Bmj Military Health最新文献

{"title":"Comparison of army personnel with single versus multiple suicidality events.","authors":"Samantha Hodges, C Meurk, E Heffernan","doi":"10.1136/military-2025-003131","DOIUrl":"https://doi.org/10.1136/military-2025-003131","url":null,"abstract":"<p><strong>Introduction: </strong>Individuals who experience repeated suicidality (ideation, self-harm and attempted suicide) are more at risk of future death by suicide and are often more clinically complex than those with a single suicidality event. Despite this, repeated suicidality appears to be under-researched in military populations.</p><p><strong>Method: </strong>This study compares Australian Army personnel who experience one episode of suicidality to those who experience multiple events using army administrative records from 2012 to 2021. Demographics, event characteristics and outcome variables are presented.</p><p><strong>Results: </strong>While similar demographically, those with multiple events were significantly more likely to engage in: self-harm or suicide attempt, to use alcohol or substances around the event, to avoid military locations and support networks around the event, and were significantly less likely to make a successful return to work.</p><p><strong>Conclusion: </strong>Repeat suicidality represents a key opportunity to reduce suicidality morbidity and mortality in the Australian Army. Enhanced data surveillance, reducing the use of alcohol and substances and targeted management and transition protocols may assist in reducing the incidence. Implications for the army and future research directions are discussed.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contraception in the Royal Navy: a service evaluation of the lived experience of serving women.","authors":"Isabel S Austin, C E Moore, F Crowsley-Allen, R Guest","doi":"10.1136/military-2025-003036","DOIUrl":"https://doi.org/10.1136/military-2025-003036","url":null,"abstract":"","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large-scale combat operations: French lessons on prolonged casualty care in the Sahel.","authors":"Cyril Pernod, J Schmitt, C Dubecq, E Meaudre, P Pasquier","doi":"10.1136/military-2025-003108","DOIUrl":"https://doi.org/10.1136/military-2025-003108","url":null,"abstract":"","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cold operational readiness in the military: from science to practice.","authors":"Tommi Ojanen, L Margolis, K van der Sanden, F Haman, B Kingma, G Simonelli","doi":"10.1136/military-2024-002740","DOIUrl":"10.1136/military-2024-002740","url":null,"abstract":"<p><p>Cold weather operations are logistically difficult to orchestrate and extremely challenging for soldiers. Decades of research and empirical evidence indicate that humans are extremely vulnerable to cold and that individual responses are highly variable. In this context, it may be necessary to develop personalised strategies to sustain soldiers' performance and ensure overall mission success in the cold. Systematic cold weather training is essential for soldiers to best prepare to operate during, and recover from, cold weather operations. The purpose of this review is to highlight key aspects of cold weather training, including (1) human responses to cold, (2) nutrition, (3) sleep and (4) protective equipment requirements. Bringing science to practice to improve training principles can facilitate soldiers performing safely and effectively in the cold. Cold weather training prepares soldiers for operations in cold, harsh environments. However, decreases in physical, psychological and thermoregulatory performance have been reported following such training, which influences operational ability and increases the overall risk of injuries. When optimising the planning of field training exercises or operational missions, it is important to understand the soldiers' physical and cognitive performance capacity, as well as their capacity to cope and recover during and after the exercise or mission. Even though the body is fully recovered in terms of body composition or hormonal concentrations, physical or cognitive performance can still be unrecovered. When overlooked, symptoms of overtraining and risk of injury may increase, decreasing operational readiness.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"428-432"},"PeriodicalIF":1.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatigue and management of warfighter mental endurance.","authors":"Arnaud Rabat, J Van Cutsem, S M Marcora, A Lambert, R Markwald, A G Kubala, K E Friedl","doi":"10.1136/military-2025-002963","DOIUrl":"10.1136/military-2025-002963","url":null,"abstract":"<p><p>Mental fatigue (MF) is a psychobiological state induced by prolonged exertion that has the potential to reduce performance. In military operations, MF coincides with inadequate sleep, circadian disruption and other stressors, further increasing the risk of fatigue-related errors of judgement and reduction in physical and psychological performance. Experienced leaders can detect MF, but multimodal monitoring and assessment technologies still cannot duplicate this capability. Experiments to define signals that cue this human percept could inform future technologies. Countermeasures include engagement strategies, brain endurance training to extend physical endurance, and caffeine and modafinil to temporarily sustain performance. An infrastructure for physiological monitoring and integrated analyses will advance team performance enhancement, along with the use of explainable and interpretable artificial intelligence modelling, refined through iterative experimentation. More precise definitions that distinguish MF from other types of fatigue will help advance the development of monitoring technologies and countermeasures by targeting the right physiological and behavioural metrics.