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1.
Mental health problems and suicide in the younger generation - implications for prevention in the Navy and merchant fleet.
Rozanov, V
International maritime health. 2020;(1):34-41
Abstract
Psychologists and psychiatrists worldwide are expressing concerns regarding the growing prevalence of mental health problems and the incidence of suicide in young adults. The reasons are seen in the extremely high tempo of social changes, information pressure, and values evolution in the younger generations, which are exposed to growing inequalities, loneliness and lack of social support. Poverty, social isolation, consumerism, hedonism, and unrealistic expectations of the future generate in the vulnerable part of the young adults inevitable frustrations, which give way to depression, anxiety, addictions, and suicide. This creates additional risks for the situation on board ships, both military and merchant, and requires greater efforts during pre-admission selection and in the course of the service or voyages. Suicides in the Navy are better registered than in the cargo fleet and are lower than in the same age and gender groups from the general population, and usually lower than in other types of forces. Data on suicides in the civilian maritime sector are less conclusive, but suggest it as a growing problem, especially considering stress on board. Recent studies revealed quite a lot of mental health problems in the merchant fleet crews, including depression, anxiety, and suicidal thoughts. Among the reasons such factor as "flag of convenience" strategy that implies lower standards, recruiting of the less trained and lower-paid workforce, multinational and multilanguage rotating crews, higher workload and stress and insufficient level of the pre-employment medical examination are mentioned. Recent trends in the mental health of the youth demand higher awareness both in the military ships and in the merchant fleet. We consider that more education and training aimed at mental health problems identification and stress-resilience promotion are needed both for the military and civilian staff on board. Better education of the whole personnel and "healthy ship" approach (better recognition of the crew members' needs, attention to mental health problems, nutrition, physical activity, etc.) may be applied both for the Navy and merchant fleet.
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2.
Epidemiological Evidence and Possible Mechanisms for the Association Between Cigarette Smoking and Injuries (Part 1).
Knapik, JJ, Bedno, SA
Journal of special operations medicine : a peer reviewed journal for SOF medical professionals. 2018;(1):108-112
Abstract
Surveys indicated that 24% of military personnel are current cigarette smokers. Smoking is well known to increase the risk of cancers, cardiovascular and respiratory diseases, reproductive problems, and other medical maladies, but one of the little known effects of smoking is that on injuries. There is considerable evidence from a variety of sources that (1) smoking increases overall injury risk, (2) the greater the amount of smoking, the higher is the injury risk, and (3) smoking is an independent injury risk factor. Smoking not only affects the overall injury risk but also impairs healing processes following fractures (e.g., longer healing times, more nonunions, more complications), ligament injury (e.g., lower subjective function scores, greater joint laxity, lower subsequent physical activity, more infections), and wounding (e.g., delayed healing, more complications, less satisfying cosmetic results). Smoking may elicit effects on fractures through low bone mineral density (BMD), lower dietary intake of calcium and vitamin D, altered calcium metabolism, and effects on osteogenesis and sex hormones. Effects on wound healing may be mediated through altered neutrophils and monocytes functions resulting in reduced ability to fight infections and remove damaged tissue, reduced gene expression of cytokines important for tissue healing, and altered fibroblast function leading to lower density and amount of new tissue formation. Limited data suggest smoking cessation has favorable effects on various aspects of bone health over periods of 1 to 30 years. Favorable effects on neutrophil and monocyte functions may occur as early as 4 weeks, but fibroblast function and collagen metabolism (important for wound remodeling) appear to take considerably longer and may be dependent on the amount of prior smoking. Part 2 of this series will use this information to explore the possibility of a causal relationship between smoking and injuries.
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3.
Soldier Health Habits and the Metabolically Optimized Brain.
Friedl, KE, Breivik, TJ, Carter, R, Leyk, D, Opstad, PK, Taverniers, J, Trousselard, M
Military medicine. 2016;(11):e1499-e1507
Abstract
Human performance enhancement was the subject of a NATO workshop that considered the direct benefits of individual soldier health and fitness habits to brain health and performance. Some of the important health and fitness include physical activity and purposeful exercise, nutritional intake, sleep and rest behaviors, psychological outlook and mindfulness, and other physiologically based systemic challenges such as thermal exposure. These influences were considered in an integrated framework with insights contributed by each of five participating NATO member countries using representative research to highlight relevant interrelationships. Key conclusions are that (1) understanding the neurobiological bases and consequences of personal health behaviors is a priority for soldier performance research, and this also involves long-term brain health consequences to veterans and (2) health and fitness habits have been underappreciated as reliably effective performance enhancers and these should be preferred targets in the development of scientifically based recommendations for soldier brain health and performance.
