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1.
JAMA Netw Open ; 3(1): e1919935, 2020 Jan 03.
Artículo en Inglés | MEDLINE | ID: mdl-31995212

RESUMEN

Importance: Understanding suicide ideation (SI) during combat deployment can inform prevention and treatment during and after deployment. Objective: To examine associations of sociodemographic characteristics, lifetime and past-year stressors, and mental disorders with 30-day SI among a representative sample of US Army soldiers deployed in Afghanistan. Design, Setting, and Participants: In this survey study, soldiers deployed to Afghanistan completed self-administered questionnaires in July 2012. The sample was weighted to represent all 87 032 soldiers serving in Afghanistan. Prevalence of lifetime, past-year, and 30-day SI and mental disorders was determined. Logistic regression analyses examined risk factors associated with SI. Data analyses for this study were conducted between August 2018 and August 2019. Main Outcomes and Measures: Suicide ideation, lifetime and 12-month stressors, and mental disorders were assessed with questionnaires. Administrative records identified sociodemographic characteristics and suicide attempts. Results: A total of 3957 soldiers (3473 [weighted 87.5%] male; 2135 [weighted 52.6%] aged ≤29 years) completed self-administered questionnaires during their deployment in Afghanistan. Lifetime, past-year, and 30-day SI prevalence estimates were 11.7%, 3.0%, and 1.9%, respectively. Among soldiers with SI, 44.2% had major depressive disorder (MDD) and 19.3% had posttraumatic stress disorder in the past 30-day period. A series of analyses of the 23 grouped variables potentially associated with SI resulted in a final model of sex; race/ethnicity; lifetime noncombat trauma; past 12-month relationship problems, legal problems, and death or illness of a friend or family member; and MDD. In this final multivariable model, white race/ethnicity (odds ratio [OR], 3.1 [95% CI, 1.8-5.1]), lifetime noncombat trauma (OR, 2.1 [95% CI, 1.1-4.0]), and MDD (past 30 days: OR, 31.8 [95% CI, 15.0-67.7]; before past 30 days: OR, 4.9 [95% CI, 2.5-9.6]) were associated with SI. Among the 85 soldiers with past 30-day SI, from survey administration through 12 months after returning from deployment, 6% (5 participants) had a documented suicide attempt vs 0.14% (6 participants) of the 3872 soldiers without SI. Conclusions and Relevance: This study suggests that major depressive disorder and noncombat trauma are important factors in identifying SI risk during combat deployment.


Asunto(s)
Personal Militar/psicología , Trastornos por Estrés Postraumático/psicología , Ideación Suicida , Suicidio/psicología , Adaptación Psicológica , Adulto , Campaña Afgana 2001- , Factores de Edad , Femenino , Humanos , Masculino , Personal Militar/estadística & datos numéricos , Resiliencia Psicológica , Medición de Riesgo/estadística & datos numéricos , Factores de Riesgo , Trastornos por Estrés Postraumático/epidemiología , Suicidio/estadística & datos numéricos , Adulto Joven
2.
J Music Ther ; 56(4): 315-347, 2019 Nov 19.
Artículo en Inglés | MEDLINE | ID: mdl-31696919

RESUMEN

Music therapy treatment is increasingly being used to promote health, enhance quality of life, and improve functioning in military personnel, but evidence on the use of music interventions with military service members is still emerging. The purpose of this scoping review was to synthesize the available literature regarding music therapy treatment with military personnel by identifying the types of information available, key characteristics, and gaps in the knowledge base. The review was completed using the methodological framework proposed by Arksey and O'Malley. A total of 27 publications met the criteria for review. The results included anecdotal reports, white papers/ briefs, case studies, historical reviews, clinical program descriptions, and research studies. Both active duty and veteran service members were represented in the literature, and post-traumatic stress disorder and traumatic brain injury were the most commonly listed conditions among those served. Music therapy services were offered in both group and individual formats, and drumming was the most common music intervention cited. Most publications accurately represented music therapy, and the historical reviews highlighted the connection between the development of the field of music therapy and the use of music with military personnel. Several gaps were identified, including a lack of specificity in reporting, low levels of evidence, and limited inclusion of women service members.


