Introduction This paper presents the burden of mental health cases throughout UK military exercise SAIF SAREEA 3 (SS3), a low-tempo armoured brigade exercise in Oman from June to November 2018, and aims to discuss ways that mental health may be better managed on future large exercises. Methods A retrospective review of all attendances at army medical facilities and relevant computerised medical records was undertaken. Results 14 mental health cases were identified, which required 51 follow-up presentations throughout the duration of SS3. This represented 1.2% of all first patient presentations, and 6.3% of all follow-up work. 64% had diagnoses which predated deployment and could all be classified within 10th revision of International Statistical Classification of Diseases and Related Health Problems as either F30-F39 mood (affective) disorders, or F40-F48 neurotic, stress-related and somatoform disorders; all new diagnoses made while deployed were adjustment disorders. The medical officer spent an average of 147 min total clinical care time per patient. Six patients were aeromedically evacuated (AE), which represented 26% of all AE cases from SS3. Conclusions Presentations were low, but time consuming and with poor disposal outcomes. Most conditions predated the exercise, and could have been predicted to worsen through the deployment. Given the disproportionate burden that mental health cases afforded during SS3, future brigade-sized deployments should include deployed mental health professionals in order to offer evidence-based therapy which should lead to improved disposal outcomes and a reduced AE burden.Health and risk management of personnel in hot climates remains a Commander's responsibility, with Joint Service Publication 539 Heat Illness and Cold Injury Prevention and Management (JSP 539) being the guiding document for the UK military. This policy can be challenging to interpret occasionally, needing medical professionals to provide ongoing advice to commanders. This is to achieve a shared understanding of scientific concepts and risks to allow a more informed decision-making by commanders. This then leads to the appropriate mitigation of risks to as low as reasonably practical. Exercise SAIF SAREEA 3 saw commanders and medical cooperation at all levels with a practical and pragmatic application of the principles articulated in joint policy. The elements which saw enhanced cooperation included pathophysiology, work rates and workrest ratios, rest and sleep periods, uniform, acclimatisation, and hydration and electrolyte balance. This approach was exhibited throughout the planning, deployment and execution of Exercise SAIF SAREEA 3, which saw extremely low levels of heat injury throughout the exercise when compared with SAIF SAREEA 2 and related exercises. This personal view aims to describe the command and medical interaction on SAIF SAREEA 3 which the authors feel contributed to those successes against climatic effects.Visual standards for military aviators were historically set in the 1920s with requirements based on the visual systems of aircraft at the time, and these standards have changed very little despite significant advances in aircraft technology. Helmet-mounted displays (HMDs) today enable pilots to keep their head out of the cockpit while flying and can be monocular, biocular or binocular in design. With next generation binocular HMDs, flight data can be displayed in three-dimensional stereo to declutter information presented, improving search times and potentially improve overall performance further.  https://www.selleckchem.com/products/rin1.html  However, these new visually demanding technologies place previously unconsidered stresses on the human visual system. As such, new medical vision standards may be required for military aircrew along with improved testing methods to accurately characterise stereo acuity.Introduction Trauma centre capacity and surge volume may affect decisions on where to transport a critically injured patient and whether to bypass the closest facility. Our hypothesis was that overcrowding and high patient acuity would contribute to increase the mortality risk for incoming admissions. Methods For a 6-year period, we merged and cross-correlated our institutional trauma registry with a database on Trauma Resuscitation Unit (TRU) patient admissions, movement and discharges, with average capacity of 12 trauma bays. The outcomes of overall hospital and 24 hours mortality for new trauma admissions (NEW) were assessed by multivariate logistic regression. Results There were 42 003 (mean=7000/year) admissions having complete data sets, with 36 354 (87%) patients who were primary trauma admissions, age ≥18 and survival ≥15 min. In the logistic regression model for the entire cohort, NEW admission hospital mortality was only associated with NEW admission age and prehospital Glasgow Coma Scale (GCS) and Shock Index (SI) (all p1 hour) with SI ≥0.9, recent admissions (TRU ≤1 hour) with age ≥65, NEW admission age and prehospital GCS and SI (all p less then 0.05). Conclusion The mortality of incoming patients is not impacted by routine trauma centre overcapacity. In conditions of severe overcrowding, the number of admitted patients with shock physiology and a recent surge of elderly/debilitated patients may influence the mortality risk of a new trauma admission.Objective After deployment, service members can experience difficulties reintegrating. Sustaining injuries on the battlefield can disrupt the reintegration period. The first aim was to follow-up the reintegration attitude towards family, work and on a personal level after deployment in Dutch battlefield casualties (BCs). The second was to compare their postdeployment reintegration attitude with that of healthy controls. Methods A questionnaire concerning reintegration attitude, the Postdeployment Reintegration Scale (PDRS), was provided to all service members who received rehabilitation after sustaining injuries in Op TASK FORCE URUZGAN. The questionnaire was administered in 27 BCs at a median of 2 years post incident and 5.5 years post incident. At 5.5 years post incident, the PDRS of the BCs was compared with a control group consisting of service members from the same combat units. Results A significant difference was found for the BCs with an increased negative personal attitude (p=0.02) and a decreased negative attitude towards work (p=0.