Martin Bricknell - Academia.edu (original) (raw)
Papers by Martin Bricknell
Scientometrics, 2020
Expertise in the treatment of wounded and mentally damaged military personnel can be transferred ... more Expertise in the treatment of wounded and mentally damaged military personnel can be transferred to the clinical care of civilian patients by military clinicians though academic publications and working alongside civilian colleagues. Citations to papers written by military authors by civilian researchers can show the transfer of this military knowledge into civilian practice. We examined citations to UK and US academic papers on military physical and mental injury from 2001 to 2018 in the Web of Science, and determined the numbers from civilian and military sources in the authors' own country, and for the US papers, also the Veterans Administration. United States civilian researchers contributed to 52% of the US citations in 2006, rising to 65% in 2018. The numbers of US citing papers from the individual states correlated fairly well with their population sizes. For the UK, civilian citations to its papers also increased with time, but were heavily concentrated in London and Birmingham. This study shows that it is possible to track the diffusion of knowledge in the experience of treating combat casualties from military authors to subsequent military and civilian publications through analysis of the citation history of the original papers.
Revista Científica General José María Córdova, 2021
This paper summarizes medical ethics in the military profession to raise military leaders’ awaren... more This paper summarizes medical ethics in the military profession to raise military leaders’ awareness of Military Medical Ethics (MME) and the ethical issues that may impact their medical services and personnel. First, it summarizes core concepts, including the four principles of medical ethics (autonomy, beneficence, non-maleficence, and justice), the two legal frameworks for the use of military force in war, jus ad bellum and jus in bello, and the concept of dual loyalty. It then examines MME issues during conflict, in garrison healthcare, and during the COVID-19 epidemic. Finally, it concludes by arguing that MME is an important domain of military ethics that should be taught to military leaders to complement the detailed education of MME for military medical professionals.
Journal of the Royal Army Medical Corps, 2017
In 2004, Macmillan and Bricknell[1][1] identified the need to adopt an integrated through career ... more In 2004, Macmillan and Bricknell[1][1] identified the need to adopt an integrated through career approach to medical training and recommended seeking external academic accreditation of military courses. Postgraduate qualifications in specialist practice are well established in civilian medical
Journal of the Royal Army Medical Corps, 1992
Journal of the Royal Army Medical Corps, 1999
Journal of the Royal Army Medical Corps, 1987
Journal of the Royal Army Medical Corps, 1991
Airborne operations may demand an intense level of activity prior to parachuting. In addition the... more Airborne operations may demand an intense level of activity prior to parachuting. In addition the movement of troops to the theatre of operations may well involve the crossing of several time zones. These factors may well deprive the troops of sleep. Furthermore, a parachute assault may well be at night leading to a long period without rest. Scheduled sleep may help ameliorate this sleep deprivation. Studies have shown that daytime sleep prior to overnight activity can improve performance. A study was undertaken to see whether temazepam would improve daytime sleep during a scheduled rest period compared to placebo. The results showed a significant increase in the average sleep period in the group taking 20mg and lOmg of temazepan compared to placebo. The quality of sleep was also improved yet there was no difference in subjective alertness between the groups six hours post ingestion.
Journal of the Royal Army Medical Corps, 1997
Heat illness is a recognised risk of military training. The Combat Fitness Test (CFT) has been id... more Heat illness is a recognised risk of military training. The Combat Fitness Test (CFT) has been identified as an activity that has been associated with heat casualties. The aim of this study was to establish whether a heat stress limit could be set for acclimatised soldiers performing the CFT by measuring the group mean rises in core temperature whilst performing the CFT at various environmental temperatures. The study showed that CFTs should not be undertaken when the start or expected end Wet Bulb Globe Test (WBGT) is greater than 25°C if the group mean rise in core temperature is not to exceed O.6°C (95% Cl O.2°C to 1°C).
Journal of the Royal Army Medical Corps, 2007
We present a case finding study of serologically confirmed Pertussis amongst BFG-based returnees ... more We present a case finding study of serologically confirmed Pertussis amongst BFG-based returnees from Op HERRICK. The role of Pertussis in the aetiology of the commonplace "Kabul Cough" is discussed. It is recommended that enhanced health surveillance for Pertussis takes place both during and after future deployments to Afghanistan, to prevent the potential onward transmission of a potentially fatal illness to unimmunised children.
