Experienced Personnel Research Articles

Reflecting on JMVFH’s most popular article of 2023: ‘Experiences of ethnic minority personnel in the armed forces: A systematic review’

Reflecting on <i>JMVFH</i>’s most popular article of 2023: ‘Experiences of ethnic minority personnel in the armed forces: A systematic review’

Experiences of ethnic minority personnel in the armed forces: A systematic review

LAY SUMMARY An armed forces consisting of personnel from diverse and ethnic minority backgrounds offers considerable benefits, not just in terms of reflecting society but for improving the effectiveness of military operations. Many ethnic minority individuals serve for long periods, during which they experience personal growth and benefit from military service. However, little research has explored the impact these experiences might have on ethnic minority communities within the Armed Forces, who report higher levels of bullying, harassment, and discrimination. Given the lack of empirical research into armed forces ethnic minority personnel, this systematic review aimed to provide insight into and understanding of existing international research, relevant reports, and policy. The review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and included articles written in English since 2010. The review identified three themes — cultural identity, health status and health utilization, and trauma and discrimination — and indicated that ethnic minority personnel experience greater disadvantage than their native counterparts, both during and after service.

TIG welding of in-situ produced syntactic metal foam-filled tubes

Abstract Aluminium matrix double composites were produced via an in-situ pressure infiltration method. AlSi12 alloy matrix with densely packed lightweight expanded clay aggregate particle-filled foam was produced in-situ within AlMgSi0.5 alloy tubes. The attainable size of such double composites is limited; therefore, joining them is required to create larger parts. For the joining of these double composites, the applicability of tungsten inert gas (TIG) welding was tested. TIG welding was found to be applicable to join such composites. Metallurgically sound welded joints were produced. Nevertheless, the TIG welding of metal foam-filled tubes is very challenging and needs experienced welding personnel, and the weld bead was a bulk material, not a foam anymore.

“We just ignored them.” Adaptation strategies used by emergency department personnel in the face of workplace violence: A qualitative study

BackgroundWorkplace violence (WPV) can have adverse psychological, physical, and emotional effects on emergency department (ED) personnel. Adaptive strategies can help them better adapt to WPV. The study aimed to explore ED personnel’s experiences with adaptive strategies used in the face of WPV. MethodsIn this qualitative study, 22 ED personnel (nurses, doctors, services patient care assistants, and security guards) were selected using purposive sampling from Urmia city hospitals. Deep semi-structured individual face-to-face interviews were used to collect data. After recording and implementing interviews, conventional content analysis was used to extract concepts. ResultsData analysis led to extracting an overarching theme of “mastering the situation and avoiding harm.” Two categories that supported the main theme were: “effort to avoid violence” and “effort to escape suffering.” The seven subcategories supported main categories included “managing patients and companions, ”self-control,“ ”seeking support, “emotional discharge,” “thought diversion, ”tendency to spirituality,“ and ”seeking medical assistance.“ ConclusionGiven the experiences of ED personnel regarding strategies used, health managers and policymakers are recommended to develop and implement comprehensive programs to reduce violence and empower nurses before and after dealing with violence. The following programs will help: developing and implementing guidelines such as zero-tolerance WPV policy, criminalizing violence against personnel and punishing perpetrators; holding classes related to communication skills, self-control skills, and deviant thinking skills for ED personnel; raising public awareness of the prevailing conditions in the emergency through mass media, and counseling and treating violent ED personnel.

The burden of iatrogenic obstetric fistulas in Sub-Saharan Africa: Systematic review and meta-analysis protocol.

