Bmj Military Health最新文献

{"title":"UKAF performance tool: a structured tool for management of common mental health disorders in defence primary healthcare.","authors":"Adrian M Hucks","doi":"10.1136/military-2025-002996","DOIUrl":"https://doi.org/10.1136/military-2025-002996","url":null,"abstract":"","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561592","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":"Ending water fluoridation will threaten warfighter health.","authors":"Adejare Jay Atanda","doi":"10.1136/military-2025-002961","DOIUrl":"https://doi.org/10.1136/military-2025-002961","url":null,"abstract":"","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530451","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":"Establishment and evaluation of a smoking cessation programme on the prevalence and intensity of smoking during a 6-month military deployment.","authors":"Kirsten A L Morris, A Munns, M R Riley, H Taylor","doi":"10.1136/military-2025-002957","DOIUrl":"https://doi.org/10.1136/military-2025-002957","url":null,"abstract":"<p><strong>Introduction: </strong>Military personnel smoke more frequently and intensely than civilians, with deployments often destabilising smoking behaviours and influencing long-term tobacco use. This study evaluated smoking prevalence and intensity at the start and end of a deployment among personnel with access to a smoking cessation service, identifying factors affecting cessation using the capability, opportunity, motivation, behaviour (COM-B) model.</p><p><strong>Methods: </strong>During a 6-month deployment (January-June 2019), a smoking cessation programme was established and evaluated through a prospective longitudinal service evaluation. Two British Army medical officers, certified by the National Centre for Smoking Cessation and Training, delivered the programme to approximately 120 UK Armed Forces personnel. At both the start and end of the deployment, participants voluntarily and anonymously completed a questionnaire recording age, rank, sex, smoking status and smoking intensity.</p><p><strong>Results: </strong>Surveys were completed by 112 (95%) personnel at the start and 87 (77.7%) at the end. Initially, 44 personnel (39.3%) identified as smokers, compared with 38 (43.7%) at the end. The relative risk of smoking at the end versus the 2019 British Army trained strength was 1.9 (95% CI 1.5 to 2.41; p<0.0001). Smoking prevalence was higher among men and other ranks, with 44.6% of junior and 63.6% of senior other ranks smoking by the tour's end. Median daily cigarette consumption increased, though not significantly. Provider-level factors in the COM-B model were the primary facilitators, while system-level factors were the main barriers to smoking cessation.</p><p><strong>Conclusions: </strong>This is a novel prospective evaluation of a smoking cessation programme in the context of a deployed military setting. It contributes to the existing literature by detailing the unique barriers and facilitators that can influence smoking behaviours in such settings, as well as identifying leverage points for intervention. The findings highlight the importance of tailored smoking cessation interventions that account for the unique challenges and opportunities present during military deployments.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530452","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":"Simulated activation of emergency donor panels.","authors":"Simon William James Grant, Ed Scanlon","doi":"10.1136/military-2025-003001","DOIUrl":"https://doi.org/10.1136/military-2025-003001","url":null,"abstract":"","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530453","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":"Sensitisation patterns and burden of uncontrolled respiratory allergy symptoms in military personnel.","authors":"Senne Gorris, I Baron, J De Brouwer, A Vanden Daele, J Verstraelen, D Loeckx, J Bousquet, L Van Gerven, S F Seys","doi":"10.1136/military-2025-003006","DOIUrl":"https://doi.org/10.1136/military-2025-003006","url":null,"abstract":"<p><strong>Introduction: </strong>Military personnel is often deployed in environmentally distinct areas across the globe and thereby exposed to a multitude of new plants, weeds or trees. Sensitisation to inhalant allergens occurs upon exposure in predisposed individuals. This causes frequent problems that may affect the readiness of the personnel.</p><p><strong>Methods: </strong>Study participants were recruited among the military personnel of the Belgian Army and invited to receive an allergy test by the skin prick automated test (SPAT) device for a panel of 22 inhalant allergens. A questionnaire was completed to retrieve information on demographics, lifestyle, history of allergy, rhinitis and asthma symptoms, as well as treatment and history of deployment.