Bmj Military Health最新文献_第7页

Future of service member monitoring: the intersection of biology, wearables and artificial intelligence. 军人监控的未来：生物学、可穿戴设备和人工智能的交叉点。

IF 1.4 4区医学

Bmj Military Health Pub Date : 2024-09-20 DOI: 10.1136/military-2022-002306

Brent Winslow, E Mills

{"title":"Future of service member monitoring: the intersection of biology, wearables and artificial intelligence.","authors":"Brent Winslow, E Mills","doi":"10.1136/military-2022-002306","DOIUrl":"10.1136/military-2022-002306","url":null,"abstract":"While substantial investment has been made in the early identification of mental and behavioural health disorders in service members, rates of depression, substance abuse and suicidality continue to climb. Objective and persistent measures are needed for early identification and treatment of these rising health issues. Considerable potential lies at the intersection of biology, wearables and artificial intelligence to provide high accuracy, objective monitoring of mental and behavioural health in training, operations and healthcare settings. While the current generation of wearable devices has predominantly targeted non-military use cases, military agencies have demonstrated successes in monitoring and diagnosis via off-label uses. Combined with context-aware and individualised algorithms, the integration of wearable data with artificial intelligence allows for a deeper understanding of individual-level and group-level mental and behavioural health at scale. Emerging digital phenotyping approaches which leverage ubiquitous sensing technology can provide monitoring at a greater scale, lower price point and lower individual burden by removing the need for additional body-worn technology. The intersection of this technology will enable individualised strategies to promote service member mental and physical health, reduce injury, and improve long-term well-being and deployability.","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"412-414"},"PeriodicalIF":1.4,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10624467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Is inflammatory change associated with psychological risk and resilience in high-risk military personnel? 炎症变化与高危军人的心理风险和复原力有关吗？

IF 1.4 4区医学

Bmj Military Health Pub Date : 2024-09-20 DOI: 10.1136/military-2024-002725

Neanne Bennett, E Lawrence-Wood, A McFarlane

{"title":"Is inflammatory change associated with psychological risk and resilience in high-risk military personnel?","authors":"Neanne Bennett, E Lawrence-Wood, A McFarlane","doi":"10.1136/military-2024-002725","DOIUrl":"10.1136/military-2024-002725","url":null,"abstract":"Introduction: In military populations, the potential for under-reporting of Post-traumatic Stress Disorder (PTSD) symptoms and challenges in recognising early changes can make it difficult to detect an emerging disorder. However, early identification of PTSD symptoms would improve opportunities for intervention, and potentially reduce the likelihood of chronic mental health problems.Method: This study explored if changes in levels of inflammation, measured by C reactive protein (CRP) and interleukin 6 (IL-6), were associated with the onset of psychological symptoms associated with PTSD. It also examined if changes in inflammation over time contributed to psychological risk and resilience, which was defined by psychological reactivity to deployment-related combat exposures. Participants were special forces personnel who completed psychological self-report questionnaires and had measures of CRP and IL-6 taken pre and post deployment. Regression analysis was used to examine how psychological symptoms predicted change in inflammation, and Analysis of Variance (ANOVA) were used to examine differences between identified subgroups.Results: Results identify this population as having high levels of combat and trauma exposures, with low-level psychological symptoms. The results also identified a decrease in CRP and an increase in IL-6 over time. A significant difference in inflammation was identified between subgroups (p<0.05). An association between inflammatory markers and subthreshold symptoms related to anger (p<0.01) and sleep (p<0.05) was also identified.Conclusion: These preliminary findings suggest inflammatory markers may help to identify adaptive responses post deployment. In addition, low-level increases in inflammatory markers may be associated with subthreshold PTSD symptoms. These findings offer potential insights for prevention, early identification and treatment in military and veteran populations.","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"396-401"},"PeriodicalIF":1.4,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Using statistical techniques to understand the unique needs of military personnel experiencing mental health difficulties: moving away from assuming patient homogeneity to understanding heterogeneity. 利用统计技术了解有心理健康问题的军人的独特需求：从假设病人的同质性转向了解异质性。

IF 1.4 4区医学

Bmj Military Health Pub Date : 2024-09-20 DOI: 10.1136/military-2022-002253

Laura Josephine Hendrikx, D Murphy

引用次数: 0

Optimising and personalising behavioural healthcare in the US Department of Defense through Primary Care Behavioral Health. 美国国防部通过初级保健行为医疗优化和个性化行为医疗。

IF 1.4 4区医学

Bmj Military Health Pub Date : 2024-09-20 DOI: 10.1136/military-2022-002312

Jeffrey L Goodie, C L Hunter, A C Dobmeyer

引用次数: 0

Preface to the special edition: personalised medicine in military mental health and performance. 特刊序言：军事心理健康与表现的个性化医疗。

