Bmj Military Health最新文献

{"title":"Prevalence of axial spondyloarthritis among military draft-eligible populations in South Korea: national and regional trends over recent decades.","authors":"Hong Jin Kim, P W Yoon, J Y Yoon, D-H Lee, E Cho, S M Park, S Park, J-K Moon","doi":"10.1136/military-2024-002901","DOIUrl":"10.1136/military-2024-002901","url":null,"abstract":"<p><strong>Introduction: </strong>Axial spondyloarthritis (axSpA) is a chronic inflammatory disorder characterised by inflammation of the axial manifestations. For the military draftees, there are no epidemiological data on axSpA in nationwide and population-based databases. This retrospective, nationwide and population-based study aimed to assess the national and regional trends in axSpA prevalence among draft-eligible military populations in South Korea between 2014 and 2023.</p><p><strong>Methods: </strong>The study included 3 063 805 males examined by the Regional Military Manpower Administration. The annual nationwide prevalence was presented as the prevalence per 10 000 and a 95% CIs. The severity of axSpA was assessed using radiographic scoring of the sacroiliac joint based on the New York criteria. Regional trends of axSpA were evaluated for Seoul, metropolitan areas and provinces, categorised according to transportation accessibility.</p><p><strong>Results: </strong>The nationwide prevalence of axSpA increased from 10.75 (95% CI 9.68 to 11.81) in 2014 to 21.18 (95% CI 19.37 to 23.00). The prevalence of radiographic axSpA (r-axSpA) followed a similar upward trend, whereas the prevalence of non-radiographic axSpA (nr-axSpA) remained stable. The prevalence of r-axSpA (52.73% in 2015 and 79.52% in 2019) was higher than that of nr-axSpA. Meanwhile, r-axSpA patients with grade 3 sacroiliitis showed the highest prevalence during the recent 3-year follow-up. The mean regional prevalence of nr-axSpA differed significantly among the three regions (p=0.013), whereas there were no differences in the prevalence of r-axSpA (p=0.084).</p><p><strong>Conclusions: </strong>This epidemiological study revealed an increasing trend in the nationwide prevalence of axSpA over the past decade, primarily driven by an increase in moderate-grade r-axSpA. Therefore, early recognition and awareness of axSpA in young males are essential for initiating appropriate treatment options to slow disease progression.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"320-326"},"PeriodicalIF":1.7,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086884","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":"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":"10.1136/military-2025-002996","url":null,"abstract":"","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"381-382"},"PeriodicalIF":1.7,"publicationDate":"2026-07-22","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":"Clinical, tactical and strategic benefits of a UK Spray Dried Plasma production capability.","authors":"Matt Ellington, E Barnard, L Bower, S Huish, L Green, P Moor, T Woolley, R Cardigan","doi":"10.1136/military-2024-002875","DOIUrl":"10.1136/military-2024-002875","url":null,"abstract":"<p><p>UK experience from recent conflicts in Iraq and Afghanistan has resulted in improvements in clinical care of injured patients. Resuscitation and blood transfusion is an area that has seen some of the greatest changes. The ongoing war in Ukraine has highlighted the challenges of medical support to Large-Scale Combat Operations (LSCO), one of which is the ability to deliver blood-based resuscitation near to the point of wounding.Plasma is a key aspect of damage control resuscitation and balanced blood transfusion strategies. It is supported by a strong evidence base, which also demonstrates that early administration improves patient outcomes. Conventional plasma transfusion using thawed fresh frozen plasma (FFP) has logistical constraints that preclude its expedient use in the prehospital environment.Temperature-controlled storage, and transport, of sufficient FFP to support LSCO is unrealistic, and temporary campaigns to increase civilian plasma donations signal a combat intent and could compromise Operational Security.Dried plasma components are stable in storage at ambient temperature. They are easily and quickly reconstituted to produce a plasma component with clinically acceptable clotting and coagulation profiles. The UK has access to dried plasma from two European allies, but availability is very limited and use is off-licence. The ongoing UK dried plasma project will provide clinical, tactical and strategic benefits to UK and allied armed forces in future conflicts.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"288-291"},"PeriodicalIF":1.7,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789115","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":"Scorpion sting: a narrative review and proposed guidelines for contemporary UK armed forces operations.","authors":"Daniel Wilkins, S Jc Pallett, J Potter, S D Woolley, G Holden, K Chapman, A Kew, D A Warrell, D Lalloo, L Lamb","doi":"10.1136/military-2025-003107","DOIUrl":"10.1136/military-2025-003107","url":null,"abstract":"<p><p>Scorpions are venomous arthropods with a wide geographical footprint and are endemic throughout all UK Armed Forces operational areas outside of Northern Europe. Scorpion stings are common on military exercises and operations. Here, we present a narrative review summarising epidemiological data pertaining to scorpions in geographical areas of contemporary operational relevance to the UK Armed Forces and suggest evidence-based treatment recommendations suitable for use in a military environment, providing an update to the last detailed review in 2008. The overwhelming majority of stings will result only in local pain and can be managed with analgesia at Role 1 medical treatment facilities. The risk of severe envenoming is greatest in the Middle East. Children and pregnant women are at increased risk of severe envenoming which most commonly manifests as hypertensive crisis. These patients should be evacuated to hospital care and managed supportively in a critical care environment.