Army Training Research Articles

Specific features of hospital practices in military psychiatry

The practice of psychic care for military personnel in the context of hospital care in metropolitan France is singular. Army training hospitals act as rear bases, taking in repatriated medical personnel as well as everyday sufferers, and blending the stigma of a clinic that is more heterogeneous than that which would be specific to the context of war, yet equally involving care teams - nurses, psychologists and psychiatrists - acculturated to the military environment, and singularizing their practice to ever-changing needs in the face of a changing society and world.

Cutaneous leishmaniasis in British troops following jungle training in Belize: Cumulative incidence and potential risk practices

BackgroundBritish soldiers undergoing jungle training in Belize typically experience a relatively low risk of developing cutaneous leishmaniasis. However, an uncharacteristically large outbreak of cutaneous leishmaniasis occurred in 2022. This study aimed to determine the cumulative incidence of the disease and highlight potential shortcomings in personal protective measures to mitigate exposure to sand fly vector bites. MethodsA retrospective analysis was conducted on medical records of cutaneous leishmaniasis cases between 2005 and 2022, as well as on questionnaire responses regarding personal protective measures administered to cutaneous leishmaniasis cases in 2022. Data were sourced from Defence Public Health Unit, Military Environmental Health Department and British Army Training Support Unit Belize. ResultsEighty-one confirmed clinical cutaneous leishmaniasis cases were recorded between 2005 and 2022, with a substantial peak (38 cases) in 2022. Most cases occurred during the wet season. Pre-2022, the median cumulative incidence per 8-week deployment was 0.90 % (Q1–Q3: 0.34 %–1.34 %), with an annual variation of 0.2 % to 2.0 %. In 2022, the cumulative incidence spiked to 4.22 %, associated with a risk ratio of 5.3 (95 % C.I.s, 3.41, 8.16), and rising to a cumulative incidence of 7.3 % in a single unit of 450 men (33 cases) in late 2022. These values are significantly higher than the median cumulative incidence of all previous years, and to published reports for other cutaneous leishmaniasis -endemic regions. Troop responses identified limitations in the supply of optimal equipment, and in sand fly bite and leishmaniasis risk avoidance information provided by the pre-deployment health education programme. Compliance with health education advise was also suboptimal, with irregular use of insect repellents, protective clothing / head netting, and insecticide-treated hammocks. ConclusionsThe reasons behind the unusually high numbers of cutaneous leishmaniasis cases and cumulative incidence in 2022 remain unclear, emphasising the need to improve personal protective measures provision and implement a comprehensive health education programme for troops undergoing jungle training in Belize.

A paramedical team "on the front line" of hospital care for legionnaires

The psychiatric department at the Laveran Army Training Hospital in Marseille is a referral center for legionnaires, a population at high risk of psychological trauma. As part of a multi-disciplinary team, nurses and orderlies play a major role in their care. The dual status of caregiver and soldier is an asset in providing comprehensive care for psychologically injured legionnaires. The service's civilian staff also have extensive knowledge of the military environment.

The difference in leadership between the British army and NHS surgical training

What lessons in leadership could the NHS learn from the army?

The PREFIT Study: Bone-Targeted Pre-conditioning Reduces Musculoskeletal Injury and Associated Costs in Australian Army Recruit Training

The PREFIT Study: Bone-Targeted Pre-conditioning Reduces Musculoskeletal Injury and Associated Costs in Australian Army Recruit Training

사회생태학적 모형에 기반한 육군훈련소 병사들의 호흡기감염병 예방행위 영향 요인

사회생태학적 모형에 기반한 육군훈련소 병사들의 호흡기감염병 예방행위 영향 요인

Musculoskeletal injury and medical discharge prevalence during Army basic training