IF 1.4 4区医学

Bmj Military Health Pub Date : 2024-09-20 DOI: 10.1136/military-2024-002857

Sebastian R Schnellbacher, M McCauley

引用次数: 0

Identifying psychological risk and resilience in high-risk military personnel. 识别高风险军事人员的心理风险和复原力。

IF 1.4 4区医学

Bmj Military Health Pub Date : 2024-09-20 DOI: 10.1136/military-2024-002724

Neanne Bennett, E Lawrence-Wood, A McFarlane

{"title":"Identifying psychological risk and resilience in high-risk military personnel.","authors":"Neanne Bennett, E Lawrence-Wood, A McFarlane","doi":"10.1136/military-2024-002724","DOIUrl":"10.1136/military-2024-002724","url":null,"abstract":"Introduction: Combat exposure has been associated with the emergence of post-traumatic stress disorder (PTSD) symptoms in military personnel; however, not all veterans are negatively impacted by their operational experience. In many instances, the absence of symptoms following operational service is attributed to resilience. This study explored the construct of resilience by examining the relationship between levels of deployment-related exposures and psychological symptoms, as well as identifying factors that may contribute to resilience and emerging risk.Method: Participants were special forces personnel who completed self-report questionnaires 1 month before deployment and 4 months post deployment. Subgroups were created based on psychological reactivity to deployment exposures, representing risk, vulnerability and resilience. Regression analysis assessed the contribution of factors that were predictive of risk or resilience groups specifically.Results: Results showed the overall levels of psychological reactivity in this population post deployment were low; however, differences between risk and resilience subgroups were found. Subthreshold indicators of psychological reactivity, as well as deployment factors such as increased deployment frequency and time spent away from home, were found to contribute to differences between risk and resilient trajectories.Conclusion: Findings reflect a military population with low psychological symptoms despite high trauma exposure. However, subtle underlying differences between subgroups suggest that the early identification of risk and emerging trajectories is possible. Risk and resilience in military populations needs to consider subthreshold indicators and individual differences over time.","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"390-395"},"PeriodicalIF":1.4,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141427983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluating the prospective utility of pharmacogenetics reporting among Canadian Armed Forces personnel receiving pharmacotherapy: a preliminary assessment towards precision psychiatric care. 在接受药物治疗的加拿大武装部队人员中评估药物遗传学报告的前瞻性效用：实现精准精神病治疗的初步评估。

IF 1.4 4区医学

Bmj Military Health Pub Date : 2024-09-20 DOI: 10.1136/military-2023-002447

Maya Roth, L King, K St Cyr, U Mohsin, K Balderson, S Rhind, A Goldman, D Richardson

{"title":"Evaluating the prospective utility of pharmacogenetics reporting among Canadian Armed Forces personnel receiving pharmacotherapy: a preliminary assessment towards precision psychiatric care.","authors":"Maya Roth, L King, K St Cyr, U Mohsin, K Balderson, S Rhind, A Goldman, D Richardson","doi":"10.1136/military-2023-002447","DOIUrl":"10.1136/military-2023-002447","url":null,"abstract":"Pharmacological interventions for treating posttraumatic stress disorder in Canadian Armed Forces (CAF) members and Veterans often achieve modest results. The field of pharmacogenetics, or the study of how genes influence an individual's response to different medications, offers insight into how prior knowledge of gene-drug interactions may potentially improve the trial-and-error process of drug selection in pharmacotherapy, thereby improving treatment effects and remission rates. Given the relative recency of pharmacogenetics testing and sparse research in military samples, we used pharmacogenetics testing in a small pilot group (n=23) of CAF members and Veterans who were already engaged in pharmacotherapy for a service-related mental health condition to better understand the associated opportunities and challenges of pharmacogenetics testing in this population. Our preliminary evaluation involved: (1) reporting the prevalence of pharmacogenetics testing 'bin' status according to participants' reports ('green', 'yellow' or 'red'; intending to signal 'go', 'caution' or 'stop', regarding the potential for gene-drug interactions); (2) calculating the percentage of currently prescribed psychotropic medications that were assessed and included in the reports; (3) evaluating whether prescribers used pharmacogenetics testing information according to clinical notes and (4) collecting informal feedback from participating psychiatrists. While pharmacogenetics testing appeared to provide valuable information for a number of clients, a major limitation was the number of commonly prescribed medications not included in the reports.","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"440-445"},"PeriodicalIF":1.4,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10137798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Caring for the carers: an evaluation of the recovery, readjustment and reintegration programme (R3P). 关爱照顾者：康复、重新适应和重返社会计划（R3P）评估。

