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The early postoperative results of 44 surgically treated popliteal arterial injuries from the Yugoslav civil war are reported. Of these patients, 41 (93%) were males and three (7%) were females, average age was 28 (range 6-45) years. Twenty patients (45%) had gunshot wounds and 24 (55%) explosive wounds. Twelve (28%) suffered isolated vascular damage, while 32 (72%) suffered concomitant bone fractures. Isolated arterial lesions were found in 24 (55%) cases, and concomitant arterial and venous lesions in 20 (45%). Twenty-four (55%) had primary reconstructions after haemostasis in the initial war hospital, and 20 (45%) secondary reconstructions after inadequate primary reconstruction in a regional war hospital. Artery procedures included 19 reverse saphenous vein graft interpositions, 10 reverse saphenous vein bypasses, 12 'in situ' saphenous vein bypasses and five lateral subcutaneous saphenous vein bypasses. The early graft patency rate was 100%, and limb salvage 72%. Major amputation was performed in 28%. Concomitant bone fractures, secondary reconstructions, secondary haemorrhage from an infected graft, and explosion wounds significantly increased the amputation rate (P < 0.01). Eleven amputations were performed after an anatomic, and only one after an extra-anatomic reconstruction (P < 0.01). The authors recommend an in situ or lateral subcutaneous reconstruction in cases of complicated popliteal artery injuries, such as concomitant bone fractures accompanied by massive soft tissue damage, and this type of reconstruction should also be used if infection is present or the procedure is delayed. PMID:9158121
Davidovi?, L; Lotina, S; Kosti?, D; Velimirovi?, D; Duki?, P; Cinara, I; Vranes, M; Markovi?, M
Objective: To examine the differences between war and domestic ocular injuries during the Lebanese Civil War in terms of baseline characteristics, treatment provided and prognosis. Methods: We retrospectively reviewed the charts of subjects with traumatic ocular injuries referred to a major medical center from 1980 to 1996. The variables were tabulated according to the international classification of ocular trauma. Results:
Ahmad M. Mansour; Wadih M. Zein; Tarek A. Sibai; Abla Mehio-Sibai; Hussein Ismail; Sawsan Bu Orm
In a society struggling to rebuild its country after 3 decades of years of dictatorships and wars, Iraqi maxillofacial and craniofacial surgeons play a critical role in treatment of many most serious terrorist missile injuries of the face by ongoing conflict in Iraq. This study reflects our surgical techniques of treating explosive missile injuries and other combat- and terrorism-related injuries and also evaluates the immediate and secondary phase managements of patients with missile injuries. This study includes 235 patients with missile warinjuries of the face during a period of 4 years; all injured patients were treated in the Maxillofacial Unit of Surgical Specialties Hospital, Medical City, Baghdad. There were 195 men and 40 women; their ages ranged from 1 to 70 years (mean, 39.5 years). Posttraumatic missile facial deformities were classified as follows: 95 patients (40.43%) had bone loss; 72 patients (30.64%) had soft tissue loss; 33 patients (14.05%) had orbital injuries; and 35 patients (14.90%) had other deformities of scar contracture, fistula, and sinus formation. Two techniques were used for reconstruction of the bony defect, either by bone chips carried by osteomesh tray harvested from the iliac crest or by free block of corticocancellous bone graft from the iliac crest. Soft tissue reconstruction was done by local flaps and regional flaps such as lateral cervical and cervicofacial flaps, and the orbit was reconstructed by bone graft, lyophilized dura, and sialastic implant. Scar contracture was treated by scar revision and sinus tract excised at the same time of scar revision. In conclusion, the primary phase required an urgent airway management, controlling an active bleeding by surgical intervention; most entrance and exit wounds as well as retained missiles were located in the cheek, chin, and mandibular body, with few cases of mortality due to complications related to head injuries. The secondary phase management of deformities of the face as a complication of missile injuries was classified as bone loss, soft tissue loss, combined bone and soft tissue loss, and others (sinus tracts and poor scars). PMID:22067852
Bacterial contamination of war wounds occurs either at the time of injury or during the course of therapy. Characterization of the bacteria recovered at the time of initial trauma could influence the selection of empiric antimicrobial agents used to preve...
C. K. Murray D. P. Dooley D. R. Hospenthal K. Wenner S. A. Roop
During armed combat serious hand injuries are often neglected only to receive the attention they deserve far too late. The authors have employed a vigorous approach to the primary care of severe warinjuries to dorsum of the hand introducing silicone rods where extensor tendons have been destroyed and where skin closure is obtained using inguinal skin flaps. PMID:334639
The warinjuries of 361 patients admitted to Mubarak Al-Kabeer Teaching Hospital, during the Gulf War are reported. More abdominal and chest injuries were seen in this series in comparison with other conflicts owing to the short evacuation time. Of the injuries, 54% were caused by gunshots, 34% were fragment injuries and 5.5% were glass and stab injuries. Civilians accounted for 50% of the injured. Wound infection rate was 7%, average hospital stay was 8.8 days and hospital mortality was 5.5%. We advocate radical wound excision, exploration of penetrating wounds of neck and abdomen, and mainly conservative management of chest injuries that do not involve the mediastinum.
Behbehani, A.; Abu-Zidan, F.; Hasaniya, N.; Merei, J.
The retrospective analysis of 1,514 cases treated at the Clinic for Plastic Surgery and Burns of the Military Medical Academy in the period between 1991 and 1995, established that the percentage of the injuries caused by gunshots and those caused by explosives during the conflict in former Yugoslavia, was more or less the same. The injuries caused by gunshot more often occurred on the head, neck, arms and trunk. The injuries of the legs caused by the explosives were more frequent, and they occurred in 83% of the cases. All the plastic surgeons who took part in the treatment of patients and in preparing the surgeons of other specialties for the treatment applied the original classification of the warinjuries according to the structure of the defects that had occurred, to standardize the approach to the planning of treatment and the treatment itself of the wounded. In the delayed primary or secondary treatment of the injuries with the tissue defects all known plastic and reconstructive methods were applied. In the cases requiring the covering of the the tissue defect with the full thickness skin, local skin, fasciocutaneous, fascioadipose or muscle flap was chosen. Distant pedicled direct flaps were used in cases when it was not possible to use a more suitable reconstructive method. Free skin, myocutaneous or complex microvascular flaps were applied in cases of more extensive defects or if a more suitable solution could not be found. Our experience in surgical treatment of warinjuries with skin defects during the civil war in former Yugoslavia has shown that over 50% of all the injured patients required the treatment of a plastic surgeon in a definite surgical treatment of a warinjury. A multidisciplinary approach is necessary in the majority of the injured, and the surgical team is composed according to the affected area and the extent of the injury. PMID:10838953
Jevtovi?, D; Panteli?, B; Kozarski, J; Novakovi?, M; Piscevi?, B; Milovi?, B; Gacevi?, M
The document consists of three previously announced reports: The CIA under Truman: CIA Cold War Records (PB94-928005); The Cuban Missile Crisis, 1962 (PB92-927906); and Selected Estimates on the Soviet Union (PB93-928112).
At the time of the American Civil War (1861-1865), a great deal was known about closed head injury and gunshot wounds to the head. Compression was differentiated from concussion, but localization of lesions was not precise. Ether and especially chloroform were used to provide anesthesia. Failure to understand how to prevent infection discouraged physicians from aggressive surgery. Manuals written to educate inexperienced doctors at the onset of the war provide an overview of the advice given by senior surgeons. The Union experiences in the treatment of head injury in the Civil War were discussed in the three surgical volumes of The Medical and Surgical History of the War of the Rebellion. Wounds were divided into incised and puncture wounds, blunt injuries, and gunshot wounds, which were analyzed separately. Because the patients were not stratified by severity of injury and because there was no neuroimaging, it is difficult to understand the clinical problems and the effectiveness of surgery. Almost immediately after the war, increased knowledge about cerebral localization and the development of antisepsis (and then asepsis) permitted the development of modern neurosurgery. PMID:8468618
The last decade has generated a robust study on the role of external interventions into civil wars. This literature builds on a rather small but influential foundation that at minimum pointed in the direction for a more systematic exploration for the conditions that lead to effective interventions. After a decade or more of research, it seems appropriate to take stock
Since March 2003, military operations in Iraq "Operation Iraqi Freedom" (OIF) and in Afghanistan "Operation Enduring Freedom" (OEF), have made many wounded and killed in action (KIA). This article proposes to highlight the specific epidemiology of combat casualties, met in these both non-conventional and asymmetric conflicts. Personal protective equipments, Kevlar helmet and body armor, proved their efficiency in changing features of warinjuries. Health Force Services organized trauma care system in different levels, with three main objectives: immediate basic medical care in battalion aid station, forward surgery and early aeromedical evacuation. The Joint Theater Trauma Registry (JTTR), a warinjury registry, provides medical data, analyzed from the combat theater to the military hospital in United States. This analysis concluded that during modern conflicts, most injuries are caused by explosive devices; injuries are more severe and interestingly more specifically the head region and extremities than the trunk. Hemorrhage is the first cause of death, leading to the concept of avoidable death. Specific databases focused on mechanisms and severity of injuries, diagnostic and treatment difficulties, outcomes can guide research programs to improve warinjuries prevention and treatment. PMID:21981845
Pasquier, P; de Rudnicki, S; Donat, N; Auroy, Y; Merat, S
Study design: A retrospective review examining the cases of 137 individuals with spinal cord injury (SCI) as a result of a suicide attempt between 1951–1992. Objective: To ascertain demographic details of this participant sample, explore and identify the type of psychiatric condition evident around the time of injury, and to review outcome information of this sample with specific focus on
The post-September 11, 2001 wars in and around Afghanistan and Iraq have increased awareness of traumatic brain injury (TBI), particularly blast-induced mild TBI. This article provides an overview of TBI and its neuropsychiatric sequelae in U.S. war veterans who participated in the current operations in and around Afghanistan and Iraq, with particular emphasis on blast-related mild TBI. Psychiatric disorders, particularly posttraumatic stress disorder, pain, and sensory impairments are prevalent in war veterans with TBI. Research is needed to more definitively characterize the epidemiology of TBI-related functional difficulties, the effects of blasts compared with other mechanisms of injury, recovery trajectories, and treatment outcomes in this population. PMID:22248327
This retrospective longitudinal study aims to describe reported Taekwondo injuries and to examine associations between competitor experience level, age and gender, and the type, location, and mechanism of injury sustained. Additionally, we examined whether recent rule changes concerning increased point value of head shots in adult Taekwondo competition had affected injury incidence. This study was a summation of 9 years of data of competition injury reports, which included 904 injury reports spanning 58 individual competitions. The data was collected on standardized injury reports at time of injury during competition. Care was provided to the athletes, but the type of care provided was not included in the study. Participants included athletes injured during competition who sought care by the health care team, and for whom an injury report was filled out. The data analysis was performed at the Canadian Memorial Chiropractic College. The three most common locations of presenting injury were the head (19%), foot (16%), and thigh (9%). The most common mechanism of presenting injury was found to be a defensive kick (44%), followed by an offensive kick (35%). The most commonly diagnosed injuries were contusions (36%), sprains (19%), and strains (15%). Coloured belts had a higher incidence of contusions, while black belts sustained more joint irritation injuries. Black belts were more likely to suffer multiple injuries. Colored belts suffered more injuries while receiving a kick, while black belts had a larger influence of past history of injury. We found no significant difference in location or type of injury when comparing pre versus post rule change. The most common locations of injury are head, foot, and thigh respectively, and are areas for concern when considering preventative measures. Colour belt competitors are more likely to sustain contusions, which the authors believe is due to more aggressive tactics and lack of control. Those more likely to be injured tend to be younger than 18 years. Recent rule changes have no significant effect on head injuries.
This retrospective longitudinal study aims to describe reported Taekwondo injuries and to examine associations between competitor experience level, age and gender, and the type, location, and mechanism of injury sustained. Additionally, we examined whether recent rule changes concerning increased point value of head shots in adult Taekwondo competition had affected injury incidence.This study was a summation of 9 years of data of competition injury reports, which included 904 injury reports spanning 58 individual competitions. The data was collected on standardized injury reports at time of injury during competition. Care was provided to the athletes, but the type of care provided was not included in the study. Participants included athletes injured during competition who sought care by the health care team, and for whom an injury report was filled out. The data analysis was performed at the Canadian Memorial Chiropractic College.The three most common locations of presenting injury were the head (19%), foot (16%), and thigh (9%). The most common mechanism of presenting injury was found to be a defensive kick (44%), followed by an offensive kick (35%). The most commonly diagnosed injuries were contusions (36%), sprains (19%), and strains (15%). Coloured belts had a higher incidence of contusions, while black belts sustained more joint irritation injuries. Black belts were more likely to suffer multiple injuries. Colored belts suffered more injuries while receiving a kick, while black belts had a larger influence of past history of injury. We found no significant difference in location or type of injury when comparing pre versus post rule change. The most common locations of injury are head, foot, and thigh respectively, and are areas for concern when considering preventative measures. Colour belt competitors are more likely to sustain contusions, which the authors believe is due to more aggressive tactics and lack of control. Those more likely to be injured tend to be younger than 18 years. Recent rule changes have no significant effect on head injuries. PMID:20037692
The basic problems of bone-and-joint surgery with special emphasis on warinjuries and the role of reconstructive surgery in relieving the gravest consequences of warinjuries are discussed. Since bone and joint injuries rank high among the warinjuries with a share of over 70% including more than 30% of fractures, they pose not only a serious medical and surgical but also a major public health problem. The economic and social consequences of these injuries are further aggravated by the necessity for prolonged treatment and multiple surgical interventions. The basic preconditions which must be fulfilled for bone healing to take place are discussed in the light of the ultimate goal of all therapeutic efforts. i.e. restoration of full functional ability of the injured extremity. The importance of bone fragment immobilization for the process of bone healing is emphasized. Impaired bone healing, resulting from insufficient immobilization or inadequate reposition of bone fragments, is a common problem with war fractures, mainly because of the great forces involved and extensive destruction of bone and all other surrounding tissues. One of the main features of war fractures is delayed bone healing caused by massive circulatory defects in the injured bone. Some special problems attending warinjuries, such as pseudarthroses and associated defects, soft tissue infections and defects, may only be effectively solved by cooperation with a plastic-vascular- or neurosurgeon. In one and joint surgery profound understanding of the physiology, pathophysiology and biomechanics of bone healing, knowledge of modern methods of osteosynthesis, skill in the management of bone and other infections as well as knowledge of the latest developments in postoperative care are essential for achieving satisfactory therapeutic results. Availability of various implants and a wide range of surgical instruments is a precondition which needs no further discussion. It is only in this way that the most promising course of action can be selected for each wounded person individually, a course of action which will, in the shortest possible time and the most convenient manner, lead to the desired therapeutic goal, i.e. restoration of satisfactory bone and joint function. PMID:1343117
|Introduces a symposium in this journal issue: "Technology through a Retrospective Eye: Imaging Practices between the World Wars and Beyond." Notes that each article of the symposium keys into a central moment of expansion of imaging practice and focuses on the debates that accompanied that expansion. (SR)|
The extravasation of many agents during administration by way of the peripheral veins can produce severe necrosis of the skin and subcutaneous tissue. The incidence of an extravasation injury is elevated in the populations prone to complications, including the younger age groups. The severity of the necrosis depends on properties of the extravasated agent (vinca alkaloids, antracyclines, catecholamines, cationic solutions, osmotically active chemicals) including the type, concentration, and the quantity injected. In general, the primary diseases were chronic diseases such as hepatic or ischaemic encephalopathies, cardiac or pulmonary diseases, diabetes mellitus, and oncological diseases. The aim of this article was to explore the prevention, diagnosis, and treatment of extravasation injuries with a review of the literature. From January 2009 to August 2011, 22 patients were reviewed. Ten patients were children, and the others were adults. The surgical interventions were delayed until the development of the necrosis. A topical boric acid 3% solution was applied to all wounds with repetitive debridement. Debridement was performed once every 2 days and was continued until healthy tissue was obtained. The wounds of eight patients were repaired with split-thickness skin grafts, the wounds of six patients were reconstructed with randomised fasciocutaneous flaps, and the wounds of five patients healed by secondary intention. The wounds of three patients with massive swelling of the forearms were treated with only conservative modalities and limb elevation for 24-48 hours. Boric acid was found to promote granulation tissue in the wounds. The extravasation injuries can be prevented by using appropriate measures, such as the avoidance of perfusion under pressure, patient participation in pain follow-up, wound management by experienced health professionals, and preference for large and suitable veins. PMID:23190022
F?rat, Cemal; Erbatur, Serkan; Aytekin, Ahmet Hamdi
ISSUE: Literature from the Vietnam War, Iran-Iraq War, and field reports from Landsthul Regional Medical Center and USNS Comfort, identified multidrug-resistant acinetobacter (MDRA) and other gram-negative rods (GNR) as war-zone community-acquired pathogens both colonizing and infecting war casualties.PROJECT: Infection control professionals (ICPs) formed a multidisciplinary team to design a surveillance protocol for patients admitted with injuries from the Iraqi War
E. Vasquez; M. J. Duncan; K. Petersen; J. English; S. Tasker
ABSTRACT A retrospective analysis of the NASS/CDS database from 1993 to 2000 was used to investigate lower extremity injury in lateral impact. The analysis includes the study of the injury patterns, crash characteristics and the interactions between the occupant and the vehicle interior, including injuries to the farside occupants. The findings include significantly different injury patterns for the nearside and farside impacts. In particular, while the proportion of pelvis/hip injuries, with respect to AIS2 and AIS3 lower extremity skeletal injuries and 2-4 and 10-8 o'clock side impacts, was higher in nearside (70.4%) than farside (38.3%), the opposite trend was observed for the thigh (2.8% vs 4.5%), knee (6.2% vs 16.7%), leg (10.1% vs 19.5%) and foot/ankle (5.6% vs 14.7) injuries. Analysis of the PDOF suggested that a large proportion the impacts occurred obliquely, at approximately 10 and 2 o'clock, with a rearward component of force. It is hoped that the findings of the current study can help to investigate injury mechanisms. PMID:12941240
Banglmaier, R F; Rouhana, S W; Beillas, P; Yang, K H
Paintball shooting is played with increasing frequency in the Netherlands. A bullet, filled with paint, shot at 60 m/sec can cause serious damage to the eye. All five patients seen in two years showed a hyphaema. Four out of five patients showed damage of the posterior pole, including vitreous haemorrhage, choroidal rupture, retinal detachment, and sub- or intraretinal haemorrhage. Three out of five patients incurred permanent visual loss, varying from 3/60 to 25/100. Adequate instruction of the participants in the game and proper use of the eye protector will be of help in preventing eye injuries. PMID:8487887
Verburg-van der Marel, E H; ten Napel, J A; de Keizer, R J
The importance of human needs during the retrospective peacetime in 1990 and the Persian Gulf War in 1991 was examined among 564 college students in the United States. Results of factor analyses showed that during peacetime, two factors (higher-order and lower-order needs) were identified. During the war, all needs were rated as more important and…
|The importance of human needs during the retrospective peacetime in 1990 and the Persian Gulf War in 1991 was examined among 564 college students in the United States. Results of factor analyses showed that during peacetime, two factors (higher-order and lower-order needs) were identified. During the war, all needs were rated as more important…
Objective: Describe the influence of S. Weir Mitchell's (1829-1914) work, and in particular his ideas on causalgia, on European physicians who treated peripheral nerve injuries during World War I (WWI). Background: During the American Civil War (1861-1865), Mitchell studied peripheral nerve injuries with colleagues George Read Morehouse and William Williams Keen. Three monographs resulted from this work. All were important
1 This exchange reflects the moral and physical paradoxes that have made the Korean War the so-called' forgotten war'.2 Unlike the Second World War with its clear-cut enemies and its moral crusade for decisive victory, Korea seemed confusing and indecisive. The conflict was partly a civil war; partly an East-West ideological struggle; partly a United Nations police action; and partly
Retrospective reports of the frequency of war-zone exposure are commonly used as objective indices in studies investigating the mental health consequences of exposure to such stressors. To explore the temporal stability of these types of reports, we obtained frequency estimates of exposure to war-zone stressors at two time points from 460 U.S. soldiers who had served in the peace-keeping mission
Lizabeth Roeraer; Brett T. Litz; Susan M. Orsillo; Peter J. Ehlich; Matthew J. Friedman
Background In the literature, little is known about the level and pattern of rugby injuries. Of the shoulder injuries reported, 51% of these are caused during a tackle, and 65% of all match injuries affected the shoulder. Objective The study aims to describe a sport-specific unique intra-articular shoulder pathology of professional rugby players, who presented with persistent pain and dysfunction despite physiotherapeutic treatment and rest. Method This study is a retrospective analysis set at a university sports medicine clinic. Eighty-seven professional rugby players, referred by their professional medical team since they could no longer play, underwent shoulder arthroscopy between June 2001 and October 2007 due to persistent shoulder pain and dysfunction. All were full-time professional male rugby union and rugby league players. They all had failed conservative treatment for their complaint, and the diagnosis was unclear. Arthroscopic findings were used as a measure of main outcome. Results The primary mechanism of injury was reported as direct tackling (56%; n = 49) followed in succession by falling onto the arm (10%; n = 8). However, in 30% of the cases, no definite injury could be recalled. The main operative finding was that most patients exhibited multiple shoulder pathologies, with 75% of cases presenting with two or more pathologies. A superior labrum anterior to posterior (SLAP) lesion was evident at arthroscopy in 72 of the 87 cases (83%), while rotator cuff tears were evident in 43% of cases (n = 37). One-third of all cases had a Bankart tear (n = 29), despite none of them reporting previous dislocations, while other labral tears, excluding SLAP tears, to the inferior or posterior labrum were present in 34% (n = 30) of the cohort. Conclusions Repeated tackling, which is clearly rugby specific, is most likely to be responsible for most of these shoulder injuries, which upon arthroscopic examination, showed signs of mixed pathology. We suggest that an early arthroscopic investigation is valuable in this population in order to confirm treatable diagnosis on the painful shoulder and expedite a safe return to play.
OBJECTIVES: An 18 month prospective injury survey was conducted on 64 Australian elite and subelite female gymnasts. The aims were to determine the rate of injury, anatomical location, and types of injury incurred by female competitive gymnasts, and to compare the findings with data collected retrospectively from the same sample of gymnasts. METHODS: The gymnasts recorded (weekly) in an injury
BACKGROUND The aim of this study was to analyze the effect of early surgical management protocol and other important clinical features on the prognosis of patients suffering from war missile skull base injuries.METHODS Twenty-one patients who suffered from war missile skull base injuries were analyzed in this study. The wounds were mainly caused by shells and\\/or bullets. Craniotomy represented the
Bruno Splavski; Djuro Vrankovi?; Gordan Šari?; Robert Safti?; Zlatko Maksimovi?; Goran Bajek; Velebit Ivekovi?
Early in the 20th century during the Russo-Japanese War and World War I (WWI), some of the most important, lasting contributions to clinical neurology were descriptive clinical studies, especially those concerning war-related peripheral nerve disorders (eg, Hoffmann-Tinel sign, Guillain-Barré-Strohl syndrome [GBS]) and occipital bullet wounds (eg, the retinal projection on the cortex by Inouye and later by Holmes and Lister, and the functional partitioning of visual processes in the occipital cortex by Riddoch), but there were also other important descriptive studies concerning war-related aphasia, cerebellar injuries, and spinal cord injuries (eg, cerebellar injuries by Holmes, and autonomic dysreflexia by Head and Riddoch). Later progress, during and shortly after World War II (WWII), included major progress in understanding the pathophysiology of traumatic brain injuries by Denny-Brown, Russell, and Holbourn, pioneering accident injury studies by Cairns and Holbourn, promulgation of helmets to prevent motorcycle injuries by Cairns, development of comprehensive multidisciplinary neurorehabilitation by Rusk, and development of spinal cord injury care by Munro, Guttman, and Bors. These studies and developments were possible only because of the large number of cases that allowed individual physicians the opportunity to collect, collate, and synthesize observations of numerous cases in a short span of time. Such studies also required dedicated, disciplined, and knowledgeable investigators who made the most out of their opportunities to systematically assess large numbers of seriously ill and injured soldiers under stressful and often overtly dangerous situations. PMID:19847911
During a 4-year period, in the Departments of Plastic Surgery and Vascular Surgery at the Clinical Hospital Centre in Zagreb, 151 upper limb nerve injuries caused by war weapons were treated using microsurgical procedures, and 119 patients have been assessed. Among them, 44 patients with 58 nerve injuries had associated arterial injuries. It is of great importance that peripheral nerve as well as vessel injuries should be considered in all extremity war wounds. Every effort should be made to perform immediate revascularization of a damaged artery, as this is the best guarantee for long-term arterial patency. Reconstruction with autologous vein has been the method of choice for arterial warinjuries. Injured peripheral nerves, at the time of vascular repair, were marked and left for secondary reconstruction. Primary repair of such injuries was contraindicated because it was impossible to determine the exact proximal and distal extent of injury. Functional results were obtained in only 44.8 per cent of cases with concomitant nerve and arterial warinjuries, an outcome that could be explained by insufficient vascularization at the site of nerve repair (using both mechanisms of graft revascularization), as well as proximal levels of injury and extent of nerve damage, which resulted in long nerve defects. PMID:9509088
Stanec, S; Tonkovi?, I; Stanec, Z; Tonkovi?, D; Dzepina, I
The purpose of this study was to evaluate the outcome of endovascular management of iatrogenic vascular injuries (IVIs). We retrospectively reviewed the clinical records of 19 consecutive patients who underwent endovascular therapy of IVIs. Endograft implantation was conducted in 13 patients, intravascular embolization using coil was performed in four patients, combined treatment involving endovascular balloon intervention and percutaneous thrombin injection was done in one patient and the remaining one patient received balloon compression for hemostasis. There were no deaths after the operation. In the patients with vessel rupture (n = 9) or perforation (n = 4), cessation of bleeding and restoration of blood flow were achieved following the endovascular treatments. Four cases of pseudoaneurysm and one case of arteriovenous fistula were successfully eliminated. At a median follow-up of 23.8 months (range 4-84), one patient suffered a mild cerebral infarction secondary to covered stent placement and one patient developed a partial renal infarction secondary to coil embolization. Additionally, stent collapse was found in one patient with stenosis of the iliofemoral vein, accounting for the failure to resolve the lower limb edema. In conclusion, endovascular therapy is an effective technique in the management of different types of IVIs, but is associated with minor ischemic complications. PMID:22490785
Ballistics is the science of thrown or projected objects. The consequences of ballistic injuries to the face may be devastating and lead to considerable disability and disfigurement. Reconstructive techniques for maxillofacial injuries have improved greatly since World War II; however, the basic principles for the initial, early and reconstructive phases of treatment have stood the test of time. This paper gives an overview of the management of ballistic injuries to the face and jaws. PMID:12861767
The Korean War may be mislaid, stolen, forgotten, and misunderstood in North American and western Europe, but its memory still shapes political calculations in Beijing, Tokyo, Pyongyang, and Seoul. To Asians, the war and fifty years of aftershocks have once again demonstrated the unwillingness or incapacity of Westerners to come to grips with the political culture of Asia. Unlike Australia,
BACKGROUNDSpinal cord injuries due to penetrating wounds are not uncommon. The management of these injuries remains controversial especially with regard to the effect of laminectomy on the neurological outcome.METHODSBetween 1980 and 1989, 64 patients injured by bullets and shell fragments to the spinal cord were reviewed. There were 58 males and 6 females: 24 injuries (37.5%) involved the cervical spine,
Maarouf A Hammoud; Fuad S Haddad; Nazih A Moufarrij
Objective To examine the link between different weapons used in modern wars and their potential to injury civilians. Design Retrospective analysis of prospectively collected data about hospital admissions. Setting Hospitals of the International Committee of the Red Cross. Subjects 18?877 people wounded by bullets, fragmentation munitions, or mines. Of these, 2012 had been admitted to the hospital in Kabul within six hours of injury. Main outcome measures Age and sex of wounded people according to cause of injury and whether they were civilians (women and girls, boys under 16 years old, or men of 50 or more). Results 18.7% of those injured by bullets, 34.1% of those injured by fragments, and 30.8% of those injured by mines were civilians. Of those admitted to the Red Cross hospital in Kabul within six hours of injury, 39.1% of those injured by bullets, 60.6% of those injured by fragments, and 55.0% of those injured by mines were civilians. Conclusions The proportion of civilians injured differs between weapon systems. The higher proportion injured by fragments and mines is explicable in terms of the military efficiency of weapons, the distance between user and victim, and the effect that the kind of weapon has on the psychology of the user. Key messagesDuring war, mines and fragmenting munitions (mortars, bombs, and shells) are more likely than bullets to injure civiliansCivilians in a city under siege are particularly at risk of being injured by weapons whose users are not able to see the victimThe inherent nature of weapons may be a factor in determining whether civilians are killed or injuredThere is a need for greater respect for the Fourth Geneva Convention and for greater controls on weapons being transferred to untrained and undisciplined forces
Attention deficit hyperactivity disorder (ADHD) has been described as a preexisting psychiatric disorder for patients with burns that may have contributed significantly to their injury. The authors are not aware of any studies that have specifically looked at ADHD in burn patients and its role in the injury. A retrospective chart review of all youth that were admitted to a
Christopher R Thomas; Mohammed Ayoub; Laura Rosenberg; Rhonda S Robert; Walter J Meyer
Background Floating knee injuries are usually associated with other significant injuries. Do these injuries have implications on the management of the floating knee and the final outcome of patients? Our study aims to assess the implications of associated injuries in the management and final outcome of floating knee. Methods 29 patients with floating knees were assessed in our institution. A retrospective analysis of medical records and radiographs were done and all associated injuries were identified. The impact of associated injuries on delay in initial surgical management, delay in rehabilitation & final outcome of the floating knee were assessed. Results 38 associated injuries were noted. 7 were associated with ipsilateral knee injuries. Lower limb injuries were most commonly associated with the floating knee. Patients with some associated injuries had a delay in surgical management and others a delay in post-operative rehabilitation. Knee ligament and vascular injuries were associated with poor outcome. Conclusion The associated injuries were quite frequent with the floating knee. Some of the associated injuries caused a delay in surgical management and post-operative rehabilitation. In assessment of the final outcome, patients with associated knee and vascular injuries had a poor prognosis. Majority of the patients with associated injuries had a good or excellent outcome.
War chest wounds are very common, but wound balistic notions are not known of physicians. Different threats are being listed, and we might retain the important rate of shrapnels wounds. Concerning the bullet behavior in soft tissue, one can discern full jacketed war bullets which may tumble after a variable "neck", and non jacketed missiles which cause wound through "mushrooming" and/or fragmentation effect. Buckshot wounds obey the rule of "all or none". Body reactions, particularly the clash with a hard material like bone, may overturn everything described in soft tissues. Every kind of possible chest wounds are analyzed from a ballistic point of view. We insist on the effects of so called terrible high velocity little bullets which do not wound because of an "explosive" shock wave, but with a fragmentation effect. The treatment sums up to the advice of good common sense which has had such a good effect on our masters. PMID:2187894
A total of 65 suicidal cases due to sharp force injuries (cut and/or stab wounds) were investigated. Suicide by sharp force injuries accounted for 2.5% of all suicides in our prefecture during 1995-2005. The 65 victims were composed of 49 males and 16 females, and the age range of 50-70 years was most common. A history of psychiatric disease was found in 11 victims, and depression was the most common disease followed by schizophrenia. Of 65 cases, 8 victims had a history of previously attempting suicide. In 41 cases, a suicide note or will was found. Forty-six cases had pleural sharp force injuries. Interestingly, the remaining 19 deaths were due to a single sharp injury. Cutting injuries were predominantly located at the flexor side of the wrist (11 cases, 38%), followed by the neck (10 cases, 34%). On the other hand, stab wounds were most commonly located in the chest (17 cases, 49%). Tentative wounds, which were superficial cut wounds or stab wounds, were present in 37 cases (57%). In 27 of 37, hesitation marks were observed in close proximity. Tentative wounds more frequently appeared in cut injuries than in stab injuries. Of 28 cases with fatal cut or stab wounds localized in the trunk, 11 cases (39%) had clothing damage. In the discrimination between suicide and homicide, forensic pathologists should obtain information on victims and witnesses as well as investigating the scene and postmortem examination of the victim. PMID:18313011
The document consists of three previously announced reports: The CIA under Truman: CIA Cold War Records (PB94-928005); The Cuban Missile Crisis, 1962 (PB92-927906); and Selected Estimates on the Soviet Union (PB93-928112).
Introduction Despite the worldwide increase in the incidence of gunshot injuries, there are few large published series on craniocerebral gunshot injuries in children. Materials and methods The records of 30 consecutive children who were treated for craniocerebral gunshot injuries at the Red Cross War Memorial Children's Hospital from 1989 to 2002 were reviewed retrospectively. The circumstances of the injury, clinical
Marc D. Coughlan; A. Graham Fieggen; Patrick L. Semple; Jonathan C. Peter
Sayer NA, Chiros CE, Sigford B, Scott S, Clothier B, Pickett T, Lew HL. Characteristics and rehabilitation outcomes among patients with blast and other injuries sustained during the Global War on Terror.