Obstetric fistulas are abnormal open connection(s) between the vagina and the urinary tract or the rectum resulting from tragic injuries sustained by mothers during childbirth that lead to urine and/or faecal incontinence. Due to the rapidly growing middle class in sub-Saharan Africa (SSA) and the corresponding quest for hospital delivery and caesarean section, surgery-related (iatrogenic) obstetric fistulas are on the rise. Worryingly, there is scanty data on surgery-related fistulas. This review aims to collate empirical evidence on the magnitude of iatrogenic obstetric fistulas in SSA, generate country-specific data and explore factors that influence obstetric surgery-related fistulas. All relevant databases, PubMed, LILACS, CINAHL, SCOPUS and Google Scholar will be searched from 1st January 2000 to 31st March 2024 using search terms developed from the major concepts in the title without restrictions by language. The Cochrane Library, African Journals Online, Data Base of African Thesis and Dissertations Including Research (DATAD-R D Space) and preprint repositories will also be searched. Reference lists of relevant studies will be searched and experts in the field will be contacted for additional (unpublished) studies. The search output will be exported to Endnote where duplicate studies will be removed. The deduplicated studies will be exported to Rayyan where study screening and selection will be conducted. At least two authors will independently select studies, extract data and assess quality in the included studies using pretested tools. Disagreements between reviewers will be resolved through discussion. Data analysis will be performed with RevMan 5.4. Comparative binary outcomes will be reported as odds ratio (OR) or risk ratio (RR) and for continuous outcomes, mean difference and standard deviations (SDs) will be used. Non-comparative studies will be analysed as weighted proportions. Heterogeneity between studies will be assessed graphically and statistically, and where a significant level is detected, the random-effects model meta-analysis will be performed. All estimates will be reported with their 95% confidence intervals (CIs). Where data permit, we will conduct subgroup and sensitivity analyses to test the robustness of the estimates on key quality domains. The overall quality of the evidence will be assessed using GRADE (Grading of Recommendations Assessment, Development and Evaluation). This systematic review and meta-analysis uses rigorous methods and best practices to attempt to collate all empirical evidence and estimate country-specific proportions of iatrogenic (surgery-related) fistulas among obstetric fistula patients across countries in SSA. This review will explore context-specific variables, provide insights into their impact and relate them to the type and experience of personnel performing the obstetric procedures that lead to obstetric fistulas. The findings of the full review are expected to inform the development of national and regional Training Programs for Medical Officers, support the development of a consensus "minimum acceptable standard of care" and inform quality assurance standards for clinicians involved in the provision of surgical obstetric care.

Artificial intelligence (AI) and process safety: Some cautionary observations

AbstractArtificial intelligence (AI) has become a vogue topic in the press, and descriptions of its potential impact range from apocalyptic to salvational. Interest in the topic will no doubt stimulate the search for applications to support both the technical and management systems aspects of process safety management. Within our industries, maintaining institutional memory and technical capability is made increasingly challenging by more frequent job movement among younger staff and the loss to the retirement of more senior staff. One would hope that AI could help fill the gaps caused by these factors. However, the author's sampling of current AI capabilities suggests that AI is not yet ready to do so. This paper provides some examples of errors and insufficiencies identified when seeking AI assistance in addressing process safety issues. It also suggests some existing challenges to better “training” of AI to support the needs of the process safety community. It concludes that caution should be applied, especially by less experienced personnel, when seeking AI assistance in addressing process safety–related technical matters.

Challenges and possible improvements for healthcare teams at outreach clinics in Nepal – a qualitative study

ABSTRACT Background All Nepalese citizens have the right to high-quality healthcare services free of charge. To achieve this, healthcare services for the rural population in Nepal need to be improved in terms of personnel, medicines, and medical equipment. Objectives To explore challenges and possible improvements healthcare personnel experience when travelling to rural parts of Nepal to provide healthcare. Method Data was collected from various health professionals using focus group discussions at Dhulikhel Hospital in Nepal. The data were transcribed and analysed using Systematic text condensation. Results Twenty-two professional healthcare personnel participated in five group discussions. Four categories emerged from the collected material: Finding ORC services being underutilised, Wanting to fulfil tasks and do a good job, Facing inadequate resources, and Seeing the need for improved organisation and cooperation. There was consensus that rural clinics are important to maintaining health for the rural population of Nepal. However, there was frustration that the rural population was not benefitting from all available healthcare services due to underutilisation. Conclusion Rural healthcare clinics are not utilised appropriately, according to healthcare workers at the rural outreach clinics. Potential ways of overcoming the perceived challenges of underutilising available healthcare services include financial and human resources. The rural population´s health awareness needs to be increased, and the work environment for rural healthcare workers needs to be improved. These issues need to be prioritised by the government and policymakers.

