British Army Personnel Research Articles

Development of an evidence-based swimming representative military task to assess swimming competency in the British Army.

There is a requirement for British Army personnel to operate in/around water. Assessing role-related swimming/water competence will support personnel to conduct their job-roles safely and effectively. To undertake a Job-Task Analysis (JTA) of British Army personnel when working in/around water and use this information to develop a Swimming Representative Military Task (RMT) to assess swimming/water competence. Workshops, surveys, and observations were used to conduct a JTA, which identified and described job-tasks conducted by British Army personnel in/around water. Ergonomic analysis of these job-tasks identified seven water-based physical actions, which were considered fundamental for all personnel to be competent in performing. These seven actions guided design of a Swimming RMT, which was subsequently conducted twice by 103 serving personnel (89 men, 11 women) and once by 65 recruits (49 men, 16 women). The RMT comprised of entering the water in combat fatigues and webbing, removing webbing, swimming 50 m, and staying afloat for up to 10 minutes. During RMT trials, in trial 1, 85% of serving personnel and 74% of recruits successfully completed the RMT, which increased to 93% in serving personnel for trial 2. Across trials 1 and 2, all three timed RMT elements showed moderate-high correlational reliability (ICC range: 0.462-0.791). On average, serving personnel were quicker to complete the 50 m swim phase compared to recruits (91±24 s vs. 100±26 s; U = 2575.0, rb = -0.192, p = 0.039). The JTA-informed Swimming RMT provides an assessment of the minimum role-related swimming/water competence standard for British Army personnel.

Five-day evaluation of the acceptability and comfort of wearable technology at four anatomical locations during military training

IntroductionWearable sensor technologies enable Defence to optimise human performance, remotely identify physiological abnormalities and enhance medical support. Maximising the acceptability of devices will ensure they are worn alongside other equipment....

Kevin Barry: An Irish Rebel in Life and Death by Eunan O'Halpin (review)

Eunan O’Halpin, Kevin Barry:An Irish Rebel in Life and Death (Newbridge: Merrion Press, 2020), xii+250 pages. Kevin Barry is one of the most famous of the dead in Ireland’s War of Independence. It is not because of any fame during his life. It was the circumstances of his death that bequeathed him fame. Just eighteen years old when he was sentenced to death by court martial for his involvement in an IRA operation that led to the death of three British soldiers, Barry was executed by hanging at Mountjoy Jail on All Saints’ Day 1920, at a time when social disorder in Ireland was reaching a climax. In a new book, part biography, part analytical history and part family memoir, the Emeritus Professor of Contemporary Irish History at Trinity College Dublin, Eunan O’Halpin, asks why Kevin Barry’s solitary image remains the dominant icon of youthful patriotic sacrifice for the War of Independence. Barry was one of approximately 550 IRA volunteers, 750 civilians and over 700 Royal Irish Constabulary (RIC) and British Army personnel to lose their lives during that war. Nine other IRA men were sentenced to death and executed for similar actions in 1921, one of them – Frank Flood – a good friend (and fellow medical student) of Kevin Barry’s. In some ways Barry was unremarkable. Why then has his name continued to resonate in Irish republican, as well as popular, culture? With an ease facilitated by the author’s in-depth knowledge of the events and personalities of this period in Irish history and knowledge of archival material on Kevin Barry himself, Eunan O’Halpin, a grandnephew of Barry, addresses this question, as well as setting his life in the context of the politics and society of Ireland in the 1910s and 1920s. His subject’s story is intertwined with that of the divisions within society on Ireland’s political future and the gradual shift in public opinion towards a more separatist vision of Ireland, this shift largely caused by the social disorder brought about by political and military conflict. O’Halpin draws on family and school records to present a likeable, balanced boy with academic and sporting abilities (in rugby and hurling) and many friends, who was politically minded and increasingly more radical than mainstream opinion in 1917. More than anything O’Halpin presents a very human and real picture of an ordinary boy who progressed to become a ‘Jesuit-educated medical student’, leading a full life in addition to his role Studies • volume 110 • number 437 124 Spring 2021: Book Reviews in the IRA (which he had joined at the age of fifteen in 1917), both in Dublin and Carlow. He and his large family, to whom he was very close and by whom he was much influenced, especially in the case of his eldest sister Kitby [sic], had grown sympathetic to advanced nationalism even before the Rising, as a result of influences in both home places. He was inspired at thirteen years of age by a speech by Bulmer Hobson (a senior figure of the IRB), at an event which he attended with his eldest sister. The tickets for this had been given to him by schoolmates at St Mary’s College, Rathmines, which he attended before transferring to Belvedere College in 1916. Later, he was a medical student at UCD, in the last stage of his short but relatively well-connected life. The Barry family appear to have been part of a slightly privileged and interesting political class developing in Ireland in the 1920s. His sister Kitby herself later played a key role in ensuring communication between Éamon de Valera and Liam Lynch during the civil war and married Jim Maloney, son of P J Maloney, a TD in the first Dáil. Kitby’s daughter married the poet Patrick Kavanagh; Eglin, Kevin’s sister, married the eldest son of prominent Volunteer The O’Rahilly; and Mary, Kevin’s other sister, married Jim O’Donovan – the IRA’s leading expert on explosives. There is a fascinating insight into Kevin Barry, the schoolboy, which draws on homework – mostly essays – and on scrawls and doodles which appear on the margins...