Musculoskeletal injuries (MSKIs) pose the primary health and operational risk to the military trainee population particularly those within basic training, leading to several issues such as reduced training time, chronic morbidity, and inevitably increased medical discharge. The purpose of the study was to investigate the current incidence, prevalence, and nature of MSKIs across British Army basic training. In addition to identifying the prevalence of MSKI medical discharges concerning the type and nature of the injury. A retrospective analysis of the Army Recruiting and Initial Training Command MSKI and Medical Discharge database was undertaken. Injury data was collected from Primary Care Rehabilitation Facilities at British Army training units, using a standardised procedure. A multiple-choice questionnaire was used within the initial consultation with the clinician to determine the severity and progression of the injury, whilst consenting to a data privacy notice. Prevalence of MSKIs (% recruits) was articulated in relation to the total number of recruits starting each training year. Over the past decade MSKIs have declined from a peak of 47% in men and 58% in women in 2013/14, to 22% in men and 21% in women in the 2022/23 training year, with the prevalence of female MSKIs being lower than male counterparts for the first time in this population. Trauma and overuse injuries correspond for 48% and 52% of these MSKIs respectively in 2022/2023, whereas historically overuse injuries have been responsible for a greater proportion. These overuse and trauma injuries were most common in the early stages of training. Lower limb injuries were more prevalent throughout training, resembling 2021/22 data where lower limb injuries accounted for c.80% of total MSKIs among both sexes. The total number of MSKIs resulting in medical discharges was 70, constituting 1.1% of all recruits. Among these discharges, 54 were observed in men and 16 in women. The prevalence of MSKIs resulting in medical discharges was 4.5% in men and 12.4 % in women. The gap between MSKI prevalence between sexes has decreased with recent data showing prevalence being similar. Despite this, women had an increased risk of medical discharge, suggesting gender differences in the severity of MSKIs. To reduce MSKI prevalence, strategies should focus on lower limb injuries, with an emphasis on the early stages of training.

Sociological analysis of military education in Kazakhstan

Relevance. High-quality military education, which guarantees the creation of effective armed forces capable of repelling threats to national security, is one of the main factors in determining the strength and influence of a state in the international arena. Purpose. The purpose of the study was to determine the features and specifics of military education in Kazakhstan by studying the activities of military educational institutions and departments in large cities of the country. Methodology. The study used system-analytical method, with the help of which it became possible to consider the basic characteristics of the military education system in Kazakhstan; and the historical method, facilitating the analysis of the process of training in military specialities over time. Results. The determining factors and prerequisites for the formation and development of the independent armed forces of the Republics of Kazakhstan were identified and the state's military education system was characterized at all levels, from school to postgraduate education and advanced training courses. Key points in the processes of transformation of state military education were identified, in particular regarding the reorganization of a number of higher military institutions and the creation of a state higher educational institution � National University of Defence of the First President of the Republic of Kazakhstan � Elbasy. The effectiveness of the military sector was measured using qualitative and quantitative indicators. Additionally, the main military specialities and faculties offered in higher educational institutions in major cities were listed. Conclusions. This study covered the main directions, issues, tasks, and methods of the educational process in Kazakh military universities. It also examined the development of military education in Turkey and Russia, identifying key factors affecting their educational systems. The findings and conclusions can serve as a practical foundation for enhancing national programs to train military specialists in Kazakhstan and other countries. Keywords: army training; higher education institutions; specialized departments; military science; national security

Inaptitude ophtalmologique dans les armées : étude épidémiologique multicentrique

This article aims to describe the causes of ophthalmological disqualification from the military services detected during specialist consultations conducted at Army Training Hospitals. This observational, cross-sectional, multicenter study retrospectively included individuals deemed as "unfit for military service" due to eye diseases identified during the specialist consultation conducted at 3 ATHs between January 2020 and December 2021. The data collected included age, medical and surgical history, reasons for ophthalmological disqualification, uncorrected distance visual acuity, best corrected distance visual acuity and cycloplegic refraction. Over this period, 133 subjects (98 men and 35 women) were included. Thirty-eight candidates (28.6%) were declared unfit due to a refractive error beyond the required limits, including 30 myopic subjects in excess of -10 diopters (D) and 8 hypermetropic subjects over +8 D. Twenty-five candidates (18.8%) were unfit under the age of 21 years due to corneal refractive surgery performed before the required age. Four subjects (3.0%) were unfit due to phakic intraocular lenses. Degenerative conditions were observed in 23 subjects (17.3%), including 21 patients with severe keratoconus. Other causes of incapacity were linked to oculo-orbital trauma in 11 subjects (8.3%), moderate or severe amblyopia in 7 patients (5.3%), congenital causes in 7 subjects (5.3%), inflammatory or infectious diseases in 7 candidates (5.3%), hereditary causes in 6 subjects (4.5%) and undetermined visual dysfunctions in 4 subjects (3.0%). The three main causes of ophthalmological disqualification were high ametropia, refractive surgery performed before the required age and keratoconus.