IF 1.4 4区医学

Bmj Military Health Pub Date : 2024-09-20 DOI: 10.1136/military-2023-002359

Amos Simms, D Leightley, D Lamb

{"title":"Caring for the carers: an evaluation of the recovery, readjustment and reintegration programme (R3P).","authors":"Amos Simms, D Leightley, D Lamb","doi":"10.1136/military-2023-002359","DOIUrl":"10.1136/military-2023-002359","url":null,"abstract":"Introduction: The challenges faced by healthcare workers, not least during the response to the COVID-19 pandemic, have been extensively studied, and concerns continue to be highlighted in relation to their long-term mental health. Identifying the need to support their personnel, a leader-led structured programme of reflection: the recovery, readjustment and reintegration programme (R3P) was designed by the UK Defence Medical Services to mitigate the potential stressors associated with this outbreak and enhance the resilience of the workforce.Methods: 128 military personnel completed an evaluation of R3P. A survey included measures of anxiety before and after the intervention, perceptions of the discussion themes and whether these brought a sense of closure to areas of distress, and attitudes to help-seeking.Results: Most respondents (86%-92%) rated the five discussion themes either 'helpful' or 'very helpful', 51% of respondents reported a sense of closure about an issue that had been causing distress and 72% of respondents felt better able to seek help should it be necessary. Evaluating the effect R3P had on anxiety, a Wilcoxon signed rank test elicited a statistically significant difference in anxiety pre-R3P and post-R3P; Z=-3.54, p<0.001. The median anxiety rating was 3.5 (IQR 4.75, 95% CI 1.25 to 6.00) before undertaking R3P, which decreased to 3 (IQR 4.75, 95% CI 1.00 to 5.75) after undertaking R3P. 39.1% of participants reported decreased anxiety, 18.8% reported increased anxiety and 42.2% reported no change.Conclusion: This evaluation has identified several positive aspects to R3P with many personnel reporting a reduction in anxiety, a sense of closure and increased likelihood of help-seeking. Several participants did report an increase in anxiety and the long-term impact of R3P on mental health and well-being is unclear. Further mixed-methods evaluation incorporating a longer follow-up is required.","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"384-389"},"PeriodicalIF":1.4,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9919530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Current advances in microbiome sciences within the US Department of Defense: part 2 - enabling technologies and environmental microbiomes. 美国国防部微生物组科学的当前进展：第 2 部分--使能技术和环境微生物组。

IF 1.4 4区医学

Bmj Military Health Pub Date : 2024-09-20 DOI: 10.1136/military-2022-002308

Sophie M Colston, R A Barbato, M S Goodson, J P Karl, R J Kokoska, D D Leary, K Racicot, V Varaljay, J W Soares

{"title":"Current advances in microbiome sciences within the US Department of Defense: part 2 - enabling technologies and environmental microbiomes.","authors":"Sophie M Colston, R A Barbato, M S Goodson, J P Karl, R J Kokoska, D D Leary, K Racicot, V Varaljay, J W Soares","doi":"10.1136/military-2022-002308","DOIUrl":"10.1136/military-2022-002308","url":null,"abstract":"Microbiomes involve complex microbial communities wherein the micro-organisms interact with one another as well as their associated hosts or environmental niches. Much of the characterisation of these communities and the associations have been achieved through 'omics' technologies, such as metagenomics, metaproteomics and metametabolomics, and model systems. Recent research in host-associated microbiomes has been aimed at understanding the role microbes may play in host fitness or conversely how host activities/conditions may perturb the microbial community, which can further affect host health. These studies have led to the investigation of detection, intervention or modulation methods, which may serve to provide benefits to the host and advance our understanding of microbiome associations. With the clear implications on human health and disease, the US Department of Defense (DoD) has made microbiome research a priority, with the founding of the Tri-Service Microbiome Consortium (TSMC) to enhance collaboration, coordination,and communication of microbiome research among DoD organisations and partners in academia and industry. DoD microbiome research focuses mainly on the following themes: (1) human health and performance, (2) environmental microbiomes and (3) enabling technologies. This review provides an update of current DoD microbiome research efforts centred on enabling technologies and environmental microbiomes and highlights innovative research being done in academia and industry that can be leveraged by the DoD. These topics were also communicated and further discussed in the Fifth Annual TSMC Symposium. This paper forms part of the special issue of BMJ Military Health dedicated to personalised digital technology for mental health in the Armed Forces.","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"435-439"},"PeriodicalIF":1.4,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9667360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sleep and adaptation disorders in military personnel with blast injury. 爆炸伤军人的睡眠和适应障碍。

IF 1.4 4区医学

Bmj Military Health Pub Date : 2024-09-12 DOI: 10.1136/military-2024-002793

Kateryna Sаrаzhynа, O Ruskykh, I Serbin, Y Solodovnikova, A Son

引用次数: 0