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Military Medicine Jun 2024Drill instructors (DIs) are responsible for executing their Services' recruit training programs and for training recruits. DIs assume a variety of roles, including...
INTRODUCTION
Drill instructors (DIs) are responsible for executing their Services' recruit training programs and for training recruits. DIs assume a variety of roles, including teaching and developing practical skills and knowledge, mentoring, modeling appropriate behavior and attitudes, motivating recruits for success during and after recruit training, applying and instilling discipline, and ensuring the safety and welfare of recruits. This article examines two major research questions at the intersection of gender, gender-integrated training, and the DI role: (1) What differences exist in how DIs experience their role by gender? and (2) how does gender-integrated recruit training affect DIs' approach to training?
MATERIALS AND METHODS
This article draws from 87 semistructured interviews conducted with Service leaders, training cadre, and DIs in service of a broader Marine Corps interdisciplinary study on gender integration at recruit training. Interviews were conducted virtually and in-person with Marine Corps, Army, Navy, Air Force, and Coast Guard personnel from June to November 2021. Each interview was coded with initial and secondary codes developed through a flexible coding approach. Data were analyzed across and within relevant categories such as gender and Service to identify themes and patterns.
RESULTS
Although the DI role was universally described as demanding and difficult, unique challenges for women consistently emerged from the data. The top reported challenges faced by female DIs were personnel shortages, work and family conflict, culture-driven sexism in the training environment from male peers and recruits, and pressure to excel above and beyond their male peers. In recruit training, DIs are responsible for executing gender-integrated practices. Service leaders, training cadre, and DIs described how gender integration practices affect their approach to the role and implementation of training, including addressing and dismantling sexism, shutting down recruit romantic relationships, training all recruits in an equal manner, knowing gender-specific grooming standards, increasing communication among DIs, and working with mixed-gender DI teams.
CONCLUSIONS
Female DIs face additional challenges in and outside the role compared with their male peers, and some of these challenges are preventable. Staffing and personnel issues plague the female DI population and are a persistent and pervasive challenge to gender integration efforts. Women are a necessary and highly desirable population to fill the DI role, particularly as Services aim to expose recruits to leaders of both genders during their critical first training experience. DIs play an important role in ensuring the successful completion of recruit training, ultimately helping to build the future leaders of the military. The success of gender integration efforts depends on DIs' intentional approach to the process. Future research can build on this work by expanding the scope to other military training environments (beyond recruit training) and examining how DIs' own sociodemographic positions (e.g., gender, race, ethnicity, and sexual orientation) inform their perspective on and approach to equity in the training environment.
Topics: Humans; Female; Male; Personnel Selection; Adult; Qualitative Research; Military Personnel; Interviews as Topic
PubMed: 38920033
DOI: 10.1093/milmed/usad422 -
Military Medicine Jun 2024This article uses recent survey data from a study on gender integration at recruit training across the U.S. Armed Forces to examine service, gender, and training...
INTRODUCTION
This article uses recent survey data from a study on gender integration at recruit training across the U.S. Armed Forces to examine service, gender, and training differences in recruit's gender attitudes, beliefs, and cohesion metrics. In addition to providing a descriptive understanding of our recruit sample, this article examines factors germane to gender integration at recruit training such as gender attitudes, sexist beliefs, and unit cohesion.
MATERIALS AND METHODS
This article uses data from a survey of U.S. Marine Corps (USMC), U.S. Army, U.S. Air Force, U.S. Navy, and U.S. Coast Guard recruits as part of a USMC-commissioned study to develop alternate models and recommendations for increasing gender integration in USMC recruit training. At all sites but the USMC, recruits completed the survey 1 to 2 weeks before graduation. At the Marine Corps Recruit Depots, recruits participated in the survey at the beginning (week 2) and end (week 11) of their 13-week training cycle. A 19-question survey captured sociodemographic information, perspectives and experiences during recruit training, and gender attitudes and beliefs. Analyses were conducted on the sample with complete data on the measures reported, including those USMC recruits observed at both week 2 and week 11 (n = 629). Descriptive statistics (percentage) were calculated for all categorical outcome variables. Outcome variables (cohesion, gender, and sexism attitudes) were compared between groups using chi-squared tests or Fisher's exact tests, as appropriate.
