JournalTOCs

Journal of the Royal Army Medical Corps
Journal Prestige (SJR): 0.303

Citation Impact (citeScore): 1
Number of Followers: 9

Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0035-8665 - ISSN (Online) 2052-0468
Published by BMJ Publishing Group

[62 journals]

How 'STRONG is the British Army'
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  Authors: Ladlow, P; Suffield, C, Greeves, J. P, Comfort, P, Hughes, J, Cassidy, R. P, Bennett, A. N, Coppack, R. J.
  Pages: 283 - 286
  Keywords: Open access
  PubDate: 2024-07-24T01:48:02-07:00
  DOI: 10.1136/military-2023-002508
  Issue No: Vol. 170, No. 4 (2024)
Surveillance of bacterial disease in wartime Ukraine
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  Authors: Keep, J. R; Heslop, D. J.
  Pages: 287 - 289
  Abstract: This analysis considers circulation of bacterial disease in wartime Ukraine. Anthrax, brucellosis, botulism and tularaemia are all naturally occurring in the country. The causative agents of these diseases also formed components of the biological weapons programme the Russian Federation inherited from the Soviet Union at the end of the Cold War. Differentiating between natural and unnatural outbreaks of disease in Ukraine is essential for combating disinformation and maintaining health security as the war intensifies.
  PubDate: 2024-07-24T01:48:02-07:00
  DOI: 10.1136/military-2023-002512
  Issue No: Vol. 170, No. 4 (2024)
Does policy that provides choice in athletic footwear affect
musculoskeletal injury risk in US Coast Guard recruits'
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  Authors: Fraser, J. J; Pommier, R, MacGregor, A. J, Silder, A, Sander, T. C.
  Pages: 290 - 295
  Abstract: IntroductionMusculoskeletal injuries (MSKIs) are ubiquitous during initial entry military training, with overuse injuries the most common. A common injury mechanism is running, an activity that is integral to US Coast Guard (USCG) training and a requirement for graduation. The purpose of this study was to assess the effects of a policy that allowed for athletic footwear choice on risk of lower quarter MSKI in USCG recruits.MethodsA retrospective cohort study was performed that included 1230 recruits (1040 men, 190 women) who trained under a policy that allowed self-selection of athletic footwear and 2951 recruits (2329 men, 622 women) who trained under a policy that mandated use of prescribed uniform athletic shoes and served as controls. Demographic data and physical performance were derived from administrative records. Injury data were abstracted from a medical tracking database. Unadjusted risk calculations and multivariable logistic regression assessing the effects of group, age, sex, height, body mass and 2.4 km run times on MSKI were performed.ResultsAnkle-foot, leg, knee and lumbopelvic-hip complex injuries were ubiquitous in both groups (experimental: 13.13 per 1000 person-weeks; control: 11.69 per 1000 person-weeks). Group was not a significant factor for any of the injuries assessed in either the unadjusted or adjusted analysis, despite widespread reports of pain (58.6%), perceived injury attribution (15.7%), perceived deleterious effect on performance (25.3%), general dissatisfaction (46.3%) and intended discontinuance of use following graduation (87.7%).ConclusionMSKI continues to be a major source of morbidity in the recruit training population. The policy that allowed USCG recruits to self-select athletic footwear did not decrease or increase the risk of MSKI. While regulations pertaining to footwear choice did not influence injury outcomes, there was general dissatisfaction with the prescribed uniform athletic footwear conveyed by the recruits and widespread reports of discomfort, perceived deleterious effects from wear and intended discontinued use following training completion.
  PubDate: 2024-07-24T01:48:02-07:00
  DOI: 10.1136/military-2022-002211
  Issue No: Vol. 170, No. 4 (2024)
Analysis of heart rate variability during emergency flight simulator
missions in fighter pilots
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  Authors: Fernandez-Morales, C; Espejo-Antunez, L, Clemente-Suarez, V. J, Tabla-Hinojosa, F. B, Albornoz-Cabello, M.
