Journal of the Royal Army Medical Corps
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UK Ministry of Defence (MOD) policy and strategy recommend the use of a 'Defence MODified' version of the Health and Safety Executive Management Standards Indicator Tool to help managers identify risks of work-related stress among Defence personnel. The Defence MODified Tool ('Stress Indicator Survey') asks personnel to rate their perceptions of eight working conditions known to be significantly associated with work-related stress. MOD psychologists are developing a Defence norm group against which future survey scores can be compared. This article describes the use of the Stress Indicator Survey in MOD and gives an overview of findings from 2016 to 2018. ⋯ Possible explanations for the observed differences in risk of work-related stress are discussed, including the nature of military life and planned changes to Defence civilian headcount. Examples of managerial actions to improve working conditions based on individual survey findings are given.
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The Defence Clinical Psychology Service (DCPS) is the professional clinical psychology service and community of clinical psychology practice within UK Ministry of Defence (MoD). The DCPS provides professional clinical care, consultation and research in support of the UK Armed Forces. ⋯ The following paper offers an overview of the history, service context, training and mission of the DCPS. Areas for future development are also considered.
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Pelvic fractures, although infrequent, are a significant cause of morbidity and mortality in the trauma population. Currently, the mainstay of emergent management of a suspected pelvic fracture is placement of a pelvic binder, and their use in the prehospital setting is recommended for any individual involved in high-energy trauma. Obesity in the trauma patient has been shown to be an independent risk factor of morbidity and mortality, and the incidence of pelvic and lower extremity fractures has consistently demonstrated to be higher in the obese patient compared with an individual with a normal body habitus. This article aims to highlight the challenges associated with pelvic fracture in the obese population.
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The influence of rib impact on thoracic gunshot trauma remains unclear, despite its high occurrence. This study therefore investigates the effect of rib impact on a bullet's terminal properties and injury severity. ⋯ This study provides new insights into the role of rib impact in thoracic gunshot injuries, and indicates that the effects are ammunition dependent. Unlike the 5.56×45 mm rounds, rib impact with the 7.62×51 mm rounds increases the risk of severe wounding.
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The Reconstructive Trauma Surgery Fellowship is a based at the Queen Elizabeth Hospital, Birmingham, and focuses on the multidisciplinary management of major trauma from presentation to discharge. It is unique to the UK in that it provides both management and leadership experience as well as operative surgical skills particularly in terms of reconstruction on complex trauma patients including those from the military. This paper describes the relevance of fellowships in modern surgical training, composition of the reconstructive trauma fellowship and the relevance for both civilian and military trainees.