The nature and impacts of deployment-related encounters with children among Canadian military Veterans: a qualitative analysis.

Background: As armed conflict grows increasingly complex, the involvement of children in armed violence across diverse roles is rising. Consequently, military personnel are more likely to encounter children during deployment. However, little is known about deployment-related encounters with children and their impact on the mental health of military personnel and Veterans.Objective: This study qualitatively examines the nature and impacts of deployment-related encounters with children.Methods: We conducted semi-structured interviews with 16 Canadian Armed Forces Veterans, eliciting rich information on the nature of child encounters on deployment, the psycho-social-spiritual impacts of these encounters, and perceptions of support. Interview transcripts were analysed using thematic analysis.Results: Six primary themes were identified: types of encounters (i.e. factual aspects of deployment-related encounters with children), contextual factors (i.e. aspects of the mission, environment, and personal context relevant to one's experience of the encounter), appraisals of encounters (i.e. sensory or sense-making experiences relevant to the encounter), impacts of encounters (i.e. psycho-social, existential, and occupational impacts), coping strategies engaged in both during and after deployment, and support experiences, describing both formal and informal sources of support.Conclusions: Encounters with children are diverse and highly stressful, resulting in impacts pertinent to mental health, including psychological and moral distress, and difficulties with identity, spirituality, and relationships. These impacts are prompted by complex interactions among appraisals, expectations of morality, cultural norms, and professional duties and are amplified by various personal factors (e.g. childhood maltreatment history, parenthood), feelings of unpreparedness, and lack of post-deployment support. Implications for prevention, intervention, and policy are discussed with the aim of informing future efforts to safeguard and support military personnel facing a high likelihood of encounters with children.

Deployment-related encounters with children result in diverse impacts, including psychological and moral distress, along with disruptions in identity, spirituality, and interpersonal relationships.Encounters with children during military deployments are diverse and highly stressful, characterized by complex interactions among appraisals and expectations of morality, cultural norms, and professional duties.Emphasis on feeling unprepared for encounters with children highlights the need for future efforts to safeguard and support military personnel facing such situations.

Characterization of wound infections among patients injured during the Ruso-Ukrainian war in a Role 4 hospital.

INTRODUCTION: The management of infections in war wounds is a problem aggravated by the presence of multiresistant bacteria and requires a combined approach with surgery. Literature has identified the risks and patterns of antibiotic resistance in previous armed conflicts, but the Russian-Ukrainian conflict has required the study of specific bacterial resistance patterns. METHODS: We included war-injured patients from the Russian-Ukrainian conflict transferred for treatment to the General Defense Hospital of Zaragoza from May 2022 to October 2023. Epidemiological data, factors related to the injury, presence of infection and microbiological results were collected; These data were subsequently analyzed statistically. RESULTS: Fifty-three patients were included in the study, with a mean age of 35.6 years; 83% were injured by an explosive mechanism and all received antibiotic therapy prior to transfer. Seventeen patients had skin, soft tissue or joint infection. Correlation was demonstrated with the presence of bone lesion (p 0.03), skin coverage defect (p 0.000) and presence of foreign bodies (p 0.006). Nine patients had monomicrobial cultures, and the most frequently isolated microorganisms were Gram negative bacilli (GNB) and Staphylococcus aureus. Virtually all GNB presented some resistance mechanism. CONCLUSION: Our work shows the correlation of war wound infection with the presence of foreign bodies and affected tissues. Likewise, the presence of polymicrobial wounds is emphasized, with a predominance of GNB and multidrug-resistant S. aureus.

Perfil da mortalidade de policiais militares por causas violentas, segundo cor da pele, na Bahia, Brasil / Profile of military police officers' mortality from violent causes, according to skin color, in Bahia, Brazil / Perfil de mortalidad por causas violentas de policías militares según el color de piel en Bahía, Brasil

O Brasil é um país com altas taxas de violência, o que afeta, além da sociedade civil, os agentes das forças da segurança pública, cujas taxas de mortalidade por causas violentas são superiores às da população geral. Portanto, objetivou-se caracterizar o perfil da mortalidade de policiais militares por causas violentas, segundo a cor da pele, no estado da Bahia. Neste estudo, foram analisadas as mortes violentas de policiais militares da ativa ocorridas entre 2012 e 2019, considerando variáveis tanto sociodemográficas quanto relacionadas à corporação policial e às circunstâncias da ocorrência. A análise dos resultados foi realizada por meio da linguagem computacional R versão 4.2.2. Foram registradas 110 mortes de policiais militares, em sua maioria negros (83,64%). Em relação à faixa etária, os policiais militares negros morreram mais jovens, entre 30 e 39 anos (41,30%), enquanto os brancos, entre 40 e 49 anos (61,11%). Em 50% dos casos envolvendo policiais militares negros, a motivação do crime permaneceu desconhecida, enquanto 33,33% das mortes envolvendo policiais brancos foram por confronto com criminosos. Conclui-se que o perfil das mortes de policiais militares no estado da Bahia é semelhante ao da população em geral, com predomínio de homens, negros, jovens e solteiros.

Brazil is a country with high rates of violence, which affects, in addition to civil society, public security agents, whose mortality rates from violent causes are higher than those of the general population. Therefore, the objective was to characterize the profile of mortality of military police officers due to violent causes, according to skin color, in the state of Bahia. This study analyzed violent deaths of active military police officers that occurred between 2012 and 2019, considering both sociodemographic variables and those related to the police force and the circumstances of the occurrence. The analysis of the results was carried out using the computational language R version 4.2.2. A total of 110 military police deaths were recorded, most were black (83.64%). Regarding age group, black military police officers died younger, between 30 and 39 years old (41.30%), whereas white military police officers, between 40 and 49 years old (61.11%). In 50% of cases involving black military police officers, the motivation for the crime remained unknown, whereas 33.33% of deaths involving white police officers were due to confrontation with criminals. In conclusion, the profile of military police deaths in the state of Bahia is similar to that of the general population, with a predominance of male, black, young, and single people.