Asunto(s)
Personal Militar/psicología , Musicoterapia , Calidad de Vida , Trastornos por Estrés Postraumático/terapia , Femenino , Humanos
3.
BMC Public Health ; 19(1): 1517, 2019 Nov 12.
Artículo en Inglés | MEDLINE | ID: mdl-31718613

RESUMEN

BACKGROUND: The health and well-being of military spouses directly contribute to a robust military force by enabling the spouse to better support the active duty member's career. In order to understand the overall health and well-being of military spouses, we assessed health indicators among military spouses using the Healthy People 2020 framework and examined associations of these health indicators with military experiences and psychosocial factors. METHODS: Using data from the Millennium Cohort Family Study, a U.S. Department of Defense-sponsored survey of 9872 spouses of service members with 2-5 years of military service, we examined attainment of Healthy People 2020 goals for spouses and service members, including healthy weight, exercise, sleep, and alcohol and tobacco use. Multivariable logistic regression models assessed associations of spouse health indicators with stressful military life experiences and social support, adjusting for demographics and military descriptors. The spousal survey was administered nationwide in 2011. RESULTS: The majority of military spouses met each health goal assessed. However, less than half met the healthy weight and the strength training goals. Reporting greater perceived family support from the military was associated with better behavioral health outcomes, while having no one to turn to for support was associated with poorer outcomes. Using the Healthy People 2020 objectives as a framework for identifying key health behaviors and benchmarks, this study identified factors, including military-specific experiences, that may contribute to physical health behaviors and outcomes among military spouses. With respect to demographic characteristics, the findings are consistent with other literature that women are more likely to refrain from risky substance use and that greater education is associated with better overall health outcomes. CONCLUSIONS: Findings suggest that enhanced social and military support and tailored programming for military spouses may improve health outcomes and contribute to the well-being of military couples. Such programming could also bolster force readiness and retention.


Asunto(s)
Conductas Relacionadas con la Salud , Estado de Salud , Estilo de Vida , Personal Militar , Apoyo Social , Esposos , Adolescente , Adulto , Peso Corporal , Estudios de Cohortes , Escolaridad , Composición Familiar , Femenino , Humanos , Modelos Logísticos , Masculino , Personal Militar/psicología , Proyectos de Investigación , Entrenamiento de Resistencia , Factores Sexuales , Esposos/psicología , Trastornos Relacionados con Sustancias , Encuestas y Cuestionarios , Estados Unidos , Adulto Joven
4.
BMC Public Health ; 19(1): 1394, 2019 Oct 28.
Artículo en Inglés | MEDLINE | ID: mdl-31660935

RESUMEN

BACKGROUND: Alcohol misuse is an important contributor to sexual acquisition and transmission of HIV in military communities. This cross-sectional study quantified the prevalence of probable problematic alcohol use among male service members in the Armed Forces of the Democratic Republic of the Congo (FARDC), identified associated factors, and investigated associations of alcohol misuse with risky sexual behaviors. METHODS: Participants included 2549 active duty male soldiers ≥ 18 years old. Data were collected via computer-assisted personal-interview from October 2013-April 2014. The Alcohol Use Disorders Identification Test (AUDIT) was used to identify probable problematic alcohol use (AUDIT score ≥ 8) compared to no/low-risk alcohol use (AUDIT score ≤ 7). Bivariate logistic regressions were used to identify factors associated with probable problematic alcohol use. Several multivariable logistic regressions (adjusted for age, marital status, education level) were used to examine associations of probable problematic alcohol use with risky sexual behaviors. Tests were two sided; statistical significance was defined as p < 0.05. RESULTS: Fifteen percent of men screened positive for probable problematic alcohol use. The odds of probable problematic alcohol use were elevated among men who were single and living with a partner (OR = 1.66; 95% CI = 1.24-2.21), ranked as a non-commissioned officer [NCO] (OR = 1.40; 95% CI = 1.10-1.77), and in the 30-39 and 40-49 age groups (OR 30-39 age group = 2.17; 95% CI = 1.56-3.02; OR 40-49 age group = 1.79; 95% CI = 1.26-2.55). Probable problematic alcohol use was associated with increased odds of having sex with a sex worker (SW), having multiple sexual partners, and participating in transactional sex (aOR sex with a SW = 2.36; 95% CI = 1.78-3.13; aOR multiple sexual partners = 2.08; 95% CI = 1.66-2.60; aOR transactional sex = 1.99; 95% CI = 1.59-2.50). CONCLUSIONS: Results emphasize the need to address alcohol use in the FARDC and integrate alcohol abuse education into HIV prevention programs among male service members. Alcohol abuse prevention efforts should target men who are 30-49 years of age, unmarried, and ranked as a NCO. Messages and interventions to reduce alcohol misuse in relation to risky sexual behaviors are needed.


Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Personal Militar/psicología , Asunción de Riesgos , Conducta Sexual/psicología , Adolescente , Adulto , Estudios Transversales , República Democrática del Congo/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Personal Militar/estadística & datos numéricos , Prevalencia , Adulto Joven
5.
BMC Womens Health ; 19(1): 119, 2019 10 17.
Artículo en Inglés | MEDLINE | ID: mdl-31623632

RESUMEN

BACKGROUND: Substantial research has found that women assess their health as poor relative to men, but the reasons for this are not fully understood. Military women are characterised by good health and the ability to work in an archetypically male culture. Thus, studies on the gender pattern of self-reported health in military personnel could generate hypotheses for future research on the possible associations between gender and health. However, such studies are rare and limited to a few countries. The aim of this study was to examine self-reported physical and mental health in Norwegian military women. METHODS: We compared responses on self-reported health of 1068 active duty military women in Norway to those of active duty military men (n = 8100). Further, we compared the military women to civilian women working in the Norwegian Armed Forces (n = 1081). Participants were stratified into three age groups: 20-29; 30-39; and 40-60 years. We used Pearson Chi-square tests, Students t-tests and regression models to assess differences between the groups. RESULTS: The military women in our study reported physical illness and injuries equal to those of military men, but more military women used pain relieving and psychotropic drugs. More military women aged 20-29 and 30-39 years reported mental health issues than military men of the same age. In the age group 30-39 years, twice as many military women assessed their health as poor compared to military men. In the age group 40-60 years, more military women than men reported musculoskeletal pain. Military women used less smokeless tobacco than military men, but there were few differences in alcohol consumption and smoking. Military women appeared to be more physically healthy than civilian women, but we found few differences in mental health between these two groups. CONCLUSION: Most military women reported physical symptoms equal to those of military men, but there were differences between the genders in mental health and drug use. More favourable health compared to civilian women was most evident in the youngest age group and did not apply to mental health.


Asunto(s)
Autoevaluación Diagnóstica , Personal Militar/psicología , Grupos de Población/psicología , Factores Sexuales , Adulto , Distribución de Chi-Cuadrado , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Noruega , Análisis de Regresión , Autoinforme , Adulto Joven
6.
J Consult Clin Psychol ; 87(11): 1019-1029, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31556650

RESUMEN

OBJECTIVE: We evaluated patterns and predictors of change from three efficacy trials of trauma-focused cognitive-behavioral treatments (TF-CBT) among service members (N = 702; mean age = 32.88; 89.4% male; 79.8% non-Hispanic/Latino). Rates of clinically significant change were also compared with other trials. METHOD: The trials were conducted in the same setting with identical measures. The primary outcome was symptom severity scores on the PTSD Symptom Scale-Interview Version (PSS-I; Foa, Riggs, Dancu, & Rothbaum, 1993). RESULTS: Symptom change was best explained by baseline scores and individual slopes. TF-CBT was not associated with better slope change relative to Present-Centered Therapy, a comparison arm in 2 trials. Lower baseline scores (ß = .33, p < .01) and higher ratings of treatment credibility (ß = -.22, p < .01) and expectancy for change (ß = -.16, p < .01) were associated with greater symptom change. Older service members also responded less well to treatment (ß = .09, p < .05). Based on the Jacobson and Truax (1991) metric for clinically significant change, 31% of trial participants either recovered or improved. CONCLUSIONS: Clinicians should individually tailor treatment for service members with high baseline symptoms, older patients, and those with low levels of credibility and expectancy for change. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Asunto(s)
Conflictos Armados/psicología , Terapia Cognitivo-Conductual/métodos , Personal Militar/psicología , Trastornos por Estrés Postraumático/psicología , Trastornos por Estrés Postraumático/terapia , Adulto , Femenino , Humanos , Masculino , Resultado del Tratamiento , Adulto Joven
7.
Georgian Med News ; (292-293): 108-112, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31560674

RESUMEN

The article reviews the theoretical and methodological basis of specialized assistance to participants in military actions. The essence of specialized assistance and its features in conditions of geopolitical conflicts reveal it to be a social phenomenon and a system of medical support in our country and in world practice. The state of specialized assistance to participants of an antiterrorist operation and members of their families were investigated, as well as the peculiarities of practical actions to ensure it with institutions of different levels. Some features of state regulation of the processes of social rehabilitation and re-socialization of combatants were analysed.