The association between obesity related health risk and fitness test results in the British Army personnel

ObjectiveIn the British Army, fitness is assessed by a load carriage test (Annual Fitness Test, AFT) and by a three event Personal Fitness Assessment (PFA). Body composition based on body mass index (BMI) and abdominal circumference (AC) is also part of a mandatory annual assessment. This study examined the influence of BMI and AC on fitness test results within a comprehensive sample of British Army personnel. DesignSecondary analyse were carried out on data obtained from the 2011 Defence Analytical Services and Advice (DASA) database for 50,635 soldiers (47,173 men and 3,462 women). MethodsComparisons using loglinear analysis were made between groups of individuals classified by body mass index as obese (≥30kg/m2) and not obese (<30kg/m2), and further classified using combined BMI and AC for obesity-related health risks to compare “no risk” with “increased risk.” ResultsNot obese or “no risk” soldiers had a significant relationship with success in the AFT (p<0.01) and PFA (p<0.01). Of those soldiers who attempted the AFT, 99% of men and 92% of women passed; for the PFA, 92% of men and 91% of women passed. Obese or “at risk” soldiers were more likely to fail and far less likely to take both tests (p<0.05). Compared to older obese soldiers, young obese soldiers were more likely to attempt the tests. ConclusionsWe conclude that BMI and AC are useful indicators of fitness test outcome in the British Army.

1.5 mile run time and body mass predict 8 mile loaded march performance, irrespective of sex

ObjectivesTo develop a statistical model to predict 8mile Loaded March (LM) performance and quantify differences in physical characteristics for men and women British Army Personnel. Design135 trained soldiers (87 men; 48 women) completed two sessions, seven days apart. MethodsSession 1: Participants’ stature, body mass, Fat Free Mass (FFM) [by dual-energy X-ray absorptiometry], Single Lift (SL), Water Can Carry (WCC), and 1.5mile run performance were measured. Session 2: Participants completed an 8mile LM, carrying 25kg (4miles paced and 4miles individual best effort). Sex differences were compared using independent samples t-tests and 8mile LM performance time was predicted using various multiple linear regression analysis: hierarchical forced entry multiple ordinary least squares, principal component and ordinary least products. ResultsA combination of 1.5mile run time and body mass were the strongest predictors of 8mile LM time (R2=0.71; SEE=4.17min; p<0.001). Including stature, FFM, sex, SL score, or WCC score did not further improve predictions (p>0.05). Compared to women, men had faster mean 1.5mile run and LM times, greater body mass and total FFM and higher SL and WCC scores (p<0.001), however some women outperformed men. Conclusion1.5mile run time and body mass predict 8mile LM performance with no further improvement gained in the model by including sex as a variable.

