Combat veterans: impressions of an analytic observer in a non-analytic setting.

PubMed

Stein, Herbert H

2007-01-01

The hallmark presentation of combat trauma-nightmares, waking hallucinations, intrusive traumatic memories, and extreme affective reactions to environmental triggers-may best be conceptualized as part of an adaptive mechanism intended to protect the individual against a repetition of trauma. Combat veterans continuously must cope with the extreme affects that combat induced. Fear, rage, guilt, and grief predominate. Their mental and emotional life is complicated by a conscience split between war zone and civilian morality and by the special group dynamics of combat. Optimal clinical understanding of combat-related trauma, whether in a psychoanalytic or general mental health setting, requires an awareness of the interaction of the personal dynamics of each individual with the specific characteristics of their combat situation.

THE ROLES OF COMBAT EXPOSURE, PERSONAL VULNERABILITY, AND INVOLVEMENT IN HARM TO CIVILIANS OR PRISONERS IN VIETNAM WAR-RELATED POSTTRAUMATIC STRESS DISORDER

PubMed Central

Dohrenwend, Bruce P.; Yager, Thomas J.; Wall, Melanie M.; Adams, Ben G.

2014-01-01

The diagnosis, Posttraumatic Stress Disorder, was introduced in 1980 amidst debate about the psychiatric toll of the Vietnam War. There is controversy, however, about its central assumption that potentially traumatic stressors are more important than personal vulnerability in causing the disorder. We tested this assumption with data from a rigorously diagnosed male subsample (n = 260) from the National Vietnam Veterans Readjustment Study. Combat exposure, pre-war vulnerability, and involvement in harming civilians or prisoners were examined, with only combat exposure proving necessary for disorder onset. While none of the three factors proved sufficient, estimated onset reached 97% for veterans high on all three, with harm to civilians or prisoners showing the largest independent contribution. Severity of combat exposure proved more important than pre-war vulnerability in onset; pre-war vulnerability at least as important in long-term persistence. Implications for the primacy of the stressor assumption, further research, and policy are discussed. PMID:25309830

Lessons denied: a history of therapeutic response to combat stress reaction during Israel's War of Independence (1948), the Sinai Campaign (1956) and the Six Day War (1967)

PubMed

Witztum, E; Levy, A; Solomon, Z

1996-01-01

The current article examines the history of therapeutic response in the Israel Defense Forces toward combat stress reaction during two decades, and in the course of three wars: the 1948 War of Independence, the 1956 Sinai Campaign, and the 1967 Six Day War. Three independent sources were used: recorded debriefing materials; interviews conducted with therapists, commanders and military historians; and professional literature on the wars in Hebrew and other languages. The collected material is described and issues of attitudes, treatment approaches and preparedness are discussed.

PTSD, resilience and posttraumatic growth among ex-prisoners of war and combat veterans.

PubMed

Zerach, Gadi; Solomon, Zahava; Cohen, Assaf; Ein-Dor, Tsachi

2013-01-01

Past studies have shown that adversity may yield various salutogenic outcomes. two constructs that have been at the center of this scientific investigation are resilience and posttraumatic growth (PTG). the present study aims to clarify the relations between posttraumatic stress symptoms, resilience and PTG among israeli war veterans. the sample includes former prisoners of war (ex-POWs) (n=103) and comparable veterans (n=106) of the 1973 Yom Kippur War. the veterans were assessed twice: 18 and 30 years after the war with self-report questionnaires. resilience, defined as the absence of posttraumatic symptoms, and PTG are negatively correlated. resilient ex- POWs and veterans reported the lowest levels of PTG when compared to participants diagnosed with clinical and sub-clinical posttraumatic stress disorder (PtSd). Furthermore, PTG dimensions were found to be the most differentiating factor between study groups, followed by war exposure measures and clinical reports of depression and anxiety symptoms. this study strengthens the understanding that combatants who report high-level PtSd symptoms also report higher levels of positive psychological changes in the face of severe adversity.

Marital Relations and Combat Stress Reaction: The Wives' Perspective.

ERIC Educational Resources Information Center

Solomon, Zahava; And Others

1992-01-01

Examined changes over time in marital relations of Israeli combat veterans who sustained combat stress reaction (CSR) during 1982 Lebanon War. Interviewed wives of CSR veterans and non-CSR veterans. CRS couples were characterized at four points in time by more conflict, less intimacy, less consensus, less cohesion, and less expressiveness that…

Historical approaches to post-combat disorders

PubMed Central

Jones, Edgar

2006-01-01

Almost every major war in the last century involving western nations has seen combatants diagnosed with a form of post-combat disorder. Some took a psychological form (exhaustion, combat fatigue, combat stress reaction and post-traumatic stress disorder), while others were characterized by medically unexplained symptoms (soldier's heart, effort syndrome, shell shock, non-ulcer dyspepsia, effects of Agent Orange and Gulf War Syndrome). Although many of these disorders have common symptoms, the explanations attached to them showed considerable diversity often reflected in the labels themselves. These causal hypotheses ranged from the effects of climate, compressive forces released by shell explosions, side effects of vaccinations, changes in diet, toxic effects of organophosphates, oil-well fires or depleted-uranium munitions. Military history suggests that these disorders, which coexisted in the civilian population, reflected popular health fears and emerged in the gaps left by the advance of medical science. While the current Iraq conflict has yet to produce a syndrome typified by medically unexplained symptoms, it is unlikely that we have seen the last of post-combat disorders as past experience suggests that they have the capacity to catch both military planners and doctors by surprise. PMID:16687259

Historical approaches to post-combat disorders.