Brasil tiene altos índices de violencia que no solo afectan a la sociedad civil, sino también a los agentes de seguridad pública, cuyas tasas de mortalidad por causas violentas superan a las de la población general. Así, el objetivo de este estudio fue caracterizar el perfil de mortalidad por causas violentas de los policías militares según el color de la piel, en el estado de Bahía (Brasil). En este estudio se analizaron muertes violentas de policías militares en activo, ocurridas entre 2012 y 2019, considerando variables sociodemográficas relacionadas con el cuerpo policial y las circunstancias de la ocurrencia. El análisis de los resultados se realizó utilizando el lenguaje computacional R, versión 4.2.2. Se registraron 110 muertes de policías militares, la mayoría negros (83,64%). Con relación al grupo de edad, los policías militares negros murieron más jóvenes, de entre 30 y 39 años (41,30%), que los policías militares blancos, de entre 40 y 49 años (61,11%). En el 50% de los casos que involucraron a policías militares negros, la motivación del crimen seguía siendo desconocida, mientras que en el 33,33% de las muertes que involucraron a policías blancos se debieron a enfrentamientos con delincuentes. Se concluye que el perfil de las muertes de policías militares en Bahía es similar al de la población general, con predominio de hombres, negros, jóvenes y solteros.

Male sex and hazardous alcohol use following military sexual assault increase suicide risk among US service members and veterans.

Background: Higher alcohol use and military sexual assault (MSA) are associated with increased risk of death by suicide. Risk for death by suicide is rapidly increasing among females, who report higher rates of MSA, yet actual death by suicide and alcohol use are higher among males. It is not well understood whether higher alcohol use confers greater suicide risk in male or female service members and veterans who have experienced MSA.Objective: To determine whether the association between alcohol misuse and suicide risk was moderated by biological sex in a sample of male and female service members (N = 400, 50% female) who reported MSA.Method: Participants completed surveys of alcohol use and suicide risk as well as a demographic inventory. Linear regression with an interaction term was used to determine if suicide risk differed by sex and alcohol use severity after accounting for discharge status, sexual orientation, and age.Results: Average scores on the suicide risk measure were consistent with an inpatient psychiatric sample and scores on the AUDIT-C were indicative of a probable positive screen for alcohol misuse. Suicide risk was most pronounced among males who reported higher levels of hazardous alcohol use. A sensitivity analysis examining suicide risk by sex and screening results for alcohol misuse (positive/negative) showed that men with a probable positive screen had higher suicide risk.Discussion: The current study provides novel findings on suicide risk among survivors of military sexual violence by including both male and female survivors. Interventions to decrease suicide risk following MSA may consider alcohol reduction strategies, and optimizing these interventions in males. Engaging military culture at both the US Departments of Defense and Veterans Affairs to encourage more healthy alcohol consumption may mitigate this public health concern. Future research may consider how country of origin relates to these associations.

Average scores for the suicide risk measure and alcohol use were high among a sample of male and female survivors of military sexual assault.Suicide risk was most pronounced among males who reported higher levels of hazardous alcohol use.A sensitivity analysis examining suicide risk by sex and screening results for alcohol misuse (positive/negative) showed that men with a probable positive screen had higher suicide risk.

Cognitive-behavioural conjoint therapy versus prolonged exposure for PTSD in military service members and veterans: results and lessons from a randomized controlled trial.

Military personnel and veterans are at heightened risk for exposure to traumatic events and posttraumatic stress disorder (PTSD), as well as intimate relationship problems associated with PTSD.The purpose of this study was to evaluate the relative efficacy of CBCT and PE in improving intimate relationship functioning in active duty military personnel or veterans and their intimate partners; both conditions were hypothesized to significantly improve PTSD. Method: In this study, 32 military service members or veterans with PTSD and their intimate partners were randomized to receive either Cognitive-Behavioral Conjoint Therapy for PTSD (n = 15; CBCT; [Monson, C. M., & Fredman, S. J. (2012). Cognitive-behavioral conjoint therapy for posttraumatic stress disorder: Harnessing the healing power of relationships. Guilford]), a trauma-focused couple therapy, or Prolonged Exposure (n = 17; PE; [Foa, E. B., Hembree, E. A., Dancu, C. V., Peterson, A. L., Cigrang, J. A., & Riggs, D. S. (2008). Prolonged exposure treatment for combat-related stress disorders - provider's treatment manual [unpublished]. Department of Psychiatry, University of Pennsylvania]), a front-line evidence-based individual treatment for PTSD.There were significant challenges with recruitment and a significant difference in dropout from treatment for the two therapies (65% for PE; 27% for CBCT). Treatment dropout was differentially related to pre-treatment relationship functioning; those with below average relationship functioning had higher dropout in PE compared with CBCT, whereas those with above average relationship functioning did not show differential dropout. In general, CBCT led to relational improvements, but this was not consistently found in PE. Clinician- and self-reported PTSD symptoms improved with both treatments.This study is the first to test a couple or family therapy against a well-established, front-line recommended treatment for PTSD, with expected superiority of CBCT over PE on relationship outcomes. Lessons learned in trial design, including considerations of equipoise, and the effects of differential dropout on trial analyses are discussed. This trial provides further support for the efficacy of CBCT in the treatment of PTSD and enhancement of intimate relationships.

Differential dropout from trial of couple versus individual therapy for PTSD.General pattern of improvements in relationship outcomes in couple therapy for PTSD.PTSD symptoms improved in the individual and couple therapy for PTSD.Lessons learned in trial design, including considerations of equipoise, and the effects of differential dropout by condition on trial analyses are discussed.

Retorno a la actividad completa tras cirugía de reconstrucción de ligamento cruzado anterior en personal militar: metaanálisis / Return to full duty after anterior cruciate ligament reconstruction surgery in military personnel: A meta-analysis