Occupational Medicine, 1999
This article is a literature review of the aspects of military parachuting related to occupationa... more This article is a literature review of the aspects of military parachuting related to occupational medicine and focuses on 'conventional' military static line parachuting using a round parachute. The analysis of injuries resulting from military parachuting provide an excellent example of military occupational medicine practice. The techniques of military parachuting are described in order to illustrate the potential mechanisms of injury, and a number of 'classical' parachuting Injuries are described. Rnally some recommendations are made for the recording of parachute injuries which would assist in the international comparison of injury rates and anatomical distribution.
Journal of the Royal Army Medical Corps, 2011
This paper discusses the organisational developments in hospital support to expeditionary militar... more This paper discusses the organisational developments in hospital support to expeditionary military operations – Deployed Hospital Care (DHC). It discusses the evolution in deployed hospital care arising from operations in Iraq and Afghanistan and the limitations of current doctrine. It highlights the transition from deployable infrastructure to fixed infrastructure for medical units as a critical aspect of the adaptation from intervention operations to enduring operations. The paper closes by considering some of the emerging issues in the management of personnel within DHC units.
Occupational Medicine, 1996
Heat illness in the British Armed Forces is a significant occupational risk. This paper analyzes ... more Heat illness in the British Armed Forces is a significant occupational risk. This paper analyzes reports of heat casualties occurring in Episkopi, Cyprus from January 1990 through December 1994. A total of 96 casualties were reported from 48 separate incidents. On seven occasions, three or more casualties occurred concurrently (maximum 19). There were 20 incidents causing 32 casualties from Cyprus-based units and 28 incidents causing 64 casualties from units visiting Cyprus. There was a clear seasonal variation of reports with the maximum number of reports occurring from May to August. The majority of reported casualties occurred when the Wet Bulb Globe Temperature was between 26°C and 29°C. Cyprus-based units had most casualties occurring as a consequence of forced marching whereas most casualties from visiting units occurred during military field exercise training. Visiting Territorial Army units had the highest incidence of heat casualties for visiting units. The majority of heat casualties were mild; there were only ten severe cases. It was not possible to identify any particular risk factors applicable to individuals except incomplete acclimatization. The study showed that the current guidelines used by the British Armed Forces do not prevent all heat casualties. It is not possible to estimate how many casualties are prevented by the guidelines. All incidents involving a serious casualty or multiple casualties should be investigated to determine whether the guidelines should be further amended.
The Journal of Laryngology & Otology, 1992
Impaction of a foreign body in the oesophagus is common in children. If the event is not witnesse... more Impaction of a foreign body in the oesophagus is common in children. If the event is not witnessed by an adult or the object is radiolucent the diagnosis is difficult as respiratory symptoms may predominate. We report a three-week-old child with respiratory symptoms who had both a respiratory syncytial virus infection and a radio-lucent oesophageal foreign body. This case is the youngest yet reported and serves as a reminder of the difficulties in the diagnosis of this important condition.
Occupational Medicine, 1999
Military parachuting has been recognized as a hazardous activity since it was first introduced In... more Military parachuting has been recognized as a hazardous activity since it was first introduced In World War II. Other risks associated with military service include actual war-fighting, training with weapons and explosives, operating with armoured vehicles or deployment to climatic extremes. These other hazards should be considered in any assessment of the additional risk associated with military parachuting. The aim of this study was to identify the risk attributable to parachuting amongst US Army enlisted soldiers. This study identified a cohort of infantry soldiers who served between 1990-94. They were separated by receipt of parachute hazardous duty pay. There was a total of 329,794 person-years (PY) available for study of which 18% were in the exposed group. The rate of hospitalization was very similar in both groups [123.9 per 1,000 PYs for the exposed group, 127 in the non-exposed group: relative risk (RR) = 0.98, 95% confidence interval (Cl) = 0.96-1.00). The exposed group was 1.49 times (Cl = 1.42-1.57) more Ilkety to be admitted as a result of an injury as compared with the non-exposed group. Military parachuting was 20 times (Cl = 16.6-24.3) more likely to be the cause of an injury. This study has shown that receipt of hazardous duty pay for military parachuting can be used as a marker in identifying significant additional risks to the health of infantry soldiers associated with military parachuting. This was reflected in an increased incidence of admission for acute injury and musculoskeletal trauma (particularly a trauma pattern associated with parachuting) as a result of military parachuting. Other risks, which are associated with parachute pay, are admission for the effects of heat, battle injury and helicopter accidents.