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"447-451"},"PeriodicalIF":1.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clothing and individual equipment for the female soldier: developing a framework to improve the evidence base which informs future design and evaluation.","authors":"Nicola C Armstrong, S A Rodrigues, K M Gruevski, K B Mitchell, A Fogarty, S Saunders, L Bossi","doi":"10.1136/military-2024-002735","DOIUrl":"10.1136/military-2024-002735","url":null,"abstract":"<p><p>The development of inclusive equipment and clothing is a priority across national defence departments that are part of The Technical Cooperation Programme. As such, a collaborative effort has been established to inform the development of clothing and equipment for women. This invited review provides an overview of an ongoing collaborative project presented at the sixth International Congress on Soldiers Physical Performance. The purpose of this review was to summarise the outputs of scoping work conducted to inform the direction of future research programmes. The scoping work has recommended a framework, which includes improved objective metrics for assessment, standardised methods to characterise study participants and improved methods for characterising the system being evaluated. The longer-term research project aims to implement the framework so that the design of future equipment and clothing is optimised for all end users.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"397-401"},"PeriodicalIF":1.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Holistically assessing dismounted warfighter military performance: bridging science and operational relevancy.","authors":"Jennifer Sperlein, K Hinde, T Karakolis, S D Myers, M O'Donovan, B Sheffield","doi":"10.1136/military-2024-002748","DOIUrl":"10.1136/military-2024-002748","url":null,"abstract":"<p><p>Dismounted warfighter physical and cognitive performance is complex, involving interdependent domains such as mobility, lethality, survivability and sustainability. This article provides an overview of topics presented during the 'holistically assessing dismounted infantry performance: bridging science and operational relevancy' session of the sixth International Congress on Soldiers' Physical Performance, held in London, UK, 2023. These topics include the investigation of multivariate aspects of dismounted performance at both the individual warfighter and squad levels. Discussion includes a general approach to quantifying warfighter and squad-level dismounted performance, specific body-worn sensors used to investigate performance, including heart rate variability and movement mechanics, a specific investigation into the effect of hearing acuity on individual and group performance, and lastly moving towards predicting performance with body-worn sensors.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"423-427"},"PeriodicalIF":1.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel approaches to evaluate characteristics that affect military load carriage.","authors":"Ryan B Graham, A Mir-Orefice, M P Mavor, V G Bode, T L A Doyle, K R Kelly, A K Silverman, P H Sessoms","doi":"10.1136/military-2024-002899","DOIUrl":"10.1136/military-2024-002899","url":null,"abstract":"<p><p>Carrying heavy body-borne loads, an essential component of a service member's duties, is a significant injury risk factor. Physiological and biomechanical data can help illuminate the relationship between load carriage and injuries for service members. This review highlights characteristics that affect load carriage performance and summarises novel approaches to evaluate associated biomechanical changes. Personal characteristics, such as physical fitness and body composition, are good predictors of injury risk and load carriage ability. Effective training programmes can improve load carriage ability by altering fitness and body composition; however, careful planning is needed to integrate training with regular duties to prevent overtraining and, consequently, reduce injury risk in service members. Recent research supports the need for sex-specific training programmes since men and women achieve different training outcomes from similar stimuli. To further minimise injury risk, it is necessary to consider the effects of equipment characteristics (eg, load distribution, form and comfort) on physiological and biomechanical responses. Moreover, novel approaches to evaluate the effects of the various characteristics on load carriage performance are summarised in this review. Markerless motion capture and inertial measurement units have recently been used to evaluate kinematic changes while wearing various combat ensembles. Musculoskeletal modelling can complement kinematic analyses by evaluating internal joint mechanics during dynamic movements. By using frameworks that can leverage modelling approaches in real-time, service members can receive data-driven biofeedback on their load carriage performance and understand the loading experienced by their tissues to ultimately help mitigate their injury risks.