  Pages: 296 - 302
  Abstract: IntroductionManaging emergency situations in different simulated flight segments can entail a workload that could affect the performance of military pilots. The aim was to analyse the modifications in neurovegetative balance (using HR variability, HRV) of professional fighter pilots attending learning/training sessions on emergency situations in a flight simulator.MethodsA total of 18 pilots from the Spanish Air and Space Force were included. HRV was recorded simultaneously during diverse simulated emergency situations in three different flight segments: take-off, in-flight and landing.ResultsThe comparison between take-off and in-flight revealed a statistically significant increase (p
  PubDate: 2024-07-24T01:48:02-07:00
  DOI: 10.1136/military-2022-002242
  Issue No: Vol. 170, No. 4 (2024)
Exertional rhabdomyolysis: an analysis of 321 hospitalised US military
service members and its relationship with heat illness
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  Authors: Oh, R. C; Bury, D. C, McClure, C. J.
  Pages: 303 - 307
  Abstract: IntroductionExertional rhabdomyolysis is a syndrome of muscle breakdown following exercise. This study describes laboratory and demographic trends of service members hospitalised for exertional rhabdomyolysis and examines the relationships with heat illness.MethodsWe queried the US Armed Forces Health Surveillance Center’s Defence Medical Epidemiology Database for hospitalised cases of rhabdomyolysis associated with physical exertion from January 2010 July 2013. Descriptive statistics reported means and medians of initial, peak and minimal levels of creatine kinase (CK). Correlations explored the relationship between CK, creatinine, length of hospital stay (LOS) and demographic data.ResultsWe analysed 321 hospitalised cases of exertional rhabdomyolysis. 193 (60.1%) cases were associated with heat; 104 (32.4%) were not associated with heat; and 24 (7.5%) were classified as medical-associated exertional rhabdomyolysis. Initial, maximum and minimal CK levels were significantly lower in heat cases: CK=6528 U/L vs 19 247 U/L, p=0.001; 13 146 U/L vs 22 201 U/L, p=0.03; and 3618 U/L vs 10 321 U/L, p=0.023) respectively, compared with cases of rhabdomyolysis with exertion alone. Median LOS was 2 days (range=0–25). In the rhabdomyolysis with exertion alone group and the rhabdomyolysis with heat group, LOS was moderately correlated with maximal CK (Spearman’s =0.52, p
  PubDate: 2024-07-24T01:48:02-07:00
  DOI: 10.1136/military-2021-002028
  Issue No: Vol. 170, No. 4 (2024)
Cardiopulmonary exercise testing excludes significant disease in patients
recovering from COVID-19
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  Authors: Holdsworth, D. A; Barker-Davies, R. M, Chamley, R. R, OSullivan, O, Ladlow, P, May, S, Houston, A. D, Mulae, J, Xie, C, Cranley, M, Sellon, E, Naylor, J, Halle, M, Parati, G, Davos, C, Rider, O. J, Bennett, A. B, Nicol, E. D.
  Pages: 308 - 314
  Abstract: ObjectivePost-COVID-19 syndrome presents a health and economic challenge affecting ~10% of patients recovering from COVID-19. Accurate assessment of patients with post-COVID-19 syndrome is complicated by health anxiety and coincident symptomatic autonomic dysfunction. We sought to determine whether either symptoms or objective cardiopulmonary exercise testing could predict clinically significant findings.Methods113 consecutive military patients were assessed in a comprehensive clinical pathway. This included symptom reporting, history, examination, spirometry, echocardiography and cardiopulmonary exercise testing (CPET) in all, with chest CT, dual-energy CT pulmonary angiography and cardiac MRI where indicated. Symptoms, CPET findings and presence/absence of significant pathology were reviewed. Data were analysed to identify diagnostic strategies that may be used to exclude significant disease.Results7/113 (6%) patients had clinically significant disease adjudicated by cardiothoracic multidisciplinary team (MDT). These patients had reduced fitness (VO2 26.7 (±5.1) vs 34.6 (±7.0) mL/kg/min; p=0.002) and functional capacity (peak power 200 (±36) vs 247 (±55) W; p=0.026) compared with those without significant disease. Simple CPET criteria (oxygen uptake (VO2)>100% predicted and minute ventilation (VE)/carbon dioxide elimination (VCO2) slope
  Keywords: Open access, COVID-19
  PubDate: 2024-07-24T01:48:02-07:00
  DOI: 10.1136/military-2022-002193
  Issue No: Vol. 170, No. 4 (2024)
Musculoskeletal system injuries in the Polish Territorial Defence Forces
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  Authors: Gołuchowska, A; Sobieszek, K.
