Journal of Military and Veteran’s Health - JMVH

"Infection Prevention and Control Practices in the Deployed Military Field Hospital: AN integrative review" by John Skipp examines the critical role of infection prevention and control (IPC) within deployed military medical facilities, where harsh conditions often complicate patient safety. While modern technology has improved initial survival rates for soldiers, healthcare-associated infections remain a major threat throughout the evacuation and treatment process. The authors identify four essential strategies to mitigate these risks: specialized predeployment training for staff, strict adherence to basic hygiene practices, the use of standardized operating procedures, and robust antimicrobial stewardship. By comparing international military models, the text highlights how dedicated experts and consistent education can significantly reduce the transmission of multidrug-resistant organisms. Ultimately, the research suggests that aligning field hospital standards with civilian healthcare quality improves outcomes for both personnel and civilians. This comprehensive analysis serves as a framework for military forces to refine their clinical governance in austere environments.

You can read the original article here: https://jmvh.org/article/infection-prevention-and-control-practices-in-the-deployed-military-field-hospital-an-integrative-review/
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"Load carriage: minimising soldier injuries through physical conditioning – a narrative review" by Julia Coyle is a narrative review that examines how physical conditioning can improve performance and reduce injuries associated with military load carriage. The authors highlight that while soldiers are carrying heavier weights than ever, a lack of practical training guidelines often leads to musculoskeletal issues and stress fractures. Research suggests that the most effective programs utilize the principle of specificity, incorporating actual load-bearing marches between two and four times per month. Effective conditioning also benefits from concurrent training, which combines aerobic exercises with resistance training to improve upper body strength and posture. To ensure long-term health, the review emphasizes the principle of recovery, recommending structured "orthopedic holidays" to prevent overuse injuries while maintaining fitness levels. Ultimately, the text provides a framework for practitioners to develop progressive training regimes that balance intensity, volume, and sufficient rest.

You can read the original article here: https://jmvh.org/article/load-carriage-minimising-soldier-injuries-through-physical-conditioning-a-narrative-review-2/
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"Paramedics in the Australian Defence Force – A Time for Change?" by Lauren D'Arcy argues that the Australian Defence Force (ADF) should modernize its medical structure to better utilize the advanced skills and education of contemporary paramedics. While civilian paramedicine has transitioned toward degree-based qualifications and national registration, military roles for these professionals remain limited and lack the officer status granted to other health specialists. The author suggests that the ADF could improve its medical capability by adopting international models, such as the Physician Assistant or Extended Care Practitioner, which allow for greater clinical autonomy. Integrating these roles would help address the rising complexity of modern warfare and peacekeeping operations. Ultimately, failing to recognize these professional advancements may hinder the recruitment and retention of highly skilled medical personnel within the military.

You can read the original article here: https://jmvh.org/article/paramedics-in-the-australian-defence-force-a-time-for-change/
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"An Overview to Military Medical Ethics" by Martin Bricknell examines the complex field of military medical ethics (MME), which exists at the vital intersection of professional healthcare standards and military necessity. It highlights the unique dual loyalty faced by practitioners who must balance their clinical obligations to patients with their duties as uniformed officers. The source outlines how ethical challenges manifest differently in combat zones, where international humanitarian law prevails, versus garrison settings, where issues like informed consent and research oversight are paramount. Key areas of concern include the neutrality of medical personnel, the fair distribution of scarce resources, and the protection of vulnerable populations during conflicts. Furthermore, the text advocates for robust education and policy frameworks to help medical professionals navigate these dilemmas and mitigate the risk of moral injury. Ultimately, the source serves as a comprehensive primer on the evolving legal and moral responsibilities inherent in providing healthcare within an armed forces environment.

You can read the original article here: https://jmvh.org/article/an-overview-to-military-medical-ethics/
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"Gastrointestinal Mortality in Military / Prison Camps of the 19th-20th Centuries" by G Dennis Shanks is an historical article that delves into the historical records that gastrointestinal diseases and malnutrition were the primary drivers of extreme mortality in military and penal camps. Whether in the American Civil War's Andersonville or World War II’s Thai-Burma railway, overcrowding and poor sanitation created lethal environments where dysentery flourished. Even as medical science advanced, logistical failures regarding clean water and waste disposal continued to claim lives across diverse climates and conflicts. The data suggests that high death rates often peaked during the initial organization of a camp or following a sudden influx of new arrivals. These tragedies serve as a vital warning for modern humanitarian crises, emphasizing that basic field hygiene remains the most critical factor for survival. Modern military and relief officers must prioritize separating waste from food sources to prevent the recurrence of these historical medical disasters.

