Psychophysiological support for the professional activities of servicemen

Optimal solution of the personnel replenishment problem, the necessity of training and education process improvement in the training centers and schools, the outcome of social, psychological and medical measures greatly depend on the overall physical and mental health state of the servicemen and their professional training quality. On the basis of their long standing experience the authors discuss the traits of the psychophysiological maintenance of the military professional activities of servicemen, in particular--the methodology and theory of professional psychological selection, the importance of body functional indications for the estimation of the fighting capabilities of military units. They examine some prospects for the psychophysiological expertise in the promotion procedures of commanding officers and make a suggestion that psychophysiological maintenance in the Armed Forces would increase its combat capabilities and help to avoid some negative effects in military groups.     

Cystic tumours of the pancreas: a diagnostic dilemma

Pulsatile lavage is an effective means of irrigation for grossly contaminated wounds. Pulse lavage was first used by oral surgeons in the U.S. Army during the war in Vietnam, and U.S. military investigators pioneered its early development and scientifically validated its efficacy. Modern pulse lavage units are ideally suited for military use because they enable first- and second-echelon medical personnel (including nonphysicians) to rapidly and effectively decontaminate combat wounds with minimal logistic burden. Pulse lavage units should become standard issue in all combat medical supply canisters or Authorized Medical Allowance blocks, and medical personnel should be trained in their use.     

Viral hepatitis in the US Air Force, 1980-1989

Viral hepatitis and its acute and chronic complications continue to pose significant threats to the readiness of military personnel. Knowledge about the specific viral agents and their routes of transmission are important in developing prevention strategies. A recent analysis of hepatitis in the US Navy for the period 1975-1984 is reviewed. In order to better characterize the risk of viral hepatitis among US Air Force personnel, a comprehensive review of inpatient and quarters data for hepatitis A, B and 'non-A, non-B' were reviewed from Air Force medical treatment facilities worldwide for the period 1980-1989. Following a discussion of the study methodology, preliminary data and hepatitis type-specific demographic risk variables are discussed. Preliminary results from a hepatitis serosurvey (A, B and C antibody with use of a supplemental validating assay) of the subset of the study cohort who are currently on active duty are briefly reviewed.     

Contributions of Canadian psychologists to the war effort, 1939–1945.

Reviews one component of Canada's World War II enterprise, applied psychology. Psychologists' main interest was in the efficient use of manpower through personnel selection and classification, although near the end of the war they became involved with discharge counseling as well. Whereas some psychologists were research- and measurement-oriented, others took a humanistic-clinical approach. Therefore, each of the military services acquired a distinctive "psychological style." Psychology also made substantial contributions in the areas of military and civilian morale. (French abstract) (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Satisfaction of active duty U.S. service members with military dental care

This study explores what factors influence whether active duty U.S. military personnel enroll their families in Department of Defense (DoD) or non-DoD dental insurance plans. The data come from a 26-site, cross-sectional survey of U.S. service members conducted from April 1994 to January 1995. A prestratified, randomly selected target sample of 15,915 service members yielded 12,950 respondents (81% response rate); 7,243 of these had insurance-eligible families. Age, gender, ethnicity, education, rank, marital status, branch of service, number of children, number of years of military service, and insurance status of respondents were collected on self-administered questionnaires. We performed stepwise, backward, logistic regression analysis to determine which factors influence a military family's dental insurance status. Results show that enrollment in DoD insurance is influenced by every demographic factor collected; enrollment in non-DoD insurance is influenced by fewer factors. The decision by U.S. service members to enroll their families in dental insurance plans is subject to many and complex influences.     

Sexual orientation and military service: A social science perspective.