Nina A. Sayer; Christine E. Chiros; Barbara Sigford; Steven Scott; Barbara Clothier; Treven Pickett; Henry L. Lew
We undertook a retrospective study to document and analyze the occurrence of cervical spinal injuries in rugby in the United States from 1970 to 1994. We studied 59 cases (average, 2.36 per year). Thirty jun ior-level players (50.8%) (college or high school), 28 (47.5%) men's club players, and 1 (1.7%) woman player were injured. Fifty-seven injuries (97%) oc curred during
Merrick J. Wetzler; Toks Akpata; Todd Albert; Timothy E. Foster; Andrew S. Levy
The authors present the case-history of patients with chronic osteomyelitis of the proximal third of the tibia-resulting from an injury during the Second World War. The defect of bone and soft tissues was treated by free transfer of a musculocutaneous flap. The behaviour of the flap in the osteomyelitic cavity is followed up and checked by repeated CT and NMR examinations. PMID:7515540
Kletenský, J; Tvrdek, M; Nejedlý, A; Pros, Z; Lebeda, V; Prokopová, J; St?nhová, H
This study provided a retrospective analysis of 106 pedi- atric patients 17 years of age or younger who incurred spinal cord injuries (SCIs) during the last decade in Istanbul. Data were retrieved from the medical records of the patients, who were admitted to Istanbul University's Cerrahpasa Medical Faculty and 70. Yil Physical Medicine and Rehabilitation Training Hospital from January 1992
Belgin Erhan; Mustafa Onur Ulu; Berrin Gunduz; Taner Tanriverdi
Background: Infection control training for predoctoral dental students, dental hygiene students, and dental assistant students has assumed an important role in the educational process at our institution. As part of an ongoign review of the curriculum at our school, we conducted a retrospective analysis of reported percutaneous injuries during the years 1991 through 1994 to determine whether the increase in
OBJECTIVES: An 18 month prospective injury survey was conducted on 64 Australian elite and subelite female gymnasts. The aims were to determine the rate of injury, anatomical location, and types of injury incurred by female competitive gymnasts, and to compare the findings with data collected retrospectively from the same sample of gymnasts. METHODS: The gymnasts recorded (weekly) in an injury record booklet the number of hours trained and information on any injuries suffered over that week. RESULTS: The sample reported 349 injuries, a rate of 5.45 per person (6.29 for the elite and 4.95 for subelite gymnasts) over the 18 month survey. Injuries to the ankle and foot (31.2%) were the most commonly reported, followed by the lower back (14.9%). The most prevalent type of injury were sprains (29.7%), followed by strains (23.2%), and growth plate injuries (12.3%). The elite gymnasts reported that, for each injury, they missed fewer training sessions (p = 0.01), but modified more sessions (p = 0.0001) than their subelite counterparts. Further, the elite gymnasts spent 21.0% of the year training at less than full capacity because of injury. Although a significantly higher number of injuries were recorded in the prospective study (p = 0.0004), no differences were found between the distribution of injury by anatomical location or type between the two methods of data collection. CONCLUSIONS: The findings have important implications in terms of training procedures and periodic screening of gymnasts. ???
Methamphetamine production and use has increased dramatically during the past 10 years. Methamphetamine production requires combining hazardous and volatile chemicals that expose the manufacturer to burn injuries from explosions and chemical spills. We sought to review the epidemiology of burn injuries in a rural burn center secondary to the use of amphetamine or methamphetamine and/or the manufacture of methamphetamine. Review of the records of 507 patients who were admitted to our burn unit from December 1, 1998, to December 31, 2001, revealed 34 patients who were involved in the use of amphetamines or methamphetamines and/or the manufacture of methamphetamine. Thirty-one patients tested positive for either amphetamine (n = 2) or methamphetamine (n = 29) on routine admission urine drug screens. Twenty of these patients were involved in the manufacture of methamphetamines. Three additional patients were identified as methamphetamine manufacturers but tested negative for the use of methamphetamines. The mean age of the study population was 31.88 +/- 7.65 years, with a male:female ratio of 10.3:1. The average burn size was 18.86 +/- 20.72, with the majority secondary to flame (n = 26). Patient burn admission histories were vague, and the patient's involvement in the manufacture of methamphetamine was often only later confirmed by media, the fire marshal, family members, or the patient. Fifteen patients showed the usual withdrawal pattern of agitation and hypersomnolence, with seven patients requiring detoxification with benzodiazepines. Two were admitted acutely to the psychiatric ward for uncontrollable agitation. Eighteen patients were offered chemical dependency treatment, and two completed therapy. There was one mortality. The mean cost per person was US 77,580 dollars (range, US 112 dollars - US 426,386 dollars). The increasing use of and manufacture of methamphetamine presents new challenges for the burn team because these patients can become violent and frequently need assistance with detoxification. Routine drug screens are mandatory in identifying methamphetamine use to alert burn unit personnel to particular management problems and target individuals who may be receptive to drug rehabilitation. PMID:15353935
Danks, Roy R; Wibbenmeyer, Lucy A; Faucher, Lee D; Sihler, Kristen C; Kealey, G Patrick; Chang, Phyllis; Amelon, Marge; Lewis, Robert W
Due to political instability in many Third World countries doctors in simply equipped rural hospitals are sometimes confronted with warinjuries. In those situations sending patients to specialized centres is often impossible. We studied a series of 100 consecutive patients with missile injuries treated during 1982/3 in an Ugandan mission hospital. Out of these 87 were available for sufficient follow-up, 11 disappeared before completing the treatment, and two died. The results are reported. It is concluded that many cases of missile injuries, except the most serious thoraco-abdominal lesions and major neurovascular problems, can be managed satisfactorily in rural hospitals with basic facilities only, provided sound surgical principles are observed, particularly wound treatment in two stages. PMID:3674679
Background A retrospective examination was conducted of injuries, physical fitness, and their association among Federal Bureau of Investigation (FBI) new agent trainees. Methods Injuries and activities associated with injuries were obtained from a review of medical records in the medical clinic that served the new agents. A physical fitness test (PFT) was administered at Weeks 1, 7 and 14 of the 17-week new agent training course. The PFT consisted of push-ups, sit-ups, pull-ups, a 300-meter sprint, and a 1.5-mile run. Injury data were available from 2000 to 2008 and fitness data were available from 2004 to early 2009. Results During the survey period, 37% of men and 44% of women experienced one or more injuries during the new agent training course (risk ratio (women/men) = 1.18, 95% confidence interval = 1.07-1.31). The most common injury diagnoses were musculoskeletal pain (not otherwise specified) (27%), strains (11%), sprains (10%), contusions (9%), and abrasions/lacerations (9%). Activities associated with injury included defensive tactics training (48%), physical fitness training (26%), physical fitness testing (6%), and firearms training (6%). Over a 6-year period, there was little difference in performance of push-ups, sit-ups, pull-ups, or the 300-meter sprint; 1.5-mile run performance was higher in recent years. Among both men and women, higher injury incidence was associated with lower performance on any of the physical fitness measures. Conclusion This investigation documented injury diagnoses, activities associated with injury, and changes in physical fitness, and demonstrated that higher levels of physical fitness were associated with lower injury risk.
Vessels of broad-leaved trees have been analyzed to study how trees deal with various environmental factors. Cambial injury, in particular, has been reported to induce the formation of narrower conduits. Yet, little or no effort has been devoted to the elaboration of vessel sampling strategies for retrospectiveinjury detection based on vessel lumen size reduction. To fill this methodological gap, four wounded individuals each of grey alder (Alnus incana (L.) Moench) and downy birch (Betula pubescens Ehrh.) were harvested in an avalanche path. Earlywood vessel lumina were measured and compared for each tree between the injury ring built during the growing season following wounding and the control ring laid down the previous year. Measurements were performed along a 10 mm wide radial strip, located directly next to the injury. Specifically, this study aimed at (i) investigating the intra-annual duration and local extension of vessel narrowing close to the wound margin and (ii) identifying an adequate sample of earlywood vessels (number and intra-ring location of cells) attesting to cambial injury. Based on the results of this study, we recommend analyzing at least 30 vessels in each ring. Within the 10 mm wide segment of the injury ring, wound-induced reduction in vessel lumen size did not fade with increasing radial and tangential distances, but we nevertheless advise favoring early earlywood vessels located closest to the injury. These findings, derived from two species widespread across subarctic, mountainous, and temperate regions, will assist retrospectiveinjury detection in Alnus, Betula, and other diffuse-porous species as well as future related research on hydraulic implications after wounding. PMID:22761707
The purpose of this article was to describe and analyze the nursing management of head-injured soldiers by military nurses serving in the Vietnam War. This study used traditional historical methods and a military history framework. Primary sources included original military reports, letters, and policies from the Vietnam War period (located in the archives of the Army Medical Department, Office of Medical History in Falls Church, VA); journal articles of the time period; and autobiographical texts. Secondary sources consisted of biographical and historical texts and Web sites of historical societies. Findings supported that advances in medicine, nursing, and technology throughout the 1960s have an overall positive impact on patient care in a combat zone. The Vietnam War was a time when new theories in the management of head injuries led directly to overall improvements in survival. In conclusion, nurses were professionally and emotionally challenged on a near daily basis but were able to directly apply new nursing science in a combat environment to help improve survivability for those who may not have previously survived off the battlefield. PMID:22555353
A number of long-distance running events are held each year in the United States; the Army Ten Miler (ATM) is one such race held annually in Washington, DC. The purpose of the present study was to retrospectively analyze medical encounters for runners participating in the ATM from 1998 to 2004. Of the estimated 91,750 runners over the 6-year period, 73,100 participants finished the race and were included in the data analysis. Demographic and injury data were collected from medical records of participants who received medical care while participating in the ATM, and injury-related factors were assessed. The most common category of injury was musculoskeletal (44%), followed by medical-related problems (27%) and dermatological injuries (27%). Similar to marathon and ironman races, ATM injury rates correlate with race-day temperature and dew point. Overall, however, the injury rates observed at the ATM were relatively low compared to those reported for longer distance events. Finally, we detail the medical coverage provided at the ATM, as this coverage could be used as a guide for similarly distanced races. PMID:23356120
Pasquina, Paul F; Griffin, Sarah C; Anderson-Barnes, Victoria C; Tsao, Jack W; O'Connor, Francis G
BackgroundThe purpose of this retrospective study was to determine the frequency of occurrence of visual field defects in a sample of visually symptomatic, ambulatory outpatients who have acquired brain injury (ABI), either traumatic brain injury (TBI) or cerebral vascular accident (CVA).
Irwin B. Suchoff; Neera Kapoor; Kenneth J. Ciuffreda; Daniella Rutner; Esther Han; Shoshana Craig
During the War in Croatia from 1991 to 1992, we conducted an epidemiological study of the most frequent skin changes on the feet of 1,702 Croatian soldiers stationed in trenches and exposed to direct war activities. We saw significant increases in dermatomycosis, hyperhydrosis, and mechanical injury to the skin of the feet. Soldiers involved in this study did not have any specific medications or powders available as standard gear to prevent any of these foot diseases, but upon physical examination they received treatment. We can conclude that, in war situations, conditions are sufficient to cause an increased number of dermatomycosis, hyperhydrosis and chronic mechanical injuries of the foot. This study suggests the need for planned prevention to avoid these foot diseases in combat situations. PMID:18751600
The factors assumed to exert an influence on the outcomes of 176 patients who sustained head injuries through projectiles during the Croatian War were evaluated. The type of projectile, wound age, retained foreign bodies, and patient sex and age had no significant influence on outcome. Patients with a Glasgow Coma Scale score of 3 to 5 had 7.3 times higher relative risk of poor outcome than those with a score of 6 to 15. Patients with penetrating injuries (47%), with a projectile's path traversing both hemispheres (45.5%), and with intracranial hematomas (49%) had significantly poorer outcomes than patients without such lesions. Infections were more common in patients with retained foreign bodies in wounds that were older than 48 hours (43%) and in patients with cerebrospinal fluid fistulas (50%). In assessing the outcomes of missile head injuries in wartime, the Glasgow Coma Scale score, type of head wound, site of skull penetration, endocranial projectile path, intracranial hematomas, and complications, especially infectious, represent reliable predictors of outcome. PMID:9695616
STUDY OBJECTIVE—To examine the impact of non-fatal war related injuries on physical disability in a group of war wounded civilians and to assess their needs.?DESIGN—Cross sectional study. Home interviews were conducted using a structured interview schedule around one month after the injury, to assess impairments, disabilities, and needs.?STUDY POPULATION AND SETTING—War wounded persons in towns and villages in South Lebanon during the attack "Grapes of Wrath" in 1996.?RESULTS—The majority of the study population were young and in their productive age, mostly injured in the street or while hiding in open shelters. Around half of the injuries resulted in impairments, but, there were no age, gender or geographical differentials by severity of impairment. Almost one third (29%) of the students enrolled in schools at the time of the injury reported failure to continue their education and 42% of the working members lost their jobs with no potential for 34% of them to resume their former jobs. The impact of the injury on impairments, motor disabilities and physical independence was highest for injuries to the lower limbs (age and sex adjusted risk ratio (RR) 1.62, 95% confidence intervals (CI) 1.25, 2.10; 2.98, 95% CI 2.09, 4.23; and 2.13, 95% CI 1.39, 3.27, respectively). Despite the acute and early relief services provided by all those concerned at the time of the injury, when asked about unmet needs, the majority of the impaired (66%) reported the need for additional services, mostly medical in nature. The degree of disability was a salient factor for the need for rehabilitative services but not for medical services.?CONCLUSIONS—The chronic and diverse needs of people with warinjuries are often neglected and underestimated by the governmental institutions and relief agencies. Research funds as well as services should be allocated to tackle the long term and continuous health and social needs of those injured and their families.???Keywords: warinjuries; impairments and disabilities
A retrospective multicentric series of 54 cases of knee trauma with acute ischemia by popliteal artery injury were analyzed. These high-energy traumas involved 25 dislocations and 29 fractures, 11 involving distal femur, 15 the proximal tibia and 3 a floating knee. There were 45 men and 7 women, mean age 42 years. Thirty-three patients suffered multiple injuries. The knee injury was open in 25 cases and associated with sciatic paralysis in 32. Vascular repair was almost always achieved with bypass surgery. An external fixator was used in 39 patients. Vascular repair was unsuccessful in three cases requiring amputation, all three cases involving fractures. There were also six secondary amputations due to muscle necrosis or septic nonunion. The rate of complete recovery of the sciatic was 25%. The rate of nonunion was 37%, half due to infection. Outcome assessed at at least one year follow-up was moderate with frequent functional sequelae. The analysis of these results and data reported in the literature provided indications for diagnostic and therapeutic propositions. PMID:17088747
This paper describes how German psychiatrists in two World Wars treated psychologically injured soldiers, and the concepts of related illnesses which they developed. The literature is reviewed, and symptomatolgy of patients and therapeutic practice in the wars are compared. By 1916 German psychiatrists had already established a concept of illness that continued to be used until World War II and
Ruth Kloocke; Heinz-Peter Schmiedebach; Stefan Priebe
the risk of needlestick injury (NI) in nurses caring the risk of needlestick injury (NI) in nurses caring the risk of needlestick injury (NI) in nurses caring the risk of needlestick injury (NI) in nurses caring the risk of needlestick injury (NI) in nurses caring the risk of needlestick injury (NI) in nurses caring the risk of needlestick injury (NI)
Jennifer M. Lee; Marc F. Botteman; Lars Nicklasson; David Cobden; Chris L. Pashos
In February 1945, the Canadian government agreed to provide the Everest and Jennings folding, self-propelled wheelchair to all World War II veterans with spinal cord injury. These wheelchairs replaced wooden and wicker invalid wheelchairs that were usually assigned to hospital wards rather than to individuals. Veterans with spinal cord injury were among the first group of Canadians to use these
The first Persian Gulf War, an offensive led by US and coalition troops in January 1991, followed the August 1990 Iraqi invasion of Kuwait. The war was over on February 28, 1991; an official cease-fire was signed in April 1991, and the last US troops who ...
Objective: To review injury occurrence and to evaluate various injury surveillance systems used on recent deployments of U.S. military personnel.Background: Injuries that occur in a deployed military force are more likely to have an immediate and detrimental effect on the military mission than those in garrison or training. These injuries have a direct impact on deployed personnel and unit readiness
Introduction—Death rates among US veterans of the Persian Gulf War were lower than rates among non-deployed veterans and the US population at large, with the exception of injury deaths; returning veterans were at significantly greater risk of injury mortality. Similar patterns of excess injury mortality were documented among US and Australian veterans returning from Vietnam. In spite of these consistent findings little has been done to explain these associations and in particular to determine whether or not, and how, war related exposures influence injury risk among veterans returning home after deployments. Hypothesized pathways—Several potential pathways are proposed through which injury might be related to deployment. First, increases in injury mortality may be a consequence of depression, post-traumatic stress disorder, and symptoms of other psychiatric conditions developed after the war. Second, physical and psychological traumas experienced during the war may result in the postwar adoption of "coping" behaviors that also increase injury risk (for example, heavy drinking). Third, greater injury risk may be the indirect consequence of increased experiences of ill defined diseases and symptoms reported by many returning veterans. Fourth, veterans may experience poorer survivability for a given injury event resulting in greater mortality but not morbidity. Finally, the process that selects certain individuals for deployment may lead to a spurious association between deployment status and injury mortality by preferentially selecting individuals who are risk takers and/or exposed to greater hazards. Conclusions—More research and attention from policymakers is needed to clarify the link between deployment and postwar increased risk of injury.
Background and Aim: Maxillofacial trauma is frequently encountered in the Accident and Emergency department of hospitals either as an isolated injury or as a part of multiple injuries to the head, neck, chest, and abdomen. This study aimed to assess retrospectively the profile of maxillofacial injuries in patients reporting to a tertiary care hospital in East Delhi. Materials and Methods: The study was conducted in the Department of Dentistry, UCMS and GTB Hospital, Delhi. Dental case record sheets of 1000 medicolegal cases reporting to the hospital emergency were scrutinized and various demographic and epidemiologic factors, including the patient's age and gender, time and day of reporting, and the etiology and nature of injury were recorded. Results: The peak incidence of maxillofacial injury was observed in the age group of 21–30 years, with males outnumbering females in all age groups. Maximum number of trauma cases reported in late evening hours, especially on weekends. Interpersonal assault was the primary etiological factor followed by road traffic accidents. Soft tissue injuries were very common and maxillofacial fractures, when present, were most frequently observed in the mandible followed by the midface. Conclusion: The changing trend of the etiology of maxillofacial injuries in East Delhi necessitates strict legislation against violence and education in alcohol abuse. Periodic review of driving skills and stricter implementation of traffic rules in this area is a must to minimize the physical, psychological, and emotional distress associated with maxillofacial trauma.
The American Civil War was a sad, ugly war. Nearly 2% of the U.S. population participated, and more than 600,000 died dur- ing the 4 years of conflict. The prevalence of casualties and disease, cou- pled with advances in battlefield technology and medicine, made the time period, 1861-1865, a pivotal moment for American medicine. Veterans' disabling or disfiguring wounds led
Background & objectives: Pedestrians contribute to 30-40 per cent of all road traffic injuries in India. However, there is a paucity of literature on pedestrian head injury as compared to two wheeler trauma. The purpose of the present study was to study the pattern of pedestrian injuries and their outcome with a special focus on head injuries. Methods: The study was conducted in two parts in the Trauma Center at National Institute of Mental Health & Neuro Sciences, Bangalore. A retrospective study was conducted at the casualty services of the hospital in which 529 consecutive pedestrians who sustained injury in a road traffic accident were studied from June to September 2009. In the second part, records from the hospital mortuary were retrospectively analyzed from 2007 to 2009. An analysis of 326 patients who died as a pedestrian in road accidents during this period was performed. Results: Patients in both paediatric and elderly age groups constituted 47.6 per cent (252/529) of all casualty admissions. Majority of the pedestrian injuries (41.7%, 221/529) occurred between 1600 - 2100 h; 87.1 per cent of all patients received some primary care before admission. The most common offending vehicle was a two wheeler (49.1%, 260/529). At the time of admission, 55.2 per cent (292/529) patients had sustained a moderate or severe head injury (GCS 3-13), and 40.5 per cent (214/529) had an abnormal CT scan. In addition, 90.4 per cent (478/529) patients had also sustained associated injuries. Major thoracoabdominal trauma was seen in 4 per cent and spine injury in 2.3 per cent of the patients. The mortality rate was 6.6 per cent. In the postmortem group, pedestrian deaths constituted 26.2 per cent of all the postmortems conducted. Two wheelers were the offending vehicle in the majority of the fatal crashes (39.9%). Interpretation & conclusions: Pedestrian injuries form a major part of the workload of a neurotrauma emergency. Majority of them sustained moderate to severe head injury. More attention, infrastructure and strict implementation of rules may help reduce this burden.
Pruthi, Nupur; Ashok, M.; Shiva, Kumar V.; Jhavar, Ketaki; Sampath, S.; Devi, B. Indira
Background Playground injuries are fairly common and can require hospitalization and or surgery. Previous research has suggested that compliance with guidelines or standards can reduce the incidence of such injuries, and that poorer children are at increased risk of playground injuries. Objective The objective of this study was to determine the association between playground injury and school socioeconomic status before and after the upgrading of playground equipment to meet CSA guidelines. Methods Injury data were collected from January 1998-December 1999 and January 2004 - June 2007 for 374 elementary schools in Toronto, Canada. The objective of this study was to investigate the effect of a program of playground assessment, upgrading, and replacement on school injury rates and socio-economic status. Injury rates were calculated for all injuries, injuries that did not occur on equipment, and injuries on play equipment. Poisson regression was performed to determine the relationship between injury rates and school socio-economic status. Results Prior to upgrading the equipment there was a significant relationship between socio-economic status and equipment-related injuries with children at poorer schools being at increased risk (Relative risk: 1.52 [95% CI = 1.24-1.86]). After unsafe equipment was upgraded, the relationship between injury and SES decreased and was no longer significant (RR 1.13 [95% CI = 0.95-1.32]). Conclusions Improvements in playground equipment can result in an environment in which students from schools in poorer neighbourhoods are no longer at increased risk of injuries on play equipment.
Objectives To identify potentially fatal injury patterns in explosive blast fatalities in order to focus research and mitigation strategies, to further improve survival rates from blast trauma. Design Retrospective cohort study. Participants UK military personnel killed by improvised explosive device (IED) blasts in Afghanistan, November 2007–August 2010. Setting UK military deployment, through NATO, in support of the International Security Assistance Force (ISAF) mission in Afghanistan. Data sources UK military postmortem CT records, UK Joint Theatre Trauma Registry and associated incident data. Main outcome measures Potentially fatal injuries attributable to IEDs. Results We identified 121 cases, 42 mounted (in-vehicle) and 79 dismounted (on foot), at a point of wounding. There were 354 potentially fatal injuries in total. Leading causes of death were traumatic brain injury (50%, 62/124 fatal injuries), followed by intracavity haemorrhage (20.2%, 25/124) in the mounted group, and extremity haemorrhage (42.6%, 98/230 fatal injuries), junctional haemorrhage (22.2%, 51/230 fatal injuries) and traumatic brain injury (18.7%, 43/230 fatal injuries) in the dismounted group. Conclusions Head trauma severity in both mounted and dismounted IED fatalities indicated prevention and mitigation as the most effective strategies to decrease resultant mortality. Two-thirds of dismounted fatalities had haemorrhage implicated as a cause of death that may have been anatomically amenable to prehospital intervention. One-fifth of the mounted fatalities had haemorrhagic trauma which currently could only be addressed surgically. Maintaining the drive to improve all haemostatic techniques for blast casualties, from point of wounding to definitive surgical proximal vascular control, alongside the development and application of novel haemostatic interventions could yield a significant survival benefit. Prospective studies in this field are indicated.
Singleton, James A G; Gibb, Iain E; Hunt, Nicholas C A; Bull, Anthony M J; Clasper, Jonathan C
What's known on the subject? and What does the study add? Prior to the First World War, traumatic injuries to the spinal cord rapidly led to death from severe infections of the bladder. During the Second World War, Ludwig Guttmann resurrected the use of intermittent catheterisation at Stoke Mandeville Hospital, by meticulous attention to detail and was so successful, that this method was introduced into general urological practice. Historical review of the management of the bladder in patients with spinal injuries. Spinal injury patients--literature review--personal experience at Stoke Mandeville Hospital. Review of the different methods of catheterisation from the 19th century to today. Methods learned from the management of the bladder of spinal injuries patients were adopted into mainstream urology. PMID:21592294
Cervical spine injuries in Rugby Union are a concerning issue at all levels of the game. The primary aim of this retrospective analysis conducted in a professional Rugby Union squad was to determine whether a 26-week isometric neck strengthening intervention program (13-week strengthening phase and 13-week maintenance phase) was effective in reducing the number and severity of cervical spine injuries. The secondary aim was to determine whether at week five, where the program had been the similar for all players, there was increased isometric neck strength. All 27 players who were common to both the 2007-2008 and 2008-2009 seasons were included in this analysis and data was extracted from a Sports Medicine/Sports Science database which included the squad's injury records. Primary outcome variables included; the number of cervical spine injuries and the severity of these injuries as determined by the total number of days lost from training and competition. Secondary outcome variables included isometric neck strength in flexion, extension and left and right lateral flexion. Using non-parametric statistical methods, no significant differences were evident for the total number of cervical spine injuries (n = 8 in 2007-2008, n = 6 in 2008-2009) or time loss due to these injuries (100 days in 2007-2008, 40 days in 2008-2009). However, a significant (p = 0.03) reduction in the number of match injuries was evident from 2007-2008 (n = 11) to 2008-09 (n = 2). Non-significant increases in isometric neck strength were found in all directions examined. A significant reduction in the number of match injuries was evident in this study. However, no other significant changes to primary outcome variables were achieved. Further, no significant increases in isometric neck strength were found in this well-trained group of professional athletes. Key Points While many authors have proposed that neck strengthening could be an effective strategy in preventing cervical spine injuries in Rugby Union, there is currently little information in the literature pertaining to how such a study might be conducted. A significant decrease in the number of injuries recorded in matches can be achieved using a specific neck strengthening program at the elite level. In an elite rugby union team as investigated in this study a significant increase in neck strength is difficult to achieve in a short period of time such as five weeks.
Cervical spine injuries in Rugby Union are a concerning issue at all levels of the game. The primary aim of this retrospective analysis conducted in a professional Rugby Union squad was to determine whether a 26-week isometric neck strengthening intervention program (13-week strengthening phase and 13-week maintenance phase) was effective in reducing the number and severity of cervical spine injuries. The secondary aim was to determine whether at week five, where the program had been the similar for all players, there was increased isometric neck strength. All 27 players who were common to both the 2007-2008 and 2008-2009 seasons were included in this analysis and data was extracted from a Sports Medicine/Sports Science database which included the squad's injury records. Primary outcome variables included; the number of cervical spine injuries and the severity of these injuries as determined by the total number of days lost from training and competition. Secondary outcome variables included isometric neck strength in flexion, extension and left and right lateral flexion. Using non-parametric statistical methods, no significant differences were evident for the total number of cervical spine injuries (n = 8 in 2007-2008, n = 6 in 2008-2009) or time loss due to these injuries (100 days in 2007-2008, 40 days in 2008-2009). However, a significant (p = 0.03) reduction in the number of match injuries was evident from 2007-2008 (n = 11) to 2008-09 (n = 2). Non-significant increases in isometric neck strength were found in all directions examined. A significant reduction in the number of match injuries was evident in this study. However, no other significant changes to primary outcome variables were achieved. Further, no significant increases in isometric neck strength were found in this well-trained group of professional athletes. Key PointsWhile many authors have proposed that neck strengthening could be an effective strategy in preventing cervical spine injuries in Rugby Union, there is currently little information in the literature pertaining to how such a study might be conducted.A significant decrease in the number of injuries recorded in matches can be achieved using a specific neck strengthening program at the elite level.In an elite rugby union team as investigated in this study a significant increase in neck strength is difficult to achieve in a short period of time such as five weeks. PMID:24149163
This article reviews the growing numbers of returning military personnel attending higher education based on emerging national trends, including the new GI Educational Bill, amendments to the ADA, and the rising unemployment rate. The trauma of war and the high survival rate have resulted in a high percentage of veterans returning from the Global…
Background The participation of children and adolescents in sports has become increasingly frequent, including soccer. This growing involvement gives rise to concerns regarding the risk of sports injuries. Therefore, the aim of the present study was to describe the musculoskeletal injuries in young soccer players. Methods 301 male soccer players with a mean age 14.67?±?2.08 years were randomly recruited. The Referred Condition Inquiry was used to collect information on the mechanism of injury and anatomic site affected as well as personal data on the participants. The variables were analyzed based on the degree of association using Goodman’s test for contrasts between multinomial populations, with the p?0.05. Results Among the 301 athletes, 24.25% reported at least one injury. With regard to height, taller individuals reported more injuries than shorter individuals (62.5% and 37.5%, respectively; p?0.05). Injuries were more frequent among players with a training duration greater than five years (69.65%) in comparison to those who trained for a shorter duration (30.35%) (p?0.05). The lower limbs, especially the ankle/foot and knee, were the most affected anatomic sites. Impact was the most common mechanism of injury. Conclusion The young practitioners of soccer analyzed had low rates of injury. The main causal mechanism was the impact. A taller height and longer exposure to training were the main risk factors for injury among young soccer players.
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The purpose of this study was to determine the num ber and types of injuries which occur to competitive and noncompetitive gymnasts in private clubs. Sec ondary purposes were to determine which events were most hazardous, and whether or not the ratio between participant and instructor, the availability of safety equipment, and the conditioning programs used af fected the injury
Trauma to the lower extremity associated with fracture and vascular injury has a high reported incidence of limb loss. This study reviews and contrasts the experience at Tulane University affiliated hospitals (TU) and the American University of Beirut (AUB) (1980 to 1984), both of which are surrounded by hostile action. Seventy-six male patients (28--AUB, 48--TU) with an average age of 21.2 (TU) and 24.4 (AUB) years (range, 17 to 42) presented with popliteal artery injuries with (34 [14--AUB; 20--TU] ) and without (42 [14--AUB; 28--TU]) associated fractures. All patients were clinically evaluated, angiogrammed, begun on cephalosporin antibiotics, and operated upon. Fractures were treated with extraskeletal fixation or splinting. Time of initiation of operative therapy varied from less than one to greater than 12 hours. When necessary, contralateral limb reversed saphenous vein was used as an interposition graft. Fasciotomies were done for popliteal artery injuries with greater than 6 hours' ischemic time, and combined popliteal artery and popliteal vein injuries. Nine limbs of 76 at risk were amputated: 5/34 (2/14--AUB; 3/20--TU) with popliteal injuries and fractures, and 4/42 (1/14--AUB; 3/28--TU) with popliteal injuries and without fractures. Five of the amputated limbs had initiation of therapy at greater than 12 hours; three had initiation of therapy at greater than 8 hours. Good communication between surgeons, prompt fracture reduction, antibiotics, angiography, and total repair of the vascular injury resulted in limb salvage in 30/40 patients with popliteal artery injury and fracture, and in 39/42 patients with popliteal artery injury without fracture.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3385829
OBJECTIVE: To determine differences between hospitalized injured children who had preinjury cognitive impairments (IMPs) and children who had no preinjury cognitive conditions (NO).\\u000aDESIGN: Comparative analysis, excluding fatalities, of patients with IMP (n = 371) with patients with NO (n = 58 745), aged from 0 to 19 years.\\u000aMAIN OUTCOME MEASURES: Demographics, injury characteristics, injury nature and severity, use
Forchheimer MB, Richards JS, Chiodo AE, Bryce TN, Dyson-Hudson TA. Cut point determination in the measurement of pain and its relationship to psychosocial and functional measures after traumatic spinal cord injury: a retrospective Model Spinal Cord Injury System analysis.
Martin B. Forchheimer; J. Scott Richards; Anthony E. Chiodo; Thomas N. Bryce; Trevor A. Dyson-Hudson
Increased awareness of the spleen's immunologic function and the risk of overwhelming post-splenectomy sepsis has aroused interest in methods of splenic preservation in patients with abdominal trauma. During an 8-year period, 164 patients with documented blunt splenic injuries were treated in accordance with an evolving therapeutic program. Definitive treatment included nonoperative management in 19 patients (group I, 11.6%), repair in 50 (group II, 30.5%) and splenectomy in 95 (group III, 57.9%). Mortality and morbidity were higher in group III (6.3% and 34.3% respectively) according to the Injury Severity Score (ISS 33.3 +/- 13). In group II one patient died from severe head injuries. Only one patient failed nonoperative management and required laparotomy with resultant splenectomy on hospital day 10. Observation without surgery has proved to be safe and effective in children (failure incidence less than 10%); success rates in adults would not parallel the experience reported in children because of differences in anatomy and mechanism of injury. Selective criteria, including hemodynamic stability after initial fluid challenge, normal level of consciousness, lack of peritoneal signs, transfusion requirements of less than 4 units of blood, CT demonstration of minor splenic lesion and exclusion of associated abdominal injuries requiring surgery, make eligible for nonoperative management 12 to 18% of adults with anticipated success in over 75%. Operative repair or partial splenectomy can be employed in many patients, both adults and children, with a 1% incidence of rebleeding necessitating reoperation. PMID:7808662
Background In Switzerland there are about 150,000 equestrians. Horse related injuries, including head and spinal injuries, are frequently treated at our level I trauma centre. Objectives To analyse injury patterns, protective factors, and risk factors related to horse riding, and to define groups of safer riders and those at greater risk Methods We present a retrospective and a case-control survey at conducted a tertiary trauma centre in Bern, Switzerland. Injured equestrians from July 2000 - June 2006 were retrospectively classified by injury pattern and neurological symptoms. Injured equestrians from July-December 2008 were prospectively collected using a questionnaire with 17 variables. The same questionnaire was applied in non-injured controls. Multiple logistic regression was performed, and combined risk factors were calculated using inference trees. Results Retrospective survey A total of 528 injuries occured in 365 patients. The injury pattern revealed as follows: extremities (32%: upper 17%, lower 15%), head (24%), spine (14%), thorax (9%), face (9%), pelvis (7%) and abdomen (2%). Two injuries were fatal. One case resulted in quadriplegia, one in paraplegia. Case-control survey 61 patients and 102 controls (patients: 72% female, 28% male; controls: 63% female, 37% male) were included. Falls were most frequent (65%), followed by horse kicks (19%) and horse bites (2%). Variables statistically significant for the controls were: Older age (p = 0.015), male gender (p = 0.04) and holding a diploma in horse riding (p = 0.004). Inference trees revealed typical groups less and more likely to suffer injury. Conclusions Experience with riding and having passed a diploma in horse riding seem to be protective factors. Educational levels and injury risk should be graded within an educational level-injury risk index.