Motivation Factors and Work Performance at Malaysian Army Training Centre’s

Motivation Factors and Work Performance at Malaysian Army Training Centre’s

Optimization of Micro Hydro Power Plants to Support Community Energy and Indonesian National Army Training in Gunung Halu, West Bandung Regency

Gunung Halu Village, Tangsi Jaya hamlet to reach 250 people in 2023, is faced with significant challenges related to the need for sustainable energy. The energy crisis and environmental issues have encouraged research into alternative energy sources, including Micro Hydro Power Plants (PLTMH), especially in areas with abundant water potential such as Gunung Halu, namely the Ciputri River. The main problem currently being faced is that the PLTMH, which was built in 2007 with a capacity of 18 kW has experienced overload due to population growth and increasing household electronic needs. The aim of the research is to determine the potential of PLTMH in Gunung Halu, develop ways to optimize PLTMH to provide the community's electricity needs and optimize PLTMH as an alternative option for TNI training areas. The method used in this research is a descriptive qualitative method which is carried out in depth so that it is supported by literature studies and then combined with field observation data, interviews and documentation. The research results show that the PLTMH that can be optimized on Gunung Halu is 30 kW by optimizing turbine efficiency and considering changes in height differences according to the characteristics of the area. In conclusion, it was found that optimizing the PLTMH is important to provide adequate electrical energy and support TNI training so that it hopes to become sustainable energy and a practical solution to increase local energy independence and support national defense.

Lahure Culture and Educational Achievement in the Gorkha Communities in Pokhara Metropolitan City, Nepal

Nepalese societies have a long history of Gurkha Army culture for centuries. There is no question about the role of this culture in enhancing the socioeconomic status of these communities from the past. However, along with its positive aspects, this trend has brought some possible adverse effects on those communities who are directly or indirectly associated with the Gurkha Army recruitment process. This study has aimed to explain the possible impact on education attainment of youth from these communities due to participation in the Army preparation and selection process. For the study explanatory research methods were used, utilizing both quantitative and qualitative data for insightful investigation of the phenomenon, where 184 aspiring youths from different army training centers operated in Pokhara Metropolitan City, Kaski were selected to gather quantitative insights from young individuals from the Gurkha community actively engaged in Army preparation training. Furthermore, qualitative data was collected through Key Informant Interviews (KIIs) conducted with esteemed principals and administrative figures from educational institutions offering class 11 and 12 courses in Pokhara, Kaski. The recruitment process for the Army, particularly among youths from the Gurkha communities, presents a significant challenge to educational pursuits, resulting in a diversion of focus away from academic endeavors. This trend has led to a substantial number of individuals prioritizing military training over education. Consequently, this phenomenon has adversely affected educational attainment, limiting future opportunities for these communities. Additionally, the Gurkha community’s historical involvement primarily in Gurkha recruitment has perpetuated their societal exclusion and marginalization. While self-realization within the Gurkha community is crucial, effective governmental policies promoting inclusive education and opportunities are equally imperative. Collaborative efforts between communities and policymakers are necessary to bridge these disparities, fostering an equitable environment and integration beyond traditional roles.