Asunto(s)
Prestación de Atención de Salud , Personal Militar/psicología , Política , Guerra , Humanos , Apoyo Social
8.
J Bone Joint Surg Am ; 101(16): 1470-1478, 2019 Aug 21.
Artículo en Inglés | MEDLINE | ID: mdl-31436655

RESUMEN

BACKGROUND: Severe upper-extremity injuries account for almost one-half of all extremity trauma in recent conflicts in the Global War on Terror. Few long-term outcomes studies address severe combat-related upper-extremity injuries. This study's objective was to describe long-term functional outcomes of amputation compared with those of limb salvage in Global War on Terror veterans who sustained severe upper-extremity injuries. Limb salvage was hypothesized to result in better arm and hand function scores, overall functional status, and quality of life, with similar pain interference. METHODS: This retrospective cohort study utilized data from the Military Extremity Trauma Amputation/Limb Salvage (METALS) study for a subset of 155 individuals who sustained major upper-extremity injuries treated with amputation or limb salvage. Participants were interviewed by telephone 40 months after injury, assessing social support, personal habits, and patient-reported outcome instruments for function, activity, depression, pain, and posttraumatic stress. Outcomes were evaluated for participants with severe upper-extremity injuries and were compared with participants with concomitant severe, lower-extremity injury. The analysis of outcomes comparing limb salvage with amputation was restricted to the 137 participants with a unilateral upper-extremity injury because of the small number of patients with bilateral upper-extremity injuries (n = 18). RESULTS: Overall, participants with upper-extremity injuries reported moderate to high levels of physical and psychosocial disability. Short Musculoskeletal Function Assessment (SMFA) scores were high across domains; 19.4% screened positive for posttraumatic stress disorder (PTSD), and 12.3% were positive for depression. Nonetheless, 63.6% of participants were working, were on active duty, or were attending school, and 38.7% of participants were involved in vigorous recreational activities. No significant differences in outcomes were observed between patients who underwent limb salvage and those who underwent amputation. CONCLUSIONS: Severe, combat-related upper-extremity injuries result in diminished self-reported function and psychosocial health. Our results suggest that long-term outcomes are equivalent for those treated with amputation or limb salvage. Addressing or preventing PTSD, depression, chronic pain, and associated health habits may result in less disability burden in this population. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.


Asunto(s)
Amputación/métodos , Traumatismos del Brazo/cirugía , Recuperación del Miembro/métodos , Personal Militar/estadística & datos numéricos , Trastornos por Estrés Postraumático/epidemiología , Adulto , Amputación/psicología , Traumatismos del Brazo/diagnóstico , Traumatismos del Brazo/rehabilitación , Miembros Artificiales , Estudios de Cohortes , Evaluación de la Discapacidad , Femenino , Estudios de Seguimiento , Humanos , Puntaje de Gravedad del Traumatismo , Guerra de Irak 2003-2011 , Recuperación del Miembro/psicología , Masculino , Personal Militar/psicología , Medición de Resultados Informados por el Paciente , Implantación de Prótesis/métodos , Estudios Retrospectivos , Medición de Riesgo , Trastornos por Estrés Postraumático/diagnóstico , Factores de Tiempo , Resultado del Tratamiento , Adulto Joven
9.
Sleep Health ; 5(6): 651-657, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31377248