Background The amount and identity of metals incorporated into "weapons without fragments" remain undisclosed to health personnel. This poses a long-term risk of assumption and contributes to additional hazards for victims because of increased difficulties with clinical management. We assessed if there was evidence that metals are embedded in "wounds without fragments" of victims of the Israeli military operations in Gaza in 2006 and 2009. Methods Biopsies of "wounds without fragments" from clinically classified injuries, amputation (A), charred (C), burns (B), multiple piercing wounds by White Phosphorus (WP) (M), were analyzed by ICP/MS for content in 32 metals. Results Toxic and carcinogenic metals were detected in folds over control tissues in wound tissues from all injuries: in A and C wounds (Al, Ti, Cu, Sr, Ba, Co, Hg, V, Cs and Sn), in M wounds (Al, Ti, Cu, Sr, Ba, Co and Hg) and in B wounds (Co, Hg, Cs, and Sn); Pb and U in wounds of all classes; B, As, Mn, Rb, Cd, Cr, Zn in wounds of all classes, but M; Ni was in wounds of class A. Kind and amounts of metals correlate with clinical classification of injuries, exposing a specific metal signature, similar for 2006 and 2009 samples. Conclusions The presence of toxic and carcinogenic metals in wound tissue is indicative of the presence in weapon inducing the injury. Metal contamination of wounds carries unknown long term risks for survivors, and can imply effects on populations from environmental contamination. We discuss remediation strategies, and believe that these data suggest the need for epidemiological and environmental surveys.
A case of delayed presentation of a traumatic false aneurysm in the left arm 50 years after penetrating injury sustained during World War II is described. The original injury resulted in brachial artery occlusion and complete median nerve palsy. The false aneurysm presented with a spontaneous, contained rupture. Surgical repair was performed after duplex ultrasound localization of the lesion to a small collateral artery lateral to the elbow, thereby avoiding dissection in the densely scarred tissue plains in the antecubital fossa. Duplex ultrasound was also used intraoperatively to facilitate localization of the aneurysm neck and to confirm absence of flow in the sac after repair. A brief historical review of traumatic false aneurysms caused by combat injuries, is provided. The progress in the treatment of such injuries gained by wartime experience is reviewed. PMID:9253933
The Koje Island prison riots were one of the great military cockups of the Korean War, a war which in general provided a rich source of military cockups. The American leadership of United Nations Command (UNC) in Korea sought to turn the stigma of the Koje Island disaster from an American cockup into a United Nations cockup. The involvement of
Somatosensory evoked potential (SSEP) monitoring is used to prevent nerve damage in spine surgery and to detect changes in upper extremity nerve function. Up- per extremity SSEP conduction changes may indicate impending nerve injury. We investigated the effect of operative positioning on upper extremity nerve func- tion retrospectively in 1000 consecutive spine surgeries that used SSEP monitoring. The vast majority
Ihab R. Kamel; Elizabeth T. Drum; Stephen A. Koch; Joseph A. Whitten; John P. Gaughan; Rodger E. Barnette; Woodrow W. Wendling
BACKGROUND AND PURPOSE: The impact of traumatic brain injury (TBI) on the pathogenesis of Alzheimer disease (AD) is still controversial. The aim of our retrospective autopsy study was to assess the impact of TBE and ApoE allele frequency on the development of AD. MATERIAL AND METHODS: We examined 1. the incidence of AD pathology (Braak stageing, CERAD, NIA-Reagan Institute criteria)
Kurt A Jellinger; Werner Paulus; Christian Wrocklage; Irene Litvan
Studies of the relationship between explicit episodic memory of a traumatic event (MTE) and posttraumatic stress disorder (PTSD) are inconclusive. The authors examined whether memory for the details of the traumatic event as reported by patients with mild traumatic brain injury was associated with the development of PTSD. In a retrospective study of 120 participants, MTE was found to be
Yael Caspi; Sharon Gil; Irit Zilberman Ben-Ari; Danny Koren; Judith Aaron-Peretz; Ehud Klein
Purpose: This retrospective study assessed the overall outcome of dental implants used for the rehabilitation of war-injured victims during the 6-year period from 1992 to 1998.Materials and Methods: Seventy-three patients suffering various maxillofacial warinjuries were rehabilitated using the Branemark implant system. A total of 442 implants were placed. The patients ranged from 20 to 61 years of age, with
Mohammad Hosein Kalantar Motamedi; Hamid Mahmood Hashemi; Mohammad Ghasem Shams; Abbas Nakhaie Nejad
This book examines the potential radiation hazards and environmental impacts of nuclear weapons. Topics considered include medical responsibility and thermonuclear war, the threat of nuclear war, nuclear weaponry, biological effects, radiation injury, decontamination, long-term effects, ecological effects, psychological aspects, the economic implications of nuclear weapons and war, ethics, civil defense, arms control, nuclear winter, and long-term biological consequences of nuclear
Mild traumatic brain injury (TBI) is a common source of morbidity from the wars in Iraq and Afghanistan. With no overt lesions on structural MRI, diagnosis of chronic mild TBI in military veterans relies on obtaining an accurate history and assessment of behavioral symptoms that are also associated with frequent comorbid disorders, particularly posttraumatic stress disorder (PTSD) and depression. Military veterans from Iraq and Afghanistan with mild TBI (n=30) with comorbid PTSD and depression and non-TBI participants from primary (n=42) and confirmatory (n=28) control groups were assessed with high angular resolution diffusion imaging (HARDI). White matter-specific registration followed by whole-brain voxelwise analysis of crossing fibers provided separate partial volume fractions reflecting the integrity of primary fibers and secondary (crossing) fibers. Loss of white matter integrity in primary fibers (p < .05; corrected) was associated with chronic mild TBI in a widely distributed pattern of major fiber bundles and smaller peripheral tracts including the corpus callosum (genu, body, splenium), forceps minor, forceps major, superior and posterior corona radiata, internal capsule, superior longitudinal fasciculus, and others. Distributed loss of white matter integrity correlated with duration of loss of consciousness and most notably with “feeling dazed or confused,” but not diagnosis of PTSD or depressive symptoms. This widespread spatial extent of white matter damage has typically been reported in moderate to severe TBI. The diffuse loss of white matter integrity appears consistent with systemic mechanisms of damage shared by blast- and impact-related mild TBI that involves a cascade of inflammatory and neurochemical events.
Introduction: Muscle atrophy, spasticity, and deformity are among long term complication of spinal cord injury (SCI) veterans. There are numerous studies evaluating effect of functional electrical stimulation on muscle properties of SCI people, but less research has focused on the benefits of passive cycling in the management of spasticity and improving ROM of lower limbs in individuals with SCI. Aims: To evaluate the effect of electrical passive cycling on passive range of movement spasticity and electrodiagnostic parameters in SCI veterans. Methods: Sixty-four SCI veterans referred to two clinical and research center in Tehran were recruited in this prospective clinical trial. The subjects were divided into two groups according to electrical passive cycling usage: (1) patients who did not use pedal exercise (control group), (2) patients used Electrical passive cycling up to optimal level (intervention group). Main outcome measures included hip, knee, and ankle range of motion, spasticity scale, and electrodiagnostic parameters including F-Wave Consistency, F-Wave Amplitude, H/M Ratio, F/M Ratio, H-Reflex Onset Latency, and H-Reflex Amplitude. Data were recorded at the time of receiving and 1?year after pedal exercise usage. Results: Sixty-four SCI patients including 95.3% male, 4.7% female with mean age 43?years old were included in this study. All patients except one suffered from complete SCI. The involved spinal levels were cervical (17.2%), upper thoracic (34.4%), lower thoracic (45.3%), and lumbar (3.1%). Spasticity scale decreased significantly after passive cycling in group 2. Also hip, knee, and ankle ROM in group 2 were significantly improved after pedal exercise. There was a significant difference in H max/M max (RT<) and F/M ratio after versus before electric passive cycling system in group 2. Conclusion: These findings suggest that passive rhythmic leg exercise can lead to decrease in spasticity, increase in passive ROM of lower limbs and improvement in electrodiagnostic parameters of spasticity in patients with SCI. PMID:21734906
This book examines the potential radiation hazards and environmental impacts of nuclear weapons. Topics considered include medical responsibility and thermonuclear war, the threat of nuclear war, nuclear weaponry, biological effects, radiation injury, decontamination, long-term effects, ecological effects, psychological aspects, the economic implications of nuclear weapons and war, ethics, civil defense, arms control, nuclear winter, and long-term biological consequences of nuclear war.
This article describes McIndoe's revolutionary methods of burn treatment and rehabilitation of patients with burn injury and outlines his personality traits that made him one of the most important plastic surgeons of the twentieth century. As a consultant plastic surgeon to the Royal Air Force, he set up a plastic surgery unit in the Queen Victoria Hospital in East Grinstead. By using biographical data and photography, McIndoe's work on burns treatment and the challenges he faced are presented. Before World War II, little was known about the treatment of severe burns and their complications, and even less was done about the rehabilitation and social reintegration of patients with burn injury. McIndoe changed all that by developing new techniques for the management and reconstruction of burn injuries. He helped his patients become and get accepted as a normal part of society again. The patients with burn injury treated by him formed the Guinea Pig Club. Sir Archibald Hector McIndoe, a charismatic plastic surgeon with an uncanny instinctive knowledge of psychology, recognized early that the rehabilitation of a burned patient was as important as the reconstruction of his physical body. His therapeutic approach to patients with burn injury was mental and physical. PMID:21422943
Geomelas, Menedimos; Ghods, Mojtaba; Ring, Andrej; Ottomann, Christian
We sought to analyze the early results of civil and war peripheral arterial injury treatment and to identify risk factors associated with limb loss. Between 1992 and 2001, data collected retrospectively and prospectively on 413 patients with 448 peripheral arterial injuries were analyzed. Of these, there were 140 patients with warinjuries and 273 patients with civil injuries. The mechanism of injury was gunshot in 40%, blunt injury in 24%, explosive trauma in 20.3%, and stabbing in 15.7% of the cases. The most frequently injured vessels were the femoral arteries (37.3%), followed by the popliteal (27.8%), axillary and brachial (23.5%), and crural arteries (6.5%). Associated injuries, which included bone, nerve, and remote injuries affecting the head, chest, or abdomen, were present in 60.8% of the cases. Surgery was carried out on all patients, with a limb salvage rate of 89.1% and a survival rate of 97.3%. In spite of a rising trend in peripheral arterial injuries, our total and delayed amputation rates remained stable. On statistical analysis, significant risk factors for amputation were found to be failed revascularization, associated injuries, secondary operation, explosive injury, warinjury (p < .01) and arterial contusion with consecutive thrombosis, popliteal artery injury, and late surgery (p < .05). Peripheral arterial injuries, if inadequately treated, carry a high amputation rate. Explosive injuries are the most likely to lead to amputations, whereas stab injuries are the least likely to do so. The most significant independent risk factor for limb loss was failed revascularization. PMID:15996371
Davidovic, Lazar B; Cinara, Ilijas S; Ille, Tanja; Kostic, Dusan M; Dragas, Marko V; Markovic, Dragan M
Suspected deep tissue injury (sDTI) was recently defined as a pressure ulcer category, and knowledge about the evolution of these ulcers is limited. The purpose of this single-site, 2-year, retrospective, IRB-approved study was to increase understanding of the evolution and outcomes of sDTI. Inclusion criteria were hospitalized patients, 18 years or older, with a sDTI confirmed by a wound care nurse. Patient charts and WOC nurse notes were examined and patient demographics and DTI variables abstracted. All patients received standardized, comprehensive care for pressure ulcer prevention and treatment. Seventy-seven (77) patients, average age 67.5 years (range 32-91 years), with 128 sDTIs were identified and included in the study. The majority were men (52, 67.5%) and non-Hispanic Caucasian (68, 88.3%). Twenty-three (23, 31%) were overweight. The most common comorbidities were coronary artery disease (38, 50%) and diabetes mellitus (33, 43%), and the vast majority (67, 88.1%) had altered mobility (67, 88.1%), spent time in the intensive care unit (64, 84.2%), and were incontinent (64, 84.2%). The most common areas involved were the sacrum (51, 39.8%) and the heel/Achilles region (37, 28.9%). Maroon-purple discoloration of intact skin was the most commonly documented presentation (115 ulcers, 89.9%). Average length of follow-up was 6 days (range 1 day to 14 weeks). At the final assessment, 85 sDTIs (66.4%) completely resolved or were progressing toward resolution, 31 remained unchanged and were still documented as purple-maroon discoloration or a blood-filled blister, and deterioration to full-thickness tissue loss occurredin 12 (9.3%). These observations may offer important insights into the evolution of sDTIs. Research is needed to identify sDTI risk factors and most effective protocols of care. PMID:24018390
Blast injuries are becoming increasingly common in military conflicts as the nature of combat changes from conventional to asymmetrical warfare and counter-insurgency. This article describes a retrospective database review of cases from the UK joint theatre trauma registry from 2003 to 2009, containing details of over 3000 patients, mainly injured in Iraq and Afghanistan. During this period, 1678 patients were injured by explosion of whom 113 had evidence of blast lung injury. Of the 50 patients who survived to reach a medical facility, 80 per cent required ventilatory support. Injuries caused by explosion are increasing when compared with those caused by other mechanisms, and blast lung represents a significant clinical problem in a deployed military setting. Management of these patients should be optimized from point of wounding to definitive care.
Background The ability to determine athletic performance in varsity athletes using preseason measures has been established. The ability of pre-season performance measures and athlete’s exposure to predict the incidence of injuries is unclear. Thus our purpose was to determine the ability of pre-season measures of athletic performance to predict time to injury in varsity athletes. Methods Male and female varsity athletes competing in basketball, volleyball and ice hockey participated in this study. The main outcome measures were injury prevalence, time to injury (based on calculated exposure) and pre-season fitness measures as predictors of time to injury. Fitness measures were Apley’s range of motion, push-up, curl-ups, vertical jump, modified Illinois agility, and sit-and-reach. Cox regression models were used to identify which baseline fitness measures were predictors of time to injury. Results Seventy-six percent of the athletes reported 1 or more injuries. Mean times to initial injury were significantly different for females and males (40.6% and 66.1% of the total season (p?0.05), respectively). A significant univariate correlation was observed between push-up performance and time to injury (Pearson’s r?=?0.332, p?0.01). No preseason fitness measure impacted the hazard of injury. Regardless of sport, female athletes had significantly shorter time to injury than males (Hazard Ratio?=?2.2, p?0.01). Athletes playing volleyball had significantly shorter time to injury (Hazard Ratio?=?4.2, p?0.01) compared to those playing hockey or basketball. Conclusions When accounting for exposure, gender, sport and fitness measures, prediction of time to injury was influenced most heavily by gender and sport.
James Baxter Bean published a series of articles in the Southern Dental Examiner in 1862 describing his work with “plaster and its manipulations.” This early experience included a new way of managing jaw fractures, with customized splints uniquely based on pretraumatic occlusion. Bean's oral splints and their method of construction, using an articulator, became the standard of care in the Atlanta region during the American Civil War and, by 1864, throughout The Confederacy. In short course, Bean's approach also swept The Union, following in large part the efforts of a colleague in the North, T.B. Gunning. Thus, what began in the early 1860s in a dental laboratory in the southeast swept the continental United States and revolutionized management of jaw-fractures during, and immediately after, the American Civil War.
James Baxter Bean published a series of articles in the Southern Dental Examiner in 1862 describing his work with "plaster and its manipulations." This early experience included a new way of managing jaw fractures, with customized splints uniquely based on pretraumatic occlusion. Bean's oral splints and their method of construction, using an articulator, became the standard of care in the Atlanta region during the American Civil War and, by 1864, throughout The Confederacy. In short course, Bean's approach also swept The Union, following in large part the efforts of a colleague in the North, T.B. Gunning. Thus, what began in the early 1860s in a dental laboratory in the southeast swept the continental United States and revolutionized management of jaw-fractures during, and immediately after, the American Civil War. PMID:22655119
Children bear disproportionate consequences of armed conflict. The 21st century continues to see patterns of children enmeshed in international violence between opposing combatant forces, as victims of terrorist warfare, and, perhaps most tragically of all, as victims of civil wars. Innocent children so often are the victims of high-energy wounding from military ordinance. They sustain high-energy tissue damage and massive burns - injuries that are not commonly seen in civilian populations. Children have also been deliberately targeted victims in genocidal civil wars in Africa in the past decade, and hundreds of thousands have been killed and maimed in the context of close-quarter, hand-to-hand assaults of great ferocity. Paediatricians serve as uniformed military surgeons and as civilian doctors in both international and civil wars, and have a significant strategic role to play as advocates for the rights and welfare of children in the context of the evolving 'Laws of War'. One chronic legacy of contemporary warfare is blast injury to children from landmines. Such blasts leave children without feet or lower limbs, with genital injuries, blindness and deafness. This pattern of injury has become one of the post-civil war syndromes encountered by all intensivists and surgeons serving in four of the world's continents. The continued advocacy for the international ban on the manufacture, commerce and military use of antipersonnel landmines is a part of all paediatricians' obligation to promote the ethos of the Laws of War. Post-traumatic stress disorder remains an undertreated legacy of children who have been trapped in the shot and shell of battle as well as those displaced as refugees. An urgent, unfocused and unmet challenge has been the increase in, and plight of, child soldiers themselves. A new class of combatant comprises these children, who also become enmeshed in the triad of anarchic civil war, light-weight weaponry and drug or alcohol addiction. The International Criminal Court has outlawed as a War Crime, the conscription of children under 15 years of age. Nevertheless, there remain more than 300000 child soldiers active and enmeshed in psychopathic violence as part of both civil and international warfare. The typical profile of a child soldier is of a boy between the ages of 8 and 18 years, bonded into a group of armed peers, almost always an orphan, drug or alcohol addicted, amoral, merciless, illiterate and dangerous. Paediatricians have much to do to protect such war-enmeshed children, irrespective of the accident of their place of birth. Only by such vigorous and maintained advocacy can the world's children be better protected from the scourge of future wars. PMID:12654137
Abstract The aim of this study was to evaluate the acute bite wounds in children treated on an inpatient basis over a 10-year period and the criteria for inpatient treatment. This study comprised all acute mammalian bite injuries in relation to all paediatric bite injuries seen at the Emergency Surgical Department (ESD). Inclusion criteria were: aged between 0-18 years; acute human or animal bite injuries (presenting for the first time); and inpatient treatment. Exclusion criteria were: bite wounds treated elsewhere and referred for complications; bites treated on an outpatient basis referred for complications; and all insect bites. Over 10 years, 12,948 children were seen at the ESD. There were 167 children (0.77%) with mammalian bite wounds. Twelve of them responded to the inclusion criteria. They presented 7.18% of all mammalian bite injuries and 0.09% of all paediatric emergency visits at the ESD. The average age was 3.82 ± 1.63 years (from 1.3-7 years). The time elapsed between the accident to the wound debridement was 118.64 ± 101.39 minutes. There were 10 dogs, one horse, and one rabbit bite. Surgical treatment comprised debridement, saline irrigation, and primary closure or reconstruction. All patients received antibiotics in the postoperative period. The average hospital stay was 5.92 ± 2.39 days. In one case a partial distal flap necrosis occurred. Animal bite injuries treated on an inpatient basis are predominantly dog bites in young children under 10 years of age, with deep, extended, and commonly multiple injuries. Only 7% of paediatric bite injuries require inpatient treatment. PMID:23586322
The author reviews the subject rising the following topics and subtopics: I. Nuclear explosions: heat, nuclear radiation, and radioactive fallout; II. Effects: radiation sickness, burns, blast injuries, and equivalent areas of death; III. Nuclear war: battlefield, regional, intercontinental - counterforce, and intercontinental - counter-city and industry. There are two appendices. 34 references, 32 figures.
Traumatic brain injury (TBI) is a serious condition affecting many American veterans who have served in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF). Using a biopsychosocial perspective, the authors delineate and discuss the challenges of diagnosing and treating this neurological disability among soldiers who have returned to the United States from combat theaters in the Middle East. They
War wounds are devastating with extensive soft tissue and osseous destruction and heavy contamination. War casualties generally reach the reconstructive surgery centre after a delayed period due to additional injuries to the vital organs. This delay in their transfer to a tertiary care centre is responsible for progressive deterioration in wound conditions. In the prevailing circumstances, a majority of war wounds undergo delayed reconstruction, after a series of debridements. In the recent military conflicts, hydrosurgery jet debridement and negative pressure wound therapy have been successfully used in the preparation of war wounds. In warinjuries, due to a heavy casualty load, a faster and reliable method of reconstruction is aimed at. Pedicle flaps in extremities provide rapid and reliable cover in extremity wounds. Large complex defects can be reconstructed using microvascular free flaps in a single stage. This article highlights the peculiarities and the challenges encountered in the reconstruction of these ghastly wounds.
Bhandari, Prem Singh; Maurya, Sanjay; Mukherjee, Mrinal Kanti
To demonstrate the potential usefulness of radial arterial line monitoring in detection of brachial plexus injury in spinal surgery. Multiple neuromonitoring modalities including SEPs, MEPs and EMG were performed for a posterior thoracicolumbar surgery. Radial arterial line (A-line) was placed on the right wrist for arterial blood pressure monitoring. Reliable ulnar nerve SEPs, hand muscle MEPs and arterial blood pressure readings were obtained after patient was placed in a prone position. A-line malfunction was noted about 15 min after incision. Loss of ulnar nerve SEPs and hand muscle MEPs with a cold hand on the right was noticed when neuromonitoring resumed after spine exposure. SEPs, MEPs, A-line readings and hand temperature returned after modification of the right arm position. Radial arterial line monitoring may help detect positional brachial plexus injury in spinal surgery when continuous neuromonitoring is interrupted during spine exposure in prone position. PMID:22552876
The purpose of this study was to establish if injuries sustained during a player’s career in baseball had consequences later in life following retirement from participation. Seventy-five retired Australian baseball players (mean age 55.8 ±11.4 years) completed a survey to establish the long-term consequences of major (i.e. those resulting in five or more consecutive weeks of training or playing being
For humans, war remains an inexhaustible subject of storytelling and analysis—such a compelling topic that experts trace the origins of written history, historiography, to the Athenian general Thucydides, who wrote The Peloponnesian War nearly 2,500 years ago. The appeal of war stories, whether we read them for elevation or escape, is eternal. Science fiction, like every other genre whose authors
Most nations have experienced an internal armed conflict since 1960. Yet while civil war is central to many nations' development, it has stood at the periphery of economics research and teaching. The past decade has witnessed a long overdue explosion of research into war's causes and consequences. We summarize progress, identify weaknesses, and chart a path forward. Why war? Existing
Introduction Acute respiratory dysfunction syndrome (ARDS), defined as acute hypoxemia accompanied by radiographic pulmonary infiltrates without a clearly identifiable cause, is a major cause of morbidity and mortality after pulmonary resection. The aim of the study was to determine the pre and intraoperative factors associated with ARDS after pulmonary resection retrospectively. Methods Patients undergoing elective pulmonary resection at Adnan Menderes University Medical Faculty Thoracic Surgery Department from January 2005 to February 2010 were included in this retrospective study. The authors collected data on demographics, relevant co-morbidities, the American Society of Anesthesiologists (ASA) Physical Status classification score, pulmonary function tests, type of operation, duration of surgery and intraoperative fluid administration (fluid therapy and blood products). The primary outcome measure was postoperative ARDS, defined as the need for continuation of mechanical ventilation for greater than 48-hours postoperatively or the need for reinstitution of mechanical ventilation after extubation. Statistical analysis was performed with Fisher exact test for categorical variables and logistic regression analysis for continuous variables. Results Of one hundred forty-three pulmonary resection patients, 11 (7.5%) developed postoperative ARDS. Alcohol abuse (p = 0.01, OR = 39.6), ASA score (p = 0.001, OR: 1257.3), resection type (p = 0.032, OR = 28.6) and fresh frozen plasma (FFP)(p = 0.027, OR = 1.4) were the factors found to be statistically significant. Conclusion In the light of the current study, lung injury after lung resection has a high mortality. Preoperative and postoperative risk factor were significant predictors of postoperative lung injury.
The aim of this study is to survey different types of injuries as the cause for prosthesis fitting in the Institute of Physical Medicine and Rehabilitation (IPM&R). This retrospective chart review was conducted at the IPM&R at the Dow University of Health Sciences, from the year 2007 till 2009. We selected all amputees who got enrolled in our institute for prosthesis fitting with major amputations, during the above mentioned period of time. Informed verbal consent was taken from each patient before recording their data at the IPM&R. Anonymity has been maintained. Data for this study was collected through a structured questionnaire, variables included: gender, age, town of origin, cause of amputation, level of amputation, limb involvement (unilateral or bilateral), level and causes of amputations. The data entry and analysis were done on SPSS (Statistical Package of Social Sciences) version 16.0. Of the amputee burden of our study, 55.9% was due to trauma, which is a preventable cause of disability. This is mostly affecting men in the productive age group. New strategies need to be devised in order to alleviate the burden of amputations resulting from preventable injuries. PMID:22630112
Traumatic brain injury (TBI) resulting from exposure to blast energy released by Improvised Explosive Devices (IEDs) has been recognized as the "signature injury" of Operation Iraqi Freedom and Operation Enduring Freedom. Repeated exposure to mild blasts may produce subtle deficits that are difficult to detect and quantify. Several techniques have been used to detect subtle brain dysfunction including neuropsychological assessments, computerized function testing and neuroimaging. Another approach is based on measurement of biologic substances (e.g. proteins) that are released into the body after a TBI. Recent studies measuring biomarkers in CSF and serum from patients with severe TBI have demonstrated the diagnostic, prognostic, and monitoring potential. Advancement of the field will require 1) biochemical mining for new biomarker candidates, 2) clinical validation of utility, 3) technical advances for more sensitive, portable detectors, 4) novel statistical approach to evaluate multiple biomarkers, and 5) commercialization. Animal models have been developed to simulate elements of blast-relevant TBI including gas-driven shock tubes to generate pressure waves similar to those produced by explosives. These models can reproduce hallmark clinical neuropathological responses such as neuronal degeneration and inflammation, as well as behavioral impairments. An important application of these models is to screen novel therapies and conduct proteomic, genomic, and lipodomic studies to mine for new biomarker candidates specific to blast relevant TBI.
Background In critical injury, the occurrence of increased oxidative stress or a reduced antioxidant status has been observed. The purpose of this study was to correlate the degree of oxidative stress, by measuring the oxidation-reduction potential (ORP) of plasma in the critically injured, with injury severity and serum amyloid A (SAA) levels. Methods A total of 140 subjects were included in this retrospective study comprising 3 groups: healthy volunteers (N = 21), mild to moderate trauma (ISS < 16, N = 41), and severe trauma (ISS ? 16, N = 78). For the trauma groups, plasma was collected on an almost daily basis during the course of hospitalization. ORP analysis was performed using a microelectrode, and ORP maxima were recorded for the trauma groups. SAA, a sensitive marker of inflammation in critical injury, was measured by liquid chromatography/mass spectrometry. Results ORP maxima were reached on day 3 (± 0.4 SEM) and day 5 (± 0.5 SEM) for the ISS < 16 and ISS ? 16 groups, respectively. ORP maxima were significantly higher in the ISS < 16 (-14.5 mV ± 2.5 SEM) and ISS ? 16 groups (-1.1 mV ± 2.3 SEM) compared to controls (-34.2 mV ± 2.6 SEM). Also, ORP maxima were significantly different between the trauma groups. SAA was significantly elevated in the ISS ? 16 group on the ORP maxima day compared to controls and the ISS < 16 group. Conclusion The results suggest the presence of an oxidative environment in the plasma of the critically injured as measured by ORP. More importantly, ORP can differentiate the degree of oxidative stress based on the severity of the trauma and degree of inflammation.
Background: Sulfur mustard (SM) is an alkylating chemical warfare agent that was widely used during Iran–Iraq war between 1983 and 1988. SM exposure leads to various late complications. The aim of this study was to determine the late cardiovascular effects of SM in war-disabled Iranian victims. Materials and Methods: This was a retrospective cohort case control study on 50 patients with symptoms of SM exposure and 50 cases who had been in Iran–Iraq war, without chemical injury. We performed exercise stress test and echocardiography for all of patients. Results: The study group comprised 100 males of mean age 45.6 ± 6.2 years. In chemical warinjury group, two patients (4%) had positive exercise stress test. On coronary angiography, they were found to have coronary artery disease. One patient had severe mitral regurgitation and normal coronary angiography; he was referred for mitral valve replacement. Left ventricular (LV) diastolic abnormality was detected in 23% of these subjects. In another group, 5% had LV diastolic abnormality (P = 0.02) and all of them had normal stress test. Conclusions: Cardiovascular abnormalities are another late complication in chemical war disabled Iranian victims. Diastolic dysfunction was the most common abnormality in both groups of patients.
Patients on warfarin who have traumatic intracranial haemorrhage have a high mortality. The procoagulant recombinant factor VIIa (rFVIIa) is widely used off-label to treat intracranial haemorrhaging in patients taking warfarin to try to improve these adverse outcomes, but its effectiveness is unknown. In this study, medical records from 2002 to 2010 were reviewed for 27 warfarin patients who received rFVIIa for their traumatic intracranial haemorrhage and were compared with a matched control group of 27 warfarin patients who did not receive rFVIIa. The two groups were matched for sex, age and Injury Severity Score. The rFVIIa patients had 33.3% mortality compared with the 37% for the control patients, but this was not a statistically significant difference. There was also no significant difference in plasma unit use between the groups. However, the rFVIIa group had a significantly higher number of subdural haemorrhages, which carry a better prognosis. The initial international normalized ratios (INRs) of the rFVIIa patients were higher, and the decrease of INR was more pronounced than in the control patients. From the data, it appears that although the INRs of rFVIIa patients did improve compared with the control group, there was no reduction in plasma use or mortality. PMID:23429251
DeLoughery, Emma P; Lenfesty, Barbara; DeLoughery, Thomas G
Carolyn Nordstrom argues that millions of girl-youths are affected by political violence taking place in the world today, yet less is known about what happens to girls in war zones than to any other segment of the population. This ‘invisibility’ is not an accident, but relates to the many ‘wars’ children encounter on the frontlines. Girls suffer the assaults of
Civil wars are intricate social, political and psychological phenomena. However, economics can offer analytical insights which are useful alongside the more conventional approach of case-studies. Indeed, the policy conclusions drawn from economic analysis sometimes cast doubt on conventional advice. The use of economic theory and statistical evidence help to guard against excessive generalization from individual civil wars that inevitably suffer
Most nations have experienced an internal armed conflict since 1960. The past decade has witnessed an explosion of research into the causes and consequences of civil wars, belatedly bringing the topic into the economics mainstream. This article critically reviews this interdisciplinary literature and charts productive paths forward. Formal theory has focused on a central puzzle: why do civil wars occur
Objective. Only limited data exists in terms of the incidence of intracranial bleeding (ICB) in patients with mild traumatic brain injury (MTBI). Methods. We retrospectively identified 3088 patients (mean age 41 range (7–99) years) presenting with isolated MTBI and GCS 14-15 at our Emergency Department who had undergone cranial CT (CCT) between 2002 and 2011. Indication for CCT was according to the “Canadian CT head rules.” Patients with ICB were either submitted for neurosurgical treatment or kept under surveillance for at least 24 hours. Pearson's correlation coefficient was used to correlate the incidence of ICB with age, gender, or intake of coumarins, platelet aggregation inhibitors, or heparins. Results. 149 patients (4.8%) had ICB on CCT. No patient with ICB died or deteriorated neurologically. The incidence of ICB increased with age and intake of anticoagulants without clinically relevant correlation (R = 0.11; P < 0.001; R = ?0.06; P < 0.001). Conclusion. Our data show an incidence of 4.8% for ICB after MTBI. However, neurological deterioration after MTBI seems to be rare, and the need for neurosurgical intervention is only required in selected cases. The general need for CCT in patients after MTBI is therefore questionable, and clinical surveillance may be sufficient when CCT is not available.
Albers, C. E.; von Allmen, M.; Evangelopoulos, D. S.; Zisakis, A. K.; Zimmermann, H.; Exadaktylos, A. K.
