158 research outputs found

    Editorial. Nurse Education Today Veterans' Special Issue

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    Editorial.Editorial from the Nurse Education Today Military Veterans Special Issu

    Reflecting on the characteristics and values of military nurses: war zone qualitative research

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    Background. Between 2001 and 2014, British military nurses served in Afghanistan caring for both Service personnel and local nationals of all ages. However, there have been few research studies assessing the effectiveness of the military nurses’ operational role and no papers naming the core values and characteristics. This paper is the only qualitative nursing study completed in this period where data was collected in the War Zone. Objective. To explore the characteristics and values that are intrinsic to military nurses in undertaking their operational role. Design. A Constructivist Grounded Theory was utilised. The first author designed the interview schedule, then conducted and transcribed the discussions. Informed consent and UK Ministry of Defence Research Ethical Committee approval was obtained. Setting. Camp Bastion Hospital, Afghanistan, in 2013. Method. Semi-structured interviews were conducted with 18 British Armed Forces nurses. Results. A theoretical model was developed that identifies the intrinsic characteristics and values required to be a military nurse. Nursing care delivered within the operational environment was perceived as outstanding. Nurses consciously detached themselves from any legal processes and treated each casualty as a vulnerable patient, resulting in care, compassion and dignity being provided for all patients, irrespective of their background, beliefs or affiliations. Conclusion. The study findings provides military nurses with a framework for a realistic personal development plan that will allow them to build upon their strengths as well as to identify and ameliorate potential areas of weakness. Placing nurses first, with a model that focusses on the requirements of a good nurse has the potential to lead to better patient care, and improve the quality of the tour for defence nurses. These findings have international implications and have the potential for transferability to any level of military or civilian nursing practice

    Factors affecting mental health support to the British Armed Forces: Part One

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    To help the British armed forces minimise mental health problems while undertaking military duties, operational psychological support is provided by military mental health nurses. This series of two articles is part of the first qualitative research completed in Afghanistan by British armed forces into the effectiveness of the military mental health nursing role. The authors aim to increase understanding of the factors that affect the delivery of nursing care during an operational deployment, including educational and clinical competency, multiprofessional and multinational boundaries, and the challenges of providing nursing care for both military personnel and local nationals. This article, the first of the two-part series, looks at the set up of the study, while the second article (featured in the next issue of JCN) will look at the study finding

    Factors affecting mental health support to the British armed forces: part two

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    The first part of this series (JCN, 28(5): 30–32) provided the background to the study, which used semi-structured interviews with 18 nurses based in Afghanistan during 2013 to focus on factors affecting the delivery of mental health care in the field. This, the second part of the series, details the results of the study in the form of analysis of the interviewees’ verbatim transcripts. The study offers an insight into the role of deployed mental health nurses and examines some of the challenges they face. The findings demonstrate that managing the mental health of armed forces personnel on an operational deployment requires the ability to develop trusting relationships, identify factors leading to stress, and help staff to feel supported

    Effective Support for Serving Personnel

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    The British Armed Forces aim to provide a capable workforce, able to undertake military duties without mental health (MH) problems. This is achieved by maximising the psychological support afforded to soldiers by providing immediate and effective MH care wherever they are serving. The most common MH disorders affecting UK Armed Forces are depression, alcohol misuse and anxiety. Military Mental Health (MMH) provides an occupational MH service that makes recommendations regarding a service person’s suitability for service. In a peacetime setting, this is delivered through a clearly defined integrated care pathway between Primary Health Care, military Departments of Community Mental Health (DCMHs) and Secondary Health Care. DCMHs consist of multi-disciplinary clinical staff, providing service personnel with a medium for sharing problems, whilst utilising recognised treatments such as Cognitive Behavioural Therapy (CBT) including Eye Movement Desensitisation and Reprocessing. Hospital care is provided within the NHS through a defined contract. Performance indicators and military satisfaction surveys indicate that the British Armed Forces MH service is of a very high standar

    Veteran help-seeking behaviour for mental health issues: a systematic review

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    This article has been accepted for publication in [BMJ Military Health] following peer review, and the Version of Record can be accessed online at [http://dx.doi.org/10.1136/bmjmilitary-2021-001903].” “© Authors (or their employer(s).Introduction Serving military personnel and veterans have been identified to have a high prevalence of mental health disorders. Despite this, only a significantly small number seek mental healthcare. With the UK beginning to invest further support to the armed forces community, identification of barriers and facilitators of help-seeking behaviour is needed. Methods Corresponding literature search was conducted in PsycINFO, PsycArticles, Medline, Web of Science and EBSCO. Articles which discussed barriers and facilitators of seeking help for mental health concerns in the veteran population were included. Those which discussed serving personnel or physical problems were not included within this review. A total of 26 papers were analysed. Results A number of barriers and facilitators of help-seeking for a mental health issue within the veteran population were identified. Barriers included stigma, military culture of stoicism and self-reliance, as well as deployment characteristics of combat exposure and different warzone deployments. Health service difficulties such as access and lack of understanding by civilian staff were also identified. Facilitators to help combat these barriers included a campaign to dispel the stigma, including involvement of veterans and training of military personnel, as well as more accessibility and understanding from healthcare staff. Conclusions While some barriers and facilitators have been identified, much of this research has been conducted within the USA and on male veterans and lacks longitudinal evidence. Further research is needed within the context of other nations and female veterans and to further indicate the facilitators of help-seeking among veterans

    Prevalence of common mental health disorders in military veterans: using primary healthcare data

