTEXT: The most revolutionary concept in rhytidectomy is the role of Sub Muscular Aponeurotic System (SMAS, even if many alternative approaches have been proposed. The main aim of face lift is to bring back the time, preventing the "lifted-face" appearance. SETTINGS AND DESIGN: The authors present their personal experience with different levels of undermining, i.e. subperiosteal forehead lift, subcutaneous midface lift with SMAS plication and platysmal suspension, and discuss the anatomical and biomechanical elements of rhytidectomy. RESULTS: Optimal aesthetic results were achieved by repositioning the neck, face and forehead tissues in a global and harmonious fashion, without distorting face characteristics and disguising surgery trails as much as possible. CONCLUSIONS: Different levels of undermining can give good and stable aesthetic results minimizing the risks and preventing face distortion.
Brooks, Matthew S; Laditka, Sarah B; Laditka, James N
Comparing outcomes of veterans who served in Vietnam and those who served elsewhere, we examined treatment of post-traumatic stress disorder, treatment of other mental health conditions, psychiatric treatment location, and six mental health well-being measures. The analytic sample consisted of nationally representative data from the 2001 National Survey of Veterans. Analyses included multivariate logistic regression that controlled for sociodemographic characteristics. Of Vietnam War-era veterans in the National Survey of Veterans (N = 7,914), 3,937 served in Vietnam and 3,977 served elsewhere. These veterans were stratified into or = 60 years of age (N = 1,766). Veterans who served in Vietnam had notably poorer mental health than did those who served elsewhere. There were striking mental health differences between younger and older veterans; younger veterans had substantially worse measures of mental health. These results suggest greater resource needs among younger Vietnam War veterans. Clinicians and the Department of Veterans Affairs should focus on mental health services for younger veterans.
Langer, David A.; McLeod, Bryce D.; Weisz, John R
Objective: Some critics of treatment manuals have argued that their use may undermine the quality of the client–therapist alliance. This notion was tested in the context of youth psychotherapy delivered by therapists in community clinics. Method: Seventy-six clinically referred youths (57% female, age 8–15 years, 34% Caucasian) were randomly assigned to receive nonmanualized usual care or manual-guided treatment to address anxiety or depressive disorders. Treatment was provided in community c...
... on health safety and performance, the PBRC performs the following eight research tasks: 1) Clinical Laboratory for Human and Food Samples performs laboratory analysis of samples from studies conducted...
Charlotte Beatriz Spode; Álvaro Roberto Crespo Merlo
This article conveys a research report in which the relations between the work of Military Police Captains and their mental health were approached, arising from the aspects of this profession that generate pleasure and suffering. Three procedures were adopted as methodological strategies: Documental research, observation of daily work and interviews. The results show that in spite of the excessive administrative working load and perils inherent to the profession, the pleasure in work is relat...
Wang, Jianqin; Otgaar, Henry; Howe, Mark L; Smeets, Tom; Merckelbach, Harald; Nahouli, Zacharia
Memories of events for which the belief in the occurrence of those events is undermined, but recollection is retained, are called nonbelieved memories (NBMs). The present experiments examined the effects of NBMs on subsequent problem-solving behaviour. In Experiment 1, we challenged participants' beliefs in their memories and examined whether NBMs affected subsequent solution rates on insight-based problems. True and false memories were elicited using the Deese/Roediger-McDermott (DRM) paradigm. Then participants' belief in true and false memories was challenged by telling them the item had not been presented. We found that when the challenge led to undermining belief in false memories, fewer problems were solved than when belief was not challenged. In Experiment 2, a similar procedure was used except that some participants solved the problems one week rather than immediately after the feedback. Again, our results showed that undermining belief in false memories resulted in lower problem solution rates. These findings suggest that for false memories, belief is an important agent in whether memories serve as effective primes for immediate and delayed problem-solving.
Meier, Laurenz L; Cho, Eunae
With the mounting evidence that employees' work experiences spill over into the family domain and cross over to family members, it is important to understand the underlying mechanism through which work experiences affect the family domain and what factors may alleviate the adverse impact of work stress. Expanding previous research that mainly focused on the affect-based mechanism (negative affect), the present research investigated a resource-based mechanism (psychological detachment from work) in the relationship linking two work stressors (high workload and workplace incivility) with social undermining toward the partner at home. We also explored the relative strength of the mediating effects of the two mechanisms. In addition, we tested whether relationship satisfaction moderates the proposed effect of detachment on partner undermining. We tested these research questions using two studies with differing designs: a five-wave longitudinal study (N = 470) and a multisource study (N = 131). The results suggest that stressful work experiences affect the family domain via lack of detachment as well as negative affect, that the two pathways have comparable strength, and that high relationship satisfaction mitigates the negative effect of lack of detachment on partner undermining. In sum, this research extends the spillover-crossover model by establishing that poor psychological detachment from work during leisure time is an additional mechanism that links work and family. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Full Text Available The purpose of this study was to test the support to undermined occlusal enamel provided by posterior restorative composite (FiltekTM P60, 3M Dental products USA, polyacid modified resin composite (F2000 compomer, 3M Dental products, USA., radiopaque silver alloy-glass ionomer cement (Miracle Mix. GC Corp, Tokyo, Japan and Glass Ionomer cement (Fuji IX GP. To test each material, 20 human permanent mandibular third molars were selected. The lingual cusps were removed and the dentin supporting the facial cusps was cut away, leaving a shell of enamel. Each group of prepared teeth was restored using the materials according to the manufacturer′s instructions. All the specimens were thermocycled (250 cycles, 6°C- 60°C, dwell time 30 seconds and then mounted on an acrylic base. Specimens were loaded evenly across the cusp tips at a crosshead speed of 5 mm /minute in Hounsfield universal testing machine until fracture occurred. Data obtained was analyzed using analysis of variance and Studentized- Newman- Keul′s range test. No significant differences were detected in the support provided by P-60, F 2000, Miracle Mix or Fuji IX GP groups. The support provided to undermined occlusal enamel by these materials was intermediate between no support and that provided by sound dentin. Without further development in dental material technology and evidence of its efficacy, restorative materials should not be relied upon to support undermined occlusal enamel to a level comparable to that provided by sound dentin.
Full Text Available What are young Australians’ understandings of, and attitudes to, the military and military service? This article describes a pilot study of 320 young Australian university students’ attitudes to the military and military service during a time when Australia was engaged in the Afghanistan war. The main purpose of this study was to develop a survey instrument for further work in researching civil–military relations in Australia. Civil–military relations describe the complex set of relationships between the civil and military spheres. The role of the military, the relationship between the state and the military, the division of labor between civilian and military entities, foreign policy, and knowledge of military service are some of the fields that constitute a study of civil–military relations. This article reports on beliefs about, and attitudes to the specificities of military service and responses to the broader field of civil–military relations.
depression, panic disorder, other anxiety disorders, bulimia nervosa, binge‑eating disorders, and PTSD are reported in one mental health variable...22. 42. Wright KM, Huffman AH, Adler AB, Castro CA. Psychological screening program over‑ view. Mil Med 2002; 167:853‑61. 43. Brewin CR. Systematic
government studies of health effects of the Gulf War. Am J Epidemiol. 1998;148(4):315---323. 18. Lazarus RS, Folkman S. Stress, appraisal, and coping...Iraqi Freedom (N = 65 704): 2003–2007 Characteristic 1 Deployment (n = 49 328) 2 Deployments (n = 16 376) Age, y , median (range)a 22 (17–57) 22 (19
Peltonen, Kirsi; Qouta, Samir; El Sarraj, Eyad; Punamaki, Raija-Leena
We first examined how war-related traumatic events impact on peer and sibling relations, and how the quality of these relations in turn are associated with children's mental health, indicating a mediation model. Second, we tested the moderating (protective) effects of good peer and sibling relations in attenuating the link between trauma and…
Jenkins; David Luxton, PhD; Danielle Mitchell; Kristin Motylinski; Anna Nagel, MPH; Chiping Nieh, PhD; Chris O’Malley, MPH; Ser- guey Parkhomovsky...1996;143:228-239. 36. Barlas FM, Higgins WB, Pflieger JC, Diecker K. 2011 Department of Defense Health Related Behaviors Survey of Active Duty
Christopherson, Gregory T; Nesti, Leon J
There are many similarities between health issues affecting military and civilian patient populations, with the exception of the relatively small but vital segment of active soldiers who experience high-energy blast injuries during combat. A rising incidence of major injuries from explosive devices in recent campaigns has further complicated treatment and recovery, highlighting the need for tissue regenerative options and intensifying interest in the possible role of stem cells for military m...
end in itself, a final cause of seeking the good in other pursuits (Abelson & Nielsen, 1967). Immanuel Kant’s ideas also have a significant influence...on ethics. Kant defined ethics as the philosophical science that "... deals with the laws of free moral action" ( Kant , 1964, p. 13). Kant’s ethical...Organization, (n.d.). Biography of the Honorable William Winkenwerder, Jr., M.D., MB.A., Assistant Secretary of Defense for Health Affairs. Retrieved
Savitsky, Laura; Illingworth, Maria; DuLaney, Megan
This article discusses social work practice areas for civilian social workers who provide services to military service members,veterans, and their families. These practice areas include education, child welfare, domestic violence, mental health, health care, substance abuse, and criminal justice. The authors examine the impact of the contemporary military lifestyle and current military operations on service members and their families in the context of these practice areas, with the goal of compelling civilian social workers to acknowledge their responsibility to competently serve military and veteran clients.
Goodman, Petra; Turner, Annette; Agazio, Janice; Throop, Meryia; Padden, Diane; Greiner, Shawna; Hillier, Shannon L
Military mothers and their children cope with unique issues when mothers are deployed. In this article, we present mothers' perspectives on how military resources affected them, their children, and their caregivers during deployment. Mothers described beneficial features of military programs such as family readiness groups and behavioral health care, processes such as unit support, and policies on length and timing of deployments. Aspects that were not supportive included inflexibility in family care plans, using personal leave time and funds for transporting children, denial of release to resolve caretaker issues, and limited time for reintegration. We offer recommendations for enhanced support to these families that the military could provide. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.
Charlotte Beatriz Spode
Full Text Available This article conveys a research report in which the relations between the work of Military Police Captains and their mental health were approached, arising from the aspects of this profession that generate pleasure and suffering. Three procedures were adopted as methodological strategies: Documental research, observation of daily work and interviews. The results show that in spite of the excessive administrative working load and perils inherent to the profession, the pleasure in work is related to management activities, which provide spaces for creating in the workplace. However, the pressures imposed by the disciplinary mechanism of vigilance and control, characteristics of the organization of military police work, constitute in itself a source of suffering. Since they engender the division of workers and impose barriers where bonds of cooperation and confidence are needed, aspects that are of great importance considering the nature of this type of work, permeated by risks.
Full Text Available Nursing career professionals with solid-humanistic way scientific, ethical and basis in order that they can properly integrate the multidisciplinary team to creatively solve health problems through nursing care. This article analyzes the formation of the military nurse in Venezuela, with the help of logical historical method to uncover trends and regularities that characterize this process. The nurse is a professional attitudes, values, knowledge and skills to assume their social responsibility, applying theories and models of discipline in the promotion, prevention, recovery and rehabilitation of health. Similarly, military nurse career provides to the military institution and especially health institutions of the country leadership training in the management of custodial care, management and research on health and committed to education continues in his practice.
Wade, Darryl; Mewton, Louise; Varker, Tracey; Phelps, Andrea; Forbes, David
The study investigated the impact of potentially traumatic events on mental health outcomes among males who had ever served in the Australian Defence Force. Data from a nationally representative household survey of Australian residents, the 2007 National Survey of Mental Health and Wellbeing, were used for this study. Compared with community members, Australian Defence Force males were significantly more likely to have experienced not only deployment and other war-like events but also accidents or other unexpected events, and trauma to someone close. For non-deployed males, Australian Defence Force members were at increased risk of accidents or other unexpected events compared to community members. After controlling for the effect of potentially traumatic events that were more prevalent among all Australian Defence Force members, the increased risk of mental disorders among Australian Defence Force members was no longer evident. For non-deployed males, Australian Defence Force and community members were at comparable risk of poor mental health outcomes. A significant minority of Australian Defence Force members had onset of a mental disorder prior to their first deployment. Deployment and other potentially traumatic events among Australian Defence Force members can help to explain their increased vulnerability to mental disorders compared with community members. Providers should routinely enquire about a range of potentially traumatic events among serving and ex-serving military personnel.
