Effect of changing threat conditions on police and military commanders' preferences for urgent and offensive actions: An analysis of decision making at the operational level of war.

A simulation was conducted to examine the decision making of 102 high-ranking police and military commanders (male/female = 88/12, mean years of employment = 22.15) engaged in a simulated hybrid attack on Norway. Four 2 × 3 repeated-measures ANOVA tests were performed, with two groups (police, military) and three phases (peace, war, and post-conflict) as independent variables. The decision tasks of force posture and mission urgency, along with Subject Matter Expert (SME) ratings of decision-making performance, served as dependent variables. By using social cognitive theory as the theoretical framework, the analysis demonstrated within-group effects indicating how the transition from peace to war caused more offensive postures, higher urgency levels, and increased performance in wartime. Between-group differences were also found, illustrating that police commanders had higher levels of urgency than military commanders in general. Regarding force posture, within-group differences were only found in the post-conflict phase, when police commanders returned to pre-war levels, while military commanders showed less offensive postures than in peacetime. No significant between-group differences were found in decision-making performance. The analysis demonstrated new empirical findings about how crisis management is impacted by change and the backgrounds of those in charge. The findings have implications for designing interagency frameworks that improve police-military interoperability in collaborative efforts.

Developing local crisis leadership - A research and training agenda.

The crisis triggered by Covid-19 has exposed the interdependencies of modern society and sparked interest in local response to protracted and complex crisis situations. There has been a growing awareness and interest in the key roles of political and professional stakeholders, their emotional regulation and how they influence team performance and outcomes in dealing with uncertainty and complex crisis situations. While cognitive and behavioral aspects of crisis leadership are well researched, less is understood about how one can mitigate negative emotions, instill trust, or restore public faith and support of security forces and emergency response teams during crises. In addressing this gap, we propose a simplified conceptual roadmap for research and training of local crisis leadership. In this, we emphasize complex problem solving, team interaction, team context and technology and team training design. These four factors represent significant barriers if neglected. On the other side, they may be considerable force multipliers when better understood and managed. We suggest how seven research and training questions could be linked to the four conceptual factors and guide an evidence-based approach to develop local crisis leadership.

From peacetime to war: a path analysis of the factors that predict performance among police and military commanders in collaborative crisis response.

Purpose: This study aimed to examine the applicability of Bandura's social cognitive theory in predicting organizational performance in dynamic and ambiguous hybrid warfare contexts. Specifically, the study investigated the influence of dyad composition, past performance in peacetime, collective self-efficacy, and persistence on wartime performance among high-ranking police and military commanders. Study design/methodology/approach: One hundred and thirty-eight participants, consisting of police and military commanders, took part in a simulation exercise that escalated from peace to war. The participants were assigned to three types of dyads (N = 69); all-police (n = 20), all-military (n = 27), and mixed police-military (n = 22). The study utilized path analysis to examine the direct and indirect effects of the variables on wartime performance. Results: The model developed in this study accounted for 54% of the variance in wartime performance (R2 = 0.54). Path analysis showed direct effects of persistence (ß = -0.33) and peacetime performance (ß = 0.45) on actual performance in wartime. Direct effects also showed how persistence was predicted by dyad composition (ß = -0.24) and peacetime performance (ß = -0.50). Indirect effects indicated how persistence mediated the effects of peacetime performance (ß = 0.17) and dyad composition (ß = 0.08) on actual performance in wartime. Originality/value: This study contributes to the understanding of how social cognitive factors, as described by Bandura's theory, can predict decision outcomes in collaborative crisis response settings involving police and military commanders. The findings have implications for policy-making and provide recommendations for further research in this area.

Distributed team processes in healthcare services: a scoping review.