RESULTS
Recruits differed significantly across services in perceptions of unit cohesion on 3 of the 4 indicators: Platoon members are cooperative, know they can depend on each other, and really respect each other (P < .05). These differences appear to be driven by female recruit difference across service. They reported significant differences in gender role attitudes across the services, with USMC recruits being most likely to endorse traditional gender roles compared to other service recruits. Male USMC recruits were significantly more likely than their female peers to agree that men should achieve outside the home and women should take care of the home and family (21.3% versus 6.3%, P < .05). The only statistical differences in attitudes about equality of treatment and opportunity among recruits were between male and female USMC recruits. All items capturing sexist attitudes elicited statistically significant differences between male USMC recruits and male recruits in other services (P < .05). There were significant differences in all sexism measures between male and female USMC recruits (P < .05). There is a significant decline in some sexist attitudes between weeks 2 and 11 of training among male USMC recruits (P < .05). Nearly one-half to three-fourths of male USMC recruits hold sexist attitudes, even near the end of recruit training.
CONCLUSIONS
The disparate gender and sexism attitudes of male USMC recruits compared with their peers in other services, and their fellow female USMC recruits suggest efforts to increase gender integration at entry-level training are needed, but also may be challenging since male USMC recruits report the highest levels of sexist attitudes among all recruits.
Topics: Humans; Female; Male; Military Personnel; United States; Surveys and Questionnaires; Adult; Personnel Selection; Gender Identity
PubMed: 38920032
DOI: 10.1093/milmed/usae254 -
Minerva Urology and Nephrology Jun 2024Lower urinary tract symptoms (LUTS) and nocturnal enuresis (NE) are complex conditions requiring a long-term follow-up. Telemedicine is an emerging technological tool in...
The digital era of pediatric urological clinical care: telemedicine for management of lower urinary tract symptoms and nocturnal enuresis - a comprehensive tertiary center insight.
BACKGROUND
Lower urinary tract symptoms (LUTS) and nocturnal enuresis (NE) are complex conditions requiring a long-term follow-up. Telemedicine is an emerging technological tool in the surgical field, and its availability exponentially grew during the COVID-19 pandemic, expanding its application fields, optimizing technical aspects, reducing costs, and ensuring high-quality standards. This work describes our experience with telemedicine in a Division of Pediatric Urology for the follow-up of enuresis and LUTS.
METHODS
A retrospective analysis of our telemedicine preliminary experience was conducted at Regina Margherita Children's Hospital in Turin, Italy. This study included all the patients aged <18 years who were monitored for enuresis and LUTS through telemedicine between September 1, 2021 and July 31, 2023. Clinical data and outcomes were analyzed, and patients and families were asked to voluntary fill an evaluation questionnaire on their satisfaction. Additionally, we focused on the post COVID-19 period, between September 2022 and July 2023, analyzing the data of two different patients' populations: the first one (G1) of patients choosing telemedicine outpatients visits (TOVs) and the second one (G2) of those choosing a face-to-face visit.
RESULTS
One hundred five patients were enrolled. One hundred sixty-two TOVs were performed. The median age at first visit was 9.7±0.66 years (range 7-16 years). Diagnosis were: 77/105 (67%) NE and 28/105 (33%) LUTS. The average referred distance between the patients' residence and the hospital was 46.35±129.37 km (range 2-1300 kilometers) and the time taken to overcome it was 44.21±77.29 minutes (range 10-780 minutes). In 64/105 cases (61%) the follow-up was interrupted for total healing or symptoms resumption. Only two cases (2%) required the conversion to an in-person ambulatory consult, due to a social-linguistic barrier. 146/162 families (90%) filled the survey questionnaire at the end of each TOV, reporting in 94% of cases a high satisfaction level. In the comparative statistical analysis of the two patient groups, G1 (52 telemedicine office visits, [TOVs]) vs. G2 (25 face-to-face visits), the average referred distance was 17.78±7.98 km (range: 5-35 km) for G1, contrasting with 7.04±3.35 km (range: 2.5-14 km) for G2 (P=0.00001). Additionally, the waiting time before the visit was 3.96±2.90 minutes (range: 0-10 minutes) for G1, in contrast to 26.52±11.22 minutes (range: 5-44 minutes) for G2 (P=0.00001). Furthermore, a higher compliance with behavioral or pharmacological indications was observed in the G1 group, exhibiting lower adherence in only 12 out of 52 cases compared to 14 out of 25 cases in G2 (P=0.0091).
CONCLUSIONS
Telemedicine is a proper solution and an effective tool to manage the therapeutic follow-up of NE and LUTS, ensuring suitable quality standards and reducing social costs, such as the loss of working days and transport costs. The implementation and complete integration of its use into the healthcare system should be the goals to pursue in order to take full advantage of all its potentials.