During the past century, nurses have served as caregivers for United States military personnel in every major theater of war. Military nurses in the war zone deliver patient care while working in austere conditions, and are under constant threat of personal danger. This article gives a historical overview of the role of nurses in war zones, followed by a review from the perspectives of environment, safety, the nature of injuries, and treatment of military personnel and civilians. PMID:19850184
Traumatic Brain Injury (TBI) is the signature injury of Operation Enduring Freedom (OEF) and Operation Iraq Freedom (OIF). This article examines the reasons for increased TBI injuries, calculates the costs associated with those injuries, and evaluates TBI at the Department of Veterans Affairs. This article discusses the current diagnosis challenges, and addresses the subsequent impact of TBI on special populations
... refers to harm caused by accidents, falls, blows, burns, weapons, and more. In the U.S., millions of ... or walking across the street. Common injuries include Burns Dislocations Fractures Sprains and strains
The aim of this study was to evaluate the prevalence and characteristics of injuries to the head and orofacial region in physically abused children and adolescents from a city of the Northeast of Brazil, based on the review of forensic medical reports. This retrospective study was undertaken by the analysis of expert medical reports derived from medical forensic exams performed at the Department of Forensic Medicine of the city of Campina Grande, PB, Brazil, between January 2003 and December 2006. From a universe of 11 624 reports issued in this time span, the study sample consisted of 1070 reports referring to children and adolescents aged 0-17 years that were confirmedly victims of physical abuse. Male children (52.8%) in the 13- to 17-year-old range (72.4%) were the most frequent victims, with an association between gender and age group (P = 0.039). Most children (58.2%) presented a single type of injury, with a statistically significant association between number of injuries and gender (P = 0.040), but no significant association between number of injuries and age (P = 0.163). The percentage of victims injured in the head and face corresponded to 56.3%, with a statistically significant association between the presence of injury in the head and face and gender (P = 0.046). As much as 12.4% of the children and adolescents presented intraoral injuries, with no significant difference between genders (P = 0.543). However, a statistically significant association was observed between the number of existing injuries and the presence of oral injuries (P = 0.005). The maxilla was predominantly affected (55.6%), most injuries (94.8%) being soft-tissue lacerations located mainly in the upper lip (46.4%). The findings of this survey revealed a high prevalence of injuries to the head and orofacial region of physically abused children and adolescents. PMID:20070347
Burn injuries are common among victims of terrorism. Since bombs are the most common weapon used by terrorists all over the\\u000a world, the inevitable results are a combination of blast injuries, penetrating injuries, and burns. This type of injury is\\u000a very similar to injuries seen in wars. The main difference between war and terrorist attacks is in the targeted population
World Conflict How did the second world war progress in Europe?War in Europe What happened before and after the war in the Pacific?The Pacific Theatre How did World War II change the world?World War, 1939-1945 What did World War II mean to the United States?World War II ...
Background: When venous thromboembolism (VTE) includes deep-vein thrombosis (DVT) and pulmonary embolism (PE), patients with acute traumatic spinal cord injury (SCI) have the highest incidence of VTE among all hospitalized groups, with PE the third most common cause of death. Although low–molecular-weight heparin (LMWH) outperforms low-dose unfractionated heparin (LDUH) in other patient populations, the evidence in SCI remains less robust. Objective: To determine whether the efficacy for LMWH shown in previous SCI surveillance studies (eg, routine Doppler ultrasound) would translate into real-world effectiveness in which only clinically evident VTE is investigated (ie, after symptoms or signs present). Methods: A retrospective cohort study was conducted of 90 patients receiving LMWH dalteparin (5,000 U daily) or LDUH (5,000 U twice daily) for VTE prophylaxis after acute traumatic SCI. The incidence of radiographically confirmed VTE was primarily analyzed, and secondary outcomes included complications of bleeding and heparin-induced thrombocytopenia. Results: There was no statistically significant association (p = 0.7054) between the incidence of VTE (7.78% overall) and the type of prophylaxis received (LDUH 3/47 vs dalteparin 4/43). There was no significant differences in complications, location of VTE, and incidence of fatal PE. Paraplegia (as opposed to tetraplegia) was the only risk factor identified for VTE. Conclusions: There continues to be an absence of definitive evidence for dalteparin (or other LMWH) over LDUH as the choice for VTE prophylaxis in patients with SCI. Novel approaches to VTE prophylaxis are urgently required for this population, whose risk of fatal PE has not decreased over the last 25 years.
The attention of physicians is being drawn to the issue of nuclear weapons and nuclear war, creating controversy about whether a political concern is appropriate for health care professionals. The use of nuclear weapons would incur human death and injury on a scale both unprecedented and unimaginable, and possibly damage the ecosphere far beyond the weapons' immediate effects. Medical supplies
Contents: The SCOPE ENUWAR Report on the climatic consequences of nuclear war; Climatic consequences of nuclear war; Medical consequences of nuclear war; Nuclear war--consequences on ecological, agricultural, and human systems; Societal consequences of nu...
Use the following resources as you research the Civil War. Resources Pioneer Library World Book Web Albion Library Online Catalog "Name of Battle" NPS Civil War The American Civil War Homepage American Civil War The Civil War Causes of the Civil War What Caused the American Civil War? Secession North Carolina Majority Against Secession in 1860 (1866 Meeting) Slavery Abolition and Slavery Twenty Reasons for Total Abstinence from Slave-Labour Produce Influence of Prominent Abolitionists The Underground Railroad Battles of the Civil War Civil War Battle Summaries By State 10 Costliest Battles of the Civil War Battle of Gettysburg Virtual Tour Battle of Shiloh Battle of Antietam Important People in the Civil War Civil War Biographies Women of the American Civil War Political Cartoons John Tenniel and the American Civil War Lincoln vs. Douglas America in Caricature 1765-1865 Virtual Museums Civil War @ Smithsonian Gettysburg: Camp Life Selected Civil War Photographs ...
War has been a subject of many different mediums. Through the portrayal of war, great movies have given insights on human conditions in wartime. War has also been the subject of several video games that are incredibly popular in mass culture. The difference between war movies and war games are that war games are interactive, requiring the players to act
More than a dozen countries, including Brazil, China, India, Japan, and Korea, have been intervening in the foreign exchange market to prevent their currencies from appreciating. There are fears that the second dose of quantitative easing in the United States (dubbed QE2) may worsen currency appreciation. These developments raise the prospect of a currency war, which the Group of Twenty
Technological supremacy means that the West can avoid getting up close and personal to kill. Our legacies of imperial power ensure that our wars are fought ‘over there’, and men in post-industrial societies are disassociated from the death embracing culture of the warrior. However, in the aftermath of September 11, we have entered a new era of global militarization –
Background Political conflicts in Bangkok, Thailand have caused mass casualties, especially the latest event April 10, 2010, in which many military personnel were injured. Most of them were transferred to Phramongkutklao Hospital, the largest military hospital in Thailand. The current study aimed to assess factors influencing Injury Severity Score (ISS) regarding Thai military personnel injured in the mass casualty incident (MCI) April 10, 2010. Methods A total of 728 injured soldiers transferred to Phramongkutklao Hospital were reviewed. Descriptive statistics was used to display characteristics of the injuries, relationship between mechanism of injury and injured body regions. Multiple logistic regressions were used to calculate the adjusted odds ratio (adjusted OR) of ISS comparing injured body region categories. Results In all, 153 subjects defined as major data category were enrolled in this study. Blast injury was the most common mechanism of injury (90.2%). These victims displayed 276 injured body regions. The most common injured body region was the extremities (48.5%). A total of 18 patients (11.7%) had an ISS revealing more than 16 points. Three victims who died were expected to die due to high Trauma and Injury Severity Score (TRISS). However, one with high TRISS survived. Factors influencing ISS were age (p = 0.04), abdomen injury (adjusted OR = 29.9; 95% CI, 5.8-153.5; P < 0.01), head & neck injury (adjusted OR = 13.8; 95% CI, 2.4-80.4; P < 0.01) and chest injury (adjusted OR = 9.9; 95% CI, 2.1-47.3; P < 0.01). Conclusions Blast injury was the most common mechanism of injury among Thai military personnel injured in the MCI April 10, 2010. Age and injured body region such as head & neck, chest and abdomen significantly influenced ISS. These factors should be investigated for effective medical treatment and preparing protective equipment to prevent such injuries in the future.
BACKGROUND: In critical injury, the occurrence of increased oxidative stress or a reduced antioxidant status has been observed. The purpose of this study was to correlate the degree of oxidative stress, by measuring the oxidation-reduction potential (ORP) of plasma in the critically injured, with injury severity and serum amyloid A (SAA) levels. METHODS: A total of 140 subjects were included
Leonard T Rael; Raphael Bar-Or; Kristin Salottolo; Charles W Mains; Denetta S Slone; Patrick J Offner; David Bar-Or
Introduction In adults, small (< 50%) serum creatinine (SCr) increases predict mortality. It is unclear whether different baseline serum\\u000a creatinine (bSCr) estimation methods affect findings of acute kidney injury (AKI)-outcome associations. We characterized pediatric\\u000a AKI, evaluated the effect of bSCr estimation approaches on AKI-outcome associations and evaluated the use of small SCr increases\\u000a to predict AKI development.\\u000a \\u000a \\u000a \\u000a \\u000a Methods We conducted a retrospective
Omar Alkandari; K Allen Eddington; Ayaz Hyder; France Gauvin; Thierry Ducruet; Ronald Gottesman; Véronique Phan; Michael Zappitelli
Moral theory has mostly focused on idealized situations in which the morally relevant properties of human actions can be known\\u000a beforehand. Here, a framework is proposed that is intended to sharpen moral intuitions and improve moral argumentation in\\u000a problems involving risk and uncertainty. Guidelines are proposed for a systematic search of suitable future viewpoints for\\u000a hypothetical retrospection. In hypothetical retrospection,
This twelve months survey compared injury risk and injury types by genders (312 females, 262 males) in 15- to 35-year-old cross-country skiers, swimmers, long- distance runners and soccer players. More male than female athletes reported at least one acute injury (44% vs. 35%, p < 0.05), and more male than female runners reported at least one overuse injury (69% vs. 51%, p < 0.05). When the incidence of acute and overuse injuries both separately and combined was calculated per 1000 training hours, per 1000 competition hours and all exposure hours combined we found no gender differences in either of these comparisons. After adjustment for sport event males were at increased risk for posterior thigh overuse injuries compared to females (relative risk (RR) 5.8, 95% confidence interval (CI) 1.3 to 26.4, p < 0.05) while females were at increased risk for overuse injuries in the ankle compared to males (RR 3.1, 95% CI 1.0 to 9.3, p < 0.05). After adjustment for exposure time (injuries/1000 exposure hours) significance of the difference between the sexes in overuse injury to the ankle persisted (female 0.11 vs. male 0.02 injuries/1000 exposure hours, p < 0.05). Six athletes had an anterior cruciate ligament (ACL) injury, of whom four were female soccer players. After combining all reported acute and overuse ankle and knee injuries, the proportion of athletes with such injury was higher in the female compared to male soccer players (75% and 54% respectively; p < 0.05), but no difference was found in such injuries when calculated per 1000 exposure hours. In conclusion, we found some gender differences in sport-related injuries, but most of these differences seemed to be explained at least in part by differences in the amount of training. Key points Only a few sport injury studies have compared in-jury rates between the sexes Overall gender-related risk for acute and overuse injuries in top-level athletes between the sexes was small Some gender differences in the specific anatomical locations of injuries as well as in specific injuries in sports were found Some of these differences seem to be explained by the differences in the amount of training
Ristolainen, Leena; Heinonen, Ari; Waller, Benjamin; Kujala, Urho M.; Kettunen, Jyrki A.
Cold War is a major, 24-part series directed by renowned documentary filmmaker Jeremy Isaacs that recently premiered on CNN and BBC2. Whether or not this series will become "the definitive account of the Cold War" remains to be seen, but the research that has made it possible is quite impressive. This feature-filled, comprehensive site complements the series by offering, among other things, video previews and multimedia recaps of each episode; video, audio, and text excerpts from nearly 100 interviews filmed for the series; text from archival documents and contemporaneous Time and Russian newspaper stories; in-depth sections on Cold War culture; and a Knowledge Bank section containing a glossary, "Cold Warrior" profiles, related links, and a chronology. Additional resources include a classroom guide to the series, online Shockwave quiz games, and an online discussion group. As large as it is now, the site will continue to expand and add new features as the series progresses over the next three months.
To evaluate the risk factors affecting the survival of children with warinjuries involving the abdomen, 270 children under 16 years of age with abdominal injuries during the civil war in Lebanon were studied. One hundred and ninety (70%) sustained penetrating injuries and 80 (30%) blunt trauma. The overall infection rate was 7.8%. There were 13 deaths (4.8%), 7 early
Michel S. Slim; Charles Her; Samir R. Akel; Omar M. Dajani; Hani A. Hajj; Anis Baraka
The dynamics of the epileptic syndrome was studied in 55 patients with penetrating cranial wound and in 65 patients with closed cranial injury. Account was taken of the anamnesis, all-round clinical examination data, EEG and computer-aided tomography readings. The patients had been followed up over 40 years. Among the patients with fighting cranial injury, the incidence of the epileptic syndrome amounted to 14.01%. The epileptic syndrome was established to occur most frequently during the first year after injury, with that time (in patients with penetrating cranial wound) being the less the graver injury and longer consciousness loss. At the same time the later was the onset of epileptic attacks in patients with closed cranial injury the rarer was their incidence and more pronounced were mental disorders. In patients with penetrating cranial wound, focal and secondary-generalized attacks dominated in the structure of the epileptic syndrome, whereas in patients with closed cranial injury, convulsions and psychomotor fits ranked the first. With age the rate of epileptic attacks declined along with reduction and disappearance of epileptic activity on the EEG, augmentation of mental disorders and atrophy of substantia medullaris. PMID:2171278
The term "radiation combined injury" (RCI) is used to describe conditions where radiation injury is coupled with other insults such as burns, wounds, infection, or blunt trauma. A retrospective account of injuries sustained following the atomic bombing of Hiroshima estimates that RCI comprised approximately 65% of all injuries observed. Much of the research that has been performed on RCI was carried out during the Cold War and our understanding of the clinical problem RCI presents does not reflect the latest advances in medicine or science. Because concerns have increased that terrorists might employ radiological or nuclear weapons, and because of the likelihood that victims of such terrorism would experience RCI, the National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health sponsored a meeting in 2007 to explore the state of the research in this area, identify programmatic gaps, and establish priorities for future research. As a follow-up to that meeting, in 2008 NIAID sponsored an initiative on RCI, leading to the award of several exploratory/developmental grants, the goals of which are to better understand biological synergy involved in RCI-induced damage, develop improved animal models for various type of RCI, and advance identification and testing of potential countermeasures to treat injuries that would be expected following a radiological or nuclear event. This program has already yielded new insight into the nature of combined injuries and has identified a number of novel and existing compounds that may be effective treatments for this condition. PMID:20445395
DiCarlo, Andrea L; Ramakrishnan, Narayani; Hatchett, Richard J
In human liver transplantation, air embolism is seldom encountered after graft reperfusion. Nevertheless, despite adequate flushing and clamping routines, air emboli have been reported in transesophageal echocardiography (TEE) studies performed during the reperfusion phase. We retrospectively investigated whether air in the donor liver — as observed with pretransplant magnetic resonace imaging (MRI) — resulted in clinical air embolism or contributed
R. F. E. Wolf; W. J. Sluiter; A. Ballast; R. Verwer; R. M. Dam; M. J. H. Slooff
BACKGROUND: This study investigated the role of a negative FAST in the diagnostic and therapeutic algorithm of multiply injured patients with liver or splenic lesions. METHODS: A retrospective analysis of 226 multiply injured patients with liver or splenic lesions treated at Bern University Hospital, Switzerland. RESULTS: FAST failed to detect free fluid or organ lesions in 45 of 226 patients
Beat Schnüriger; Joachim Kilz; Daniel Inderbitzin; Miranda Schafer; Ralph Kickuth; Martin Luginbühl; Daniel Candinas; Aristomenis K Exadaktylos; Heinz Zimmermann
War against terrorism is a cliché in the twenty-first century. This paper focuses on the hypothesis that the on-going war against terrorism is infact a war for terrorism. As it is usually considered that America is the only superpower therefore, balance of power in the world suits America. It should not go against any other nation. Contrary to this, it
Experience as a prisoner of war (POW) could lead to cognitive impairment because of the injuries, including head trauma, and other stressors endured preceding and during capture, and during incarceration. Some research has reported decreased cognitive per...
|Although the Vietnam War ended more than thirty years ago, historians remain as divided on what happened as the American people were during the war. Mark Moyar maps the ongoing battle between "orthodox" and "revisionist" Vietnam War historians: the first group, those who depict Vietnam as a bad war that the United States should not have fought,…
By the early 1990s, when I began studying the Vietnam War, the American public had largely lost interest in the history of that conflict. The Civil War and World War II were the wars that historians were advised to cover if they wanted to reach the public. Among government officials, military officers, and political scientists, Vietnam was considered irrelevant, because
Research question of the paper is what factors lead to third-party intervention in civil wars by both major and minor powers. For this purpose, I propose that we consider four dimensions of civil war intervention. The first dimension to consider is the civil war itself. The characteristics of civil war are assumed to have some impact on a third party?s
We distinguish between four types of warfare (conventional, irregular, symmetric non-conventional, and urban) and disaggregate civil wars accordingly. We find that while irregular war is the most common type of civil war, it is not the only one. Conventional war turns out to be less exceptional than previously thought, while symmetric non-conventional warfare is an important, though localized, type of
Methods—A retrospective review of cases reported to the database is reported, with representative case histories. Results—No injuries from paintball were reported during the period June 1992 to June 1996. Over the next two years 11 injuries were reported, representing 4% of all ocular trauma reports over this period. Visual outcome is poor in many of these eyes and more than one half present with posterior segment ocular injury. Conclusions—Severe ocular trauma results from impacts from paintball pellets, and the occurrence of injuries appears to be increasing due to growth in popularity of this war game. Diligent use of eye protection by all participants is necessary to prevent a continuing rise in ocular trauma prevalence from this activity.
This overview of the practice of military ophthalmology by US army ophthalmologists during the Vietnam War focuses on administrative\\u000a management of eye and adnexal injuries, care of the wounded military and of Vietnamese civilians, and research activities.\\u000a It concludes with improvements that have been subsequently adopted.
Roughly 3,000 war veterans with moderate or severe brain injury have suffered from a psychiatric disturbance. Psychotic disorders are found in approximately 750 cases. The material of this preliminary report consists of the first 100 veterans with paranoid disorders. Delusional psychosis is the most common main diagnosis (28% of veterans), followed by major depression (21 %), delirium (18 %) and
Kalle Achté; Leo Jarho; Timo Kyykkä; Eija Vesterinen
Purpose: To investigate the features of orbital injuries by pellets fired from the front. Design: Retrospective, 4 cases of pellet injuries. Methods: Five orbits of 4 patients who sustained pellet injuries received from the front were reviewed retrospectively. The course of injury and results were assessed. Radiological examinations were reviewed. The patients were evaluated between December 1996 and June 2004.
Turgut Yilmaz; Serdal Çelebi; Gürsoy Alagöz; Didem Serin; M. Akif Acar; M. Faik Özveren
The attention of physicians is being drawn to the issue of nuclear weapons and nuclear war, creating controversy about whether a political concern is appropriate for health care professionals. The use of nuclear weapons would incur human death and injury on a scale both unprecedented and unimaginable, and possibly damage the ecosphere far beyond the weapons' immediate effects. Medical supplies and facilities would be nonexistent; no meaningful medical response would be possible. A physician's responsibility to prevent nuclear war is based on the imperative to prevent a devastating incurable disease that cannot be treated. Such an imperative is consistent with the historic tradition of the social responsibility of health professionals, and can be justified by philosophical argument.
The Cold War sanitized the author's analysis of political violence among revolutionary peasants in El Salvador during the 1980s. A 20-year retrospective analysis of his fieldnote(s) documents the ways political terror and repression become embedded in daily interactions that normalize interpersonal brutality in a dynamic of everyday violence. Furthermore, the structural, symbolic and interpersonal violence that accompanies both revolutionary mobilization
The nine principles of war have guided American military doctrine since 1921. However, these principles since their formulation eighty years ago, have not accounted for the human dimension of war. Major military operations and campaigns are not won or los...
Today s advances in evolutionary biology are unifying competing theories of natural selection and serve as a timely call for a similar unification of competing theories of war. This paper explores the relationship between war and natural selection by firs...
This book presents opposing viewpoints on nuclear war. Topics discussed include: how nuclear would begin; would humanity survive; would civil defense work; will an arms agreement work; and can space weapons reduce the risk of nuclear war.
Renowned for its heroism, intrigue, pathos, and freezing cold, the compelling story of the Russo-Finnish War, in which “tiny” Finland repulsed a much larger Soviet invasion force, has been thoroughly studied and recorded. Less well-researched are the influences of military strategy on the generals in that war. The conflict provides many examples of the theories on warfare advanced by Carl
On the basis of a retrospective analysis of results of treatment of 1097 patients with wounds and injuries of the colon of the peace and war time as well as of experiments in 160 dogs it has been established that the level of lethal outcomes and amount of complications are dependent on the size, number and localization of the colon wounds, severity of peritonitis by the moment of primary operation, degree of traumatic shock, blood loss volume, severity of the coexisting injuries and the chosen method of surgical treatment. A classification of the wounds according to the volume of injuries of the colon is proposed. Different variants of surgical treatment and outcomes are considered. Experiments in dogs have shown the indisputable effectiveness of precise one-row sero-musculo-submucous sutures with the present-day sutural material as compared with other methods of treatment of wounds of the colon. The peritoneal sorption with liquid colloid sorbents at the early postoperative period facilitate the prophylaxis and treatment of peritonitis, reduce lethality. A surgical classification of injuries of the colon is developed and types of operative interventions are recommended. PMID:9490533
The existence of Gulf War Syndrome is a topic of much controversy. Many highly respected scientists initially concluded that no single disease or unique condition affected the veterans of the Gulf War. More recent studies have concluded that there is evidence that some of the conditions suffered by many Gulf War veterans are more common among those who served in
Thirty-five patients with self-inflicted gunshot brain injury were admitted to our hospital during 1991–1996. War conditions and availability of firearms influenced the increase in these injuries, nearly six times greater than in the previous 6-year peace time period (1985–1990). Our management protocol consisted of radical debridement of the missile track and evacuation of haematomata. For in-driven bone fragments we followed
Dj. Vrankovi?; B. Splavski; I. He?imovi?; K. Glavina; B. Murši?; G. Blagus; B. Dmitrovi?
Background: There are few epidemiologic studies of cheerleading injuries.Purpose: To develop a profile of catastrophic injuries in cheerleading and to describe relevant risk factors.Study Design: Retrospective cohort study.Methods: We reviewed 29 of 39 incidents of cheerleading injuries reported to the National Center for Catastrophic Sports Injury Research from 1982 to 2002.Results: Twenty-seven of the injured cheerleaders were women. There were
Barry P. Boden; Robin Tacchetti; Frederick O. Mueller
In the present prospective study, we examine relationships between sport injury anxiety, injury history, and the occurrence of injuries. Using the Sport Injury Trait Anxiety Scale (SITAS), 114 male and 92 female sport students were questioned on their concern for sustaining an injury. Furthermore, injury history was assessed using a retrospective-oriented questionnaire concerning foregoing 1-year and 5-year periods of sport
There are two categories of cold injury. The first is hypothermia, which is a systemic injury to cold, and the second is frostbite, which is a local injury. Throughout history, entire armies, from George Washington to the Germans on the Russian Front in World War II, have fallen prey to prolonged cold exposure. Cold injury is common and can occur in all seasons if ambient temperature is lower than the core body temperature. In the 1985 Boston Marathon, even though it was 76 degrees and sunny, there were 75 runners treated for hypothermia. In general, humans adapt poorly to cold exposure. Children are at particular risk because of their relatively greater surface area/body mass ratio, causing them to cool even more rapidly than adults. Because of this, the human's best defense against cold injury is to limit his/her exposure to cold and to dress appropriately. If cold injury has occurred and is mild, often simple passive rewarming such as dry blankets and a warm room are sufficient treatment. PMID:17630517
The results of a retrospective analysis of treatment of 1106 patients with injuries of the colon in peace and war time as well as experimental investigations in 160 dogs have shown the lethality and amount of complications to depend on the size, amount and localization of the colon injuries, trauma shock degree, volume of blood loss, severity of concomitant injuries, the presence and phase of peritonitis by the moment of operation and on the method of treatment. The extension of the operation volume and putting the injured part out onto the anterior abdominal wall are most frequently followed by complications and higher lethality. The one-row precision sero-muscular-submucous interrupted intestinal sutures as well as the early peritoneal sorption with liquid colloid sorbents give better results of the surgical treatment. A classification and algorithm of the surgeon's actions for wounds of the colon are proposed. PMID:11188812
We conducted a retrospective review of all patients with orthopedic injuries evacuated to a single medical center to evaluate the treatment and outcome of these injuries in three recent U.S. military conflicts: Operation Urgent Fury (Grenada), Operation Desert Shield/Storm (southwest Asia), and Operation Restore Hope (Somalia). Sixteen orthopedic casualties were originally treated at the medical detachment in Grenada before evacuation to the medical center. Most of these injuries were gunshot wounds to the extremities (11), with three known open fractures. Two patients (three extremities) sustained traumatic amputation (19% amputation rate). One hundred eighty-one patients with orthopedic injuries were medically evacuated from southeast Asia to the medical center for definitive treatment. Of these injuries, there were 143 fractures in 69 patients. One hundred of these fractures were open fractures, and 60% of these injuries were blast injuries. Furthermore, there were 26 amputations (14%). Twenty-two patients with orthopedic injuries were treated in Somalia and evacuated to the medical center. Thirteen of the 22 patients (59%) sustained gunshot wounds, and 2 (9%) sustained blast injuries. There were eight open fractures (36%) and three amputations in two patients (14%). Three of the 22 patients underwent successful limb salvage when ablation was the only other surgical alternative. It appears that a large percentage of medical center evacuations from military conflicts are for orthopedic injuries. Many of these injuries are the result of high-velocity weapons or blast injuries. Regardless of the size and/or purpose of the intervention, similar injury patterns and severity can be expected, because 51% of orthopedic patients had open fractures. Similarly, the rate of amputation associated with extremity trauma has not varied significantly since the Vietnam War. PMID:10870364
The authors conducted an extensive search for published works concerning healthcare utilization and mortality among Gulf War veterans of the Coalition forces who served during the1990–1991 Gulf War. Reports concerning the health experience of US, UK, Canadian, Saudi and Australian veterans were reviewed. This report summarizes 15 years of observations and research in four categories: Gulf War veteran healthcare registry studies, hospitalization studies, outpatient studies and mortality studies. A total of 149?728 (19.8%) of 756?373 US, UK, Canadian and Australian Gulf War veterans received health registry evaluations revealing a vast number of symptoms and clinical conditions but no suggestion that a new unique illness was associated with service during the Gulf War. Additionally, no Gulf War exposure was uniquely implicated as a cause for post-war morbidity. Numerous large, controlled studies of US Gulf War veterans' hospitalizations, often involving more than a million veterans, have been conducted. They revealed an increased post-war risk for mental health diagnoses, multi-symptom conditions and musculoskeletal disorders. Again, these data failed to demonstrate that Gulf War veterans suffered from a unique Gulf War-related illness. The sparsely available ambulatory care reports documented that respiratory and gastrointestinal complaints were quite common during deployment. Using perhaps the most reliable data, controlled mortality studies have revealed that Gulf War veterans were at increased risk of injuries, especially those due to vehicular accidents. In general, healthcare utilization data are now exhausted. These findings have now been incorporated into preventive measures in support of current military forces. With a few diagnostic exceptions such as amyotrophic lateral sclerosis, mental disorders and cancer, it now seems time to cease examining Gulf War veteran morbidity and to direct future research efforts to preventing illness among current and future military personnel.
This report estimates the health care burden related to the wars in Iraq and Afghanistan by calculating the difference between the total health care delivered to U.S. military members during wartime (October 2001 to June 2012) and that which would have been delivered if pre-war (January 1998 to August 2001) rates of ambulatory visits, hospitalizations, and hospital bed days of active component members of the U.S. Armed Forces had persisted during the war. Overall, there were estimated excesses of 17,023,491 ambulatory visits, 66,768 hospitalizations, and 634,720 hospital bed days during the war period relative to that expected based on pre-war experience. Army and Marine Corps members and service members older than 30 accounted for the majority of excess medical care during the war period. The illness/injury-specific category of mental disorders was the single largest contributor to the total estimated excesses of ambulatory visits, hospitalizations, and bed days. The total health care burdens associated with the wars in Afghanistan and Iraq are undoubtedly greater than those enumerated in this report because this analysis did not address care delivered in deployment locations or at sea, care rendered by civilian providers to reserve component members in their home communities, care of veterans by the Departments of Defense and Veterans Affairs, preventive care for the sake of force health protection, and future health care associated with wartime injuries and illnesses. PMID:23231050
In the still early aftermath of the Persian Gulf War and the Somalia expedition, the need for skilled practitioners cannot be ignored. In the years ahead, civilian mental health professionals will encounter war-related stress in clients who fought in both long ago and more recent wars. This article contends that today's training for social workers with its here-and-now, present-oriented foxus
The conflict in the Democratic Republic of Congo (DROC) has reinforced Africa's status as a strategic ghetto in the post-Cold War world. The absence of non-African involvement or even interest underscores a break with earlier eras of colonial ambition and Cold War rivalries. Some observers have seen in this war the division of DROC and thus the break-up of central
With this site you will be able to find all the necessary information about the background of the Civil War. You will find out when it happened, why it happenend, and most importantly of all, what happened. Use the following resource to gain a good overall of the important dates, names, and events of the Civil War: A Nation Divided: The U.S. Civil War 1861-1865 One of the most important battles of the Civil War was the Battle of Gettysburg. President Abraham Lincoln gave one of the most famous speeches in American History after ...
The treatment of war wounds is an ancient art, constantly refined to reflect improvements in weapons technology, transportation,\\u000a antiseptic practices, and surgical techniques. Throughout most of the history of warfare, more soldiers died from disease\\u000a than combat wounds, and misconceptions regarding the best timing and mode of treatment for injuries often resulted in more\\u000a harm than good. Since the 19th
M. M. Manring; Alan Hawk; Jason H. Calhoun; Romney C. Andersen
The 1940's were a turning point in married women's labor force participation, leading many to credit World War II with spurring economic and social change. This paper uses information from two retrospective surveys, one in 1944 and another in 1951, to resolve the role of World War II in the rise of women's paid work. More than 50% of all
Purpose This study aimed at analyzing the causes of death of prisoners of war (POWs) during the Korean War (1950-1953) who fought for the Communist side (North Korea and the People's Republic of China). In 1998, the United States Department of Defense released new information about the prisoners including, 7,614 deaths of the POW during the Korean War. The data on the causes of death of the POWs during the Korean War provides valuable information on the both the public health and history of the conflict. Materials and Methods To analyze the causes of death of the POWs, we classified the clinical diagnosis and findings on 7,614 deaths into 22 chapters, as outlined in the International Statistical Classification of Diseases and Related Health Problems-10th Revision (ICD-10). Second, we traced changes in the monthly death totals of POWs as well as deaths caused by common infectious diseases and external causes of death including injury over time from August 1950 to September 1953. Results The most common category of causes of deaths of POWs was infectious disease, 5,013 (65.8%) out of 7,614 deaths, followed by external causes including injury, 817 (10.7%). Overall, tuberculosis and dysentery/diarrhea were the most common causes of death. Deaths caused by acute and chronic infection, or external causes showed different patterns of increases and decline over time during the Korean War. Conclusion The information and data on POWs' deaths during the Korean War reflects the critical impact of the POWs' living conditions and the effect of public health measures implemented in POW camps during the war.
War is a major global threat to human health, not only in the immediate effects of death and injury to the people, but also in the damage to infrastructures such as food, water, and power supplies and to social structures that support families, economies, and governments. Iraq's devastating aftershocks from the Gulf War include the physical and psychologic effects of displacement, poverty, famine, disease, and environmental destruction. Early nursing leaders vocally opposed World War I, and contemporary nurses should consider becoming activists in the primary and secondary prevention of this major global health problem. PMID:9845484
Limited war has been a prominent feature in United States military history. Past applications of limited military power in war have dramatically furthered U.S. national interests. But despite encouraging experiences with limited war from independence to t...
This review critically evaluates the largely consensual view that wars naturally and reflexively augment presidential power. After summarizing the key arguments advanced by presidency scholars in the aftermath of World War II, this article canvasses the existing empirical basis for their claims and the theoretical microfoundations upon which they are offered. Both appear wanting. Few systematic studies yield unambiguous evidence
This review critically evaluates the largely consensual view that wars naturally and reflexively augment presidential power. After summarizing the key arguments advanced by presidency scholars in the aftermath of World War II, this article canvasses the existing empirical basis for their claims and the theoretical microfoundations upon which they are offered. Both appear wanting. Few systematic studies yield unambiguous evidence
|The author describes and elaborates on how to use his public-television reports on the costs of the war in Iraq to teach economics. He shows how the Iraq war can provide economics instructors with an example for discussing cost-benefit analysis and opportunity costs in class. (Contains 4 notes.)|
Presents an annotated bibliography that provides Web sites focusing on the U.S. homefront during World War II. Covers various topics such as the homefront, Japanese Americans, women during World War II, posters, and African Americans. Includes lesson plan sources and a list of additional resources. (CMK)
In our current thinking on war, we rely on political leaders to define the character of war and to provide military-achievable goals. In many cases, not understanding the background to these goals can lead to tragedy. Understanding where these goals come ...
The vocabulary of American Presidents is analyzed to locate the images, or vocabularies of motives, that they project in justification of war. Kenneth Burke's dramatism provides the methodological resources to chart and synthesize the language of Madison, Polk, McKinley, Wilson, Roosevelt, Truman, and Johnson in selected war messages and to discover that their vocabulary establishes a rigid and truncated pattern
Based on Stephen Crane's poems about war and his novel "The Red Badge of Courage," this lesson plan presents activities designed to help students understand that Crane examined war-related themes in prose and poetry; that close study of a poem for oral presentation helps readers see meaning or techniques not noted earlier; and that not all readers…
Of the classic antebellum authors who lived to write about the Civil War, none was so artistically disabled by it as Nathaniel Hawthorne. Turning from his biting satire Chiefly About War-Matters to compose a new romance, he struggled with it until he died, no longer capable of beautifying and idealizing our rude, material life.
Psychologists, scientists and philosophers from Sigmund Freud to Konrad Lorenz and Bertrand Russell, concerned with the problem of war, have advanced the catharsis theory. Sport, they have argued, allows a cathartic discharge of the aggressive urge and provides a safety valve for war?like tendencies.Britain has a long history of adventurous aggression over the centuries when it was acquiring an empire.