Objetivo: Se realizó un metaanálisis para evaluar los resultados clínico-funcionales de la cirugía de ligamento cruzado anterior en militares, así como las complicaciones asociadas a la misma. Material y métodos: Se realizó una búsqueda en las 3 principales fuentes de bases de datos hasta diciembre de 2022 (PubMed, Google Scholar y ScienceDirect) en cuanto a los resultados tras la cirugía de ligamento cruzado anterior en personal militar. La revisión sistemática se realizó siguiendo las normas Preferred Reporting Items for Systematic Reviews and Meta-Analyses –PRISMA–, y los criterios de inclusión siguieron la estrategia PICO. Los datos de los estudios incluidos se analizaron mediante el software Review Manager 5.4. Resultados: Se seleccionaron un total de 7 estudios retrospectivos. La tasa general de retorno a la actividad completa en el personal militar fue del 62,3% (61,5% para el grupo de no oficiales frente a 68,3% para el grupo de oficiales), sin ser esta diferencia significativa (p=0,92). La tasa general de lesión meniscal en los militares fue del 58,8%, sin ser esta diferencia significativa (p=0,88). La homogeneidad en ambos casos fue buena (I2=0%, p=0,99). Conclusión: El regreso a la actividad militar completa puede usarse en la población militar como un marcador de éxito después de una reconstrucción de ligamento cruzado anterior. Hay que destacar que una gran cantidad de militares experimentan limitaciones permanentes en la actividad que impiden el regreso completo al servicio.(AU)

Objective: A meta-analysis was carried out to evaluate the clinical-functional results of anterior cruciate ligament surgery in military population, as well as the complications associated with it. Material and method: Three major database sources up to December 2022 (PubMed, Google Scholar, and ScienceDirect) were searched for outcomes after anterior cruciate ligament surgery in military personnel. The systematic review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses –PRISMA– standards, and the inclusion criteria following the PICO strategy. Data from included studies were analyzed using Review Manager 5.4 software. Results: A total of 7 retrospective studies were selected. The general rate of return to full duty in military personnel was 62.3% (61.5% for the non-officer group vs. 68.3% for the officer group) without this difference being significant (p=0.92). The general rate of meniscal injury in the military was 58.8%, without this difference being significant (p=0.88). The homogeneity in both cases was good (I2=0%, p=0.99). Conclusion: Return to full military duty can be used in the military population as a marker of success after anterior cruciate ligament reconstruction. It should be noted that a large number of military personnel experience permanent activity limitations that prevent full return to service.(AU)

[Translated article] Return to full duty after anterior cruciate ligament reconstruction surgery in military personnel: A meta-analysis / Retorno a la actividad completa tras cirugía de reconstrucción del ligamento cruzado anterior en personal militar: metaanálisis

Objetivo: Se realizó un metaanálisis para evaluar los resultados clínico-funcionales de la cirugía de ligamento cruzado anterior en militares, así como las complicaciones asociadas a la misma. Material y métodos: Se realizó una búsqueda en las 3 principales fuentes de bases de datos hasta diciembre de 2022 (PubMed, Google Scholar y ScienceDirect) en cuanto a los resultados tras la cirugía de ligamento cruzado anterior en personal militar. La revisión sistemática se realizó siguiendo las normas Preferred Reporting Items for Systematic Reviews and Meta-Analyses –PRISMA–, y los criterios de inclusión siguieron la estrategia PICO. Los datos de los estudios incluidos se analizaron mediante el software Review Manager 5.4. Resultados: Se seleccionaron un total de 7 estudios retrospectivos. La tasa general de retorno a la actividad completa en el personal militar fue del 62,3% (61,5% para el grupo de no oficiales frente a 68,3% para el grupo de oficiales), sin ser esta diferencia significativa (p=0,92). La tasa general de lesión meniscal en los militares fue del 58,8%, sin ser esta diferencia significativa (p=0,88). La homogeneidad en ambos casos fue buena (I2=0%, p=0,99). Conclusión: El regreso a la actividad militar completa puede usarse en la población militar como un marcador de éxito después de una reconstrucción de ligamento cruzado anterior. Hay que destacar que una gran cantidad de militares experimentan limitaciones permanentes en la actividad que impiden el regreso completo al servicio.(AU)

Objective: A meta-analysis was carried out to evaluate the clinical-functional results of anterior cruciate ligament surgery in military population, as well as the complications associated with it. Material and method: Three major database sources up to December 2022 (PubMed, Google Scholar, and ScienceDirect) were searched for outcomes after anterior cruciate ligament surgery in military personnel. The systematic review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses –PRISMA– standards, and the inclusion criteria following the PICO strategy. Data from included studies were analyzed using Review Manager 5.4 software. Results: A total of 7 retrospective studies were selected. The general rate of return to full duty in military personnel was 62.3% (61.5% for the non-officer group vs. 68.3% for the officer group) without this difference being significant (p=0.92). The general rate of meniscal injury in the military was 58.8%, without this difference being significant (p=0.88). The homogeneity in both cases was good (I2=0%, p=0.99). Conclusion: Return to full military duty can be used in the military population as a marker of success after anterior cruciate ligament reconstruction. It should be noted that a large number of military personnel experience permanent activity limitations that prevent full return to service.(AU)

Mental healthcare utilisation among Danish formerly deployed military personnel and their civilian counterparts: a cohort study.

Background: Prior studies comparing the mental healthcare utilisation (MHU) of Danish formerly deployed military personnel (FDP) with the general population have not included data on psychotherapy through the Defence or talking therapy with the general practitioner. This study included these and several other data sources in a comprehensive comparison of MHU between Danish FDP and civilians.Methods: First-time deployed military personnel (N = 10,971) who had returned from a mission to Kosovo, Afghanistan, Iraq or Lebanon between January 2005 and July 2017 were included. A sex and birth-year-matched civilian reference group was randomly drawn from the entire Danish non-deployed population (N = 253,714). Furthermore, a sub-cohort, including male FDP and civilians deemed eligible for military service, was defined. These cohorts were followed up in military medical records and registers covering the primary and secondary civilian health sectors from 2005 to 2018, and the rates of MHU were compared.Results: Approximately half of the initial help-seeking for FDP took place through the Defence (49.4%), and the remainder through the civilian healthcare system. When help-seeking through the Defence was not included, MHU was significantly lower among FDP in the main cohort during the first two years (IRR = 0.84, 95% CI: [0.77, 0.92]) compared to civilians. When help-seeking through the Defence was included, MHU was significantly higher among FDP compared to civilians both in the first two years of follow-up (IRR = 2.01, 95% CI: [1.89, 2.13]) and thereafter (IRR = 1.18, 95% CI: [1.13, 1.23]). In the sub-cohort, these differences were even more pronounced both in the first two years of follow-up and thereafter.Conclusions: MHU was higher among Danish FDP compared to civilians only when data from the Defence was included. The inclusion of data on both civilian and military healthcare services is necessary to evaluate the full impact of deployment on MHU among Danish FDP.