Topics: Humans; Telemedicine; Child; Retrospective Studies; Male; Female; COVID-19; Nocturnal Enuresis; Lower Urinary Tract Symptoms; Adolescent; Italy; Tertiary Care Centers; Patient Satisfaction
PubMed: 38920014
DOI: 10.23736/S2724-6051.24.05846-4 -
Frontiers in Public Health 2024To investigate parental knowledge, attitudes, and practices (KAP) toward adolescent depression.
OBJECTIVE
To investigate parental knowledge, attitudes, and practices (KAP) toward adolescent depression.
METHODS
A cross-sectional survey was conducted between October 2022 and October 2023 at The First Affiliated Hospital of Ningbo University among parents of adolescents diagnosed with depression. A self-administered questionnaire was used to collect the parents' demographic characteristics and KAP toward adolescent depression.
RESULTS
A total of 522 questionnaires were collected from parents of depressed adolescents. Among the participants, 383 (73.37%) were female. In addition, 426 participants (81.61%) had children aged 14-18. The mean knowledge, attitude, and practice scores were 9.09 ± 2.37 (possible range: 0-12), 37.04 ± 4.11 (possible range: 11-55), and 31.53 ± 3.84 (possible range: 8-40), respectively. There were significant positive correlations between knowledge and attitude ( = 0.225, < 0.001), knowledge and practice ( = 0.240, < 0.001), and attitude and practice ( = 0.381, < 0.001). The path analysis showed significant direct effects of knowledge on attitude (β = 0.422, < 0.001) and practice (β = 0.283, < 0.001). There was an indirect effect of knowledge on practice through attitude (β = 0.131, = 0.004). Attitude directly impacted practice (β = 0.311, < 0.001).
CONCLUSION
Parents of adolescents diagnosed with depression exhibited moderate KAP regarding adolescent depression. The study underscored the importance of targeted interventions to improve parental KAP in supporting adolescents with depression. Moreover, future research should explore additional factors influencing parental attitudes and behaviors toward adolescent depression to develop more effective interventions.
Topics: Humans; Female; Male; Adolescent; Cross-Sectional Studies; Health Knowledge, Attitudes, Practice; China; Parents; Surveys and Questionnaires; Depression; Adult; Middle Aged
PubMed: 38919922
DOI: 10.3389/fpubh.2024.1404819 -
Frontiers in Public Health 2024The increase in adolescents reporting mental health problems presents a major public health challenge. The complex association between mental health and social capital...
BACKGROUND
The increase in adolescents reporting mental health problems presents a major public health challenge. The complex association between mental health and social capital motivates further investigation of social capital as a crucial aspect in shaping adolescents' help-seeking knowledge, attitudes, and behaviours.
AIM
This protocol presents a project that aims to investigate social capital in relation to help-seeking and mental health in close collaboration with adolescents and key stakeholders in the school setting, in the southern part of Sweden.
METHODS
A mixed-method design with three interconnected work packages (WP) will be undertaken with an emphasis on co-production where adolescents are involved throughout the process. WP1 is a development and validation of two questionnaire instruments for assessing social capital and help-seeking in adolescence. WP2 is a longitudinal quantitative study involving 1,500 adolescents from two regions representing rural and suburban/urban settings. Adolescents aged 15 will be asked to complete questionnaires concerning social capital, mental health, and help-seeking in a baseline and one-year follow-up, allowing for investigation of the role of social capital for help-seeking. WP3 is designed to elucidate experiences and knowledge of adolescents and key stakeholders via collaborative World Café workshops. These will be held along the project to evolve the generated knowledge and maximize it's applicability during and after the project is finalized.
CONCLUSION
The results are expected to further the understanding of the relationship between adolescents' social capital, mental health, and help-seeking, to contribute to a deeper understanding of the mechanisms behind the paradoxical help-seeking patterns among adolescents today and to narrow the gap between research and practice to produce sustainable and efficient strategies, which may facilitate help-seeking and improve the mental health of adolescents within existing organizational structures.
Topics: Humans; Adolescent; Sweden; Social Capital; Surveys and Questionnaires; Female; Male; Mental Health; Longitudinal Studies; Patient Acceptance of Health Care; Help-Seeking Behavior
PubMed: 38919916
DOI: 10.3389/fpubh.2024.1406649 -
Frontiers in Sociology 2024Homophobia is well-documented as key to social regulation of masculine behavior and practices in Western settings. Yet, empirical data from a number of Western settings...
INTRODUCTION
Homophobia is well-documented as key to social regulation of masculine behavior and practices in Western settings. Yet, empirical data from a number of Western settings has shown a decline in overt homophobic attitudes in the past decade, leading some to suggest that the nature of masculinities is also changing. However, theorizing on the changing nature of masculinities among adolescents has received limited quantitative attention. Research is needed to better understand shifts in adolescent masculinities in contemporary Western settings.