Surgery for gigantomastia at the AKANDA Army Training Hospital: Analysis of 4 cases and literature review

Objective: This study aims to evaluate the outcomes of surgical interventions for gigantomastia in at the obstetrics and gynaecology department of the Hôpital d'Instruction des Armées d'Akanda (HIAA). Patients and Methods: This was a prospective, descriptive study conducted from 1 June 2019 to 31 October 2022, Inclusion criteria comprised women who seeked consultation at HIAA due to unilateral or bilateral gigantomastia, have a benign primary or tumoral gigantomastia. Participants were required to consent to a minimum follow-up period of 6 months post-operation by the HIAA medical team and be available for telephone follow-ups beyond the initial 6 months. Results: The prevalence of gigantomastia was 1.05% (10/952). The mean age of the patients was 27 years. The mean BMI was 27.7 kg/m2. All patients wore a very large (≥D) cup size. The mean breast axis was 36.25 cm for straight breasts. The most frequently performed method was the inverted T with superior-internal flap (57%). The average weight of the operative parts was 1350 g for right breasts. Only one patient had delayed skin wound closure. Only one patient had a suture disunion. Regarding the plastic result, two patients were classified <<average result>> and the other two (50%) <<good result>>. Two patients report << very satisfied>>and the other two were satisfied. Conclusion: This study presented the preliminary results of an ongoing study at the HIAA. The inverted T technique with syuperomedial flap was the most commonly used, with few early complications. The plastic results after the 6th month are appreciable.

The Effect of Indonesian Army Training on the Performance and Professionalism of Army Soldiers

Professionalism is the essential commitment of the Indonesian Armed Forces as an organization that is in charge of upholding the sovereignty of Indonesia. However, due to the decrease in professionalism and performance, training was deemed less effective. This leads to the conclusion that training elements purportedly influence the performance and professionalism of the Indonesian Army. Therefore, this research aimed to determine the effect of Army training on the performance and professionalism of the Indonesian Army. This study used structural equation modeling (SEM) to analyze primary data from the units that participated in the Battalion Combat Team East Kalimantan joint operation exercise in 2022. It indicates that while Army training improves performance, it does not affect the Army's professionalism. The performance also has a favorable effect on the Army's professionalism. The roles of some of the trainees were incompatible with their regular occupations, and the data revealed that not all the weapon systems had been deployed. The exciting thing is that performance can indirectly mediate the influence of training on the professionalism of the Army soldiers, which means that the higher the training, the higher the performance, which in turn affects professionalism. The data used generally do not represent all units within the Indonesian territory. The research has several differences from previous research, such as testing the effect of training on professionalism through the mediation variables of the performance of the Indonesian Army, using different dimensions, and the lack of research in the Army.

Vitamin D Metabolites Are Associated With Musculoskeletal Injury in Young Adults: A Prospective Cohort Study.

The relationship between vitamin D metabolites and lower body (pelvis and lower limb) overuse injury is unclear. In a prospective cohort study, we investigated the association between vitamin D metabolites and incidence of lower body overuse musculoskeletal and bone stress injury in young adults undergoing initial military training during all seasons. In 1637 men and 530 women (aged 22.6 ± 7.5 years; body mass index [BMI], 24.0 ± 2.6 kg/m- 2 ; 94.3% white ethnicity), we measured serum 25-hydroxyvitamin D (25(OH)D) and 24,25-dihydroxyvitamin D (24,25(OH)2 D) by high-performance liquid chromatography tandem mass spectrometry, and 1,25-dihydroxyvitamin D (1,25(OH)2 D) by immunoassay during week 1 of training. We examined whether the relationship between 25(OH)D and 1,25(OH)2 D:24,25(OH)2 D ratio was associated with overuse injury. During 12 weeks of training, 21.0% sustained ≥1 overuse musculoskeletal injury, and 5.6% sustained ≥1 bone stress injury. After controlling for sex, BMI, 2.4 km run time, smoking, bone injury history, and Army training course (Officer, standard, or Infantry), lower body overuse musculoskeletal injury incidence was higher for participants within the second lowest versus highest quartile of 24,25(OH)2 D (odds ratio [OR] = 1.62; 95% confidence interval [CI] 1.13-2.32; p = 0.009) and lowest versus highest cluster of 25(OH)D and 1,25(OH)2 D:24,25(OH)2 D (OR = 6.30; 95% CI 1.89-21.2; p = 0.003). Lower body bone stress injury incidence was higher for participants within the lowest versus highest quartile of 24,25(OH)2 D (OR = 4.02; 95% CI 1.82-8.87; p < 0.001) and lowest versus highest cluster of 25(OH)D and 1,25(OH)2 D:24,25(OH)2 D (OR = 22.08; 95% CI 3.26-149.4; p = 0.001), after controlling for the same covariates. Greater conversion of 25(OH)D to 24,25(OH)2 D, relative to 1,25(OH)2 D (ie, low 1,25(OH)2 D:24,25(OH)2 D), and higher serum 24,25(OH)2 D were associated with a lower incidence of lower body overuse musculoskeletal and bone stress injury. Serum 24,25(OH)2 D may have a role in preventing overuse injury in young adults undertaking arduous physical training. © 2023 Crown copyright and The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR). This article is published with the permission of the Controller of HMSO and the King's Printer for Scotland.