Since 1982, the policy of the US Department of Defense has been that homosexuality is incompatible with military service. In January of 1993, however, President Clinton announced his intention to reverse the military's ban and called for discussion about how best to implement a new, nondiscriminatory policy. This article reviews the social science literature relevant to such a discussion. Empirical data suggest that lesbians and gay men are not inherently less capable of military service than are heterosexual women and men; that prejudice in the military can be overcome; that heterosexual personnel can adapt to living and working in close quarters with lesbian and gay male personnel; and that public opinion will be influenced by the way this issue is framed. Any change in policy should be accompanied by strong measures to prevent harassment and violence against lesbians and gay men, educate heterosexual personnel, and enforce uniform policies regarding all forms of sexual harassment. Considerations relevant to a new policy that does not discriminate on the basis of sexual orientation are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dental utilization by active duty Army personnel

In spring 1989, a random, Army-wide sample of 15,364 enlisted and 4,529 officer personnel was surveyed on dental utilization. Results show no difference in annual dental utilization between officer and enlisted personnel when age is controlled. Because annual dental utilization increases with age and enlisted ranks contain a disproportionately large number of younger personnel, a difference in annual dental utilization between enlisted and officer personnel emerges when age is not controlled. Check-ups are the most common reason for dental visits. Nearly all soldiers seek care exclusively in military dental clinics. Non-use is highest among 18- to 19-year-olds (12.2%).     

Improving nursing practice with staff education: the challenges of dysphagia

The 15 million Americans who experience some degree of dysphagia risk choking, airway obstruction, aspiration-related pulmonary disease, and/or death. These complications increase mortality, morbidity, length of hospitalization, and healthcare costs, but may be preventable through nursing intervention. Fifty-four nursing care workers (NCWs) from medical/surgical units in two acute care hospitals were assigned by convenience to two experimental groups and a control group. Experimental groups A and B participated in an educational program on dysphagia designed to increase their knowledge of dysphagia, knowledge attention, and the number of dysphagic patients identified and referred. Group B received deliberate reinforcement of program content over a 1-month period. The educational intervention had a significant effect on knowledge level and knowledge retention, immediately and at 1-month posttest in both experimental groups. NCWs applied what they learned to clinical practice as evidenced by an increase in the number of patients identified as being at risk for or experiencing dysphagia. Reinforcement of program content did not affect the outcomes. The study has implications for staff educators and nursing personnel who care for persons at risk for dysphagia.     

The medical aspects in the psychological training of the troops

A study of psychological training methods tested on 318 servicemen--armed conflicts participants, including 22 military doctors, veterans of Afghanistan. The results of the research prove that various departures in psychological traits are highly relevant to extreme situations and that a psychological training programme for the medical service personnel is a necessity. The development of the programme should be based on the troops medical maintenance experience in the armed conflicts.     

The standards of care in laparoscopic surgery. The specific case of cholecystectomy

Legal suits against visceral surgeons have increased since the advent of laparoscopic surgery. The duties of physicians have not however changed with the development of laparoscopic techniques. Since the decree promulgated in 1936, physicians have a legal commitment to provide the means required for patient care. This obligation has been recalled in different court judgements and in the new deontology code. In addition, jurisprudence tends more and more towards responsibility without risk. Laparoscopic cholecystectomy is not risk-free. Although morbidity and mortality have not risen with laparoscopic procedures, the types of complications encountered have changed. Reported accidents have become more frequent. The number of suits against surgeons has also increased. Surgeons must therefore be highly prudent and diligent. Precautions concerning personnel management, the choice of material and its upkeep. Special care must be given to the peroperative pneumoperitoneum and the use of monopolar electrocoagulation. A peroperative cholangiogram should be obtained. A careful operative report is very important. The surgeon must be able to justify his competence. Finally, the surgical community should publish more results concerning the rate of complications in order to establish reference material for experts.     

