Journal of the Royal Army Medical Corps最新文献

{"title":"Military ethics: an operational priority.","authors":"Rich Withnall, A Brockie","doi":"10.1136/jramc-2019-001262","DOIUrl":"https://doi.org/10.1136/jramc-2019-001262","url":null,"abstract":"Military ethical frameworks exist to guide those who are not specialists in ethics, but who must carry out their duties as honourably and correctly as possible. They catalyse thought and better understanding of the moral challenges and dilemmas inherent within military service and enable and","PeriodicalId":17327,"journal":{"name":"Journal of the Royal Army Medical Corps","volume":"165 4","pages":"219"},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jramc-2019-001262","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37400880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dispatched from the Editor in Chief: does the impact factor have any real relevance to our military health journal?","authors":"J. Breeze","doi":"10.1136/jramc-2019-001278","DOIUrl":"https://doi.org/10.1136/jramc-2019-001278","url":null,"abstract":"Welcome to the fifth issue of 2019 of the Journal of the Royal Army Medical Corps ( JRAMC ). I am writing these dispatches during my deployment to the US-led Role 3 Craig Joint Theater Hospital at Bagram Airfield, Afghanistan. Running the journal remotely is challenging, and I continue to be","PeriodicalId":17327,"journal":{"name":"Journal of the Royal Army Medical Corps","volume":"165 1","pages":"307 - 309"},"PeriodicalIF":0.0,"publicationDate":"2019-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jramc-2019-001278","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43322196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Highlights of the edition: the military medical ethics special issue","authors":"A. Brockie, J. Breeze","doi":"10.1136/jramc-2019-001212","DOIUrl":"https://doi.org/10.1136/jramc-2019-001212","url":null,"abstract":"‘Medical ethics in times of armed conflict is identical to medical ethics in times of peace’. So states the first line of the World Medical Association’s (WMA) Regulations in Times of Armed Conflict and Other Situations of Violence,[1][1] which can also be found in the WMA International Code","PeriodicalId":17327,"journal":{"name":"Journal of the Royal Army Medical Corps","volume":"165 1","pages":"217 - 218"},"PeriodicalIF":0.0,"publicationDate":"2019-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jramc-2019-001212","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48485887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concept of error and nature of nursing error detectors in military hospitals: a qualitative content analysis.","authors":"M. Ajri-Khameslou, S. Aliyari, A. Pishgooie, N. Jafari-Golestan, Pouya Farokhnezhad Afshar","doi":"10.1136/jramc-2019-001198","DOIUrl":"https://doi.org/10.1136/jramc-2019-001198","url":null,"abstract":"BACKGROUND AND OBJECTIVES\u0000Nursing errors can cause irreparable consequences. Understanding the concept of error and the nature of nursing error detectors can significantly reduce this type of errors. The present study was conducted to explain the concept of error and the nature of nursing error detectors in military hospitals.\u0000\u0000\u0000MATERIALS AND METHODS\u0000The present study was conducted on eight nurses working in different wards of military hospitals using a qualitative approach to content analysis proposed by Graneheim and Lundman. Data were collected through in-depth semistructured interviews.\u0000\u0000\u0000FINDINGS\u0000'The concept of error' and 'the nature of error detectors' in military hospitals were the two main categories extracted from data analysis. The present findings showed that the nature of errors in military hospitals is inevitable, a threat to job position and bipolar. Nurses use different resources to identify errors, including personal, environmental and organisational factors of detection.\u0000\u0000\u0000DISCUSSION AND CONCLUSION\u0000Given the military nature of the study hospitals, organisational factors of detection played a key role in identifying errors. Moreover, given the perception of military nurses of errors, they were not inclined to personal detectors. The managers of military hospitals are therefore recommended to pursue a justice-oriented and supportive culture to help nurses play a more active role in identifying errors.","PeriodicalId":17327,"journal":{"name":"Journal of the Royal Army Medical Corps","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jramc-2019-001198","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42090976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood Groups","authors":"","doi":"10.5772/intechopen.73434","DOIUrl":"https://doi.org/10.5772/intechopen.73434","url":null,"abstract":"","PeriodicalId":17327,"journal":{"name":"Journal of the Royal Army Medical Corps","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71003101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond bombs and bayonets: Defence Engagement and the Defence Medical Services.","authors":"John Whitaker, D Bowley","doi":"10.1136/jramc-2017-000838","DOIUrl":"https://doi.org/10.1136/jramc-2017-000838","url":null,"abstract":"The UK Government entrusts the Ministry of Defence (MoD) to ‘efficiently protect our people, project our global influence, promote our prosperity, and maintain a strategic base and integrated global support network’ .[1 2][1] Defence Engagement (DE), now enshrined as a core MoD task,[3][2]","PeriodicalId":17327,"journal":{"name":"Journal of the Royal Army Medical Corps","volume":"165 3","pages":"140-142"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jramc-2017-000838","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35254291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One hundred years (and counting) of blast-associated traumatic brain injury.","authors":"Kevin Kinch,&nbsp;J L Fullerton,&nbsp;W Stewart","doi":"10.1136/jramc-2017-000867","DOIUrl":"https://doi.org/10.1136/jramc-2017-000867","url":null,"abstract":"<p><p>Blast-associated traumatic brain injury (TBI) has become one of the signature issues of modern warfare and is increasingly a concern in the civilian population due to a rise in terrorist attacks. Despite being a recognised feature of combat since the introduction of high explosives in conventional warfare over a century ago, only recently has there been interest in understanding the biology and pathology of blast TBI and the potential long-term consequences. Progress made has been slow and there remain remarkably few robust human neuropathology studies in this field. This article provides a broad overview of the history of blast TBI and reviews the pathology described in the limitedscientific studies found in the literature.