DISCUSSION Introduction of AUDIT-C has seen Defence successfully deliver a whole population alcohol initiative, overcoming implementation barriers to demonstrate the flexibility of a dental workforce to deliver a public health intervention at scale and contributing towards promoting positive attitudes towards alcohol use. The initiative represents a first step towards the goal of a standardised alcohol screening and treatment pathway across DPHC while recognising that the Defence Medical Services are only one aspect of the broader public health approach required to tackle alcohol-related harm in Service Personnel. © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.INTRODUCTION Sleep disturbance is common at high altitude and likely driven by an exaggerated peripheral chemoreceptor response which leads to apnoeic episodes and arousal. We hypothesised that this heightened response is in part mediated through angiotensin II receptors in the carotid body. To examine this link, we studied the effect of angiotensin II receptor blocker on sleep disturbance. METHODS Twenty participants paired by age, gender and ACE phenotype ascended to the Whymper Hut (5000 m) on Chimborazo in the Ecuadorean Andes as part of a double-blinded randomised placebo-controlled study of physiological mechanisms. Subjects were randomised to either losartan 100 mg daily or placebo. The primary outcome of sleep efficiency was measured using wrist-mounted actigraphs. One pair was excluded from analysis after descending before the end of the study due to acute mountain sickness. RESULTS There was a significantly different response to altitude between the two groups (F=3.274, p=0.029), as a decline in sleep efficiency in the placebo group (F=10.259, p less then 0.001) was not replicated in the angiotensin II receptor blocker group (F=0.459, p=0.713). CONCLUSION The absence of any significant sleep disturbance in the intervention group suggests that peripheral chemoreceptor hypersensitivity is largely mediated by angiotensin II receptor activation. However, further research is needed to confirm our findings and to study the potential mechanisms of action. © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.BACKGROUND Diet changes through disasters may affect psychological health as well as general health. The present study aimed to find food security status-that is defined by having enough food for an active, healthy life-dietary patterns and their relationship with probable psychiatric disorders in earthquake survivors. METHODS This cross-sectional study conducted on 350 women who survived in East Azarbaijan earthquake (At 453 am on 11 August 2012).  https://www.selleckchem.com/products/rin1.html  Food frequency questionnaire, Depression, Anxiety and Stress Scale and food security questionnaire of the US Department of Agriculture were used to assess dietary patterns, psychological and food security status, respectively. P values were considered significant at 0.05). CONCLUSION There was no statistically significant association between major dietary patterns and psychiatric disorders. Further well-designed studies need to find any significant association. © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.BACKGROUND The Israel Defense Force is the only military organisation in the world that mandatorily conscripts women since its founding. Despite legislative changes, the percentage of women serving as combat soldiers is low, and the dropout rate is high. Women in these professions experience a complex and unique adaptation process. AIMS To characterise the experiences of female combat soldiers adjusting to combat roles in comparison with male soldiers and non-warfighter female soldiers. METHOD A pilot study was undertaken in order to inform further research. Mental health officers in the women's units conducted group interviews. These were composed of four stages projection, reflection, processing and formulating solutions. RESULTS The themes apparent in the interviews conform to phenomena appearing in the literature such as tokenism, disruption of gender identity and internalisation of the superiority of male values. In addition, we identified distortion of body image and increased burnout. DISCUSSION AND CONCLUSIONS The study points to the significance of gender aspects in the mental adaptation process of women in combat positions. Issues pertaining perceptions of inequality should not be deemed to be purely sociological, but rather as a gateway facilitating adjustment. This should be taken into account in future research and in the formulation of support strategies. © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.INTRODUCTION The purpose of this study is to evaluate the factors affecting multiple surgeries, worse visual outcome, eye removal (ER) and vitrectomy requirement in terror-related open-globe injuries (OGI) in the Turkish Military. Secondary purpose is to specify surgery and injury characteristics of terror-related OGI. METHODS A total of 372 eyes of 251 patients with OGI that occurred during terroristic attacks between January 1996 and January 2016 were included in the study. A retrospective investigation of the preoperative variables associated with further surgeries, visual outcome, vitrectomy requirement and evisceration/enucleation was achieved. RESULTS A total of 1118 separate operative sessions with a median of 2 (1-14) surgeries were performed to 372 eyes. Preoperative factors predicting follow-up surgery included visual acuity (VA) less then 20/200, lens injury, vitreous haemorrhage (VH), presence of vitreous prolapse. Baseline VA less then 20/200, initial retinal detachment and ruptured globe injury were the independent factors of worse visual result. Ruptured globe injury (p0.000) and initial vitreous prolapse (p0.001) were significantly linked to ER surgery. Patients required vitrectomy significantly tend to have VH (p0.000) and zone 3 injury (p0.000) compared with non-vitrectomy group. Single surgery cases tend to have significantly better baseline (p0.000) and final VA (p0.007) and shorter follow-up period (p0.000) compared with multiple surgery group. CONCLUSIONS Terror-related OGI necessitate remarkable surgical follow-up and multiple surgery sessions with a relatively higher evisceration/enucleation rate than other types of OGI. A comprehensive surgical approach with multiple surgery types is needed to treat terror-related OGI. © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.