A study on combat motivation: how soldiers get immune to the perpetual fear of death

ABSTRACT The present review addresses the effectiveness of combat motivation and how it can bring positive change that helps the Military services to improve and be innovative in the current tough environment. It aimed to identify the factors that influence the soldiers to get immune from the perpetual fear of Death. A sample of 415 soldiers has been conducted with the help of a self-structured interview. Exploratory Factor Analysis (EFA) highlights duty, honor, and country; the military slogan and war cry; leadership& training; Regiment pride or community Pride;The desire to win war and go home; Avenging The Matrydom & Atitude Towards Enemy; Personal Gratification and commitment to Brothers in ARMS & Commitment towards nation are the major Combat Motivational factors in the Indian army. Combat Motivation is confirmed as an eighth factor model in the army by confirmatory factor analysis (CFA). The study suggests using commitment-based leadership strategies and tactics in the army that increase the motivation to get immune from the perpetual fear of Death of soldiers from the selected sample. The information obtained from this study can provide a framework to assist Army leaders, Commanders, and training and development for future soldiers.

Regional Differences in Intestinal Parasitic Infections among Army Recruits in a Southern Mozambique Training Center: A Cross-Sectional Study.

Due to the high prevalence and diversity of clinical manifestations, intestinal parasitic infections (IPIs) represent a public health problem. The objective of the work was to determine the prevalence of IPIs among army recruits at a practice and training center in southern Mozambique. Sociodemographic information was obtained through semi-structured interviews. Single urine and stool samples were collected from 362 recruits. Parasite diagnosis was made by filtration, formaldehyde-ether and Kato-Katz techniques. Positive individuals underwent abdominal ultrasound. Then, descriptive statistics and cross-tabulations were performed, and p-values < 0.05 were considered significant. The prevalence of infection with at least one parasite was 25.1% (95% CI: 20.5-29.6; n = 91). The most common parasites were Entamoeba coli (10.7%; 95% CI: 7.4-13.7; n = 37) and Trichuris trichiura (6.1%; 95% CI: 4.6-9.9; n = 25). Parasitic infection was associated with the origin of the participant (p-value < 0.001), and the province of Sofala had the highest prevalence among the provinces studied (70.6%; 95% CI: 47.0-87.8; 12/17). Since oral fecal transmission occurs for several parasites, routine screening and deworming prior to enrollment at the army training center is recommended to reduce transmission of intestinal parasites among recruits.

The Poetics of Borderlands: Reflections on Oral Folk Poetry from Assam’s Barak Valley during Bangladesh Liberation War

In 1971, the civil war in the Pakistani state and consequent genocide in present Bangladesh (erstwhile East Pakistan) led to a great influx of refugees who were desperately crossing the porous borderlands of the eastern states of India. Despite the abject living conditions in the saturated refugee camps and the stringent regimentation of the youth camps and muktijoddhā (Liberation Warrior) training sectors in West Bengal, Tripura and Assam borderlands, the space inhabited by the refugees was charged with powerful national imaginaries laced with an eclectic blend of emotions – resistance, hope, nostalgia, desire, aspiration. Drawing on ethnographic and anthropological research, the essay aims to explore various folk forms of poetry which emerged out of these refugee camps and guerrilla army training sectors during the war, such as kabigān (a form of lyrical oral poetry where the poet spontaneously composes verses to be performed at a public gathering) or hāture kabitā (poems to be read aloud in the middle of a hāt or marketplace) written and performed by refugees from Assam’s Barak Valley in North-East India, and later collected by Bangladeshi historian Shahid Quader Chowdhury. Besides problematising aesthetic practices and their relationship to the idea of border-crossing, refugeehood and national identities, to what extent do these poems – loka kabitā or oral folk poetry, open up a discursive space where shared cultures, histories and memories play a momentous role in political mobilisation and in the creation of a radical alterity within the “national” culture and history? To what extent do these aesthetic registers succeed in combating the irrepresentability of violence, injustice and trauma? These are primarily the questions that this essay aims to ask and resolve.