METHODS
In this paper, we investigate the application of one newer approach to explore masculinities in context - hybrid masculinities - in a sample of cisgender, heterosexual, mid-adolescent boys in one province in Western Canada ( 873, mean age (SD) = 14.39 (0.37)). Data were collected from nine cohorts of grade 9 youth over a 10-year period (2013-2022) as part of the baseline survey of an ongoing evaluation of a gender-transformative healthy relationships program.
RESULTS AND DISCUSSION
We hypothesized that if the ideas of hybrid masculinities held in our sample, we would find that overt homophobic attitudes and adherence to related patriarchal norms (e.g., avoidance of femininity) would decline over this period, but that the use of homophobic name-calling would remain differentiated in terms of to whom it was directed (e.g., a friend, someone they thought was gay). We did find a significant decline in homophobic attitudes and norms related to emotional restriction and avoidance of femininity over the 10-year period, but also found that homophobic name-calling remained differentiated, with significantly higher name-calling toward a friend than toward someone the youth thought was gay. Thus, our hypotheses were supported. We discuss the implications of our findings for future theory and research on understanding adolescent masculinities in context.
PubMed: 38919864
DOI: 10.3389/fsoc.2024.1347568 -
Frontiers in Sociology 2024Boredom, a state where the task at hand presents difficulties in attentional resources and attributed meaning, can be detrimental to talent development by reducing...
INTRODUCTION
Boredom, a state where the task at hand presents difficulties in attentional resources and attributed meaning, can be detrimental to talent development by reducing cognitive engagement. This study employed a mixed sequential design to assess boredom in adolescents with exceptional mathematical talent in Paraguay participating in a talent development program.
METHODS
First, in the quantitative phase 54 students completed the Boredom Short Scale, School Attitudes Assessment Survey-Revised, and Psychological Well-Being Scale for Adolescents. Next, in the qualitative phase 50 students participated in focus groups to explore their personal experiences of boredom, along with their perception of possible factors that impact boredom.
RESULTS
Boredom in this population was similar to the general population of adolescents, albeit significant differences existed in items and subscales showing a pattern unique to this population; they tended to become bored quicker but had an easier time sparking interest in activities. Higher boredom had small to moderate correlations with worse attitudes at school and with teachers, lower motivation and self-regulation in academic activities, lower self-control, and lower involvement in personal projects. Higher valuation of goals and academic self-perception related with a lower tendency toward boredom only in the context of a talent development program, but not at school. Boredom seemed multifaceted, with dimensions such as the absence of meaning, superficial entertainment, and wasted time. Contributing factors included waiting for other people's slower pace, limited choices, lack of novelty, insufficient intellectual challenge, and the influence of teachers and social dynamics. Coping mechanisms included inner intellectual stimulation, seeking entertainment and escape, pursuing independent learning, extracurricular activities, like-minded peers, and extreme sensation-seeking.
DISCUSSION
Fostering adequate challenge and support in advanced academic endeavors for the development of mathematical talent can prevent negative consequences associated with boredom in exceptionally talented populations.
PubMed: 38919863
DOI: 10.3389/fsoc.2024.1214878 -
Frontiers in Health Services 2024Evidence-based practice (EBP) involves making clinical decisions based on three sources of information: evidence, clinical experience and patient preferences. Despite... (Review)
Review
BACKGROUND
Evidence-based practice (EBP) involves making clinical decisions based on three sources of information: evidence, clinical experience and patient preferences. Despite popularization of EBP, research has shown that there are many barriers to achieving the goals of the EBP model. The use of artificial intelligence (AI) in healthcare has been proposed as a means to improve clinical decision-making. The aim of this paper was to pinpoint key challenges pertaining to the three pillars of EBP and to investigate the potential of AI in surmounting these challenges and contributing to a more evidence-based healthcare practice. We conducted a selective review of the literature on EBP and the integration of AI in healthcare to achieve this.
CHALLENGES WITH THE THREE COMPONENTS OF EBP
Clinical decision-making in line with the EBP model presents several challenges. The availability and existence of robust evidence sometimes pose limitations due to slow generation and dissemination processes, as well as the scarcity of high-quality evidence. Direct application of evidence is not always viable because studies often involve patient groups distinct from those encountered in routine healthcare. Clinicians need to rely on their clinical experience to interpret the relevance of evidence and contextualize it within the unique needs of their patients. Moreover, clinical decision-making might be influenced by cognitive and implicit biases. Achieving patient involvement and shared decision-making between clinicians and patients remains challenging in routine healthcare practice due to factors such as low levels of health literacy among patients and their reluctance to actively participate, barriers rooted in clinicians' attitudes, scepticism towards patient knowledge and ineffective communication strategies, busy healthcare environments and limited resources.