Project Sandman: A Quasi-Experimental Evaluation of a Group-Based Brief Sleep Intervention in Air Force Technical Training

ABSTRACT Objectives Approximately 70% of the military personnel experience chronic sleep insufficiency, which negatively impacts military readiness and health. Military sleep health does not appear to be improving despite targeted programs to optimize sleep. The present quasi-experimental study aims to evaluate a single-session sleep intervention in United States Air Force (USAF) Technical Training. Method A group-based Brief Sleep Intervention (BSI) was developed for the target population. Participants included 321 technical school students (Mean age = 21; 82% male; 67% White) who were assigned to the BSI (n = 203) or a control group (n = 118). Propensity-score-weighted multivariable logistic regression was employed to compare outcomes. Results At the 2-week follow-up, students in the BSI were significantly more likely to report sleeping 6 or more hours on weekdays (OR = 1.49, p < .001) and “Good/Very Good” sleep quality (OR = 1.50, p = .032) than those in the control group. In addition, 69.2% of the students in BSI reported having engaged in the self-selected “Action Step” chosen during the intervention. Conclusions To our knowledge, this is the first study to test a preventative sleep intervention in USAF Technical Training. Results suggest that a single-session group intervention can promote behavioral changes and improve sleep health.

Tuscany Normothermic Regional Perfusion Mobile Teams for Controlled Donation After Circulatory Death.

To facilitate the implementation of controlled donation after circulatory death (cDCD) programs even in hospitals not equipped with a local extracorporeal membrane oxygenation (ECMO) team, some countries have launched a local cDCD network with an ECMO mobile team for normothermic regional perfusion (NRP). In the Tuscany region, in 2021, the Regional Transplant Authority launched a cDCD program to make the cDCD pathway feasible even in peripheral hospitals with NRP mobile teams, which were "converted" existing ECMO mobile teams, composed of highly skilled and experienced personnel. We describe the Tuscany cDCD program, (2021-2023), for cDCD from peripheral hospitals with NRP mobile teams. Twenty-six cDCDs (26/40, 65%) came from peripheral hospitals. Following the launch of the cDCD program, cDCDs from peripheral hospitals increased, from 33% (2021) to 75% (2022 and 2023) of the overall cDCDs. The mean age was 63 years, with older donors (>75 years) in half the cases. The median warm ischemia time was 45 min (20 min are required by the Italian law for death certification), ranging from 35 to 59 min. Among the 20 livers retrieved and 18 kidneys retrieved, 16 livers, and 11 kidneys (single kidney transplantation) were transplanted, after ex vivo reperfusion, respectively. The use of NRP mobile teams proved to be feasible and safe in the management of cDCD in peripheral hospitals. No complications were reported with NRP despite the advanced age of most cDCDs.

ANALYSIS OF HEALTHCARE QUALITY IN THE ERA OF DIGITALIZATION: CHALLENGES AND OPPORTUNITIES

Digitalization offers numerous opportunities to improve the quality of health services. This study aims to analyze the impact of digitalization on the health services, identify the challenges faced in the implementation of digital technology, and explore the opportunities offered by digitalization in improving the health service quality. A qualitative approach is used to understand the perspectives and experiences of patients and medical personnel towards digitalization. Quantitative analysis is carried out using descriptive and inferential statistics to identify trends and patterns in the data. Thematic analysis techniques are used to identify the main themes and categories that emerged from the interview and observation data. Digitalization has a significant impact on the quality services, both positive and negative. To maximize the benefits of the digitalization, efforts are needed to address existing challenges, including increasing access to digital technology and strengthening data security and privacy, and providing training and support for medical personnel. Further research is needed to explore how digital technology can be used to improve health services and provide recommendations to overcome existing challenges.

