Assessing Optimal Relationships Among Multi-Touch Gestures and Functions in Computer Applications

Predictors of Likelihood and Intensity of Past-Year Mental Health Service Use in an Active Canadian Military Sample

This study proposes a submenu window as a navigation aid for mobile Internet access on a cellular phone. The submenu window presents child-level menu items along with their upper-level menu. The effectiveness of the submenu window was investigated in an experiment. The factors manipulated in the experiment include the types of submenu window, age of participants, and timing of presenting the submenu. Task completion time, number of button clicks, and subjective preference were measured while the participants were performing target search tasks. The results showed that they preferred the separate submenu window. The best performance was obtained when the submenu immediately followed the selection of its parent menu. In addition, the participants in their 20s found a target menu item with fewer button clicks than did the teenagers. The separate submenu window with no delay was recommended in terms of both performance and subjective preference. The design guidelines for submenu windows on a small-screen device are also provided. The results of this study are expected to be applicable to menu-driven interfaces of many small-screen devices such as digital cameras and personal digital assistants.

ObjectivesRecurrent instability is common after shoulder dislocation in the young, particularly those engaged in physical jobs or sport. The management of recurrent traumatic shoulder instability is predominantly operative. However, the...

ObjectivesSLAP (superior labrum anterior and posterior) lesions are a recognised cause of shoulder pain and instability. They can occur following a direct blow, biceps traction and compression injuries, and are...

Service members and veterans (collectively, "military populations") are more likely to drop out of posttraumatic stress disorder (PTSD) psychotherapies than civilians, especially for trauma-focused treatments (Varker et al., 2021). Yet, it remains unclear whether specific protocols are linked with higher dropout risk, and no meta-analysis has investigated this for military populations. Therefore, this study aimed to conduct a secondary analysis of a large meta-analysis (Penix-Smith et al., 2025) to estimate dropout among specific PTSD treatments in United States military populations. Overall, 181 articles provided PTSD dropout rates for 232 treatments (N = 124,092 clients) among military populations. The weighted dropout rate for all PTSD interventions was 25.6%, 95% CI [22.9%, 28.5%] using a random effects model, where dropout significantly differed across treatments, Q(21) = 96.86, p < .001, I² = 98.49. Treatments linked with higher dropout included weekly formats of cognitive processing therapy (CPT; 40.1%), prolonged exposure therapy (PE; 34.7%), and virtual reality exposure therapy (37.2%). Lower dropout was linked with weekly formats of present-centered therapy (PCT; 16.1%), mindfulness-based stress reduction (17.4%), and group-based exposure therapy (6.9%). Intensive outpatient programs (IOPs) yielded the lowest dropout rates overall, even when IOPs included CPT (8.5%) and PE (5.5%). Together, this study provided dropout benchmarks for specific PTSD treatments and identified treatments with the highest risk for dropout, including weekly CPT and PE. Findings suggest that resources targeting dropout and increasing the reach of treatments with lower dropout risk (e.g., PCT, IOPs) may facilitate psychotherapy engagement among military populations. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Musculoskeletal injuries (MSKIs) are a significant health problem in the military. Accordingly, identifying risk factors associated with MSKI to develop targeted strategies that attenuate injury risk remains a top priority within the military. Insufficient sleep has garnered increased attention as a potential risk factor for MSKI in both civilians and military personnel. Yet, there are no systematic evaluations of the potential association between sleep and MSKI in the military. The purpose of this review is to examine the relationship between sleep and injury in military personnel. Literature searches were performed in multiple electronic databases using keywords relevant to sleep quantity and quality, MSKI, and military populations. Two investigators independently assessed the methodological quality of each study using the Newcastle-Ottawa Scale for cohort studies or an adapted form of this scale for cross-sectional studies. The search yielded 2402 total citations, with 8 studies (3 cohort and 5 cross-sectional) fitting the inclusion criteria. Overall, the systematic review found 5 of the 8 reviewed studies supporting an association between sleep (quality and duration) and MSKI in military personnel. Specifically, poor sleep was associated with increased injury incidence in 2 cohort and 3 cross-sectional studies. This is the first systematic review to evaluate the published literature on the association between sleep and MSKI risk in military populations. Although there is currently limited research on this topic, findings suggest that sleep is associated with MSKI and should be considered when designing strategies aimed at reducing MSKI risk in military personnel.

