Bmj Military Health最新文献

{"title":"Oral tranexamic acid as a preferred administration route for severe trauma in the extreme cold weather environment.","authors":"Jonathon Lowe, M Warner, E Barnard","doi":"10.1136/military-2024-002915","DOIUrl":"https://doi.org/10.1136/military-2024-002915","url":null,"abstract":"","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014370","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":"Progressive facial atrophy: a rare case of Parry-Romberg syndrome in an active-duty soldier.","authors":"Lindsay Martin, C Simmons, P Castaneda, S Smilow, B Carius","doi":"10.1136/military-2024-002852","DOIUrl":"https://doi.org/10.1136/military-2024-002852","url":null,"abstract":"","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014372","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":"Resilience measures for the attacked Role 2 facility: lessons and strategies for future planning.","authors":"David N Naumann, T S G Short, B M Lomas, A M Rennie, K Clayton, I L Freshwater, C Tunstall, J Burns, C Bundy, B Gurung, D J Bond, A Wichaisri, A T Flanagan, R Chauhan","doi":"10.1136/military-2024-002882","DOIUrl":"https://doi.org/10.1136/military-2024-002882","url":null,"abstract":"","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014374","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":"Infantry training outcomes: are they improved with an initial reduction in load carriage mass and additional sprint intensity exercise?","authors":"Herbert Groeller, P Larsen, J R Drain, N Gibson, M Kitcher, L Alfiero, B J Dascombe, J A Sampson","doi":"10.1136/military-2024-002765","DOIUrl":"https://doi.org/10.1136/military-2024-002765","url":null,"abstract":"<p><strong>Introduction: </strong>Infantry is a physically demanding trade that is associated with elevated rates of musculoskeletal injury. A 17-week longitudinal intervention assessed the effect of a progressive increase in load carriage mass and sprint-intensity intervals on physical performance, physical complaints, medical encounters, physical activity and sleep in infantry trainees.</p><p><strong>Methods: </strong>91 infantry trainees from 2 separate platoons, randomly assigned as control (CON) or experimental (EXP), provided written voluntary consent. Both completed a 17-week training syllabus that included physical training and military education lessons. Compared with CON, EXP completed a modified regimen that included; a 25%-30% reduction in load carriage mass (weeks 1-4), sprint (weeks 1-7) and 3 min running intervals. Endurance, strength, power and functional performance were assessed (weeks 1, 6-8), physical activity and sleep were recorded using actigraphy (each day of training, weeks 1-17), with daily physical complaints tabulated (weeks 1-7) and frequency of medical encounters retrospectively extracted from defence health records (weeks 1-17).</p><p><strong>Results: </strong>On-time completion of training was attained in 93% and 79% of CON and EXP, respectively. Total load carriage mass (weeks 1-4) was 27% lower in EXP (10.1 kg/hour) than CON (13.9 kg/hour). Push-up repetitions in CON (5 reps) improved compared with EXP, with functional performance improving markedly in both groups (71 m, 23%). All other fitness assessments were similar between groups. No difference in sleep quality and quantity was observed between groups, with 77% and 16% of trainees sleeping <7 hours (suboptimal) and <6 hours (sleep restricted) per night, respectively. Physical complaints in CON were higher (62), despite no difference observed in medical encounters.</p><p><strong>Conclusions: </strong>The reduction in load carriage mass and inclusion of sprint interval training did not modify the adaptative or maladaptive responses to infantry training. Most trainees experienced chronic suboptimal sleep quantity and quality with over 15% classified as sleep restricted.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014369","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":"UK Defence Rehabilitation consensus agreement for the conservative management of Achilles and patellar tendinopathy: a modified Delphi approach.","authors":"Alice Judd, K Wild, L Puxley, R Barker-Davies","doi":"10.1136/military-2024-002893","DOIUrl":"https://doi.org/10.1136/military-2024-002893","url":null,"abstract":"<p><p>Achilles and patellar tendinopathy are common in military personnel due to the repetitive high loads and challenging extrinsic risk factors associated with the demands of their role. Sports medicine is rapidly evolving. Up-to-date evidence-based research is essential, alongside clinical reasoning, to deliver best-practice treatment to service personnel, underpinned by the duty of care to their long-term career.The aim of this research was to develop recommendations on conservative management of Achilles and patellar tendinopathy in relation to the military population. A systematic review was conducted by a multidisciplinary clinical panel from across Defence Rehabilitation. The panel was split into four subgroups (diagnosis and outcome measures, medical, exercise and adjuncts). Each subgroup proposed recommendations for voting across the wider authorship in a modified Delphi process. 