Pilot Assessment of Piezoelectric Transducers as a Cost-Effective Alternative to EndoPAT

Introduction: Current microvascular assessments may not be practical or accessible requiring experienced personnel and/or ongoing equipment costs. Piezoelectric transducers can reliably obtain finger blood pressure waves, similar to peripheral arterial tonometry devices; thus, they could be used to estimate microvascular function. We aimed to validate piezoelectric transducers as an alternative measure of microvascular function compared to EndoPAT. Methods: Twenty-five adults (aged 20–64 years) completed reactive hyperemia (5 min forearm circulatory occlusion and 3 min recovery) with piezoelectric transducers on the middle fingers and EndoPAT probes on the index fingers. Average area under the curve (AUC) of the pulse wave signal for the occluded and control arms was determined at baseline, every 30 s post-occlusion, and 10 s around the peak response. Microvascular function index (MFI) was calculated as the ratio of AUC post-occlusion to AUC baseline in the test arm, then normalized to the same ratio in the control arm. MFI at each time point was correlated with the reactive hyperemia index (RHI) from the EndoPAT. Results: The greatest significance was found between RHI and MFI at 10 s around the peak response (Spearman’s r = 0.67, p = 0.0002; Pearson’s r = 0.76, p = 0.00001). Conclusion: MFI is a reusable and user-friendly microvascular function assessment that could provide better access to vascular health screening.

Primary healthcare in the aftermath of the COVID-19 pandemic: a qualitative interview study in Sweden

ObjectiveTo explore how primary healthcare workers in Sweden experienced and perceived the long-term impact of the pandemic on their work.DesignThis is a descriptive qualitative study with individual semistructured interviews conducted...

Raman microscopy allows to follow internalization, subcellular accumulation and fate of iron oxide nanoparticles in cells

An important issue in the context of both potenial toxicity of iron oxide nanoparticles (IONP) and their medical applications is tracking of the internalization process of these nanomaterials into living cells, as well as their localization and fate within them. The typical methods used for this purpose are transmission electron microscopy, confocal fluorescence microscopy as well as light-scattering techniques including dark-field microscopy and flow cytometry. All the techniques mentioned have their advantages and disadvantages. Among the problems it is necessary to mention complicated sample preparation, difficult interpretation of experimental data requiring qualified and experienced personnel, different behavior of fluorescently labeled IONP comparing to those label-free or finally the lack of possibility of chemical composition characteristics of nanomaterials.The purpose of the present investigation was the assessment of the usefulness of Raman microscopy for the tracking of the internalization of IONP into cells, as well as the optimization of this process. Moreover, the study focused on identification of the potential differences in the cellular fate of superparamagnetic nanoparticles having magnetite and maghemite core.The Raman spectra of U87MG cells which internalized IONP presented additional bands which position depended on the used laser wavelength. They occurred at the wavenumber range 1700–2400 cm−1 for laser 488 nm and below the wavenumber of 800 cm−1 in case of laser 532 nm. The intensity of the mentioned Raman bands was higher for the green laser (532 nm) and their position, was independent and not characteristic on the primary core material of IONP (magnetite, maghemite).The obtained results showed that Raman microscopy is an excellent, non-destructive and objective technique that allows monitoring the process of internalization of IONP into cells and visualizing such nanoparticles and/or their metabolism products within them at low exposure levels. What is more, the process of tracking IONP using the technique may be further improved by using appropriate wavelength and power of the laser source.

Perspectives and Experiences of Public Safety Personnel Engaged in a Peer-Led Workplace Reintegration Program Post Critical Incident or Operational Stress Injury: A Qualitative Thematic Analysis.