Comparison of Pandolf Equation and Measured Metabolic Cost of Load Carriage in UK Military Personnel

PURPOSE: The metabolic cost of load carriage (LC) is frequently predicted using the Pandolf et al. (1977) equation. Recent laboratory investigations have identified that the Pandolf equation under-predicts the metabolic cost of LC in untrained personnel during treadmill walking (Drain et al., 2017). However, the relationship between the actual and Pandolf predicted metabolic cost of outdoor LC in UK Armed Forces personnel has not been established. METHODS: Twenty-two UK Armed Forces personnel (Royal Marine Commandos and Parachute Regiment, mean ± SD: age 23 ± 3 years; stature 180.9 ± 4.9 cm; body mass 83.1 ± 6.6 kg; predicted V[Combining Dot Above]O2max 54.0 ± 3.1 ml·kg-1·min-1) completed 15, 20 minute stages of outdoor LC, with external load masses ranging from 25 to 70 kg. The stages were completed at a patrol, forced, and insertion marching speed (2.5, 4.8, and 5.5 km·h-1, respectively). During the final 2-4 minutes of each LC stage, oxygen uptake (V[Combining Dot Above]O ) was measured using the Douglas bag technique. Predicted V[Combining Dot Above]O2 for each speed-load mass combination was calculated using the Pandolf equation and compared to the measured V[Combining Dot Above]O2 using paired t-tests and 95 % Limits of Agreement (LoA). RESULTS: The Pandolf equation systematically under-predicted the metabolic cost of LC for all speeds and load masses combined [mean difference 3.2 ± 2.9 ml·kg-1·min-1 2 p<0.001), 95% LoA -2.5-8.9 ml·kg-1·min-1] resulting in a V predictive error of 17.5 %. Mean difference and 95% LoA at the different speeds were: (a) 2.5 km·h-1 [4.8 ± 1.9 ml·kg-1·min-1, (p<0.001), 95% LoA 1.0-8.6 ml·kg-1·min-1], (b) 4.8 km·h-1 [1.5 ± 2.7 ml·kg-1·min-1 (p<0.001), 95% LoA -3.9-6.9 ml·kg-1·min-1], and (c) 5.5 km·h-1 [4.2 ± 3.3 ml·kg-1·min-1 (p<0.001), 95% LoA -2.1-10.7 ml·kg-1·min-1], with prediction errors of 30 %, 6 % and 14 %, respectively. CONCLUSIONS: The current study demonstrates a systematic under-prediction of V[Combining Dot Above]O2 for British Army personnel during outdoor LC when applying the Pandolf equation, supporting the findings of previous laboratory studies. Furthermore, the error appears to be of greater magnitude when LC speeds are lower, i.e. at a representative patrolling pace. This in part could be attributed to the load mass distribution of the modern solider, which differs from the back mounted load carried data used to develop and refine the Pandolf equation.

The association between weight status and fitness test results in British Army personnel

The association between weight status and fitness test results in British Army personnel

A Predictive Model of 12.8km Loaded March Performance for Male and Female British Army Personnel

A Predictive Model of 12.8km Loaded March Performance for Male and Female British Army Personnel

The French Syrette of morphine for administration to combat casualties.

As French military physicians currently deployed in Theatre of Operations, we read with great interest the study by Blankenstein et al. determining the opinions of recently deployed British Army personnel with forward medical care experience on the importance of effective battlefield analgesia, the efficacy and shortcomings of current battlefield analgesia and desirable features of the ideal battlefield analgesic.1 Their results supported existing evidence for the introduction of an adjunct to intramuscular (IM) morphine. Surprisingly, in the introduction section, the authors stated that ‘The British armed forces are unique in supplying parenteral opiates to all deployed soldiers, comprising two 10 mg morphine auto-injectors designed for intramuscular (IM) administration to casualties’. We don’t totally agree with this statement since the French Army has a long experience of battlefield analgesia, using a 10 mg morphine auto-injector, also known as the Syrette of morphine. The Syrette is a device for injecting liquid through a needle, almost similar to a syringe, except that it has a closed flexible tube, instead of a rigid tube and piston. Before deployment in a combat zone, every French soldier undergoes the Forward Combat Casualty Care Level 1-courses and is trained to use his combat first aid kit, including the subcutaneous injection of 10 mg of morphine, using this Syrette.2 Finally, in the French Military Health Service policy for combat analgesia, and also suggested by the authors, other techniques are encouraged, including titration of intravenous morphine, use of ketamine and fascia-iliaca compartment block for lower limb injuries.3