This study compared mental healthcare utilisation among Danish deployed military personnel and civilians.Most personnel sought help first through the Defence.When all data sources were included, mental healthcare utilisation was significantly higher among military personnel.

Return to full duty after anterior cruciate ligament reconstruction surgery in military personnel: A meta-analysis. / Retorno a la actividad completa tras cirugía de reconstrucción de ligamento cruzado anterior en personal militar: metaanálisis.

OBJECTIVE: A meta-analysis was carried out to evaluate the clinical-functional results of anterior cruciate ligament surgery in military population, as well as the complications associated with it. MATERIAL AND METHOD: Three major database sources up to December 2022 (PubMed, Google Scholar, and ScienceDirect) were searched for outcomes after anterior cruciate ligament surgery in military personnel. The systematic review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses -PRISMA- standards, and the inclusion criteria following the PICO strategy. Data from included studies were analyzed using Review Manager 5.4 software. RESULTS: A total of 7 retrospective studies were selected. The general rate of return to full duty in military personnel was 62.3% (61.5% for the non-officer group vs. 68.3% for the officer group) without this difference being significant (p=0.92). The general rate of meniscal injury in the military was 58.8%, without this difference being significant (p=0.88). The homogeneity in both cases was good (I2=0%, p=0.99). CONCLUSION: Return to full military duty can be used in the military population as a marker of success after anterior cruciate ligament reconstruction. It should be noted that a large number of military personnel experience permanent activity limitations that prevent full return to service.

[Translated article] Return to full duty after anterior cruciate ligament reconstruction surgery in military personnel: A meta-analysis.

OBJECTIVE: A meta-analysis was carried out to evaluate the clinical-functional results of anterior cruciate ligament surgery in military population, as well as the complications associated with it. MATERIAL AND METHOD: Three major database sources up to December 2022 (PubMed, Google Scholar, and ScienceDirect) were searched for outcomes after anterior cruciate ligament surgery in military personnel. The systematic review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses -PRISMA- standards, and the inclusion criteria following the PICO strategy. Data from included studies were analysed using Review Manager 5.4 software. RESULTS: A total of seven retrospective studies were selected. The general rate of return to full duty in military personnel was 62.3% (61.5% for the non-officer group versus 68.3% for the officer group) without this difference being significant (p=0.92). The general rate of meniscal injury in the military was 58.8%, without this difference being significant (p=0.88). The homogeneity in both cases was good (I2=0%, p=0.99). CONCLUSION: Return to full military duty can be used in the military population as a marker of success after anterior cruciate ligament reconstruction. It should be noted that a large number of military personnel experience permanent activity limitations that prevent full return to service.

Mulheres no trabalho militar: uma revisão bibliométrica e crítica / Mujeres en el trabajo militar: una revisión bibliométrica y crítica / Women in military work: a bibliometric and critical review

Resumo: O trabalho militar, historicamente, é uma profissão predominantemente masculina. A crescente inserção das mulheres nas instituições militares tem enfrentado entraves importantes. A presente revisão bibliométrica objetivou mapear e analisar criticamente a literatura indexada sobre gênero no contexto militar, pretendendo especificamente identificar características, tendências e lacunas da produção científica sobre o tema nos últimos 10 anos na psicologia. Além da ausência de estudos brasileiros ou em língua portuguesa, identificou-se predominância de métodos quantitativos e de participantes homens nas pesquisas. O tema mais abordado foi o trauma sexual militar. Aponta-se a necessidade de mais investigações com mulheres militares em contexto brasileiro.

Resumen: El trabajo militar ha sido históricamente una profesión predominantemente masculina. La creciente inserción de la mujer en las instituciones militares ha enfrentado importantes obstáculos. La presente revisión bibliométrica tuvo como objetivo mapear y analizar críticamente la literatura indexada sobre género en el contexto militar, con el objetivo de identificar características, tendencias y vacíos en la producción científica sobre el tema en los últimos 10 años. Además de la ausencia de estudios brasileños o en lengua portuguesa, se identificó predominio de métodos cuantitativos y participantes del sexo masculino en la investigación. El tema más discutido fue el trauma sexual militar. Se destaca la necesidad de más investigaciones con mujeres militares en el contexto brasileño.

Abstract: Military work is, historically, a predominantly male profession. The growing insertion of women in military institutions has faced important obstacles. This bibliometric review aimed to map and critically analyze the indexed literature on gender in the military context, specifically intending to identify characteristics, trends and gaps in scientific production on the topic in the last 10 years. In addition to the absence of Brazilian or Portuguese-language studies, a predominance of quantitative methods and male participants was identified. The most discussed topic was military sexual trauma. The need for more research with military women in the Brazilian context is highlighted.

La Cruz Roja española en la profesionalización enfermera entre 1912 y 1939 / Spanish Red Cross In Nursing Professionalization Between 1912 And 1939. Bibliographic Review

Introducción: La fundación de la Cruz Roja Española se puede remontar a la tercera Guerra Carlista, los fines, principios y el servicio de esta institución repercutieron en el desarrollo de la profesión de enfermería en la época. Objetivo: determinar la implicación de la Cruz Roja Española en la profesionalización enfermera entre 1912 y 1939. Material y método: se realizó una búsqueda bibliográfica en los principales portales de búsqueda, así como en bibliotecas de especialización en historia de la enfermería. Resultados: la Cruz Roja Española participó en el desarrollo asistencial y formativo de la enfermería, fundando y regentando hospitales propios y hospitales de campaña para atender a los heridos surgidos de diferentes conflictos bélicos, como las propias Guerras Carlistas, la Guerra del Rif o la Guerra Civil Española. En la formación fundaron diversos Hospitales-Escuelas que impartían una formación teórico-práctica, supervisada por monjas religiosas. Conclusión: la participación de la Cruz Roja en la profesionalización enfermera radica en la colaboración, atención y asistencia de los heridos en numerosos conflictos bélicos a nivel nacional, como fueron las Guerras Carlistas, la Guerra del Rif y la Guerra Civil Española. La Cruz Roja también participó en el avance y mejora de la formación reglada hasta la época, contando con figuras como la de Dama Enfermera, Enfermeras profesionales y enfermeras especialistas. (AU)