RESUMEN

OBJECTIVES: The current study sought to characterize the sleep problems of soldiers entering Basic Combat Training and to identify the link between sleep problems and subsequent performance, psychological distress, anger reactions, and attention. DESIGN: Soldiers were surveyed at 4 time points throughout the standard 10 weeks of Basic Combat Training. Surveys were administered at weeks 1, 3, 6, and 9. Sleep problems were identified as either present or absent at each time point using a sleep problem screening questionnaire. Four sleep patterns were identified and then used to evaluate outcomes throughout training (n = 1577). RESULTS: When compared to those who never had a sleep problem ("healthy "; 60.6%), those who recovered from their initial sleep problem ("recovered"; 12.8%) started training with higher psychological distress and anger reactions and lower attention but steadily improved throughout training. Those who developed a sleep problem during training ("new onset"; 20.0%) and those who had a sleep problem throughout training ("chronic"; 6.6%) also started off significantly worse than the healthy group. The new-onset and chronic groups saw slower psychological distress improvement and a decline in attention throughout the course compared to the healthy group. The chronic group also significantly increased their anger reactions throughout training compared to the healthy group. CONCLUSION: Sleep problems during Basic Combat Training may be an indicator for difficulties managing entry into the military. These findings highlight the importance of improving sleep health for soldiers throughout Basic Combat Training and for others with similar training in high-risk occupations.


Asunto(s)
Personal Militar/educación , Personal Militar/psicología , Rendimiento Físico Funcional , Trastornos del Sueño-Vigilia/psicología , Enseñanza , Adolescente , Adulto , Ira , Atención/fisiología , Femenino , Humanos , Masculino , Personal Militar/estadística & datos numéricos , Medición de Riesgo , Trastornos del Sueño-Vigilia/epidemiología , Encuestas y Cuestionarios , Adulto Joven
10.
Psicothema (Oviedo) ; 31(3): 277-283, ago. 2019. tab, graf
Artículo en Inglés | IBECS | ID: ibc-185354

RESUMEN

Background: Worker wellbeing is known to positively impact both the employer organization and the employee. However, the hardship inherent to military life may hinder the achievement of satisfactory levels of worker wellbeing. In this study we aim to address whether psychological capital, work satisfaction and health self-perception are able to predict psychological wellbeing in a military population. Method: A descriptive, correlational study was performed using a cohort of 492 Spanish soldiers by applying multiple linear regression. The resulting regression array between the variables psychological capital, work satisfaction and health self-perception was used to predict psychological wellbeing. Results: A positive, significative correlation was detected between the variables psychological capital, work satisfaction and health self-perception and psychological wellbeing, altogether explaining up to 53% of the variance of the latter. The most important predictor was psychological capital, responsible for 80% of the predictive power. Conclusions: Due to the significant predictive power of psychological capital over individuals’ wellbeing, the development of programs aimed at enhancing psychological capital may have a positive outcome on military personnel’s psychological wellbeing


Antecedentes: uno de los objetivos de las organizaciones es el bienestar de su personal por los beneficios que conlleva para sí mismas y para sus trabajadores. Sin embargo, las condiciones propias de la vida castrense pueden dificultar esta meta. Este estudio pretende conocer si el capital psicológico, la satisfacción laboral y la percepción de salud pueden predecir el bienestar psicológico del personal militar. Método: se desarrolló un estudio descriptivo correlacional en una muestra de 492 militares españoles. Se aplicó una regresión lineal múltiple, utilizándose las variables capital psicológico, satisfacción laboral y autopercepción de la salud para predecir el bienestar psicológico. Resultados: se constata una relación positiva y significativa entre bienestar psicológico, capital psicológico, satisfacción laboral y salud general percibida, teniendo estas tres últimas un poder predictivo del cambio sobre el bienestar del 53%, el 80% del cual corresponde al capital psicológico. Conclusiones: debido al importante poder predictivo del capital psicológico en el bienestar de las personas, el desarrollo de programas dirigidos a mejorar el capital psicológico puede tener un resultado positivo en el bienestar psicológico del personal militar


Asunto(s)
Humanos , Masculino , Femenino , Adulto Joven , Adulto , Persona de Mediana Edad , Actitud , Autoevaluación Diagnóstica , Satisfacción en el Trabajo , Personal Militar/psicología , Medicina Militar , Salud Mental , España
11.
Psicothema ; 31(3): 277-283, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31292042

RESUMEN

BACKGROUND: Worker wellbeing is known to positively impact both the employer organization and the employee. However, the hardship inherent to military life may hinder the achievement of satisfactory levels of worker wellbeing. In this study we aim to address whether psychological capital, work satisfaction and health self-perception are able to predict psychological wellbeing in a military population. METHOD: A descriptive, correlational study was performed using a cohort of 492 Spanish soldiers by applying multiple linear regression. The resulting regression array between the variables psychological capital, work satisfaction and health self-perception was used to predict psychological wellbeing. RESULTS: A positive, significative correlation was detected between the variables psychological capital, work satisfaction and health self-perception and psychological wellbeing, altogether explaining up to 53% of the variance of the latter. The most important predictor was psychological capital, responsible for 80% of the predictive power. CONCLUSIONS: Due to the significant predictive power of psychological capital over individuals’ wellbeing, the development of programs aimed at enhancing psychological capital may have a positive outcome on military personnel’s psychological wellbeing.