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4.
Vocal Effects in Military Students Submitted to an Intense Recruit Training: A Pilot Study.
Nascimento, CL, Constantini, AC, MourĂ£o, LF
Journal of voice : official journal of the Voice Foundation. 2016;(1):61-9
Abstract
OBJECTIVES This study aims at evaluating the vocal parameters of military officers before and after an Intense Recruit Training (IRT), consisting of a 48-hour exercise protocol involving high vocal demand combined with physical effort, lower body hydration levels, and fewer hours of sleep. STUDY DESIGN Eighty-three young male military officers (aged between 18 and 22 years) were recorded on three occasions: before, immediately after, and 2 weeks after the IRT. METHODS Maximum phonation times (MPTs) using vocalization of the vowel /a/, the fricative consonants /s/ and /z/, and connected speech samples were collected. A number of acoustic parameters were analyzed: mean fundamental frequency, mean intensity, jitter, shimmer, harmonics-to-noise ratio, spectral emphasis (acoustic correlate of vocal effort), H1-H2 (difference between the amplitude of the first and the second harmonic), and the frequency and intensity ranges. For the immediate effects, statistical analyses were conducted using a paired sample t test (P = 0.05) to compare two moments: before and after the IRT. For the long-lasting effect, statistical analyses were conducted using a one-way analysis of variance (ANOVA) test (P = 0.05) to compare between all three moments (before, immediately after, and 2 weeks after the IRT). RESULTS The MPTs of /a/, /s/, and /z/, the acoustic parameters as spectral emphasis, and the mean of intensity showed statistically significant changes between the data from before and immediately after training took place. The MPT of /a/ and the intensity range showed statistically significant changes between the measurements taken immediately after training and the ones taken 2 weeks after training; there were significant differences in the comparisons between the three groups of data acquired. CONCLUSIONS Some of the acoustic parameters were able to identify changes in the vocal conditions of the military students as consequence of high intensity voice and physical military training. The changes in the vocal intensity and MPT parameters seem to be related to general fatigue and lower hydration. The absence of impact in some parameters, specially 2 weeks after the IRT, may reveal that the students' voice is getting used to the military activities.
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5.
Effects of work-related sleep restriction on acute physiological and psychological stress responses and their interactions: A review among emergency service personnel.
Wolkow, A, Ferguson, S, Aisbett, B, Main, L
International journal of occupational medicine and environmental health. 2015;(2):183-208
Abstract
Emergency work can expose personnel to sleep restriction. Inadequate amounts of sleep can negatively affect physiological and psychological stress responses. This review critiqued the emergency service literature (e.g., firefighting, police/law enforcement, defense forces, ambulance/paramedic personnel) that has investigated the effect of sleep restriction on hormonal, inflammatory and psychological responses. Furthermore, it investigated if a psycho-physiological approach can help contextualize the significance of such responses to assist emergency service agencies monitor the health of their personnel. The available literature suggests that sleep restriction across multiple work days can disrupt cytokine and cortisol levels, deteriorate mood and elicit simultaneous physiological and psychological responses. However, research concerning the interaction between such responses is limited and inconclusive. Therefore, it is unknown if a psycho-physiological relationship exists and as a result, it is currently not feasible for agencies to monitor sleep restriction related stress based on psycho- physiological interactions. Sleep restriction does however, appear to be a major stressor contributing to physiological and psychological responses and thus, warrants further investigation.
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6.
The invisible soldiers: understanding how the life experiences of girl child soldiers impacts upon their health and rehabilitation needs.