From September 1990 to June 1991, the UK deployed 53,462 military personnel to the Gulf War. In 1993 reports began to surface in the UK about unexplained health problems occurring among Gulf War veterans. Unlike other research into this illness, this work focuses on sufferers' own accounts to better understand the way the illness is perceived by those it affects.
Civil wars are intricate social, political and psychological phenomena. However, economics can offer analytical insights which are useful alongside the more conventional approach of case-studies. Indeed, the policy conclusions drawn from economic analysis sometimes cast doubt on conventional advice. The use of economic theory and statistical evidence help to guard against excessive generalization from individual civil wars that inevitably suffer
This article reviews the civil war and terrorism literature and then explores the international communities' responses to both. Both the academic literature and the international community tend to approach terrorism and civil war along separate tracks. A key question is whether or not this approach needs to be re-evaluated given the blurring of the distinction between what goes on inside
Objective: An institutional review of sharps injuries was conducted to assist in establishing priorities for resource allocation in a sharps prevention program. Design: A retrospective review of 221 sharps injuries occurring during a 1-year period was conducted by a 4-member multidisciplinary team. Each injury was categorized as either moderate\\/high, low, or unknown risk for acquisition of bloodborne diseases by using
E. A. Bryce; J. Ford; L. Chase; C. Taylor; S. Scharf
Based on the book by Andrew Carroll, War Letters is a television special airing on PBS on Sunday, May 26, at 9pm (Eastern Time). Revealing personal correspondence from the Revolutionary War to the Gulf War, War Letters gives accounts of famous battles, intimate declarations of love and longing, heartbreaking "Dear John" letters from home, and much more. The accompanying Web site provides a comprehensive description of the film and a transcript. It also provides a timeline of US military actions and wars from 1775 to the present, excerpts of letters from Carroll's book, and a teachers guide section grouped into categories of history, economics, geography, and civics. Additionally, for those interested in letter preservation, the site also provides tips on how to keep letters safe.
Gulf War illness, the multisymptom condition resulting from service in the 1990-1991 Gulf War, is the most prominent health issue affecting Gulf War veterans, but not the only one. The Congressionally- mandated Research Advisory Committee on Gulf War Vete...
B. A. Golomb C. Barlow D. J. Clauw F. E. Bloom J. H. Binns
Unlike past American wars, the current war on terror has not been associated with a centrally proff ered narrative providing some guidance and orientation for those administering government services under state-of- war conditions. War is as much a cultural endeavor as it is a military undertaking, and the absence of a clear sensemaking narrative was detected in this study of
Kathe Callahan; Melvin J. Dubnick; Dorothy Olshfski
Military personnel deployed to the Middle East included an unprecedented number of women, many of whom were mothers. Using a structural equation modeling approach, we examined the predictors of children's adjustment problems in data collected from a representative sample of 263 Air Force mothers 2 years after the Gulf War. Using a retrospective survey, we found that the main predictors
Penny F. Pierce; Amiram D. Vinokur; Catherine L. Buck
The tag line of this website is "Everything you Need to Plan your Civil War Trips." With the 150th anniversary of the Civil War being commemorated this year, this website offers everything for the mildly interested to the downright enthusiastic. Visitors can find every kind of map here, including "Civil War Trails Maps," almost two dozen "Podcast Tour Maps," "Interactive Maps," "National Park Service Maps," and relevant "State Highway Maps." The "Multimedia" link on the site gives visitors access to 26 podcasts of tours of Civil War sites. The podcasts are narrated by noted national park service historians and accompanied by period music. Also in the Multimedia area are the "Richmond Walking Tours" in Richmond, VA, which was the capitol of the Confederate States of America during the Civil War. These include five tours, maps for each, and an hour-long podcast to accompany each tour. Visitors interested in going to some Civil War lectures, reenactments, tours, or demonstrations should definitely check out the "Events" link to see a list of all the Civil War events for the 150th anniversary, month by month. The month of April alone has over 100 on the calendar throughout the South.
Angola's seemingly endless civil war has generated untold human suffering through death, injury, displacement and destruction. The social cost of the return to war after the elections in 1992, and again after the abandonment by UNITA of the Lusaka Accords in late 1998 has arguably been greater than previously. This paper examines the human cost of this latest period of
The period before the March-April 2003 war on Iraq witnessed unprecedented preparation for post-war reconstruction. This 'pre-war reconstruction' or 'pre-emptive reconstruction' confronts those involved in humanitarian activity with urgent practical and ethical questions. This article begins with an outline of the development of post-war reconstruction as a specific area of focus for humanitarian organisations and academia, before examining the pre-war
With the ten year anniversary of Sept. 11, many have questioned the continuation of the War on Terrorism. Study the links and docmunets below to prepare yourself for a class debate on the question: Should the U.S. continue military action in the War on Terror? Debate Question : Should the U.S. continue military action in the War on Terror? Pro: The U.S. and its allies need to continue military action to disrupt terrorist networks and prevent further attacks. Con: The terrorist threat has been exaggerated and military operations can be scaled back. Debate Information : Use the following links to ...
Potential paths to nuclear war and the available means of prevention of nuclear war are discussed. Presented is a detailed description of six nuclear war scenarios, and brief examples of types of potential deterrents to nuclear war (firebreaks) which are relevant for each. To be effective, the right combination of firebreaks must be used, the…
How did economic and financial factors determine how America waged war in the twentieth century? This important new book exposes the influence of economics and finance on the questions of whether the nation should go to war, how wars would be fought, how resources would be mobilized, and the long-term consequences for the American economy. Ranging from the Spanish–American War
This paper examines the determinants of economic growth in countries emerging from civil war. While there is substantial evidence that economic growth is a key factor in maintaining peace after civil war, the existing literature has not explained the unique factors that may account for the large variation in growth across post-civil war countries. I argue that war outcomes affect
Deaths and injuries are the most immediate effects of war, but war also causes living conditions to fall below minimum levels, favours the spread of disease and makes health interventions difficult. Thus the first victims of modern war are civilians. A co...
IntroductionRoad traffic accidents are a major cause of injury and trauma in Uganda, of which head injuries are a major cause of morbidity and mortality among casualties.ObjectivesTo determine the leading cause of head injuries, factors associated and the outcomes.MethodsA retrospective study was carried out. Pretested questionnaires were filled in from the Records department on patients with head injuries in the
A retrospective review of charts of patients with baby walker-related injuries presenting to a large urban emergency room over a 23-month period was undertaken. Ninety-seven percent of the children sustained injuries to their head or face. Sixty-eight percent of the injuries were the result of falling down steps. Twenty-two percent of the injuries required surgical or dental evaluation in addition to pediatric evaluation. PMID:6692642
The Marine Corps War Memorial stands as a symbol of this grateful Nation's esteem for the honored dead of the U.S. Marine Corps. While the statue depicts one of the most famous incidents of World War II, the memorial is dedicated to all Marines who have given their lives in the defense of the United States since 1775. The 32-foot-high
The treatment of war wounds is an ancient art, constantly refined to reflect improvements in weapons technology, transportation, antiseptic practices, and surgical techniques. Throughout most of the history of warfare, more soldiers died from disease than combat wounds, and misconceptions regarding the best timing and mode of treatment for injuries often resulted in more harm than good. Since the 19th century, mortality from war wounds steadily decreased as surgeons on all sides of conflicts developed systems for rapidly moving the wounded from the battlefield to frontline hospitals where surgical care is delivered. We review the most important trends in US and Western military trauma management over two centuries, including the shift from primary to delayed closure in wound management, refinement of amputation techniques, advances in evacuation philosophy and technology, the development of antiseptic practices, and the use of antibiotics. We also discuss how the lessons of history are reflected in contemporary US practices in Iraq and Afghanistan. PMID:19219516
Manring, M M; Hawk, Alan; Calhoun, Jason H; Andersen, Romney C
Over the course of history, while the underlying causes for wars have remained few, mechanisms of inflicting injury and our ability to treat the consequent wounds have dramatically changed. Success rates in treating war-related injuries have improved greatly, although the course of progress has not proceeded linearly. From Homer's Iliad to the Civil War to Vietnam, there have been significant improvements in mortality, despite a concurrent increase in the lethality of weapons. These improvements have occurred primarily as a result of progress in three key areas: management of wounds, treatment of shock, and systems of organization. PMID:19268793
Launched by the International Committee of the Red Cross (ICRC) in August 1999 to mark the 50th anniversary of the modern Geneva Conventions, the People on War Project has conducted interviews and surveys with over 20,000 people in seventeen countries on their perceptions of what is right and wrong in wartime. At present, users can read the full text of the resulting final comparative report and six country reports in HTML and .pdf formats. In addition, users can read a selection of "Best of People on War stories," view several excellent collections of annotated photographs, and (after free registration) enter CrossFire, an "interactive documentary" on the "dilemmas soldiers, civilians, and others face in war." Additional resources at the site include discussion forums, a questionnaire, and several reference sources, among them the full searchable text of the Geneva Conventions of 1949.
Almost all of the remaining veterans of World War One have passed on, but the "Great War" remains a subject of considerable interest for the general public and historians alike. This intriguing site created by the Guardian newspaper in Britain features slideshows, articles, and a set of external links to additional websites of note. First-time visitors may wish to click on the "Series" section to read the four part set of articles that delves into topics such as "The western front" and "The road to war". The site also does a nice job of weaving in modern commentary and editorials on the current state of European affairs and armed conflicts both throughout the Continent and in other regions of the world. Additionally, the site also contains video clips of veterans talking about their time in the trenches and historians commenting on the legacy of this tremendous conflict.
In the late 1990s, natural resources such as oil, diamonds, and timber came under increased scrutiny by conflict analysts and media outlets for their purported role in many contemporary wars. This article discusses some of the limitations of conventional arguments linking wars and resources. Dominated by econometric approaches and rational choice theory interpretations, arguments pertaining to “resource wars” often oversimplify
Despite widespread emphasis on the importance of winning 'the' war of ideas in recent strategic literature, one finds few analytical studies of wars of ideas as such. With that in mind, this monograph offers a brief examination of four common types of war...
ABSTRACT Background In the 1980s, many medical organizations identified the prevention of nuclear war as one of the medical profession's most important goals. An assessment of the current danger is warranted given the radically changed context of the post-Cold War era. Methods We reviewed the recent literature on the status of nuclear arsenals and the risk of nuclear war. We
Lachlan Forrow; Bruce G. Blair; Ira Helfand; George Lewis; Theodore Postol; Victor Sidel; Barry S. Levy; Herbert Abrams; Christine Cassel
Theories of the cold war that stress the imperatives of the American domestic politico-economic system or the requirements of bipolarity are undermined by the argument that the Korean war strongly influenced international history and indeed brought about most of the characteristics which we associate with the cold war. Without Korea, U.S. policy would have been very different, and there were
|Examines a unit approach to World War II that emphasizes totalitarianism, the military conduct of the war, and the Holocaust. Advocates using a variety of teaching strategies, methods, and materials. Includes several examples of innovative materials and activities. (MJP)|
The war on terrorism has changed Americans lives and strained the capacities of their government. The Federal Government confronts a confounding array of choices about priorities and coordination. Although the Cold War required synchronizing America's glo...
L. E. Davis G. F. Treverton D. Byman S. Daly W. Rosenau
War termination has usually fallen victim to neglect in military planning arenas due to its complexity, difficulty, and uncertainty throughout the course of a war. Too often our political leaders, being unfamiliar with military operations, have allowed mi...
Background: An important medical concern of the Iraq war is the potential long-term effect of mild traumatic brain injury, or concussion, particularly from blast explosions. However, the epidemiology of combat-related mild traumatic brain injury is poorly...
A. L. Cox C. C. Engel C. W. Hoge D. McGurk J. L. Thomas
|In this article, the authors provide a historical review of how the U.S. government has funded its participation in major wars during the past 150 years. They focus attention on five conflicts--the Civil War, World War I, World War II, the Korean War and the Vietnam War. Those conflicts were funded in different ways, with each funding method…
Ingmar Bergman's film Skammen (Shame) (1968), about a married couple trapped between the warring parties in a bloody civil war, triggered fierce ideological debate in Sweden. According to the harsh critics of the film, among whom the leading critic was well-known author Sara Lidman, Bergman had managed to create propaganda for the American go- vernment and its controversial war in
|This issue of the children's quarterly magazine, "The Goldfinch," focuses on World War I. A brief discussion of how the United States came to enter the War is followed by a discussion of propaganda. An article on the use of posters to encourage citizens to participate in the war effort is illustrated with reproductions of several of these…
Between 1945 and 1991, tension between the USA, its allies, and a group of nations led by the USSR, dominated world politics. This period was called the Cold War – a conflict that stopped short to a full-blown war. Benefiting from the recent research of newly open archives, the Encyclopedia of the Cold War discusses how this state of perpetual
In this course, we will adopt a different focus. We will emphasize the cultural processes through which people in the United States participated in, and came to understand, the cold war as a way of life. (This course deals with cold war culture and religion only in the U.S.) During the cold war, American citizens struggled to construct a \\
Existing research has related civil war primarily to country-specific factors or processes that take place within individual states experiencing conflict. Many contemporary civil wars, however, display a trans- national character, where actors, resources, and events span national boundaries. This article challenges the 'closed polity' approach to the study of civil war, where individual states are treated as independent entities, and
If we wish to abolish war as a legitimate means of settling disputes, what must we do? One can imagine this question guiding the drafting of the United Nations Charter. At the end of World War II, the founders of the United Nations certainly must have felt that the world had had enough of war. Some 50 million people had
The 40 wars of the past decade, all ‘minor’, have resulted in a total of more than two million deaths and 20 million refugees or displaced persons. Few have been the international wars typical of previous periods. Nine out of ten began as internal or civil wars, foreign intervention ? when it occurred ? being always secondary. The weapons used,
The dominant hypothesis in the literature that studies conflict is that poverty is the main cause of civil wars. We instead analyze the effect of institutions on civil war, controlling for income per capita. In our set up, institutions are endogenous and colonial origins affect civil wars through their legacy on institutions. Our results indicate that institutions, proxied by the
Are civil wars partly caused by low economic growth? And do democratic institutions attenuate the impact of low growth on the likelihood of civil war? Our approach to answering these questions exploits that international commodity prices have a significant effect on income growth in Sub-Saharan African countries. We show that lower income growth makes civil war more likely in non-democracies.
This article revisits the relationship between income per capita and civil con‡ict. We establish that the empirical literature identi…es two dierent patterns. First, poor countries have a higher propensity to suer from civil war. Second, civil war occurs when countries suer negative income shocks. In a formal model we examine an explanation often suggested in the informal literature: civil wars
The study of ethnicity is dominated by constructivist approaches, yet empirical studies of civil war have been oblivious to their insights. In this article, the author examines the relationship between ethnic identity and civil war and points to several empirical instances of fluidity in the behavioral expression of ethnic identities within civil war. The author identifies two processes that are
Space weapons for terrestrial conflict have been the subject of intense debate twice in the modern history of space. The first time, at the beginning of the Cold War, was over the possibility of bombardment satellites carrying nuclear weapons. The second ...
B. Preston C. Shipbaugh D. J. Johnson M. Miller S. J. Edwards
Western strategic concepts have had their own built-in images of nuclear war. These concepts concentrate largely upon the uncertainties of mass nuclear exchanges and the unbelievable devastation that would accompany such a conflict. By not considering in detail how a war of such magnitude and violence might unfold, let alone be ended, these nightmare strategists must resign themselves to either capitulation or cataclysm if their theories of deterrence should prove to be either inoperative or inappropriate in the acid test of reality. The world is at a crossroads in the development of its views of nuclear strategy. The rapid pace of technological development has profound implications for how both conventional and nuclear war might be either avoided or waged. The impact of technological development has been especially great in the area of strategic defense where, like never before, we have the opportunity to create an alternative to the exclusive reliance on the threat of retaliation. Ending a Nuclear War: Are the Superpowers Prepared provides contribution to the study of this vitally important component of deterrence.
The British Veil Wars maps the space of the British debates on Islamic women's apparel and identifies the political conditions and structures that direct the non regulation of its practice in public institutions, such as schools. The article argues that despite the poignant political dilemmas caused by the 2006 'veil debate' on the niqab (face veil) statutory regulation against its
|This book examines the complex and varied relations between educational institutions and societies at war. Drawn from the pages of the "Harvard Educational Review," the essays provide multiple perspectives on how educational institutions support and oppose wartime efforts. As the editors of the volume note, the book reveals how people swept up in…
Blair, Elizabeth E., Ed.; Miller, Rebecca B., Ed.; Tieken, Mara Casey, Ed.
|Cold War historiography has undergone major changes since the 1991 collapse of the Soviet Union. For two years (1992-1993) the principal Soviet archives fell open to scholars, and although some of the richest holdings are now once again closed, new information continues to find its way out. Moreover, critical documentary information has become…
Communist thinking on war has been shaped by many factors--Marxist-Leninist theory, the historical experience and policies of the Soviet state, the personalities of various leaders, interaction with the West, the impact of modern technology, the rise of a...
|Insecticides should not be the only weapons of war used against pests; in addition to them, a strategy aimed at winning the millenial warfare should combine the tactical use of natural plant enemies, reinforced plant genetic qualities, and the application of adequate ecological techniques. (BL)|
This book examines the complex and varied relations between educational institutions and societies at war. Drawn from the pages of the "Harvard Educational Review," the essays provide multiple perspectives on how educational institutions support and oppose wartime efforts. As the editors of the volume note, the book reveals how people swept up in…
Blair, Elizabeth E., Ed.; Miller, Rebecca B., Ed.; Tieken, Mara Casey, Ed.
This article discusses when terrorism can be classified as war (i.e. a use of force) under both ius ad bellum and ius in bello. It looks at how terrorist acts committed in a genuine armed conflict are prohibited and how those committing them must be treated under international humanitarian law (IHL). The article then analyses the relationship between armed conflicts,
|Focusing on the theme of violence, this newsletter issue includes information about resources for violence information, a list of funding and grant agencies, conference information, and the following brief articles: (1) Waging War on Violence; (2) Minority Health Perspective (Clay Simpson); (3) Inmates Learn Alternatives to Violence; (4) National…
This article recounts the battle in the "math wars" that took place in Massachusetts, United States in 1999-2000 over the scope, content and teaching of the state's K-12 mathematics curriculum. Harsh controversies arose between the partisans of a "reform-math" movement stressing an undefined "conceptual understanding" and student-created…
The purpose of this thesis is to chronicle the actions of the soldiers of Florida during the Civil War, both within and without Florida. As there has not been a great deal written on this topic, it is hoped that this thesis will contribute to the discussion and perhaps lead others to study this field.The soldiers of Florida during the
PROCEDURES Exams. The first test will be an essay exam and you will need blue books. The final is a take-home exam in which students write essays. The exams must be typed and between 10 to 12 pages, plus endnotes. The final is cumulative, but the emphasis will be on the war years. Discussions. We will use discussion periods to
... will enjoy getting your letters. Take it easy on the TV. Pictures and stories you see about war may be hard to understand and watch. Seeing ... For Parents MORE ON THIS TOPIC The Story on Stress Nightmares Being Afraid Talking About ... Contact Us Print Additional resources Send to a ...
Many caregivers are encountering the issue of communicating with children and adolescents about current world events, specifically war and terrorism. As health care providers, it is important to raise awareness of how children may understand, interpret, and respond to related fears and concerns. Although honesty and reassurance are clearly the…
DeRanieri, Joseph T.; Clements, Paul T.; Clark, Kathleen; Kuhn, Douglas Wolcik; Manno, Martin S.
The cold war on energy conservation seems to be thawing in the nation's capitol. After a decade of relentless attacks on energy conservation research and development budgets that left them 75% below their high water mark, the US Congress is embracing energy conservation as a vital ally. The authors describe all the current proposals in both the House and Senate
"Medicalized" weapons--those that rely on advances in neuroscience, physiology, and pharmacology--offer the prospect of reducing casualties and protecting civilians. They could be especially useful in modern asymmetric wars in which conventional states are pitted against guerrilla or insurgent forces. But may physicians and other medical workers participate in their development? PMID:20166514
In June 1950, some 135,000 North Korean troops attacked South Korea, sparking a bitter struggle that many have called the 'Forgotten War.' While it may have been forgotten by some, it certainly was not by the soldiers, sailors, marines, airmen, and coastg...
|Calls for an end to a "prevention war" mentality that breeds youth programs that are high profile, short term, and in competition with programs already in place. Instead, this article advocates for comprehensive, sustained efforts that promote the personal and social development of young people and address problems at their psychosocial roots.…
Elias, Michael J.; Lantieri, Linda; Patti, Janet; Shriver, Timothy P.; Walberg, Herbert J.; Weissberg, Roger P.; Zins, Joseph E.
The author models warfare as a random-walk stochastic process. Rather than model war as a single-shot lottery, as is common in the literature, nations fight a series of battles. Nations do not defeat their foe in a single battle; rather, victory results from aggregate success over a series of interactions. Only by gradually reducing an opponent's capacity to resist can
Sulfur mustards act as vesicants and alkylating agents. They have been used as chemical warfare since 1917 during the first world war. This brief report illustrates the progression of injury on a primary exposed patient to a first world war blistering agent. This case documents the rapid timeline and progression of symptoms. It emphasises the importance of appropriate personal protective equipment and immediate medical response plan with rapid decontamination and proper action from military and civilian medical treatment facilities. This case reports the first US active duty military exposure to a blistering agent in the age of global terrorism.
During the Great Patriotic War (1941-1945) there was a real danger of use by German armies of the chemical weapon against staff of Red Army. However German command didn't risked to go on conducting large-scale chemical war against the USSR that rescued from painful death millions person. A principal cause of this decision was well organized and technically provided system of antigas protection in Red Army, including precisely organized actions of sanitary-chemical protection, qualitative preparation of military doctors on these questions and presence at them effective antidotes and other means of treatment of injuries by fighting poison gases. PMID:21874887
Imangulov, R G; Grebeniuk, A N; Rybalko, V M; Nosov, A V
We carried out a retrospective study of the frequency of ankle sprains in basketball players. A questionnaire about previous ankle injuries, time off after such injuries, current ankle problems, personal data, number of practice hours and the use of prophylactic measures was sent out to 102 basketball players in a second division league in Sweden. Ninety-six players answered. 92% of
Three hypotheses regarding symptoms of war-related posttraumatic stress disorder and general psychiatric distress were tested: that symptoms are more severe the more severe the traumatic exposure, regardless of the war in question; that symptoms are less severe the older the veterans’ age; and that symptom levels differ across sociocultural cohorts. A total of 5,138 war zone veterans who were seeking
To determine the percentage of unintentional firearm-related injuries associated with hunting and to identify risk factors, we conducted a retrospective, descriptive survey of all hunting firearm injuries identified by two North Carolina surveillance systems. Almost one-third of unintentional shooting deaths are hunting-related, and young hunters appear to be at greatest risk of injury. Safety instruction and wearing highly visible clothing should be encouraged; controlled studies should test the effectiveness of these preventive measures. PMID:3189640
OBJECTIVE: The care of traumatic wounds has evolved over hundreds of years, largely as a result of armed conflicts. The lessons learned during World War I in the treatment of extensive soft-tissue injuries proved invaluable in reducing infection and preventing loss of limb and life. Foremost among these was the use of debridement. This report reviews the development of debridement as standard treatment of war wounds and highlights the surgeon largely responsible for its resurgence during one of this century's saddest chapters. SUMMARY BACKGROUND DATA: Before World War I, the care of wounds consisted of minimal exploration and liberal use of then-new antiseptics. For limited injuries, this approach appeared adequate. World War I saw the introduction of devastating weapons that produced injuries that caused extensive devitalization of tissue. Standard treatment of these patients proved woefully inadequate to prevent life-threatening infections. METHODS: This is a historical review of the conditions that occurred during World War I that prompted a change in wound management. One of those responsible for this change was the Belgian surgeon Antoine Depage. His life and contributions to the care of war wounds are profiled. Depage reintroduced the discarded French practice of wound incision and exploration (debridement) and combined it with excision of devitalized tissue. RESULTS: Through the use of debridement, excision, and delayed wound closure based on bacteriologic survey, Depage was able to reduce the incidence of infectious complications of soft-tissue injuries, particularly those involving fractures. CONCLUSIONS: Through his experiences in the Great War, Antoine Depage was able to formulate a treatment plan for wounds of war. All such injuries were assumed to be contaminated and, as such, they required early and careful debridement. Depage thought that wound closure should often be delayed and based his decision to close on the bacteriologic status of the wound. To him, we owe our current management of traumatic wounds. Images Figure 1. Figure 2. Figure 3. Figure 4. Figure 5.
Objectives. – To determine the incidence and nature of karate injuries sustained in karate clubs and to identify risk factors for injuries.Methods. – One hundred eighty-six individuals from three karate clubs in Brest, France, were entered in a retrospective study extending from September 2002 to June 2003. Each athlete was asked to complete a questionnaire on karate injuries sustained during
The criteria for hospital admission of children who have suffered a minor head injury are highly subjective. Often the presence of post-traumatic emesis becomes an influential factor, but the mechanisms that trigger emesis following minor head injuries are not known. From a prospective study of 96 consecutive children with their first mild head injury (GCS 13–15) and a retrospective study
H. Hugenholtz; D. Izukawa; P. Shear; M. Li; E. C. G. Ventureyra
OBJECTIVE: To determine the characteristics and the severity of head and facial injuries to helmeted child bicyclists, and whether the helmet contributed to the injury, and to study factors related to bicycle accidents. DESIGN: Retrospective review of two case series. Children sustaining head injury while not wearing helmets were studied as a form of reference group. SETTING: Large paediatric teaching
Summary Background: Gunshot injuries are major problems worldwide from the medical and economic perspectives and are associated with profound morbidity and significant mortality. Many previous studies were focused on specific sites of injury but this study was aimed at the pattern and presentation of the gunshot injuries. Patients and Methods: This was a combined retrospective and prospective study of gunshot
J D Ogunlusi FMCS; L M Oginni; I C Ikem; O G Hamilton; M Temitope MBBS
The objective of this study was to review the diagnosis, management, and outcome of the rare iatrogenic arterial injury associated with elective orthopedic joint procedures. A retrospective review was conducted of all patients presenting to the vascular surgery service with arterial injury after elective orthopedic procedures between 1997 and 2002. Clinical records were reviewed for presentation, type of injury, management,
Jeffrey S. Wilson; Ana Miranda; Brad L. Johnson; Murray L. Shames; Martin R. Back; Dennis F. Bandyk
Airbags are clearly successful at mitigating injury severity during motor vehicle accidents. Deployment unfortunately has introduced new injury-causing mechanisms. A retrospective review of 20 patients who sustained otologic injuries resulting from airbag inflation was conducted. The most common symptoms were hearing loss in 17 (85%) and tinnitus in 17 (85%). Objective hearing loss was documented in 21 of 24 (88%)
WILLIAM J. MCFEELY; DENNIS I. BOJRAB; KENT G. DAVIS; DOUGLAS F. HEGYI
Throughout the history of warfare, changes in weaponry have produced changes in the nature of warinjury. The 16th century saw the introduction of firearms in conventional warfare, bringing the destructive power of weaponry to new and unseen heights with a dramatic increase in the severity and complexity of battle injuries. Destructive gunshot wounding associated with embedded foreign material often led to sepsis and demanded the more radical treatment of amputation. Over the past 500 years innumerable developments have taken place in anaesthesia, asepsis, transfusion therapy and resuscitation, antibiotic therapy, vascular surgery and wound management. Medical services have had to adapt in order to cope with the changing volume and changing nature of battle casualties resulting from modern weaponry. Despite the progress made, amputation is still a commonly performed operation following traumatic limb injury. In those cases where the decision to amputate is not so clearly and distinctly defined, history has shown that prevention of infection requires aggressive primary surgery and removal of all devitalised tissue. This paper examines the history of amputation in the management of the battlefield casualty suffering limb injury, beginning in the 16th century and continuing into present day. PMID:22319981
In Afghanistan a French soldier was injured by an Improvised Explosive Device (IED). He presented with a blunt aortic arch trauma and injuries of face, neck, abdomen and lower extremities. Thanks to a staged management (triage in the field, emergency surgery in a US Combat Support Hospital) he could be evacuated to France. In a military tertiary referal center the
In “Challenging the Rhetoric of Water Wars” (Eos, In Brief, September 5, 2000, p. 410) Randy Showstack reported on the speech given by Minister Kader Asmal upon receiving the 2000 Stockholm Water Prize. This prize was well deserved for the tremendous progress South Africa has made under Minister Asmal's leadership in addressing basic water needs after apartheid. Indeed, I was one of his nominators for this prize and am an ardent fan of his bold programs. But his remarks about water-related conflicts need to be qualified. In his speech, Minister Asmal noted that water scarcity is a “crisis of biblical proportion,” but also suggested “there is not a shred of evidence” to back up arguments that there are water “wars.”
The Library of Congress (LOC) American Memory collection has recently expanded yet again with this new exhibit. This exhibit, from the LOC's Geography and Map Division, features a selection from the approximately 2,240 Civil War maps and charts and 76 atlases and sketchbooks held by the Division. The majority of the maps were made during the Civil War, although some were produced afterwards to illustrate certain events or battles. Of special interest are maps produced by Confederate Major Jedediah Hotchkiss, a topographical engineer responsible for battle maps that were used by Generals Lee and Jackson. Users can search the collection by keyword or browse by subject, creator, title, or geographic location. Maps are offered as thumbnail images with several size and zoom options. Updates will be made to the collection on a monthly basis.
Involvement in warfare can have dramatic consequences for the mental health and well-being of military personnel. During the 20th century, US military psychiatrists tried to deal with these consequences while contributing to the military goal of preserving manpower and reducing the debilitating impact of psychiatric syndromes by implementing screening programs to detect factors that predispose individuals to mental disorders, providing early intervention strategies for acute war-related syndromes, and treating long-term psychiatric disability after deployment. The success of screening has proven disappointing, the effects of treatment near the front lines are unclear, and the results of treatment for chronic postwar syndromes are mixed. After the Persian Gulf War, a number of military physicians made innovative proposals for a population-based approach, anchored in primary care instead of specialty-based care. This approach appears to hold the most promise for the future.
There are different kinds of terrorism as there are of war. It is unpersuasive to make the deliberate targeting of civilians\\u000a a defining feature of terrorism, and states as well as non-state groups can engage in terrorism. In a democracy, voters responsible\\u000a for a government’s unjustifiable policies are not necessarily innocent, while conscripts are legitimate targets. Rather than\\u000a being uniquely
This is the companion website to NOVA's documentary "Fire Wars" revealing the importance of fire to wildlife systems. Additionally, it documents major wildfires from the past century and the development of modern wildfire fighting methods, as well as detailing the integral role that weather plays in wildfires. Teachers' resources include classroom activities, handouts and wildfire simulations, a glossary of fire terms and a virtual laboratory to explore the components of fire and basics of combustion.
Nondemocratic governments under the rule of weak institutions use repression against the opposition to remain in power. Repression\\u000a both muffles the opposition’s voice and strengthens the government’s supporters. Nevertheless, when repression becomes strong\\u000a enough, it becomes intolerable to its victims who revolt and initiate a civil war. The government is aware of the mechanism\\u000a and determines the level of repression
During the 1990s, the teaching of mathematics became the subject of heated controversies known as the math wars. The immediate origins of the conflicts can be traced to the “reform” stimulated by the National Council of Teachers of Mathematics’ Curriculum and Evaluation Standards for School Mathematics. Traditionalists fear that reform-oriented, “standards-based” curricula are superficial and undermine classical mathematical values; reformers
War is an inherently traumatizing experience, and during the First World War more than 15,000 Canadian soldiers were diagnosed with some form of war-related psychological wounds. Many more went unrecognized. Yet the very act of seeking an escape from the battlefield or applying for a postwar pension for psychological traumas transgressed masculine norms that required men to be aggressive, self-reliant, and un-emotional. Using newly available archival records, contemporary medical periodicals, doctors' notes, and patient interview transcripts, this paper examines two crises that arose from this conflict between idealized masculinity and the emotional reality of war trauma. The first came on the battlefield in 1916 when, in some cases, almost half the soldiers evacuated from the front were said to be suffering from emotional breakdowns. The second came later, during the Great Depression, when a significant number of veterans began to seek compensation for their psychological injuries. In both crises, doctors working in the service of the state constructed trauma as evidence of deviance, in order to parry a larger challenge to masculine ideals. In creating this link between war trauma and deviance, they reinforced a residual conception of welfare that used tests of morals and means to determine who was deserving or undeserving of state assistance. At a time when the Canadian welfare state was being transformed in response to the needs of veterans and their families, doctors' denial that "real men" could legitimately exhibit psychosomatic symptoms in combat meant that thousands of legitimately traumatized veterans were left uncompensated by the state and were constructed as inferior, feminized men. PMID:20857589
This article examines the processes through which civilian fear was turned into a practicable investigative object in the inter-war period and the opening stages of the Second World War, and how it was invested with significance at the level of science and of public policy. Its focus is on a single historical actor, Solly Zuckerman, and on his early war work for the Ministry of Home Security-funded Extra Mural Unit based in Oxford’s Department of Anatomy (OEMU). It examines the process by which Zuckerman forged a working relationship with fear in the 1930s, and how he translated this work to questions of home front anxiety in his role as an operational research officer. In doing so it demonstrates the persistent work applied to the problem: by highlighting it as an ongoing research project, and suggesting links between seemingly disparate research objects (e.g. the phenomenon of ‘blast’ exposure as physical and physiological trauma), the article aims to show how civilian ‘nerve’ emerged from within a highly specific analytical and operational matrix which itself had complex foundations.