Public safety personnel (PSP) experience operational stress injuries (OSIs), which can put them at increased risk of experiencing mental health and functional challenges. Such challenges can result in PSP needing to take time away from the workplace. An unsuccessful workplace reintegration process may contribute to further personal challenges for PSP and their families as well as staffing shortages that adversely affect PSP organizations. The Canadian Workplace Reintegration Program (RP) has seen a global scale and spread in recent years. However, there remains a lack of evidence-based literature on this topic and the RP specifically. The current qualitative study was designed to explore the perspectives of PSP who had engaged in a Workplace RP due to experiencing a potentially psychologically injurious event or OSI. A qualitative thematic analysis analyzed interview data from 26 PSP who completed the RP. The researchers identified five themes: (1) the impact of stigma on service engagement; (2) the importance of short-term critical incident (STCI) program; (3) strengths of RP; (4) barriers and areas of improvement for the RP; and (5) support outside the RP. Preliminary results were favorable, but further research is needed to address the effectiveness, efficacy, and utility of the RP. By addressing workplace reintegration through innovation and research, future initiatives and RP iterations can provide the best possible service and support to PSP and their communities.

Experiences with Negative Behavior and Incivility: Perspectives of Unlicensed Assistive Personnel and Registered Nurses.

Healthcare professionals experience negative behaviors such as incivility from various sources within the hospital environment. However, little is known regarding the experience of unlicensed assistive personnel with these behaviors. Using a cross-sectional survey design, the research team aimed to examine the presence, sources, and impact of negative behaviors among registered nurses and unlicensed assistive personnel within a US hospital. Descriptive and inferential statistics were used to analyze quantitative data, while thematic analysis was used to analyze the qualitative responses. A total of 309 participants completed the survey, and 135 participants responded to three qualitative questions. Most respondents identified inadequate staffing/resources to handle workload (87%) and job stress leading to loss of control over behavior as contributing factors to lateral/vertical aggression in the work environment (71%). Impacts of negative behavior on job performance were related to both personal well-being and the work environment. Demoralization was identified as a common consequence of negative behaviors for individuals and within the work environment. The results suggested that registered nurses, unlicensed assistive personnel, and nursing leadership may benefit from system-wide approaches addressing negative behaviors such as incivility within the clinical environment. Specifically, efforts and policies aimed at aiding clinicians in responding to negative behaviors could potentially improve the clinical environment.

Beyond School Climate: Conceptualizing the School as a Protective Factor Approach.

The school climate concept has been promising, but has long-standing critiques that have not been adequately addressed to date. The School as a Protective Factor approach represents one attempt to offer a new approach that builds on and extends beyond the concept of school climate while addressing previously identified limitations. The School as a Protective Factor approach offers a new framework for conceptualizing, measuring, and establishing protective school social and learning environments that co-promote academic achievement and student health in schools, especially student mental health and substance use/abuse prevention. This new framework includes clear definitions, explicit goals, firmly established constructs, validated measures, and an intentionally parsimonious approach that prioritizes the implementation of well-established, high-impact constructs. CONCLUSIONS AND IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: The School as a Protective Factor approach presents a simple, easy-to-use means of ensuring a school social environment that meets the developmental, academic, and health needs of all children and adolescents while maximizing protection across a range of desired outcomes. Perhaps most importantly, it does so in a manner that is manageable and easily integrated into every aspect of schooling, resonates with the practical experience of school personnel, and includes brief, effective, and free measurement tools.

Enhancing Operational Risk Management in the Mauritian Banking Sector: A Structured Approach

The purpose of this study aims to improve risk control, mitigation, and interbank risk comparison by advocating for Mauritian banks to adopt a standardised operational risk definition. The study suggests improving operational risk reduction or hedging, encouraging openness in risk management capabilities, and standardising risk assessment methods in accordance with Bank of Mauritius requirements. The study also recommends that banks create operational risk management committees to supervise risk control and mitigation initiatives. These committees should be composed of experienced personnel who are well-versed in the consequences of operational risk in the banking industry. Using a mixed-method approach, insights are obtained from various banks operating in Mauritius, with data acquired from a substantial sample of 150 participants. Targeting Mauritian bankers, questionnaires were distributed across reputable banks, and data were meticulously collected and analysed. The findings highlight contemporary concerns regarding economic well-being and the security of assets held by banks. It is recommended to implement changes on a modest scale initially, subject to close monitoring over a specified period, with the possibility of gradual expansion if successful outcomes ensue. In conclusion, this research is significant due to the limited exploration into operational risk management within the Mauritian context.