The stress experience of the wives of service personnel

There is a paucity of research exploring the mental health of military spouses and partners. This article seeks to answer the question: what is the stress experience of the wives of British Army personnel serving in Germany? Methods included a critical literature review and reflections from the author's own practice as a community psychiatric nurse working with this community. It was found that military spouses are presented with a number of situations and stressors associated with, and unique to, their husbands' job. Increased stress among military families on a day-to-day basis is a potential trigger for the development of mental health problems. While the association between stress and mental disorders is well-documented, it is not well studied in British military families. Key issues identified include: communication, visible and invisible wounds, fatalities and homecoming. It can be concluded that current, limited research tends to focus on the stress and coping of spouses and partners during operations but not on the day-to-day stresses faced. Further research is needed into the impact of isolation, deployment, mobility and military culture on partners, and indeed, wider families.

Supplement use by UK-based British Army soldiers in training.

The use of supplements is widespread at all levels of civilian sport and a prevalence of 60-90% is reported among high-performance UK athletes, including juniors. The prevalence of supplement use among UK-based British Army personnel is not known. The aim of the present study was to establish the point prevalence of supplement use in UK-based British Army soldiers under training (SuTs) and associated staff. A cross-sectional anonymous survey was carried out in 3168 British Army SuTs and soldiers, equating to 3·1% of regular Army strength, based at eleven Phase 1, 2 and 3 UK Army training sites. Overall, 38% of the respondents reported current use of supplements, but prevalence varied according to the course attended by the respondents. The number of different supplements used was 4·7 (sd 2·9). Supplements most commonly used were protein bars, powders and drinks (66%), isotonic carbohydrate-electrolyte sports drinks (49%), creatine (38%), recovery sports drinks (35%), multivitamins (31%) and vitamin C (25%). A small proportion of respondents reported the use of amphetamines and similar compounds (1·6%), cocaine (0·8%), anabolic androgenic steroids (1·1%), growth hormone (2·0%), and other anabolic agents, e.g. testosterone (4·2%). Logistic regression modelling indicated that, for current users, younger age, being female, smoking and undergoing Officer Cadet training were associated with greater supplement use. This is the first study to investigate the prevalence of dietary and training supplement use in UK-based British military personnel. Self-administration of a wide range of supplements is reported by British military personnel in training, which is at least as great as that reported by those on deployment, and has implications for Defence policy and educational needs.

Is intramuscular morphine satisfying frontline medical personnels' requirement for battlefield analgesia in Helmand Province, Afghanistan? A questionnaire study.

All deployed British Army personnel carry intramuscular (IM) morphine auto-injectors to treat battlefield casualties. No other nation supplies parenteral opiate analgesia on individual issue. Studies highlight this agent's inefficacy and safety issues, but are limited by a relative lack of inclusion of frontline personnel. We aimed to determine the opinions of frontline medical personnel on current battlefield analgesia. We surveyed 88 British Army frontline medical personnel (medical officers (n = 12), nurses (n = 7), combat medical technicians (CMTs) (n = 67), paramedics (n = 1) and health-care assistants (n = 1)) upon completion of a six-month deployment (September 2011 to April 2012) to Helmand Province, Afghanistan, using Likert scale questions on the efficacy of battlefield analgesia, complications of IM morphine, safety of morphine auto-injectors and its suitability for treating child casualties. A total of 88/88 questionnaires were returned. Of these, 61/88 had treated casualties on the battlefield, 26/86 agreed that current battlefield analgesia is effective, 80/87 agreed that a more potent analgesic with a faster onset than IM morphine is desirable in the first hour following injury, 47/65 CMTs agreed that they can manage complications of current battlefield analgesia and 53/86 respondents correctly disagreed that current battlefield analgesia is suitable for child casualties. The potential for accidental self-injection was reported. A more potent, faster onset analgesic than IM morphine is desirable in the first hour following injury. Pre-deployment training should emphasise management of complications of opiate analgesics and treatment of child casualties. Oral transmucosal fentanyl citrate is now being issued to all frontline medical personnel. IM morphine will remain on individual issue to all deployed soldiers for environments where an oral agent is not suitable, for example, chemical, biological, radiological and nuclear warfare. Frontline medical personnel agree that a more potent, faster onset analgesic than IM morphine is desirable in the first hour following injury.The two most desirable features of the ideal analgesic were ranked as rapid onset of action, and when fully onset produces a high degree of pain relief.Oral transmucosal fentanyl citrate (OTFC) has now been issued to all frontline medical personnel as an adjunct to IM morphine.IM morphine will remain on individual issue for situations where parenteral analgesia is required.Consideration should be given to individual issue of OTFC to all deployed personnel in the future.Pre-deployment training should emphasise management of complications of opiate analgesics and treatment of child casualties.