Objective: High-quality healthcare services is delivered by teams rather than individuals and depends heavily on multidisciplinary cooperation between dispersed healthcare professionals. The aim of this scoping review is to identify common barriers and innovative applications of technology supporting team processes and patient safety, in geographically dispersed healthcare services. Methods: Studies were identified from searches in APA PsychINFO, Epistemonikos and Medline databases, from 2010 to 2023. A detailed search strategy was performed, and studies were included, based on prior established criteria. Results: Among the 19 studies that fulfilled our inclusion criteria, the majority (85%) were from Europe or North America, and most studies (53%) were quantitative, with a cross-sectional study design. Several reported observed distributed team processes in training and education. Most studies described barriers and detailed how innovative approaches and technological solutions were introduced to improve communication, coordination, and shared mental models in distributed healthcare settings. A small proportion of studies (16%) used health services data to examine interpersonal exchange and team processes. Conclusion: The scoping review offer recommendations to enhance future research on distributed team processes in healthcare services.

The MicroClimate Screen - A microscale climate exposure system for assessing the effect of CO2, temperature and UV on marine microalgae.

Global warming and anthropogenic activities are changing the ocean, inducing profound impacts on marine life and ecosystems from changing physical and chemical factors in and above the water column. Rising surface temperatures, ocean acidification, and seasonal variations in UV radiation (UVR), modulated by water clarity and sea-ice extent, affect life cycles of the marine food-web, and directly or indirectly also the global carbon fixation. Diatoms, pelagic microalgae that are responsible for 40% of the marine productivity, have limited capability to avoid exposure to changing ocean conditions, and hence, highly relevant for model studies of the influence of climate change on growth and productivity in the marine environment. A plate-based high-throughput exposure system was constructed to assess the biological effects from relevant climate change factors on the diatom Skeletonema pseudocostatum, conducted as a chronic toxicity tests over 72 h periods. The exposure system consisted of a micro-climate unit and a light-exposure unit, enabling accurate regulation of pCO2, temperature, UVR and photosynthetic active radiation (PAR). Changes in physical factors, including pH, dissolved inorganic carbon (DIC), total alkalinity (TA), temperature and salinity in the medium, as well as reduction in growth were characterised to demonstrate performance of the micro exposure system. The results demonstrate that the exposure system successfully simulated ocean acidification and could maintain stable temperature (CV < 3%), PAR and UVR irradiance (CV < 8%). Growth inhibition responses were typically dose-dependent and verified that the micro-exposure system could be used to assess effects and adaptions to climate-relevant stressors.

Coordinating Mechanisms Are More Important Than Team Processes for Geographically Dispersed Emergency Dispatch and Paramedic Teams.

In recent decades there has been an increased emphasis on non-technical skills in medical teams. One promising approach that relates teamwork to medical efficiency is the theory of Shared Mental Models (SMM). The aim of the present study was to investigate the suitability of the Shared Mental Model approach for teamwork between operators in emergency medical communication centers and the first line ambulance personnel in real-life settings. These teams collaborate while working from geographically dispersed positions, which makes them distinct from the kinds of teams examined in most previous research on team effectiveness. A pressing issue is therefore whether current models on co-located teams are valid for medical distributed teams. A total of 240 participants from 80 emergency medical teams participated in the study. A team effectiveness model was proposed based on identified team coordinating mechanisms and the "Big five" team processes. Path analyses showed that SMM was positively associated with team effectiveness (i.e., performance satisfaction and situational awareness) and negatively related to mission complexity. Furthermore, the coordinating mechanisms of SMM and Closed Loop Communication was positively related to "Big five" team scores. However, no effects were found for the "Big five" team processes on effectiveness, which could indicate that the model needs to be adjusted for application to geographically dispersed teams. Possible implications for team training of distributed emergency response teams are discussed.

Avoidance coping mediates the effect of hardiness on mental distress symptoms for both male and female subjects.