Exploring The Dynamics of Foreign Employment in Indonesian Local Businesses: Barriers, Experiences, And Opportunities for Cultural Integration

This observation delves into the dynamics of foreign employment inside nearby Indonesian agencies, focusing on barriers, stories, and possibilities for cultural integration. Recognizing the significance of know-how in these dynamics, the observer explores the effects along with foreign direct funding (FDI), multinational agencies (MNCs), and nearby research and development (R&amp;D) support. Cultural integration is emphasized, as are the challenging situations that foreign personnel face, such as language barriers, cultural differences, and regulatory hurdles. A qualitative technique is proposed, using purposive sampling and file evaluation to apprehend overseas personnel's experiences. Ethical issues are prioritized. The examination identifies barriers, including criminal and regulatory hurdles, cultural and language challenges, and perceptions toward overseas workers. The stories of foreigners working in Indonesian corporations are examined, specializing in cultural editions, workplace-demanding situations, and aid structures. Recruitment practices, place of work challenges, assistance structures are discussed, along with opportunities for talent switching and knowledge exchange. The look concludes by underscoring the significance of addressing limitations, fostering cultural integration, and maximizing possibilities for the ability to switch and understand alternatives within Indonesian businesses. It gives insights into government guidelines concerning financial development, cultural integration, and collaboration between the authorities and the personal region, imparting suggestions for future research and policy interventions.

Intelligent identification method for pipeline leakage based on GPR time–frequency features and deep learning

ABSTRACT The detection and localization of water pipeline leakages based on ground penetrating radar (GPR) technology are gradually becoming a research hotspot. Current methods mostly focus on exploring the patterns of B-Scan images, heavily relying on the subjective experience of detection personnel, which can lead to misjudgments. Moreover, the large amount of data makes it difficult for manual processing. Therefore, a method based on wavelet transform (WT) and ResNet-50 is proposed to identify the time-frequency characteristics of GPR data, thereby achieving intelligent localization of pipeline leakages. The B-Scan images from GPR are transformed into time–frequency scale images using WT, and the features in both time and frequency domains are combined to enhance the representation of leakages. Subsequently, ResNet-50 is employed for feature extraction and leakage identification. Additionally, a deviation correction mechanism is proposed to improve the clarity of the prediction results. Experimental results demonstrate that ResNet-50 achieves an accuracy of 0.917 and a recall of 0.998 on the time-frequency dataset, almost detecting all leakages, with a detection efficiency of 0.0165 s per data trace. The comprehensive method is validated in the field, indicating its capability to accurately identify and localize pipeline leakages.

An Investigation into the Causes of Payment Delays and Deliberate Delay Tactics in Public Construction Projects in Saudi Arabia

Many scientific publications pointed out delays in the progress of payments by owners as one of the top direct causes of project delays and disputes. This research investigates the causes of payment delays and explores deliberate delay tactics and their reasons within Saudi Arabian public construction projects. This research employs a robust mixed methodology, an extensive literature review, and preliminary semi-structured interviews to identify the causes of payment delays and possible tactics and reasons for deliberate delays or procrastinated payment. Subsequently, a questionnaire survey is distributed among experienced personnel. The survey aims to verify the results of the first phase, assess occurrence rates of the causes of payment delays, study tactical forms used by parties to delay payment, and identify reasons for such practices. The findings of the study reveal that the contractual issues group has the highest score for occurring, deliberate disruptions occur although they are not prevalent, tactics to deliberate delays exist and are practiced, and all the possible forms of deliberate delays under investigation and reasons for deliberate delays are confirmed valid. This study provides valuable insights for businesses and policymakers seeking to comprehend the issue of payment delays in Saudi Arabian public construction projects.