{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,4,3]],"date-time":"2022-04-03T13:26:49Z","timestamp":1648992409813},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"Supplement_1","funder":[{"name":"DOD Defense Medical Research and Development Program","award":["F1501"],"award-info":[{"award-number":["F1501"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Pressurized Submarine Escape Training (PSET) physically prepares submariners to safely escape a submarine at depth. Failure to complete PSET is not a submarine service disqualification. Serious medical incidents are rare, but the safety record tradeoff has been low throughput. From 2009 to 2015, only 34% of students screened completed PSET. Students may be medically screened out of the training altogether (disqualified), or dropout during the physical training (attrite). Training records from 12,122 U.S. Navy students were used to identify factors contributing to training disqualification and attrition. Multivariate logistic regression model predictors included demographic and screening items. Association to PSET disqualification included cold\/congestion\/cough (ORadj 12.34), limited duty status (ORadj 4.29), Physical Readiness Test failure (ORadj 3.37), pneumonia or bronchitis in last 2 years (ORadj 3.17) and nervousness or anxiety in tight spaces (ORadj 2.37). Basic Enlisted Submarine School students were more likely to be disqualified and attrite than other submariner groups, and black\/African American (ORadj 1.53) students were more likely to attrite than white students. Only cold\/congestion\/cough (ORadj 1.52), trouble swimming (ORadj 1.53), and screening during cold\/flu season (ORadj 1.28), were associated with training attrition. Recommendations to modify screening requirements are listed in conclusions.<\/jats:p>","DOI":"10.1093\/milmed\/usy377","type":"journal-article","created":{"date-parts":[[2019,3,22]],"date-time":"2019-03-22T12:12:47Z","timestamp":1553256767000},"page":"476-487","source":"Crossref","is-referenced-by-count":1,"title":["Identifying Predictors of Pressurized Submarine Escape Training (PSET) Attrition"],"prefix":"10.1093","volume":"184","author":[{"given":"Linda M","family":"Hughes","sequence":"first","affiliation":[{"name":"Naval Submarine Medical Research Laboratory, Trout Avenue, Naval Submarine Base New London, Groton, CT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Clarke","sequence":"additional","affiliation":[{"name":"Naval Submarine Medical Research Laboratory, Trout Avenue, Naval Submarine Base New London, Groton, CT"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,3,21]]},"reference":[{"issue":"10","key":"2019122605083083000_usy377C1","doi-asserted-by":"crossref","first-page":"850","DOI":"10.3357\/ASEM.2503.2009","article-title":"Physiological and psychological effects of escape from a sunken submarine on shore and at sea","volume":"80","author":"Trousselard","year":"2009","journal-title":"Aviat Space Environ Med"},{"issue":"2","key":"2019122605083083000_usy377C2","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1093\/milmed\/163.2.68","article-title":"Submarine escape: the effect of training on anxiety","volume":"163","author":"Van Wijk","year":"1998","journal-title":"J Mil Med"},{"key":"2019122605083083000_usy377C3","author":"Frank","year":"1997"},{"key":"2019122605083083000_usy377C4","author":"Neuman","year":"1974"},{"key":"2019122605083083000_usy377C5","author":"Weathersby","year":"1999"},{"issue":"3","key":"2019122605083083000_usy377C6","first-page":"269","article-title":"Submarine escape from depths of 30 and 60 feet: 41,183 training ascents without serious injury","volume":"75","author":"Yildiz","year":"2004","journal-title":"Aviat Space Environ Med"},{"key":"2019122605083083000_usy377C7","author":"Benton","year":"1994"},{"key":"2019122605083083000_usy377C8","author":"Commander, Naval Bureau of Medicine and Surgery","year":"2017"},{"issue":"5","key":"2019122605083083000_usy377C9","first-page":"429","article-title":"Low forced expiratory flow rates and forceful exhalation as a cause for arterial gas embolism during submarine escape training: a case report","volume":"42","author":"Hartge","year":"2015","journal-title":"Undersea Hyperb Med"},{"issue":"1","key":"2019122605083083000_usy377C10","first-page":"33","article-title":"Initial review of the U.S. Navy\u2019s pressurized submarine escape training outcomes","volume":"41","author":"O\u2019Donnell","year":"2014","journal-title":"Undersea Hyperb Med"},{"issue":"4","key":"2019122605083083000_usy377C11","first-page":"479","article-title":"Errata and inaccurate authorship attributions noted [letter\/errata]","volume":"43","author":"Yeo","year":"2016","journal-title":"Undersea Hyperb Med"},{"issue":"9","key":"2019122605083083000_usy377C12","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1093\/milmed\/167.9.760","article-title":"Predictors of Navy attrition. 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Analysis of 1-year attrition","volume":"167","author":"Booth-Kewley","year":"2002","journal-title":"J Mil Med"},{"issue":"4","key":"2019122605083083000_usy377C13","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1093\/milmed\/164.4.269","article-title":"Prevalence and predictors of discharge in United States Air Force Basic Military Training","volume":"164","author":"Talcott","year":"1999","journal-title":"J Mil Med"},{"issue":"4","key":"2019122605083083000_usy377C14","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1177\/0021934710385549","article-title":"The legacy of fear: is fear impacting fatal and non-fatal drowning of African American children?","volume":"42","author":"Irwin","year":"2011","journal-title":"J Black Stud"},{"issue":"4","key":"2019122605083083000_usy377C15","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1136\/ip.2008.020461","article-title":"Urban minority youth swimming (in)ability in the United States and associated demographic characteristics: toward a drowning prevention plan","volume":"15","author":"Irwin","year":"2009","journal-title":"Inj Prev"},{"issue":"12","key":"2019122605083083000_usy377C16","first-page":"1086","article-title":"Alcohol and other risk factors for drowning among male active duty U.S. army soldiers","volume":"72","author":"Bell","year":"2001","journal-title":"Aviat Space Environ Med"},{"issue":"5","key":"2019122605083083000_usy377C17","first-page":"447","article-title":"Canadian Forces submarine escape training: analysis of injury patterns. 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