Background: The foundation of the Spanish Red Cross can be traced back to the third Carlist War, the purposes, principles, and service of this institution had an impact on the development of the nursing profession at the time. Objective: to determine the involvement of the Spanish Red Cross in nursing professionalization between 1912 and 1939. Methods: A bibliographic search was carried out in the main search portals, as well as in specialized libraries in nursing history. Results: The Spanish Red Cross participated in the development of nursing care and training, founding and running its own hospitals and field hospitals to care for the wounded from various wars, such as the Carlist Wars themselves, the Rif War or the Spanish Civil War. In the training they founded various Hospital-Schools that provided theoretical practical training, supervised by religious nuns. Conclusion: The participation of the Red Cross in the professionalization of nursing lies in the collaboration, care, and assistance of the wounded in numerous armed conflicts at the national level, such as the Carlist Wars, the Rif War and the Spanish Civil War. The Red Cross also participated in the advancement and improvement of regulated training up to that time, with figures such as the Lady Nurse, professional nurses, and specialist nurses. (AU)

Evaluation of Community Reinforcement and Family Therapy in the UK military community.

Background: Partners and family can play a key role in encouraging military service and ex-service personnel to seek help for their mental health. Community Reinforcement Approach and Family Training (CRAFT) was developed to equip concerned significant others (CSOs) of those experiencing substance use disorders with skills to encourage their loved one to enter treatment and improve their own well-being. It was adapted in the US for CSOs of ex-service personnel with post-traumatic stress disorder (PTSD) (VA-CRAFT).Objective: This study aimed to evaluate an adaptation of VA-CRAFT for use with CSOs of serving and ex-service personnel experiencing PTSD and Common Mental Disorders in the UK (UKV-CRAFT).Method: Acceptability of UKV-CRAFT was assessed with interviews with experts, namely key stakeholders (n = 15) working in support provision for serving and ex-service personnel. In addition, individuals who took part in a small-scale demonstrative trial of UKV-CRAFT (three CSOs and three facilitators who delivered UKV-CRAFT) provided feedback.Results: UKV-CRAFT was viewed positively, with interviewees highlighting that programmes like UKV-CRAFT filled a gap in provision for UK Armed Forces families as most services were only available to the serving or ex-service personnel. Interviewees praised how UKV-CRAFT enhanced CSO well-being and communication with their loved one. Concerns over the confidentiality of taking part in UKV-CRAFT were raised due to the perceived negative effects of highlighting a loved one's mental ill health, especially for CSOs of serving personnel. Ideas for improvement included broadening access to all CSOs regardless of whether their loved one was seeking treatment.Conclusion: Interviewees regarded UKV-CRAFT as a potentially useful intervention suggesting it could be proactively offered universally to support timely help-seeking if required. We recommend further evaluation of UKV-CRAFT on a wider scale, incorporating our recommendations, to assess its effectiveness accurately.

Community Reinforcement And Family Therapy (CRAFT), a programme for the concerned significant others (CSOs) of people experiencing Substance Abuse Disorders (SUDs), was adapted for the CSOs of UK Armed Forces serving and ex-service personnel (UKV-CRAFT).UKV-CRAFT aimed to equip CSOs with the skills to encourage their Armed Forces loved ones to seek mental health treatment; it was evaluated by post-trial interviews with UKV-CRAFT facilitators, recipients, and Armed Forces stakeholders.UKV-CRAFT was found to be a useful intervention for CSOs but would benefit from further evaluation on a wider scale.Evaluation of Community Reinforcement And Family Therapy in the UK military community.

Nível de atividade física, capacidade funcional e flexibilidade de soldados ingressantes no Exército brasileiro / Level of physical activity, functional capacity and flexibility of soldiers entering the Brazilian Army

Objetivou avaliar o nível de atividade física, capacidade funcional (CF) e a flexibilidade de adultos jovens antes e após dez meses de ingresso em um programa de exercícios físicos no Exército brasileiro. Trata-se de uma pesquisa de coorte prospectivo. O nível de atividade física foi avaliado pelo Questionário Internacional de Atividade Física (IPAQ), a CF, pelo Teste de Cooper, e a flexibilidade, pelo Banco de Wells. Amostra (n = 198; 18±0,27 anos) com índice de massa corporal (IMC) de 23,23±3,84 kg/m2. Após dez meses de admissão no Exército, constatou-se redução na prevalência de sedentarismo (33  28%) e na CF (2.982±243,61  3.117±192,87 m), sem alteração da flexibilidade (27,31±7,39  27,52±7,40 cm). Houve grande tamanho de efeito no IMC, na relação cintura quadril (RCQ) e na flexibilidade. Conclui-se que a inserção em um programa de exercícios físicos no Exército brasileiro aumentou a CF e reduziu a RCQ dos jovens.

This study aimed to evaluate the level of physical activity, functional capacity (FC), and flexibility of young adults before and ten months after joining a physical exercise program in the Brazilian Army. This was a prospective cohort study. The level of physical activity was assessed using the International Physical Activity Questionnaire (IPAQ), FC using the Cooper Test, and flexibility using the Wells bench. Sample (n = 198; 18±0.27 years) with a body mass index (BMI) of 23.23±3.84 kg/m2. After ten months of admission to the Brazilian Army, there was a reduction in the prevalence of sedentary lifestyle (33  28%) and FC (2,982±243.61  3,117±192.87 m), without change in flexibility (27.31±7.39  27.52±7.40 cm). There was a large effect size on BMI, waist-hip ratio (WHR), and flexibility. In short, inclusion in a physical exercise program in the Brazilian Army increased FC and reduced the WHR of young recruits.