BackgroundA better understanding of adverse health and underlying risk factors in the context of military and law enforcement is essential to developing future preventative strategies. We conducted an umbrella review to provide an overview of the current literature regarding risk factors for adverse health in military and law enforcement populations.MethodsWe systematically searched the literature for systematic reviews and meta-analyses regarding risk factors for adverse health in military or law enforcement populations. We critically appraised the studies that matched our inclusion criteria, extracted the adverse health outcomes and underlying risk factors, and narratively synthesised the findings.ResultsThis umbrella review included 34 systematic reviews that covered data from 43 countries. We identified twenty-six adverse health outcomes and 220 underlying risk factors. The adverse health outcomes covered in the included systematic reviews were one infectious disease (Heliobacter pylori infection); two endocrine, nutritional, or metabolic diseases (metabolic syndrome and obesity); seven mental, behavioural, or neurodevelopmental disorders (adjustment disorder, alcohol misuse, anxiety, depression, poor mental health, PTSD, and stress); two diseases of the nervous system (insomnia and sleep-disordered breathing); one disease of the ear or mastoid process (noise-induced hearing loss); eight diseases of the musculoskeletal system and connective tissue (cervical spine injuries, injuries, lower extremity injuries, musculoskeletal injuries, neck pain, rhabdomyolysis, and stress fractures); one symptom, signs and abnormal clinical and laboratory findings, not elsewhere classified (suicidal ideation); three injuries, poisonings, or other consequences of external causes (concussion, heat illness, and suicide); and one factor influencing health status and contact with health services (burnout). Of the 220 identified risk factors, 136 were modifiable, and the most frequently reported were female sex, older age, lower functional movement screen scores, maladaptive coping, lack of social support, and neuroticism.ConclusionThis umbrella review identified twenty-six adverse health outcomes and their underlying risk factors in military and law enforcement populations. Hereby, this study provides potential starting points for preventing adverse health in these populations. It also identifies a broad lack of systematic reviews investigating mental, behavioural, or neurodevelopmental disorders in military populations and diseases of the musculoskeletal system and connective tissue in law enforcement populations.Prospero Registration NumberCRD42022378123.

BackgroundDiarrhea remains a major public health problem for both civilian and military populations. This study describes the prevalence of acute diarrheal illness etiological agents, their antibiotic resistance distribution patterns, the resulting impact upon military force health protection, and potential prevention and treatment strategies.ResultsForty-eight acute diarrhea stool samples from US military personnel deployed to Thailand from 2013–2017 were screened for enteric pathogens using ELISA, the TaqMan Array Card (TAC), and conventional microbiological methods. These isolates were also evaluated using antimicrobial susceptibility testing (AST) against ampicillin (AMP), azithromycin (AZM), ceftriaxone (CRO), ciprofloxacin (CIP), nalidixic acid (NA), erythromycin (ERY), and trimethoprim-sulfamethoxazole (SXT) using commercial methodology. Susceptibility results were interpreted following the CLSI and NARM guidelines. Questionnaire data obtained from 47/48 volunteers indicated that 89.4% (42/47) reported eating local food and the most common clinical symptoms were nausea and abdominal pain (51%; 24/47). Multiple bacterial species were identified from the 48 stool samples with diarrhea etiological agents being detected in 79% (38/48) of the samples distributed as follows: 43.8% (21/48) Campylobacter jejuni and Campylobacter species, 42% (20/48) diarrheagenic Escherichia coli, and 23% (11/48) Salmonella. Co-infections were detected in 46% (22/48) of the samples. All C. jejuni isolates were resistant to CIP and NA. One C. jejuni isolate exhibited resistance to both AZM and ERY. Lastly, an association between exposure to poultry and subsequent detection of the diarrhea-associated pathogens E. coli and P. shigelloides was significant (p < 0.05).ConclusionThe detection of Campylobacter isolates with CIP, AZM and ERY resistance has critical force health protection and public health implications, as these data should guide effective Campylobacteriosis treatment options for deployed military members and travelers to Southeast Asia. Additional research efforts are recommended to determine the association of pathogen co-infections and/or other contributing factors towards diarrheal disease in military and traveler populations. Ongoing surveillance and AST profiling of potential disease-causing bacteria is required for effective disease prevention efforts and treatment strategies.