Standard means in laparoscopic surgery. The peculiar case of cholecystectomy

Legal suits against visceral surgeons have increased since the advent of laparoscopic surgery. The duties of physicians have not however changed with the development of laparoscopic techniques. Since the decree promulgated in 1936, physicians have a legal commitment to provide the means required for patient care. This obligation has been recalled in different court judgements and in the new deontology code. In addition, jurisprudence tends more and more towards responsibility without risk. Laparoscopic cholecystectomy is not risk-free. Although morbidity and mortality have not risen with laparoscopic procedures, the types of complications encountered have changed. Reported accidents have become more frequent. The number of suits against surgeons has also increased. Surgeons must therefore be highly prudent and diligent. Precautions concerning personnel management, the choice of material and its upkeep. Special care must be given to the peroperative pneumoperitoneum and the use of monopolar electrocoagulation. A peroperative cholangiogram should be obtained. A careful operative report is very important. The surgeon must be able to justify his competence. Finally, the surgical community should publish more results concerning the rate of complications in order to establish reference material for experts.     

Acoustic trauma and development of endolymphatic hydrops among the personnel in the self defense forces

An investigation was carried out among the military personnel in the Self Defense Forces to assess acoustic trauma in association with the onset of endolymphatic hydrops (ELH). Four hundred seventy servicemen were offered general physical examinations in an inpatient setting prior to their discharge from the SDF for mandatory age retirement. A questionnaire on the history of intense acoustic exposure and of dizzy spells was given to the same individuals. A routine ENT examination and audiography were performed for each of them. The following results were noteworthy: five men had a history of Ménière's disease, and 32.5 percent of those questioned had experienced dizzy spells. Hearing thresholds in those who reported that they had had dizzy spells were considerably higher than those who had not had such spells. Although a quantitative analysis as well as a well-established control study seems necessary to implicate acoustic trauma as one of the etiological factors of ELH, this study strongly suggests a relationship between acoustic trauma and development of ELH among the SDF personnel examined.     

Intense fear, helplessness, “and” horror? An empirical investigation of DSM-IV PTSD Criterion A2.

In the Diagnostic and Statistical Manual of Mental Disorders (4th ed., DSM–IV; American Psychiatric Association [APA]), an experiential response was added to the posttraumatic stress disorder (PTSD) traumatic stressor criterion (Criterion A). In addition to witnessing or experiencing an event involving serious threat to one's life or physical integrity (Criterion A1), a traumatic stressor must also evoke an intensely negative emotional response (Criterion A2), operationalized as “intense fear, helplessness, or horror” (emphasis added, p. 428). There has been some question about, but little empirical investigation of, the PTSD predictive value of Criterion A2. Toward this end, a study was conducted to examine differential rates of PTSD among individuals who met Criterion A2 by reporting 1, 2, or all 3 A2 responses. Participants included 205 military personnel, military retirees, and military family members who were receiving services from 4 treatment programs at an army medical center. Forty-three percent of individuals who reported all 3 A2 responses met diagnostic criteria for PTSD; however, only 9% of individuals who reported fewer than 3 A2 responses met criteria for PTSD. The results suggest that the definition of PTSD Criterion A2 may be too broad. A revision or refinement of Criterion A2 in the next edition of the DSM may be indicated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Spouse abuse recidivism in the U.S. Army by gender and military status.

Recidivism by spouse abusers was investigated using records of offenders in the U.S. Army Central Registry. Recidivism by gender and military status (active-duty or civilian spouse) was compared over a 70-month period. Between fiscal years 1989–1997, 48,330 offenders were identified in initial and recidivist incidents. Recidivism was analyzed by means of a Cox proportional hazard rate model, controlling for age, race, number of dependents, education, and substance abuse. Two different sets of survival curves were obtained: (a) Men were much more likely than women to have a recurrence and (b) within gender, civilians were more likely to have a recurrence than were active-duty military personnel. At 70 months, 30% of the male civilian offenders and 27% of the male active-duty offenders had committed a subsequent spouse abuse incident compared with 20% of the female civilian offenders and 18% of the female active-duty offenders, controlling for other variables. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Study of dermatomycosis and survey of pathogens in troops of Hainan area]