Fit for the frontline? A focus group exploration of auditory tasks carried out by infantry and combat support personnel.

In order to preserve their operational effectiveness and ultimately their survival, military personnel must be able to detect important acoustic signals and maintain situational awareness. The possession of sufficient hearing ability to perform job-specific auditory tasks is defined as auditory fitness for duty (AFFD). Pure tone audiometry (PTA) is used to assess AFFD in the UK military; however, it is unclear whether PTA is able to accurately predict performance on job-specific auditory tasks. The aim of the current study was to gather information about auditory tasks carried out by infantry personnel on the frontline and the environment these tasks are performed in. The study consisted of 16 focus group interviews with an average of five participants per group. Eighty British army personnel were recruited from five infantry regiments. The focus group guideline included seven open-ended questions designed to elicit information about the auditory tasks performed on operational duty. Content analysis of the data resulted in two main themes: (1) the auditory tasks personnel are expected to perform and (2) situations where personnel felt their hearing ability was reduced. Auditory tasks were divided into subthemes of sound detection, speech communication and sound localization. Reasons for reduced performance included background noise, hearing protection and attention difficulties. The current study provided an important and novel insight to the complex auditory environment experienced by British infantry personnel and identified 17 auditory tasks carried out by personnel on operational duties. These auditory tasks will be used to inform the development of a functional AFFD test for infantry personnel.

Abdominal and Hip Flexor Muscle Activity During 2 Minutes of Sit-Ups and Curl-Ups

Previous studies have compared muscle activity between different types of sit-ups and curl-ups. However, few have examined the exercises used by the armed forces or investigated the influence of exercise duration on muscle activation. The aim of this study was to compare abdominal and hip flexor muscle activity between the style of sit-up used by the British Army and 4 variations of a curl-up, at the start, middle, and end of a 2-minute exercise period. Surface electromyograms (EMGs) were recorded from the upper and lower rectus abdominis, external oblique, transversus abdominis and internal oblique, and the rectus femoris (RF) of 23 British Army personnel. Isometric maximal voluntary contractions were used to normalize integrated EMGs to allow them to be compared between exercises. Curl-ups with arms crossed and feet restrained produced the highest integrated EMG in all the abdominal muscles (p < 0.05). Feet-restrained sit-ups and curl-ups also resulted in significantly higher activity in the RF than in nonrestrained versions of the curl-up (p < 0.001). The significant increase observed in muscle activity between the start and the end of the exercises (p < 0.001) was deemed to be in response to a reduction in force producing capacity of existing motor units. The RF experienced the greatest increase during exercises that activated the muscle the most, that is, sit-ups and curl-ups with feet restrained (p < 0.001). Previous research has indicated that such exercises produce high shear and compressive forces in the lower back, which can be injurious. Thus, if an organization wishes to assess the endurance of abdominal muscles, rather than hip flexors, then curl-ups without restraint of the feet should be performed instead of exercises in which the feet are restrained.

Coping with Knowledge: Organizational Learning in the British Army?

This article – based on data that employs interviews conducted with British Army personnel – adopts a social theory of learning in order to examine how both formal and informal learning systems have affected organizational learning within the Army in relation to the counter-insurgency campaign in Afghanistan. It argues that while the Army has adopted new, or reformed existing, formal learning systems, these have not generated a reconceptualization of how to conduct counter-insurgency warfare. It, furthermore, argues that while informal learning systems have enabled units to improve their pre-deployment preparations, these have created adaptation traps that have acted as barriers to higher-level learning.