Which US States Pose the Greatest Threats to Military Readiness and Public Health? Public Health Policy Implications for a Cross-sectional Investigation of Cardiorespiratory Fitness, Body Mass Index, and Injuries Among US Army Recruits.
Bornstein, Daniel B; Grieve, George L; Clennin, Morgan N; McLain, Alexander C; Whitsel, Laurie P; Beets, Michael W; Hauret, Keith G; Jones, Bruce H; Sarzynski, Mark A
Many states in the southern region of the United States are recognized for higher rates of obesity, physical inactivity, and chronic disease. These states are therefore recognized for their disproportionate public health burden. The purpose of this study was to investigate state-level distributions of cardiorespiratory fitness, body mass index (BMI), and injuries among US Army recruits in order to determine whether or not certain states may also pose disproportionate threats to military readiness and national security. Sex-specific state-level values for injuries and fitness among 165 584 Army recruits were determined. Next, the relationship between median cardiorespiratory fitness and injury incidence at the state level was examined using Spearman correlations. Finally, multivariable Poisson regression models stratified by sex examined state-level associations between fitness and injury incidence, while controlling for BMI, and other covariates. Cardiorespiratory fitness and training-related injury incidence. A cluster of 10 states from the south and southeastern regions (Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, and Texas) produced male or female recruits who were significantly less fit and/or more likely to become injured than recruits from other US states. Compared with the "most fit states," the incidence of injuries increased by 22% (95% CI, 17-28; P < .001) and 28% (95% CI, 19-36; P < .001) in male and female recruits from the "least fit states," respectively. The impact of policies, systems, and environments on physical activity behavior, and subsequently fitness and health, has been clearly established. Advocacy efforts aimed at active living policies, systems, and environmental changes to improve population health often fail. However, advocating for active living policies to improve national security may prove more promising, particularly with legislators. Results from this study demonstrate
Full Text Available Based on numerous studies showing that testing studied material can improve long-term retention more than restudying the same material, it is often suggested that the number of tests in education should be increased to enhance knowledge acquisition. However, testing in real-life educational settings often entails a high degree of extrinsic motivation of learners due to the common practice of placing important consequences on the outcome of a test. Such an effect on the motivation of learners may undermine the beneficial effects of testing on long-term memory because it has been shown that extrinsic motivation can reduce the quality of learning. To examine this issue, participants learned foreign language vocabulary words, followed by an immediate test in which one third of the words were tested and one third restudied. To manipulate extrinsic motivation during immediate testing, participants received either monetary reward contingent on test performance or no reward. After one week, memory for all words was tested. In the immediate test, reward reduced correct recall and increased commission errors, indicating that reward reduced the number of items that can benefit from successful retrieval. The results in the delayed test revealed that reward additionally reduced the gain received from successful retrieval because memory for initially successfully retrieved words was lower in the reward condition. However, testing was still more effective than restudying under reward conditions because reward undermined long-term memory for concurrently restudied material as well. These findings indicate that providing performance-contingent reward in a test can undermine long-term knowledge acquisition.
Kuhbandner, Christof; Aslan, Alp; Emmerdinger, Kathrin; Murayama, Kou
Based on numerous studies showing that testing studied material can improve long-term retention more than restudying the same material, it is often suggested that the number of tests in education should be increased to enhance knowledge acquisition. However, testing in real-life educational settings often entails a high degree of extrinsic motivation of learners due to the common practice of placing important consequences on the outcome of a test. Such an effect on the motivation of learners may undermine the beneficial effects of testing on long-term memory because it has been shown that extrinsic motivation can reduce the quality of learning. To examine this issue, participants learned foreign language vocabulary words, followed by an immediate test in which one-third of the words were tested and one-third restudied. To manipulate extrinsic motivation during immediate testing, participants received either monetary reward contingent on test performance or no reward. After 1 week, memory for all words was tested. In the immediate test, reward reduced correct recall and increased commission errors, indicating that reward reduced the number of items that can benefit from successful retrieval. The results in the delayed test revealed that reward additionally reduced the gain received from successful retrieval because memory for initially successfully retrieved words was lower in the reward condition. However, testing was still more effective than restudying under reward conditions because reward undermined long-term memory for concurrently restudied material as well. These findings indicate that providing performance-contingent reward in a test can undermine long-term knowledge acquisition.
Madsen, Wendy; McAllister, Margaret; Godden, Judith; Greenhill, Jennene; Reed, Rachel
This paper draws on the results of a national study of approaches to teaching nursing's history in Australia. We argue that the neglect of history learning within undergraduate nursing and midwifery education is undermining the development in students of a strong professional nursing identity. The data in our study shows that instead of proud, informed professionals, we are at risk of producing a generation of professional orphans -- unaware of who they are and where they've come from, unaware of reasons underlying cultural practices within the profession, lacking in vision for the future, insecure about their capacity to contribute to future directions, and not feeling part of something bigger and more enduring.
Voth, H J
This paper is a reexamination of the Winter hypothesis, which holds that there was a marked difference in the development of civilian health during the First World War between the central powers and the Western allies. Ultimate success on the battlefield, according to Winter, required balancing the needs of the military with civilian demands; Germany lost because it failed to achieve such a balance. The resulting decline in health standards undermined the war effort and eventually led to defeat. This article proceeds in two steps. First, it demonstrates that Winter's data does not allow him to make a proper comparison between the two camps. Second, I argue that his hypothesis can be refuted once a truly comparable source is used--infant mortality rated. There is as yet no convincing evidence to suggest that the outcome of the First world War was determined by public health policy.
Alberti, Hugh; Banner, Kimberley; Collingwood, Helen; Merritt, Kymberlee
Failure to recruit sufficient applicants to general practice (GP) training has been a problem both nationally and internationally for many years and undermining of GP is one possible contributing factor. The aim of our study was to ascertain what comments, both negative and positive, are being made in UK clinical settings to GP trainees about GP and to further explore these comments and their influence on career choice. We conducted a mixed methods study. We surveyed all foundation doctors and GP trainees within one region of Health Education England regarding any comments they experienced relating to a career in GP. We also conducted six focus groups with early GP trainees to discuss any comments that they experienced and whether these comments had any influence on their or others career choice. Positive comments reported by trainees centred around the concept that choosing GP is a positive, family-focused choice which facilities a good work-life balance. Workload was the most common negative comment, alongside the notion of being 'just a GP'; the belief that GP is boring, a waste of training and a second-class career choice. The reasons for and origin of the comments are multifactorial in nature. Thematic analysis of the focus groups identified key factors such as previous exposure to and experience of GP, family members who were GPs, GP role models, demographics of the clinician and referral behaviour. Trainees perceived that negative comments may be discouraging others from choosing GP as a career. Our study demonstrates that negative comments towards GP as a career do exist within clinical settings and are having a potential impact on poor recruitment rates to GP training. We have identified areas in which further negative comments could be prevented by changing perceptions of GP as a career. Additional time spent in GP as undergraduates and postgraduates, and positive GP role models, could particularly benefit recruitment. We recommend that undermining of GP
Larsen, Josefine Kühnel; Struwe, Lars Bangert
Military capacity building has increasingly become an integral part of Danish defence. Military capacity is a new way of thinking Danish defence and poses a new set of challenges and opportunities for the Danish military and the Political leadership. On the 12th of december, PhD. Candidate Josefine...... Kühnel Larsen and researcher Lars Bangert Struwe of CMS had organized a seminar in collaboration with Royal Danish Defense Colleg and the East African Security Governance Network. The seminar focused on some of the risks involved in Military capacity building and how these risks are dealt with from...
Rasmussen, Mikkel Vedby
If the military were a business, would you buy shares? Over recent years, Western armed forces, particularly the US, have been costing more yet achieving less. At the same time, austerity measures are reducing defence budgets. This book uses defence data to examine the workings of modern Western...... militaries and explore what kind of strategies can overcome this gap between input and output. Instead of focusing on military strategy, Mikkel Vedby Rasmussen seeks to draw on the ideas of business strategy to assess alternative business cases - reforming military HR to combat instability in the 'Global...
Rasmussen, Mikkel Vedby
If the military were a business, would you buy shares? Over recent years, Western armed forces, particularly the US, have been costing more yet achieving less. At the same time, austerity measures are reducing defence budgets. This book uses defence data to examine the workings of modern Western...... militaries and explore what kind of strategies can overcome this gap between input and output. Instead of focusing on military strategy, Mikkel Vedby Rasmussen seeks to draw on the ideas of business strategy to assess alternative business cases - reforming military HR to combat instability in the 'Global...... to fit within a nation's overall national security system without ever-increasing budgets....
Francisco Javier Martínez Antonio
Full Text Available Este trabajo plantea la consideración de los imperios como unidades socio-históricas básicas para el estudio de la historia de la ciencia, la medicina y la tecnología. Para ello se empieza por desarrollar algunas claves historiográficas y conceptuales desde las cuales modificar el concepto habitual de imperio en un sentido más simétrico, transversal y relacional. Sobre esta base, se estudia la articulación de la salud pública en el Imperio español en el periodo 1833-1868, en concreto, de una de sus ramas: la sanidad militar. El resultado es una imagen más compleja de la misma donde se revelan conexiones transimperiales, la heterogeneidad y apertura de los espacios metropolitano y colonial y la iniciativa de distintos grupos y territorios al margen de la legislación y discursos oficiales.The article analyzes the relations between public health and empire in Spain under the reign of Isabel II (1833-68. After presenting certain conceptual notions, the case of military health is proposed as a specific example of these relations. On a journey through the Empire's different settings (the Iberian peninsula, Cuba, Porto Rico, and the Philippines, the text explains the role played by different groups, often marginalized from historical accounts.
Wollscheid, Sabine; Eriksen, John; Hallvik, Jørgen
This study explores the provision of home care services (home nursing and domiciliary help) for the elderly in Norwegian municipalities with purchaser-provider split model. The study draws on the assumption that flexibility in adjusting services to the care receivers' needs, and cooperation between provider and purchasers are indicators of good quality of care. Data were collected through semi-structured telephone interviews with 22 team leaders of provider units in nine municipalities. Data were collected in 2008-2009. The study has been approved by the Norwegian Social Science Data Services. We identified four different ways of organising home care services under a purchaser-provider split model: Provider empowerment, New Public Management, Vague instructions and undermining the rules. High flexibility in providing care and cooperation with the purchaser unit were identified by the team leaders as characteristics for good care. Our findings suggest that the care providers use individual strategies that allow flexibility and cooperation rather than rigidly abiding to the regulations the purchaser-provider split models implies. Ironically, in provider units where the 'rules were undermined', the informants (team leaders of provider units) seemed to be most satisfied with the quality of home care that they delivered. © 2012 Nordic College of Caring Science.
Forbes, Chad E; Leitner, Jordan B
Stereotype threat, a situational pressure individuals experience when they fear confirming a negative group stereotype, engenders a cascade of physiological stress responses, negative appraisals, and performance monitoring processes that tax working memory resources necessary for optimal performance. Less is known, however, about how stereotype threat biases attentional processing in response to performance feedback, and how such attentional biases may undermine performance. Women received feedback on math problems in stereotype threatening compared to stereotype-neutral contexts while continuous EEG activity was recorded. Findings revealed that stereotype threatened women elicited larger midline P100 ERPs, increased phase locking between anterior cingulate cortex and dorsolateral prefrontal cortex (two regions integral for attentional processes), and increased power in left fusiform gyrus in response to negative feedback compared to positive feedback and women in stereotype-neutral contexts. Increased power in left fusiform gyrus in response to negative feedback predicted underperformance on the math task among stereotype threatened women only. Women in stereotype-neutral contexts exhibited the opposite trend. Findings suggest that in stereotype threatening contexts, neural networks integral for attention and working memory are biased toward negative, stereotype confirming feedback at very early speeds of information processing. This bias, in turn, plays a role in undermining performance. Copyright © 2014 Elsevier B.V. All rights reserved.