PubMed

Jones, Edgar

2006-04-29

Almost every major war in the last century involving western nations has seen combatants diagnosed with a form of post-combat disorder. Some took a psychological form (exhaustion, combat fatigue, combat stress reaction and post-traumatic stress disorder), while others were characterized by medically unexplained symptoms (soldier's heart, effort syndrome, shell shock, non-ulcer dyspepsia, effects of Agent Orange and Gulf War Syndrome). Although many of these disorders have common symptoms, the explanations attached to them showed considerable diversity often reflected in the labels themselves. These causal hypotheses ranged from the effects of climate, compressive forces released by shell explosions, side effects of vaccinations, changes in diet, toxic effects of organophosphates, oil-well fires or depleted-uranium munitions. Military history suggests that these disorders, which coexisted in the civilian population, reflected popular health fears and emerged in the gaps left by the advance of medical science. While the current Iraq conflict has yet to produce a syndrome typified by medically unexplained symptoms, it is unlikely that we have seen the last of post-combat disorders as past experience suggests that they have the capacity to catch both military planners and doctors by surprise.

Prevalence Estimates of Combat-Related PTSD: A Critical Review

PubMed Central

Richardson, Lisa K.; Frueh, B. Christopher; Acierno, Ronald

2010-01-01

Objective To provide a critical review of prevalence estimates of combat-related PTSD among military personnel and veterans, and of the relevant factors that may account for the variability of estimates within and across cohorts, including methodological and conceptual factors accounting for differences in prevalence rates across nations, conflicts/wars, and studies. Method We examined MEDLINE and PsycINFO databases for literature on combat-related PTSD. The following terms were used independently and in combinations in this search: PTSD, combat, veterans, military, epidemiology, prevalence. Results The point prevalence of combat-related PTSD in US military veterans since the Vietnam War ranges from about 2 – 17%. Studies of recent conflicts suggest that combat-related PTSD afflicts between 4 – 17% of US Iraq War veterans, but only 3 – 6% of returning UK Iraq War veterans. Thus, the prevalence range is narrower and tends to have a lower ceiling among combat veterans of non-US Western nations. Variability in prevalence is likely due to differences in sampling strategies; measurement strategies; inclusion and measurement of the DSM-IV clinically significant impairment criterion; timing and latency of assessment and potential for recall bias; and combat experiences. Prevalence rates are also likely affected by issues related to PTSD course, chronicity, and comorbidity; symptom overlap with other psychiatric disorders; and sociopolitical and cultural factors that may vary over time and by nation. Conclusions The disorder represents a significant and costly illness to veterans, their families, and society as a whole. However, further carefully conceptualized research is needed to advance our understanding of disorder prevalence, as well as associated information on course, phenomenology, protective factors, treatment, and economic costs. PMID:20073563

Controversies over the Pledge of Allegiance in Public Schools: Case Studies Involving State Law, 9/11, and the Culture Wars

ERIC Educational Resources Information Center

Montgomery, Jennifer J.

2015-01-01

This dissertation examines state-level efforts to mandate the Pledge of Allegiance in public schools, especially following 9/11. Despite longstanding Supreme Court precedent declaring mandatory flag salutes unconstitutional, various state legislatures sought to institute or strengthen pledge mandates irrespective of students' civil liberties.…

Groundwork for a Theory of the Combatant

DTIC Science & Technology

2017-01-03

AIR WAR COLLEGE AIR UNIVERSITY GROUNDWORK FOR A THEORY OF THE COMBATANT by Robert P. Vicars IV, Lt Col, USAF A Research Report...and synthesize them in a way that captures the fullness of the combatant’s moral reality. Such a synthesis would be a theory of the combatant. This...frame a broader theory of the combatant. 3 On Killing in War In surveying the literature on killing in war, one finds that commentators bring

Combat and Operational Stress: Minimizing Its Adverse Effects on Service Members

DTIC Science & Technology

2008-04-18

munitions. Combat stress has received many labels since the First World War. These labels include “shell shock, war neurosis , psychoneurosis, combat...war neurosis and psychoneurosis carried an inherently negative connotation because they implied by their name that a mental illness or disorder...who became combat stress casualties. In 1916, the term war neurosis replaced shell shocked as the number of combat stress casualties continued due

The Long War and Parental Combat Deployment: Effects on Military Children and At-Home Spouses

ERIC Educational Resources Information Center

Lester, Patricia; Peterson, Kris; Reeves, James; Knauss, Larry; Glover, Dorie; Mogil, Catherine; Duan, Naihua; Saltzman, William; Pynoos, Robert; Wilt, Katherine; Beardslee, William

2010-01-01

Objective: Given the growing number of military service members with families and the multiple combat deployments characterizing current war time duties, the impact of deployments on military children requires clarification. Behavioral and emotional adjustment problems were examined in children (aged 6 through 12) of an active duty Army or Marine…

Extremity War Injuries VIII: sequelae of combat injuries.