</p><p><strong>Results: </strong>In total, 160 subjects were included with varying histories of deployment to the Middle East (n=68), Western Africa (n=53), Eastern Europe (n=50), Central Africa (n=47), the USA (n=20) or no international deployment (n=31). A majority of military personnel (79.9%) did not take allergy medication. Applying Allergic Rhinitis and its Impact on Asthma criteria, 26% and 27.9% of untreated soldiers were identified with, respectively, uncontrolled and partly controlled rhinoconjunctivitis. Sensitisation to house dust mite (<i>Dermatophagoides farinae</i>: 29.5%, <i>Dermatophagoides pteronyssinus</i>: 27.5%), timothy grass (28.8%), birch (20.9%), hazel (17.9%) and cat (16.3%) was commonly detected. Also, sensitisation to allergens that are less common in Belgium were detected: <i>Cynodon dactylon</i> (13.1%), <i>Chenopodium alba</i> (6.9%), <i>Phoenix dactylifera</i> (6.2%), <i>Blattella germanica</i> (3.9%), <i>Blomia tropicalis</i> (3.1%) and <i>Salsola kali</i> (1.5%).</p><p><strong>Conclusions: </strong>Over one-quarter of military personnel not treated with allergy medication were identified with uncontrolled rhinoconjunctivitis. Timely allergy diagnosis and treatment are crucial for optimal performance of military personnel during international deployment and avoid an 'unfit-for-duty'. Allergy testing of an extended allergen panel by SPAT can be efficiently implemented in medical screening programmes for military candidates.</p><p><strong>Trial registration number: </strong>NCT05807958.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498474","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":"Expanding the all-hazards approach to include extreme cold weather: optimising emergency medical care.","authors":"Jonathon Lowe, M Warner, K Heil, S Todd","doi":"10.1136/military-2025-003051","DOIUrl":"https://doi.org/10.1136/military-2025-003051","url":null,"abstract":"","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498472","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":"Risk stratification scoring system for femoral neck bony stress injuries in military recruits: a pilot study.","authors":"Benjamin Atkin, J Evans, R Hemingway","doi":"10.1136/military-2025-003014","DOIUrl":"https://doi.org/10.1136/military-2025-003014","url":null,"abstract":"<p><strong>Background: </strong>Bony stress injury (BSI) is an overuse injury through excessive repetitive loads on normal healthy bone that commonly affects military recruits. Confirmation of diagnosis often requires costly investigations such as MRI, and there is a need for better prior screening procedures. This study aimed to assess a clinical risk assessment tool 'Hip1' for its utility to screen and identify BSI for further detailed confirmatory investigation.</p><p><strong>Methods: </strong>A retrospective cohort study using the Defence Medical Information Capability Programme, identifying all patients potentially presenting with BSI from clinical codes between 1 January 2021 and 31 December 2022 inclusive. All records were reviewed to determine if a 'Hip1' score had been performed by either a doctor or physiotherapist, and related to further investigations (X-ray and/or MRI reports) and patient outcomes.</p><p><strong>Results: </strong>47/213 patients were eligible. In the high-risk group (n=23), the mean Hip1 score was 7.4±1.7 versus the low-risk group (n=24), with a mean Hip1 score of 3.1±0.73. Nine patients from the high-risk group had a positive diagnosis of a BSI with a mean Hip1 score of 7.7±1.7. All patients in the low-risk group had a negative diagnosis and returned to training. Comparison between positive and negative cohorts gave the Hip1 score a sensitivity of 100% (95% CI 66.4% to 100%), specificity of 63.2% (95% CI 45.9% to 78.2%), positive predictive value of 39.1% (95% CI 29.8% to 49.3%) and negative predictive value of 100% (95% CI, N/A). Patients with a score of ≥5 were more likely to have a BSI than those with a score of ≤4 (p<0.05).</p><p><strong>Conclusions: </strong>The Hip1 clinical scoring system showed high sensitivity with a very high negative predictive value to exclude those subjects that did not have a BSI; therefore, reducing unnecessary investigation, while directing the diagnostic resources to those who were most likely to require them.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498473","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":"Evaluation of combat-related orthopaedic injuries: a comparative study of two military campaigns.","authors":"Tal Shachar, E Yaacobi, A M Tsur, I Radomislensky, N Ohana, O Almog","doi":"10.1136/military-2025-002989","DOIUrl":"https://doi.org/10.1136/military-2025-002989","url":null,"abstract":"<p><strong>Introduction: </strong>Traumatic orthopaedic injuries are common in warzones and are associated with a high complication rate. Our aim is to compare and characterise orthopaedic injuries sustained by the service members of the Israel Defense Forces in combat during two military campaigns in Gaza.