You can read the original article here: https://jmvh.org/article/gastrointestinal-mortality-in-military-prison-camps-of-the-19th-20th-centuries/
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"Considerations Regarding Appendicitis at Sea" by David Becerra explores the complex medical and ethical dilemmas faced by military healthcare providers when managing acute appendicitis at sea. While modern naval vessels possess surgical capabilities, the lack of advanced diagnostic imaging like CT scans often forces a choice between immediate onboard operation or a risky medical evacuation to land-based facilities. Through comparative case studies, the authors evaluate how logistical constraints, such as transport costs and operational delays, must be weighed against patient safety and clinical standards. The research highlights that while antibiotic therapy is a possible alternative, it carries a high risk of failure in austere environments compared to definitive surgery. Ultimately, the text emphasizes that collaborative decision-making must prioritize the patient's well-being over mission requirements regardless of the ship's location.

You can read the original article here: https://jmvh.org/article/considerations-regarding-appendicitis-at-sea/
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"Gulf War Illness in the 1991 Gulf War and Gulf Era Veteran Population: An Application of the Centers for Disease Control and Prevention and Kansas Case Definitions to Historical Data" by E Dursa, S Barth, B Porter, A Schneiderman examines the prevalence of Gulf War Illness (GWI) by applying established diagnostic criteria to a massive, representative group of over 20,000 veterans. By using data collected shortly after the 1991 conflict, the study identifies cases before age-related health issues could confuse the results. The findings reveal that roughly 41% to 51% of deployed veterans met the requirements for the illness, a significantly higher rate than their non-deployed peers. Notably, female veterans across all groups were found to be at a higher risk for these unexplained medical symptoms. These results provide a vital longitudinal baseline for future genetic and treatment research. Because the data avoids recall bias, it serves as a robust resource for understanding the early emergence of this complex condition.

You can read the original article here: https://jmvh.org/article/gulf-war-illness-in-the-1991-gulf-war-and-gulf-era-veteran-population-an-application-of-the-centers-for-disease-control-and-prevention-and-kansas-case-definitions-to-historical-data/
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"Adjunct Activities for Mental Health Improvements for Veterans" by Tavis Watt examines the integration of adjunct activities as supplemental treatments to address the complex mental health challenges faced by military veterans. Research suggests that traditional medical approaches may not fully satisfy the unique needs of personnel struggling with a loss of purpose or conditions like PTSD, depression, and anxiety. To bridge this gap, the authors evaluate three primary categories of intervention: physical exercise, animal-assisted therapy, and creative arts programs. These activities are supported by various behavioral, cognitive, and neurophysiological theories, such as the release of endorphins and the fostering of a sense of belonging. While evidence indicates these methods effectively reduce symptoms and improve quality of life, the text emphasizes the need for further rigorous empirical evaluation. Ultimately, the source highlights initiatives like the ADF ARRTS program as sustainable models for aiding veteran recovery and reintegration.

You can read the original article here: https://jmvh.org/article/adjunct-activities-for-mental-health-improvements-for-veterans/
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"CRM training for ADF aeromedical staff" by Jeffrey Stephenson explores the history and implementation of Crew Resource Management (CRM), a strategy originally designed to reduce aviation accidents caused by human error. While traditionally used by flight crews to improve teamwork and communication, the author argues for its critical necessity within aeromedical evacuation teams due to high fatality rates in that sector. The source outlines the six generations of CRM development, tracing its shift from correcting individual pilot behavior to establishing comprehensive organizational safety cultures. To mitigate medical errors, the article proposes a specific twelve-module training framework tailored for Australian Defence Force medical staff. Ultimately, the text emphasizes that treating air and medical personnel as a unified system is essential for managing the inevitable psychological and physiological limitations of human performance.

You can read the original article here: https://jmvh.org/article/612/
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"Artificial intelligence and expert systems – their application to military medicine" by A G Robertson explores the evolution and integration of artificial intelligence and expert systems within the field of medicine, with a specific focus on military healthcare applications. It details the historical progression from early diagnostic tools like MYCIN to contemporary neural networks used for analyzing complex radiological imagery. The author examines how these technologies enhance clinical decision-making, modernize digital medical records, and streamline professional training through interactive simulations. While acknowledging significant benefits such as increased consistency and better quality assurance, the text also addresses hurdles like difficult data entry and the need for better user interfaces. Ultimately, the source advocates for the expanded use of these intelligent systems to improve the efficiency and effectiveness of defense medical services.

You can read the original article here: https://jmvh.org/article/https-doi-ds-org-doilink-03-2023-44563148-jmvh-vol-6-no-2/
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