PubMed

Andersen, Romney C; D'Alleyrand, Jean-Claude G; Swiontkowski, Marc F; Ficke, James R

2014-01-01

The 2013 Extremity War Injury symposium focused on the sequelae of combat-related injuries, including posttraumatic osteoarthritis, amputations, and infections. Much remains to be learned about posttraumatic arthritis, and there are few circumstances in which a definitive arthroplasty should be performed in an acutely injured and open joint. Although the last decade has seen tremendous advances in the treatment of combat upper extremity injuries, many questions remain unanswered, and continued research focusing on improving reconstruction of large segmental defects remains critical. Discussion of infection centered on the need for novel methods to reduce the bacterial load following the initial débridement procedures. Novel methods of delivering antimicrobial therapy and anti-inflammatory medications directly to the wound were discussed as well as the need for near real-time assessment of bacterial and fungal burden and further means of prevention and treatment of biofilm formation and the importance of animal models to test therapies discussed. Moderators and lecturers of focus groups noted the continuing need for improved prehospital care in the management of junctional injuries, identified optimal strategies for both surgical repair and/or reconstruction of the ligaments in multiligamentous injuries, and noted the need to mitigate bone mineral density loss following amputation and/or limb salvage as well as the necessity of developing better methods of anticipating and managing heterotopic ossification.

31 CFR 315.16 - Pledge.

Code of Federal Regulations, 2010 CFR

2010-07-01

... OF THE TREASURY BUREAU OF THE PUBLIC DEBT REGULATIONS GOVERNING U.S. SAVINGS BONDS, SERIES A, B, C, D, E, F, G, H, J, AND K, AND U.S. SAVINGS NOTES Limitations on Transfer or Pledge § 315.16 Pledge. (a...

7 CFR 762.159 - Pledging of guarantee.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 7 2014-01-01 2014-01-01 false Pledging of guarantee. 762.159 Section 762.159 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE SPECIAL PROGRAMS GUARANTEED FARM LOANS § 762.159 Pledging of guarantee. A lender may pledge all or...

Taking the ocean pledge

NASA Astrophysics Data System (ADS)

Showstack, Randy

The National Oceanic and Atmospheric Administration (NOAA) is sponsoring an "ocean ambassadors pledge campaign" to encourage students and others to make a personal, long-term commitment to caring for the world's oceans.The pledge campaign, which is part of NOAA's public awareness efforts for the International Year of the Ocean, calls for people to learn what they can about oceans, be considerate to ocean wildlife, conserve water, and implement other simple measures.

[A comparison of self assessment of dental status regarding dental anxiety among combat and non-combat soldiers].

PubMed

Levin, A; Zini, A

2014-01-01

The objective of the study was to evaluate the difference in the level of self dental assessment between different groups of soldiers: 115 combats and 115 non-combats. All the solders in this study where male, Jewish, with a service record of 12-48 months, ages 18-22 and born in Israel. The data was summarized, evaluated and tested by x2 - chi square and logistic regressions analysis. In the following parameters no significant differences were found regarding time past from last visit to the dentist, self assessment of dental condition, self assessment of need of dental treatment and the frequency of tooth brushing and sugar consumption. Significant differences were found in the percentage of smokers (59.1% among non-combat vs. 31.9% among combat), and in the dental anxiety level (55.3% among non-combat vs. 38% among combat). The main difference between these two groups is the nature of the social support and society surrounding them, a society that strengthens them and gives the feeling they can deal with fears and difficulties. An additional study should be done in which the soldiers self assessment should be compared to clinical examination. The importance of this study is that the non-combat group should be defined as a high risk population regarding dental anxiety.

Prevalence estimates of combat-related post-traumatic stress disorder: critical review.

PubMed

Richardson, Lisa K; Frueh, B Christopher; Acierno, Ronald

2010-01-01

The aim of the present study was to provide a critical review of prevalence estimates of combat-related post-traumatic stress disorder (PTSD) among military personnel and veterans, and of the relevant factors that may account for the variability of estimates within and across cohorts, including methodological and conceptual factors accounting for differences in prevalence rates across nations, conflicts/wars, and studies. MEDLINE and PsycINFO databases were examined for literature on combat-related PTSD. The following terms were used independently and in combinations in this search: PTSD, combat, veterans, military, epidemiology, prevalence. The point prevalence of combat-related PTSD in US military veterans since the Vietnam War ranged from approximately 2% to 17%. Studies of recent conflicts suggest that combat-related PTSD afflicts between 4% and 17% of US Iraq War veterans, but only 3-6% of returning UK Iraq War veterans. Thus, the prevalence range is narrower and tends to have a lower ceiling among combat veterans of non-US Western nations. Variability in prevalence is likely due to differences in sampling strategies; measurement strategies; inclusion and measurement of the DSM-IV clinically significant impairment criterion; timing and latency of assessment and potential for recall bias; and combat experiences. Prevalence rates are also likely affected by issues related to PTSD course, chronicity, and comorbidity; symptom overlap with other psychiatric disorders; and sociopolitical and cultural factors that may vary over time and by nation. The disorder represents a significant and costly illness to veterans, their families, and society as a whole. Further carefully conceptualized research, however, is needed to advance our understanding of disorder prevalence, as well as associated information on course, phenomenology, protective factors, treatment, and economic costs.