</p>","PeriodicalId":17327,"journal":{"name":"Journal of the Royal Army Medical Corps","volume":"165 3","pages":"180-182"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jramc-2017-000867","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35729602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal ventilator strategies for trauma-related ARDS.","authors":"Giles Goatly,&nbsp;N Guidozzi,&nbsp;M Khan","doi":"10.1136/jramc-2017-000889","DOIUrl":"https://doi.org/10.1136/jramc-2017-000889","url":null,"abstract":"<p><strong>Background: </strong>Acute respiratory distress syndrome (ARDS) was first described in the 1960s and has become a major area of research due to the mortality and morbidity associated with it. ARDS is currently defined using the Berlin Consensus; however, this is not wholly applicable for trauma-related ARDS.</p><p><strong>Methods: </strong>A systematic review of the literature was undertaken using the Preferred Reporting for Systematic Reviews and Meta Analyses methodology. The Ovid Medline, Web of Science and PubMed online databases were interrogated for papers published between 1 January 1995 and 31 December 2017.</p><p><strong>Results: </strong>The literature search yielded a total of 64 papers that fulfilled the search criteria.</p><p><strong>Conclusions: </strong>Despite decades of dedicated research into different treatment modalities, ARDS continues to carry a high burden of mortality. The ARDS definitions laid out in the Berlin consensus are not entirely suited to trauma. While trauma-related ARDS represents a small portion of the available research, the evidence continues to favour low tidal volume ventilation as the benchmark for current practice. Positive end expiratory ventilation and airway pressure release ventilation in trauma cohorts may be beneficial; however, the evidence to date does not show this.</p>","PeriodicalId":17327,"journal":{"name":"Journal of the Royal Army Medical Corps","volume":"165 3","pages":"193-197"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jramc-2017-000889","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35960419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nursing and medical contribution to Defence Healthcare Engagement: initial experiences of the UK Defence Medical Services.","authors":"Douglas M Bowley,&nbsp;D Lamb,&nbsp;P Rumbold,&nbsp;P Hunt,&nbsp;J Kayani,&nbsp;A M Sukhera","doi":"10.1136/jramc-2017-000875","DOIUrl":"https://doi.org/10.1136/jramc-2017-000875","url":null,"abstract":"<p><strong>Introduction: </strong>The WHO Constitution enshrines '…<i>the highest attainable standard of health as a fundamental right of every human being</i>.' Strengthening delivery of health services confers benefits to individuals, families and communities, and can improve national and regional stability and security. In attempting to build international healthcare capability, UK Defence Medical Services (DMS) assets can contribute to the development of healthcare within overseas nations in a process that is known as Defence Healthcare Engagement (DHE).</p><p><strong>Methods: </strong>In the first bespoke DMS DHE tasking, a team of 12 DMS nurses and doctors deployed to a 1000-bedded urban hospital in a partner nation and worked alongside indigenous healthcare workers (doctors, nurses and paramedical staff) during April and May 2016. The DMS nurses focused on nursing hygiene skills by demonstrations of best practice and DMS care standards, clinical leadership and female empowerment. A Quality Improvement Programme was initiated that centred on hand hygiene (HH) compliance before and after patient contact, and the introduction of peripheral cannula care and surveillance.</p><p><strong>Results: </strong>After a brief induction on the ward, it was apparent that compliance with HH was poor. Peripheral cannulas were secured with adhesive zinc oxide tape and no active surveillance process (such as venous infusion phlebitis (VIP) scoring) was in place. After intensive education and training, initial week-long audits were undertaken and repeated after a further 2 weeks of training and coworking. In the second audit cycle, HH compliance had increased to 69% and VIP scoring compliance to 99%. In the final audit cycle, it was noted that nursing compliance with HH (75/98: 77%) was significantly higher than the doctors' HH compliance (76/200: 38%); p<0.0001.</p><p><strong>Conclusions: </strong>DHE is a long-term collaborative process based on the establishment and development of comprehensive relationships that can help transform indigenous healthcare services towards patient-centred systems with a focus on safety and quality of care. Short deployments to allow clinical immersion of UK healthcare workers within indigenous teams can have an immediate impact. Coworking is a powerful method of demonstrating standards of care and empowering staff to institute transformative change. A multidisciplinary group of Quality Improvement Champions has been identified and a Hospital Oversight Committee established, which will offer the prospect of longer term sustainability and development.</p>","PeriodicalId":17327,"journal":{"name":"Journal of the Royal Army Medical Corps","volume":"165 3","pages":"143-146"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jramc-2017-000875","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36371710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"For debate: health service support planning for large-scale defensive land operations (part 2).","authors":"Martin Bricknell,&nbsp;A Finn,&nbsp;J Palmer","doi":"10.1136/jramc-2018-000994","DOIUrl":"https://doi.org/10.1136/jramc-2018-000994","url":null,"abstract":"<p><p>This is the second of two articles that considers the medical planning implications of large-scale defensive military operations. This paper describes a unified approach to theatre level health services support planning based on four phases: collection, hospitalisation, evacuation and reception. It highlights the need for a modular and agile system of medical capability building blocks that can be grouped together for specific military medical challenges. It also reintroduces the concepts of mass casualty and the medical reserve. These two papers are designed to encourage debate around how we should be organised to face the new challenges of health services support in potential peer-on-peer military operations.</p>","PeriodicalId":17327,"journal":{"name":"Journal of the Royal Army Medical Corps","volume":"165 3","pages":"176-179"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jramc-2018-000994","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36413915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}