  Pages: 315 - 319
  Abstract: BackgroundMusculoskeletal system injuries (MSIs) are the major health problem of soldiers. The aim of this study was to assess the types of MSIs that occurred most frequently among soldiers and which parts of the body they generally affected.MethodsThe study included 140 Territorial Army soldiers, both men and women, serving in the Polish Territorial Defence Forces (TDF). Times and frequency of MSIs were assessed using an original questionnaire available via a web-based platform, the TDF Information Portal and the Yammer network.ResultsAmong the participants, 42% reported MSIs, most often a single one (19%), incurred while doing military service. Damaged muscles and ligaments were the most common injuries in both groups (p>0.05). The knee joint was the main location of injuries for both sexes (24% in men vs 50% in women, p>0.05). Other parts of the body often affected by injuries were the shoulder joint (24%, p>0.05), head, spine, wrist, fingers, ankle and feet (19% each) in the male soldiers and the ankle (24%), spine (14%), head, chest, shoulder joint and foot (10% each) in the female soldiers. Injuries reoccurred with similar frequency in the female and male soldiers (43% vs 40%, p>0.05) and had the same location in both groups (43% vs 40%, respectively, p>0.05). Difficult terrain, too intensive military training and heavy loads were the main risk factors for MSIs in both groups (p>0.05).ConclusionsMore than half of all the participants (19% of the men and 33% of the women) reported at least one injury incurred during military service. Over 40% of all the study subjects had reinjuries. The males and females were similar in terms of the most common type and location of MSI. Occurrence of MSIs rarely required interruption in the military training/service.
  PubDate: 2024-07-24T01:48:02-07:00
  DOI: 10.1136/military-2022-002166
  Issue No: Vol. 170, No. 4 (2024)
Alcohol use and its associated factors among Ethiopian military personnel
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  Authors: Fida, A. T; Kaba, M, Worku, A.
  Pages: 320 - 324
  Abstract: BackgroundStudies indicate that alcohol use is more prevalent in the military and that such use is related to coping mechanisms for stress. Alcohol use could result in health and social problems. However, little is known about alcohol use in Ethiopian military personnel.ObjectiveTo assess the level of alcohol use and its associated factors in the Ethiopian military.MethodsA cross-sectional study including participants from the Ground and Air Forces of the Ethiopian National Defence Forces was conducted from February to June 2021. A representative sample of 502 military personnel from the two forces participated in the study. A structured questionnaire was developed to assess the individual level of alcohol use and its associated factors. The Alcohol Use Disorder Identification Test (AUDIT) was used to identify likely problematic alcohol use (AUDIT score ≥8). Hierarchical multivariable logistic regression models were run to identify associated factors with alcohol consumption.ResultsApproximately half of the respondents (49.8%, 95% CI 45.4% to 54.0%) were alcohol drinkers. Of the current alcohol users, 142 (63.1 %) were infrequent users; 60 (26.7 %) were moderate drinkers; and 23 (10.2 %) were heavy drinkers. Based on the AUDIT composite score, 71 (33.0%) of male participants were classified as having a score indicative of hazardous and harmful drinking and possible alcohol dependence behaviours. After adjusting for covariates, alcohol drinking was statistically significantly associated with higher odds of being: male, younger age, part of the Ground Force, smoker and high risk-taker.ConclusionsThis study provides an initial step to addressing patterns of harmful and hazardous alcohol use in the Ethiopian National Defence Forces. Findings indicate the need to integrate alcohol abuse prevention into existing health education and behaviour change efforts of the Ethiopian National Defence Forces.