The Healthy Wight Commitment Foundation pledge: calories purchased by U.S. households with children, 2000-2012.

PubMed

Ng, Shu Wen; Popkin, Barry M

2014-10-01

An independent evaluation of the Healthy Weight Commitment Foundation (HWCF) marketplace pledge found that the participating companies met and exceeded their interim 2012 sales reduction pledge. This follow-up study conducted in 2013 used purchase data from 2000 to 2012 among U.S. households with children and compared trends in calorie purchases of HWCF, non-HWCF name brands, and private label (PL) products in the pre-pledge period (2000-2007) and the post-pledge period (2008-2012); controlled for potential effects of concurrent changes in demographic and economic factors, including the Great Recession and food prices; and assessed whether the HWCF marketplace pledge was associated with reductions in consumer packaged goods (CPG) calorie purchases by households with children. There has been a significant per capita decline in average daily CPG caloric purchases between 2000 and 2012 among households with children from all brand categories. Based on pre-pledge trends, declines in CPG caloric purchases were already occurring. However, post-pledge reductions in calories purchased from HWCF brands were less than expected, and reductions in calories purchased from non-HWCF name brands and PLs were greater than expected after economic, sociodemographic, and secular factors were accounted for. If the 16 HWCF companies had been able to maintain their pre-pledge trajectory, there should have been an additional 42 kcal/capita/day reduction in calories purchased from HWCF products in 2012 among households with children. A lack of change in total CPG calories purchased between 2011 and 2012 calls into question the sustainability of the decline and a need for continued monitoring. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Epidemiology of dermatophytosis in junior combat and non-combat sports participants.

PubMed

Döğen, Aylin; Gümral, Ramazan; Oksüz, Zehra; Kaplan, Engin; Serin, Mehmet Sami; Ilkit, Macit

2013-03-01

Participation in competitive sports is popular and widely encouraged worldwide. Herein, we investigated 252 male and 67 female sports players, aged 16.4 ± 1.3 years, active in 15 different types of combat (n = 143) and non-combat (n = 176) sports. Of the 319 participants in this study, 11 (3.5%) players, including six wrestlers, four football players and one handball player, all of whom were men, harboured dermatophytic fungi. Briefly, Trichophyton tonsurans was present in three athletes, who were scalp carriers of the fungus. Furthermore, T. rubrum (4), T. interdigitale (3) and Arthroderma simii (1) were recovered from eight participants with tinea inguinalis (4), tinea pedis (2) or both (1). One patient was a trunk carrier of concomitant tinea pedis. All dermatophytic fungi were identified using both direction sequence of the rDNA regions spanning the internal transcribed spacers (ITS1 and ITS2) and 5.8 rRNA gene. Although sports-active individuals are active and sweat more, we observed a low prevalence of dermatophytosis, both in combat (5.2%) and non-combat sports participants (3.4%) (P > 0.05). However, dermatophyte infections require more attention and appropriate management to eradicate the infection and to prevent possible outbreaks. This study also documents the first case of zoophilic A. simii in Turkey. © 2012 Blackwell Verlag GmbH.

Two war-torn soldiers: combat-related trauma through an intersubjective lens.

PubMed

Carr, Russell B

2013-01-01

The author, himself an Iraq war veteran, presents a contemporary psychodynamic understanding, known as intersubjective therapy, of combat-related Post-traumatic Stress Disorder (PTSD). At the onset of this case example, the patient was highly suicidal and his PTSD symptoms had not responded to a first-line treatment: manualized cognitive processing therapy. Robert Stolorow's intersubjective, psychodynamic approach to traumatic emotional experiences was then selected for treatment, and illustrates how combat in Afghanistan shattered this soldier's world and self experience. Therapeutic action arises from this intersubjective perspective by providing a relational home so that unendurable emotions can be borne, processed, and integrated to achieve a more constant and individualized sense of self. Being a two-person model of therapy, the author also describes how his work with this traumatized soldier affected him, ultimately contributing to his own sense of authentic existing. The author discusses the need for therapists to recognize and acknowledge to traumatized patients their shared finitude and the ubiquity of trauma. In the Postscript, the patient describes what he felt was therapeutic and contrasts this to his previous experiences with manualized cognitive processing therapy.

Are there atheists in foxholes? Combat intensity and religious behavior.