AI ASSISTANCE FOR THE THREE COMPONENTS OF EBP
AI presents a promising solution to address several challenges inherent in the research process, from conducting studies, generating evidence, synthesizing findings, and disseminating crucial information to clinicians to implementing these findings into routine practice. AI systems have a distinct advantage over human clinicians in processing specific types of data and information. The use of AI has shown great promise in areas such as image analysis. AI presents promising avenues to enhance patient engagement by saving time for clinicians and has the potential to increase patient autonomy although there is a lack of research on this issue.
CONCLUSION
This review underscores AI's potential to augment evidence-based healthcare practices, potentially marking the emergence of EBP 2.0. However, there are also uncertainties regarding how AI will contribute to a more evidence-based healthcare. Hence, empirical research is essential to validate and substantiate various aspects of AI use in healthcare.
PubMed: 38919828
DOI: 10.3389/frhs.2024.1368030 -
Frontiers in Psychology 2024To tackle the global waste crisis, there is an urgent need for decisive and joint action at multiple levels. The collective behavior of a community could make a...
To tackle the global waste crisis, there is an urgent need for decisive and joint action at multiple levels. The collective behavior of a community could make a significant contribution. This paper presents the results of a field experiment designed to promote packaging waste prevention - called precycling - in a newly formed community setting, in Berlin, Germany. The aim was to examine the effect of the intervention on precycling and to examine the underlying social identity processes. Over a four-week period, 132 participants from 96 different households digitally received a combination of different interventions, that were theoretically informed by the Social Identity Model of Pro-Environmental Action (SIMPEA). Households were assigned to two intervention groups and a waiting control group. Data was collected before, immediately after and four months after the intervention to assess the impact of the intervention using multilevel models. After the intervention, the overall precycling behavior increased significantly, but not as a result of the different group conditions. In the more comprehensive intervention group, which included social interaction and behavioral experimentation, the community identification was strengthened and the reuse behavior, as a subset of precycling, increased. While a number of social identity processes (collective efficacy beliefs, having a precycling action goal, crisis appraisal, and sufficiency attitudes) were found to positively predict the precycling behavior, surprisingly, the predictive power of social norms and ingroup identification could not be confirmed. Overall, the presented community intervention promoted precycling. However, in this dynamic real-world setting, not all intervention elements worked as expected. The pitfalls and opportunities of this intervention are discussed, and ideas for translating the results into everyday precycling activities are presented.
PubMed: 38919797
DOI: 10.3389/fpsyg.2024.1340305 -
Frontiers in Psychology 2024Do adults who stutter have abnormally high social anxiety? Is it related to maladaptive cognition? As these are persistent, unresolved questions in stuttering research,...
Do adults who stutter have abnormally high social anxiety? Is it related to maladaptive cognition? As these are persistent, unresolved questions in stuttering research, it behooves clinicians to at least assess and attempt to identify social anxiety in patients who stutter and its basis before decisions are made about stuttering treatment. The Unhelpful Thoughts and Beliefs About Stuttering (UTBAS) scale is a self-administered questionnaire that measures the degree of non-adaptive cognition in people who stutter (PWS) due to social anxiety. The 66-item UTBAS is time-consuming to complete, prompting the development of a shorter 6-item version, the UTBAS-6, which is in English. Here, we aimed to assess some psychometric properties of the Japanese version of the UTBAS-6, the UTBAS-6-J, which has not been done to date. In 56 adult patients (mean 32.6 ± 11.1 years) who stutter, we quantified the reliability, the internal consistency, and the concurrent validity of the UTBAS-6-J. Along with the UTBAS-6-J, patients also were administered the Overall Assessment of the Speaker's Experience of Stuttering - Japanese version (OASES-A-J), the Modified Erickson Communication Attitude Scale - Japanese version (S-24-J), and the Liebowitz Social Anxiety Scale - Japanese version (LSAS-J). Cronbach's alpha for UTBAS-6-J total scores was 0.974, indicating excellent internal consistency. UTBAS-6-J scores were significantly correlated with scores on the OASES-A-J, the S-24-J, and the LSAS-J (all < 0.005). Concurrent validity of the UTBAS-6-J with these three questionnaires was confirmed. The UTBAS-6-J has good internal consistency and concurrent validity, which will aid clinical decision-making about stuttering treatments.
PubMed: 38919794
DOI: 10.3389/fpsyg.2024.1382673