A key element of an organizational safety culture is maintaining an environment of professionalism that encourages communication and promotes high-quality care. Behavior that undermines a culture of safety, including disruptive or intimidating behavior, has a negative effect on the quality and safety of patient care. Intimidating behavior and disruptive behavior are unprofessional and should not be tolerated. Confronting disruptive individuals is difficult. Co-workers often are reluctant to report disruptive behavior because of fear of retaliation and the stigma associated with "blowing the whistle" on a colleague. Additionally, negative behavior of revenue-generating physicians may be overlooked because of concern about the perceived consequences of confronting them. The Joint Commission requires that hospitals establish a code of conduct that "defines acceptable behavior and behavior that undermines a culture of safety." Clear standards of behavior that acknowledge the consequences of disruptive and intimidating behavior must be established and communicated. Institutions and practices should develop a multifaceted approach to address disruptive behavior. Confidential reporting systems and assistance programs for physicians who exhibit disruptive behavior should be established. A concerted effort should be made within each organization to educate staff (ie, medical, nursing, and ancillary staff) about the potential negative effects of disruptive and inappropriate behavior. A clearly delineated hospital-wide policy and procedure relating to disruptive behavior should be developed and enforced by hospital administration. To preserve professional standing, physicians should understand how to respond to and mitigate the effect of complaints or reports.
Hideg, Ivona; Ferris, D Lance
Although sexist attitudes are generally thought to undermine support for employment equity (EE) policies supporting women, we argue that the effects of benevolent sexism are more complex. Across 4 studies, we extend the ambivalent sexism literature by examining both the positive and the negative effects benevolent sexism has for the support of gender-based EE policies. On the positive side, we show that individuals who endorse benevolent sexist attitudes on trait measures of sexism (Study 1) and individuals primed with benevolent sexist attitudes (Study 2) are more likely to support an EE policy, and that this effect is mediated by feelings of compassion. On the negative side, we find that this support extends only to EE policies that promote the hiring of women in feminine, and not in masculine, positions (Study 3 and 4). Thus, while benevolent sexism may appear to promote gender equality, it subtly undermines it by contributing to occupational gender segregation and leading to inaction in promoting women in positions in which they are underrepresented (i.e., masculine positions). (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Landrum, Michael L; Neumann, Charlotte; Cook, Courtney; Chukwuma, Uzo; Ellis, Michael W; Hospenthal, Duane R; Murray, Clinton K
Rates of hospital-onset methicillin-resistant Staphylococcus aureus (MRSA) infections are reported as decreasing, but recent rates of community-onset S. aureus infections are less known. To characterize the overall and annual incidence rates of community-onset and hospital-onset S. aureus bacteremia and skin and soft tissue infections (SSTIs) in a national health care system and to evaluate trends in the incidence rates of S. aureus bacteremia and SSTIs and the proportion due to MRSA. Observational study of all Department of Defense TRICARE beneficiaries from January 2005 through December 2010. Medical record databases were used to identify and classify all annual first-positive S. aureus blood and wound or abscess cultures as methicillin-susceptible S. aureus or MRSA, and as community-onset or hospital-onset infections (isolates collected >3 days after hospital admission). Unadjusted incidence rates per 100,000 person-years of observation, the proportion of infections that was due to MRSA, and annual trends for 2005 through 2010 (examined using the Spearman rank correlation test or the Mantel-Haenszel χ2 test for linear trend). During 56 million person-years (nonactive duty: 47 million person-years; active duty: 9 million person-years), there were 2643 blood and 80,281 wound or abscess annual first-positive S. aureus cultures. Annual incidence rates varied from 3.6 to 6.0 per 100,000 person-years for S. aureus bacteremia and 122.7 to 168.9 per 100,000 person-years for S. aureus SSTIs. The annual incidence rates for community-onset MRSA bacteremia decreased from 1.7 per 100,000 person-years (95% CI, 1.5-2.0 per 100,000 person-years) in 2005 to 1.2 per 100,000 person-years (95% CI, 0.9-1.4 per 100,000 person-years) in 2010 (P = .005 for trend). The annual incidence rates for hospital-onset MRSA bacteremia also decreased from 0.7 per 100,000 person-years (95% CI, 0.6-0.9 per 100,000 person-years) in 2005 to 0.4 per 100,000 person-years (95% CI, 0.3-0.5 per 100
Full Text Available The work is devoted to the studies of the problem of smoking and alcohol use among cadets of military institute as well as to the risk of diseases’ developing when using nicotine and alcohol. We have proposed the methods for solving this problem in the educational institution. This article describes not only the problem among the cadets of military institute, but also the calculated risks. Particular attention is paid to the study of the methods of controlling the bad habits in the educational institution and reduction of the number of smokers and drinkers among the cadets.
Alexey I. Podberyozkin
Full Text Available Military-political issues is an important area of research work at MGIMO. The difference in this direction from the classical international specialization is that it is at the intersection of several disciplines: military science, military-technical and military-industrial as well as International Relations. A specialist in military and political issues should not only be an expert in the field of international relations and diplomacy, but also have a deep knowledge of military-technical issues to understand the basic trends in the development of scientific and technological progress and its impact on the balance of forces in the world. Global changes in the balance of power and the nature of the conflict, the emergence of new types of weapons are changing the basic methods and approaches to the art of war, which requires a science-based perspective on problem solving and multi-disciplinary approach in achieving the goals. Military and political studies allow us to understand how the development of military technology and military organization of the state affected by the political situation in the world, the national security of the country and its place in the system of international relations. Military-political research has been developing at MGIMO for a few decades. It laid down the basis for a scientific school of political-military studies. Its founding fathers were such prominent scholars of international affairs, as I.G. Usachyov, A.D. Nikonov, A.G. Arbatov, V.G. Baranovsky, V.M. Kulagin, A.N. Nikitin and other well-known experts. Their work covers a wide range of military and political issues, including the topics of arms control and disarmament, international, and especially European security, military policy, NATO, the Western military-political doctrines and their practical application. Now the lead in the development of this research at MGIMO has taken Center for Military-Political Studies, which became a concentration of relevant
symptoms of mania or hypomania or reference to presence or absence (prior or current) of specific symptoms of mania or hypoma- nia , such as any of the...October 2004, pp. 493– 505 . Zahran, Hatice S., Rosemarie Kobau, David G. Moriarty, Matthew M. Zack, James Holt, and Ralph Donehoo, “Health-Related
Military service and other socioecological factors influencing weight and health behavior change in overweight and obese Veterans: a qualitative study to inform intervention development within primary care at the United States Veterans Health Administration.
Jay, Melanie; Mateo, Katrina F; Squires, Allison P; Kalet, Adina L; Sherman, Scott E
Obesity affects 37 % of patients at Veterans Health Administration (VHA) medical centers. The VHA offers an intensive weight management program (MOVE!) but less than 10 % of eligible patients ever attend. However, VHA patients see their primary care provider about 3.6 times per year, supporting the development of primary care-based weight management interventions. To address gaps in the literature regarding Veterans' experiences with weight management and determine whether and how to develop a primary care-based weight management intervention to both improve obesity counseling and increase attendance to MOVE!, we conducted a qualitative study to assess: 1) Veterans' personal experiences with healthy weight-related behavior change (including barriers and facilitators to behavior change and experiences with primary care providers, staff, and the MOVE! program), and 2) potential new approaches to improve weight management within primary care at the VHA including goal setting and technology. Overweight/obese VHA patients (aged 18-75, BMI greater than 30 or greater than 25 with at least 1 co-morbidity) were recruited for focus group sessions stratified by gender, MOVE! referral, and attendance. Each session was facilitated by a trained moderator, audio-recorded, and professionally transcribed. Using an iterative coding approach, two coders separately reviewed and coded transcripts, and met frequently to negotiate codes and synthesize emerging themes. Of 161 eligible patients, 54 attended one of 6 focus groups (2 female, 4 male, 9-11 participants per session): 63 % were male, 46 % identified as African-American, 32 % White/Caucasian, 74 % were college-educated or higher, and 61 % reported having attended MOVE!. We identified two major themes: Impact of Military Service and Promotion and Sustainability of Healthy Behaviors. After service in a highly structured military environment, Veterans had difficulty maintaining weight on their own. They perceived physical
Chapliuk, A L; Brovkin, S G; Kal'manov, A S; Bulavin, V V
The authors showed that at the present time military much more servicemen, suffering from obstructive pulmonary disease, may receive medical examination in outpatient conditions. Series of researches allow us to perform a medical examination on an outpatient basis. The calculation of the cost-effectiveness of health services to such patients during a military medical examination in the hospital and clinics was made. Savings during the examination in the clinic for 1 patient was 2829 rubbles.
van den Oord, M.H.A.H.
Military pilots and rear aircrew members are occupations with several occupational exposures that might cause neck pain. In addition to the negative impact of neck pain on health, safety is one of the main concerns for the military aviation, because neck pain may interfere with flying performance.
Yang, Chenglei; Wang, Lu; Sun, Bing; Yin, Xu; Wang, Xiaoting; Liu, Li; Lu, Lin
Military boxing, a kind of Chinese martial arts, is widespread and health beneficial. In this paper, the authors introduce a military boxing learning system realized by 3D motion capture, Web3D and 3D interactive technologies. The interactions with the system are natural and intuitive. Users can observe and learn the details of each action of the…
statute within the military system, persons unfamiliar with the military justice system may find the procedure something of a paradox at first blush...Manual for Courts-Martial) Is RM Nemitafinuestlitimelf.(er- V. GRAD*: c. ORGANIZATION dDT FRPR ast eiRO t: fII) EPR LCDR/ Naval Justice School
... family that loses the active presence of a parent through separation faces significant challenges and stress. During the parent's ... children can and do adjust successfully to the separation and stress involved when a parent in the military is deployed. Visit AACAP's Military ...
Recent research suggests that pollution has a large impact on asthma and other respiratory and cardiovascular conditions. But this relationship and its implications are not well understood. I use changes in location due to military transfers, which occur entirely to satisfy the needs of the army, to identify the causal impact of pollution on…
Cozza, Stephen J.; Lerner, Richard M.; Haskins, Ron
This "Social Policy Report" summarizes what is currently known about our nation's military children and families and presents ideas and proposals pertinent to the formulation of new programs and the policies that would create and sustain these initiatives. We emphasize the need for future rigorous developmental research about military…
Sun, Yong; Shao, Yani; Zhang, Zhiguo; Wang, Lianfen; Mariga, Alfred M; Pang, Guangchang; Geng, Chaoyu; Ho, Chi-Tang; Hu, Qiuhui; Zhao, Liyan
Cordyceps (Cordyceps militaris) exhibits many biological activities including antioxidant, inhibition of inflammation, cancer prevention, hypoglycemic, and antiaging properties, etc. However, a majority of studies involving C. militaris have focused only on in vitro and animal models, and there is a lack of direct translation and application of study results to clinical practice (e.g., health benefits). In this study, we investigated the regulatory effects of C. militaris micron powder (3 doses) on the human immune system. The study results showed that administration of C. militaris at various dosages reduced the activity of cytokines such as eotaxin, fibroblast growth factor-2, GRO, and monocyte chemoattractant protein-1. In addition, there was a significant decrease in the activity of various cytokines, including GRO, sCD40L, and tumor necrosis factor-α, and a significant downregulation of interleukin-12(p70), interferon-γ inducible protein 10, and macrophage inflammatory protein-1β activities, indicating that C. militaris at all three dosages downregulated the activity of cytokines, especially inflammatory cytokines and chemokines. Different dosages of C. militaris produced different changes in cytokines. Copyright © 2014. Published by Elsevier B.V.
