This thesis investigates the epidemiology of lifestyle behaviours and training injuries among British Army infantry recruits. In Study 1, the Military Pre-training Questionnaire (MPQ) was developed to assess multiple risk factors for injury (smoking; alcohol consumption; physical activity; diet; and injury history). Its feasibility and test-retest reliability was demonstrated in a representative sample (n = 58) with no evidence of systematic bias between administrations. The MPQ was subsequently completed by a large cohort of infantry recruits before commencing initial training (n = 1,960). This enabled its validity to be assessed in Study 2, which revealed that a simple, single-item measure of pre-training physical activity was a strong predictor of initial physical fitness levels and likely training outcomes. In Study 3, cross-sectional analyses of MPQ responses enabled the prevalence, co-occurrence and clustering of unhealthy lifestyle behaviours to be assessed. Although physically active, the majority of recruits entering infantry training smoked, drank hazardously and had low fruit and vegetable consumption. Six percent of recruits reported no unhealthy lifestyle behaviours, 20% reported one, 35% reported two, 31% reported three and 8% reported all four. Paired combinations of unhealthy behaviours were strongly associated, particularly smoking/drinking, smoking/inactivity and diet/inactivity. Finally, in Study 4, a high incidence of overuse injuries in infantry recruits was observed using a prospective study design. Recruits with lower pre-training fitness levels, low body mass and past injuries were exposed to a higher risk of sustaining a training injury, while there was no evidence to suggest that engaging in unhealthy lifestyle behaviours increased injury risk. Collectively, the four studies have enabled, for the first time, a comprehensive analysis of lifestyle behaviours and training injuries among British Army infantry recruits. The findings have important implications for military health improvement and injury prevention strategies.

Bakgrund: Diabetes typ 2 är en kronisk folkhälsosjukdom som beror på att upptaget av insulin i kroppsvävnaden är nedsatt. Diabetes typ 2 kan medföra många komplikationer, både akuta och sena. Det finns många faktorer som ökar risken för sjukdomen, bland annat livsstilsfaktorer. Fysisk inaktivitet och ohälsosam mat är exempel på livsstilsfaktorer som ökar risken för att bli drabbad av sjukdomen. Syfte: Syftet med denna litteraturöversikt var att beskriva patienters upplevelse av livsstilsförändringar vid diabetes typ 2. Metod: Litteraturöversikt där tio vetenskapliga artiklar analyserats från databaserna PubMed och Cinahl Complet, med utgångspunkt från Fribergs analysmodell. Resultat: Resultatet presenteras i fem teman: Att bli diagnostiserad med diabetes typ 2, vårdpersonalens bemötande och betydelse för livsstilsförändringar, förändrade kostvanor, motivationens betydelse för att genomföra livsstilsförändring samt känslor vid livsstilsförändringar. Dessa teman presenteras i resultat delen. Sammanfattning: Många patienter är i behov av stöd och motivation för att kunna genomgå livsstilsförändringar. Vårdpersonal behöver en ökad kunskap kring hur de ska kunna arbeta motivationsfrämjande och personcentrerat för att stödja patienter som behöver genomgå livsstilsförändringar vid diabetes typ 2. / Background: Diabetes type 2 is a chronic public health disease caused by the low absorption of insulin in the body tissue. Diabetes type 2 can bring many complications, both acute and late complications. There are many factors that increase the risk of the disease, for instance lifestyle factors. Physical inactivity and unhealthy food are examples of lifestyle factors that increase the risk of being affected by the disease. Aim: The aim with this literature review was to describe patients experiences of lifestyle changes when living with diabetes type 2. Method: Literature overview where ten scientific articles were analyzed from the databases PubMed and Cinahl Complet, based on Friberg's analysis model. Results: The results are presented in five themes: Being diagnosed with diabetes type 2, the treatment of the healthcare staff and the importance of lifestyle changes, changed dietary habits, the importance of motivation for implementing lifestyle changes and emotions during lifestyle changes. These themes are presented in the results section. Summary: Many patients are in need of support and motivation to be able to undergo lifestyle changes. Health care professionals need increased knowledge about how they could work in a motivational and person-centered way to support patients who need a lifestyle change in type 2 diabetes.