  Keywords: Open access
  PubDate: 2024-07-24T01:48:02-07:00
  DOI: 10.1136/military-2022-002217
  Issue No: Vol. 170, No. 4 (2024)
Impact of 12 weeks of basic military training on testosterone and cortisol
responses
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  Authors: L Tait, J; M Bulmer, S, M Drake, J, R Drain, J, C Main, L.
  Pages: 325 - 330
  Abstract: IntroductionMilitary personnel train and operate in challenging multistressor environments, which can affect hormonal levels, and subsequently compromise performance and recovery. The aims of this project were to evaluate concentrations of cortisol and testosterone and subjective perceptions of stress and recovery across basic military training (BMT).Methods32 male recruits undergoing BMT were tracked over a 12-week course. Saliva samples were collected weekly, on waking, 30 min postwaking and bedtime. Perceptions of stress and recovery were collected weekly. Daily physical activity (steps) were measured via wrist-mounted accelerometers across BMT. Physical fitness was assessed via the multistage fitness test and push-ups in weeks 2 and 8.ResultsConcentrations of testosterone and cortisol, and the testosterone:cortisol ratio changed significantly across BMT, with variations in responses concurrent with programmatic demands. Perceptions of stress and recovery also fluctuated according to training elements. Recruits averaged 17 027 steps per day between weeks 2 and 12, with week-to-week variations. On average, recruits significantly increased predicted VO2max (3.6 (95% CI 1.0 to 6.1) mL/kg/min) and push-ups (5. 5 (95% CI 1.4 to 9.7) repetitions) between weeks 2 and 8.ConclusionsRecruit stress responses oscillated over BMT in line with programmatic demands indicating that BMT was, at a group level, well-tolerated with no signs of enduring physiological strain or overtraining. The sensitivity of cortisol, testosterone and the testosterone:cortisol ratio to the stressors of military training, suggest they may have a role in monitoring physiological strain in military personnel. Subjective measures may also have utility within a monitoring framework to help ensure adaptive, rather than maladaptive (eg, injury, attrition), outcomes in military recruits.
  PubDate: 2024-07-24T01:48:02-07:00
  DOI: 10.1136/military-2022-002179
  Issue No: Vol. 170, No. 4 (2024)
Poor association between tendon structure and self-reported symptoms
following conservative management in active soldiers with mid-portion
Achilles tendinopathy
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  Authors: Paantjens, M. A; Helmhout, P. H, Backx, F. J. G, Martens, M. T. A. W, van Dongen, J. P. A, Bakker, E. W. P.
  Pages: 331 - 336
  Abstract: IntroductionMid-portion Achilles tendinopathy (mid-AT) is currently the preferred term for persistent Achilles tendon pain, defined as located 2–7 cm proximal to the calcaneus, and with loss of function related to mechanical loading. Histologically, mid-AT is considered to represent a degenerative condition. Therefore, monitoring of tendon structure additional to pain and function may be warranted, to prevent progression of degeneration or even tendon rupture. The aim of this study was to determine the association between pain and function, relative to the Achilles tendon structure, in soldiers treated with a conservative programme for mid-AT.MethodsA total of 40 soldiers (40 unilateral symptomatic tendons) were included in this study. Pain and function were evaluated with the Victorian Institute of Sports Assessment -Achilles (VISA-A) questionnaire. Tendon structure was quantified using ultrasound tissue characterisation (UTC). We quantified both the Achilles tendon mid-portion (2–7 cm) and the area of maximum degeneration (AoMD) within the tendon mid-portion. VISA-A and UTC measurements were taken at baseline and after 26 weeks of follow-up. Spearman’s rho was used to determine the correlation between VISA-A and UTC. Correlations were calculated for baseline, follow-up and change score values.ResultsNegligible correlations were found for all analyses, ranging from –0.173 to 0.166 between mid-portion tendon structure and VISA-A, and from –0.137 to 0.150 between AoMD and VISA-A. While VISA-A scores improved, on average, from 59.4 points at baseline to 93.5 points at follow-up, no detectable improvement in aligned fibrillar structure was observed in our population.ConclusionPain and function are poorly associated with Achilles tendon structure in soldiers treated with a conservative programme for mid-AT. Therefore, we advise clinicians to use great caution in communicating relationships between both clinical entities.Trial registration numberNL69527.028.19.