Asunto(s)
Actitud , Autoevaluación Diagnóstica , Satisfacción en el Trabajo , Personal Militar/psicología , Adulto , Femenino , Humanos , Masculino , Salud Mental , Persona de Mediana Edad , España , Adulto Joven
13.
Z Kinder Jugendpsychiatr Psychother ; 47(6): 503-526, 2019 Nov.
Artículo en Alemán | MEDLINE | ID: mdl-31269864

RESUMEN

Intervention programs for psychological stress in children of military personnel in the USA - Results of a systematic literature review with regard to transferability to Germany Abstract. Military personnel who have been deployed in war zones or other unstable regions are at an increased risk to develop mental health disorders, including posttraumatic stress disorder. Likewise, their children are at high risk to develop mental health problems as well as emotional and behavioral difficulties. Most research on prevalence of mental health problems as well as on interventions within this group was conducted in the USA. In Germany, no systematic intervention for children of military members focusing on their experiences of deployment exist. The systematic literature review aimed to analyze existing intervention programs in the USA, in particular for children of military members regarding evidence, type and addressed target group (parents, children, both). Compared to the social welfare and health care systems in the USA, the German systems are different. Hence, a second aim was to examine the transferability of these programs to the specific needs of children of German military members (Bundeswehr). 27 intervention programs could be included in the review. Programs, directly or indirectly, are addressing the needs of children of a deployed parent. They are usually focusing on the "emotional cycle of deployment" (phase of preparation of deployment, separation phase of deployment and the return of the deployed parent). The programs mainly focused on parenting skills, family reactions to stress, coping strategies of families, and the feeling of coherence within the family. Only 20 % of the interventions could be assigned to the type of indicated prevention. Nine interventions have shown positive effects (either in RCT or non-experimental designs). Several elements of the programs are transferable to the German situation of children of military members. In particular, contents which address the specific situation of families with a military member are desperately needed in Germany. Transferability is limited by the non-comparability of health care and social welfare systems in the USA and in Germany.


Asunto(s)
Personal Militar , Padres , Estrés Psicológico/prevención & control , Estrés Psicológico/psicología , Adaptación Psicológica , Niño , Prestación de Atención de Salud/organización & administración , Alemania , Humanos , Personal Militar/psicología , Padres/psicología , Bienestar Social , Estados Unidos
14.
Appl Ergon ; 80: 17-27, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31280802

RESUMEN

Wearable Augmented Reality Displays (WARDs) present situated, real-time information visually, providing immediate access to information to support decision making. The impacts of WARD use on operator performance, Situation Awareness (SA), and communication in one safety-critical system, marine transportation, were examined in a real-time physical simulator. WARD use improved operator trackkeeping performance, the practice of good seamanship, and SA, although operator responsiveness decreased. WARD users who used more closed-loop communication and information sharing showed improved threat avoidance, suggesting that operators can avoid accidents and failure through WARD use that promotes sharing and confirming information. WARD use also promoted information source diversity, a means of developing requisite variety. These operational impacts are important in safety-critical settings where failures can be catastrophic.


Asunto(s)
Realidad Aumentada , Concienciación , Comunicación , Análisis y Desempeño de Tareas , Dispositivos Electrónicos Vestibles/psicología , Adulto , Toma de Decisiones , Femenino , Humanos , Masculino , Personal Militar/psicología , Navíos , Interfaz Usuario-Computador
16.
Biomed Res Int ; 2019: 7589275, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31263708