Full Text Available Cordyceps (Cordyceps militaris exhibits many biological activities including antioxidant, inhibition of inflammation, cancer prevention, hypoglycemic, and antiaging properties, etc. However, a majority of studies involving C. militaris have focused only on in vitro and animal models, and there is a lack of direct translation and application of study results to clinical practice (e.g., health benefits. In this study, we investigated the regulatory effects of C. militaris micron powder (3 doses on the human immune system. The study results showed that administration of C. militaris at various dosages reduced the activity of cytokines such as eotaxin, fibroblast growth factor-2, GRO, and monocyte chemoattractant protein-1. In addition, there was a significant decrease in the activity of various cytokines, including GRO, sCD40L, and tumor necrosis factor-α, and a significant downregulation of interleukin-12(p70, interferon-γ inducible protein 10, and macrophage inflammatory protein-1β activities, indicating that C. militaris at all three dosages downregulated the activity of cytokines, especially inflammatory cytokines and chemokines. Different dosages of C. militaris produced different changes in cytokines.
Elder, William B; Domino, Jessica L; Rentz, Timothy O; Mata-Galán, Emma L
Male sexual trauma is understudied, leaving much to be known about the unique mental health needs of male survivors. This study examined veteran men's perceptions of the effects of military sexual trauma. Military sexual trauma was defined as physically forced, verbally coerced, or substance-incapacitated acts experienced during military service. Interviews were conducted with 21 male veterans who reported experiencing military sexual trauma. Data were drawn together using a grounded theory methodology. Three categories emerged from data analysis, including (a) types of military sexual trauma (being touched in a sexual way against their will [N = 18]; sexual remarks directed at them [N = 15]; being physically forced to have sex [N = 13]); (b) negative life effects (difficulty trusting others [N = 18]; fear of abandonment [N = 17]; substance use [N = 13]; fear of interpersonal violence [N = 12]; conduct and vocational problems [N = 11]; irritability/aggression [N = 8]; insecurity about sexual performance [N = 8]; difficulty managing anger [N = 8]); and (c) posttraumatic growth (N = 15). Results from this study suggest sexual trauma in the military context may affect systems of self-organization, specifically problems in affective, self-concept, and relational domains, similar to symptoms of those who have experienced prolonged traumatic stressors. This model can be used by clinicians to select treatments that specifically target these symptoms and promote posttraumatic growth. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Nodar Z. Mossaki
Full Text Available The article analyzes the system of training of officers in military academies in Iraq – in Zakho, Qalacholan, ar-Rustamiyah and an-Nasiriyah. The author describes the history of creation, process of evolution, challenges and features of training in these colleges. Particular attention paid to military academies in the territory of Iraqi Kurdistan, which actually do not obey the central government of Iraq, however, have the highest level of training. Currently, Iraq's military academies operate on the basis of the NATO standards. Iraqi military academies paid miuch attention to the specifics of the military and political situation in Iraq – counterinsurgency and counterterrorism operations, patrolling cities, fighting in an urban environment etc. Significant place in the curriculum take the courses contributing to the formation of pro-Western sentiment.
Zimmermann, Peter; Ströhle, Andreas; Langner, Franziska; Lanczik, Mario
In 2001, women were admitted to all military careers in the German Armed Forces. This study examines whether the utilization of psychiatric services of female military personnel has changed since then. The central medical database of German military personnel for the years 2000 and 2006 was analyzed. Between 2000 and 2006, the percentage (based on the average totals of male and female military personnel) of consultations of primary care unit surgeons for psychiatric problems increased significantly for both male and female military personnel, this increase being more apparent for women than for men. Stress-related disorders showed the greatest rise. In 2006, as opposed to 2000, the total proportion of both outpatient and inpatient mental health treatment provided to female military personnel was significantly higher than for males, particularly regarding stress-related, affective and personality disorders. Gender-specific aspects should be considered more intensely in preventive and therapeutic psychiatric supply in the German Armed Forces.
Military facilities provide health care services to an important segment of both themilitary and civil population. Methods: The aim of this study was to evaluate drug prescribing practices at a Nigerian military hospital (MilitaryHospital, Ikoyi, Lagos) and tomake recommendations for its improvement.UsingWHOrational drug use ...
Wang, Lin; Elder, Glen H; Spence, Naomi J
The U.S. Armed Forces offer educational and training benefits as incentives for service. This study investigates the influence of status configurations on military enlistment and their link to greater educational opportunity. Three statuses (socioeconomic status of origin, cognitive ability and academic performance) have particular relevance for life course options. We hypothesize that young men with inconsistent statuses are more likely to enlist than men with consistent status profiles, and that military service improves access to college for certain configurations. Analyses of the National Longitudinal Study of Adolescent Health (Add Health) show (1. that several status configurations markedly increased the likelihood of military enlistment and (2. within status configurations, recruits were generally more likely to enroll in higher education than nonveterans, with associate degrees being more likely.
Wang, Lin; Elder, Glen H.; Spence, Naomi J.
The U.S. Armed Forces offer educational and training benefits as incentives for service. This study investigates the influence of status configurations on military enlistment and their link to greater educational opportunity. Three statuses (socioeconomic status of origin, cognitive ability and academic performance) have particular relevance for life course options. We hypothesize that young men with inconsistent statuses are more likely to enlist than men with consistent status profiles, and that military service improves access to college for certain configurations. Analyses of the National Longitudinal Study of Adolescent Health (Add Health) show (1. that several status configurations markedly increased the likelihood of military enlistment and (2. within status configurations, recruits were generally more likely to enroll in higher education than nonveterans, with associate degrees being more likely. PMID:24511161
Moller, Arlen C; Buscemi, Joanna; McFadden, H Gene; Hedeker, Donald; Spring, Bonnie
The use of material incentives in healthy lifestyle interventions is becoming widespread. However, self-determination theory (SDT) posits that when material incentives are perceived as controlling, they undermine intrinsic motivation. We analyzed data from the Make Better Choices trial-a trial testing strategies for improving four risk behaviors: low fruit-vegetable intake, high saturated fat intake, low physical activity, and high sedentary activity. At baseline, participants reported the degree to which financial incentives were an important motivator (financial motivation); self-reported enjoyment of each behavior was assessed before and after the 3-week incentivization phase. Consistent with SDT, after controlling for general motivation and group assignment, lower financial motivation predicted more adaptive changes in enjoyment. Whereas participants low in financial motivation experienced adaptive changes, adaptive changes were suppressed among those high in financial motivation.
Moller, Arlen C.; Buscemi, Joanna; McFadden, H. Gene; Hedeker, Donald; Spring, Bonnie
The use of material incentives in healthy lifestyle interventions is becoming widespread. However, self-determination theory (SDT) posits that when material incentives are perceived as controlling, they undermine intrinsic motivation. We analyzed data from the Make Better Choices trial—a trial testing strategies for improving four risk behaviors: low fruit–vegetable intake, high saturated fat intake, low physical activity, and high sedentary activity. At baseline, participants reported the degree to which financial incentives were an important motivator (financial motivation); self-reported enjoyment of each behavior was assessed before and after the 3-week incentivization phase. Consistent with SDT, after controlling for general motivation and group assignment, lower financial motivation predicted more adaptive changes in enjoyment. Whereas participants low in financial motivation experienced adaptive changes, adaptive changes were suppressed among those high in financial motivation. PMID:24142187
Finkel, Eli J; Norton, Michael I; Reis, Harry T; Ariely, Dan; Caprariello, Peter A; Eastwick, Paul W; Frost, Jeana H; Maniaci, Michael R
This article began as an adversarial collaboration between two groups of researchers with competing views on a longstanding question: Does familiarity promote or undermine interpersonal attraction? As we explored our respective positions, it became clear that the limitations of our conceptualizations of the familiarity-attraction link, as well as the limitations of prior research, were masking a set of higher order principles capable of integrating these diverse conceptualizations. This realization led us to adopt a broader perspective, which focuses on three distinct relationship stages-awareness, surface contact, and mutuality-and suggests that the influence of familiarity on attraction depends on both the nature and the stage of the relationship between perceivers and targets. This article introduces the framework that emerged from our discussions and suggests directions for research to investigate its validity. © The Author(s) 2014.
Research shows that enforcing cooperation using contracts or tangible sanctions can backfire, undermining people's intrinsic motivation to cooperate: when the enforcement is removed, people are less trusting or trustworthy than when there is no enforcement to begin with. The author examines whether reputation systems have similar consequences for generalized trust and trustworthiness. Using a web-based experiment simulating online market transactions (studies 1 and 2), he shows that reputation systems can reinforce generalized trust and trustworthiness, unlike contractual enforcement or relational enforcement based on repeated interactions. In a survey experiment (study 3), he finds that recalling their eBay feedback scores made participants more trusting and trustworthy. These results are predicated on the diffuse nature of reputational enforcement to reinforce perceptions of trust and trustworthiness. These results have implications for understanding how different forms of governance affect generalized trust and trustworthiness.
Pierce, John P; Distefan, Janet M; Jackson, Christine; White, Martha M; Gilpin, Elizabeth A
The tobacco industry contends that parenting practices, not marketing practices, are critical to youth smoking. Our objective was to examine whether tobacco-industry marketing practices undermine the protective effect of recommended authoritative parenting against adolescent smoking. Receptivity to tobacco advertising and promotions was assessed in 1996 from a representative sample of California adolescent never-smokers aged 12 to 14 years. A follow-up survey of 1641 of these adolescents was conducted in 1999 that included measures of the key components of authoritative parenting: parental responsiveness, monitoring, and limit setting. Smoking initiation in adolescents. Adolescents in families with more-authoritative parents were half as likely to smoke by follow-up as adolescents in families with less-authoritative parents (20% vs 41%, p parents, adolescents who were highly receptive to tobacco-industry advertising and promotions were significantly more likely to smoke (odds ratio=3.52, 95% confidence interval =1.10-11.23), compared to those who were minimally receptive. This effect was not significant in adolescents in families with less-authoritative parents. The overall attributable risk (adjusted for exposure to peer smokers) of smoking from tobacco-industry advertising and promotions was 25%. However, an estimated 40% of adolescent smoking in families with more-authoritative parents was attributable to tobacco-industry advertising and promotions; this was five times the attributable risk seen in families with less-authoritative parents (8%). The promotion of smoking by the tobacco industry appears to undermine the capability of authoritative parenting to prevent adolescents from starting to smoke.
Ben Wadham; Grace Skrzypiec; Phillip Slee
What are young Australians’ understandings of, and attitudes to, the military and military service? This article describes a pilot study of 320 young Australian university students’ attitudes to the military and military service during a time when Australia was engaged in the Afghanistan war. The main purpose of this study was to develop a survey instrument for further work in researching civil–military relations in Au...
Approved for public release; distribution is unlimited In performing jobs related to national security and defense, personnel must comply with rules and decisions communicated in the form of written legislation, which includes directives, memos, instructions, manuals, standard operating procedures, and reports. Incorrect understanding of legislative provisions may lead to disastrous consequences, making clear communication through these documents paramount. The vast majority of military of...
Snihs, Jan Olof; Akerblom, Gustav
During and after the Balkans conflict in 1999 there were rumours that so-called depleted uranium (DU) had been used in military operations by NATO. Attention was drawn to this issue by a number of countries, and consequently, there is a concern amongst the people of Serbia and Kosovo regarding the possible post-conflict chemical and radiological risk to health and the environment. The UN also has to deal with such concerns from the point of view of security of UN staff in the field. UNEP/Habitat Balkans Task Force (BTF) has been set up to make an overall assessment of the environmental consequences of the conflict and impacts of the conflict on human settlements in Kosovo, Macedonia, Montenegro, Albania and in Serbia. The work was done by organising Technical Missions to provide independent and reliable information which is relevant for the problem under consideration. As regards depleted uranium, a special international expert group, the 'Depleted Uranium Desk Assessment Group' was appointed to analyse and assess the situation. The group was chaired by Snihs. Since little or no information was available on the actual use of depleted uranium in the Kosovo conflict, the expert group was reduced to using available information from the 1990 Gulf conflict and published data on the risks of depleted uranium. It was possible to organise only one visit to Kosovo during the time available for this study, and that visit did not give any indications of contamination from depleted uranium. However, this does not exclude the possibility that there are DU-contaminated areas in Kosovo. By using basic facts relevant for risk assessment and making assumptions about the conditions for exposure to depleted uranium, that are as accurate as possible, it has been possible to assess likely consequences for health and environment. In case of uncertainties in the assumptions, conservative values have been used. On the basis of the conclusions of the assessments there are a number of
Full Text Available The actual study is aimed at defining the place and the role of the concepts of authority, management and leadership and their connexions within the recognized military strategic systems. In addition to the above mentioned main objective, the following related aims will be achieved in the present work: - to analyze the command, management and leadership nexus; - to make suggestions for configuring an effective professional framework to address the armed forces leadership challenges and the visionary leader concept. Eventually, the present study will emphasize the need for the military leaders to lead not only the members of the organization but the military organizations themselves.