This is a submission for a PhD by portfolio on the subject of managing health services support to... more This is a submission for a PhD by portfolio on the subject of managing health services support to military operations. It is based upon my prior published work supported by an ‘action research’ analysis of the application of this prior knowledge to my experiences from spending a year in the South of Afghanistan from October 2009 to November 2010. The submission is structured around three thematic areas; medical planning to support military operations, management of military medical operations and international military medical engagement with indigenous health sectors. The submission presents evidence for my contribution to original thinking in each of these thematic areas by means of a review of my published work, my application of these concepts in support of NATO operations in Afghanistan and evidence of the impact of these concepts in influencing other military organisations. The first theme area on medical planning to support military operations will be supported by 3 monograph...
U.S. Army Medical Department journal, 2012
This article presents a methodology to construct an operational casualty estimate for insurgent c... more This article presents a methodology to construct an operational casualty estimate for insurgent clearance operations conducted in 2 districts around Kandahar City appropriate for a multinational operational headquarters. It demonstrates how to identify relevant and recent historical data to establish a casualty rate, apply it against a tactical operational sequence and population at risk to get a daily casualty estimate, and compare that estimate to the capacity of the medical system. This allows medical planners from any contributing nation to express the medical risk and mitigation plan to operational leadership and the commander.
Scientometrics, 2020
Expertise in the treatment of wounded and mentally damaged military personnel can be transferred ... more Expertise in the treatment of wounded and mentally damaged military personnel can be transferred to the clinical care of civilian patients by military clinicians though academic publications and working alongside civilian colleagues. Citations to papers written by military authors by civilian researchers can show the transfer of this military knowledge into civilian practice. We examined citations to UK and US academic papers on military physical and mental injury from 2001 to 2018 in the Web of Science, and determined the numbers from civilian and military sources in the authors' own country, and for the US papers, also the Veterans Administration. United States civilian researchers contributed to 52% of the US citations in 2006, rising to 65% in 2018. The numbers of US citing papers from the individual states correlated fairly well with their population sizes. For the UK, civilian citations to its papers also increased with time, but were heavily concentrated in London and Bir...
Scientometrics, 2020
Expertise in the treatment of wounded and mentally damaged military personnel can be transferred ... more Expertise in the treatment of wounded and mentally damaged military personnel can be transferred to the clinical care of civilian patients by military clinicians though academic publications and working alongside civilian colleagues. Citations to papers written by military authors by civilian researchers can show the transfer of this military knowledge into civilian practice. We examined citations to UK and US academic papers on military physical and mental injury from 2001 to 2018 in the Web of Science, and determined the numbers from civilian and military sources in the authors' own country, and for the US papers, also the Veterans Administration. United States civilian researchers contributed to 52% of the US citations in 2006, rising to 65% in 2018. The numbers of US citing papers from the individual states correlated fairly well with their population sizes. For the UK, civilian citations to its papers also increased with time, but were heavily concentrated in London and Birmingham. This study shows that it is possible to track the diffusion of knowledge in the experience of treating combat casualties from military authors to subsequent military and civilian publications through analysis of the citation history of the original papers.
Revista Científica General José María Córdova, 2021
This paper summarizes medical ethics in the military profession to raise military leaders’ awaren... more This paper summarizes medical ethics in the military profession to raise military leaders’ awareness of Military Medical Ethics (MME) and the ethical issues that may impact their medical services and personnel. First, it summarizes core concepts, including the four principles of medical ethics (autonomy, beneficence, non-maleficence, and justice), the two legal frameworks for the use of military force in war, jus ad bellum and jus in bello, and the concept of dual loyalty. It then examines MME issues during conflict, in garrison healthcare, and during the COVID-19 epidemic. Finally, it concludes by arguing that MME is an important domain of military ethics that should be taught to military leaders to complement the detailed education of MME for military medical professionals.
Journal of the Royal Army Medical Corps, 2017
In 2004, Macmillan and Bricknell[1][1] identified the need to adopt an integrated through career ... more In 2004, Macmillan and Bricknell[1][1] identified the need to adopt an integrated through career approach to medical training and recommended seeking external academic accreditation of military courses. Postgraduate qualifications in specialist practice are well established in civilian medical
Journal of the Royal Army Medical Corps, 1992
Journal of the Royal Army Medical Corps, 1999
Journal of the Royal Army Medical Corps, 1987
Journal of the Royal Army Medical Corps, 1991
Airborne operations may demand an intense level of activity prior to parachuting. In addition the... more Airborne operations may demand an intense level of activity prior to parachuting. In addition the movement of troops to the theatre of operations may well involve the crossing of several time zones. These factors may well deprive the troops of sleep. Furthermore, a parachute assault may well be at night leading to a long period without rest. Scheduled sleep may help ameliorate this sleep deprivation. Studies have shown that daytime sleep prior to overnight activity can improve performance. A study was undertaken to see whether temazepam would improve daytime sleep during a scheduled rest period compared to placebo. The results showed a significant increase in the average sleep period in the group taking 20mg and lOmg of temazepan compared to placebo. The quality of sleep was also improved yet there was no difference in subjective alertness between the groups six hours post ingestion.