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"301-308"},"PeriodicalIF":1.7,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349472","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":"Effect of tirzepatide on body weight in Czech soldiers.","authors":"Vladimir Pavlik, B Kupsová, V Šafka","doi":"10.1136/military-2025-003076","DOIUrl":"10.1136/military-2025-003076","url":null,"abstract":"","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"376"},"PeriodicalIF":1.7,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765673","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":"Arboviruses in UK Armed Forces: a review of historical cases and identification of future threats.","authors":"Matthew J W Kain, M Eskell, B Clark, C Lambert, E Weaver, G Holden, M A Dermont, N J Beeching, T Fletcher, S Woolley","doi":"10.1136/military-2025-002987","DOIUrl":"10.1136/military-2025-002987","url":null,"abstract":"<p><strong>Introduction: </strong>Arboviruses are a diverse group of arthropod-borne pathogens and are emerging global public health threats with no approved therapeutics. Arboviruses are spreading rapidly, posing a health threat to UK Armed Forces (UKAF) service personnel (SP) through deployment to endemic regions. There are limited data on the burden of arboviral infections in UKAF SP.</p><p><strong>Methods: </strong>A retrospective service evaluation of UKAF electronic healthcare records (eHRs) and statutory notifications to the Defence Public Health Unit was conducted. Cases with possible/confirmed dengue, chikungunya or Zika virus infections between 2005 and 2023 were included. eHRs were interrogated and trends analysed.</p><p><strong>Results: </strong>Of 107 suspected infections between 2005 and 2023, 49 (45.8%) were laboratory-confirmed. Dengue fever was the most common (45/49) followed by chikungunya (3/49) and Zika (1/49) virus infections. The average yearly incidence of reported dengue infection increased from 0.51 cases per 100 000 UKAF SP per year in 2009-2011 to 3.85 cases per 100 000 SP per year in 2021-2023. 19/45 (42.2%) cases occurred during operational deployments and 24/45 (53.3%) during non-military activity. Dengue infection was most frequently acquired in Southeast Asia.Using WHO clinical severity criteria, 33/45 (73.3%) had dengue with warning signs and 5 (11.1%) had severe dengue. 23/45 (51.1%) dengue cases were hospitalised (median length of stay 5 days, IQR 3, range 1-9). No dengue fatalities or medical discharges occurred. Occupational impact was significant, with a median of 11 days stood down (IQR 10, range 0-45); 3/19 (15.8%) cases on operations required aeromedical evacuation (AEROMED). One deployed case of chikungunya required AEROMED and a 35-day downgrade.</p><p><strong>Conclusions: </strong>Reports of arboviral infections, particularly dengue, are increasing in UKAF personnel, presenting an emerging health threat. This has implications for UKAF provision of deployed diagnostics and dengue vaccination policy. The rapid spread of arboviruses outside their traditional geographical areas, including into Europe, necessitates further surveillance and requires diagnostic and therapeutic research.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"361-365"},"PeriodicalIF":1.7,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062783","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":"Does immobilisation improve outcomes in proximal tibial stress fractures among military recruits?","authors":"Christopher Martin, B Park, B M Wheatley","doi":"10.1136/military-2024-002923","DOIUrl":"10.1136/military-2024-002923","url":null,"abstract":"<p><strong>Introduction: </strong>Proximal tibial stress fractures (PTSFs) are a significant cause of morbidity in military recruits, often requiring prolonged rehabilitation and leading to attrition from training. Despite their impact, little data exist to guide optimal treatment strategies, and most recommendations are extrapolated from diaphyseal tibial stress fractures. This study aims to describe fracture characteristics, treatment protocols and outcomes of Marine Corps recruits diagnosed with PTSFs.</p><p><strong>Methods: </strong>A retrospective review was conducted of Marine recruits at the Marine Corps Recruit Depot San Diego-an all-male training centre during the data collection period (2019-2021)-with MRI-confirmed PTSF. Patients who were initially treated non-operatively were included in this study. MRI and radiograph characteristics, age, bilateral or unilateral injury, treatment protocols (casting vs protected weight bearing) and outcomes-including return to full duty (RTFD) or separation-were evaluated. Statistical analyses included χ²testing, t-tests and logistic and linear regression modelling.</p><p><strong>Results: </strong>80 patients (105 total fractures) met inclusion criteria, with a mean age of 20 years. 25 patients had bilateral fractures. No patient initially treated non-operatively progressed to require surgery. PTSFs demonstrated a high likelihood of military separation, with over one in four eventually separating and an average time to disposition of 121 days. There were no statistically significant predictors of RTFD or ultimate disposition based on treating provider's specialty, casting or fracture characteristics. A trend towards decreased return to duty in bilateral fractures did not reach significance. Of the 21 separations, eight were directly attributable to the stress fracture.