The personality disposition hardiness has been shown to be associated with adaptive coping strategies and is considered an important protective factor against development of mental health symptoms. One of the criticisms found in the hardiness literature concerns the question whether the construct is equally important for men and women. Using a prospective design in a moderated mediation model, regression analyses were performed to examine the effect of avoidance coping in the association between hardiness and mental distress. The effect of biological sex was examined in the association between hardiness and avoidance coping. Our sample included 410 civilian personnel employed in a military organization. The results showed that higher hardiness levels were associated with lower reported use of avoidance coping, which in turn was associated with lower levels of distress symptoms. Avoidance coping mediated the effect of hardiness on anxiety symptoms and this indirect effect was not moderated by biological sex. These results indicate that hardiness operates similarly for women and men as a factor influencing mental distress symptoms.

Teamwork on Patrol: Investigating Teamwork Processes and Underlaying Coordinating Mechanisms in a Police Training Program.

The Big Five theory suggests that five components in teamwork are essential for team effectiveness in stressful environments. Furthermore, three coordinating mechanisms are claimed to be decisive to upholding and informing vital teamwork processes. Although much research has been conducted into the Big Five theory and its components, to the best of our knowledge, no study has yet been made of the relative importance of the three mechanisms and their impact on team effectiveness. Also, only a few studies have tried to investigate whether the components and the coordinating mechanisms are trainable. This study aims to make a theoretical contribution to the part of the theory focusing on the coordinating mechanisms. Secondly, it investigates whether training can improve team performance. Working in teams of two, 166 police officers participated in a simulated operational scenario. Correlational analyses indicated that all Big Five teamwork behaviors and coordinating mechanisms relate to external ratings of team performance. Only the mechanisms of Closed Loop Communication (CLC) and Shared Mental Model (SMM) predicted performance indicators, with SMM predicting above and beyond the effect of CLC. No effect of the training program was found. The study provides new evidence in a police situation that the most important coordinating mechanism of the Big Five theory is that of shared mental models, which in turn has consequences for the type of training needed.

Crossing the Antarctica: Exploring the Effects of Appetite-Regulating Hormones and Indicators of Nutrition Status during a 93-Day Solo-Expedition.

Future deep space astronauts must maintain adequate nutrition despite highly stressful, isolated, confined and dangerous environments. The present case-study investigated appetite regulating hormones, nutrition status, and physical and emotional stress in a space analog condition: an explorer conducting a 93-day unsupported solo crossing of Antarctica. Using the dried blood spot (DBS) method, the subject drew samples of his blood on a regular basis during the expedition. The DBSs were later analyzed for the appetite regulating hormones leptin and adiponectin. Energy intake and nutritional status were monitored by analysis of albumin and globulin (including their ratio). Interleukin-6 (IL-6) was also analyzed and used as an energy sensor. The results showed a marked reduction in levels of the appetite-reducing hormone, leptin, and the appetite stimulating hormone, adiponectin, during both extreme physical and psychological strain. Nutrition status showed a variation over the expedition, with below-normal levels during extreme psychological strain and levels abutting the lower bounds of the normal range during a phase dominated by extreme physical hardship. The IL-6 levels varied substantially, with levels above the normal range except during the recovery phase. It was concluded that a daily intake of 5058 to 5931 calories seemed to allow recovery of both appetite and nutritional status between extreme physical and psychological hardship during a long Arctic expedition. Furthermore, IL-6 may be a sensor in the muscle-liver, muscle-fat and muscle-brain crosstalk. These results may help guide nutrition planning for future astronaut crews, mountaineers and others involved in highly demanding missions.

Violet-blue light exposure of the skin: is there need for protection?

Advocates of skin protection against blue light express concern about exposure to indoor lighting and electronic screens as well as natural outdoor exposure. However, the nature of adverse effects in skin is unclear and the doses to induce effects are unknown. We aimed to reveal whether there is a scientific basis for promoting skin protection against violet-blue light (400-500 nm, VBL). Based on published literature, we determined the time to reach a threshold dose that induced a biological response in human skin. In the absence of an action spectrum for effects on skin, we used a hand held probe with a defined spectral response and measurements of the unweighted exposure between 400 and 500 nm to estimate the exposure by a selection of artificial light sources and solar light. For comparison, an outdoor threshold erythemally weighted UV dose was set to 1 SED (standard erythema dose). Outdoor, weighted irradiances were obtained using a radiative transfer model. Induction of pigmentation in human skin tissue was the only consistently reported endpoint after VBL exposure of about 65 Jcm-2. This threshold dose was reached in 0.5 to 20 months of exposure to indoor lighting sources. In comparison, specialised medical sources reached this dose in 0.5 min to 45 h. The time outdoors to reach 1 SED was shorter than the time to reach a VBL threshold dose throughout all seasons. Skin protection against VBL is superfluous for exposures to domestic lighting sources or screens and for solar radiation; however, it may be advantageous for patients suffering from photosensitive diseases or taking photosensitising medication.