Many American military personnel who served in the Iraq and Afghanistan wars will need long-term management of war-related conditions. There is pressing need for expertise in veterans' care outside of the Military Health System (MHS) and Department of Veterans Affairs (VA), as many will seek care elsewhere: Veterans receive free MHS care only while on active duty; enhanced eligibility for VA healthcare ends 5 years after military discharge; many veterans eligible for VA healthcare use non-VA services instead; and the Affordable Care Act will expand Medicaid coverage for uninsured veterans. Families of veterans also may need care for conditions related to war service. Most medical schools lack veteran-focused curricula beyond VA clerkships, which often do not provide specific training on service-related conditions. The VA, Department of Defense (DoD), veterans groups, and medical professional organizations should partner to develop technical competencies in veteran and family health care for clinicians at all career stages, and cultural competencies to ensure contextually appropriate care. National and state licensing boards should assess these competencies formally. Partnerships between VA, DoD, and the community for care delivery can improve transitions and the quality of veterans' post-deployment care. PMID:23435767
Data was analyzed retrospectively of a ten year period at the Neurology clinic in Sarajevo, with regards to the treatment of patients with acute cerebrovascular accident (CVA or stroke). The whole period has been divided into three segments: a) pre-war period 01.01.1990-05.04.1992, b) the war period 06.04.1992-15.12.1995, and c) post-war period 16.12.1995-31.12.1999. There has been the total of 6,255 patients with a completed stroke, while the patients with transitory ischemic attacks were not involved in the study. General mortality from stroke rose considerably during the war, the rate is somewhat reduced post-war, but not as low as pre-war (35%, 48%, 38% respectively). During the war there was a greater number of patients with intracerebral haemorrhage compared to the atherothrombotic brain infarction group, but the relationship changed after the war in favor of the latter. No difference in sex structure was noticed in the observed three periods. During the war, there was 0 minor increase in the percentage of patients in the 51-60 years age group, but after the war there was a remarkable increase in the 70+ age group. As far as risk factors are concerned, we have traced a marked raise in rates of the hypertension and cardiopathy during the war, with a lower frequency of diabetes. The first two risk factors have kept the same trend post-war, and diabetes returned to the its approximately pre-war level. All changes described here are pointing towards a remarkable influence of war activities on morbidity and mortality of the cerebrovascular accident, where the rates are slowly and incompletely returning to its pre war levels. PMID:12378860
Objective—To provide epidemiological data on whitewater kayaking injuries using a descriptive study. Methods—A retrospective survey was distributed at whitewater events and club meetings, and made available and advertised on the world wide web, through postings and announcements to newsgroups, related sites, and search engines. Data on sex, age, experience, and ability were collected. Injury data collected included mechanism, activity, difficulty of rapid, and self reported severity. Results—Of the 392 kayaking respondents included in the final analysis, 219 suffered 282 distinct injury events. The number of days spent kayaking per season was the only independent predictor of injury. The overwhelming majority of injuries occurred while the kayaker was still in the boat (87%). Striking an object was the most common mechanism of injury (44%), followed by traumatic stress and overuse (25% each). The most common types of injury were abrasion (25%), tendinitis (25%), contusion (22%), and dislocation (17%). The upper extremity, especially the shoulder, was the most commonly injured area of the body. Although half of injured kayakers sought medical care for their injury, and almost one third missed more than one month of kayaking because of the injury, almost all (96%) reported a complete or good recovery. Conclusions—Factors relating to likelihood of injury appear to be connected with exposure, namely the number of days a year that the sport was pursued. Except for class V (extreme) kayakers, reports of injuries paralleled the number of participants. Kayakers reported injuries predominantly on rivers that they assessed to be at a level appropriate to their skills. Key Words: kayaking; whitewater; injuries
Study design:Retrospective review.Objective:This retrospective review observes the evolution of bladder management by time and reports adult urological outcomes and complications in paediatric onset spinal cord injury (SCI).Setting:Spinal Injuries Unit RNOH Stanmore.Method:In total, 10 traumatic SCI patients with mean age at injury of 13.6 years underwent treatment, for a mean period of 13.1 years. Characteristics of injury were noted. Two diagnostic
P Patki; R Hamid; S Somayaji; J Bycroft; P J R Shah; M Craggs
This paper discusses the effects of modern war on children in the 20th century, focusing on direct and indirect effects of World War II, Vietnam War, war in Afghanistan, conflicts in Africa and in Central America, and Persian Gulf War. The paper notes the devastating effects on children of disruption of education and other public services in…
|This paper discusses the effects of modern war on children in the 20th century, focusing on direct and indirect effects of World War II, Vietnam War, war in Afghanistan, conflicts in Africa and in Central America, and Persian Gulf War. The paper notes the devastating effects on children of disruption of education and other public services in…
This article explores the question of whether the war on terror is just. It begins by arguing that the Just War tradition offers a better way of asking moral questions about war than either pacifism or realism. Applying the Just War tradition suggests that in order to justify a war on terrorism, we need to know exactly who the terrorists
Study design:Retrospective review.Objectives:To identify relationships between lower extremity innervation and level of injury, mechanism of injury, and age at injury in a pediatric population with spinal cord injury (SCI). Secondarily, relationships between innervation and completeness of injury, time since injury, race, and sex were evaluated.Setting:Pediatric orthopedic referral hospital, Philadelphia, Pennsylvania.Methods:Records of 190 subjects, ages 1–21 years, were reviewed. Data collected
T E Johnston; M N Greco; J P Gaughan; B T Smith; R R Betz
The purpose of this study was to determine the rate and type of injury in elite Canadian Taekwondo athletes, before and during competition and to investigate the relationship between past injuries, injuries during competition and success. This retrospective case-series study incorporated Taekwondo injuries sustained by 75 male and female elite Canadian Taekwondo athletes over 10 years and its relationship to
The purpose of this study was to determine the rate and type of injury in elite Canadian Taekwondo athletes, before and during competition and to investigate the relationship between past injuries, injuries during competition and success. This retrospective case-series study incorporated Taekwondo injuries sustained by 75 male and female elite Canadian Taekwondo athletes over 10 years and its relationship to
AIM: To retrospectively evaluate the preoperative diagnostic approaches and management of colonic injuries following blunt abdominal trauma. METHODS: A total of 82 patients with colonic injuries caused by blunt trauma between January 1992 and December 2005 were enrolled. Data were collected on clinical presentation, investigations, diagnostic methods, associated injuries, and operative management. Colonic injury-related mortality and abdominal complications were analyzed.
Yi-Xiong Zheng; Li Chen; Si-Feng Tao; Ping Song; Shao-Ming Xu
This thesis contains a nearly exhaustive compilation of biblical passages that are germane to the issue of war, both from a descriptive and prescriptive viewpoint. In Chapter 2, God’s theocentric rationale for using war to achieve God’s sovereign purposes in the Older Testament was found in biblical passages that stress the soteriological, axiological, moral and spiritual nature of Israel’s wars
Abstract This article revisits the relationship between,income,per capita and civil con‡ict. We establish that the empirical literature identi…es two di¤erent patterns. First, poor countries have a higher propensity to su¤er from civil war. Second, civil war occurs when countries su¤er negative income,shocks. In a formal model,we examine,an explanation,often suggested in the informal literature: civil wars occur in poor countries because,the
Mild traumatic brain injury has been called the signature injury of the wars in Iraq and Afghanistan. In both theaters of operation, traumatic brain injury has been a significant cause of mortality and morbidity, with blast-related injury the most common cause. Improvised explosive devices have been the major cause of blast injuries. It is estimated that 10% to 20% of veterans returning from these operations have suffered a traumatic brain injury, and there is concern that blast-related injury may produce adverse long-term health affects and affect the resilience and in-theater performance of troops. Blast-related injury occurs through several mechanisms related to the nature of the blast overpressure wave itself as well as secondary and tertiary injuries. Animal studies clearly show that blast overpressure waves are transmitted to the brain and can cause changes that neuropathologically are most similar to diffuse axonal injury. One striking feature of the mild traumatic brain injury cases being seen in veterans of the wars in Iraq and Afghanistan is the high association of mild traumatic brain injury with posttraumatic stress disorder. The overlap in symptoms between the disorders has made distinguishing them clinically challenging. The high rates of mild traumatic brain injury and posttraumatic stress disorder in the current operations are of significant concern for the long-term health of US veterans with associated economic implications. PMID:19306373
The aim of this study was to evaluate the sensitivity, specificity, accuracy, and positive and negative predictive values of emergent ultrasound examination in the detection of hemoperitoneum among war casualties, and to compare the results of this method in a specific war situation and civil conditions. Ninety-four wounded individuals with suspected blunt or penetrating abdominal trauma were treated at a level I war hospital (group W), and 242 civilians with multiple injuries with suspected blunt abdominal trauma were evaluated at the emergency center of a university hospital (group C). All examinations were performed in less than 5 minutes with a portable ultrasonographic scanner, and typical points were scanned (Morison's pouch, Douglas and perisplenic spaces, paracolic gutter). In group W, hemoperitoneum was identified correctly in 19 patients, with three false-negative and no false-positive findings, whereas group C presented 98 true-positive results, 13 false-negative results, and again no false-positive results. We observed that ultrasonography in specific war conditions showed sensitivity of 86%, specificity of 100%, accuracy as high as 97%, positive predictive value of 100%, and negative predictive value of 96%, whereas in civil conditions the corresponding values were 88%, 100%, 95%, 100%, and 91%, respectively. The sensitivity, specificity, accuracy, and positive and negative predictive values of emergent ultrasound examination in the diagnosis of hemoperitoneum are approximately equal in war and civil conditions. PMID:10459274
Mileti?, D; Fuckar, Z; Mraovi?, B; Dimec, D; Mozetic, V
Since the Vietnam War experience we have known that there is a high association between knee dislocations and popliteal artery injuries. In an effort to improve the quality of care we asked whether every patient with a knee dislocation needs an arteriogram. This is a retrospective chart review of all injured patients who presented to Louisiana State University Health Science Center with knee dislocations between January 1, 1993 and March 31, 1998. Twenty-one patients met the study criteria. There were no deaths in this series. Twelve patients presented with normal palpable pulses. Nine of these 12 patients underwent an arteriogram. There was only one abnormal arteriogram (intimal defect) in this group. None of the patients who presented with normal pulses were operated on. There were no in-hospital complications from this nonoperative management. In the group of patients with either diminished pulses or no pulses arteriograms were performed on all patients. Fifty-five per cent of these arteriograms were abnormal, and one-third of these patients (two) were taken to the operating room for repair. In the group of patients who present with knee dislocations and normal peripheral vascular examination arteriograms are not helpful. PMID:11243542
Cultural variations between communities may impact injury rates, especially among children. We conducted a retrospective study\\u000a of three communities in Israel using data from the Israel National Trauma Registry (1998–2007). Pediatric injury hospitalization\\u000a rates in urban communities with varied levels of socio-economic status (low, medium, and high) were compared for all injuries\\u000a and cause-specific injuries. Age-standardized and age-specific rates were
BackgroundLimited knowledge exists on injuries among professional freestyle skiers.ObjectiveTo describe the risk of injury and injury patterns among competitive World Cup (WC) freestyle skiers during the competitive season.MethodsRetrospective interviews were conducted with WC freestyle skiers from 20 nations in a cohort study at the end of the 2006–2007, 2007–2008 and 2008–2009 winter seasons, and all acute injuries occurring during the
Tonje Wåle Flørenes; Stig Heir; Lars Nordsletten; Roald Bahr
A retrospective study of eight pediatric patients (under 15 years of age) who had pancreatic injuries was undertaken. Comparisons were made with 59 adult patients who sustained pancreatic injuries over the same 15-year period. All the pediatric injuries and 96.6% of the adult resulted from blunt abdominal trauma. Bicycle accidents (children, 75.0%; adults, 0%; P < .001) and automobile accidents
In an 8-year retrospective study, 631 injuries due to the racquet sports of squash (59%), tennis (21%) and badminton (20%) were seen in a sports injury clinic, males predominating (58 to 66%). The proportion of squash injuries was higher than expected and probably relates to higher physical stress and risk of contact in this sport. Also they occurred mainly in
Throughout the world, injuries and violence are a leading cause of mortality and suffering among Indigenous communities. Among American Indian and Alaska Native children aged 1 to 19 years, 71% of deaths are from injuries. Motor-vehicle accidents, attempted suicide, and interpersonal violence are the most common causes of injuries in highly industrialized countries. For Indigenous populations in middle- and low-income countries, trauma caused by motor-vehicle accidents, agricultural injuries, interpersonal violence, child labor, and the ravages of war are priorities for intervention. To be effective, injury-prevention efforts should be based on scientific evidence, be developmentally and culturally appropriate, and draw on the inherent strengths of Indigenous communities. PMID:19962034
Berger, Lawrence R; Wallace, L J David; Bill, Nancy M
Operation BRAVA (Blast Resuscitation and Victim Assistance) was conceived as a means of conducting humanitarian assistance, education, and training in the acute surgical management of land mine and other blast injuries. The first Operation BRAVA mission was carried out in Sri Lanka during 1998 at a time of civil war between government forces and Tamil separatists. Thirty-seven patients with orthopedic war wounds were seen during this mission because of the fighting. Exploding ordnance injured 24 patients (65%), and 13 patients (35%) sustained gunshot wounds. Sixty-seven percent of explosive injuries were from mortar rounds, and the remainder was from a variety of detonating munitions. Twenty-two patients (59%) sustained injuries to one or both lower limbs, and compartment syndrome of the leg developed in two of these patients as a result of multiple fragment injuries. Nine patients (24%) sustained concomitant neurological or vascular injuries. Operation BRAVA provided a novel approach to enhancing the combat medical skills of U.S. military personnel and was successful in developing working relationships with host country medical professionals, facilitating participation in the care of wounded patients, and establishing a framework upon which future BRAVA teams might build. PMID:14964504
Almost a decade after the horrific events of September 11 it is timely to reflect on some of the lessons learned from the global ‘war on terror’. The evolution of a more sophisticated understanding of the threat posed by contemporary terrorism has cast doubt on the value and accuracy of using a war metaphor to define an effective global response.
Despite its own extensive experience in nontraditional wars, the United States has rarely excelled at this portion of the conflict spectrum in the past half century. Its current conventional military superiority will ensure that it gets much more experience in today's Small Wars Century, an era that began in the 1950s with the rise of revolutionary warfare. For several decades,
The century-old US War on Drugs based on supply control measures is endangering its War on Terror in Afghanistan. With opium poppy cultivation the most profitable crop available to Afghan farmers, the Taliban has been able to use the illegal profits from the trade to buy arms and recruit farmers by offering protection from US led aerial spraying of the
Citizen journalism has changed the nature of how news is disseminated about local and global events. We conducted an ethnographic study of a particular kind of citizen journalism: the use of war diaries on the Internet. These diaries were targeted to an audience outside of the informants' countries and cultures. We found that people wrote war diaries to reach out
Only one prospective, controlled study has compared the risk of accidental injury in persons with epilepsy to controls without seizures. A mildly increased risk in the epilepsy group was found, predominantly due to injuries that result directly from a seizure. With regard to injury type, this study found significantly higher rates of only head and soft tissue injury; however, most injuries were minor. Several retrospective, population-based studies have suggested increased rates of more serious injury types. Submersion injury has a high mortality; the risk of submersion in children with epilepsy is 7.5-13.9 fold higher than in the general population. The risk of fracture is elevated approximately twofold, either resulting directly from seizure-induced injury or predisposed by drug-induced reduction in bone mineral density. Burns due to seizures account for between 1.6% and 3.7% of burn unit admissions. The risk of motor vehicle accidents in drivers with epilepsy also appears increased, albeit marginally. Several factors predispose to a higher risk of injury among those with epilepsy. Seizures resulting in falls increase the risk of concussion and other injuries. Higher seizure frequency, lack of a prolonged seizure-free interval, comorbid attention deficit disorder, or cognitive handicap may also increase the risk of injury. While some restrictions are necessary to protect the safety of the person with epilepsy, undue limitations may further limit achievement of independence. Given the high morbidity and mortality of submersion injury, those with active epilepsy should bathe or swim only with supervision; however, showering is a reasonable option. Appropriate vitamin D and calcium supplementation and periodic measurement of bone mineral density in those at risk for osteopenia are recommended. PMID:17044832
A debate has ensued about the long-term consequences of mild traumatic brain injury, the 'signature injury' of the Iraq and Afghanistan Wars. Most epidemiological studies have found that mild traumatic brain injury is unrelated to unspecific post-concussion symptoms based on self-reported symptoms. A longitudinal study, in this issue of the Journal, using objective tests has demonstrated that mild traumatic brain injury has limited lasting neuropsychological consequences. PMID:22945923
The purpose of this IA is to make comparison/contrasts between the advertising and propaganda efforts of the U.S. government and Nazi government during WWII. Also racial issues are addressed. It works with core curriculum Standard 7, Objective 2 and 2a Please use these sites to view posters produced during the World War II Era and follow the instructions below to complete the assignment. German Propaganda Posters from WWII Pick three of the posters listed on this website and compare them with the three U.S. produced posters that you will ...
The authors emphasize that the knowledge of terminal ballistics is important for understanding the pathophysiology of war wounds. They present their own experiences in the treatment of war wounds in 504 casualties treated at the Institute of Plastic and Reconstructive Surgery, Department of Surgery, Clinical Hospital Center in Zagreb. The locations of soft-tissue defects were: head and neck, 103; trunk, 90; and extremities, 903. War wounds were divided into four main categories with regard to the type of the injury and the extension of soft-tissue defect, thus showing the differences in primary excision and reconstruction of the wounds. About 30% of head and neck injuries were treated by primary or delayed primary reconstruction. All thoraco-abdominal wounds were type I or II, and most of them (53.3%) were reconstructed with split-thickness skin grafts. The greatest number of sophisticated reconstructions were performed on extremity injuries (63 wounds were reconstructed by local flaps, while free flaps were used in 40 cases). The authors emphasize the importance of proper primary treatment, which is the condition for early reconstruction. This results in significantly shorter hospitalization, so that 62% of the patients were cured in 20 days and then discharged to early rehabilitation. PMID:7532048
Stanec, Z; Skrbi?, S; Dzepina, I; Hulina, D; Ivrlac, R
This article describes implementing the MARC holdings format through machine conversion and through hands-on coding and data entry. It presents two actual and one potential means of retrospective conversion that have taken place or are being tested at University Libraries, Virginia Polytechnic Institute and State University. One conversion project from nonstandard holdings in an online catalog, converted thorough holdings information
To participate in automated serials check-in systems or online catalogs, libraries must convert their manual periodicals records into machine-readable form. This article describes retrospective conversion, using OCLC and currently available staff and resources, of an uncataloged periodicals collection. Various phases of the conversion project, including planning, staffing, training, inventorying, editing procedures and updating, are discussed, as are problems encountered and
This study describes a set of empirically derived safety rules that if followed, would have prevented the occurrence of minor injuries. Epidemiologists have criticized behavioral interventions as increasing "safe" behavior but failing to demonstrate a decrease in injury. The present study documents retrospectively the link between safe behavior and injury. It demonstrates that these empirically derived rules are very similar to rules for the prevention of serious injury. The study also shows that these rules are not widely accepted and implemented by parents. Suggestions for future research in this area are advanced.
The Library of Congress' collection of 120 Spanish Civil War posters dating from 1936-1939 are a good-looking group of items that portray both the Republican and Nationalist causes of Spain during the Spanish Civil War. In order to start searching or browsing all the images of this collection, click on "Search This Collection" in the middle of the page. To browse the images, click on "View All". If you would rather search, you have many modes to do so, including subjects and formats, creators and other associated names, and titles. As most of the text on the posters is in Spanish, visitors may wish to look over the English translations. Unfortunately, many of the posters can only be viewed as thumbnails, unless they are being viewed in person at the Library of Congress. Although many of the posters are in bold reds, blues and yellows, their undertones are dark. Some of the black and white prints look much like newsprint, and are more pedestrian in form.
Studies aiming to identify if war veterans are at higher risk of suicide have often produced inconsistent results; this could be due to the complexity of comparisons and different methodological approaches. It should be noted that this contingent has many risk factors, such as stressful exposures, wounds, brain trauma and pain syndrome. Most recent observations confirm that veterans are really more likely to die of suicide as compared to the general population; they are also more likely to experience suicidal ideation and suffer from mental health problems. Suicides are more frequent in those who develop PTSD, depression and comorbid states due to war exposure. Combat stress and its' frequency may be an important factor leading to suicide within the frame of the stress-vulnerability model. According to this model, the effects of stress may interact with social factors, interpersonal relations and psychological variables producing suicidal tendencies. Modern understanding of stress-vulnerability mechanisms based on genetic predispositions, early life development, level of exposure to stress and stress-reactivity together with interpersonal aspects may help to build more effective suicide prevention programs based on universal/selective/indicated prevention principles. PMID:22851956
The War Crimes Act of 1996, as amended, makes it a criminal offense to commit certain violations of the laws of war when such offenses are committed by or against U.S. nationals or Armed Service members. Among other things, the Act prohibits certain viola...
Provides information on programs and activities relevant to psychology and World War II. The Advisory Board on Clinical Psychology announces the creation of a clinical psychology program in the hospitals of the Army. The Office of War Information has instituted monthly newsletters in a number of fields such as psychology, physics, and medicine through their Overseas Branch. These newsletters are
This lesson plan presents activities in which students read, analyze, and discuss excerpts from children's war diaries; and create a storyboard for a public service announcement on children's rights in wartime. It includes objectives, materials, procedures, extension activities, excerpts of children's war diaries, suggested readings, and web…
|This article explores literature taught in three different courses and the peace education approaches used for each, including epics in literature courses, Vietnam War literature, and literature of anger and hope. The author recommends the teaching of war literature as an essential part of a peace education curriculum. Devastating events such as…
Today, a growing number of teachers are moving beyond the textbook in teaching about the war, and U.S. history more broadly. Teachers are digging directly into primary sources and harnessing technology, all in an attempt to help students better understand the past and bring it to life. Doing so may be especially important with the Civil War,…
Modern communications, combined with the near instantaneous publication of information on the World Wide Web, are providing the means to dramatically affect the pursuit, conduct, and public opinion of war on both sides. The current war in Iraq is the firs...
In recent years scholars have begun to focus on the consequences of individuals' exposure to civil war, including its severe health and psychological consequences. Our innovation is to move beyond the survey methodology that is widespread in this literature to analyze the actual behavior of individuals with varying degrees of exposure to civil war in a common institutional setting. We
This paper develops a model of a war against the producers of illegal hard drugs. This war occurs on two fronts. First, to prevent the cultivation of crops that are the raw material for producing drugs the state engages the drug producers in conflict over the control of arable land. Second, to impede further the production and exportation of drugs
The article aims at reviewing the historical production on the Cold War in Italy (both research and teaching activities). Some preliminary remarks deal with the Italian university system and the role some historical disciplines, especially the history of international relations, play in such a context. In Italy, historical studies on the Cold War had their origins in the 1970s mainly
Proxies that measure the effect of World War II on a country's capital stock are used as instruments for estimating standard cross-country growth regressions. The war's destruction should offer a natural experiment that allows us to consistently estimate the speed at which productivity growth converges to its long-run path. This paper presents evidence that convergence rates are approximately 4% to
This book contains chapters on the following topics related to nuclear arms and nuclear war: crisis decision making; behavioral aspects of negotiations on mutual security; democracy, public opinion, and nuclear weapons; the case of wars; A review of theories; methodological themes and variations.
Tetlock, P.E.; Husbands, J.L.; Jervis, R.; Stern, P.C.; Tilly, C.
This article revisits the relationship between income per capita and civil con‡ict. We begin by documenting that the empirical literature iden- ti…es two dierent patterns. First, poor countries have a higher propensity to suer from civil war. Second, civil war occurs when countries suer neg- ative income shocks. In a formal model we examine an explanation often suggested in the
... prime candidates for overuse injuries. WHAT TYPE OF DANCE INJURIES OCCUR? Across the whole spectrum of dance there ... can do to prevent future injuries. WHAT CAUSES DANCE INJURIES? It is generally acknowledged that dancers are exposed ...
\\u000a Despite the development of improved protective personal equipment, orthopedic injury patterns remained unchanged from World\\u000a War I. Orthopedic trauma comprises the vast majority of warinjuries, as 70% of casualties involve the musculoskeletal system\\u000a and extremity injuries represent the most common type. Factors influencing the development of wound infections in a combat\\u000a theater include wound type and severity, the presence
Background In March 2003, the United States invaded Iraq. The subsequent number, rates, and causes of mortality in Iraq resulting from the war remain unclear, despite intense international attention. Understanding mortality estimates from modern warfare, where the majority of casualties are civilian, is of critical importance for public health and protection afforded under international humanitarian law. We aimed to review the studies, reports and counts on Iraqi deaths since the start of the war and assessed their methodological quality and results. Methods We performed a systematic search of 15 electronic databases from inception to January 2008. In addition, we conducted a non-structured search of 3 other databases, reviewed study reference lists and contacted subject matter experts. We included studies that provided estimates of Iraqi deaths based on primary research over a reported period of time since the invasion. We excluded studies that summarized mortality estimates and combined non-fatal injuries and also studies of specific sub-populations, e.g. under-5 mortality. We calculated crude and cause-specific mortality rates attributable to violence and average deaths per day for each study, where not already provided. Results Thirteen studies met the eligibility criteria. The studies used a wide range of methodologies, varying from sentinel-data collection to population-based surveys. Studies assessed as the highest quality, those using population-based methods, yielded the highest estimates. Average deaths per day ranged from 48 to 759. The cause-specific mortality rates attributable to violence ranged from 0.64 to 10.25 per 1,000 per year. Conclusion Our review indicates that, despite varying estimates, the mortality burden of the war and its sequelae on Iraq is large. The use of established epidemiological methods is rare. This review illustrates the pressing need to promote sound epidemiologic approaches to determining mortality estimates and to establish guidelines for policy-makers, the media and the public on how to interpret these estimates.
Tapp, Christine; Burkle, Frederick M; Wilson, Kumanan; Takaro, Tim; Guyatt, Gordon H; Amad, Hani; Mills, Edward J
A retrospective study of 134 patients with Types I, II, and III acromioclavicular separations was carried out. The average followup was 6.3 years, with the longest being 19 years, and the shortest being 1 year. The mechanism of injury was a direct blow in 92% of the patients. The average age of the patients was 30.1 years, with a range
John P. Park; James A. Arnold; Tom P. Coker; Walter Duke Harris; David A. Becker
The 1940s were a turning point in married women's labor-force participation, leading many to credit World War II with spurring economic and social change. This paper uses two retrospective surveys from 1944 and 1951 to show that half of all married women employed in 1950 were working in 1940, and more than half of the decade's new entrants joined after
Two chemical engineering professors at Carnegie Mellon University are the authors of Retrospective on Optimization, a fairly comprehensive paper chronicling the history of optimization problems and the development of solution methods. The 51-page document is divided into two main parts; the first outlines some of the most significant advances in the field, and the second looks ahead toward key areas of research needed to evolve optimization further.
Aim To investigate the association between parental war involvement and different indicators of psychosocial distress in a community sample of early adolescents ten years after the war in Croatia 1991-1995. Methods A total of 695 adolescents were screened with a self-report questionnaire assessing parental war involvement, sociodemographic characteristics, and alcohol and drug consumption. Personality traits were assessed with the Junior Eysenck Personality Questionnaire; depressive symptoms with the Children’s Depression Inventory (CDI); and unintentional injuries, physical fighting, and bullying with the World Health Organization survey Health Behavior in School-aged Children. Suicidal ideation was assessed with three dichotomous items. Suicidal attempts were assessed with one dichotomous item. Results Out of 348 boys and 347 girls who were included in the analysis, 57.7% had at least one veteran parent. Male children of war veterans had higher rates of unintentional injuries (odds ratio [OR], 1.2; 95% confidence interval [CI], 0.56 to 2.63) and more frequent affirmative responses across the full suicidal spectrum (thoughts about death – OR, 2.1; 95% CI, 1.02 to 4.3; thoughts about suicide – OR, 5; 95% CI, 1.72 to 14.66; suicide attempts – OR, 3.6; 95% CI, 1.03 to 12.67). In boys, thoughts about suicide and unintentional injuries were associated with parental war involvement even after logistic regression. However, girls were less likely to be affected by parental war involvement, and only exhibited signs of psychopathology on the CDI total score. Conclusion Parental war involvement was associated with negative psychosocial sequels for male children. This relationship is possibly mediated by some kind of identification or secondary traumatization. Suicidality and unintentional injuries are nonspecific markers for a broad range of psychosocial distresses, which is why the suggested target group for preventive interventions should be veteran parents as vectors of this distress.
During World War II, government expenditures were financed primarily by issuing debt. During the Korean War, expenditures were financed almost exclusively by higher taxes, reflecting President Truman's preference for balanced budgets. This paper evaluates quantitatively the economic effects of the different policies used to finance these two wars. Counterfactual experiments are used to explore the implications of financing World War
Most of today's 1.7 million women veterans obtain all or most of their medical care outside the VA health care system, where their veteran status is rarely recognized or acknowledged. Several aspects of women's military service have been associated with adverse psychologic and physical outcomes, and failure to assess women's veteran status, their deployment status, and military trauma history could delay identifying or treating such conditions. Yet few clinicians know of women's military history—or of military service's impact on women's subsequent health and well being. Because an individual's military service may be best understood within the historical context in which it occurred, we provide a focused historical overview of women's military contributions and their steady integration into the Armed Forces since the War for Independence. We then describe some of the medical and psychiatric conditions associated with military service.
Murdoch, Maureen; Bradley, Arlene; Mather, Susan H; Klein, Robert E; Turner, Carole L; Yano, Elizabeth M
A longterm study (begun in 1956) of the people of four villages in Gwembe District in Zambia provides information on deaths due to Rhodesian action or to Zimbabwean freedom fighters and on deaths due to domestic violence (which is likely to have been underreported because it is considered shameful). During the decade of the 1970s, one woman and three men died from Rhodesian action and 5 women were killed by kinsmen (two husbands, two sons, and one brother). The police left the kin to settle the case of the sister killed by the brother. One man who killed his mother persuaded a younger, unmarried kinsman to be charged and punished in his stead; another left the community. One of the men who killed his wife was released because of his age (he paid damages to his children in accordance with matrilineal tradition); the other was released for lack of evidence. Battered women usually do not press charges against their husbands but may leave them and, if young, marry again. In some cases, battered women seeking divorce have also won compensation for broken bones. Domestic violence may have been especially prevalent in this period because the economic situation deteriorated, men could not find work, and the Rhodesian war added stress and disrupted the local transportation system. In response, men began to drink more heavily and male violence directed against women and men brewed along with locally-produced alcohol. Domestic violence may be exacerbated when men use women as an outlet for their anger and frustration in stressful times of war. PMID:12295013
Since the end of the American Civil War, unexplained symptoms in military personnel arising after a war or peace mission have frequently been described. The pattern of symptoms is highly similar for all of the various war syndromes although the conditions of each war or peace mission are widely different. Many somatic hypotheses have been formulated to explain these syndromes; a considerable proportion of them are already outdated. In the last few years much attention has been given to Gulf War Syndrome and to unexplained symptoms of military personnel who were sent to Cambodia, Rwanda, Burundi, Zaire, or the former Yugoslavia. In this review the symptoms of war syndromes will be considered in more detail and the suggested somatic explanations will be discussed. During the last decade the following somatic causes have been suggested as possible explanations for these symptoms: (persistent) infection, abnormal immune response, administration of multiple vaccinations within a short period of time, use of malaria chemoprophylaxis, neurological abnormalities, exposure to toxicological substances and environmental factors. The various investigations performed to study these hypotheses are discussed. The fact that bias regularly occurs in the course of these investigations is pointed out. For the future, a reliable investigation of a war syndrome should be a prospective multidisciplinary study and should distinguish between causative and sustaining factors. PMID:10886303
Soetekouw, P M; de Vries, M; van Bergen, L; Galama, J M; Keyser, A; Bleijenberg, G; van der Meer, J W
Objective: The objective is the evaluation of treatment outcome difference between men and women through measuring quality of life persons who experienced war torture in Bosnia and Herzegovina. Method: The research is analytical-descriptive and retrospective. It was conducted at two samples which were homogeneous according to gender. All persons included in the research regarding torture consequences have received comprehensive psychosocial rehabilitation at the Association for Rehabilitation of Torture Victims-Centre for Torture Victims in Sarajevo, Bosnia and Herzegovina. MANSA (Manchester Short Assessment of Quality of Life) questionnaire have been applied as instrument of research. Results: The results indicates that women who experienced war torture, after completition of psychosocial rehabilitation, have bit better quality of life in post war conditions comparing to men. Conclusion: Generally, the quality of life results, both men and women war torture survivors are representing the evaluation of treatment outcome, justifying fully purpose of this treatment type. PMID:19114944
Salci?-Dizdarevi?, Dubravka; Dizdarevi?, Tarik; Kucukali?, Abdulah; Bravo-Mehmedbasi?, Alma
Recurrent intentional injury (RII) is a phenomenon that is often noted by those who treat the injured. The authors have observed two groups of assault-related injured patients at the District of Columbia General Hospital Level I urban trauma center to determine the magnitude of this phenomenon in the patient population, to examine the characteristics of such a group of patients, and to identify the risk factors that predispose to repeated assault-related injuries. In a retrospective group of 232 patients admitted over a 4-year period who had sustained penetrating abdominal trauma there were 76 (33%) patients who had been previously treated at our center for assault-related injury. A prospective study of 78 consecutive assault-related injured patients admitted during a 4-month period revealed that 35 patients (45%) had a history of previous hospitalization for injuries as a result of assault. Within the male group (72 patients) 49% exhibited RII. When comparing this group of patients with those patients who had no previous injuries secondary to assault, there was a significantly higher rate of unemployment for the RII group and no difference in educational level. Also, the RII group incurred significantly higher hospital charges when compared to the group of patients who had their first of such injuries ($9673 versus $6973). Efforts to reduce unemployment should be included in preventive strategies if the high incidence of assault-related injury is to be decreased.
