Volume 27 Number 3 July 2019 Journal of Military and Veterans’ Health Public Perception of Dentists’ Ability to Manage a Medical Emergency RY ME A DI IT C L I Does Current Policy Support Reproductive Health of Australian Defence Force Veterans? I N M E A N S A I S O S A C L I A Case Report of a Former Soldier Using TRE For Post-Traumatic Stress Disorder Self-Care A T R I T O S N U A IN C. The Journal of the Australasian Military Medicine Association REGISTER now amma.asn.au/amma2019 Table of Contents View from the Front Medical Officer Training - An Infantryman’s Perspective ��������������������������������������������������������������������������������6 Original Articles Neurofeedback Training and Physical Training Differentially Impacted on Reaction Time and Balance Skills Among Iranian Veterans with Spinal Cord Injury ������������������������������� 11 Public Perception of Dentists’ Ability to Manage a Medical Emergency ��������������������������������������������������������� 19 Review Articles Does Current Policy Support Reproductive Health of Australian Defence Force Veterans? A Review of Australian Defence Force Policy ������������������������������������������������������������������������������������������������ 25 Case Study Case Report of a Former Soldier Using TRE (Tension/Trauma Releasing Exercises) For Post-Traumatic Stress Disorder Self-Care ��������������������������������������������������������������������������������������������� 35 History Article A History of Australian Navy Health Officer Uniforms and Ranks (Part Two) ������������������������������������������������ 41 now Reprinted Article The Battle of the River Plate: Excerpts from the Diary of REGISTER Surgeon Commander Jack Cussen RN, PMO of HMS EXETER �������������������������������������������������������������������� 57 amma.asn.au/amma2019 Front Cover Photo courtesy of Colonel Murray Hayes, RAADC Volume 27 Number 3; July 2019 Journal of Military and Veterans’ Health EDITORIAL BOARD CDRE Andy Robertson, CSC, PSM (Editor in Chief) Associate Professor Martin Richardson (Deputy Editor) Maj Gen Prof Dr Mohd Zin Bidin (Ret’d) BRIG Anne Campbell CDRE Michael Dowsett Dr Helen Kelsall COL Prof Peter Leggat, AM Benjamin Mackie David Robertson Tyler C Smith, MS, PhD Dr Darryl Tong Jason Watterson Australasian Military Medicine Association PATRON STATEMENT OF OBJECTIVES RADM Jenny Firman The Australasian Military Medicine Association is Surgeon General Australian Defence Force Reserves an independent, professional scientific organisation of health professionals with the objectives of: COUNCIL • Promoting the study of military medicine President GPCAPT (Retd) • Bringing together those with an interest in Geoff Robinson, NSC military medicine Vice President Dr Nader Abou-Seif • Disseminating knowledge of military medicine • Publishing and distributing a journal in military Secretary Dr Janet Scott medicine Treasurer CMDR Ian Young • Promoting research in military medicine Council Members CDRE Andrew Robertson Membership of the Association is open to doctors, Dr Peter Hurly dentists, nurses, pharmacists, paramedics and Rachelle Warner anyone with a professional interest in any of the disciplines of military medicine� The Association is Past President Dr Greg Mahoney totally independent of the Australian Defence Force� Public Officer Ms Paula Leishman JMVH is published by the Australasian Military Medicine Association 227 Collins Street Hobart Tas 7000 Australia Ph: +61 3 62347844 Email: [email protected] ISSN No. 1835-1271 Journal of Military and Veterans’ Health Editorial D-Day and Binh Ba – 6 June In this issue, we have a number of papers looking at rehabilitation, from rehabilitation for spinal Just over 75 years ago, 7,000 vessels carried cord injury to post traumatic stress disorder and 190,000 sailors and 130,000 soldiers across the addressing reproductive health in veterans� English Channel to five designated beaches – Utah and Omaha on the American side, Gold and Sword Our third issue of 2019 also contains articles on for the British, and Juno for the Canadians� Some medical and dental officer training and two historical 7,000 aircraft took part, including transport planes, articles� We continue to get a good range of articles, gliders, fighters and heavy bombers� Australia, with but other military and veterans’ health articles are its forces largely in the Pacific, played a relatively always very welcome, and we would encourage small part, but still contributed about 3,000 all our readers to consider writing on their areas Australians� The contribution was primarily in the of military or veterans’ health interest� We would air, with between 2,000 and 2,500 Australian airmen particularly welcome papers based on our 2019 serving in various