When Addiction Co-Occurs With Traumatic Brain Injury

BackgroundMild traumatic brain injury (mTBI) occurs at a higher frequency among military personnel than among civilians. A common symptom of mTBIs is cognitive dysfunction. Health care professionals use neuropsychological assessments as part of a multidisciplinary and best practice approach for mTBI management. Such assessments support clinical diagnosis, symptom management, rehabilitation, and return-to-duty planning. Military health care organizations currently use computerized neurocognitive assessment tools (NCATs). NCATs and more traditional neuropsychological assessments present unique challenges in both clinical and military settings. Many research gaps remain regarding psychometric properties, usability, acceptance, feasibility, effectiveness, sensitivity, and utility of both types of assessments in military environments.ObjectiveThe aims of this study were to explore evidence regarding the use of NCATs among military personnel who have sustained mTBIs; evaluate the psychometric properties of the most commonly tested NCATs for this population; and synthesize the data to explore the range and extent of NCATs among this population, clinical recommendations for use, and knowledge gaps requiring future research.MethodsStudies were identified using MEDLINE, Embase, American Psychological Association PsycINFO, CINAHL Plus with Full Text, Psych Article, Scopus, and Military & Government Collection. Data were analyzed using descriptive analysis, thematic analysis, and the Randolph Criteria. Narrative synthesis and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews) guided the reporting of findings. The psychometric properties of NCATs were evaluated with specific criteria and summarized.ResultsOf the 104 papers, 33 met the inclusion criteria for this scoping review. Thematic analysis and NCAT psychometrics were reported and summarized.ConclusionsWhen considering the psychometric properties of the most commonly used NCATs in military populations, these assessments have yet to demonstrate adequate validity, reliability, sensitivity, and clinical utility among military personnel with mTBIs. Additional research is needed to further validate NCATs within military populations, especially for those living outside of the United States and individuals experiencing other conditions known to adversely affect cognitive processing. Knowledge gaps remain, warranting further study of psychometric properties and the utility of baseline and normative testing for NCATs.

Section one reports on a quantitative systematic literature review examining the relationship between post-traumatic stress disorder and eating disorders within a military population. Six academic databases were systematically searched using key words related to the concepts of post-traumatic stress disorder, eating disorders, and military personnel and veterans. The findings suggested that there is a significant positive association between post-traumatic stress disorder and eating disorders within a military population. Females were at a greater likelihood than males of experiencing co-occurring post-traumatic stress disorder and eating disorders. Furthermore, longitudinal studies suggested a directional relationship wherein military personnel and veterans experiencing post-traumatic stress disorder were later more likely to engage in disordered eating behaviours. However, the majority of research reviewed was cross-sectional and related to US military veterans, therefore the area would benefit from additional studies, particularly those examining international active military service members and veterans. Section two reports on an empirical study examining the effect of fear of compassion on the relationship between self-criticism and disordered eating within an adult population. Individuals across the spectrum of disordered eating took part in an online survey. A series of mediation models were employed in order to explore the relationships between self-criticism, fear of compassion, and disordered eating. Findings indicated that the relationships between two forms of self-criticism, namely self-critical rumination and self-criticism in relation to a sense of personal inadequacy, and disordered eating were mediated by fear of both showing compassion to oneself and receiving compassion from others. These results highlight a need for the assessment of fear of compassion within therapeutic interventions for people who experience disordered eating, particularly in clients who experience high levels of self-criticism. Section three includes a critical appraisal of the thesis. It includes a summary of overall findings in addition to reflections upon key decision-making points.