  Keywords: Open access
  PubDate: 2024-07-24T01:48:02-07:00
  DOI: 10.1136/military-2022-002241
  Issue No: Vol. 170, No. 4 (2024)
Aerobic fitness predicted by demographics, anthropometrics, health
behaviour, physical activity and muscle fitness in male and female
recruits entering military service
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  Authors: Santtila, M; Pihlainen, K, Vaara, J, Nindl, B. C, Heikkinen, R, Kyröläinen, H.
  Pages: 337 - 341
  Abstract: IntroductionThe physical and mental training load can be high during military service. Therefore, tailored preconditioning programmes based on assessment of physical fitness could increase readiness for military service, especially among those ones with lower baseline fitness level. The purpose of present study was to investigate how self-assessed health behaviour, physical activity and muscle fitness can predict physical fitness in young male and female military cohorts.MethodsDemographics, health behaviour and daily physical activity preceding military service were surveyed by a questionnaire. Thereafter, physical fitness was assessed during the military service by the tests of 12 min running, 1 min push-ups and sit-ups. Explosive power of the lower extremities was studied by maximal standing long jump. Measurements of body anthropometry consisted of body mass, height, and waist circumference.ResultsThe two strongest individual predictors of objectively measured running distance in 12 min were self-reported physical activity and physical readiness in both men and women. Self-reported physical activity, readiness for military service, sitting time, education, smoking and body anthropometrics together explained 52% of the variance in the 12 min running test result (R2=0.52, mean absolute percentage error (MAPE) 8.8%, mean absolute error (MAE) 207 m) in men, while for women the predictive values were weaker. Addition of muscle fitness results to the adjusted regression model further improved the model, which explained 59% of the variance in the 12 min running tests result of male conscripts (R2=0.59, MAPE 7.8%, MAE 181 m).ConclusionIn the present study, self-reported physical activity, muscle fitness, physical readiness for military service, sitting time, education, smoking and body anthropometrics predicted inadequately the measured endurance capacity among recruits. The present questionnaire-based variables do not accurately predict physical fitness of recruits and thus, they are not either suitable for practical use for preconditioning programmes or preselection before entering the military service.
  PubDate: 2024-07-24T01:48:02-07:00
  DOI: 10.1136/military-2022-002267
  Issue No: Vol. 170, No. 4 (2024)
Quantification of physiological and mental workloads of faster and slower
finishers of a long-distance military training activity
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  Authors: Chatterjee, T; Bhattacharyya, D, Yadav, A, Pal, M.
  Pages: 342 - 347
  Abstract: BackgroundLong-distance runs with equipment are practised in military training establishments to develop physical stamina and prepare for battles. A study was planned to quantify and compare the physiological and mental workloads of the early and late finishers of a military endurance run through the jungle terrain of north-eastern India in hot and humid conditions.MethodsTwenty-five soldiers of the Indian Army completed a 15 km run through a rural and jungle track with 6.5 kg of equipment. Twelve participants who finished the race before 130 min were categorised as ‘early finishers’, and 13 were categorised as ‘late finishers’ who finished the race after 130 min. Physiological parameters, viz., heart rate (HR), breathing rate (BR), estimated core temperature (ECT), peak acceleration (PAC), and physiological intensity (PHYI) and mechanical intensity (MECHI) were recorded using BioHarness V.3 (Zephyr Technologies, USA) and NASA Task Load Index scores were obtained to assess mental workload. Mann-Whitney U test was applied to assess the level of significance at a p value of
  PubDate: 2024-07-24T01:48:02-07:00
  DOI: 10.1136/military-2022-002154
  Issue No: Vol. 170, No. 4 (2024)
Epidemiology of cruciate ligament reconstruction in the Australian Defence
Force and predictors of outcome
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  Authors: Williams, O; Ross, V. R, Lau, C. L, Mayfield, H. J.