28 recommendations achieved substantial agreement following a chaired meeting attended by all authors. A summary infographic was produced to highlight themes relevant to the military patient population.Diagnosis of Achilles and patellar tendinopathy remains clinical. The consensus panel strongly advocates exercise rehabilitation as the primary management of Achilles and patellar tendinopathy. Medical interventions should respect the long-term occupational needs of the military population. Education is advised, but further adjunctive interventions should only be considered on a case-by-case basis. This consensus agreement provides a framework for the development of local guidelines for the management of Achilles and patellar tendinopathy in the UK military population.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014375","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":"Demographic characteristics, gambling engagement, mental health, and associations with harmful gambling risk among UK Armed Forces serving personnel.","authors":"Matthew Jones, H Champion, G Dighton, J Larcombe, M Fossey, S Dymond","doi":"10.1136/military-2024-002726","DOIUrl":"10.1136/military-2024-002726","url":null,"abstract":"<p><strong>Introduction: </strong>Harmful gambling negatively impacts individuals, families and communities. Growing international evidence indicates that the Armed Forces (AF) community may be at a comparatively higher risk of experiencing harm from gambling than the general population. The current study sought to identify general predictors of harmful gambling and gambling engagement among UK AF serving personnel (AFSP).</p><p><strong>Methods: </strong>We conducted a cross-sectional, exploratory survey to identify associations between demographic factors, mental health, gambling engagement and gambling type in a sample (N=608) of AFSP.</p><p><strong>Results: </strong>Most of the sample reported past-year gambling, with 23% having experienced harm. Male gender, younger age and lower educational attainment all predicted harmful gambling, as did mental health variables of prior generalised anxiety and post-traumatic stress symptomatology. Strategy-based gambling and online sports betting were also predictive of experiencing harm from gambling.</p><p><strong>Conclusions: </strong>The risk of harm from gambling is associated with demographic, mental health and gambling engagement variables among AFSP. Better understanding of these predictors is important for the development of individualised treatment approaches for harmful gambling.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477679","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":"Estimates of unintended pregnancy among US active-duty service women and the impact on Women Peace and Security objectives as measured by potential readiness days lost.","authors":"Miranda Lynn Janvrin, A Banaag, L L Lawry, R Scott, T Koehlmoos","doi":"10.1136/military-2023-002654","DOIUrl":"10.1136/military-2023-002654","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of unintended pregnancy (UIP) in the United States is high among active-duty service women (ADSW).</p><p><strong>Objective: </strong>To estimate the number of UIPs and the impact these pregnancies have on the ability to meet Women, Peace and Security objectives as measured by maximum potential readiness days lost (mRDL).</p><p><strong>Methods: </strong>Using data from the Military Health System Data Repository, ADSW aged 18 to 44 years, were identified from fiscal year (FY) 2019 data. Deliveries were identified using Medicare Severity Diagnosis-Related Group codes. The estimated number of UIPs was calculated by multiplying both the number of ADSW and the number of deliveries by age-adjusted rates of UIP. Post partum women do not have to meet height and weight standards or complete a physical fitness test for up to 365 days after a full-term delivery. Lost readiness days were calculated by multiplying the number of UIPs by 365 days. Data were stratified by age, race, rank and branch of service.</p><p><strong>Results: </strong>A total of 230 596 ADSW were identified in FY2019. Using the number of ADSW, an estimated 12 683 ADSW experienced an unintended pregnancy, resulting in an estimated 4 629 215 mRDL. Using the number of deliveries, an estimated 6785 deliveries were a result of UIPs, resulting in an estimated 2 476 364 mRDL. The highest estimates of UIPs were among ADSW aged 18 to 24 years, of White race, in a Junior Enlisted rank and in the Army.</p><p><strong>Conclusion: </strong>Estimates of UIPs among ADSW would result in considerable impact on their military career. Dealng with UIPs proactively, by encouraging comprehensive family planning and instituting additional reproductive health policies for service members by ensuring that service members can make informed decisions about their reproductive health while maintaining operational effectiveness, is important for meeting United States Department of Defense Women, Peace and Security objectives.