</p><p><strong>Conclusion: </strong>In Marine recruits with PTSFs, conservative management without casting is safe and effective, even in bilateral cases or those with extensive fracture morphology. Outcomes were similar regardless of treating provider specialty. Casting offered no additional benefit and may be unnecessary in most cases.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"315-319"},"PeriodicalIF":1.7,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974586","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":"Assessing the responses of the armed forces of NATO member states to the COVID-19 pandemic.","authors":"George Bundy, M Bricknell","doi":"10.1136/military-2025-002973","DOIUrl":"10.1136/military-2025-002973","url":null,"abstract":"<p><strong>Introduction: </strong>The COVID-19 pandemic tested global health systems and national resilience, requiring extensive civil-military cooperation. While individual military responses have been documented, comparative analysis across North Atlantic Treaty Organization (NATO) member states based on military health service reports is limited. This study analyses the contributions of NATO armed forces to their governments' COVID-19 response, addressing this gap.</p><p><strong>Methods: </strong>Representatives from Canada, Poland, Portugal, Slovakia, France, Italy and the USA participated in a NATO Military Medical Centre of Excellence workshop. Attendees completed a 'CIV-MIL COVID-19 Data Collection Table', and their responses were reviewed during the workshop and analysed using a validated typology of military activities.</p><p><strong>Results: </strong>NATO armed forces provided significant support in response to the pandemic, including emergency capacity reinforcement, repatriation of citizens and logistics. Healthcare contributions included augmenting health system management, procuring and distributing health commodities and converting military hospitals for civilian use. Military forces also supported public awareness campaigns, enforced COVID-19 measures and provided critical care in civilian hospitals.</p><p><strong>Conclusions: </strong>The study underscores the essential role of military forces in supporting national COVID-19 responses and highlights the importance of civil-military cooperation. Recommendations include embedding permanent military liaisons within civilian health systems and reassessing the effectiveness of certain military activities. The validated typology serves as a framework for future analyses of military roles in health emergencies.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"342-347"},"PeriodicalIF":1.7,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162922","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":"Reframing neurotrauma research for LSCO: lessons from Ukraine for the UK Defence Medical Services.","authors":"David Baxter, Rocco Armonda, Alex Valadka, Damian Jenkins, John Breeze, Ed Barnard, Timothy Nicholson Roberts, Jonathan Bull, Stuart Roberts, Andrii Sirko","doi":"10.1136/military-2025-003102","DOIUrl":"10.1136/military-2025-003102","url":null,"abstract":"","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"285-287"},"PeriodicalIF":1.7,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989277","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":"Impact of the COVID-19 outbreak on stress among the Bruneian military personnel: a cross-sectional study.","authors":"Tajidah Talip","doi":"10.1136/military-2024-002933","DOIUrl":"10.1136/military-2024-002933","url":null,"abstract":"<p><strong>Introduction: </strong>The COVID-19 outbreak has been associated with increased stress levels, with significant consequences for military personnel. This study aimed to explore stress levels and associated factors among Royal Brunei Armed Forces (RBAF) and Ministry of Defence (MINDEF) military personnel deployed to assist civilian authorities during the COVID-19 outbreak in Brunei Darussalam.</p><p><strong>Methods: </strong>A quantitative cross-sectional study was conducted in January 2022 using an online survey. A total of 1007 military personnel participated, consisting of 289 deployed and 718 non-deployed personnel, selected through purposive sampling. The survey, available in both Malay and English, collected data on demographics, military service details, involvement in COVID-19 management, psychological responses, work-related stress and stress-inducing factors, with some responses measured using a Likert scale. Descriptive statistics, <i>t</i>-tests, one-way analysis of variance, χ² tests, Pearson's correlation and general linear regression were used to analyse the data, with stepwise linear regressions identifying the best predictors and a significance level set at <i>p</i><0.05.</p><p><strong>Results: </strong>Findings indicated that the stress level has changed significantly from before COVID-19 to during, indicating that during COVID-19, the stress level was significantly higher than before. No significant difference found in the mean level of stress between the deployed and non-deployed participants (<i>p</i>=0.363). Main sources of stress were due to the high perceived risk of getting infected and infecting family members, and exhaustion due to increased workload, inadequate staffing and inadequate rest that were a result of lack of proper working structure and management practices, and also lack of leadership management.</p><p><strong>Conclusions: </strong>The findings highlight the need to develop strategies for stress interventions for RBAF and MINDEF to maintain personnel well-being and performance throughout outbreaks and/or during similar emergencies should they occur in the future. Furthermore, the findings can also inform general stress interventions in the workplace during non-COVID-19 periods to improve overall workplace well-being and resilience.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"366-371"},"PeriodicalIF":1.7,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337112","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}