Stevens, AJ
Archives of disease in childhood. 2014;(5):458-62
Abstract
There are estimated 120,000 girl child soldiers worldwide. Recruitment makes girls vulnerable to the violence of war, torture, psychological trauma and sexual abuse with huge impact on their physical, mental and reproductive health. Despite this, girl soldiers often remain an invisible and marginalised group frequently neglected from disarmament, demobilisation and reintegration programmes. This is not just a local issue: with former child soldiers seeking asylum as refugees there is an increasing need for health workers in the destination countries to understand their health needs in order to inform appropriate holistic service provision. This review provides an overview of how the duties and life experiences of girl soldiers, including gender-specific abuses, impacts upon their health and concludes with a summary of recommendations as to how their rehabilitation needs can be addressed.
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7.
Energy drinks: review of performance benefits, health concerns, and use by military personnel.
Johnson, LA, Foster, D, McDowell, JC
Military medicine. 2014;(4):375-80
Abstract
Energy drinks (EDs) are highly caffeinated beverages usually containing herbal ingredients promoted and consumed for purported improvements in attention and athletic performance. The popularity of EDs among adolescents and young adults has steadily increased for more than a decade. Reports suggest U.S. military populations consume EDs with greater frequency as compared to age-matched civilian populations. This article reviews the literature and outlines the current body of evidence evaluating the human performance benefits and potential harms associated with ED use.
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8.
Synthesis of the psychometric properties of the PTSD checklist (PCL) military, civilian, and specific versions.
Wilkins, KC, Lang, AJ, Norman, SB
Depression and anxiety. 2011;(7):596-606
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Abstract
The posttraumatic stress disorder checklist is a commonly used measure, with military (PCL-M), civilian (PCL-C), and specific trauma (PCL-S) versions. This synthesis of the psychometric properties of all three versions found the PCL to be a well-validated measure. The PCL shows good temporal stability, internal consistency, test-retest reliability, and convergent validity. The majority of structural validity studies support four factor models. Little is available on discriminant validity and sensitivity to change. Strengths, limitations, and future research directions are discussed. Understanding the PCL's psychometric properties, strengths (e.g., items map on to DSM-IV diagnostic criteria), and limitations (e.g., may overestimate PTSD prevalence) will help clinicians and researchers make educated decisions regarding the appropriate use of this measure in their particular setting.
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9.
Family issues associated with military deployment, family violence, and military sexual trauma.
Fraser, C
The Nursing clinics of North America. 2011;(4):445-55, vi
Abstract
Today's military has a greater percentage of families and children in comparison with previous generations. There are many, and unique, demands on military families made by the ongoing conflicts, and military life can be stressful. The presence of an increasing number of stressors is associated with an increased likelihood of domestic violence in military families and sexual trauma in service members. In this article, literature and research are presented to provide an overview of military deployment and families, and the effect of deployment on families; this is followed by a review of research on family violence and military sexual trauma.
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10.
United States Army Research Institute of Environmental Medicine: Warfighter research focusing on the past 25 years.
Pandolf, KB, Francesconi, R, Sawka, MN, Cymerman, A, Hoyt, RW, Young, AJ, Zambraski, EJ
Advances in physiology education. 2011;(4):353-60
Abstract
The United States Army Research Institute of Environmental Medicine (USARIEM) celebrated its 50th anniversary on July 1, 2011. This article reviews its history, evolution, and transition of its research programs as well as its scientific and military accomplishments, emphasizing the past 25 yr. During the 1990s, USARIEM published a series of pocket guides providing guidance for sustaining Warfighter health and performance in Southwest Asia, Somalia, the former Republic of Yugoslavia, Rwanda, and Haiti. Issues identified during Operation Desert Storm elicited research that improved nutritional guidelines for protracted desert operations; safer use of nuclear, chemical, and biological protective clothing; equipment, development, and fielding of efficient microclimate cooling systems; and effective evaluation of pharmaceuticals to protect soldiers from chemical and biological threats. During the first decade of the 21st century, USARIEM and the Department of the Army published official medical/performance doctrines for operations in the heat and cold and at high altitude. The current Global War on Terrorism focused research to improve doctrines for hot, cold, and high-altitude operations, reduce musculoskeletal training injuries, provide improved field nutrition, more efficient planning for operational water requirements, and improve both military clothing and materiel. This article also describes the critically important interactions and communications between USARIEM and deployed units and the benefits to Warfighters from this association. This report presents USARIEM's unique and world-class facilities, organizational changes, scientific and support personnel, and major research accomplishments, including the publication of 2,200 scientific papers over the past 25 yr.