Journal of the Royal Army Medical Corps, 1997
Heat illness is a recognised risk of military training. The Combat Fitness Test (CFT) has been id... more Heat illness is a recognised risk of military training. The Combat Fitness Test (CFT) has been identified as an activity that has been associated with heat casualties. The aim of this study was to establish whether a heat stress limit could be set for acclimatised soldiers performing the CFT by measuring the group mean rises in core temperature whilst performing the CFT at various environmental temperatures. The study showed that CFTs should not be undertaken when the start or expected end Wet Bulb Globe Test (WBGT) is greater than 25°C if the group mean rise in core temperature is not to exceed O.6°C (95% Cl O.2°C to 1°C).
Journal of the Royal Army Medical Corps, 2007
We present a case finding study of serologically confirmed Pertussis amongst BFG-based returnees ... more We present a case finding study of serologically confirmed Pertussis amongst BFG-based returnees from Op HERRICK. The role of Pertussis in the aetiology of the commonplace "Kabul Cough" is discussed. It is recommended that enhanced health surveillance for Pertussis takes place both during and after future deployments to Afghanistan, to prevent the potential onward transmission of a potentially fatal illness to unimmunised children.
Occupational Medicine, 1999
This article is a literature review of the aspects of military parachuting related to occupationa... more This article is a literature review of the aspects of military parachuting related to occupational medicine and focuses on 'conventional' military static line parachuting using a round parachute. The analysis of injuries resulting from military parachuting provide an excellent example of military occupational medicine practice. The techniques of military parachuting are described in order to illustrate the potential mechanisms of injury, and a number of 'classical' parachuting Injuries are described. Rnally some recommendations are made for the recording of parachute injuries which would assist in the international comparison of injury rates and anatomical distribution.
Journal of the Royal Army Medical Corps, 2011
This paper discusses the organisational developments in hospital support to expeditionary militar... more This paper discusses the organisational developments in hospital support to expeditionary military operations – Deployed Hospital Care (DHC). It discusses the evolution in deployed hospital care arising from operations in Iraq and Afghanistan and the limitations of current doctrine. It highlights the transition from deployable infrastructure to fixed infrastructure for medical units as a critical aspect of the adaptation from intervention operations to enduring operations. The paper closes by considering some of the emerging issues in the management of personnel within DHC units.
Occupational Medicine, 1996
Heat illness in the British Armed Forces is a significant occupational risk. This paper analyzes ... more Heat illness in the British Armed Forces is a significant occupational risk. This paper analyzes reports of heat casualties occurring in Episkopi, Cyprus from January 1990 through December 1994. A total of 96 casualties were reported from 48 separate incidents. On seven occasions, three or more casualties occurred concurrently (maximum 19). There were 20 incidents causing 32 casualties from Cyprus-based units and 28 incidents causing 64 casualties from units visiting Cyprus. There was a clear seasonal variation of reports with the maximum number of reports occurring from May to August. The majority of reported casualties occurred when the Wet Bulb Globe Temperature was between 26°C and 29°C. Cyprus-based units had most casualties occurring as a consequence of forced marching whereas most casualties from visiting units occurred during military field exercise training. Visiting Territorial Army units had the highest incidence of heat casualties for visiting units. The majority of heat casualties were mild; there were only ten severe cases. It was not possible to identify any particular risk factors applicable to individuals except incomplete acclimatization. The study showed that the current guidelines used by the British Armed Forces do not prevent all heat casualties. It is not possible to estimate how many casualties are prevented by the guidelines. All incidents involving a serious casualty or multiple casualties should be investigated to determine whether the guidelines should be further amended.
The Journal of Laryngology & Otology, 1992
Impaction of a foreign body in the oesophagus is common in children. If the event is not witnesse... more Impaction of a foreign body in the oesophagus is common in children. If the event is not witnessed by an adult or the object is radiolucent the diagnosis is difficult as respiratory symptoms may predominate. We report a three-week-old child with respiratory symptoms who had both a respiratory syncytial virus infection and a radio-lucent oesophageal foreign body. This case is the youngest yet reported and serves as a reminder of the difficulties in the diagnosis of this important condition.