Stepanova, M I; Sazaniuk, Z I; Voronova, B Z; Lashneva, I P; Berezina, N O
The sociomedical status of senior military school students was studied, by examining the formed stereotype of a healthy lifestyle, spiritual and patriotic values, as well as physical health indices. It was established that among the significant spiritual and patriotic values, most (62.3%) cadets reported love for their country in the first three places: 68.4% of the schoolchildren called physical health; 47.6% put a readiness at defending the motherland in the first three places while 53.9% named physical health. Psychoemotional studies revealed a low level of anxiety and neurotization in the cadets than in the schoolchildren. Physical health studies (hand muscle strength, vital capacity, hypoxic resistance) indicated that the senior military school students had higher fitness than the general educational school children. These differences in the physical health indices of the adolescents are chiefly associated with the greater attention given by the cadets to their physical education than that shown by the general educational schoolchildren.
Dr. Joel Gaydos, science advisor for the Armed Forces Health Surveillance Center, and Dr. Robert Potter, a research associate for the Armed Forces Medical Examiner System, discuss deaths from adenovirus in the US military. Created: 3/26/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID). Date Released: 3/29/2012.
Vasterling, Jennifer J; Proctor, Susan P
Unexplained health symptoms appear to be ubiquitous to modern war. However, questions remain regarding linkages between military operational deployment and the development of physical or mental health symptoms...
Full Text Available To what extent do frequently cited determinants of military spending allow us to predict and forecast future levels of expenditure? The authors draw on the data and specifications of a recent model on military expenditure and assess the predictive power of its variables using in-sample predictions, out-of-sample forecasts and Bayesian model averaging. To this end, this paper provides guidelines for prediction exercises in general using these three techniques. More substantially, however, the findings emphasize that previous levels of military spending as well as a country’s institutional and economic characteristics particularly improve our ability to predict future levels of investment in the military. Variables pertaining to the international security environment also matter, but seem less important. In addition, the results highlight that the updated model, which drops weak predictors, is not only more parsimonious, but also slightly more accurate than the original specification.
Martin, Charmaine L
...: focus, integration, timeliness, security, objective, and centralized control. However, I propose that operational advantage, consisting of surprise, information advantage and security, are essential elements of a successful military deception...
Renzi, Jr, Alfred E
.... This thesis will describe a structure to assist with both those needs. The premise is that an expanded and improved network of US Military Groups is the weapon of choice for the war on terror, and beyond...
Waitzkin, Howard; Noble, Marylou
Due to the wars in Iraq and Afghanistan, the unmet medical and psychological needs of military personnel are creating major challenges. Increasingly, active duty military personnel are seeking physical and mental health services from civilian professionals. The Civilian Medical Resources Network attempts to address these unmet needs. Participants in the Network include primary care and mental health practitioners in all regions of the country. Network professionals provide independent assessments, clinical interventions in acute situations, and documentation that assists GIs in obtaining reassignment or discharge. Most clients who use Network services come from low-income backgrounds and manifest psychological rather than physical disorders. Qualitative themes in professional-client encounters have focused on ethical conflicts, the impact of violence without meaning (especially violence against civilians), and perceived problems in military health and mental health policies. Unmet needs of active duty military personnel deserve more concerted attention from medical professionals and policy makers. PMID:21339846
U.S. Department of Health & Human Services — This file contains U.S. military hospital data for timely & effective care (process of care) measures collected by the Department of Defense (DoD). DoD collects...
As part of the Walter Reed Army Institute of Research (WRAIR) program to model soldier stress, health, and performance, stressors are analyzed across a variety of environments in terms of their impact on military personnel...
Underwood, P K; Armour, V M
Lyme disease, a growing public health problem in the United States, is also an increasing threat in Europe. Cases identified in a military community in West Germany are presented and problems of diagnosis and treatment discussed.
Full Text Available Due to the wars in Iraq and Afghanistan, the unmet medical and psychological needs of military personnel are creating major challenges. Increasingly, active duty military personnel are seeking physical and mental health services from civilian professionals. The Civilian Medical Resources Network attempts to address these unmet needs. Participants in the Network include primary care and mental health practitioners in all regions of the country. Network professionals provide independent assessments, clinical interventions in acute situations, and documentation that assists GIs in obtaining reassignment or discharge. Most clients who use Network services come from low-income backgrounds and manifest psychological rather than physical disorders. Qualitative themes in professional-client encounters have focused on ethical conflicts, the impact of violence without meaning (especially violence against civilians, and perceived problems in military health and mental health policies. Unmet needs of active duty military personnel deserve more concerted attention from medical professionals and policy makers.
environment such as that in Abu Grahib prison , where military personnel tasked with similar duties to that of contractors have been held legally accountable... Grahib Prison . The Washington Post. Office of Management and Budget Circular A-76. (August 4, 1988. Revised 1999). Performance of Commercial...downsizes the military after the Global War on Terror as it did after the Cold War. Private contractors depend largely upon former service members to
would require of us. (In fact, it could ultimately end up requiring us to do harm.) This is a case of cultural relativism in its least plausible...recent accounts of the PME that seek its source in various artifacts of our military culture and society. Moral obligation is a product of...that seek its source in various artifacts of our military culture and society. Moral obligation is a product of individual abilities and relationships
following questions: In what fields are military personnel most likely to patent, and how do demographics, such as age, race, and gender , along with...technologies, which have transformed how the United States wages war. DARPA continues to develop new technologies and capabilities for the U.S. military today...build the European navies so it instead decided to utilize an innovative ship design to exploit a gap specific to the British Royal Navy. The six
This study was conducted to evaluate potential human and ecological health risks associated with emission of pyrotechnic compounds during future training exercises at the Massachusetts Military Reservation...
Zakikhani, Mansour; Dortch, Mark S; Gerald, Jeffrey A; Hawkins, Melanie S
This study was conducted to evaluate potential human and ecological health risks associated with emission of pyrotechnic compounds during future training exercises at the Massachusetts Military Reservation...
Stannard, Adam; Tai, Nigel R; Bowley, Douglas M; Midwinter, Mark; Hodgetts, Tim J
Key performance indicators (KPI) are tools for assessing process and outcome in systems of health care provision and are an essential component in performance improvement. Although KPI have been used in British military trauma for 10 years, they remain poorly defined and are derived from civilian metrics that do not adjust for the realities of field trauma care. Our aim was to modify current trauma KPI to ensure they more faithfully reflect both the military setting and contemporary evidence in order to both aid accurate calibration of the performance of the British Defence Medical Services and act as a driver for performance improvement. A workshop was convened that was attended by senior, experienced doctors and nurses from all disciplines of trauma care in the British military. "Speciality-specific" KPI were developed by interest groups using evidence-based data where available and collective experience where this was lacking. In a final discussion these were streamlined into 60 KPI covering each phase of trauma management. The introduction of these KPI sets a number of important benchmarks by which British military trauma can be measured. As part of a performance improvement programme, these will allow closer monitoring of our performance and assist efforts to develop, train, and resource British military trauma providers.
This article examines what petroleum products and services the US military buys, the contracts awarded to Asian and European refiners for supplies outside the USA, and military specifications and test methods including the specifications of JP-8 battlefield fuel and the JP-8+100 additive package for military aircraft. The way in which the military buys petroleum products is described, and details are given of the types of military contracts, the bidding on Defense Energy Support Center (DESC) petroleum contracts, the performance of military petroleum contracts, socio-economic programmes, the Prompt Payment Act requiring contractors to be paid promptly, and procedures for claims and disputes
Laird, Robert D; Zeringue, Megan M; Lambert, Emily S
This study focused on adolescents' negative reactions to parental monitoring to determine whether parents should avoid excessive monitoring because adolescents find monitoring behaviors to be over-controlling and privacy invasive. Adolescents (n = 242, M age = 15.4 years; 51% female) reported monitoring, negative reactions, warmth, antisocial behavior, depressive symptoms, and disclosure. Adolescents additionally reported antisocial behavior, depressive symptoms, and disclosure one to two years later. In cross-sectional analyses, less monitoring but more negative reactions were linked with less disclosure, suggesting that negative reactions can undermine parents' ability to obtain information. Although monitoring behaviors were not related to depressive symptoms, more negative reactions were linked with more depressive symptoms, suggesting that negative reactions also may increase depressive symptoms as a side effect of monitoring behavior. Negative reactions were not linked to antisocial behavior. There were no longitudinal links between negative reactions and changes in disclosure, antisocial behavior, or depressive symptoms. Copyright © 2017. Published by Elsevier Ltd.
We examine how demographic context influences the trust that boundary spanners experience in their dyadic relationships with clients. Because of the salience of age as a demographic characteristic as well as the increasing prevalence of age diversity and intergenerational conflict in the workplace, we focus on team age diversity as a demographic social context that affects trust between boundary spanners and their clients. Using social categorization theory and theories of social capital, we develop and test our contextual argument that a boundary spanner's experience of being trusted is influenced by the social categorization processes that occur in dyadic interactions with a specific client and, simultaneously, by similar social categorization processes that influence the degree to which the client team as a whole serves as a cooperative resource for demographically similar versus dissimilar boundary spanner-client dyads. Using a sample of 168 senior boundary spanners from the consulting industry, we find that generational diversity among client team members from a client organization undermines the perception of being trusted within homogeneous boundary spanner-client dyads while it enhances the perception of being trusted within heterogeneous dyads. The perception of being trusted is an important aspect of cross-boundary relationships because it influences coordination and the costs associated with coordination. © 2015 The Author Journal of Organizational Behavior Published by John Wiley & Sons Ltd.
Full Text Available Despite a plethora of case studies in the social sciences, it is the authors' opinion that case studies remain relatively under-mined sources of expertise. Cross-case analysis is a research method that can mobilize knowledge from individual case studies. The authors propose that mobilization of case knowledge occurs when researchers accumulate case knowledge, compare and contrast cases, and in doing so, produce new knowledge. In this article, the authors present theories of how people can learn from sets of cases. Second, existing techniques for cross-case analysis are discussed. Third, considerations that enable researchers to engage in cross-case analysis are suggested. Finally, the authors introduce a novel online database: the Foresee (4C database. The purpose of the database is to mobilize case knowledge by helping researchers perform cross-case analysis and by creating an online research community that facilitates dialogue and the mobilization of case knowledge. The design of the 4C database is informed by theories of how people learn from case studies and cross-case analysis techniques. We present evidence from case study research that use of the 4C database helps to mobilize previously dormant case study knowledge to foster greater expertise. URN: urn:nbn:de:0114-fqs0801348
Pleger, Lyn; Sager, Fritz
Evaluations can only serve as a neutral evidence base for policy decision-making as long as they have not been altered along non-scientific criteria. Studies show that evaluators are repeatedly put under pressure to deliver results in line with given expectations. The study of pressure and influence to misrepresent findings is hence an important research strand for the development of evaluation praxis. A conceptual challenge in the area of evaluation ethics research is the fact that pressure can be not only negative, but also positive. We develop a heuristic model of influence on evaluations that does justice to this ambivalence of influence: the BUSD-model (betterment, undermining, support, distortion). The model is based on the distinction of two dimensions, namely 'explicitness of pressure' and 'direction of influence'. We demonstrate how the model can be applied to understand pressure and offer a practical tool to distinguish positive from negative influence in the form of three so-called differentiators (awareness, accordance, intention). The differentiators comprise a practical component by assisting evaluators who are confronted with influence. Copyright © 2016 Elsevier Ltd. All rights reserved.