Physiology of Health and Performance: Enabling Success of Women in Combat Arms Roles.

The modern female soldier has yet to be fully characterized as she steps up to fill new combat roles that have only recently been opened to women. Both U.S. and U.K. military operational research efforts are supporting a science-based evolution of physical training and standards for female warfighters. The increasing representation of women in all military occupations makes it possible to discover and document the limits of female physiological performance. An informal Delphi process was used to synthesize an integrated concept of current military female physiological research priorities and emerging findings using a panel of subject matter experts who presented their research and perspectives during the second Women in Combat Summit hosted by the TriService Nursing Research Program in February 2021. The physical characteristics of the modern soldier are changing as women train for nontraditional military roles, and they are emerging as stronger and leaner. Capabilities and physique will likely continue to evolve in response to new Army standards and training programs designed around science-based sex-neutral requirements. Strong bones may be a feature of the female pioneers who successfully complete training and secure roles traditionally reserved for men. Injury risk can be reduced by smarter, targeted training and with attention directed to female-specific hormonal status, biomechanics, and musculoskeletal architecture. An "estrogen advantage" appears to metabolically support enhanced mental endurance in physically demanding high-stress field conditions; a healthy estrogen environment is also essential for musculoskeletal health. The performance of female soldiers can be further enhanced by attention to equipment that serves their needs with seemingly simple solutions such as a suitable sports bra and personal protective equipment that accommodates the female anatomy. Female physiological limits and performance have yet to be adequately defined as women move into new roles that were previously developed and reserved for men. Emerging evidence indicates much greater physical capacity and physiological resilience than previously postulated.

Concordance of CT imaging and surgical lesions in penetrating abdominal trauma

The management of penetrating abdominal wounds has greatly benefited from the development of computed tomography (CT), particularly in stable patients. In this setting, the scanner is the reference examination. Our study aims to evaluate the performance of preoperative CT in the assessment of penetrating abdominal lesions. Between January 1, 2015 and January 1, 2022, 81 patients were hospitalized following penetrating abdominal trauma at the Army Training Hospitals of Sainte-Anne and Laveran. Fifty-one stable patients who had an abdominopelvic CT scan and thereafter underwent abdominal surgery (laparotomy or laparoscopy) were included. Radiological and surgical data were collected from the electronic record and compared by a descriptive analysis (calculation of the sensitivity, specificity, positive and negative predictive value of the CT for the detection of lesions of the various organs) and by a correlation of the CT findings with surgical findings using Kripendorff's alpha coefficient. The cohort was largely male (n=45; 88%), with injuries by knife wound in 62.7% of cases (n=32) and gunshot in 35.3% (n=18) of cases. The median age was 36years (25-47). The median index of severity score (ISS) was 17 (10-26). Excellent agreement between predicted and actual findings was obtained for solid organs (α=0.801) with high sensitivity and specificity (81.8% and 96.6%, respectively). The largest discrepancies were observed for the hollow organs (α=26.2%, sensitivity of 53.3% and specificity of 76.2%) and the diaphragm (α=67.3%, sensitivity 75%, specificity 92.3%). Surgical exploration was non-therapeutic for five patients (9.8%). The failure rate for non-operative treatment was 10% (n=1). CT detection of solid organ lesions in patients with penetrating abdominal wounds is excellent. However, the detection of hollow organ and diaphragmatic wounds remains a challenge with a risk of over- and underdiagnosis. Laparoscopic exploration should be able to fill in the gaps in the CT findings.