Occupational Medicine, 1999
Military parachuting has been recognized as a hazardous activity since it was first introduced In... more Military parachuting has been recognized as a hazardous activity since it was first introduced In World War II. Other risks associated with military service include actual war-fighting, training with weapons and explosives, operating with armoured vehicles or deployment to climatic extremes. These other hazards should be considered in any assessment of the additional risk associated with military parachuting. The aim of this study was to identify the risk attributable to parachuting amongst US Army enlisted soldiers. This study identified a cohort of infantry soldiers who served between 1990-94. They were separated by receipt of parachute hazardous duty pay. There was a total of 329,794 person-years (PY) available for study of which 18% were in the exposed group. The rate of hospitalization was very similar in both groups [123.9 per 1,000 PYs for the exposed group, 127 in the non-exposed group: relative risk (RR) = 0.98, 95% confidence interval (Cl) = 0.96-1.00). The exposed group was 1.49 times (Cl = 1.42-1.57) more Ilkety to be admitted as a result of an injury as compared with the non-exposed group. Military parachuting was 20 times (Cl = 16.6-24.3) more likely to be the cause of an injury. This study has shown that receipt of hazardous duty pay for military parachuting can be used as a marker in identifying significant additional risks to the health of infantry soldiers associated with military parachuting. This was reflected in an increased incidence of admission for acute injury and musculoskeletal trauma (particularly a trauma pattern associated with parachuting) as a result of military parachuting. Other risks, which are associated with parachute pay, are admission for the effects of heat, battle injury and helicopter accidents.
This is a submission for a PhD by portfolio on the subject of managing health services support to... more This is a submission for a PhD by portfolio on the subject of managing health services support to military operations. It is based upon my prior published work supported by an ‘action research’ analysis of the application of this prior knowledge to my experiences from spending a year in the South of Afghanistan from October 2009 to November 2010. The submission is structured around three thematic areas; medical planning to support military operations, management of military medical operations and international military medical engagement with indigenous health sectors. The submission presents evidence for my contribution to original thinking in each of these thematic areas by means of a review of my published work, my application of these concepts in support of NATO operations in Afghanistan and evidence of the impact of these concepts in influencing other military organisations. The first theme area on medical planning to support military operations will be supported by 3 monograph...
U.S. Army Medical Department journal, 2012
This article presents a methodology to construct an operational casualty estimate for insurgent c... more This article presents a methodology to construct an operational casualty estimate for insurgent clearance operations conducted in 2 districts around Kandahar City appropriate for a multinational operational headquarters. It demonstrates how to identify relevant and recent historical data to establish a casualty rate, apply it against a tactical operational sequence and population at risk to get a daily casualty estimate, and compare that estimate to the capacity of the medical system. This allows medical planners from any contributing nation to express the medical risk and mitigation plan to operational leadership and the commander.
Scientometrics, 2020
Expertise in the treatment of wounded and mentally damaged military personnel can be transferred ... more Expertise in the treatment of wounded and mentally damaged military personnel can be transferred to the clinical care of civilian patients by military clinicians though academic publications and working alongside civilian colleagues. Citations to papers written by military authors by civilian researchers can show the transfer of this military knowledge into civilian practice. We examined citations to UK and US academic papers on military physical and mental injury from 2001 to 2018 in the Web of Science, and determined the numbers from civilian and military sources in the authors' own country, and for the US papers, also the Veterans Administration. United States civilian researchers contributed to 52% of the US citations in 2006, rising to 65% in 2018. The numbers of US citing papers from the individual states correlated fairly well with their population sizes. For the UK, civilian citations to its papers also increased with time, but were heavily concentrated in London and Bir...
Revista Científica General José María Córdova, 2021
This paper summarizes medical ethics in the military profession to raise military leaders’ awaren... more This paper summarizes medical ethics in the military profession to raise military leaders’ awareness of Military Medical Ethics (MME) and the ethical issues that may impact their medical services and personnel. First, it summarizes core concepts, including the four principles of medical ethics (autonomy, beneficence, non-maleficence, and justice), the two legal frameworks for the use of military force in war, jus ad bellum and jus in bello, and the concept of dual loyalty. It then examines MME issues during conflict, in garrison healthcare, and during the COVID-19 epidemic. Finally, it concludes by arguing that MME is an important domain of military ethics that should be taught to military leaders to complement the detailed education of MME for military medical professionals.