To assess the prevalence of self-reported symptoms and illnesses among military personnel deployed during the Persian Gulf War (PGW) and to compare the prevalence of these conditions with the prevalence among military personnel on active duty at the same time, but not deployed to the Persian Gulf (non-PGW).Cross-sectional telephone interview survey of PGW and non-PGW military personnel. The study instrument consisted of validated questions, validated questionnaires, and investigator-derived questions designed to assess relevant medical and psychiatric conditions.Population-based sample of military personnel from Iowa.A total of 4886 study subjects were randomly selected from 1 of 4 study domains (PGW regular military, PGW National Guard/Reserve, non-PGW regular military, and non-PGW National Guard/Reserve), stratifying for age, sex, race, rank, and branch of military service.Self-reported symptoms and symptoms of medical illnesses and psychiatric conditions.Overall, 3695 eligible study subjects (76%) and 91% of the located subjects completed the telephone interview. Compared with non-PGW military personnel, PGW military personnel reported a significantly higher prevalence of symptoms of depression (17.0% vs 10.9%; Cochran-Mantel-Haenszel test statistic, P<.001), posttraumatic stress disorder (PTSD) (1.9% vs 0.8%, P=.007), chronic fatigue (1.3% vs 0.3%, P<.001), cognitive dysfunction (18.7% vs 7.6%, P<.001), bronchitis (3.7% vs 2.7%, P<.001), asthma (7.2% vs 4.1%, P=.004), fibromyalgia (19.2% vs 9.6%, P<.001), alcohol abuse (17.4% vs 12.6%, P=.02), anxiety (4.0% vs 1.8%, P<.001), and sexual discomfort (respondent, 1.5% vs 1.1%, P=.009; respondent's female partner, 5.1% vs 2.4%, P<.001). Assessment of health-related quality of life demonstrated diminished mental and physical functioning scores for PGW military personnel. In almost all cases, larger differences between PGW and non-PGW military personnel were observed in the National Guard/Reserve comparison. Within the PGW military study population, compared with veterans in the regular military, veterans in the National Guard/Reserve only reported more symptoms of chronic fatigue (2.9% vs 1.0%, P=.03) and alcohol abuse (19.4% vs 17.0%, P=.004).Military personnel who participated in the PGW have a higher self-reported prevalence of medical and psychiatric conditions than contemporary military personnel who were not deployed to the Persian Gulf. These findings establish the need to further investigate the potential etiologic, clinical, pathogenic, and public health implications of the increased prevalence of multiple medical and psychiatric conditions in populations of military personnel deployed to the Persian Gulf.

Retorno a la actividad completa tras cirugía de reconstrucción de ligamento cruzado anterior en personal militar: metaanálisis