RAF and ten RAAF squadrons of themes of recovery, rehabilitation and repatriation, all kinds� Fourteen Australians were killed on D-Day but welcome any articles across the broader (two RAN and 12 RAAF)�1 25 years later, 5RAR troops spectrum of military health� As many of our readers and tanks from 1 Armoured Regiment were involved are getting ready to present at the Australian Military in a ferocious battle around Binh Ba in Vietnam�2 Medicine Conference in October 2019 (https:// Both of these key battles led to wounded personnel, amma�asn�au/amma2019/), we would encourage who required repatriation and rehabilitation� all presenters to submit their completed papers to the Journal for consideration� Reviewers are also The theme of this issue is ‘rehabilitation’, which critical for ensuring the quality of articles and we follows on from the ‘repatriation’ theme in the April would encourage any budding reviewers to nominate 2019 issue� It also picks up on Prime Minister ‘Billy’ for articles of interest� Hughes promise to the country’s armed forces that ‘When you come back we will look after you’, as it Dr Andy Robertson, CSC, PSM was an important part of the Repatriation system�3 Commodore, RANR Editor-in-Chief References: 1� Stanley P� Australians and D-Day� Australian War Memorial; Canberra: 2004 https://www�awm�gov� au/articles/blog/australians-and-dday-2004 2� Ekins A� 'It had been a ferocious fight'� Australian War Memorial; Canberra: 2019 https://www�awm� gov�au/articles/blog/battle-of-binh-ba-50-years-on 3� Payton P� ‘Repat’: A concise history of repatriation in Australia� Department of Veterans’ Affairs; Canberra: 2018� Volume 27 Number 3; July 2019 Page 5 View from the Front Medical Officer Training - An Infantryman’s Perspective R Worswick Preface that I was expected to fulfil� I assumed that this would also be the case with my career as an Army This article is based on a presentation the author medical officer� However, the closer I got to the end of delivered at the annual conference of the Australasian my training, the more I realised that this was not the Military Medical Association, Canberra, October case� This worried me� So much so that shortly before 2018� re-entering the Army as a doctor, I felt compelled to express my concerns in writing: Introduction ‘As an infantry company commander, The aim of this paper is to provide an infantryman’s I assumed that the Battalion Medical perspective on how the Army trains its medical Officer had the skills and knowledge officers� It is written in the first person because necessary to competently provide an it is my story and my opinion� I spent 19 years appropriate level of care to soldiers in as an infantry officer before starting my medical a field/deployed environment. Now, training� I completed General Service Officer (GSO) having almost completed my junior training through the Australian Defence Force medical officer training, I realise that Academy (ADFA) and the Royal Military College this assumption is wrong. The current (RMC) Duntroon; followed by the suite of courses paradigm for medical officer training under the Army all-corps officer-training continuum does not provide an appropriate level of (ACOTC) and the infantry regimental officer-training capability to Army.’ continuum� At all stages of my career as an infantry officer I felt satisfied and confident that the training In this paper I intend to discuss what I believe are I was provided prepared me for the roles and tasks shortfalls in the way that Army trains its medical Page 6 Journal of Military and Veterans’ Health View from the Front officers� It is an Army-centric discussion because pre-vocational training prior to commencing their after 31 years of service in the Army, I feel comfortable service as a uniformed medical officer� From an talking about Army training issues, but confess to infantryman’s perspective, this initiative was a long knowing only a little about the Navy and Air Force� time coming� If an independent review of Army GSO However, I believe that the issues I raise are also officer training found that the Army’s officer-training applicable to Navy and Air Force medical officers� continuum did not adequately prepare GSOs to be platoon commanders, the Army would not have Medical Officer Training Shortfalls waited five years to address the problem� In general terms, infantry officer training and Within the pre-vocational training period, there are medical officer training follow a similar approach, stark differences between how Army trains a GSO, illustrated in the schematic above� They both start and the training that medical officers receive� For with pre-vocational training—tertiary studies (for Army trainees—soldiers and officers alike—training many GSO officers) followed