Creative self-beliefs of civilian and military school students / Crenças do self criativo de estudantes de escolas civis e militares / Creencias del self creativo de estudiantes de escuelas civiles y militares

Creative Self-Efficacy (CSE) and Creative Personal Identity (CPI) are creative self-beliefs which act as creative achievement predictors in different contexts, including school. Brazilian theoretical studies suggest that characteristics of military school can inhibit creative expression. The question is raised whether the school environment can influence CSE and CPI. Therefore, the goal was to compare male and female students from military and civilian schools, in terms of CSE and IPC, in addition to verifying the interaction between the variables. Participants were 230 secondary school students, with a mean age of 16.07 years (SD = .92). The Short Scale of Creative Self (SSCS) and a sociodemographic questionnaire were used. No significant differences or interactions were observed, except for the higher IPC in women when compared to men. Thus, it is possible that the typical restrictions of the military model of education do not necessarily imply barriers to creativity.(AU)

Autoeficácia Criativa (AEC) e Identidade Pessoal Criativa (IPC) são crenças do self criativo que atuam como preditoras da realização criativa em diversos contextos, inclusive escolar. Estudos teóricos brasileiros sugerem que as características da escola militar podem inibir a expressão criativa. Questiona-se como AEC e IPC podem ser influenciadas pelo ambiente escolar. Portanto, o objetivo deste estudo foi comparar estudantes de escolas militares e civis, do sexo masculino e feminino, quanto à AEC e IPC, além de verificar possível interação entre as variáveis. Participaram 230 estudantes do ensino médio, com idade média de 16,07 anos (DP = 0,92). Utilizou-se a Escala Breve do Self Criativo (EBSC) e um questionário sociodemográfico. Não foram observadas diferenças ou interações significativas entre os grupos, exceto pela IPC superior nas mulheres, quando comparadas aos homens. Nesse sentido, é possível que as restrições típicas do modelo militar de educação não impliquem necessariamente barreiras à criatividade.(AU)

La Autoeficacia Creativa (AEC) y la Identidad Personal Creativa (IPC) son creencias del self creativo que actúan como predictores del logro creativo en diferentes contextos, incluyendo el escolar. Estudios teóricos brasileños sugieren que las características de las escuelas militares pueden inhibir la expresión creativa. Se cuestiona si el entorno escolar puede influir en la AEC y la IPC. Por lo tanto, el objetivo de este estudio fue comparar alumnos y alumnas de escuelas militares y civiles, en términos de AEC y IPC, además de verificar la interacción entre las variables. Participaron 230 estudiantes de secundaria de escuelas públicas, con una edad promedia de 16,07 años (DS = 0,92). Se utilizó la escala Short Scale of Creative Self (SSCS) y un cuestionario sociodemográfico. No se observaron diferencias o interacciones significativas entre los grupos, excepto por una IPC superior en mujeres en comparación con los hombres. Es posible que las restricciones típicas del modelo educativo militar no necesariamente impliquen barreras para la creatividad.(AU)

Estresse ocupacional e enfrentamento em enfermeiros de um Hospital do Exército Brasileiro: abordagem qualitativa / Occupational stress and coping among nurses at a Brazilian Army Hospital: a qualitative approach

Este estudo buscou compreender os estressores ocupacionais percebidos por enfermeiras militares e os seus modos de enfrentamento. Pesquisa de abordagem qualitativa, realizada em um hospital do Exército Brasileiro. A coleta de dados ocorreu de agosto a outubro de 2019 por meio de entrevista com uso de gravador eletrônico. Os dados foram analisados de forma descritiva, e utilizou-se como referencial o Método Hermenêutico-Dialético com fundamentação na teoria dos sistemas de Betty Neuman. Com base nas unidades de significação dos discursos das participantes, foram identificadas três categorias de análise: (1) Estressores ocupacionais percebidos; (2) Percepção das enfermeiras sobre as repercussões do ambiente de trabalho na vida cotidiana; e (3) Enfrentamento dos estressores ocupacionais. A percepção das enfermeiras militares sobre o estresse ocupacional evidenciou que esse cenário é constituído de estressores típicos da profissão, do ser enfermeiro e do ser militar, podendo haver respostas diversas ao enfrentamento do estresse percebido.

This study aimed to understand the occupational stressors perceived by military nurses and their ways of coping. A qualitative research was carried out at a Brazilian Army hospital. Data collection took place from August to October 2019 through an interview by using an electronic recorder. The data were analyzed in a descriptive way, and the hermeneutic-dialectical method was used as a reference based on Betty Neuman's systems theory. Based on the units of signification of the participants' discourses, three categories of analysis were identified: (1)Perceived occupational stressors; (2) Perception of nurses about the repercussions of their work environment in everyday life; and (3) Coping with occupational stressors. The military nurses' perception of occupational stress showed that this scenario consists of stressors typical of the profession, of what it is like to be a nurse and to be in the military. There may be several responses to coping with perceived stress.

La toma de decisión emocional afecta negativamente la eficacia de la primera ayuda psicológica, más allá del perfil psicológico del rescatista / Emotional Decision Making Negatively Affects the Effectiveness of Psychological First Aid, Irrespective the Rescuer's Psychological Profile / A tomada de decisão emocional afeta negativamente a eficácia dos primeiros auxílios psicológicos, além do perfil psicológico do socorrista

El protocolo de primera ayuda psicológica basado en el modelo de las 4 C (PAP-4C) establece pautas para brindar apoyo y rescatar a individuos afectados en el lugar y momentos inmediatos posteriores a un desastre. Los objetivos de esta investigación fueron estudiar los efectos de la toma de decisión y el entrenamiento presencial breve en la PAP-4C sobre la propensión al comportamiento eficaz de rescate según ese modelo, evaluada una semana después de la capacitación recibida; e identificar otras variables psicológicas que se vinculan con dicha propensión. Para este estudio, se adoptó un enfoque explicativo, que involucró la implementación de un diseño experimental factorial 2x2, con los factores toma de decisión y entrenamiento presencial breve en la PAP-4C, en una muestra de 175 estudiantes universitarios de una academia militar sin entrenamiento previo en rescate en situaciones de desastre. Los resultados de un ancova mostraron que la toma de decisión basada en la emoción perjudica la propensión al comportamiento eficaz en la PAP-4C en comparación con una toma de decisiones basada en la racionalidad, luego de controlar estadísticamente a las covariables. Con relación a la identificación de estas, una serie de características psicológicas se habían mostrado asociadas con la propensión al comportamiento eficaz de rescate. En este sentido, se habían hallado correlaciones positivas con tenacidad, honestidad, apertura, jovialidad, agradabilidad, la atracción afectiva hacia los demás y la toma de la perspectiva del otro. Además, se habían hallado asociaciones positivas con las estrategias de afrontamiento cognitivo dirigido a cambiar la situación, y cognitivo y conductual motor para reducir la emoción. Finalmente, se habían encontrado también asociaciones negativas con la aversión afectiva hacia los demás y el afrontamiento evitativo. En conclusión, por una parte, los resultados de este estudio apuntan a mostrar la importancia de que los líderes de grupos de rescate indiquen a los rescatistas que, cuando realizan la tarea del rescate de personas afectadas por desastres, eviten tomar decisiones emocionales. Por otra parte, los resultados también ofrecen orientación para la selección de personal sin experiencia previa en la asistencia en situaciones de desastre, ya que se identificó una amplia serie de variables psicológicas asociadas a la propensión al comportamiento eficaz en la PAP-4C. En suma, esta investigación proporciona un valioso aporte al campo de la asistencia psicológica en situaciones de crisis, al identificar factores y variables psicológicas que podrían influir en los comportamientos de los rescatistas no profesionales y sin experiencia previa cuando se debe rescatar y brindar apoyo psicológico a personas afectadas por un desastre.