PubMed

Wansink, Brian; Wansink, Craig S

2013-09-01

After battle, the moral and mortality stresses influence different soldiers in different ways. Using two large-scale surveys of World War II veterans, this research investigates the impact of combat on religiosity. Study 1 shows that as combat became more frightening, the percentage of soldiers who reported praying rose from 42 to 72%. Study 2 shows that 50 years later, many soldiers still exhibited religious behavior, but it varied by their war experience. Soldiers who faced heavy combat (vs. no combat) attended church 21% more often if they claimed their war experience was negative, but those who claimed their experience was positive attended 26% less often. The more a combat veteran disliked the war, the more religious they were 50 years later. While implications for counselors, clergy, support groups, and health practitioners are outlined, saying there are no atheists in foxholes may be less of an argument against atheism than it is against foxholes.

Life satisfaction and quality in Korean War veterans five decades after the war.

PubMed

Ikin, J F; Sim, M R; McKenzie, D P; Horsley, K W A; Wilson, E J; Harrex, W K; Moore, M R; Jelfs, P L; Henderson, S

2009-05-01

Military service is considered to be a hidden variable underlying current knowledge about well-being in the elderly. This study aimed to examine life satisfaction and quality of life in Australia's surviving male Korean War veterans and a community comparison group, and to investigate any association with war deployment-related factors. Participants completed a postal questionnaire which included the Life Satisfaction Scale, the brief World Health Organization Quality of Life (WHOQOL-Bref) questionnaire and the Combat Exposure Scale. Korean War veterans reported significantly lower Percentage Life Satisfaction (PLS) and quality of life scores on four WHOQOL-Bref domains, compared with similarly aged Australian men (each p value <0.001). These outcomes were most strongly associated with severity of combat exposure and low rank. Mean PLS was approximately 15% lower in veterans who reported heavy combat compared with those reporting no combat, and approximately 12% lower in enlisted ranked veterans compared with officers. Fifty years after the Korean War, life satisfaction and quality in Australian veterans is poor relative to other Australian men, and is associated with deployment-related factors including combat severity and low rank. In order to respond effectively to current and projected population health needs, nations with large veteran populations may need to consider the impact of military service on well-being in later life.

The Long War and Parental Combat Deployment: Effects on Military Children and At-Home Spouses

PubMed Central

Lester, Patricia; Peterson, Kris; Reeves, James; Knauss, Larry; Glover, Dorie; Mogil, Catherine; Duan, Naihua; Saltzman, William; Pynoos, Robert; Wilt, Katherine; Beardslee, William

2010-01-01

OBJECTIVE Given the growing number of military service members with families and the multiple combat deployments characterizing current war time duties, the impact of deployments on military children requires clarification. Behavioral and emotional adjustment problems were examined in children (aged 6 –12) of an active duty Army or Marine Corps parent currently deployed (CD) or recently returned (RR) from Afghanistan or Iraq. METHOD Children (N=272) and their at-home civilian (AHC) (N=163) and/or recently returned active duty (AD) parent (N=65) were interviewed. Child adjustment outcomes were examined in relation to parental psychological distress and months of combat deployment (of the AD) using mixed effects linear models. RESULTS Parental distress (AHC and AD) and cumulative length of parental combat-related deployments during the child’s lifetime independently predicted increased child depression and externalizing symptoms. Although behavioral adjustment and depression levels were comparable to community norms, anxiety was significantly elevated in children in both deployment groups. In contrast, AHC parental distress was greater in those with a CD (vs. RR) spouse. CONCLUSIONS Findings indicate parental combat deployment has a cumulative effect on children which remains even after the deployed parent returns home, and is predicted by psychological distress of both the AD and AHC parent. Such data may be informative for screening, prevention and intervention strategies. PMID:20410724

The fog of war: decrements in cognitive performance and mood associated with combat-like stress.

PubMed

Lieberman, Harris R; Bathalon, Gaston P; Falco, Christina M; Morgan, Charles A; Niro, Philip J; Tharion, William J

2005-07-01

Anecdotal reports from military conflicts suggest cognitive performance and mood are severely degraded by the stress of combat. However, little objective information is available to confirm these observations. Our laboratory had several unique opportunities to study cognitive function in warfighters engaged in exercises designed to simulate the stress of combat. These studies were conducted in different environments with two different types of military volunteers. In one study, subjects were officers, with an average 9 yr of military service, who were members of an elite U.S. Army unit, the Rangers. In the other study, participants were younger, mostly enlisted, trainees with only 3 yr of military experience on average, in training to determine if they would qualify for an elite U.S. Navy unit, the SEALS. We administered a variety of identical, computer-based cognitive tests to both groups. In both groups, during stressful combat-like training, every aspect of cognitive function assessed was severely degraded compared with baseline, pre-stress performance. Relatively simple cognitive functions such as reaction time and vigilance were significantly impaired, as were more complex functions, including memory and logical reasoning. The deficits observed were greater than those typically produced by alcohol intoxication, treatment with sedating drugs, or clinical hypoglycemia. Undoubtedly, such decrements would severely degrade operational effectiveness. Furthermore, it is likely such cognitive decrements would be greater during actual combat. War planners, doctrine developers, and warfighters, especially leaders, need to be aware that combat stress will result in extensive and severe deficits in cognitive performance.