RESUMEN

Objective: To investigate the mediation effect of approach/avoidance motivation between hardiness and depressive symptoms. Methods: Cross-sectional design was utilized. Two independent samples of military servicemen (G1: military personnel in the Armed Forces; G2: Chinese army military cadets) (n1 = 98, n2 =140) were sampled and investigated. The assessment tools of hardiness scale (DRS), behavioral activation and inhibition scales (BAS/BIS), and Center for Epidemiological Survey-Depression Scale (CES-D)/Beck Depression Inventory (BDI) were used. General linear model was conducted to examine the predictive role of hardiness (DRS) and motivation (BAS/BIS) on depressive symptoms (CES-D or BDI). The mediating role of BAS/BIS between hardiness and depressive symptoms was examined. Results: (1) Across army soldiers and military medical university cadets, hardiness (ß=-0.394, P<0.001) and behavioral inhibition (ß=0.297, P<0.001) significantly predicted depressive symptoms. (2) For soldiers only, behavioral inhibition mediated the significant association between hardiness and depressive symptoms (ß=-0.043, SE=0.027, 95%CI=-0.130~-0.008). (3) For cadets only, behavioral activation-Drive significantly predicted depressive symptoms (ß=-0.237, P=0.012), and hardiness operates through behavioral activation-Drive to influence depressive symptoms (ß=-0.057, SE=0.036, 95%CI=-0.151~-0.078). Conclusion: Individuals who are low in hardiness and behavioral activation-Drive and who are high in behavioral inhibition showed more severe depressive symptoms. The relationship between hardiness and depressive symptoms was mediated by behavioral activation-Drive in cadets and behavioral inhibition in soldiers. The proposed model offers a useful approach for the development of hardiness training programs to alter approach/avoidance motivation in the military context. Future training program of hardiness could lay more emphasis on promotion of perseverance in pursuing goals in hardy individuals, which may in turn improve active coping.


Asunto(s)
Depresión/psicología , Personal Militar/psicología , Motivación , Resiliencia Psicológica , Adolescente , Adulto , Reacción de Prevención , Femenino , Humanos , Masculino , Adulto Joven
17.
NeuroRehabilitation ; 44(4): 511-521, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31256090

RESUMEN

BACKGROUND: Many with a history of mild traumatic brain injury (TBI) experience sleep problems, which are also common symptoms of stress-related and mood disorders. OBJECTIVE: To determine if sleep problems contributed unique variance to post-concussive symptoms above and beyond symptoms of posttraumatic stress disorder/major depressive disorder (PTSD/MDD) after mild TBI. METHODS: 313 active duty service members with a history of mild TBI completed sleep, PTSD, and mood symptom questionnaires, which were used to determine contributions to the Neurobehavioral Symptom Inventory. RESULTS: 59% of the variance in post-concussive symptoms were due to PTSD symptom severity while depressive symptoms and sleep problems contributed an additional 1% each. This pattern differed between those with and without clinical diagnosis of PTSD/MDD. For those with PTSD/MDD, PTSD and depression symptoms but not sleep contributed to post-concussive symptoms. For those without PTSD/MDD, PTSD symptoms and sleep contributed specifically to somatosensory post-concussive symptoms. Daytime dysfunction and sleep disturbances were associated with post-concussive symptoms after PTSD and depression symptoms were controlled. CONCLUSIONS: PTSD symptom severity explained the most variance for post-concussive symptoms among service members with a history of mild TBI, while depression symptoms, daytime dysfunction, and sleep disturbances independently contributed small amounts of variance.


Asunto(s)
Conmoción Encefálica/psicología , Trastorno Depresivo Mayor , Personal Militar/psicología , Síndrome Posconmocional/psicología , Trastornos del Sueño-Vigilia/psicología , Trastornos por Estrés Postraumático , Adulto , Conmoción Encefálica/diagnóstico , Conmoción Encefálica/epidemiología , Femenino , Humanos , Masculino , Síndrome Posconmocional/diagnóstico , Síndrome Posconmocional/epidemiología , Autoinforme , Sueño/fisiología , Trastornos del Sueño-Vigilia/diagnóstico , Trastornos del Sueño-Vigilia/epidemiología , Encuestas y Cuestionarios
18.
BMC Public Health ; 19(1): 855, 2019 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-31262273