Prediagnostic serum 25-hydroxyvitamin D and melanoma risk.

Previous studies of serum 25-hydroxyvitamin D (25(OH)D) in relation to melanoma have shown conflicting results. We conducted a nested case-control study of 708 cases and 708 controls, using prediagnostically collected serum, to study 25(OH)D and melanoma risk in the population-based Janus Serum Bank Cohort. Stratified Cox regression was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) adjusted for ultraviolet radiation (UVR) indicators and stratified by ambient UVB of residence and body mass index (BMI). Non-linear associations were studied by restricted cubic splines. Missing data were handled with multiple imputation by chained equations. We found an HR of melanoma risk of 1.01 (95% CI: 0.99, 1.04) and an HRimputed of 1.02 (95% CI: 1.00, 1.04) per 5-nmol/L increase. The spline model showed exposure-risk curves with significantly reduced melanoma risk between 60 and 85 nmol/L 25(OH)D (reference 50 nmol/L). Non-significant J-shaped curves were found in sub-analyses of subjects with high ambient UVB of residence and of subjects with BMI < 25 kg/m2. Our data did not yield persuasive evidence for an association between 25(OH)D and melanoma risk overall. Serum levels within the medium range might be associated with reduced risk, an association possibly mediated by BMI.

Effects of artificial ultraviolet B radiation on the macrophyte Lemna minor: a conceptual study for toxicity pathway characterization.

MAIN CONCLUSION: UVB radiation caused irradiance-dependent and target-specific responses in non-UVB acclimated Lemna minor. Conceptual toxicity pathways were developed to propose causal relationships between UVB-mediated effects at multiple levels of biological organisation. Macrophytes inhabit waterways around the world and are used in hydroponics or aquaponics for different purposes such as feed and wastewater treatment and are thus exposed to elevated levels of UVB from natural and artificial sources. Although high UVB levels are harmful to macrophytes, mechanistic understanding of irradiance-dependent effects and associated modes of action in non-UVB acclimated plants still remains low. The present study was conducted to characterise the irradiance-dependent mechanisms of UVB leading to growth inhibition in Lemna minor as an aquatic macrophyte model. The L. minor were continuously exposed to UVB (0.008-4.2 W m-2) and constant UVA (4 W m-2) and photosynthetically active radiation, PAR (80 µmol m-2 s-1) for 7 days. A suite of bioassays was deployed to assess effects on oxidative stress, photosynthesis, DNA damage, and transcription of antioxidant biosynthesis, DNA repair, programmed cell death, pigment metabolism and respiration. The results showed that UVB triggered both irradiance-dependent and target-specific effects at multiple levels of biological organization, whereas exposure to UVA alone did not cause any effects. Inhibition of photosystem II and induction of carotenoids were observed at 0.23 W m-2, whereas growth inhibition, excessive reactive oxygen species, lipid peroxidation, cyclobutane pyrimidine dimer formation, mitochondrial membrane potential reduction and chlorophyll depletion were observed at 0.5-1 W m-2. Relationships between responses at different levels of biological organization were used to establish a putative network of toxicity pathways to improve our understanding of UVB effects in aquatic macrophytes under continuous UVB exposures. Additional studies under natural illuminations were proposed to assess whether these putative toxicity pathways may also be relevant for more ecologically relevant exposure scenarios.

The Dimensionality of the 12-Item General Health Questionnaire (GHQ-12): Comparisons of Factor Structures and Invariance Across Samples and Time.