Broken Promises: Abstinence Pledging and Sexual and Reproductive Health

PubMed Central

Paik, Anthony; Sanchagrin, Kenneth J.; Heimer, Karen

2016-01-01

Approximately 12% of girls and young women in the United States pledge abstinence. Yet most break their pledges, engaging in first intercourse before marriage. The extant literature reports few differences between pledge breakers and nonpledgers in sexually transmitted infections and nonmarital pregnancies. The present research maintains that previous studies may have obscured important differences in exposure risk and hypothesizes that female pledge breakers who have higher exposure risk are more likely to experience human papillomavirus (HPV) and nonmarital pregnancies. To test this hypothesis, this study uses the National Longitudinal Study of Adolescent to Adult Health, logistic regression, and event history modeling. The results show that, after accounting for differences in exposure risk, pledge breakers have higher risk of HPV and nonmarital pregnancy. As a set, the results are consistent with the argument that pledgers use condoms and contraceptives less consistently and highlight unintended consequences of abstinence promotion. PMID:27019521

Hydrodynamic rupture of liver in combat patient: a case of successful application of "damage control" tactic in area of the hybrid war in East Ukraine.

PubMed

Khomenko, Igor; Shapovalov, Vitalii; Tsema, Ievgen; Makarov, Georgii; Palytsia, Roman; Zavodovskyi, Ievgen; Ishchenko, Ivan; Dinets, Andrii; Mishalov, Vladimir

2017-08-15

The hybrid war of Russia against Ukraine has been started in certain districts of Donetsk and Luhansk oblasts within the Donbas area in 2014. We report a clinical case of a combat patient who was injured after the multiple launcher rocket system "Grad" shelling, diagnosed with hydrodynamic liver rupture followed by medical management with application of damage control (DC) tactic in conditions of hybrid war. The patient underwent relaparatomy, liver resection, endoscopic papillosphincterotomy, endoscopic retrograde cholecystopancreatography, stenting of the common bile duct, and VAC-therapy. Applied treatment modalities were effective; the patient was discharged on the 49th day after injury. To our best knowledge, this is the first report describing a successful application of DC tactic in the hybrid war in East Ukraine. From this case, we suggest that application of DC tactic at all levels of combat medical care could save more lives.

Controversy over the Pledge of Allegiance Continues

ERIC Educational Resources Information Center

Russo, Charles J.

2010-01-01

This article discusses the steady stream of litigation that emerged shortly after the Pledge of Allegiance was introduced in 1892. The constitutionality of requiring students to take part in its daily recitation in schools continues to be challenged. Parents who objected to the statute and the words "under God" in the pledge filed suit, alleging…

31 CFR 225.4 - Pledge of book-entry Government obligations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance:Treasury 2 2013-07-01 2013-07-01 false Pledge of book-entry Government... SECURED BY GOVERNMENT OBLIGATIONS IN LIEU OF BONDS WITH SURETIES § 225.4 Pledge of book-entry Government... pledge pursuant to the prior agreement and approval of the bond official, of book-entry Government...

31 CFR 225.4 - Pledge of book-entry Government obligations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 2 2011-07-01 2011-07-01 false Pledge of book-entry Government... SECURED BY GOVERNMENT OBLIGATIONS IN LIEU OF BONDS WITH SURETIES § 225.4 Pledge of book-entry Government... pledge pursuant to the prior agreement and approval of the bond official, of book-entry Government...

31 CFR 225.4 - Pledge of book-entry Government obligations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Pledge of book-entry Government... SECURED BY GOVERNMENT OBLIGATIONS IN LIEU OF BONDS WITH SURETIES § 225.4 Pledge of book-entry Government... pledge pursuant to the prior agreement and approval of the bond official, of book-entry Government...

31 CFR 225.4 - Pledge of book-entry Government obligations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance: Treasury 2 2014-07-01 2014-07-01 false Pledge of book-entry Government... SECURED BY GOVERNMENT OBLIGATIONS IN LIEU OF BONDS WITH SURETIES § 225.4 Pledge of book-entry Government... pledge pursuant to the prior agreement and approval of the bond official, of book-entry Government...

31 CFR 225.4 - Pledge of book-entry Government obligations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance:Treasury 2 2012-07-01 2012-07-01 false Pledge of book-entry Government... SECURED BY GOVERNMENT OBLIGATIONS IN LIEU OF BONDS WITH SURETIES § 225.4 Pledge of book-entry Government... pledge pursuant to the prior agreement and approval of the bond official, of book-entry Government...

Legal Services during War.

DTIC Science & Technology

1987-03-23

thorough education about the laws of war, suggesting that even lawyers were ill prepared to address many of the questions that arose. In addition, there...should be "more intensive education of troops prior to combat to help avoid breaches of the laws and usages of war. 147 28 Military Affairs Military...must be determined, Inter lqa , whether damage or injury was caused by US forces during combat. Interests of both the claimant and government are served

76 FR 58006 - Consumer Health IT Pledge Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-19

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Consumer Health IT Pledge Program AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of availability for Consumer Health IT Pledge Program. SUMMARY: The U.S. Department of Health & Human Services' Office of the National...

