Britannia Royal Naval College

IntroductionMusculoskeletal injuries (MSKIs) are a significant problem in the Royal Navy, contributing to 48% of all medical discharges from service between 2019 and 2020. The objective of the study was to assess efficacy of implementing a neuromuscular training intervention to improve movement quality and reduce MSKIs in Royal Navy recruits undertaking initial military training.MethodsNeuromuscular training (pre-activation exercises, focusing on hip control) was integrated into the warm-up exercise regimen preceding physical training during the 10-week initial naval training (recruits) programme (January–March 2020) at HMS Raleigh (intervention group; n=162). A control group comprised (n=90) of recruits entering training from January 2019, who completed the standard warm-up programme prior to physical training. Movement control of the intervention group (intervention) was assessed before and after the 10-week programme using the Hip and Lower-Limb Movement Screen (HLLMS). Injury incidence proportion for both groups was determined retrospectively by review of medical notes.ResultsThe control group’s MSKI incidence proportion was 31%, which was higher (p<0.05) than the 8% reported in the intervention group. The majority of MSKIs were of the lower limb, and were reported in weeks 1, 2 and 5 of the 10-week training programme. Movement control, as assessed by the HLLMS score, improved (pretraining (week 1) and post-training (week 10) HLLMS score (mean (SD) pre: 11.2 (5.6); post: 8.4 (3.9); t=5.829, p<0.001) following the neuromuscular training in the intervention group but was not assessed in the control group.ConclusionA neuromuscular control intervention was successfully implemented during the initial military training in the Royal Navy. The cohort undertaking the intervention demonstrated lower injury incidence compared with an equivalent cohort of recruits who undertook standard training. Movement control improved following the intervention, indicating better movement quality. Continued use of the programme may reduce military training attrition in the Royal Navy.

In Chapter 19, “Designer Benzodiazepines: New Challenges and Treatment Options”, Peter Maskell and Nathan Wilson focus on new designer/NPS benzodiazepines, which have been recently detected and caused a series of fatalities in both the United States and the United Kingdom. This chapter provides an overview on benzodiazepine abuse, including desired and side effects, while drawing parallels with licenced benzodiazepines and how new benzodiazepines have emerged inside that framework of abuse. The chapter also explores the cases of acute hospital admission and provides advice for the clinical management in case of overdose and intoxication.

The use of corrosion resistant and adhesion promoting films and coatings is established industrial practice for many fatigue sensitive components and structures. However, recent environmental legislation restricting the use of a range of toxic heavy metals and their derivative processes, such as chromic acid anodising (CAA), has meant that a number of new coatings systems and pretreatments are currently being developed to replace the traditional processes still in use. Typical of these new systems are the boric–sulphuric acid anodising (BSAA) process, which can be modified to provide excellent adhesive bonding properties, the sulphuric acid anodising process, which includes an additional electrolytic phosphoric acid deoxidising stage (EPAD) to produce a duplex oxide layer, and the recently patented ACDC sulphuric acid anodising process which produces a two layered oxide film which can be tailored to produce different porosity volume fractions within each layer. This communication reports the preliminary findings of a study carried out to assess the fatigue response of Al2618:T6 aluminium alloys to these new processes. In contrast to CAA anodising, the initial results indicate that the EPAD and ACDC processes do not appear to have a significant effect on fatigue.

Background: Overuse lower limb injury is common in incidence and morbidity. Many risk factors, gait related and biomechanical, have been identified, although little conclusive evidence has been found in terms of injury prevention to date. Hypothesis: Orthoses, as produced by proprietary software interpretation of plantar pressures, are able to reduce injury rates in an “at risk” military population. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Four hundred military officer trainees were assessed by means of pressure plate recording of their contact foot pressures during walking. Participants were risk assessed and randomized to receive or not receive customized orthoses using the D3D system. Both cohorts were followed up for injury through their basic training at the 7-week point. Results: The orthotic intervention group sustained 21 injuries in total (1 injury per 4666 hours of training), whereas the control group sustained 61 injuries in total (1 injury per 1600 hours of training) (P < .0001), thereby demonstrating an absolute risk reduction of 0.49 from use of the orthoses (P < .0001, chi square; confidence interval, 1.7, 2.4). Conclusion: In this military trainee population, orthoses were effective in the prevention of overuse lower limb injury. This is the first study to identify a positive preventive role of orthoses.

Space imagery offers remote surveillance of ethnic people groups at risk of human rights abuse. We highlight work in alleged violations in Burma and Sudan, using satellite imagery for verification with Amnesty International. We consider how imaging may effectively support small to medium-sized Non Governmental Organisations and charities, e.g. HART, working in dangerous zones on the ground. Satellite based sensing applications are now at a sufficiently mature stage for moderate Governmental funding levels to help prevent human rights abuse, rather than the greater cost of rebuilding communities and healing sectarian divisions after abuse has taken place.

Residual stresses in thin films are usually evaluated either by measurement of elastic strains in the film or from the curvature or deflection of a film coated substrate material (the Stoney technique). Both methods are prone to serious measurement errors particularly for thinner films or smaller curvatures or deflections. The Stoney technique is popular because the analysis does not require the elastic modulus of the film. However, residual stress can be determined more accurately using the film modulus. A simple strain–energy analysis using this modulus has been developed to investigate residual stresses in boric acid–sulphuric acid (BSA) anodised films, based on bending measurements of thin coupons. The method is an improvement over Stoney's equation because the square root of the thickness of the film, rather than the thickness itself, is involved, therefore reducing one of the larger sources of error. The modulus of the film was determined from nanoindentation measurements. The strain–energy method allows analysis of residual stress development in the coupons as functions of film thickness and time. The results show that the residual stress in BSA anodised films formed on high strength Al–Cu alloy is highly tensile with stress levels up to 400 MPa. The effects of coupon geometry on stress development were also studied and were found to influence the final levels of residual stress developed. These results have implications for the measurement of residual stresses by beam deflection methods.

A new structural waveguide, which is referred to as a channel-planar composite optical waveguide (COWG), has been fabricated by sputtering of a titanium dioxide (TiO>(2)) film onto a glass substrate with potassium ion-exchanged channel waveguides. By use of a mask during deposition, the TiO(2) film was formed into a 27-nm-thick, 5-mm-wide strip with two 1-mm-long tapered ends perpendicular to the channel waveguides. Adiabatic transition of the TE(00) mode and the TE(00)- TM(00) mode separation inside such a channel-planar COWG were demonstrated by combination of theoretical analysis and measurement of the experimental attenuation that arises from scattering loss and evanescent-field dye absorption. Changing the superstrate index in the region of the TiO(2) film in the channel-planar COWG yielded polarimetric interference patterns. This new technique can be applied to integrated optical chemical and biological sensors to produce enhanced sensitivity.