‘They Even Gave Us Oranges on One Occasion’: Human Experimentation in the British Army During the Second World War

This article explores the various human experiments that were conducted on British army personnel during the Second World War. While some historical work has focused on trials at the Porton Down facility, this paper will start by placing these in the context of the wider range of research projects that were conducted using British troops in the Second World War. It will then consider the question of why conscript soldiers participated in trials. Comparative studies have focused on the ethics of human experimentation in military contexts but this article argues that ethical considerations were only part of the story. Using the oral testimonies of those that were involved in this type of research, it considers how military culture, material incentives and sentiments of national duty all influenced soldiers’ participation in human trials.

Mental Health, Stigmatising Beliefs, Barriers to Care and Help-Seeking in a Non-Deployed Sample of UK Army Personnel

Introduction: Stigmatising beliefs about seeking help for mental health problems and perceived barriers to care (stigma/BTC) are commonplace among military personnel; how they influence help-seeking is unclear. Aim: To explore the role of stigma/BTC in mental health help-seeking among British Army personnel. Method: Randomly selected non-deployed personnel were assessed by questionnaire for mental health and alcohol use status, stigma/BTC levels, help-seeking and mental health related perceptions. Results: The response rate was 81.5% (n=484). 35.0% screened positive for harmful alcohol use, 25.2% for common mental disorder symptoms, and 12.4% for probable PTSD. 40.0% of symptomatic personnel had not sought help. 70.3% of alcohol misusers had not sought any form of help; over 80% of probable mental health cases believed that seeking support was helpful or necessary and required courage or strength. Non-medical help sources were accessed more frequently than military medical services. Stigma/BTC significantly affected probable mental health cases but not alcohol misusers. Greater stigmatisation/BTC were associated with both interest in and receiving support. Friends or family were the commonest preferred and actual help source; unit commanders were among the least preferred but were the second most commonly accessed help source. Conclusion: A substantial number of symptomatic personnel had not sought help. The highest levels of stigma/ BTC were most strongly associated with interest in receiving help. Perceptions of potential negative occupational and social consequences of help-seeking and current mental health status may influence the decision to seek support. Military stigma reduction strategies may need to focus upon reassuring personnel and their families that adverse consequences are not inevitable and that help-seeking from any source may be a useful step in addressing mental health problems. Alcohol misusers may benefit from a strategy that helps them to view their alcohol use as potentially socially and occupationally problematic.

Self-Administration of Exercise and Dietary Supplements in Deployed British Military Personnel During Operation TELIC 13

ObjectivesRecent operational experience has led to the identification of several potentially serious adverse events related to the use of dietary and exercise supplements among British Army personnel. This study aimed...

Retrospective Analysis of the Ethnic Origins of Male British Army Soldiers with Peripheral Cold Weather Injury

ObjectivesTo determine if African Americans, Pacific Islanders and Gurkhas have a different incidence and severity of peripheral cold injury when compared to Caucasians in the British Army.MethodThe design was a...

Psychosis in the British Army: A 2-Year Follow-Up Study

Recent research into mental illness in military populations has tended to focus on minor mental illness and the consequences of trauma. The literature contains very little on serious mental illness, including its occupational implications. To identify the incidence and factors associated with nonaffective psychosis in British Army personnel, to evaluate service quality in terms of duration of untreated psychosis, and to identify predictors of occupational outcome after 2 years, to inform future management of similar cases. A retrospective study of the case notes of all Army personnel admitted to the U.K. military psychiatric inpatient facility in Catterick Garrison with a nonaffective psychosis over a 4-year period between 1999 and 2002 was performed. There were 48 cases of nonaffective psychosis and 14 cases of schizophrenia, corresponding to mean annual incidences of 0.11 cases per 1,000 and 0.03 cases per 1,000, respectively. The mean duration of untreated psychosis was 11 months, and 29 cases (60%) were diagnosed and treated in < 4 months. Officer status and longer duration of service predicted retention. Only eight patients (16.7%) were still in service at 2 years. These findings indicate (1) there is a low incidence of nonaffective psychosis, (2) the military performs well in early detection and intervention in psychosis, and (3) a well-established military career and the premorbid psychological stability this implies predict a good occupational outcome.