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"458-462"},"PeriodicalIF":1.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Holistic Health and Fitness Management System (H2FMS): a modernised software capability for optimising soldier readiness and performance.","authors":"Andrew G Thompson, N A Rinaldi, C L Smith, K A Bigelman","doi":"10.1136/military-2024-002945","DOIUrl":"10.1136/military-2024-002945","url":null,"abstract":"<p><p>The Holistic Health and Fitness Management System (H2FMS) is a secure, cloud-based platform designed to assess, understand and improve soldier health, fitness and performance across five readiness domains: physical, mental, spiritual, nutritional and sleep. By leveraging automated support actions, domain-specific tools, role-based dashboards and integrated analytics, H2FMS empowers the interdisciplinary Holistic Health and Fitness (H2F) Performance Teams (HPTs) to effectively develop, employ and retain talented soldiers within the US Army.H2FMS unifies data from advanced biometric technologies, performance assessments, self-reported psychometrics and existing systems, ensuring every soldier has on-demand access to HPT support through guided education, interactive coaching, expert-informed training and personalised biofeedback. The platform enhances awareness for individual soldiers, HPT staff and cadre/command teams, driving optimal resource allocation and enabling data-informed interventions that boost performance, reduce injuries, expedite rehabilitation and significantly enhance quality of life and service. H2FMS represents a cost-efficient strategy for scaling HPT access across the Total Army, providing an equitable framework that maximises individual and organisational return on investment.Critically, H2FMS aligns with the Army's modernisation and national defence objectives by supporting multidomain overmatch through superior human performance management. It advances the long-term goal of generating and maintaining a lethal, adaptable and enduring force. This review details the requirements for H2FMS capabilities and illustrates how it can guide optimisation strategies while creating institutional efficiencies essential for modern force management. Ultimately, H2FMS marks a strategic milestone investment in modernising the foundation of the Army's 'human advantage,' ensuring sustained effectiveness and resilience in current and future conflicts.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"438-446"},"PeriodicalIF":1.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MSKI reduction strategies: evidence-based interventions to reduce musculoskeletal injuries in military service members.","authors":"Hans Christian Tingelstad, E Robitaille, T J O'Leary, M-A Laroche, P Larsen, T Reilly","doi":"10.1136/military-2024-002747","DOIUrl":"10.1136/military-2024-002747","url":null,"abstract":"<p><p>Musculoskeletal injuries (MSKI) are one of the biggest challenges for military services globally, contributing to substantial financial burdens and lost training and working days. Effective evidence-based intervention strategies are essential to reduce MSKI incidence, and research has shown the positive effect of both nutritional interventions and physical training (PT) interventions on reducing MSKI incidence. Levels of vitamin D metabolites have been associated with MSKI and bone stress fracture risk, while calcium and vitamin D supplementation has been shown to reduce the incidence of stress fractures during military training. Protein and carbohydrate supplementation during arduous military training (high volume, high intensity) has also been shown to reduce MSKI risk and the number of limited/missed duty days. PT has played a key role in soldier development to meet the occupational demands of serving in the armed forces. Paradoxically, while PT is fundamental to enhancing soldier readiness, PT can also be a major contributor to MSKI; emerging evidence suggests that the nature of the PT being performed is a risk factor for MSKI. However, strategies like reducing training load and implementing PT programmes using evidence-based training principles can reduce MSKI incidence among military service members by 33-62%, and reduce the financial burdens for military services. This review provides a summary of effective MSKI reduction interventions and provides strategies to enhance the success and adoption of such interventions.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"418-422"},"PeriodicalIF":1.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}