Because of its brevity, the 12-item General Health Questionnaire (GHQ-12) has become one of the most popular and used measure for detecting psychological distress. Originally intended as a unidimensional measure, the majority of subsequent factor-analytic studies have failed to support GHQ-12 as a unitary construct and have instead proposed a plethora of multidimensional structures. In this study, we further examined the factor structure in two different military samples, one consisting of crewmembers from four different frigates deployed in anti-piracy operations and Standing NATO Maritime Group deployments (N = 591) and one consisting of crewmember from three different minehunters/sweepers serving in Standing NATO Mine Counter-Measures Group deployments (N = 196). Results from confirmatory factor analyses (CFA) performed in the first sample supported a bifactor model, consisting of a general factor representing communality among all items and two specific factors reflecting common variance due to wording effects (negatively and positively phrased items). A multi-group CFA further confirmed this structure to be invariant across our second sample. Structural equation modeling also showed that the general factor was strongly associated with symptoms of insomnia and mental health, whereas the specific factors were either non-significantly or considerably weaker associated with the criterion variables. Overall, our results are congruent with the notion that the multidimensionality demonstrated in many previous investigations is most likely an expression of method-specific variance caused by item wording. The explained unique variance associated with these specific factors was further relatively small. Ignoring the multidimensionality and treating GHQ-12 as a unitary construct will therefore most likely introduce minimal bias to most practical applications.

Record-Breaking Increases in Arctic Solar Ultraviolet Radiation Caused by Exceptionally Large Ozone Depletion in 2020.

Measurements of solar ultraviolet radiation (UVR) performed between January and June 2020 at 10 Arctic and subarctic locations are compared with historical observations. Differences between 2020 and prior years are also assessed with total ozone column and UVR data from satellites. Erythemal (sunburning) UVR is quantified with the UV Index (UVI) derived from these measurements. UVI data show unprecedently large anomalies, occurring mostly between early March and mid-April 2020. For several days, UVIs observed in 2020 exceeded measurements of previous years by up to 140%. Historical means were surpassed by more than six standard deviations at several locations in the Arctic. In northern Canada, the average UVI for March was about 75% larger than usual. UVIs in April 2020 were elevated on average by about 25% at all sites. However, absolute anomalies remained below 3.0 UVI units because the enhancements occurred during times when the solar elevation was still low.

Mental Health During Naval Deployment: The Protective Role of Family Support.

INTRODUCTION: Minor mental health problems among service members deployed in combat areas are relatively common, but social support is a protective factor. With the advent of digital communication, as well as more frequent family separations, a stable family support system may be more important than before. In this exploratory study, we aimed to test the relationship between perceived family support and the development of minor psychiatric symptoms during a 4-month naval counter piracy mission in the Gulf of Aden. MATERIALS AND METHODS: We measured minor mental health problems with the general health questionnaire 12 (GHQ-12) and family support at three intervals, 3 weeks before deployment, 2 months into the mission, and at the end of deployment. We used mixed multilevel regression analysis to analyze the main effects of family support and time, as well as their interaction. All analyses were controlled for military rank. RESULTS: We found that minor psychiatric symptoms increased at both midway (B = 0.51, P < 0.05) and toward the end of the mission (B = 0.72, P < 0.01). The results also showed that receiving more family support is associated with fewer psychiatric symptoms (B = -0.87, P < 0.01). Family support also moderated the development of symptoms toward the end of the mission (B = -0.73, P < 0.01). The buffering effect was such that service members with a high degree of family support experienced no increase in minor psychiatric symptoms during the deployment. CONCLUSIONS: The results indicate that naval deployment is associated with a small increase in minor mental health problems and that having a high degree of family support buffers this effect. Efforts to increase support among military families may positively influence the wellbeing of naval sailors during combat missions.

Rapid diagnostics of orthopedic implant-associated infections using Unyvero ITI implant and tissue infection application is not optimal for Staphylococcus species identification.