Carr, Stuart C; McWha, Ishbel; Maclachlan, Malcolm; Furnham, Adrian
Despite the rhetoric of a single global economy, professionals in poorer countries continue to be remunerated differently depending on whether they are compensated at a local vs. international rate. Project ADDUP (Are Development Discrepancies Undermining Performance?) surveyed 1290 expatriate and local professionals (response rate = 47%) from aid, education, government, and business sectors in (1) Island Nations (Papua New Guinea, Solomon Islands), (2) landlocked economies (Malaŵi, Uganda), and (3) emerging economies (India, China). Difference in pay was estimated using purchasing power parity, from the World Bank's World Development Indicators 2007. Psychological measures included self-reported pay and benefits (remuneration), self-attributed ability, remuneration comparison, sense of justice in remuneration, remuneration-related motivation, thoughts of turnover and thoughts about international mobility. We included control measures of candour, culture shock, cultural values (horizontal/vertical individualism/collectivism), personality (from the "big five"), job satisfaction and work engagement. Controlling for these and country (small effects) and organization effects (medium), (a) pay ratios between international and local workers exceeded what were perceived to be acceptable pay thresholds among respondents remunerated locally; who also reported a combination of a sense of relative (b) injustice and demotivation; which (c) together with job satisfaction/work engagement predicted turnover and international mobility. These findings question the wisdom of dual salary systems in general, expose and challenge a major contradiction between contemporary development policy and practice, and have a range of practical, organizational, and theoretical implications for poverty reduction work.
Hammond, Matthew D; Overall, Nickola C
The current research demonstrates how benevolent sexism functions to undermine women's competence while facilitating men's access to heterosexual intimacy by prompting different support behaviors by men and women. Objective coders rated the support provision exhibited during heterosexual couples' (N = 100) video-recorded discussions of each other's personal goals. Men who endorsed benevolent sexism provided more dependency-oriented support, including directly providing plans and solutions and neglecting the recipient's own abilities, which led to their female partners feeling less competent and less positively regarded. In contrast, women who endorsed benevolent sexism provided greater relationship-oriented support, characterized by affection and emphasizing the positive relationship outcomes associated with their partner's goals, which led their male partners to perceive greater regard and intimacy in their relationship. This study is the first to investigate how benevolent sexism prompts naturalistic support behaviors that can impede women's capacity for independent success while supporting the fulfillment of men's intimacy needs. © 2015 by the Society for Personality and Social Psychology, Inc.
High-performance organizations and economies work on the basis not only of material interests but also of Adam Smith's "moral sentiments." Well-designed laws and public policies can harness self-interest for the common good. However, incentives that appeal to self-interest may fail when they undermine the moral values that lead people to act altruistically or in other public-spirited ways. Behavioral experiments reviewed here suggest that economic incentives may be counterproductive when they signal that selfishness is an appropriate response; constitute a learning environment through which over time people come to adopt more self-interested motivations; compromise the individual's sense of self-determination and thereby degrade intrinsic motivations; or convey a message of distrust, disrespect, and unfair intent. Many of these unintended effects of incentives occur because people act not only to acquire economic goods and services but also to constitute themselves as dignified, autonomous, and moral individuals. Good organizational and institutional design can channel the material interests for the achievement of social goals while also enhancing the contribution of the moral sentiments to the same ends.
Cooke, Lucy J; Chambers, Lucy C; Añez, Elizabeth V; Wardle, Jane
Using rewards in child feeding is commonplace and viewed as effective by parents, although some express concern about using 'bribery'. Psychological and economic theorists emphasize the beneficial effects of rewards in enhancing performance, although, there is evidence that the offer of rewards undermines intrinsic motivation and decreases enjoyment of the rewarded task. In the food domain, results have been mixed, but this may be explained, at least partly in terms of the measured outcome (liking vs intake) and the initial level of motivation towards the target foods (liked vs disliked). Where intake is the outcome, rewards have had broadly positive effects, but when it is liking, rewards can have negative effects if the target food is already liked. Another issue concerns the type of reward offered. While offering food as a reward appear to be universally negative, there is evidence to suggest that non-food tangible rewards (e.g., stickers), or non-tangible rewards (praise) can be highly effective in encouraging children to taste new or less liked foods sufficiently often to benefit from the 'mere exposure' effect. We suggest that the judicious use of rewards may facilitate children's acceptance of healthy foods. Copyright © 2011 Elsevier Ltd. All rights reserved.
Full Text Available African trypanosomosis is a debilitating disease of great medical and socioeconomical importance. It is caused by strictly extracellular protozoan parasites capable of infecting all vertebrate classes including human, livestock, and game animals. To survive within their mammalian host, trypanosomes have evolved efficient immune escape mechanisms and manipulate the entire host immune response, including the humoral response. This report provides an overview of how trypanosomes initially trigger and subsequently undermine the development of an effective host antibody response. Indeed, results available to date obtained in both natural and experimental infection models show that trypanosomes impair homeostatic B-cell lymphopoiesis, B-cell maturation and survival and B-cell memory development. Data on B-cell dysfunctioning in correlation with parasite virulence and trypanosome-mediated inflammation will be discussed, as well as the impact of trypanosomosis on heterologous vaccine efficacy and diagnosis. Therefore, new strategies aiming at enhancing vaccination efficacy could benefit from a combination of (i early parasite diagnosis, (ii anti-trypanosome (drugs treatment, and (iii anti-inflammatory treatment that collectively might allow B-cell recovery and improve vaccination.
Cary A. Brown
Full Text Available Background. Many individuals who work in the military experience sleep deficiency which presents a significant problem given the nature of their work. The cause of their sleep problems is likely multifactorial, stemming from the interplay between their personal health, habits and lifestyle juxtaposed with the stress of their military work such as emotional and physical trauma experienced in service. Objective. To present an overview of sleep deficiency in military members (MMs and review of nonpharmacological treatment options. Discussion. Although there are a number of promising nonpharmacological treatment options available for people working in the military who experience problems sleeping, testing interventions within the context of the military are still in the early stages. Further research utilizing rigorous design and standardized, context appropriate outcome measures is needed to help treat this burgeoning problem.
Dufty, Ngozi E; Bailey, M S
NATO describes 'Role 4' military medical services as those provided for the definitive care of patients who cannot be treated within a theatre of operations and these are usually located in a military force's country of origin and may include the involvement of civilian medical services. The UK Defence Medical Services have a proud history of developing and providing clinical services in infectious diseases and tropical medicine, sexual health and HIV medicine, and medical microbiology and virology. These UK Role 4 Military Infection Services have adapted well to recent overseas deployments, but new challenges will arise due to current military cutbacks and a greater diversity of contingency operations in the future. Further evidence-based development of these services will require leadership by military clinicians and improved communication and support for 'reach-back' services.
work.10 Military history has recorded a strong role for private actors in military affairs firmly ..... Evidence records that, while the state military officers found by a military ... Should it be the chief executive officer (CEO) of .... The Financial Times.
Eckerlin, Denise M; Kovalesky, Andrea; Jakupcak, Matthew
: The experience of military sexual trauma (MST), which can result from assault, battery, or harassment of a sexual nature, may jeopardize the mental health of service members as well as that of their family members, colleagues, and community members. Although a greater proportion of female than male service members are subjected to MST, the Department of Defense estimates that the absolute numbers of affected men and women, across all ranks and branches of military service, are nearly equal because roughly 85% of military members are men. Little research has explored the effects of MST on men. This article discusses the unique ways in which men may experience MST, and examines how social stereotypes of masculinity, myths surrounding sexual assault, and military culture and structure often influence a man's interpretation of an attack and his likelihood of reporting the incident or seeking treatment. It describes current treatments for MST-related mental health conditions and addresses implications for nurses and other health care professionals.
Barsoumian, Alice E; Hartzell, Joshua D; Bonura, Erin M; Ressner, Roseanne A; Whitman, Timothy J; Yun, Heather C
Nationally, the number of internal medicine physicians practicing in primary care has decreased amidst increasing interest in hospitalist medicine. Current priorities in the Military Health System include access to primary care and retention of trained personnel. Recently, we have conducted a study of military internal medicine residents' decision to enter infectious disease. As part of our larger effort, we saw an opportunity to characterize factors impacting decision making of internal medicine residents' desire to apply for subspecialty training and to extend active duty service obligations. Questions were developed after discussion with various military graduate medical education and internal medicine leaders, underwent external review, and were added to a larger question set. The survey link was distributed electronically to all U.S. military affiliated residencies' graduating internal medicine residents in December 2016-January 2017. Data were analyzed by decision to apply to fellowship and decision to extend military obligation using Fisher's exact test or Pearon's chi-square test. Sixty-eight residents from 10 of 11 military residency programs responded, for a response rate of 51%. The majority (62%) applied to fellowship to start after residency completion. Reasons cited for applying to fellowship included wanting to become a specialist as soon as possible (74%), wishing to avoid being a general internist (57%), and because they are unable to practice as a hospitalist in the military (52%). Fellowship applicants were more likely to plan to extend their military obligation than non-applicants, as did those with longer duration of military commitments. No other factors, including Uniformed Services University attendance or participation in undergraduate military experiences, were found to impact plan to extend active duty service commitment. The majority of graduating internal medicine residents apply for fellowship and report a desire to avoid being a
Do shorter delays to care and mental health system renewal translate into better occupational outcome after mental disorder diagnosis in a cohort of Canadian military personnel who returned from an Afghanistan deployment?
Boulos, David; Zamorski, Mark A
Mental disorders in military personnel result in high rates of attrition. Military organisations have strengthened their mental health systems and attempted to overcome barriers to care in order to see better outcomes. This study investigated the roles of mental health services renewal and delay to care in Canadian Armed Forces (CAF) personnel diagnosed with mental disorders. Administrative data were used to identify a retrospective cohort of 30,513 CAF personnel who deployed in support of the mission in Afghanistan. Study participants included 508 individuals with a mental disorder diagnosis identified from CAF medical records of a weighted, stratified random sample of 2014 individuals selected from the study cohort. Weighted Cox proportional hazards regression assessed the association of diagnosis era and delay to care with the outcome, after controlling for a broad range of potential confounders (eg, disorder severity, comorbidity). Taylor series linearisation methods and sample design weights were applied in generating descriptive and regression analysis statistics. The outcome was release from military service for medical reasons, assessed using administrative data for the 508 individuals with a mental disorder diagnosis. 17.5% (95% CI 16.0% to 19.0%) of the cohort had a mental disorder diagnosis after an Afghanistan-related deployment, of which 21.3% (95% CI 17.2% to 25.5%) had a medical release over a median follow-up of 3.5 years. Medical release risk was elevated for individuals diagnosed before 30 April 2008 relative to those with recent diagnoses (adjusted HR (aHR)=1.77 (95% CI 1.01 to 3.11)) and for individuals with a long delay to care (>21 months after return) relative to those with intermediate delays (8-21 months, aHR 2.47=(95% CI 1.28 to 4.76)). Mental health services renewal in the CAF was associated with a better occupational outcome for those diagnosed with mental disorders. Longer delays to care were associated with a less favourable outcome
Building Capacity for Complementary and Integrative Medicine Through a Large, Cross-Agency, Acupuncture Training Program: Lessons Learned from a Military Health System and Veterans Health Administration Joint Initiative Project.