  Pages: 348 - 353
  Abstract: BackgroundThe ability to predict the risk of poor outcome following knee cruciate ligament reconstruction in the Australian Defence Force (ADF) population would help direct individual rehabilitation programmes and workforce planning. This study describes the epidemiology of cruciate ligament reconstruction in the ADF and demonstrates the use of Bayesian networks (BN) to predict the likelihood of fitness for ongoing service under different scenarios.MethodsMembers who had knee cruciate ligament reconstruction through ADF were identified from billing data and matched to electronic medical records to extract demographic and clinical data. Outcome measure was medical fitness for ADF service up to 24 months after reconstruction. BN models were used to compare outcomes between (1) age groups according to military service, and (2) sexes according to body mass index (BMI).ResultsFrom November 2012 to June 2019, a total of 1199 individuals had knee cruciate ligament reconstruction (average 169 reconstructions/year). Following reconstruction and rehabilitation, 89 (7.4%) were medically unfit for service. Scenario analysis using a tree-augmented naïve BN model showed that, compared with Navy and Air Force, Army members had a higher probability of being unfit in those aged
  PubDate: 2024-07-24T01:48:02-07:00
  DOI: 10.1136/military-2022-002150
  Issue No: Vol. 170, No. 4 (2024)
Body composition of extreme performers in the US Marine Corps
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  Authors: Potter, A. W; Soto, L. D, Friedl, K. E.
  Pages: 354 - 358
  Abstract: BackgroundThe creation of highly muscled and strong fighters is a recurring theme in human performance enhancement concepts. Physical readiness standards, intended to prevent obesity in the military, produce contradictory objectives, hounding large individuals to lose weight because of confusion between body size and body composition. Through selection, specialised training and policy exceptions the US Marine Corps has successfully developed a unique group of large (body mass index (BMI)>30 kg/m2) and strong individuals, the body bearers (BB) who carry coffins of Marines to their final resting place.MethodsWe examined the relationship between adiposity and body size from nine male BB (age 25.0±2.1, height: 1.84±0.04 (1.80–1.92) m, BMI: 33.0±2.1 (30–37) kg/m2). Body composition was assessed by dual-energy X-ray absorptiometry (DXA), bioelectrical impedance (BIA) and tape measured abdominal circumference (AC)-based equations and from three-dimensional scanning (3DS).ResultsMeasures were made of fat-free mass (FFM): 90.5±7.0 (82.0–106.7) kg, where FFM included total body water: 62.8±5.0 (55.8–71.8) L, representing 69±2 (67–73) % of FFM, along with calculated FFM index: 26.8±2.4 (24.4–32.9) kg/m2). DXA measures were made for bone mineral content 4.1±0.4 (3.5–4.9) kg, bone mineral density (BMD) 1.56±0.10 (1.37–1.76) g/cm2 and %BF 19.5±6.6 (9.0–27.8). Additional measures of percent body fat (%BF) were made by AC: 20.3±2.9 (15.2–24.6), BIA: 23.7±6.4 (9.8–29.2) and 3DS: 25.5±4.7 (18.9–32.2). AC %BF reasonably matched DXA %BF, with expected overprediction and underprediction at low and high DXA %BF. BIA %BF was affected by deviations from assumed FFM hydration (72%–73%).ConclusionThese men are classified as obese by BMI but carried massive amounts of muscle and bone on their large frames, while presenting a range of %BF irrelevant to strength performance. BMI did not predict obesity and adiposity had no association with muscle mass and strength performance.
  Keywords: Open access
  PubDate: 2024-07-24T01:48:02-07:00
  DOI: 10.1136/military-2022-002189
  Issue No: Vol. 170, No. 4 (2024)
Osteoarthritis in the UK Armed Forces: a review of its impact, treatment
and future research
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  Authors: O'Sullivan, O; Behan, F. P, Coppack, R. J, Stocks, J, Kluzek, S, Valdes, A. M, Bennett, A. N.