OBJECTIVES: This pilot study aimed to compare the commercial Unyvero ITI multiplex PCR application (U-ITI, Curetis GmbH) with conventional culturing concerning (a) detection of pathogens, (b) time to detection of pathogens and (c) time to and quality of antibiotic treatment recommendation in diagnostics of orthopedic implant-associated infections (OIAI). RESULTS: 72 tissue biopsies from 15 consecutive patients with deep OIAI infections were analyzed with conventional culturing including phenotypic antibiotic susceptibility testing and the U-ITI. U-ITI showed lower sensitivity than conventional culturing concerning detection of pathogens (73% vs 93%). 4/15 patients would have been given false negative results by U-ITI, all of which were culture-positive for Staphylococcus species. Median time to detection of pathogens was 47 h and antibiotic resistance 89 h by conventional methods compared to 13.5 h with the U-ITI. The U-ITI did not detect antibiotic resistance, whereas conventional culturing showed resistance to antibiotics covered by the U-ITI panel in 2 patients. Time to detection of pathogens was improved, but the detection limit for staphylococci was unsatisfactory. Although the time to antibiotic treatment recommendation was significantly reduced, the U-ITI would have resulted in incorrect antibiotic recommendation in 2 patients. Our data do not support use of this assay in diagnostics.

The impact of age on risk assessment, therapeutic practice and outcome in candidemia.

BACKGROUND: In Norway, the epidemiological situation of candidemia is followed closely. We have previously demonstrated the highest incidence of candidemia in elderly >65 years of age. However, knowledge of other aspects of this infection is lacking. OBJECTIVE: The aim of this nationwide, retrospective study was to examine risk factors, therapeutic practice and outcome in adult candidemia patients according to age. METHODS: We retrieved data from medical records from patients who developed candidemia in Norway between 1 January 2008 and 31 December 2012. Data were analyzed according to age, younger patients being between 18 and 65 years, elderly being ≥65 years of age. RESULTS: From 771 eligible patients, 738 patients (95.7%) were included (58% men, mean age 65.2 years, 58.1% being ≥65 years). Exposure to health-care related risk factors for candidemia were significantly more common in the younger patients (neutropenia, central venous catheter, mechanical ventilation and chemotherapy) who received empirical treatment more often than the elderly (29.8% vs. 21.7%, p = .01). More elderly did not received any antifungal therapy (27.3% vs 16.8%, p < 0001) and had higher mortality compared to younger patients (45.5% vs 23.9%, p < .0001). In the study population, mortality was higher with age (per 10-years increase, OR 1.43;1.28-1.59, p < 0.0001), in patients not receiving targeted therapy (OR 2.5; CI 1.82-3.36, p < .0001) or any therapy at all (OR 4.64; 3.23-6.68, p < .0001). CONCLUSIONS: Risk factors for candidemia, treatment and outcome differed significantly according to age. Given the increasing numbers of elderly, scrutiny on our clinical practice is warranted.

Dispositional resilience in treatment-seeking patients with obsessive-compulsive disorder and its association with treatment outcome.

There is a lack of research on the relation between obsessive-compulsive disorder (OCD) and resilience. Dispositional resilience, as described and defined in literature on hardiness, consists of three facets, namely beliefs about having control in everyday living, having a sense of purpose or commitment, and a positive attitude toward challenges. This study explores associations between dispositional resilience (measured with the Dispositional Resilience Scale (DRS-15-R)), symptom severity, and treatment outcome in a sample of 89 patients treated with concentrated exposure therapy (cET), and compares the findings with scores from two reference groups (students and soldiers). The patient group had significantly lower resilience scores than the two reference groups. Weak correlations were observed between dispositional resilience and OCD symptoms. Differences in dispositional resilience were weakly related to remission status at follow-up (odds ratio of 1.11). Furthermore, resilience improved from pre- to post-treatment (Cohen's d of 0.65). Our results imply that patients' initial resilience score does not hinder nor facilitate treatment effects to a great extent in this format of ERP treatment.