The psychological first aid protocol based on the 4 Cs model (PAP-4C) establishes guidelines for providing support and rescue to affected individuals at the scene and in the immediate aftermath of a disaster. The ob-jectives of this research were to study the effects of decision making and brief training in the PAP-4C on the propensity for effective rescue behaviour according to that model, assessed one week after the training received; and to identify other psychological variables that are linked to that propensity. For this study, an explanatory approach was adopted, involving the implementation of a 2x2 factorial experimental design, with the factors decision making and brief face-to-face training in the PAP-4C, in a sample of 175 university students from a military academy with no previous training in disaster rescue. The results of an ancova showed that emotionbased decision making impaired the propensity for effective behaviour in PAP-4C compared to rationality-based decision making, after statistically controlling for covariates. In relation to the identification of covariates, a number of psychological characteristics had been shown to be associated with the propensity for efficient rescue behaviour. In this regard, positive correlations were found with tenacity, honesty, openness to experience, cheerfulness, agreeableness, affective attraction to the other and taking the other's perspective. In addition, positive associations were found with cognitive coping strategies aimed at changing the situation, and cognitive and behavioural motor coping strategies aimed at reducing the emotion. Finally, negative associations were also found with an affective aversion towards the other and avoidant coping. In conclusion, on the one hand, the results of this study aim to show the importance of rescue team leaders instructing rescuers to avoid making emotional decisions when carrying out rescuing disaster affected people. On the other hand, the results provide guidance for the selection of personnel with no previous expe-rience in disaster relief, as a wide range of psycho-logical variables associated with the propensity for effective behaviour in PAP-4C were identified. In sum, this research provides a valuable contribution to the field of psychological assistance in crisis situations by identifying psychological factors and variables that may influence the behaviours of non-professional and inexperienced rescuers when rescuing and providing psychological support to disaster-affected people.

O protocolo de primeiros auxílios psicológicos baseado no modelo 4 C (PAP-4C) estabelece diretrizes para fornecer apoio e resgatar indivíduos afetados no local e imediatamente após um desastre. Os objetivos desta pesquisa foram estudar os efeitos da tomada de decisão e do breve treinamento presencial no PAP-4C sobre a propensão para um comportamento de resgate eficaz de acordo com esse modelo, avaliado uma semana após o treinamento recebido; e identificar outras variáveis psicológicas que estão ligadas a essa propensão. Para este estudo foi adotada uma abordagem explicativa, que envolveu a implementação de um desenho experi-mental fatorial 2x2, com os fatores tomada de decisão e breve treinamento presencial sobre o PAP-4C, em uma amostra de 175 estudantes universitários de uma academia militar sem treinamento prévio em resgate em situações de desastre. Os resultados de uma ancova mostraram que a tomada de decisão baseada na emoção, prejudica a propensão para um comportamento eficaz no PAP-4C em comparação com a tomada de decisão baseada na racionalidade, após controlar estatisticamente as covariáveis. Em relação à identificação destas, uma série de características psicológicas mostraramse associadas à propensão para comportamentos de resgate eficazes. Nesse sentido, foram encontradas correlações positivas com tenacidade, honestidade, abertura, jo-vialidade, simpatia, atração emocional pelos outros e tomada de perspectiva do outro. Além disso, foram en-contradas associações positivas com estratégias de enfrentamento cognitivas destinadas a mudar a situação e estratégias de enfrentamento comportamentais cog-nitivas e motoras para reduzir a emoção. Finalmente, também foram encontradas associações negativas com aversão afetiva em relação aos outros e enfrentamento evitativo. Concluindo, por um lado, os resultados deste estudo pretendem mostrar a importância de os líderes dos grupos de resgate dizerem aos socorristas que, ao realizarem a tarefa de resgatar pessoas afetadas por de-sastres, devem evitar tomar decisões emocionais. Por outro lado, os resultados também oferecem orientação para a seleção de pessoal sem experiência anterior em assistência em situações de desastre, uma vez que foi identificada uma ampla série de variáveis psicológicas associadas à propensão para comportamentos eficazes no PAP-4C. Em resumo, esta investigação proporciona uma valiosa contribuição para o campo da assistência psicológica em situações de crise, ao identificar fato-res e variáveis psicológicas que podem influenciar os comportamentos de socorristas não profissionais e sem experiência prévia, ao resgatar e prestar apoio psicoló-gico a pessoas afetadas por um desastre

Honores a Sir Ernest Shackleton en Sanidad Militar / Honors to Sir Ernest Shackleton in Military Health / Honras a Sir Ernest Shackleton em Saúde Militar

Ernest Shackleton ha sido en la historia, un personaje que dejó huella como ejemplo de resiliencia y liderazgo. En 1914 realizó como jefe de expedición su segundo viaje antártico, frustrado por el hundimiento de su buque insignia. La operación de rescate del grueso de la tripulación varada en el continente más meridional lo llevó a recalar en Montevideo. Desde este puerto partió el buque Instituto de Pesca N°1, con tripulación de Uruguay y Shackleton incluido, no logrando completar el salvamento. De esta acción nació el aprecio hacia la persona del explorador por parte del gobierno de la República. En su postrer travesía, ya fallecido llegó a las Islas Georgia del Sur y a su cuerpo se le realizó un proceso de conservación para ser traído a nuestro país y continuar viaje al puerto de origen en Inglaterra. Es en esa circunstancia que el gobierno del doctor Baltasar Brum solicitó a la Comisión Permanente del Parlamento, se le rindieran honores fúnebres de Ministro de Estado. El embalsamado del cuerpo fue realizado el 30 de enero de 1922, por parte de personal médico y técnico del Hospital Militar, así como los honores que le rindieron por el Servicio de Sanidad del Ejército y la Armada.