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753140","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":"Whole body vibrations and lower back pain: a systematic review of the current literature.","authors":"Abigail Bainbridge, I Moutsos, A Johnson, L McMenemy, A Ramasamy, S D Masouros","doi":"10.1136/military-2024-002801","DOIUrl":"https://doi.org/10.1136/military-2024-002801","url":null,"abstract":"<p><strong>Introduction: </strong>Whole body vibration (WBV) is thought to be associated with low back pain (LBP). To mitigate against this the International Organisation for Standardisation (ISO) have created the ISO 2631 standard, recommending safe dose limits. The aim of this research is to conduct a systematic review of available literature addressing the question, is WBV associated with LBP?</p><p><strong>Methods: </strong>A literature search was performed from January 1970 until April 2022, including studies focusing on LBP and sciatica in association with WBV, looking specifically for ones reporting on military populations. Studies on populations less than 18 years old or case studies were excluded. We conducted two subgroup analyses on studies that used a validated method to assess LBP and measured an A(8) (daily exposure) or VDV value (highest vibration exposure) as per ISO 2631-1 standard.</p><p><strong>Results: </strong>37 studies were included, 11 showed an association between LBP and WBV. 97.9% of the population was male with an average age of 40.2, 47% used a version of the Standard Nordic Questionnaire (SNQ) to assess LBP and 51% used a triaxial accelerometer standard to measure vibration. Two studies reported on military populations.The subgroup analysis for A(8) identified six studies with a total population of 1413. A(8) ranged from 0.17 m/s² to 0.59 m/s² and LBP prevalence from 25% to 66%. The subgroup analysis for VDV identified three papers with a total population of 1239. VDV ranged from 6.84 m/s^0.75 to 14.7 m/s^0.75 and LBP prevalence from 25% to 60.9%.</p><p><strong>Discussion: </strong>This paper suggests WBV and LBP are associated but there is a research gap for high-level evidence and comparable data. The use of the SNQ was a preferrable method to assess LBP in most included studies. Using this in combination with a protocolised standard for measuring vibration exposure is needed for further research.</p><p><strong>Prospero registration number: </strong>CRD42022298283.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972840","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":"What is the risk of transfusing group O RhD-positive red blood cells to female service personnel of childbearing potential?","authors":"Mark H Yazer, T Scorer, D McConnell, J Gluyas-Harris","doi":"10.1136/military-2024-002904","DOIUrl":"https://doi.org/10.1136/military-2024-002904","url":null,"abstract":"<p><p>The traditional approach to resuscitating injured women of childbearing potential (WCBP) with an unknown RhD type is to transfuse RhD-negative blood products. This is to prevent alloimmunisation to the RhD antigen and ultimately prevent haemolytic disease of the fetus and newborn (HDFN) in future pregnancies should she survive. RhD-negative blood products are scarce in both military and civilian blood stocks. It is likely that only RhD-positive blood products are available for a servicewoman injured in combat. This analysis will review the latest models of D-alloimmunisation following transfusion of RhD-positive blood products to injured WCBPs, the subsequent rates of adverse events from HDFN and describe some surveys of WCBPs' preferences for transfusion in emergency situations. These data and opinions all point to the same conclusion: RhD-negative blood products should be the first choice for the resuscitation of women at risk of HDFN, but their absence should never lead to withholding a lifesaving transfusion.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972839","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":"Whole System Approach to designing, implementing and measuring health and performance benefits of improving diet behaviour in a military setting.","authors":"Joanne L Fallowfield, J Carins","doi":"10.1136/military-2024-002861","DOIUrl":"https://doi.org/10.1136/military-2024-002861","url":null,"abstract":"<p><p>Many employers-including the military-are experiencing systemic workforce capacity and capability challenges. This coincides with a time of declining workforce health, especially among military service entrants, where many performance-limiting health conditions are preventable if healthier behaviours are practised. Effectively tackling complex, interconnected health problems demands a multilevel, multicomponent Whole System Approach (WSA). However, despite recognition of the issues impacting international militaries, current policies and practices supporting healthy, performing workforces have failed. To arrest ill-health trends in personnel, military employers must develop transformational ways to support good health. This paper presents a military workplace WSA model, operationalised through COM-B to specifically target diet behaviour, supporting individual good health, promoting human performance and realising organisational benefits. The challenges of a military occupational setting to individual nutrition practices across the career are discussed. Finally, Impact Value Chain analysis is proposed to monitor system delivery and measure the effectiveness of an integrated, organisation-wide WSA.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967142","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}