  Pages: 359 - 364
  Abstract: Within the UK Armed Forces, musculoskeletal injuries account for over half of all medical downgrades and discharges. Data from other Armed Forces show that osteoarthritis (OA), more common in military personnel, is likely to contribute to this, both in its primary form and following injury (post-traumatic OA, PTOA), which typically presents in the third or fourth decade. OA is not a progressive ‘wear and tear’ disease, as previously thought, but a heterogenous condition with multiple aetiologies and modulators, including joint damage, abnormal morphology, altered biomechanics, genetics, low-grade inflammation and dysregulated metabolism. Currently, clinical diagnosis, based on symptomatic or radiological criteria, is followed by supportive measures, including education, exercise, analgesia, potentially surgical intervention, with a particular focus on exercise rehabilitation within the UK military. Developments in OA have led to a new paradigm of organ failure, with an emphasis on early diagnosis and risk stratification, prevention strategies (primary, secondary and tertiary) and improved aetiological classification using genotypes and phenotypes to guide management, with the introduction of biological markers (biomarkers) potentially having a role in all these areas. In the UK Armed Forces, there are multiple research studies focused on OA risk factors, epidemiology, biomarkers and effectiveness of different interventions. This review aims to highlight OA, especially PTOA, as an important diagnosis to consider in serving personnel, outline current and future management options, and detail current research trends within the Defence Medical Services.
  Keywords: Editor''s choice
  PubDate: 2024-07-24T01:48:02-07:00
  DOI: 10.1136/military-2023-002390
  Issue No: Vol. 170, No. 4 (2024)
Development, design and experience of the UK Militarys return to diving
pathway following SARS-CoV-2 infection
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  Authors: McPhail, S; Steed, D, Holdsworth, D, Nicol, E, Bennett, A, Phillips, S.
  Pages: 365 - 369
  Abstract: After the emergence of the SARS-CoV-2 virus in early 2020, it quickly became clear that symptomatic or asymptomatic infection had the potential to negatively impact on an individual’s fitness to dive through effects on the respiratory, cardiovascular or neurological systems. The significance of these effects in the military diving environment was initially unclear due to an absence of data concerning incidence, chronology or severity. In order to safely return divers to the water and maintain operational capability, the UK Military developed a pathway for SARS-CoV-2 positive divers that stratified risk of sequelae and extent of required clinical investigation, while minimising reliance on viral testing and hospital-based investigations. We present this process, provide rationale and support for its design and detail the number of SARS-CoV-2 positive divers who have been returned to full diving fitness following infection of varying degrees of severity.
  PubDate: 2024-07-24T01:48:02-07:00
  DOI: 10.1136/military-2022-002327
  Issue No: Vol. 170, No. 4 (2024)
Lessons from the past to guide the future: The RAMC at 125
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  Authors: O'Sullivan; O.
  Pages: 370 - 371
  PubDate: 2024-07-24T01:48:02-07:00
  DOI: 10.1136/military-2023-002531
  Issue No: Vol. 170, No. 4 (2024)
Athletes foot and associated risk factors: a cross-sectional mixed-methods
study
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  Authors: Aliuddin, F; Lyons, A, O'Sullivan, O, Kluzek, S, Pearson, R.
  Pages: 372 - 372
  PubDate: 2024-07-24T01:48:02-07:00
  DOI: 10.1136/military-2023-002379
  Issue No: Vol. 170, No. 4 (2024)
Surgical team simulation: assessing milestones, identifying gaps and
enhancing active learning in military surgical residents
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  Authors: Abraham, V; Jardine, D, Pasque, C, Weller, A, Osier, C.
  Pages: 373 - 373
  PubDate: 2024-07-24T01:48:02-07:00
  DOI: 10.1136/military-2023-002386
  Issue No: Vol. 170, No. 4 (2024)
Effect of COVID-19 on aeromedical primary evacuation retrieval volumes and
patient acuity
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  Authors: Gardiner, F. W; Schofield, Z.
  Pages: 374 - 375
  Keywords: COVID-19
  PubDate: 2024-07-24T01:48:02-07:00
  DOI: 10.1136/military-2023-002370
  Issue No: Vol. 170, No. 4 (2024)
Packaged food rations in the Army of the Czech Republic
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  Authors: Pavlik, V; Dlouhy, M, Kupsova, B, Safka, V.
  Pages: 375 - 376
  PubDate: 2024-07-24T01:48:02-07:00
  DOI: 10.1136/military-2023-002384
  Issue No: Vol. 170, No. 4 (2024)

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