The 40 wars of the past decade, all 'minor', have resulted in a total of more than two million deaths and 20 million refugees or displaced persons. Few have been the international wars typical of previous periods. Nine out of ten began as internal or civil wars, foreign intervention--when it occurred--being always secondary. The weapons used, the effects on the civilian populations, the type and extension of damages are different but equally destructive. The main causes of these conflicts are cultural or religious, rather than economic. The best attitudes to attempt to prevent or stop them are surveyed. PMID:11720376
|This text book on the Vietnam War is to be used in teaching high students. Each of the volume's 12 chapters is a self-contained unit on an aspect of the War. The chapters are: (1) Introduction to Vietnam: land, history, and culture; (2) America at war in Vietnam: decisions and consequences; (3) Was the Vietnam War legal? (4) who fought for the…
Summary Background UK veterans of the Gulf War report more ill health than servicemen who were not deployed to the Gulf War. We investigated whether the pattern of symptom reporting by veterans of the Gulf War differed from that in active servicemen who had not fought in the Gulf War or who had fought in other conflicts. Methods We used
Khalida Ismail; Brian Everitt; Nick Blatchley; Lisa Hull; Catherine Unwin; Anthony David; Simon Wessely
Characterized by some authors as a rehearsal for the First World War, the Russo-Japanese War was arguably the world's first modern war. During this war, the lethality of weapons on the 20th Century battlefield was clearly demonstrated. Recording the event...
Mediation is one of the few mechanisms the international community can deploy that will affect civil wars. This article introduces the dataset on mediation in civil wars - termed the Civil War Mediation (CWM) dataset. This is the first dataset to focus solely on civil war mediation. These data contribute to the present state of quantitative research on mediation in
Karl DeRouen Jr; Jacob Bercovitch; Paulina Pospieszna
Civil wars impose substantial costs on the domestic economy. We empirically measure the economic impact of such internal wars. The paper contributes to the existing literature both theoretically and methodologically. First, it explores the economic channels through which civil war affects growth. Previous studies have shown the negative growth effects of civil wars. We go a step further by identifying
Pre-World War I poetry often used picturesque images which blinded people to the actual horrors of war. The war poets, who experienced the destruction of World War I, led the way in expressing new images of the devastation and death of war, rather than focusing on honor and glory. (IS)
Historically, war trauma research has concentrated on the relationship between level of exposure and development of post-traumatic symptoms. More recently, it has been recognized that intra- and interpersonal differences can mediate how service personnel are affected by their experiences. This paper is a qualitative study exploring moral evaluations of 30 British male veterans towards their deployment in conflicts from WWII to the most recent Iraq War (2003-2009). Retrospective thematic analysis is used to explore moral evaluation and societal support. Four categories emerged based on veterans' moral evaluation of deployment: justifiable, implicitly justifiable, unclear, and unjustifiable. Analysis revealed broad differences between these groups. Veterans able to justify their experiences reported more positive aspects of both deployment and societal support than those unable to justify their deployment. These findings make clear the importance of future research exploring the interactions between civilians and service personnel, and the impact this has on mental health. PMID:20688466
Background: There are few epidemiologic studies of catastrophic baseball injuries.Purpose: To develop a profile of catastrophic injuries in baseball players and to describe relevant risk factors.Study Design: Retrospective cohort study.Methods: The authors reviewed 41 incidents of baseball injuries reported to the National Center for Catastrophic Sports Injury Research from 1982 until 2002.Results: There were an estimated 1.95 direct catastrophic injuries
The study examines the full range of effects that nuclear war would have on civilians: direct effects from blast and radiation; and indirect effects from economic, social, and political disruption. Particular attention is devoted to the ways in which the ...
The U.S. Civil War Center's area of interest includes all aspects of the Civil War and Reconstruction. The Center combines scholarly pursuits with projects and programs designed to enhance the general public's perception of the Civil War. Anyone with an interest in the Civil War is welcome to visit the CWC homepage and their collection of Web links related to the Civil War, which include indexes, letters, diaries, museums, discussion groups, newspapers, university archives, and Web-accessible documents.
The legislator has provided for a possibility of granting war disability pensions to some persons listed in appropriate legal acts. In the area of psychiatry, the most frequently indicated disorder is PTSD (post-traumatic stress disorder--formerly KZ-syndrome) manifesting in the form of neurasthenic-depressive-anxiety disturbances. The latest literature on the subject mentions the problem of simulation and meta-simulation of PTSD symptoms and claims that "... recognition of PTSD as the basis for indemnity ends can take place no sooner that PTSD symptoms have become stable and no sooner than after one year of treatment--with adequate psychological and pharmacological therapy". Expert practice, however, reveals that applications for war disability pensions with a diagnosis of PTSD mentioned in the application form--are filed by persons who have never been subject to psychiatric treatment before. It often happens that an expert draws up a disability pension form based on one psychiatric consultation. It seems fully justified to state that after half a century, which has passed since the end of the war and occupation, it is impossible to verify the causal nexus between the disorders suffered by the living combatants and the psycho-physiological injuries inflicted upon them many decades ago. Another thesis, suggesting that it would be justified to grant war disability pensions in all such cases, seems to be of discrete character and therefore appears incompatible with the nature of opinioning. PMID:16498980
Abstract \\/ Editorial writers for the US’ 10 largest newspapers,created ? during perhaps,the most critical month,in the war against terrorism ? a singular symbolic,narrative about possible military strikes in that ‘new kind of war’. The period of study is 12 September 2001, the day following the terrorist attacks, to 8 October, the day the bombing of Kabul began. It was
During the Iraq War there have been an unusually high number of leaks regarding Saddam Hussein?s WMD and post-war planning. Starting in January 2003, with President Bush?s State of the Union address and Colin Powell?s presentation to the UN, both inter and intra-departmental leaks began to emerge from the White House, CIA, State Department and Defense Department. The number of
This chapter examines the issue of unintentional injuries and focuses on a selected number of cause-specific unintentional injuries. Injuries have traditionally been defined as damage to a person caused by an acute transfer of energy (mechanical, thermal, electrical, chemical, or radiation) or by the sudden absence of heat or oxygen. Unintentional injuries consist of that subset of injuries for which
Robyn Norton; Adnan A. Hyder; David Bishai; Margie Peden
Retrospective and prospective epidemiological studies in Bucharest indicated a high rate of spinal injuries (about 28.5 per million population per year) in Romania. Most patients were poor, male, manual workers. Half of them were aged less than 40. Falls, particularly from horse-drawn carts, and road traffic accidents were the most frequent causes of injury. In summer, diving accidents were a
Methods In a retrospective, multicentre study, we used the data recorded in the trauma registry of the German Trauma S ociety to calculate the probability of survival according to the trauma and injury severity score (TRISS), revised injury severity classifi cation (RISC) score, and standardised mortality ratio (SMR, ratio of recorded to expected mortality) for 4621 patients with blunt trauma
Stefan Huber-Wagner; Rolf Lefering; Lars-Mikael Qvick; Markus Körner; Michael V Kay; Klaus-Jürgen Pfeifer; Maximilian Reiser; Wolf Mutschler; L-M Qvick; K-G Kanz
David L. Parnas, Landsdowne Professor of Computer Science at the University of Victoria resigned from the SDI Organization's Panel on Computing in Support of Battle Management on June 28, 1985. Parnas, with 20 years of research on software engineering plus 8 years of work on military aircraft real-time software, says the software portion of SDI cannot be built error-free and he doesn't expect the next 20 years of research to change that fact. Since Parnas resigned, there have been several public debates on Star Wars software questions. In November 1985 the SDIO panel from which Parnas resigned released a draft of its report, reflecting its effort to critics of the project. While one might think that errors could be entirely eliminated with enough care and checking, most software professionals believe there will always be some residue of errors in a system of this size and complexity. The general line of the critics' argument is that the larger the amount of software in a single, unified system, the higher the percentage of errors it will contain. Proponents counter that the one very large system can be divided into a number of smaller, relatively independent pieces, thus reducing the proportionate number of errors in each separate piece. This approach is in turn countered by those who point to the intricate relations between these pieces, which themselves contribute to error.
One of the great delights of general practice is the way we are allowed to share people's lives. Another facet is the humbling experience of having a patient intuitively grasp a concept that you have found difficult to understand. As regular readers of these pages are aware, I am no stranger to emergencies and trauma. Consequently I see and experience critical incident stress at first hand. This gives me some understanding of others' experiences and, I hope, might help me prevent critical incident stress developing into the more severe post-traumatic stress disorder (PTSD) in those under my care. How well I recall that it was only the fall of a marble that prevented me from being conscripted for service in Vietnam. Kerry is a long-standing patient and an old friend (in a small community, if your patients aren't your friends, you do not have too many patients!). He was seeing me for something or other when he told me the following story. I was so impressed that I asked him to write it down. It speaks eloquently of the aftermath of war and how mates help each other deal with it. It also reminds us that there continue to be new crops of returned service-men who need our help. PMID:8588756
OBJECTIVE: To assess prospectively the incidence, nature, and severity of injuries to polo riders competing in the 1996 Argentine High Polo season. METHODS: Assessment, documentation, and provision of care for all injuries sustained during the 1996 season by one of the authors. Riders were also surveyed retrospectively for their previous polo injuries. RESULTS: 34 riders took part in the study. Nine injuries were sustained prospectively and 55 injuries were reviewed retrospectively (64 total). The injuries were categorised as minor (10), moderate (13), and major (41). Twenty five (39%) injuries occurred in the arms, 20 (31%) in the legs, 12 (19%) in the head, 3 (5%) in the back, and 4 (6%) in the face. A fracture occurred in 25 (39%) injuries as most resulted from a fall from the horse. Additionally, facial lacerations occurred prospectively in five riders but did not result in missed play. An overall injury rate of 7.8/1000 player-game hours was calculated. CONCLUSIONS: Although many sports have injury rates much greater than 8/1000 player-game hours, the severity of most injuries occurring in polo was classified as major, with fractures and facial lacerations common. The use of a helmet with a face protector is recommended to decrease injury to players. A doctor experienced in the management of serious trauma should be present at all polo matches. ???
The principles of management of civilian gunshot wounds (GSWs) to the head and spine have evolved directly from the experience gained in war by military neurosurgeons. The type of craniocerebral wounds being produced in urban gang warfare and suicide at tempts using handguns or rifles at close range vary considerably from the lower velocity fragment injuries which are common in
This research report introduces the historical process of Japanese use of chemical weapons against the Chinese during the Second World War, which caused serious casualties and mass destruction. In addition, it also elaborates on the discarded chemical weapons' injuries to the Chinese people and their negative effects on environmental pollution. According to the Chemical Weapons Convention (CWC), which became effective
This research uses trauma theory, memoir theory, narratology, and recent scientific research into the effects of Post-Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI) to explore developments in the memoir coming from the wars in Iraq and Afghanistan. Specifically, the author examines the works of Shoshana Johnson, Colby Buzzell, and Anthony Shaffer to uncover the ways in which identity,
War veterans with neuromuscularskeletal injury often require significant treatment and rehabilitation, straining health care resources. In a study funded by the Office of Naval Research (ONR) and the Defense Advanced Research Projects Agency (DARPA), the Virtual Reality Medical Center (VRMC) is applying virtual reality therapy to injured military personnel at the Naval Medical Center San Diego (NMCSD). The goal of
... injuries are falls, motor vehicle accidents, violence, and sports injuries. It is important to know the warning signs of a moderate or severe head injury. Get help immediately if the injured person has A headache that gets worse or ...
Stabbing, mechanical asphyxia, blunt head injury and shooting are the most common methods of homicides, with firearm homicides on the increase throughout the world. This study was a retrospective study carried out by the Department of Forensic Medicine, University of Kelaniya, Sri Lanka over a 1 year period on firearm homicides examined at two principal forensic institutions in the western province (Office of the Judicial Medical Officer Colombo and Ragama) of Sri Lanka. During the period of the study (June 2005 to July 2006) 3100 medicolegal autopsies were carried out at these two institutions with 265 representing alleged homicides. Eighty-three cases (31%) were identified as homicides due to fatal firearm injuries. The majority of the victims (N = 76) were young adult males (aged 18-40 years). Almost half of the firearm homicides (47%; N = 39) were associated with previous enmity, while 33% (N = 27) were due to ethnic rebel killings in the North and East. Daylight hours (6.00 a.m. to 6.00 p.m.) were preferred by rebels, while there was no relation to the time of day in the other firearm deaths. The weapon of choice was a rifled firearm (98%). While 70% of war-related deaths had one or two fatal shots, either to the head or chest, homicides motivated by personal enmity had multiple wounds, with an average of 5.7 fatal shots per victim. This study demonstrates that firearm homicides in Sri Lanka mainly involve young men, and that when related to armed conflict the fatal injury usually consists of a single shot to the head or chest. PMID:20169474
Identifying whether there is a nexus between Iraq and Afghanistan combat injuries and civilian violence on return from deployment is complicated by differences in reactions of individuals to combat exposure, the overlapping effects of traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD), and the low base rate of civilian violence after combat exposure. Moreover, the overall prevalence of violence among returning Iraq and Afghanistan combat war veterans has not been well documented. Malingered symptoms and either exaggeration or outright fabrication of war zone exposure are challenges to rendering forensic opinions, with the risk reduced by accessing military documents that corroborate war zone duties and exposure. This article serves as a first step toward understanding what may potentiate violence among returning Iraq and Afghanistan veterans. We offer a systematic approach toward the purpose of forensic case formulation that addresses whether combat duty/war zone exposure and associated clinical conditions are linked to criminal violence on return to civilian life. PMID:23771940
Sreenivasan, Shoba; Garrick, Thomas; McGuire, James; Smee, Daniel E; Dow, Daniel; Woehl, Daniel
BACKGROUND: War is a known cause of tremendous physical injuries to different body organs, and eyes are not exceptions. War-related no visual acuity (NVA) affects both the victim and the family. Activity of daily living (ADL) can display personal life independency and is considered as a morbidity index. This study was designed to investigate the ADL profile of war survivors with NVA. METHODS: This cross-sectional study was conducted in 2007 in Iran. In this study, 500 Iranian people with war related NVA were invited to take part in a camp in Mashhad city. ADL was evaluated using Barthel Index and demographic data were collected using a data sheet. Stepwise linear regression was used to determine the associates of ADL. RESULTS: The overall response rate to the invitation was 50%. From the total 250 participants 96.5% were male with a mean age of 43 ± 8 years. Only 8.3% had no dependency in ADL and other 91.7% had some ranges of dependency in at least one of the daily living activities. ADL score was higher in highly educated participants, those younger than 50 years old, those with less co-morbid physical problems (hearing loss) and those with regular physical exercises. According to regression analysis, age and duration of war related NVA were significant predictors of ADL. CONCLUSIONS: According to the results, both age and the time passed from war related NVA increase the dependency of people with war related NVA.
Objectives: To ascertain the number and type of severe soccer injuries admitted to King Edward Hospital in South Africa over 42 months. Methods: This was a retrospective study of all patients admitted for treatment or observation to the orthopaedic unit only. Patients treated as outpatients, irrespective of severity, are also presented for comparison. Results: Thirty two patients were admitted with severe injuries. The injuries included 18 fractures of the tibial and femoral shaft. Two tibial shaft fractures were compound. Four tibial plateau fractures and five epiphyseal injuries were identified. One patient had a fracture-dislocation of the hip. One patient with a popliteal artery injury presented 48 hours after the injury had occurred. He had an above knee amputation. In the same period 122 patients were treated as outpatients. The types of injury in this group were similar to soccer injuries reported in other countries. Conclusions: Very serious injuries are sustained by casual soccer players in South Africa. Urgent measures need to be taken to prevent such injuries.
In this article, we describe the emergence of urban recycling as a new trade and discuss the new pattern of injuries among its practitioners. We conducted a retrospective chart review and convenience survey at an urban homeless health center. We found a high prevalence of severe, costly injuries, many of which are amenable to prevention. Lacerations, infections, needle sticks, and blunt trauma are all common in this group. Some cases are extremely expensive or even lethal. We conclude that a new trade and a new pattern of injuries associated with it have emerged around recycling. PMID:9253729
Study objective: This study evaluated the relation between self-reported marijuana use and 3-year incidence of injury. Methods: We conducted a retrospective cohort study of adult Kaiser Permanente Medical Care Program members who underwent multiphasic health examinations between 1979 and 1986 (n=4,462). Injury-related outpatient visits, hospitalizations, and fatalities within 3 years of examination were determined. Results: Outpatient injury events totaled 2,524;
Barbara L Braun; Irene S Tekawa; Susan G Gerberich; Stephen Sidney
OBJECTIVES: To measure the age and sex distribution of self reported sports and leisure injuries in a 12 month retrospective recall period among a representative national sample of Scottish adolescents, and to examine the characteristics (gender, age, handedness, and level of sports participation) of sports related injuries in relation to injuries sustained during other activities. DESIGN\\/SETTING: Self completion questionnaire survey
J. M. Williams; P. Wright; C. E. Currie; T. F. Beattie
This article evaluates the spectrum of epidemiology and treatment of children presenting with shoulder pain. These injuries are discussed to further understand the mechanism of injury, the variation of these injuries with age, treatment options, and outcomes and complications that may arise. A retrospective clinical review was performed to compliment the findings of the literature review. PMID:24095070
Dashe, Jesse; Roocroft, Joanna H; Bastrom, Tracey P; Edmonds, Eric W
A retrospective review of the patients with electrical injuries admitted over a 5-year period was performed to establish the frequency of cardiac complications. There were 145 admissions during this time. A total of 128 (88 per cent) were low voltage injuries and 17 (12 per cent) were high voltage (> 1000 V) injuries. Of the 145 admissions, 104 (72 per
This is a retrospective review of all patients seen at an urban emergency department for 9 days after an ice storm because of a fall on ice. Date of presentation, age, sex, and anatomic location and type of injury were tabulated. Risk factors for fractures were identified. A total of 327 injuries were identified in 259 patients. Back injury was
Despite progress in the management of esophageal perforations by early diagnosis, antibiotics, monitoring, and respiratory and nutritional support, it still remains as a disasterous condition. The most common cause of esophageal perforation is iatrogenic disruption. The result in the management of esophageal perforation is influenced by several factors: localization and size of the rupture, length of delay in diagnosis, age, extent of mediastinal and pleural contamination, the presence of underlying esophageal diseases, and inflammation or tumor at the perforation localization. In this study, 7 cases of esophageal perforations in the last six years have been analysed retrospectively. In study group, there were 5 males and 2 females, and the mean age was 36 (12-75). The most common cause of perforation was gunshot injury (3 cases), and stab wound (1 case), foreign body (1 case), iatrogenic distruption (2 cases). Three patients died and four patients were discharged from hospital with recovery. Esophageal perforation is a life-threatening condition. Early diagnosis and repair reduces the morbidity and mortality. PMID:11705168
Ertekin, C; Yanar, H T; Gülo?lu, R; Tavilo?lu, K; Dilege, S
Background: Childhood Injuries cause significant mortality and morbidity in Singapore. With injury surveillance, patterns of repeated injury can be identified and injury prevention strategies devised. Methods: We conducted a retrospective study of all children aged 12 and below seen for trauma in an Emergency Department over one year. Data captured in the real-time computer system was studied with regards to
Aim To present a summary of the organization, field search, repatriation, forensic anthropological examination, and DNA analysis for the purpose of identification of Finnish soldiers with unresolved fate in World War II. Methods Field searches were organized, executed, and financed by the Ministry of Education and the Association for Cherishing the Memory of the Dead of the War. Anthropological examination conducted on human remains retrieved in the field searches was used to establish the minimum number of individuals and description of the skeletal diseases, treatment, anomalies, or injuries. DNA tests were performed by extracting DNA from powdered bones and blood samples from relatives. Mitochondrial DNA (mtDNA) sequence comparisons, together with circumstantial evidence, were used to connect the remains to the putative family members. Results At present, the skeletal remains of about a thousand soldiers have been found and repatriated. In forensic anthropological examination, several injuries related to death were documented. For the total of 181 bone samples, mtDNA HVR-1 and HVR-2 sequences were successfully obtained for 167 (92.3%) and 148 (81.8%) of the samples, respectively. Five samples yielded no reliable sequence data. Our data suggests that mtDNA preserves at least for 60 years in the boreal acidic soil. The quality of the obtained mtDNA sequence data varied depending on the sample bone type, with long compact bones (femur, tibia and humerus) having significantly better (90.0%) success rate than other bones (51.2%). Conclusion Although more than 60 years have passed since the World War II, our experience is that resolving the fate of soldiers missing in action is still of uttermost importance for people having lost their relatives in the war. Although cultural and individual differences may exist, our experience presented here gives a good perspective on the importance of individual identification performed by forensic professionals.
Palo, Jukka U.; Hedman, Minttu; Soderholm, Niklas; Sajantila, Antti
Background: Mandatory celiotomy has been proposed for all patients with unexplained free fluid on abdominal computed tomography (CT) scanning after blunt abdominal injury. This recommendation has been based upon retrospective data and concerns over the potential morbidity from the late diagnosis of blunt intestinal injury. This study examined the rate of intestinal injury in patients with free fluid on abdominal
David H Livingston; Robert F Lavery; Marian R Passannante; Joan H Skurnick; Stephen Baker; Timothy C Fabian; Donald E Fry; Mark A Malangoni
The development of the USNS Comfort hospital ship during the Persian Gulf War provided an opportunity to examine the relationship of gender to stress and coping in health care providers exposed to wartime stressors. Just before the outbreak of Operation Desert Storm, medical personnel (N = 250) rated the stressfulness of current wartime experiences and the helpfulness of stress-reducing resources onboard ship in a combat theater. The responses of men and women were compared; to identify the dimensions of these responses, a principal factor analysis (orthogonal rotation) was performed. Generally, men and women ranked stressors and stress reducers similarly; women scored higher on the stress ratings. Two factors, similar for men and women, were identified in the stress ratings: fear of injury and trauma-related work demands. The dimensions of the stress reducers, however, were different for men and women. The findings support retrospective studies and suggest that different mechanisms of stress reduction may be operative even though men and women are performing the same activity. PMID:10091488
Slusarcick, A L; Ursano, R J; Fullerton, C S; Dinneen, M P
World War II, with radar, rockets, and "atomic" bombs was the physicists' war. And many of us know, or think we know, what our more senior colleagues did during it, with Hubble and Hoffleit at Aberdeen; M. Schwarzschild on active duty in Italy; Bondi, Gold, and Hoyle hunkered down in Dunsfeld, Surrey, talking about radar, and perhaps steady state; Greenstein and Henyey designing all-sky cameras; and many astronomers teaching navigation. World War I was The Chemists' War, featuring poison gases, the need to produce liquid fuels from coal on one side of the English Channel and to replace previously-imported dyesstuffs on the other. The talke will focus on what astronomers did and had done to them between 1914 and 1919, from Freundlich (taken prisoner on an eclipse expedition days after the outbreak of hostilities) to Edwin Hubble, returning from France without ever having quite reached the front lines. Other events bore richer fruit (Hale and the National Research Council), but very few of the stories are happy ones. Most of us have neither first nor second hand memories of The Chemists' War, but I had the pleasure of dining with a former Freundlich student a couple of weeks ago.
Background Environmental conditions in the Falklands Conflict of 1982 favoured the genesis of cold injuries. Immediately, post-war, cold injury morbidity and its contributory factors were assessed, in the personnel of UK 3 Commando Brigade (3 Cdo Bde). Methods A questionnaire survey of the 3,006 members of 3 Cdo Bde who landed on the islands was conducted within 6–10 weeks of the end of hostilities. Questions included those relating to features of cold injury, body morphology, age, symptoms experienced, past medical history and other possible contributory causes. Additionally, the unit medical team conducted a cursory examination. Data were sent to the Royal Navy Institute of Naval Medicine (INM), where the degree of likely cold injury was broadly classified (‘asymptomatic’ ‘mild’, ‘moderate’ or ‘severe’). A sample (total 109) was then selected at random from each category and subsequently examined and tested at the INM (nerve conduction, photoplethysmography and thermography testing). Forty-seven non-cold exposed sailors acted as a control group. These contemporaneous records have now been identified and interrogated. Results Some 2,354 (78%) completed questionnaires were returned, revealing that 1,505 (64%) had experienced symptoms of non-freezing cold injury. The morbidity in the infantry units was significantly greater than that in the support troops (1,051 (76%) vs 454 (46%), p?0.05). No evidence was found to support an influence of a number of factors, commonly believed to have an aetiological role in the production of cold injury. Whilst there was no significant relationship between past history and cold injury morbidity in the brigade as a whole, or within the infantry units alone, an association was identified in the collective infantry units (73%) and the support/headquarter units (59%) (p?0.05). In comparison with uninjured sailors who acted as controls (n?=?47), nerve conduction was impaired in 35% of those screened some months after returning to the UK, while the photoplethysmography and thermographic responses to a cold sensitivity test showed that most (including those classed by questionnaire as asymptomatic) had residual ‘cold sensitivity’. Conclusions Although the passage of time has made retrospective interrogation of historical documents hard, the available data do appear to offer valuable historical and clinical insights. Cold injury affected the majority of those fighting in the cold temperate climate of the Falklands. The overwhelming environmental conditions meant that, for most, a past history of cold injury did not appear to represent a risk factor for subsequent injury, as is the case for less severe conditions. Importantly, even asymptomatic individuals when tested often showed physiological evidence of cold injury—perhaps predisposing them to subsequent elevation in risk.
Nonpowder guns (ball-bearing [BB] guns, pellet guns, air rifles, paintball guns) continue to cause serious injuries to children and adolescents. The muzzle velocity of these guns can range from approximately 150 ft/second to 1200 ft/second (the muzzle velocities of traditional firearm pistols are 750 ft/second to 1450 ft/second). Both low- and high-velocity nonpowder guns are associated with serious injuries, and fatalities can result from high-velocity guns. A persisting problem is the lack of medical recognition of the severity of injuries that can result from these guns, including penetration of the eye, skin, internal organs, and bone. Nationally, in 2000, there were an estimated 21840 (coefficient of variation: 0.0821) injuries related to nonpowder guns, with approximately 4% resulting in hospitalization. Between 1990 and 2000, the US Consumer Product Safety Commission reported 39 nonpowder gun-related deaths, of which 32 were children younger than 15 years. The introduction of high-powered air rifles in the 1970s has been associated with approximately 4 deaths per year. The advent of war games and the use of paintball guns have resulted in a number of reports of injuries, especially to the eye. Injuries associated with nonpowder guns should receive prompt medical management similar to the management of firearm-related injuries, and nonpowder guns should never be characterized as toys. PMID:15520121
The Federal Navy's Bureau of Medicine and Surgery experienced a substantial loss of officers during 1861. It responded to the loss and the increased demand for its services by augmenting its regular medical officers with volunteer physicians. The medical corps more than doubled in size between 1861 and 1865 as a result of the recruiting efforts. Navy physicians were involved in blockade duty, anticommerce raider cruises, amphibious assaults, riverine duty, and staffing naval facilities ashore. Their services are virtually unknown despite their involvement in most naval activity during the war. This article illuminates their efforts. It does so by analyzing individual service records and reports compiled in the Official Records of the Union and Confederate Navies during the War of the Rebellion. The Bureau of Medicine and Surgery successfully met the demands made upon it during the American Civil War. PMID:14719634
Feminist philosophy can make an important contribution to the field of genocide studies, and issues relating to gender and war are gaining new attention. In this article I trace legal and philosophical analyses of sexual violence against women in war. I analyze the strengths and limitations of the concept of social death—introduced into this field by Claudia Card—for understanding the genocidal features of war rape, and draw on the work of Hannah Arendt to understand the central harm of genocide as an assault on natality. The threat to natality posed by the harms of rape, forced pregnancy and forced maternity lie in the potential expulsion from the public world of certain groups—including women who are victims, members of the 'enemy' group, and children born of forced birth. PMID:21941691
U.S. nuclear policy has become the target of increasing criticism during the past decade. Critics often argue that the use of nuclear weapons would be irrational, would destroy humankind, and thus could not serve any rational policy goal. Other critics point to the immortality of the use of nuclear weapons. Both groups condemn U.S. military policy. In Nuclear War, James Child considers and rejects both these lines of criticism. He argues that a policy of deterrence can be both rational and moral; that U.S. nuclear policy is, on balance, based on rational and moral foundations. Child examines near-term consequences of a nuclear war and finds them ghastly but not unthinkable or incomparable to the havoc produced by previous wars. He also analyzes long-term consequences, such as those proposed by the ''nuclear winter'' theory, and finds the fear of total annihilation of humankind to be unfounded.
Lightning strikes may cause a constellation of injuries. Blunt head trauma, neurologic injury, and cardiac injury are common in these patients. In contrast to high-voltage electrocutions, blunt trauma after a lightning strike is common. Thorough evaluation of all organ systems is crucial. This report discusses mechanism of injury and describes initial evaluation and treatment of lightning strike victims. PMID:12540003
Objective: The purpose of this chapter is to review the distribution and determinants of injury rates as reported in the pediatric gymnastics injury literature, and to suggest measures for the prevention of injury and directions for further research. Data sources: An extensive search of Pubmed was conducted using the Text and MeSH words ’gymnastics’ and ’injury’ and limited to the
Background and Objectives: Gunshot injuries (GSI) were first reported in West Africa following the Nigerian civil war of 1967-1970. Recent wars within and around the West African subregion have further encouraged easy access to sophisticated and locally manufactured firearms. This report examines the epidemiology and management of GSI in an urban settlement in West Africa. Patients and Methods: GSI data
Aim To examine the role of perceived stressfulness of trauma exposure and economic, social, occupational, educational, and familial adaptation after trauma in posttraumatic stress disorder (PTSD) and depression in displaced war survivors. Methods A cross-sectional survey was conducted between March 2000 and July 2002 with a sample of 173 internally displaced persons or refugees and 167 matched controls in Croatia. Clinical measures included Structured Clinical Interview for DSM-IV and Clinician-Administered PTSD Scale. Results Displaced war survivors reported the exposure to a mean?±?standard deviation of 13.1?±?8.3 war stressors, including combat, torture, serious injury, death of close persons, and loss of property. Compared to controls, they reported higher rates of marked to severe impact of war on family (16.2% vs 51.6%), social (7.2% vs 43.5%), economic (12.6% vs 55.4%), occupational (1.8% vs 15.9%), and educational (2.4% vs 8.8%) adaptation. In two logistic regression analyses, the strongest predictor of PTSD and depression was high level of perceived distress during trauma exposure. PTSD but not depression was associated with economic, social, occupational, educational, and familial adaptation after trauma. Conclusion Displaced survivors who experienced multiple war events perceived greater negative impact of war on their life domains compared to individuals who lived in a war setting but had no trauma exposure. The most important determinant of psychological outcomes was perceived stressfulness of war stressors. Although post-trauma adaptation in different life spheres had an impact, its effect was not robust and consistent across disorders. These findings suggest that it would be effective to use a trauma-focused approach in rehabilitation of war survivors.
Study design: Retrospective study.Objective: To determine if spinal cord injuries due to gunshot wounds (GW) are associated with different bladder and sphincteric behavior compared to other trauma mechanisms.Setting: Spinal injury center, Brazilian university hospital.Methods: We retrospectively evaluated the records and urodynamic studies of 71 patients with spinal cord injury (SCI) referred to the Brazilian National Spinal Cord Injury Center over
C A R Sacomani; F E Trigo-Rocha; C M Gomes; J A Greve; T E P Barros; S Arap
Oilpatch activity in the Middle East has been on the slow side recently, and with a heated-up war between Iran and Iraq throwing off violent sparks around the Arabian Gulf, it's difficult to keep one's mind on business-as-usual. The article deals with the rising cost of insurance for shipping because of the war and the effects on drilling, production and the environment (oil spills). The development and production of offshore oil and gas in Egypt, Saudi Arabia, and the United Arab Emirates is also discussed.
While physicians are often heard to complain that they are overworked with a heavy patient burden, so-called turf wars lurk under the surface, wherein physicians wrangle for the ability to perform what are generally highly-remunerated and quickly-performed procedures and interventions with excellent patient outcomes. It is very possible that within such turf wars, one specialty is consistently more skilled at performing the procedure than another, and therefore patient lives may be unnecessarily lost. This article hypothesizes that such differences in skills do exist between specialties and proposes a study to determine this. PMID:17521053
The basic question is whether or not the War Powers Resolution (WPR) will restore balance in the division of Executive and Congressional War Powers responsibilities - in particular, gain congressional participation in those future decision(s) for committi...
Litoff and Smith discuss the role of American women during World War II. The war had a significant and far-reaching impact on the lives of women, giving them increased independence, confidence and power.
This research uses an advanced statistical technique to expand upon the current understanding of war termination. Specifically, this thesis addressed questions concerning the most relevant factors toward predicting both the outcomes of interstate wars and...
This study investigates Afghanistan influences in the Tajikistan civil war. Ongoing conflict in Afghanistan overlaps the Tajikistan conflict developing after the USSR's 1991 breakup. The Tajikistan civil war includes elements of ethnic, religious and poli...
This project investigated experimental models with lab animals, which can be used to identify possible causes and therapies for the 'Gulf War Syndrome'. Some personnel who served in the 1991 Persian Gulf war have reported persistent problems that are domi...
Although civil wars and internal conflicts have been relatively common within Latin America in the nineteenth and twentieth centuries, wars between Latin American countries have been few. Of these conflicts—the Argentine-Brazilian War, 1825–28; the Chilean and Peru-Bolivian Confederation War, 1836–39; the War of the Pacific, 1879–83; the Chaco War, 1932–35; the Ecuador-Peru Conflict, 1941; and the Soccer War, 1969—The War
Lecture 17Muscle injuries are among the most common, most misunderstood, and inadequately treated conditions in sports. According to some studies, muscle injuries account for 10–30% of all injuries in sport.1 Hamstring injuries are the commonest muscle injury in all sports.Hamstrings function is complex. Depending on leg positioning and relationship to the ground it can serve as a hip extensor, knee
This study examines the genres of visual communication utilized by the daily and illustrated weekly papers during the Civil War, when photography existed, but photographs could not yet be printed using the halftone process. I propose a typology of visual genres in use at that time, wherein each genre is differentiated by conventions that governed inclusion and interpretation. Though photography
The above unintended, on-the-air, radio remark made by President Reagan in the 1980s, 'We've decided to destroy the Soviet Union; bombing begins in five minutes' captures the frightening aspect of the Cold War and just how close the world may have come to...