RESUMEN

BACKGROUND: According to internal observations within a German shipping company, obvious risk-behaviour persists among the crew members coming from the Pacific Island State of Kiribati and representing a large part of the crew aboard merchant vessels of this company. These observations were related to excessive eating habits. This study aims to assess the cardiovascular risk among seafarers and to compare lifestyle factors between Kiribati and European crew members. METHODS: In the present maritime field study 81 sailors (48 Kiribati, 33 European, average age at 38.9 and 36.8 years respectively) were examined from April until August 2014 aboard four container ships crossing the Atlantic Ocean (participation rate of 90.9%). RESULTS: Based on the number of established risk factors, 35.4% of the Kiribati and 16.7% of the European crew members were regarded as a high risk group for cardiovascular diseases. The HDL-values of Kiribati were found to be considerably lower (34.9 mg/dl) than the references values given by the WHO and in comparison to the European crew members (44.8 mg/dl) (p = 0.002). 91.7% of Kiribati and 51.5% of European participants were found to be overweight according to WHO-criteria - with a mean Body Mass Index (BMI) of 30.3 kg/m2 and 25.6 kg/m2 (p <  0.001). Regarding lifestyle factors Kiribati often claimed to eat significantly larger amounts of food aboard while most European sailors stated to eat less or about the same during their shipboard stay (p = 0.017). Daily sleeping hours were slight on both sides; however with a mean of 5.2 h a day Kiribati crew members had significant fewer sleep (p = 0.038). The examined Kiribati sailors had a mean increase in weight of 6 kg over a 12 months period of observation. CONCLUSIONS: In total the compiled data points towards a higher risk of cardiovascular diseases particularly due to alimentary habits within the Kiribati crew members. The distinct weight-gain measured among the Kiribati in spite of higher energy consumption levels at sea is alarming. Thus, the results of this study confirm the necessity of health-improving interventions aboard cargo vessels.


Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Estilo de Vida , Personal Militar/psicología , Adulto , Europa (Continente)/epidemiología , Humanos , Masculino , Micronesia/epidemiología , Persona de Mediana Edad , Personal Militar/estadística & datos numéricos , Proyectos Piloto , Prevalencia , Factores de Riesgo , Adulto Joven
19.
Med Care ; 57(7): 536-543, 2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-31194701

RESUMEN

OBJECTIVE: To examine factors associated with HIV screening among women veterans receiving health care in the Department of Veterans Affairs. MATERIALS AND METHODS: Cross-sectional study of women veterans receiving Veterans Affairs care between 2001 and 2014 derived from the Women Veteran's Cohort Study. Descriptive and bivariate statistics were calculated comparing patients with and without an HIV screen. Generalized estimating equations were conducted to estimate the odds of HIV screening among women screened for military sexual trauma (MST) and the subset with a positive MST screen. Multivariable analyses were adjusted for demographic characteristics, mental health diagnoses, pregnancy, HIV risk factors, and facility level clustering. RESULTS: Among the 113,796 women veterans in the sample, 84.3% were screened for MST and 13.2% were screened for HIV. Women screened for MST were over twice as likely to be tested for HIV (odds ratio, 2.8; 95% confidence interval, 2.2-3.5). A history of MST was inversely associated with HIV screening (odds ratio, 0.9; 95% confidence interval, 0.8-0.9). CONCLUSIONS: Women veterans screened for sexual trauma received more comprehensive preventive health care in the form of increased HIV screening.


Asunto(s)
Infecciones por VIH/diagnóstico , Tamizaje Masivo , Personal Militar/psicología , Delitos Sexuales , Veteranos/psicología , Adulto , Estudios Transversales , Femenino , Humanos , Estudios Longitudinales , Estados Unidos , United States Department of Veterans Affairs
20.
Adapt Phys Activ Q ; 36(3): 378-387, 2019 Jun 27.
Artículo en Inglés | MEDLINE | ID: mdl-31167541

RESUMEN

Participation in physical activity has been shown to improve components of psychological well-being (i.e., affect). Programs such as the Warrior Games have been designed to promote physical activity in wounded military personnel. However, sport competition typically yields a winner and a loser (i.e., game outcome). The experience of a win or a loss may affect how wounded athletes respond to game outcome. Therefore, the purpose of this study was to investigate the affective changes (positive affect, negative affect, tranquility, and fatigue) according to game outcome in a sample of wounded military wheelchair basketball players participating in a weekend tournament. The results indicated that the participants who experienced a win reported significantly higher positive affect and tranquility and significantly lower negative affect than those experiencing a loss. These findings have important implications for wounded veteran athletes, as well as coaches and administrative personnel.


Asunto(s)
Rendimiento Atlético , Baloncesto , Personal Militar/psicología , Silla de Ruedas , Adulto , Femenino , Humanos , Masculino , Satisfacción Personal , Encuestas y Cuestionarios , Adulto Joven
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