</p><p><strong>Methods: </strong>This is a retrospective study comparing and characterising isolated orthopaedic combat injuries during two of Israel's military campaigns; the ongoing 'Swords of Iron' war (SOIW) and the 2014 operation 'Protective Edge' (OPE). Data were collected from the Israel Defense Forces prehospital trauma registry cross-linked with the Israel Defense Forces trauma registry during the period from 27 October 2023 to 28 July 2024 and were compared with the data from 2014 OPE.</p><p><strong>Results: </strong>A total of 4280 injured service members were documented in both OPE and SOIW (n=743 and n=3537, respectively). Men represent all casualties. The median age was 23 years (IQR 21-28) for SOIW and 21 years (IQR=20-24.8) for OPE. It was noted that 44.2% of the casualties during the SOIW were on reserve duty compared with only 4.3% during OPE. The leading cause of injury was explosion (56.4% for SOIW and 52.2% for OPE). Upper (43.6% vs 30.4%, p=0.11) and lower (58.9% vs 73.9%, p=0.054) extremity fractures were common in both campaigns.</p><p><strong>Conclusions: </strong>While personal protective equipment provides protection to the head and torso, extremities remain exposed and thus involved in the majority of combat injuries. As orthopaedic fractures can lead to prolonged rehabilitation and potentially be life-threatening, further research is needed to enhance the planning of extremity protective measures.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498471","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":"Military Forensic Medicine: forensic and military medicine at a crossroads.","authors":"Werner Jacobs, P J T Knudsen, G Visseaux","doi":"10.1136/military-2025-003035","DOIUrl":"https://doi.org/10.1136/military-2025-003035","url":null,"abstract":"","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486639","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":"Risk and protective factors for suicide-related outcomes among serving military personnel: a systematic review of cohort studies.","authors":"Luke T Bayliss, J Hawgood, Z Jenkins, N Jamieson, E Heffernan, J Wild, K Kõlves","doi":"10.1136/military-2025-003040","DOIUrl":"https://doi.org/10.1136/military-2025-003040","url":null,"abstract":"<p><strong>Introduction: </strong>Understanding risk and protective factors for suicide-related outcomes (suicidal ideation, attempts, and deaths) among military personnel is key to the development and design of suicide prevention initiatives. Current literature has predominantly focused on ex-serving or a combination of ex-personnel and serving-personnel. Therefore, factors that may be pertinent for serving personnel are less understood. This review aims to identify risk and protective factors for suicide-related outcomes comprising serving military personnel.</p><p><strong>Methods: </strong>The review adhered to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and was registered on PROSPERO. A systematic literature search of academic databases on military personnel and suicide from 2004 was conducted. Two independent reviewers conducted study selection. Inclusion criteria included serving personnel, cohort study design, and suicide-related outcomes. Exclusion criteria were National Guard or reservists, and studies not in English. Data on study and participant characteristics, military-specific variables, and suicide-related outcomes were extracted. All studies were critically appraised.</p><p><strong>Results: </strong>A total of 53 studies were included. Most studies were published in the past 10 years, comprised army personnel from the USA, and focused on suicide attempts. Overarching risk factor categories included adverse military experiences, deployment, repeated help seeking and support, junior rank, occupation and time in service and vulnerability factors within the military context. Since many of these risk factors are inherent to military service, they may potentially be considered non-modifiable. Despite a limited number of studies on protective factors, several studies found that unit cohesion reduced the likelihood of suicidal ideation and suicide attempts.</p><p><strong>Conclusions: </strong>Suicide prevention strategies within the military may be enhanced by targeting risk factors that are potentially modifiable. Less modifiable risk factors could potentially be targeted through improved personnel management practices, particularly in preparation for and after deployment among first-year personnel. Longitudinal research programmes that identify and examine risk and protective factors for serving military personnel are needed.</p><p><strong>Prospero registration number: </strong>CRD42024558183.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486640","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}