Niemtzow, Richard; Baxter, John; Gallagher, Rollin M; Pock, Arnyce; Calabria, Kathryn; Drake, David; Galloway, Kevin; Walter, Joan; Petri, Richard; Piazza, Thomas; Burns, Stephen; Hofmann, Lew; Biery, John; Buckenmaier, Chester
Complementary and integrative medicine (CIM) use in the USA continues to expand, including within the Military Health System (MHS) and Veterans Health Administration (VHA). To mitigate the opioid crisis and provide additional non-pharmacological pain management options, a large cross-agency collaborative project sought to develop and implement a systems-wide curriculum, entitled Acupuncture Training Across Clinical Settings (ATACS). ATACS curriculum content and structure were created and refined over the course of the project in response to consultations with Subject Matter Experts and provider feedback. Course content was developed to be applicable to the MHS and VHA environments and training was open to many types of providers. Training included a 4-hr didactic and "hands on" clinical training program focused on a single auricular acupuncture protocol, Battlefield Acupuncture. Trainee learning and skills proficiency were evaluated by trainer-observation and written examination. Immediately following training, providers completed an evaluation survey on their ATACS experience. One month later, they were asked to complete another survey regarding their auricular acupuncture use and barriers to use. The present evaluation describes the ATACS curriculum, faculty and trainee characteristics, as well as trainee and program developer perspectives. Over the course of a 19-mo period, 2,712 providers completed the in-person, 4-hr didactic and hands-on clinical training session. Due to the increasing requests for training, additional ATACS faculty were trained. Overall, 113 providers were approved to be training faculty. Responses from the trainee surveys indicated high satisfaction with the ATACS training program and illuminated several challenges to using auricular acupuncture with patients. The most common reported barrier to using auricular acupuncture was the lack of obtaining privileges to administer auricular acupuncture within clinical practice. The ATACS program
In this study, Lt Col Karen O. Dunivin, USAF, examines social change in American military culture and explores the current struggle between the military's traditional and exclusionary combat, masculine-warrior (CMW...
Recent events suggest that nuclear reactors could make tempting military or terrorist targets. Despite the care with which most reactors are built, studies document their vulnerability to willful destruction through disruption of coolant mechanisms both inside and outside the containment building. In addition to reactors, such nuclear support facilities as fuel fabrication, reprocessing, and waste storage installations may be attractive military targets. A nuclear bomb which exploded in the vicinity of a reactor could increase its lethal effects by one-third. The implications of this is vulnerability for Middle East stability as well as to other volatile regions. The author suggests several avenues for controlling the dangers: international law, military and civil defense, facility siting, increasing plant safety, and the international management of nuclear energy. 21 references
Aizenman, Joshua; Glick, Reuven
This paper clarifies one of the puzzling results of the economic growth literature: the impact of military expenditure is frequently found to be non-significant or negative, yet most countries spend a large fraction of their GDP on defense and the military. We start by empirical evaluation of the non- linear interactions between military expenditure, external threats, corruption, and other relevant controls. While growth falls with higher levels of military spending, given the values of the o...
Braun, Lisa A; Kennedy, Holly P; Sadler, Lois S; Dixon, Jane
To examine literature on recruitment and retention of military women in research studies as an underrepresented, and potentially marginalized, population. A literature search was conducted to examine challenges, identify potential barriers and facilitators, and to inform strategies for recruitment and retention of military women in research studies. This search was supplemented by findings in military-specific databases and discussions with Military Women's Health Research Interest Group subject matter experts. Ten articles addressed research recruitment and retention challenges and strategies in marginalized/underrepresented populations, providing an effective context to inform research recruitment and retention in military settings. Research with military women is often challenged by logistical, cultural, social, ethical, and methodological issues, which may hinder exploration of potentially sensitive issues. Researchers must consider military-specific challenges to conducting research that include lengthy deployments, unpredictable military exercises, and foreign assignments, in accessing research participants. A case example shows strategies used in a military cervical cancer screening study. There are few published articles specific to research recruitment and retention in female military populations. Available resources broadly address recruitment challenges for Veterans, marginalized, hard-to-access, and transient research participants, which may provide guidance and strategies for success when applied to military populations. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.
This SpringerBrief reveals the latest techniques in computer vision and machine learning on robots that are designed as accurate and efficient military snipers. Militaries around the world are investigating this technology to simplify the time, cost and safety measures necessary for training human snipers. These robots are developed by combining crucial aspects of computer science research areas including image processing, robotic kinematics and learning algorithms. The authors explain how a new humanoid robot, the iCub, uses high-speed cameras and computer vision algorithms to track the objec
Wang, Hui-Po; Wang, Chun-Li
The concept of Pharmacovigilance Planning and Risk Minimization Planning (PVP/RMP), initiated by the International Conference on Harmonization (ICH), addressed an important conceptual change from monitoring the safety of individual medicine to proactively conducting risk prevention for the minimization of medication error. However, the implementation of PVP/RMP is a challenge in societies like Taiwan where irrational medication and co-medication is prevalent. It is even more difficult in Taiwan where two regulatory bodies are governing pharmaceutical affairs, namely Taiwan Food and Drug Administration (TFDA) in charge of Western Medicine (WM) and the Department of Chinese Medicine and Pharmacy (DCMP) in charge of Traditional Chinese Medicine (TCM). There are thus dual-tract drug approval panels, two GMP controls and two independent adverse drug event reporting systems. This rendered irrational co-medication of WM and TCM undetectable and the standard tools for monitoring pharmacovigilance inapplicable. The bilateral regulatory system is conceptually unscientific in accordance with PVP/RMP and unethical from humanity point of view. The first part of this review delivers (1) social aspects of polypharmacy in Taiwan; (2) regulatory aspects of pharmaceutical administration; (3) risks undermined in the bilateral regulatory system and (4) pharmacoepidemiology in relation to the risk of polypharmacy. As evidence-based medicine (EBM) forms the fundamental risk-benefit assessment on medication, the second part of this review delivers (1) the scientific aspects of the beauty and the odds of biological system that governs host-xenobiotics interaction; (2) conceptual evolution from product management (pharmacovigilance) to risk management (PVP/RMP); (3) non-biased due process is essential for risk-benefit assessment on medicinal products and (4) the opinion of the authors on system building for safe medication. Copyright © 2018. Published by Elsevier B.V.
Andradi-Brown, Dominic A; Grey, Rachel; Hendrix, Alicia; Hitchner, Drew; Hunt, Christina L; Gress, Erika; Madej, Konrad; Parry, Rachel L; Régnier-McKellar, Catriona; Jones, Owen P; Arteaga, María; Izaguirre, Andrea P; Rogers, Alex D; Exton, Dan A
Invasive lionfish ( Pterois volitans and P. miles ) have spread widely across the western Atlantic and are recognized as a major threat to native marine biodiversity. Although lionfish inhabit both shallow reefs and mesophotic coral ecosystems (MCEs; reefs from 30 to 150 m depth), the primary management response implemented by many countries has been diver-led culling limited to reefs less than 30 m. However, many reef fish undergo ontogenetic migrations, with the largest and therefore most fecund individuals found at greatest depths. Here, we study lionfish density, body size, maturity and dietary patterns across the depth gradient from the surface down to 85 m on heavily culled reefs around Utila, Honduras. We found lionfish at increased densities, body size and weight on MCEs compared with shallow reefs, with MCEs also containing the greatest proportion of actively spawning females, while shallow reefs contained the greatest proportion of immature lionfish. We then compared lionfish behaviour in response to divers on shallow culled and mesophotic unculled Utilan reefs, and on shallow unculled reefs in Tela Bay, on the Honduran mainland. We found that mesophotic lionfish exhibited high alert distances, consistent with individuals previously exposed to culling despite being below the depth limits of removal. In addition, when examining stomach content, we found that fish were the major component of lionfish diets across the depth gradient. Importantly, our results suggest that despite adjacent shallow culling, MCEs retain substantial lionfish populations that may be disproportionately contributing towards continued lionfish recruitment onto the shallow reefs of Utila, potentially undermining current culling-based management.
Grey, Rachel; Hendrix, Alicia; Hitchner, Drew; Gress, Erika; Madej, Konrad; Parry, Rachel L.; Régnier-McKellar, Catriona; Jones, Owen P.; Arteaga, María; Izaguirre, Andrea P.; Rogers, Alex D.; Exton, Dan A.
Invasive lionfish (Pterois volitans and P. miles) have spread widely across the western Atlantic and are recognized as a major threat to native marine biodiversity. Although lionfish inhabit both shallow reefs and mesophotic coral ecosystems (MCEs; reefs from 30 to 150 m depth), the primary management response implemented by many countries has been diver-led culling limited to reefs less than 30 m. However, many reef fish undergo ontogenetic migrations, with the largest and therefore most fecund individuals found at greatest depths. Here, we study lionfish density, body size, maturity and dietary patterns across the depth gradient from the surface down to 85 m on heavily culled reefs around Utila, Honduras. We found lionfish at increased densities, body size and weight on MCEs compared with shallow reefs, with MCEs also containing the greatest proportion of actively spawning females, while shallow reefs contained the greatest proportion of immature lionfish. We then compared lionfish behaviour in response to divers on shallow culled and mesophotic unculled Utilan reefs, and on shallow unculled reefs in Tela Bay, on the Honduran mainland. We found that mesophotic lionfish exhibited high alert distances, consistent with individuals previously exposed to culling despite being below the depth limits of removal. In addition, when examining stomach content, we found that fish were the major component of lionfish diets across the depth gradient. Importantly, our results suggest that despite adjacent shallow culling, MCEs retain substantial lionfish populations that may be disproportionately contributing towards continued lionfish recruitment onto the shallow reefs of Utila, potentially undermining current culling-based management. PMID:28573007
Schafer, K; De Santi, S; Schneider, L S
The Alzheimer's Disease Assessment Scale - cognitive subscale (ADAS-cog) is the most widely used cognitive outcome measure in AD trials. Although errors in administration and scoring have been suggested as factors masking accurate estimates and potential effects of treatments, there have been few formal examinations of errors with the ADAS-cog. We provided ADAS-cog administration training using standard methods to raters who were designated as experienced, potential raters by sponsors or contract research organizations for two clinical trials. Training included 1 hour sessions on test administration, scoring, question periods, and required that raters individually view and score a model ADAS-cog administration. Raters scores were compared to the criterion scores established for the model administration. A total of 108 errors were made by 80.6% of the 72 raters; 37.5% made 1 error, 25.0% made 2 errors and 18.0% made 3 or more. Errors were made in all ADAS-cog subsections. The most common were in word finding difficulty (67% of the raters), word recognition (22%), and orientation (22%). For the raters who made 1, 2, or ≥ 3 errors the ADAS-cog score was 17.5 (95% CI, 17.3 - 17.8), 17.8 (17.0 - 18.5), and 18.8 (17.6 - 20.0), respectively, and compared to the criterion score, 18.3. ADAS-cog means differed significantly and the variances were more than twice as large between those who made errors on word finding and those who did not, 17.6 (SD=1.4) vs. 18.8 (SD=0.9), respectively (χ(2) = 37.2, P ADAS-cog scores and clinical trials outcomes. These errors may undermine detection of medication effects by contributing both to a biased point estimate and increased variance of the outcome.
Chou, Han-Wei; Tzeng, Wen-Chii; Chou, Yu-Ching; Yeh, Hui-Wen; Chang, Hsin-An; Kao, Yu-Chen; Huang, San-Yuan; Yeh, Chin-Bin; Chiang, Wei-Shan; Tzeng, Nian-Sheng
The military is a unique occupational group and, because of this, military personnel face different kinds of stress than civilian populations. Sleep problems are an example. The purpose of this study was to investigate the relationship between sleep problems, depression level and coping strategies among military personnel. In this cross-sectional study, military personnel completed the Beck Depression Inventory, the Pittsburgh Sleep Quality Index and the Jalowiec Coping Scale. An evaluation of the test scores showed that officers had better sleep quality and fewer depressive symptoms than enlisted personnel. Military personnel with higher educational levels and less physical illness also had fewer depressive symptoms. Officers and noncommissioned officers preferred problem-focused strategies. Those with higher Beck Depression Inventory and Pittsburgh Sleep Quality Index scores and those who drank alcohol frequently preferred affective-focused strategies. Our results revealed that sleep quality, physical illness and alcohol consumption were associated with the mental health of military personnel. Treating these factors may improve the mental health of military personnel and enhance effective coping strategies. Copyright © 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
This background paper does not endorse any military action towards Syria. The document does not reflect or express any official Danish policy or a position of the University of Copenhagen or the Centre for Military Studies. The purpose of this paper is to briefly describe military capabilities...... and options in order to provide a factual background for the ongoing discussion on possible military intervention in the Syrian conflict and Denmark’s possible participation in such an intervention. The paper is primarily based on the Military Balance published by the International Institute for Strategic...