Ernest Shackleton has been in history, a character who left his mark as an example of resilience and leadership. In 1914, as expedition leader, he made his second Antarctic voyage, frustrated by the sinking of his flagship. The operation to rescue the bulk of the crew stranded on the southernmost continent led him to Montevideo. The Instituto de Pesca N°1, with Uruguayan crew and Shackleton included, departed from this port, but was unable to complete the rescue. From this action was born the appreciation of the explorer by the government of the Republic. In his last voyage, when he died, he reached the South Georgia Islands and his body underwent a preservation process to be brought to our country and continue his voyage to the port of origin in England. It is in this circumstance that the government of Dr. Baltasar Brum requested the Permanent Commission of the Parliament to pay him the funeral honors of a Minister of State. The embalming of the body was carried out on January 30, 1922, by medical and technical personnel of the Military Hospital, as well as the honors rendered by the Army and Navy Health Service.

Ernest Shackleton deixou sua marca na história como um exemplo de resiliência e liderança. Em 1914, ele fez sua segunda viagem à Antártica como líder da expedição, frustrado pelo naufrágio de seu navio principal. A operação para resgatar a maior parte da tripulação encalhada no continente mais ao sul o levou a Montevidéu. O Instituto de Pesca N°1, com tripulação do Uruguai e Shackleton incluído, partiu desse porto, mas não conseguiu concluir o resgate. Essa ação deu origem ao reconhecimento do explorador pelo governo da República. Em sua última viagem, quando morreu, chegou às Ilhas Geórgia do Sul e seu corpo foi preservado para que pudesse ser trazido ao nosso país e continuar sua viagem até o porto de origem na Inglaterra. Foi nessa circunstância que o governo do Dr. Baltasar Brum solicitou ao Comitê Permanente do Parlamento que lhe prestasse as honras fúnebres de um Ministro de Estado. O embalsamamento do corpo foi realizado em 30 de janeiro de 1922, pela equipe médica e técnica do Hospital Militar, bem como as honras prestadas a ele pelo Serviço de Saúde do Exército e da Marinha.

La Defensa Pasiva y su división médica de emergencia / Passive Defense and its emergency medical division / Passive Defence e sua divisão médica de emergência

Durante la Segunda Guerra Mundial el gobierno de Uruguay intentó prepararse para una eventual defensa militar del territorio y la defensa de la población civil en caso de sufrir ataques aéreos. La Defensa Pasiva, fue la estructura gubernamental que junto a la voluntad en todas las clases sociales, funcionó en todo el territorio nacional con la finalidad de proteger a la población civil de los ataques aéreos y guerra química, generando un espíritu de solidaridad a través de su División Médica de Emergencia.

During the Second World War, the government of Uruguay tried to prepare for an eventual military defense of the territory and the defense of the civilian population in case of air raids. The Passive Defense was the governmental structure that, together with the will of every social class, operated throughout the national territory with the purpose of protecting the civilian population from air raids and chemical weapons, generating a spirit of solidarity through its Emergency Medical Division.

Durante a Segunda Guerra Mundial, o governo uruguaio tentou se preparar para uma eventual defesa militar do território e para a defesa da população civil em caso de ataques aéreos. A Defesa Passiva era a estrutura governamental que, juntamente com a vontade de todas as classes sociais, operava em todo o território nacional com o objetivo de proteger a população civil de ataques aéreos e da guerra química, gerando um espírito de solidariedade por meio de sua Divisão Médica de Emergência.

Beneficios de las intervenciones en resiliencia e inteligencia emocional en personal militar

Introducción: Actualmente, se ha expuesto el papel que desempeñan las habilidades cognitivo-emocionales en el desarrollo de la resiliencia. En consecuencia, estudios realizados hasta el momento indican que un buen nivel de inteligencia emocional tiene una influencia beneficiosa en el funcionamiento psicológico y social, al mejorar los procesos cognitivos, sociales, emocionales y conductuales. Se realizó una revisión sistemática mediante 2 búsquedas en distintas bases de datos, tales como PsycINFO, Scopus, Web of Science, Psicodoc y PubMed Central. De este modo, se obtuvieron un total de 472 documentos que, tras aplicar los criterios de inclusión y exclusión quedaron 5 estudios para revisión. Objetivo: Identificar la influencia que ejercen los programas de intervención en la promoción de la resiliencia y la inteligencia emocional en militares. Desarrollo: Se mostró la relación que ejercen los programas de intervención en el desarrollo de la resiliencia e inteligencia emocional en el bienestar personal de los miembros de las fuerzas armadas. Conclusiones: Los militares que poseen mayores niveles en resiliencia e inteligencia emocional presentan mayor bienestar psicológico y físico, así como mayor capacidad para adaptarse y recuperarse con mayor éxito ante situaciones difíciles y mostrar mejor preparación para el combate. Por tanto, se considera que futuros estudios de intervención tengan en cuenta los resultados del presente trabajo, de modo que les permita corroborar estos hallazgos.

Introduction: Currently, the role of cognitive-emotional skills in the development of resilience has been exposed. Consequently, studies conducted so far indicate that a good level of emotional intelligence has a beneficial influence on psychological and social functioning by improving cognitive, social, emotional and behavioral processes. A systematic review was carried out through 2 searches in different databases, such as PsycINFO, Scopus, Web of Science, Psicodoc and PubMed Central. Objective: To identify the influence of intervention programs in the promotion of resilience and emotional intelligence in the military. Development: A total of 472 documents were obtained and, after applying the inclusion and exclusion criteria, 5 studies were left for review. The existing relationship between the intervention programs in the development of resilience and emotional intelligence in the personal well-being of the members of the Armed Forces was shown. Conclusions: Military personnel with higher levels of resilience and emotional intelligence have greater psychological and physical well-being, as well as a greater capacity to adapt and recover more successfully in difficult situations and show better combat readiness. Therefore, it is considered that future intervention studies should take into account the results found in the present work, in order to corroborate these findings.