There’s safety in numbers

Back to table of contents Previous article Next article Professional NewsFull AccessMajor Study Will Assess 'What Works' in PTSD CareAaron LevinAaron LevinPublished Online:1 Apr 2011https://doi.org/10.1176/pn.46.7.psychnews_46_7_4_1AbstractThe Department of Defense and the Department of Veterans Affairs have received enormous funding from Congress for treating PTSD, but we can't view that as a bottomless pit," Navy Capt. Paul Hammer, M.C., said at the first meeting of an Institute of Medicine (IOM) panel that will study the current status of research and treatment of posttraumatic stress disorder (PTSD). "We have to learn to treat PTSD at a reasonable cost," said Hammer, an APA member and the new director of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury. Doing that requires knowing more about the disorder, its causes, diagnosis, and treatment, so the Department of Defense (DoD) requested the IOM study. The panel is chaired by Sandro Galea, M.D., Dr.P.H., a professor and chair of the Department of Epidemiology in the Mailman School of Public Health at Columbia University. The request came three years after another report from the IOM noting that "significant gaps" existed in the evidence underlying nearly all treatments for PTSD (Psychiatric News, December 7, 2007). The earlier report said that only therapies that included some element of exposure to reminders of trauma—like prolonged exposure therapy, cognitive-behavioral therapy, or cognitive-processing therapy—were backed by sufficient evidence from clinical trials. "The 2007 PTSD report was simply an evaluation of the evidence on best practices for PTSD," said Galea. "Our mandate with this study is to understand what the best approach to screening, prevention, treatment, and rehabilitation for PTSD is and what DoD and the Department of Veterans Affairs [VA] should be doing about it." The panel will spend two years gathering information from the two federal departments "on programs and methods available for the prevention, screening, diagnosis, treatment, and rehabilitation of posttraumatic stress disorder," as well as study clinical trials of innovative treatments and services. The panel will then take another two years to evaluate the rates of success of each modality. The study could clarify how well current PTSD programs are working and identify gaps in assessment and treatment, said Hammer during the panel's initial meeting in late February. About 2.4 percent of the 2.2 million deployed service members have been diagnosed with PTSD, but depending on survey methodology, 10 percent to 17 percent of service members report some symptoms of PTSD, he noted. Several areas require special attention in any study of PTSD in military populations, Hammer pointed out.For example, "patterns of comorbidities are different in military populations, compared to the civilian sector," he said. Mild traumatic brain injury, pain, and substance abuse are common. In addition, combat troops less often report Category A ("horror") PTSD symptoms, because their military training and experience prepares them for battle. But they also have less access to protective factors due to their frequent re-exposure and the "tough-it-out" military culture, he said. National Guard and Reserve personnel are at even greater risk of PTSD and have less access to therapists skilled in PTSD care for military populations because they are dispersed geographically after they return from war zones. The armed forces have used several strategies to protect troops. Education and training begin at the start of military service. Increased screening and surveillance, interventions to manage combat stress in the field, and a full spectrum of available treatments in war zones and at home also serve as factors that may mitigate the likelihood or severity of PTSD. The Military Health System has increased behavioral health staffing from about 4,000 in 2007 to about 6,500 now, so fewer referrals for care go unfulfilled. Spending on PTSD care for the current cohort of veterans is likely to be high, and the true costs of treating them needed to be made clear, said Hammer. But more work needs to be done first. "Data are problematic on the effectiveness of current therapies," said Hammer. "We don't know what type of therapy is used or whether the therapist has made individual modifications. We don't have the ability to track measures over time." The executive director of the VA's National Center for PTSD (NCPTSD), Matthew Friedman, M.D., Ph.D., stressed that more should be done to monitor outcomes in clinical practice, expand the use of evidence-based therapies and clinical practice guidelines, and increase quality improvement and program evaluation efforts. The National Center for PTSD is a hub for research into the neuroscience of PTSD and its treatment, along with ways to move that research into the clinic. Basic research there now addresses mechanisms underlying the development of PTSD, as well as resilience, treatment effectiveness, and treatment resistance, Friedman told the IOM panel. The NCPTSD also provides PTSD-related assessment tools, training, treatment guides, and consultation services within the VA, he said. In addition, it provides information on PTSD and its treatment for outside clinicians and for the public via its Web site. The IOM study, when completed, will help guide future DoD and VA policies for screening, diagnosing, and treating service members and veterans. That can't come too soon, said Hammer. "We need to get it right and target well for what works," said Hammer.Information on the Institute of Medicine's "Assessment of Ongoing Efforts in the Treatment of PTSD" is posted at <www.iom.edu/Activities/Veterans/PTSDTreatment.aspx>. The Web site for the National Center for PTSD is <www.ptsd.va.gov>. ISSUES New Archived