External Qi therapy to treat symptoms of Agent Orange Sequelae in Korean combat veterans of the Vietnam War.

PubMed

Lee, Myeong Soo; Woo, Won-Hong; Lim, Hyun-Ja; Hong, Sung-Soo; Kim, Hye-Jung; Moon, Sun-Rock

2004-01-01

We investigated the efficacy of Qi therapy as a non-pharmacological treatment for various symptoms presented by Korean combat veterans of the Vietnam War with Agent Orange Sequelae. Nine subjects volunteered to receive 30 minutes of Qi therapy, twice per day for 7 days. There was marked improvement in 89% of the patients with impaired physical activity, 86% of those with psychological disorder, 78% of those with heavy drug use, and 67% of those with fatigue, indigestion and high blood glucose levels. This data suggests that Qi therapy combined with conventional treatment has positive effects in reducing and managing the pain, psychosomatic disorders, and substance abuse in patients with Agent Orange Sequelae. We cannot completely discount the possible influence of the placebo effect, and more objective, clinical measures are needed to study the long-term effects of Qi therapy.

An analysis of the content of food industry pledges on marketing to children.

PubMed

Hawkes, Corinna; Harris, Jennifer L

2011-08-01

To identify pledges made by the food industry to change food marketing to children worldwide, examine their content and discuss their potential to reduce the harmful effects of food marketing to children. A search for pledges and specific commitments made by participating companies and a content analysis of their scope and criteria used to define the marketing covered or excluded. Global. Food industry pledges. Between 2005 and 2009, the food industry developed thirteen pledges on food marketing to children, involving fifty-two food companies. Two of the pledges were global, two were regional and nine applied to specific countries. Three were specific to the soft drinks industry and to the fast-food industry, with the rest being food industry wide. Ten of the pledges required companies to publish individual commitments; a total of eighty-two such commitments were published, many of which extended beyond the minimum standards set in the pledges. All pledges included definitions of children and child-targeted media, as well as the communication channels and marketing techniques covered, and permitted companies to set criteria for foods that are exempted from any restrictions. There were many similarities between the pledges and individual commitments; however, there were also many differences. The development of pledges on food marketing to children in such a short span of time is impressive. However, limitations and inconsistencies in the pledges and commitments suggest that the food industry has a long way to go if its pledges are to comprehensively reduce the exposure and power of marketing to children.

Sex education and the news: lessons from how journalists framed virginity pledges.

PubMed

Mebane, Felicia E; Yam, Eileen A; Rimer, Barbara K

2006-09-01

This analysis of newspaper articles about virginity pledges published from 1987 to 2001 describes prominent news frames on sex education. The articles focused on True Love Waits, a nationwide virginity pledge campaign encouraging abstinence, and results from Add Health (TLW), a longitudinal study that included questions to evaluate the effects of virginity pledges. Our results show how news frames and sources can vary for related events. Reporting on virginity pledges was often not grounded in science, and reporting on the science of pledges did not reflect a broader context. In this case, reporting may have encouraged support for abstinence-only programs.

[Endovascular surgery in the war].

PubMed

Reva, V A; Samokhvalov, I M

2015-01-01

Rapid growth of medical technologies has led to implementation of endovascular methods of diagnosis and treatment into rapidly developing battlefield surgery. This work based on analysing all available current publications generalizes the data on using endovascular surgery in combat vascular injury. During the Korean war (1950-1953) American surgeons for the first time performed endovascular balloon occlusion of the aorta - the first intravascular intervention carried out in a zone of combat operations. Half a century thereafter, with the beginning of the war in Afghanistan (2001) and in Iraq (2003) surgeons of central hospitals of the USA Armed Forces began performing delayed endovascular operations to the wounded. The development of technologies, advent of mobile angiographs made it possible to later on implement high-tech endovascular interventions in a zone of combat operations. At first, more often they performed implantation of cava filters, somewhat afterward - angioembolization of damaged accessory vessels, stenting and endovascular repair of major arteries. The first in the theatre of war endovascular prosthetic repair of the thoracic aorta for severe closed injury was performed in 2008. Russian experience of using endovascular surgery in combat injuries is limited to diagnostic angiography and regional intraarterial perfusion. Despite the advent of stationary angiographs in large hospitals of the RF Ministry of Defence in the early 1990s, endovascular operations for combat vascular injury are casuistic. Foreign experience in active implementation of endovascular technologies to treatment of war-time injuries has substantiated feasibility of using intravascular interventions in tertiary care military hospitals. Carrying out basic training courses on endovascular surgery should become an organic part of preparing multimodality general battlefield surgeons rendering care on the theatre of combat operations.

Extremity War Injuries XII: Homeland Defense as a Translation of War Lessons Learned.

PubMed

Stinner, Maj Daniel J; Schmidt, Andrew H

2018-06-12

The 12th Extremity War Injuries Symposium focused on issues related to the transitions in medical care that are occurring as the focus of the war on terror changes. The symposium highlighted the results of Department of Defense-funded research in musculoskeletal injury, the evolution of combat casualty care, and the readiness of the fighting force. Presentations and discussions focused on force readiness of both troops and their medical support as well as the maintenance of the combat care expertise that has been developed during the previous decade of conflict.