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    This article has been accepted for publication in [BMJ Military Health, 2022] following peer review, and the Version of Record can be accessed online at [http://dx.doi.org/10.1136/bmjmilitary-2021-002045]. © Authors (or their employer(s).Introduction Serving military personnel and military veterans have been identified as having a high prevalence of mental disorders. Since 1985, UK patients’ primary healthcare (PHC) medical records contain Read Codes (now being replaced by Systematized Nomenclature of Medicine - Clinical Terms (SNOMED CT) codes) that mark characteristics such as diagnosis, ethnicity and therapeutic interventions. This English study accesses a cohort profile of British Armed Forces veterans to examine the diagnosed common mental disorders by using PHC records. Methods This analysis has been drawn from initiatives with PHC practices in the Northwest of England to increase veteran registration in general practice. Demographic data were collected including gender, age and marital status. Data were also collected on common mental health disorders associated with the Armed Forces. Result 2449 veteran PHC records were analysed. 38% (N=938) of veterans in this cohort had a code on their medical record for common mental health disorders. The highest disorder prevalence was depression (17.8%, N=437), followed by alcohol misuse (17.3%, N=423) and anxiety (15.0%, N=367). Lower disorder prevalence was seen across post-traumatic stress disorder (PTSD) (3.4%, N=83), dementia (1.8%, N=45) and substance misuse (0.8%, N=19). Female veterans had a higher prevalence of mental disorders than their male counterparts, while men a higher prevalence of PTSD; however, the gender difference in the latter was not significant (p>0.05). Conclusion The SNOMED searches do not detail why certain groups had higher recordings of certain disorders. A future study that accesses the PHC written medical notes would prove enlightening to specifically identify what situational factors are having the most impact on the veteran population. The results from a sizeable English veteran population provide information that should be considered in developing veteran-specific clinical provision, educational syllabus and policy

    Guidelines for Writing a Systematic Review

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    Guidelines for writing a systematic revie

    Social-consensus feedback as a strategy to overcome spontaneous gender stereotypes

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    Across two experiments the present research examined the use of social-consensus feedback as a strategy for overcoming spontaneous gender stereotyping when certain social role nouns and professional terms are read. Participants were presented with word pairs comprising a role noun (e.g. surgeon) and a kinship term (e.g. mother), and asked to decide whether both terms could refer to the same person. In the absence of training, participants responded more slowly and less accurately to stereotype incongruent pairings (e.g. surgeon/mother) than stereotype congruent pairings (e.g. surgeon/father). When participants were provided with (fictitious) social consensus feedback, constructed so as to suggest that past participants did not succumb to stereotypes, performance to incongruent pairings improved significantly (Experiment 1). The mechanism(s) through which the social feedback operated were then investigated (Experiment 2), with results suggesting that success was owing to social compliance processes. Implications of findings for the field of discourse processing are discussed

    Reorganization of retinotopic maps after occipital lobe infarction

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    Published in final edited form as: J Cogn Neurosci. 2014 June ; 26(6): 1266–1282. doi:10.1162/jocn_a_00538.We studied patient JS, who had a right occipital infarct that encroached on visual areas V1, V2v, and VP. When tested psychophysically, he was very impaired at detecting the direction of motion in random dot displays where a variable proportion of dots moving in one direction (signal) were embedded in masking motion noise (noise dots). The impairment on this motion coherence task was especially marked when the display was presented to the upper left (affected) visual quadrant, contralateral to his lesion. However, with extensive training, by 11 months his threshold fell to the level of healthy participants. Training on the motion coherence task generalized to another motion task, the motion discontinuity task, on which he had to detect the presence of an edge that was defined by the difference in the direction of the coherently moving dots (signal) within the display. He was much better at this task at 8 than 3 months, and this improvement was associated with an increase in the activation of the human MT complex (hMT^+) and in the kinetic occipital region as shown by repeated fMRI scans. We also used fMRI to perform retinotopic mapping at 3, 8, and 11 months after the infarct. We quantified the retinotopy and areal shifts by measuring the distances between the center of mass of functionally defined areas, computed in spherical surface-based coordinates. The functionally defined retinotopic areas V1, V2v, V2d, and VP were initially smaller in the lesioned right hemisphere, but they increased in size between 3 and 11 months. This change was not found in the normal, left hemisphere of the patient or in either hemispheres of the healthy control participants. We were interested in whether practice on the motion coherence task promoted the changes in the retinotopic maps. We compared the results for patient JS with those from another patient (PF) who had a comparable lesion but had not been given such practice. We found similar changes in the maps in the lesioned hemisphere of PF. However, PF was only scanned at 3 and 7 months, and the biggest shifts in patient JS were found between 8 and 11 months. Thus, it is important to carry out a prospective study with a trained and untrained group so as to determine whether the patterns of reorganization that we have observed can be further promoted by training.This work was supported by NIH grant R01NS064100 to L. M. V. Lucia M. Vaina dedicates this article to Charlie Gross, who has been a long-time collaborator and friend. I met him at the INS meeting in Beaune (France), and since then we often discussed the relationship between several aspects of high-level visual processing described in his work in monkeys physiology and my work in neuropsychology. In particular, his pioneering study of biological motion in monkeys' superior temporal lobe has influenced my own work on biological motion and has led us to coauthor a paper on this topic. Working with Charlie was a uniquely enjoyable experience. Alan Cowey and I often spoke fondly about Charlie, a dear friend and close colleague to us both, whose work, exquisite sense of humor, and unbound zest of living we both deeply admired and loved. (R01NS064100 - NIH)Accepted manuscrip
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