The question of surrogacy has dominated much of the European human rights agenda over the last two years, at the time writing, the Parliamentary Assembly of the Council of Europe hopes to adopt a resolution on surrogacy in the coming months. There is, however, danger in taking action at a supranational level to address the European 'surrogacy problem', without first honestly answering the question: does surrogacy undermine the human dignity and rights of the surrogate mother and child? This paper presents the case that surrogacy, by its nature, necessarily undermines the human dignity of both the woman and child born through such arrangements, and thus neither commercial nor altruistic surrogacy can ever be justified.
Bello-Utu, Cindy F; DeSocio, Janiece E
Child coping with parent military deployment and family reintegration. A systematic review of research literature was conducted to examine the effects of deployment and family reintegration on children in military families. A search of CINAHL, PubMed, Psyc-INFO, and SocINDEX databases was performed using the terms "military family," "military child," "child coping," "deployment," and "reintegration." The search was limited to publications between 2001 and 2014 to focus on the effects of Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND). Twenty-seven research reports met inclusion criteria. Three themes were extracted: A child's coping is influenced by (a) the child's age and development, (b) the mental health and coping of the non-deployed parent during deployment, and the mental health of both parents during family reintegration, and (c) the pre-existing resilience/vulnerability, cumulative risks, and resources of the child and family. © 2015 Wiley Periodicals, Inc.
Owuamalam, Chuma Kevin; Zagefka, Hanna
We investigated the effect of how one might expect one’s group to be viewed by a dominant outgroup (i.e., metastereotypes) on employability beliefs of members of disadvantaged groups. Based on the extensive literature on stereotype threat, we hypothesized that activating negative metastereotypes would undermine employability beliefs of members of disadvantaged groups, because such beliefs are likely to threaten their state self-esteem. In particular, we expected that an effect of negative met...
Full Text Available Although there have been studies that focus on the experiences of the gay and lesbian population serving in the United States military, few have focused on the experience of active duty transgender service members. Transgender individuals transgress the binary conception of gender by deviating from societal gender norms associated with assigned sex at birth. The Department of Defense has set policies and standards that reflect a binary conception of gender, with a focus on conformity. We argue that able-bodied gender variant service personnel are just as capable of serving their country as anyone else. Because of the repercussions associated with active duty transgender military personnel, our sample is small and involves nine clandestine service members and two international service members who wanted to share their stories from a different perspective. Snowball sampling was aimed at finding current active duty and reserve transgender service members. Using a combination of telephone interviews and questionnaires, data were collected from active duty transgender service personnel throughout the United States and two from international militaries that allow transgender people to serve. Data collection focused on the overall experiences of the participants along with questions regarding workplace discrimination, suggestions for policy changes, and their views about the overturn of Don’t Ask, Don’t Tell. Our findings add to a growing source of information about the transgender military experience in the U.S. armed forces and the importance of overturning discriminatory workplace policies that negatively impact transgender service members.
briefest life span of any major military equipment type - spanning not ... that country. The disadvantages of this to PLAN ... increasingly hamper the employment of heli- .... time, both attack and medium helicopters could .... balance out his armoured superiority and to im- ... derable flexibility to our operations and enhance.
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supremacy in the world. Like the foreign policies of the USSR and the USA , their military doctrines reveal the objectives they pursue: the Soviet... Gastronom or a Detskiy Mir. In- stallation of the equipment was delayed a long time as a result. The district finance service therefore did not consider
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Easterbrooks, M. Ann; Ginsburg, Kenneth; Lerner, Richard M.
In this article, the authors present their approach to understanding resilience among military connected young people, and they discuss some of the gaps in their knowledge. They begin by defining resilience, and then present a theoretical model of how young people demonstrate resilient functioning. Next they consider some of the research on…
The Ministry of Defence and the military in particular have a very strong commitment to radiation protection of personnel in war and peace. MOD endeavours to do better all the time because it is essential that the armed forces have the confidence to fulfil their role and this is best achieved by providing them with the best possible protection irrespective of the hazard. (author)
Sjøstedt, Peter; Grønlund, Thomas
The Military Instructor's handbook was written for the basic professional training of instructors in the danish defence. The book describes the work of instructors and their areas of responsibility, and it offers guidance and direction on how to plan, conduct and evaluate learning activities...
existential fear of one’s superpower rival. Nor was the Cold War the only arms race in history: naval rivalry in the late 19th and early 20th centuries...Military Review, July-August 2006; Norman Solomon, “The Bogus Blurring of Terrorism and Insurgency in Iraq,” The Humanist , Vol. 66, No. 2, March-April
Soler, Jorge H; Caldwell, Cleopatra H; Córdova, David; Harper, Gary; Bauermeister, José A
Gay and bisexual men may form chosen families in addition to or in place of families of origin. However, the characteristics of these diverse families remain largely unexamined in the quantitative literature. The purpose of this study was to develop a family typology based on responses from a racially and ethnically diverse sample of young adult gay and bisexual men (YGBM) recruited from the Detroit Metropolitan Area (N=350; 18-29 years old). To explore the role of family, we then examined family social support and social undermining in relation to YGBM psychological distress within different family types. A series of multivariate regressions were used to examine associations between family social support and social undermining with depression and anxiety outcomes. The majority (88%) of YGBM included family of origin in their definitions of family and 63% indicated having chosen families. Associations between family social processes and psychological outcomes varied by type of family, suggesting that family composition shapes how perceptions of support and undermining relate to experiencing symptoms of depression and anxiety. Chosen families play a prominent role in the lives of YGBM and should not be overlooked in family research. Findings also highlight the importance of examining co-occurring family social support and social stress processes to further address psychological distress symptoms among YGBM.
Jonsson, Linus; Larsson, Christel; Berg, Christina; Korp, Peter; Lindgren, Eva-Carin
This study aimed to illuminate factors that undermine the healthy habits of adolescents from a multicultural community with low socioeconomic status (S.E.S.) in Sweden with regard to physical activity (P.A.) and food, as stated in their own voices. Adolescents (n = 53, 12-13 y/o) were recruited from one school situated in a multicultural community characterized by low S.E.S. Embracing an interpretive approach, 10 focus-group interviews were conducted to produce data for the study. The focus-group interviews were audio recorded, transcribed verbatim, and analysed using qualitative content analysis. The analysis resulted in two major themes: (1) the availability of temptations is large, and support from the surroundings is limited; and (2) norms and demands set the agenda. The adolescents' voices illuminate a profound awareness and the magnitude of tempting screen-based activities as undermining their P.A. and healthy food habits. Moreover, several gender boundaries were highlighted as undermining girls' P.A. and healthy food habits. The adolescents' stories illuminated that it is difficult for them, within their environment, to establish healthy habits with regard to P.A. and food. To facilitate the adolescents' healthy habits, we suggest that support from family, friends, the school, and society at large is essential.
Halajová, Denisa; Petreková, Denisa; Bihuňová, Mária
The intention of this work is to highlight the importance of understanding military cemeteries as objects of cultural and historical heritage and as a part of garden design history. The design and maintenance of cemeteries and graves is a manifestation of the national culture. This is even more evident in military cemeteries, the maintenance of which is regulated by international agreements. Objects of military cemeteries are important places not only from the historical and architectural point of view, but also as green space. Most military cemeteries in Slovakia originated from World War I and II. In Slovakia, 160,000 soldiers were buried, 75,206 of them lost their lives in World War I and 93,000 in World War II. 32,495 war graves are registered by The Ministry of the Interior of the Slovak Republic - 23,316 war graves from World War I and 9,179 from World War II. From the period of World War II, there are 22 cemeteries and graveyards in Slovakia, established for soldiers of the Soviet, German, Romanian and Czechoslovak army. Military cemeteries and memorials are mostly high quality works of architecture and art. This paper focuses on the current situation and restoration issues of military cemeteries by examining the Military Cemetery in Zvolen. In the context of its planned reconstruction, a comprehensive tree assessment has been started in 2016. The Military Cemetery in Zvolen, being one of the largest military cemeteries in Slovakia, consists of The Cemetery of the Soviet Army with 17,628 buried soldiers and The Romanian Cemetery with 11,000 buried soldiers. The Romanian Cemetery is one of the largest cemeteries of the Romanian Army in Europe. Both cemeteries were declared national cultural monuments in 1963. In the cemetery, dendrometrical parameters and the health condition of trees were evaluated. In total, there are 825 woody plants. In both cemeteries, coniferous trees prevail, mainly individuals of the genus Thuja (49.4 %). Moreover, the maintenance of
REPORT TYPE 3. DATES COVERED (From- To) 10/17/2017 Abstract 4. TITLE AND SUBTITLE Sa. CONTRACT NUMBER A Shortened Stress Measure in Military...Psychology 14. ABSTRACT A Shortened Stress Measure with Military Nursing Personnel Abstract Stress is a psychological construct with important...consequences for human health. A substantial number of stress measures are available that vary in length and dimensionality. The purpose of this study was to
679–684. 39. Quevedo LA, Silva RA, Godoy R, et al. The impact of ma- ternal post - partum depression on the language development of children at 12 months...Naval Health Research Center Is Military Deployment A Risk Factor for Maternal Depression ? Stacie Nguyen Cynthia A. LeardMann Besa Smith...Sylvester Road San Diego, California 92106-3521 Original Articles Is Military Deployment a Risk Factor for Maternal Depression ? Stacie Nguyen, MPH
Alice Y. Hua
Full Text Available Behavioral variant frontotemporal dementia (bvFTD is a neurodegenerative disease characterized by profound changes in emotions and empathy. Although most patients with bvFTD become less sensitive to negative emotional cues, some patients become more sensitive to positive emotional stimuli. We investigated whether dysregulated positive emotions in bvFTD undermine empathy by making it difficult for patients to share (emotional empathy, recognize (cognitive empathy, and respond (real-world empathy to emotions in others. Fifty-one participants (26 patients with bvFTD and 25 healthy controls viewed photographs of neutral, positive, negative, and self-conscious emotional faces and then identified the emotions displayed in the photographs. We used facial electromyography to measure automatic, sub-visible activity in two facial muscles during the task: Zygomaticus major (ZM, which is active during positive emotional reactions (i.e., smiling, and Corrugator supercilii (CS, which is active during negative emotional reactions (i.e., frowning. Participants rated their baseline positive and negative emotional experience before the task, and informants rated participants' real-world empathic behavior on the Interpersonal Reactivity Index. The majority of participants also underwent structural magnetic resonance imaging. A mixed effects model found a significant diagnosis X trial interaction: patients with bvFTD showed greater ZM reactivity to neutral, negative (disgust and surprise, self-conscious (proud, and positive (happy faces than healthy controls. There was no main effect of diagnosis or diagnosis X trial interaction on CS reactivity. Compared to healthy controls, patients with bvFTD had impaired emotion recognition. Multiple regression analyses revealed that greater ZM reactivity predicted worse negative emotion recognition and worse real-world empathy. At baseline, positive emotional experience was higher in bvFTD than healthy controls and also
Christopherson, Gregory T; Nesti, Leon J
There are many similarities between health issues affecting military and civilian patient populations, with the exception of the relatively small but vital segment of active soldiers who experience high-energy blast injuries during combat. A rising incidence of major injuries from explosive devices in recent campaigns has further complicated treatment and recovery, highlighting the need for tissue regenerative options and intensifying interest in the possible role of stem cells for military medicine. In this review we outline the array of tissue-specific injuries typically seen in modern combat - as well as address a few complications unique to soldiers--and discuss the state of current stem cell research in addressing each area. Embryonic, induced-pluripotent and adult stem cell sources are defined, along with advantages and disadvantages unique to each cell type. More detailed stem cell sources are described in the context of each tissue of interest, including neural, cardiopulmonary, musculoskeletal and sensory tissues, with brief discussion of their potential role in regenerative medicine moving forward. Additional commentary is given to military stem cell applications aside from regenerative medicine, such as blood pharming, immunomodulation and drug screening, with an overview of stem cell banking and the unique opportunity provided by the military and civilian overlap of stem cell research.