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Background: ICD-11 complex post-traumatic stress disorder is a more severe condition than post-traumatic stress disorder, and recent studies indicate it is more prevalent among military samples. In this study, we tested the psychometric properties of the International Trauma Questionnaire, assessed the relative prevalence rates of post-traumatic stress disorder and complex post-traumatic stress disorder in the sample population and explored relationships between complex post-traumatic stress disorder and post-traumatic stress disorder and a range of risk factors. Methods: Survey participants (N = 189) were mental health support-seeking former-serving veterans of the Australian Defence Force (ADF) recruited from primary care. Confirmatory factor analysis was used to test the factorial validity of the International Trauma Questionnaire. Results: The latent structure of the International Trauma Questionnaire was best represented by a two-factor second-order model consistent with the ICD-11 model of complex post-traumatic stress disorder. The International Trauma Questionnaire scale scores demonstrated excellent internal reliability. Overall, 9.1% (95% confidence interval = [4.8%, 13.5%]) met diagnostic requirements for post-traumatic stress disorder and an additional 51.4% (95% confidence interval = [44.0%, 58.9%]) met requirements for complex post-traumatic stress disorder. Those meeting diagnostic requirements for complex post-traumatic stress disorder were more likely to have served in the military for 15 years or longer, had a history of more traumatic life events and had the highest levels of depression, anxiety and stress symptoms. Conclusion: The International Trauma Questionnaire can effectively distinguish between post-traumatic stress disorder and complex post-traumatic stress disorder within primary care samples of Australian Defence Force veterans. A significantly greater proportion of Australian Defence Force veterans met criteria for complex post-traumatic stress disorder than post-traumatic stress disorder. Australian military mental health services should adopt the International Trauma Questionnaire to routinely screen for complex post-traumatic stress disorder and develop complex post-traumatic stress disorder specific interventions to promote recovery in Australian Defence Force veterans with complex post-traumatic stress disorder. [ABSTRACT FROM AUTHOR]

Introduction: Our prototype wireless full-HD Augmented Reality Head-Mounted Display (AR-HMD) aims to eliminate surgeon head turning and reduce theater clutter. Learning and performance versus TV Monitors (TVM) is evaluated in simulated knee arthroscopy. Methods: 19 surgeons and 19 novices were randomized into either the control group (A) or intervention group (B) and tasked to perform 5 simulated loose-body retrieval procedures on a bench-top knee arthroscopy simulator. A cross-over study design was adopted whereby subjects alternated between devices during trials 1-3, deemed the "Unfamiliar" phase, and then used the same device consecutively in trials 4-5, to assess performance in a more "Familiarized" state. Measured outcomes were time-to-completion and incidence of bead drops. Results: In the unfamiliar phase, HMD had 67% longer mean time-to-completion than TVM (194.7 ± 152.6s vs 116.7 ± 78.7s, P <.001). Once familiarized, HMD remained inferior to TVM, with 48% longer completion times (133.8 ± 123.3s vs 90.6 ± 55s, P =.052). Cox regression revealed device type (OR = 0.526, CI 0.391-0.709, P <.001) and number of procedure repetitions (OR = 1.186, CI 1.072-1.311, P =.001) are significantly and independently related to faster time-to-completion. However, experience is not a significant factor (OR = 1.301, CI 0.971-1.741, P =.078). Bead drops were similar between the groups in both unfamiliar (HMD: 27 vs TVM: 22, P =.65) and familiarized phases (HMD: 11 vs TVM: 17, P =.97). Conclusion: Arthroscopic procedures continue to be better performed under conventional TVM. However, similar quality levels can be reached by HMD when given more time. Given the theoretical advantages, further research into improving HMD designs is advocated. [ABSTRACT FROM AUTHOR]

Introduction: Even as children experience adversity, they can become resilient adults, in large part due to their social supports as emerging adults. Objective: Authors examine constructs of social support applied to the concept of resilience among emerging adults having experienced adverse childhood experiences (ACE). Method: Authors conducted a meta-ethnography with six databases between January 1998 and October 2019. Inclusion criteria were as follows: (i) original peer-reviewed qualitative or mixed-method studies, (ii) sampling adults aged 18–35 years, (iii) reporting at least one ACE as defined by the World Health Organization, (iv) focused on resilience, and (v) in English. Data were collected from six electronic databases (MEDLINE, EMBASE, CINAHL, PsychINFO, Web of Science, and Google Scholar). Studies were appraised using the Critical Appraisal Skills Program Qualitative Checklist. Analysis drew on Bourdieu's constructs of capital following Noblit and Hare's methods. Results: Thirteen studies of 277 emerging adults, aged 18–35 years old (mean 23 years), from six countries, reported resilience as "self-righting" appraisals. These were interdependent of their social supports and within a culturally determined sense of self-reliance. Self-reliance appeared to be a precursor shaping resilience of emerging adults with ACE. Self-reliance may deter self-compassion and, as a self-righting appraisal/capacity, may inhibit accessing social support. Conclusion: This review emphasizes the life stage of emerging adulthood regarding the development of self-righting appraisal skills, which, when enabled with reliance, others help to transform ACEs and allow resilience to grow. [ABSTRACT FROM AUTHOR]

The purpose of this article is to compare and discuss the use of Likert-type scales and Q-methodology to examine perceptions and attitudes in nursing research. This article provides a brief review of each approach, and how they have been used to advance our knowledge in health-related perceptions and attitudes. Although Likert-type scales are economical, efficient, and easy to analyze, the results can be difficult to interpret or translate into meaningful practice. In contrast, Q-methodology yields holistic and in-depth information on what the prevailing perceptions and attitudes are, but its conduct is logistically challenging and the results’ generalizability can be limited. The appropriate uses of either or both approaches to answer different research questions will be discussed. Nurse scientists are called upon to continue our exploration, utilization, and expansion of unique methodologies that directly speak to a meaningful examination of these important constructs in nursing research. [ABSTRACT FROM AUTHOR]