Studies have shown that autonomous mode behavior is one cause of aircraft fatalities due to pilot error. In such cases, the pilot is in a high state of psychological and physiological arousal and tends to focus on one problem, while ignoring more critical information. This study examined the effect of training in physiological self-recognition and regulation, as a means of improving crew cockpit performance. Seventeen pilots were assigned to the treatment and control groups matched for accumulated flight hours. The treatment group contained 4 pilots from HC-130 Hercules aircraft and 4 HH-65 Dolphin helicopter pilots; the control group contained 3 pilots of HC-130s and 6 helicopter pilots. During an initial flight, physiological data were recorded on each crewmember and an instructor pilot rated individual crew performance. Eight crewmembers were then taught to regulate their own physiological response levels using Autogenic-Feedback Training Exercise (AFTE). The remaining participants received no training. During a second flight, treatment participants showed significant improvement in performance (rated by the same instructor pilot as in pretests) while controls did not improve. The results indicate that AFTE management of high states of physiological arousal may improve pilot performance during emergency flying conditions.
Five clinical health psychologists at a major medical center successfully completed a 36-hr, graduatelevel nurse practitioner course in advanced health assessment. The psychologists were trained to conduct thorough physical examinations and evaluate medical histories. All psychologists successfully completed the course and reported high levels of comfort with their ability to (a) conduct physical examinations, (b) describe physical examination findings, (c) provisionally identify medical problems and generally abnormal conditions, and (d) make appropriate referrals to medical specialists, when necessary. The nurse practitioner instructors reported high levels of satisfaction with student mastery of course content. The psychologists and nurses both reported high levels of satisfaction with the student-faculty relationship.The scope of psychological practice has expanded dramatically since the initial push for licensure in the early 1960s. Since that time, psychologists have expanded their scope of practice to include hospital privileges and, more recently, have initiated efforts to achieve prescriptive authority at the federal and state levels. Psychologists now admit and discharge patients, assume total responsibility for inpatient and outpatient care, write inpatient lab orders, and manage health psychology inpatient units (James, 1996;James & Folen, 1996; James, Polen, Davis, & Garland, 1997). Within the Department of Defense, a cadre of trained psychologists prescribe independently at a number of medical centers. As psychologists take these treatment modalities into underserved and unserved areas, the need to independently provide necessary related services, such as conducting general medical histories and physical examinations before ini-tiating medication or admitting a patient to an inpatient unit, may become critical.Such services may seem beyond the scope of psychological practice. Although Cartesian dualism would suggest that the
This paper provides an overview of the Tripler Army Medical Center LEAN Program for the treatment of obesity, hypercholesterolemia, and essential hypertension. The LEAN Program, a multi-disciplinary prevention program, emphasizes healthy Lifestyles, Exercise and Emotions, Attitudes, and Nutrition for active duty service members. The treatment model offers a medically healthy, emotionally safe, and reasonable, low-intensity exercise program to facilitate weight loss. We will discuss the philosophy behind the LEAN Program and the major components. Thereafter, we will briefly discuss the preliminary results.
Despite decades of public education, cigarette smoking remains a serious health problem. The treatment approach at Tripler Army Medical Center is a unique collaboration of family practice physicians and health psychologists providing combination therapy to patients attempting to quit smoking. This article discusses a program evaluation of the Tripler Army Medical Center smoking cessation program. Patients attempting to quit smoking were assisted with a combination of cognitive-behavioral group therapy and sustained-release bupropion hydrochloride. At 6 months postintervention, patients who attended the smoking cessation programs were contacted via telephone and asked to complete a survey regarding their smoking status. One hundred forty-four participants completed the survey. Thirty-five percent of all contacted attendees remained abstinent from smoking at 6 months after intervention. A significantly greater percentage of men quit than women. There were no significant differences of abstinence rates by any other demographic characteristic or smoking history variable. Family practice physicians and health psychologists providing a combination of pharmacological and group cognitive-behavior therapy for nicotine dependence are effective in promoting abstinence from smoking.
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