Subtropical area is the prevalent area of dermatomycosis with natural conditions suptable for the growth and proliferation of fungi causing suterficial dermatomycosis. Dermatomycosis not only brings about certain sufferings to the military personnel in peacetime, but also causes nonbattle loss in manpower in war time. In the present work, a survey of dermatomycosis in Hainan subtropical area of China and isolation of the pathogens were carried out. The results were as follows: The morbidity of superficial dermatomycosis was 34.1% and it was manifested clinically as tinea pedis, tinea versicolor, tinea corporis, tinea axillaris, tinea cruris, etc.; The main pathogen causing dermatomycosis in this area was Trichophyton rubrum which accounted for 50.4% of the pathogens isolated and the next was Trichophyton gypseum which accounted for 20.3%; Trichophyton rubrum could cause dermatomycosis of many sites of the body in this area, but the main lesious were tinea corporis and tinea cruris.     

Treatment of Posttraumatic Stress Disorder in Military and Veteran Populations.

While concerns about the psychological effects of war are not new, only recently has systematic attention been paid to such problems among past and present military personnel. There is increasing recognition that mental health has serious implications for operational performance, retention, and compensation. Although little controlled research exists with this population, preliminary evidence suggests that psychological treatments for posttraumatic stress disorder may be beneficial, albeit less so than for civilian populations. This article reviews evidence for each of several psychological treatment stages: stabilization and engagement, psychoeducation, symptom management, prolonged exposure, cognitive restructuring, and relapse prevention, with particular reference to the clinical issues raised by military personnel. Possible explanations for reduced treatment effects in this population compared with civilians are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Operationalizing the Moskos institution-occupation model: An application of Gouldner's cosmopolitan-local research.

Evaluated the problems of developing and validating measures of institutional–occupational orientations in the US Air Force. The measures were developed by modifying A. W. Gouldner's (see PA, Vol 33:4757 and 33:8067) cosmopolitan–local measurement. A questionnaire was administered that contained 8 attitudinal items concerning military and civilian life, a measure of career intent, a job satisfaction measure, and several demographic questions. Factor analysis of the 8 attitudinal items revealed 2 independent dimensions: Institutional and Occupational Orientations. Hypothesized differences between various demographic groups in a survey of 10,687 Air Force personnel of various grades, seniority levels, and educational levels were observed. The Institutional orientation was positively associated with career intent, seniority, and job satisfaction, whereas the Occupational orientation was negatively associated with those criteria. It is concluded that the developed measures provide the means to assess trends longitudinally in the military, as posited by C. Moskos (1977). (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hallux valgus in the elderly: metatarsophalangeal arthrodesis of the first ray

This study compares the dental utilization of United States of America (USA) military recruits with that of their employed civilian cohorts. Military data were collected between February and June 1994 at one recruit in processing site per service, using self-administered questionnaires on a prestratified, systematic, random sample of 2369 Army, Air Force, Navy, and Marine recruits. Women and blacks were oversampled. Civilian data come from the most recent oral health survey of working adults in the USA. Results show that annual dental utilization rates of military recruits equal or are less than those of their employed civilian cohorts. Overall, 38% of recruits have seen a dentist in the past year, while 30% have not seen a dentist in 3 or more years. Such low consumption of dental care suggests that dental utilization habits prior to service entry do not contribute appreciably to the high dental utilization rates seen among active duty US military personnel.     

On the real dollar value of CHAMPUS.

In response to H. D?rken's (see record 1978-12820-001) article on the costs of the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS), it is argued that the real cost-effectiveness of CHAMPUS-supported psychotherapy can be found in the professional functioning of the military personnel and their families. Examples are cited of the beneficial effects of psychotherapeutic intervention with military pilots who stated that family or emotional problems were affecting their ability to pilot. (PsycINFO Database Record (c) 2010 APA, all rights reserved)