The memory of the Civil War has become one of the most vibrant and contested subjects in nineteenth-century American history over the past two decades. Studies of Civil War memory potentially can reveal much about the cultural, political, and intellectual world of the Civil War, Reconstruction, and the Gilded Age. Whereas the Civil War has often been studied in historical
Exposure to organophosphate (OP's) insecticides and nerve gases during the Persian Gulf War has been implicated in the development of Gulf War Syndrome. Paraoxonase (PON1) present in human serum detoxifies OP's. We determined the levels of PON1 in the serum of Gulf War Veterans and compared these to those found in a control population. One hundred fifty-two Gulf War Veterans
Bharti Mackness; Paul N. Durrington; Michael I. Mackness
|At the height of the Vietnam War, Down by the Riverside was transformed from a traditional folk song to a popular anti-war anthem. The raucous and repetitive chorus, "I ain't gonna study war no more ...," became a rallying cry for those who wanted nothing to do with the war and the pain and controversy that surrounded it. Although it seems…
Little has been written about the trials of accused Japanese war criminals that were conducted by the U. S. Navy after World War II. Trials were held on Guam and Kwajalein by the War Crimes Branch of the Pacific Fleet from 1945 through 1949. These trials were part of over 2,000 war crimes trials held under the aegis of SCAP--the
January 2001As important as knowing how wars start and end is knowing how much war we are likely to observe in any given period. In strategies for preventing civil war, political liberalization should be a higher priority than economic development, but the best possible results would combine political reform, economic diversification, and poverty reduction.Quantitative studies of civil war have focused
Can civil war give rise to democracies? While recent civil war literature has focused on the resolution of conflict and the determinants of durable peace, little attention has been paid to what kinds of peace might emerge from war. Significantly, the few studies that do touch on this question provide surprisingly consistent theoretical and empirical evidence that civil wars can,
A retrospective review of anterior cruciate ligament injuries among professional alpine skiers was performed to compare sex-related differences in injury incidence. We screened 7155 ski patrollers or instructors (4537 men and 2618 women) for knee injuries before each ski season between 1991 and 1997. Screening involved a ski history questionnaire, a knee injury history questionnaire, and a knee physical examination.
Randall W. Viola; J. Richard Steadman; Scott D. Mair; Karen K. Briggs; William I. Sterett
Purpose: The purpose of this study was to review the incidence of cardiac and great vessel injury after blunt trauma in children. Method: A retrospective review of 2,744 patients with injuries from blunt mechanisms was performed. Results: Eleven patients sustained cardiac injury. Four patients had clinically evident cardiac contusions. All recovered. Four patients who died from central nervous system injury
G. M. Tiao; P. M. Griffith; J. R. Szmuszkovicz; G. Hossein Mahour
Summary This study analyses injuries occurring to Australian male cricketers at the state and national levels over 10 years using recently published international definitions of injury. Data was collected retrospectively for 3 years and then prospec- tively over the final 7 years. Injury incidence has stayed at a fairly constant level over the 10 years. Injury prevalence has gradually increased
The European Economy Between the Wars provides a full and up-to-date economic history of Europe in the inter-war period. The authors place the Great Depression of 1929-33 and the associated financial crisis at the centre of the narrative, and present these as both the culmination of the economic consequences of the First World War, the post-war peace treaties, and the
This paper reviews the prevalence of psychological morbidities in children who have been exposed to war-related traumas or terrorism as well as the diversity of war-related casualties and their associated psychological responses. The psychological responses to war-related stressors are categorized as (1) little or no reaction, (2) acute emotional and behavioral effects, and (3) long-term effects. Specific categories of war-related
The problem of drawing causal inferences from retrospective case-controlled studies is considered. A model for causal inference in prospective studies is applied to retrospective studies. Limitations of case-controlled studies are formulated concerning relevant parameters that can be estimated in such studies. A coffee-drinking/myocardial…
These learning activities can help students get the most out of a visit to the Tennessee World War II Memorial, a group of ten pylons located in Nashville (Tennessee). Each pylon contains informational text about the events of World War II. The ten pylons are listed as: (1) "Pylon E-1--Terror: America Enters the War against Fascism, June 1940";…
The authors discuss the scientific justifications for studying the consequences of nuclear war. The consequences of nuclear war and nuclear winter - biotic impoverishment, climate change, pollution of the air, water, and soil - recapitulate in compressed time the patterns of ecological change humankind is even now imposing on the planet. By studying the biological consequences of nuclear war, important
|The Civil War in Literature is a course in which investigation is made into the legacy that this war left to humanity. Through the reading and discussion of literary works written during or about the Civil War, including "Jubilee,""Gone with the Wind,""Red Badge of Courage," poetry by Walt Whitman, and the essays of Frederick Douglass, students…
|Describes anthropological thinking about primeval violence; how it originated, was manifested, and controlled. Discusses the role of war in Mawri of Niger society as an example of a society which preferred war to peace. Concludes with reflections on present 'secondary or induced wars,' and the need to understand these conflicts in terms of an…
Political scientists have long compared war to duelling in the hope that war could be abolished like duelling, that is, at the hands of a normative campaign. However, there has been limited investigation of duelling's past. What can the history of duelling teach us about the future of war? This paper advances two arguments. First, by refining the conventional wisdom,
Focuses on women during World War II stating that the events of the war changed the lives of women. Addresses the role of women during wartime by sharing excerpts and information gleaned from letters written by women during World War II. (CMK)
This study explores and analyzes the religious rhetoric and Biblical allusions in literature written surrounding the American Civil War: Herman Melville's Battle Pieces: Aspects of the War ; Walt Whitman's Memoranda During the War ; selected poetry of John Greenleaf Whittier published in William Lloyd Garrison's abolitionist newspaper, The Liberator ; and, Harriet Beecher Stowe's Dred. Each chapter explores how
We must conclude that war remains a major problem in the last quarter of the twentieth century. My intention in this book is to introduce you to international relations by focusing on this problem. War is not the only problem of international relations, and so this book does not exhaust the field. But war is a central problem, and the
Eisenhower's antifascist sentiments were first expressed nearly one and one-half years into the war in response to a specific incident. His more basic ideological commitment, expressed throughout the war, was to voluntary self-restraint and obedience to duty, which he called the first tenet of his religion, as the foundation of social order. His apocalyptic view of the war was based
Ballistic missiles were the highest visibility weapon of the gulf crisis and war. Prior to hostilities, Iraqi dictator Saddam Hussein issued fierce threats about how he would employ such systems, if Iraq were attacked. Later, after war had broken out, Saddam used his missiles to strike at the UN coalition and to attempt to bring Israel into the war. While
The study aim was to describe displaced Bosnian mothers' experiences caring for their children during and immediately after the war (1992-1995). Mothers described their progression into war, through war, and into vastly changed lives. Using ethnographic methods, narrative data were collected near Sarajevo, Bosnia, from 14 displaced women who participated in one to three interviews each between 1996 and 1999.
Nuclear war has been feared by the entire world since the end of World War II. Since the early 1960s, the Soviet Union has been continually improving both its capability to wage nuclear war and, more important, to protect its population. Population protec...
Since 11 September 2001, a new paradigm has developed in criminal law. Parallel to the idea of the ‘war on terror’, a paradigm based around ‘war on crime’ has emerged. Inevitably, however, a paradigm of war leads to abandoning scientific approaches based on a legal-moral vision (crime, guilt and punishment) in favour of a merely pragmatic vision, which associates national
|While the attention of the country is focused on the global and national war on terrorism, the war on academic terrorism is being waged in classrooms, infiltrating the gifted programs, and altering the outcomes derived for students participating in gifted programs. The war on academic terrorism is related to the broad areas of curriculum and…
Perhaps no aspect of Carl von Clausewitz's classic 'On War' has more continuing relevance for strategists than his assertion that war 'is an act of policy' and further that 'war is not merely an act of policy but a true political instrument a continuation...
This article examines the role of the federal courts in the war on terrorism, and contrasts the different judicial roles in reviewing decisions about the conduct of war abroad and within the United States. It explains that judicial refusal to adjudicate questions concerning the initiation and conduct of the war abroad is consistent with a narrow view of judicial review
In 1991 a coalition of Allied Nations, including British and US troops, deployed to the Persian Gulf region. Although the war-fighting phase of the 1991 conflict was short and resulted in minimal casualties, few can have failed to notice the saga of 'Gulf War syndrome' which followed the conflict. The nature, and indeed existence, of Gulf War syndrome has been
Contemporary wars make an extensive use of sophisticated weaponry and communication technologies, which allow more detailed designs of confrontation strategies. In this regard, the present paper focuses on the following questions: (i) Is contemporary war a scale-free social network? (ii) Is there any kind of memory effects in the sequence of daily fatalities in contemporary war? (iii) Is the number
J. Alvarez-Ramirez; C. Ibarra-Valdez; E. Rodriguez; R. Urrea
Despite the frequent invocations of his name in recent years, especially during the Gulf War, there is something deeply perplexing about the work of Carl von Clausewitz (1780-1831). In particular, his unfinished magnum opus On War seems to offer a theory of war, at the same time that is perversely denies many of the fundamental preconditions of theory as such
When I received the request to update my 1978 foreword to this book, I thought it might be useful to give my perspective of some aspects on the employment of airpower in the Persian Gulf War, the Air War over Serbia (Operation Allied Force), and the war i...
The manner in which and the reasons for which the United States went to war against Iraq in 2003 do not represent a radical departure from the past. American history shows that the United States has had a strong propensity to become involved in unnecessary wars. These wars share some common characteristics: they were justified in the name of America's
Following a war with widespread attention to and concern over the potential for numerous biological and chemical warfare exposures, some Gulf War veterans returned home and developed various illnesses. Although some of these illnesses are readily diagnosable, the so-called Gulf War syndrome has remained a controversial and nebulous diagnosis. It is characterized by multiple, subjective symptoms, and by a lack
Gulf War Syndrome has become a growing concern of US government, military Gulf war veterans and their families. It is suggested that research on genotype\\/phenotype of acetylcholinesterase and butyrylcholinesterase may help to discover the role of pyridostigmine bromide in the cause of Gulf War Syndrome.
I propose an evolutionary psychological perspective on wars and suggest that the ultimate cause of intergroup conflict may be the relative availability of reproductive women. Polygyny, which allows some men to monopolize all reproductive opportunities and exclude others, may increase the prevalence of civil wars, but not interstate wars, which did not exist in the ancestral environment. The analysis of
The dominant hypothesis in the literature that studies conflict is that poverty is the main cause of civil wars. We instead analyze the effect of institutions on civil war, controlling for income per capita. In our set up, institutions are endogenous and colonial origins affect civil wars through their legacy on institutions. Our results indicate that institutions, proxied by the
The media paradigm by which we understand war is increasingly the video game. These changes are not only reflected in the real-time television war, but also an increased collusion between military and commercial uses of video games. The essay charts the border-crossing of video games between military and civilian spheres alongside attendant discourses of war. Of particular interest are the
This article explains theoretically, and demonstrates empirically, the instrumental role of the balance of capabilities in shaping the form of warfare that develops in civil wars. It contends that the current common practice of labelling civil wars as either ‘guerrilla’ or ‘conventional’ (which is usually meant to accurately characterise the type of warfare throughout an entire civil war) is unable
Contents include: formation and development of views on the initial period of war from the nineteenth century until the 1940s: entry into war in the nineteenth century and at the start of the twentieth century; the organizational development of the armed forces and the development of military theories in the main capitalist nations between the two world wars; the organizational
Over recent years, hand surgeons in the Middle East and Arabic region have particularly had to deal with an increasing number of war blast injuries to the upper extremity, in the acute, subacute and chronic phases. Many have been referred from War Zone countries such as Iraq and, more recently, Syria, where the resources to treat such complex injuries are scarce. The present article is a comprehensive review of the basic principles of management of blast injuries based on the available literature merged with the authors' personal experience of these injuries. The state of the art in treatment of blast injuries to the hand, from ammunition physics and wound ballistics to radiological investigation and, ultimately, the principles of surgical management are discussed. PMID:23357578
Background:Limited knowledge exists on injuries among professional alpine skiers.Objective:To describe the risk of injury and the injury pattern among competitive World Cup alpine skiers during the competitive season.Methods:Retrospective interviews were performed with all World Cup athletes from 10 nations at the end of the 2006–7 and 2007–8 winter seasons, and all acute injuries occurring during the 4.5-month competitive season were
T W Flørenes; T Bere; L Nordsletten; S Heir; R Bahr
Global climatic consequences of a nuclear war have, until recently, been assumed to be insignificant compared with the obviously devastating direct effects from blast, heat, and short-term fallout. But a number of investigations carried out over the past few years indicate that climatic impact could actually be severe enough to threaten the global ecosystem significantly, including regions that may not
The Austrian school of economics increasingly has become identified with antiwar groups. This is not due to religious or political views. Rather, the antiwar viewpoints of the Austrians come from the fundamental tenets of economics as expressed by the school’s founders and refined for 140 years. This article applies post-WWII Austrian thought to the subject of war.
|Based on James Lincoln Collier and Christopher Collier's novel "My Brother Sam Is Dead," this lesson plan presents activities designed to help students understand that one way to learn about the past is to read historical novels; and that some people take one side or another in a war or other conflict, and some find themselves caught in the…
|George Lucas's Star Wars trilogy is used as the basis for the creation of a political subtext arising from one of America's most enduring literary myths--the American Adam. That subtext, when translated into a modern political context, pinpoints two central issues to face this democracy in the coming years, as well as a national ambivalence about…
South America veteran journalist O’Shaughnessy reports:” During the Cold War the opponents of reform throughout Latin America, fearing the loss of their privileges that any change in the status quo would bring about…set aside arguments that the fight against poverty would put money into the pockets of those who did not have any, expand the market and thus benefit local
Those in Algeria who speak out for social justice often fall prey to the political violence that has accounted for over 28,000 deaths in the last two years. Moderates on both sides are seeking peace from the undeclared civil war that resulted when the mil...
This document appears to be the user's guide to a larger document available in a multi-media-based format. Much of what has been written on the specific order of battle during the Gulf War is narrowly focused; that is, no single source adequately reflects...
M. Caffrey C. Diggs A. S. E. Eyadah S. Herring T. S. Jung
In the mid?1990s, the long?standing “war on crime” has acquired a new momentum. A major public opinion poll in January 1994 showed 37 percent of the respondents believing that crime is the nation's premier problem; this is twice as high as it had been only five months earlier, and four times the figure for January 1993 (USA Today, January 25,
Asserts that the geopolitics of the Cold War can be illustrated by the diplomatic ties among countries, particularly the superpowers and their respective allies. Describes a classroom project in which global patterns of embassy locations are examined and compared. Includes five maps and a chart indicating types of embassy locations. (CFR)
Perhaps nowhere is the metaphor of war more ingrained than in the realm of religion. This is particularly true of the sects whose roots are planted in the Middle East (Judaism, Christianity, and Islam). The scriptures of these three great religions are bloody?minded texts. In the Old Testament we find verses such as: “He shall thrust out the enemy before
Although the relationship between natural resources and civil war has received much attention, little is known about the underlying mechanisms. Controversies and contradictions in the stylized facts persist because resource extraction is treated as exogenous while in reality fighting affects extraction. We study endogenous fighting, armament, and extraction method, speed and investment. Rapacious resource exploitation has economic costs, but can
Though the majority of physicists would probably not support preemptive wars, nuclear and other weapons of mass destruction would not exist without their contributions. Einstein's anti-militaristic position has been well-documented and the present essay recalls the role of some contemporary and past physicists on this issue. The idea that the rationality of scientific thought is a reliable antidote against supporting
Although the relationship between natural resources and civil war has received much attention, little is known about the underlying mechanisms. Controversies and contradictions in the stylized facts persist because resource extraction is treated as exogenous while in reality fighting affects extraction. We study endogenous fighting, armament, and extraction method, speed and investment. Rapacious resource exploitation has economic costs, but can
This paper develops a simple model of the war against illegal drugs in producer and consumer countries. The analysis shows how the equilibrium quantity of illegal drugs, as well as their price, depend on key parametres of the model such as the price elasticity of demand and the effectiveness of the resources allocated to enforcement and prevention and treatment policies.
The dynamics of Kashmir conflict have undergone a drastic change since 9\\/11 due to dramatic changes wrought by US War on Terrorism in the region. The US focus on fighting terrorism, extremism and Islamic fundamentalism, most of the times all linked together has put tremendous pressure on Pakistan's Kashmir policy. With the blurring of distinction between freedom struggle and terrorism,
We are all fascinated by our own family's story - our origins. What trouble our parents were in when they were little. What our grandparents did during the war. Where our ancestors came from.\\u000aThese types of stories are personal and inconsequential, but at the same time, they are informative and entertaining. While we must not confuse family lore with
This strategy research paper focuses the Ramadan War, October 1973, as a turning point in the Middle East with profound strategic consequences for Egypt and the region and worthy of study by all military professionals. The strategic importance of the oper...
Modern terrorism can never be just, by classic just war standards, because the terrorists do not have the moral right to authorize attacks, and because the intended objects are noncombatants. A response to a terrorist attack, even if undertaken in the name of responsibility for the common good, can never morally involve an attack on populations of persons among whom
US and British forces used depleted uranium (DU) in armor-piercing rounds to disable enemy tanks during the Gulf and Balkan Wars. Uranium particulate is generated by DU shell impact and particulate entrained in air may be inhaled or ingested by troops and nearby civilian populations. As uranium is slightly radioactive and chemically toxic, a number of critics have asserted that
Ethan Allen Hitchcock, Civil War general and student of hermetic philosophy, included an interpretation of Chaucer's Book of the Duchess in his 1865 study of early British literature. Rejecting the tradition that equated the poem's characters with John of Gaunt, his deceased wife, Blanche, and his liege servant, Chaucer, Hitchcock instead presents the poem as cloaking Chaucer's heretical ideas on
Based on James Lincoln Collier and Christopher Collier's novel "My Brother Sam Is Dead," this lesson plan presents activities designed to help students understand that one way to learn about the past is to read historical novels; and that some people take one side or another in a war or other conflict, and some find themselves caught in the…
China's war on terrorism is among its most prominent and least understood of campaigns. An indigenous insurgency with links to the global jihad has threatened the government's grip on a massive region of northwestern China known as Xinjiang. Riots, bombings, ambushes, and assassinations have rocked the region under separatist and Islamist banners. China acted early and forcefully, and, although initially
Purpose Accidental sharps injuries are a potential route for transmission of blood-borne infection to healthcare workers. Ophthalmic staff in particular are at risk of sustaining such injuries due to the microsurgical nature of the speciality. Forthcoming European Union legislation aimed at reducing sharps injuries requires the development of risk-based sharps policy. The authors believe that this is the first study to assess the risks of sharps injuries and their management specific to ophthalmic practice within the European Union. Methods A retrospective review of all reported sharps injuries across three eye units in the UK over a period of 6 years was undertaken. Data were analysed to determine the circumstances surrounding the injury, occupation of the injured person, and whether appropriate actions were taken following incidents. Results A total of 68 sharps injuries were reported over the 6-year period. Nurses sustained 54.4% (n=37) of needlestick injuries, doctors 39.7% (n=27), and allied healthcare staff 5.9% (n=4). In all 51.5% (n=35) of sharps injuries occurred in the operating theatre, 30.9% (n=21) in the outpatient clinic, 13.2% (n=9) on the ophthalmic ward, and 4.4% (n=3) in unspecified locations. There was a median rate of 1.3 sharps injuries per 1000 surgical procedures per year and a range of 0.4–3.5 per 1000. Conclusions This study demonstrates the need to raise awareness of the unique risks of sharps injuries in ophthalmic practice. This is necessary in order to develop speciality-specific policy that promotes strategies to reduce such injuries, enhances the accuracy of reporting of such events, and provides guidance for appropriate management.
Ghauri, A-J; Amissah-Arthur, K N; Rashid, A; Mushtaq, B; Nessim, M; Elsherbiny, S
OBJECTIVES: To obtain more information about injuries of West End performers. METHODS: A retrospective survey of 269 performers appearing in 20 West End productions (12 dramas and eight musicals). RESULTS: In current productions, 46% of all performers sustained at least one injury for an average of 0.87 injuries per performer. Lower extremity injuries were the most common for dancers (52.2% of injuries) and actors (43.2%) with neck and back injuries the second most common. Sprains and strains were the most common diagnoses. 61% of performers thought that their injuries were preventable. Most performers consulted nonphysician healthcare providers. Factors significantly influencing the risk of injuries for performers include female sex, a history of previous injuries, missed performances due to previous injuries, more physically demanding roles, and performing on raked (angled) stages. CONCLUSION: West End performers commonly sustain injuries. Although primary prevention of most theatrical injuries is not possible, modification of raked stages may reduce the incidence. This study may be helpful to the growing number of healthcare providers who practice performing arts medicine and may stimulate additional concern and research in the medical and theatrical communities about the performance injuries of professionals, amateurs, and theatrical students worldwide.
Background: Professional dancers experience high rates of musculoskeletal injuries.Objective: To analyze the effect of comprehensive management (case management and intervention) on injury incidence, time loss, and patterns of musculoskeletal injury in a modern dance organization.Study Design: Retrospective\\/prospective cohort study.Methods: Injury data were analyzed over a 5-year period, 2 years without intervention and 3 years with intervention, in a modern dance
There is an increasing incidence of military traumatic brain injury (TBI), and similar injuries are seen in civilians in war zones or terrorist incidents. Indeed, blast-induced mild TBI has been referred to as the signature injury of the conflicts in Iraq and Afghanistan. Assessment involves schemes that are common in civilcian practice but, in common with civilian TBI, takes little account of information available from modern imaging (particularly diffusion tensor magnetic resonance imaging) and emerging biomarkers. The efficient logistics of clinical care delivery in the field may have a role in optimizing outcome. Clinical care has much in common with civilian TBI, but intracranial pressure monitoring is not always available, and protocols need to be modified to take account of this. In addition, severe early oedema has led to increasing use of decompressive craniectomy, and blast TBI may be associated with a higher incidence of vasospasm and pseudoaneurysm formation. Visual and/or auditory deficits are common, and there is a significant risk of post-traumatic epilepsy. TBI is rarely an isolated finding in this setting, and persistent post-concussive symptoms are commonly associated with post-traumatic stress disorder and chronic pain, a constellation of findings that has been called the polytrauma clinical triad.
The field of traumatic brain injury has evolved since the time of the Civil War in response to the needs of patients with injuries and disabilities resulting from war. The Department of Veterans Affairs and the Defense and Veterans Brain Injury Center have been in the forefront of the development of the interdisciplinary approach to the rehabilitation of soldiers with traumatic brain injury, particularly those injured from the recent conflicts in Iraq and Afghanistan. The objectives of this literature review are to examine how the casualties resulting from major wars in the past led to the establishment of the current model of evaluation and treatment of traumatic brain injury and to review how the field has expanded in response to the growing cohort of military service members and veterans with TBI. PMID:20647782
Cifu, David X; Cohen, Sara I; Lew, Henry L; Jaffee, Michael; Sigford, Barbara
The biomechanics of ankle injury have been studied extensively, primarily through mechanical testing of human cadavers. Cadaveric testing is an invaluable methodology in biomechanics, because the magnitude and direction of the loading can be measured precisely and correlated with the resulting injury pattern. Clinical and epidemiological studies provide useful descriptions of injury patterns that occur in the real world, but their retrospective nature precludes a definitive analysis of the forces that caused the injury. Understanding the mechanism of ankle injuries is essential for developing countermeasures to prevent injury and for reconstructing injurious events. Knowledge of an injury's mechanism can also suggest potential associated injuries, which is helpful in diagnosis and treatment. The purpose of this review is to summarize the published research on ankle injury mechanisms with an emphasis on biomechanical experiments on human cadavers. Injury patterns are described based on the principal axis of force or torque producing the injury in conjunction with off-axis forces and out-of-plane foot positions. A mechanistic description of ankle injuries is complicated by the fact that the same mechanism can sometimes produce different injuries and the same injury can sometimes be caused by multiple mechanisms. Nonetheless, a framework for relating injury mechanisms and injury patterns is a valuable tool in the understanding, prevention, and treatment of ankle injuries. PMID:21433082
The horrors of war are many and the fighting often extends to the homefront via various forms of propaganda. This magnificent collection from Brandeis University brings together 87 propaganda posters from World Wars I & II in glorious color and equally glorious black and white. The posters deal with a number of themes, including the work of the Red Cross, the subscription of Liberty, and Victory loans. Many notable artists contributed work to this effort, including James Montgommery Flagg, Adolph Treidler, and Haskell Coffin. Visitors can browse the posters by title, author, or date. First-time visitors may wish to start by looking at the rather dramatic "All together!" poster or the demanding "Are you 100% American" work created to promote the purchasing of U.S. government bonds. [KMG
Background. Pectoralis major tendon ruptures have been reported in the literature as occupational injuries, accidental injuries, and sporting activities. Few cases have been reported with respect to rodeo activities. Purpose. To describe a series of PM tendon ruptures in professional steer wrestlers. Study Design. Case series, level of evidence, 4. Methods. A retrospective analysis of PM ruptures in a steer wrestling cohort was performed. Injury data between 1992 and 2008 were reviewed using medical records from the University of Calgary Sport Medicine Center. Results. Nine cases of pectoralis major ruptures in professional steer wrestlers were identified. Injuries occurred during the throwing phase of the steer or while breaking a fall. All athletes reported unexpected or abnormal behavior of the steer that contributed to the mechanism of injury. Seven cases were surgically repaired, while two cases opted for nonsurgical intervention. Eight cases reported successful return to competition following the injury. Conclusion. Steer wrestlers represent a unique cohort of PM rupture case studies. Steer wrestling is a demanding sport that involves throwing maneuvers that may predispose the muscle to rupture. All cases demonstrated good functional outcomes regardless of surgical or non-surgical treatment.
Lau, Breda H. F.; Butterwick, Dale J.; Lafave, Mark R.; Mohtadi, Nicholas G.
... or Tip-Over Injuries and Fatalities Associated with Televisions, Furniture, and Appliances 2000 through 2011 September 30, 2011 Instability of Televisions, Furniture, and Appliances: Estimated Injuries and Reported Fatalities ...
... blast over-pressurization wave travels at a high velocity and is affected by the environment; for example, ... injuries are similar to those observed following high-speed motor vehicle accidents. Quaternary blast injury can occur ...
We present our experience in the treatment of war wounds in 174 patients treated in the Institute of Plastic and Reconstructive Surgery, Department of Surgery, Clinical Hospital Center in Zagreb. The wounds were divided into four categories depending on the type of injury and the extension of the soft tissue defect which showed the differences in primary excision and reconstruction of wounds. Patients were placed in one of two groups depending on their primary treatment and time of definitive reconstruction. Group A comprised 79 patients who were initially treated by plastic surgeons and whose reconstructive procedure was done within five days. Group B comprised 95 patients who were initially treated in a field hospital and referred later to the plastic surgery unit for definitive reconstruction more than five days after the injury. Sixty-nine (87%) of the patients in group A had only one or two debridements before definitive closure and stayed in hospital 20 days or less. In group B, 59 (62%) of the patients required three or more debridements before definitive closure and remained in hospital more than 21 days (p < 0.001). Proper primary treatment and early reconstruction result in significantly shorter duration of hospital stay and lead to more effective rehabilitation and recovery of the patients. A knowledge in terminal ballistics is important in the understanding of the pathophysiology of war wounds. PMID:8029651
The development of chronological reference points to which present levels of inorganic pollutants can be compared is increasingly needed. The requirements for retrospective monitoring methods are discussed in relation to their attainability. The literature has been reviewed for b...
\\u000a Colorectal injuries are caused by penetrating trauma, less often by blunt trauma, or by accidental iatrogenic injuries. Colorectal\\u000a injuries endanger the patient due to infectious complications. Prognosis is improving if treatment is initiated early. Simple\\u000a suturing may be indicated in serosal and stabbing injuries. In high velocity trauma such as gun shot wounds or intestinal\\u000a rupture following blunt trauma, resection
Our study examines injury patterns, treatment implications, discharge disposition, and injury prevention for trauma patients with dementia. It is a retrospective observational study of trauma patients at the Jon Michael Moore Trauma Center at West Virginia University Hospitals. Causes of injury, injuries sustained, and discharge disposition were examined in 286 trauma patients with a pre-existing diagnosis of dementia and 5,865 trauma patients without dementia. All patients included in this study were 40 years of age or older. Injury data were compiled for patients with dementia. Causes of injury and discharge disposition were compared for the two groups. PMID:21702416
Whiteman, Charles; Tillotson, Roger; Nicolas, Denne; Stephen, Davis
Objectives: The purpose of this chapter is to review critically the existing studies on the epidemiology of pediatric rugby injuries and discuss suggestions for injury prevention and further research. Data Sources: Data were sourced from the sports medicine and science literature mainly since 1990, and from a prospective injury surveillance project in rugby undertaken by the University of New South
Abdominal aortic injuries are uncommon following blunt trauma, with relatively few reported series in the radiology literature. This study was conducted to identify common locations and imaging features of blunt traumatic abdominal aortic injury, the presence of associated visceral and osseous injuries, and the mechanisms of trauma. A retrospective review of 9,213 trauma registry entries over a 7-year period yielded 103 patients with aortic injuries, 12 of which had direct signs of abdominal segment involvement (dissection flap, focal intimal injury, intramural hematoma, active extravasation of contrast, or pseudoaneurysm formation). The majority (75 %) was isolated to the abdomen-67 % of which was infrarenal, 33 % suprarenal-while the other 25 % was a contiguous extension from a thoracic injury. Abdominal aortic injuries were uncommonly seen in isolation: all but one patient (92 %) demonstrated either retroperitoneal blood or stranding, hemoperitoneum, and/or CT signs of hypoperfusion complex, and only one patient (8 %) had no associated solid organ or skeletal injuries. All patients had a mechanism of injury which involved direct trauma to the abdomen, most commonly a motor vehicle collision. Similar to other recent series, there was an increased rate of abdominal segment injury (11.7 % of all aortic injuries) in this series compared to more remote autopsy series. This difference is likely due to detection of injuries which went undiagnosed before the widespread use of multidetector CT, which has become the standard of care for both acute evaluation following blunt trauma and for follow-up. PMID:22395392
Mellnick, Vincent M; McDowell, Cade; Lubner, Meghan; Bhalla, Sanjeev; Menias, Christine O
Summary Injury patterns and their outcome has been the subject of interest in all kinds of military conflicts. This retrospective study was conducted in a tertiary care hospital (Level I trauma centre) to find out the trends in injuries in low intensity conflict, adequacy of pre hospital treatment, mortality patterns and adequacy of treatment after reaching tertiary care hospital. 418 patients were treated over a period of two years. All were male and 76% younger than 30 years of age. 61% patients reported directly from the site of incident and 39% were transferred from other trauma centre. Two-third of patients (73.9%) reported with at least one limb injury and 44.9% with extremity injury alone. Multiple injuries were most common injury (29%). Head and neck injuries were seen in 20% patients and Thoracic and abdominal injuries were seen in 2.6% and 3.4% patients only. Most common mode of injury was Gunshot wound (41.4%), followed by splinter injuries (39.2%) and Road traffic accident(RTA) (19.4%). Overall mortality was 3.8% and inpatient mortality of 1.4%. Head and neck injuries were leading cause of death followed by thoracic injuries.
The aim of this study was to quantify and rate acute sport climbing injuries. Acute sport climbing injuries occurring from 2002 to 2006 were retrospectively assessed with a standardized web based questionnaire. A total number of 1962 climbers reported 699 injuries, which is equivalent to 0.2 injuries per 1?000?h of sport participation. Most (74.4%) of the injuries were of minor severity rated NACA I or NACA II. Injury distribution between the upper (42.6%) and lower extremities (41.3%) was similar, with ligament injuries, contusions and fractures being the most common injury types. Years of climbing experience (p<0.01), difficulty level (p<0.01), climbing time per week during summer (p<0.01) and winter (p<0.01) months were correlated with the injury rate. Age (p<0.05 (p=0.034)), years of climbing experience (p<0.01) and average climbing level (p<0.01) were correlated to the injury severity rated through NACA scores. The risk of acute injuries per 1?000?h of sport participation in sport climbing was lower than in previous studies on general rock climbing and higher than in studies on indoor climbing. In order to perform inter-study comparisons of future studies on climbing injuries, the use of a systematic and standardized scoring system (UIAA score) is essential. PMID:21913158
The technology of modern weapons, especially nuclear weapons, poses a critical threat to the health of all people. In addition to the unprecedented risk of massive destruction to living things and to the ecosphere, the resources used in production of these arsenals cause an economic threat to the health of populations even if the weapons are never used. Medical and social scientists have a responsibility to work for the prevention of nuclear war and the reversal of the arms race. This may imply an obligation to work towards the prevention of war in general. Professional responsibility in this regard is based on (1) special expertise, (2) influence in society and (3) the symbolic power of the values of life, health and human dignity. PMID:6623125
End-of-the-Cold-War economic realities include political jockeying over the future of weapons systems, a paucity of meaningful conversion efforts, and a suspicion that a weak economy will be unable to compensate for the loss of jobs and purchasing power as defense budgets are reduced. The authors of this book present three interrelated hypotheses: The first is that the existence of a