"Alcohol Myopia," Expectations, Social Interests, and Sorority Pledge Status.

ERIC Educational Resources Information Center

Elias, Jeffrey W.; And Others

1996-01-01

Examines "alcohol myopia" (an increased use of alcohol in the face of increased negative consequences of use) in freshman college women with or without sorority pledge status. Increased alcohol use and alcohol myopia were present in the sorority pledge group. Both groups showed anomalous myopic behavior as alcohol use increased. (RJM)

General Assembly pledges support for war against AIDS.

PubMed

1988-03-01

At a special meeting held in October 1987, the World Health Organization called for a concerted, international response to acquired immunodeficiency syndrome (AIDS). Announced was the creation of a WHO Global Commission on AIDS comprised of experts in health, social, economic, legal, ethical, and biomedical fields who will advise WHO officials of developments in various aspects of the disease. Member States were united in terms of the need for open communication and support of WHO efforts to combat AIDS. By December 1987, 129 countries had reported 73,747 AIDS cases to WHO and another 3 million new cases are likely to develop by 1982. The WHO strategy is based on several concepts: 1) even in the absence of a vaccine, AIDS is controllable through widespread education; 2) longterm commitment to eradication is necessary; 3) AIDS prevention and control must be integrated into national health systems; and 4) international cooperation, coordination, and leadership is vital. National AIDS committees have been established in over 100 countries.

Does Pledging Allegiance to the Flag Have Educational Value?

ERIC Educational Resources Information Center

Benus, Matthew J.; Martin, Leisa A.; Lauzon, Glenn P.

2016-01-01

Despite extensive commentary on the Pledge of Allegiance in schools, little is known about how students think of its daily recitation. This study asked 88 Native American high school students about their experiences with classroom recitation of the Pledge of Allegiance. Aware that they had the right to refrain from participating, most students…

Marital Adjustment, Parental Functioning, and Emotional Sharing in War Veterans

ERIC Educational Resources Information Center

Solomon, Zahava; Debby-Aharon, Shimrit; Zerach, Gadi; Horesh, Danny

2011-01-01

The current study aimed to examine the implications of posttraumatic stress disorder symptoms and emotional sharing in marital adjustment and parental functioning among Israeli veterans of the 1982 Lebanon War. The sample consisted of combat stress reaction (CSR) veterans (n = 264) and non-CSR veterans (n = 209). Results show that traumatized…

Assessment of Posttraumatic Stress Disorder in World War II Veterans.

ERIC Educational Resources Information Center

Engdahl, Brian E.; And Others

1996-01-01

Four posttraumatic stress disorder (PTSD) scales were compared in a community sample of 330 former prisoners of war and World War II combat veterans. The Mississippi Scale for Combat-Related PTSD, the Minnesota Multiphasic Personality Inventory-2, and the Impact of Event Scale demonstrated moderate relationships with PTSD. (SLD)

The Healthy Weight Commitment Foundation pledge: calories sold from U.S. consumer packaged goods, 2007-2012.

PubMed

Ng, Shu Wen; Slining, Meghan M; Popkin, Barry M

2014-10-01

Corporate voluntary pledges to improve the health of Americans have not been held to either explicit measurable outcomes or a framework for independent evaluation. The Healthy Weight Commitment Foundation (HWCF), whose members include 16 of the nation's leading consumer packaged goods (CPG) food and beverage manufacturers, voluntarily pledged to collectively sell 1 trillion fewer calories in the U.S. marketplace by 2012 (against a 2007 baseline), and sell 1.5 trillion fewer calories by 2015. This paper presents the findings of an independent evaluation of the 2012 HWCF marketplace pledge, conducted in 2013. The 16 HWCF companies collectively sold approximately 6.4 trillion fewer calories (-10.6%) in 2012 than in the baseline year of 2007. Taking into account population changes over the 5-year period of 2007-2012, CPG caloric sales from brands included in the HWCF pledge declined by an average of 78 kcal/capita/day. CPG caloric sales from non-HWCF national brands during the same period declined by 11 kcal/capita/day, and there were similar declines in calories from private label products. Thus, the total reduction in CPG caloric sales between 2007 and 2012 was 99 kcal/capita/day. This independent evaluation is the first to evaluate food industry compliance with its calorie reduction pledges and to assess how sales from the CPG food and beverage sector are changing. An accompanying paper investigates the extent to which the HWCF pledge affected household-level changes in CPG calories purchased, controlling for important economic and sociodemographic factors affecting household food purchases over this period. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Impact of Battalion and Smaller African-American Combat Units on Integration of the U.S. Army in the European Theater of Operations During World War II

DTIC Science & Technology

2015-06-12

WORLD WAR II A thesis presented to the Faculty of the U.S. Army Command and General Staff College in partial fulfillment of the requirements...other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a ...combat units fought in World War II, and this is a small pool of veterans to gather information on their achievements during a normal human life span

Effect of Combat Stress in the Psychophysiological Response of Elite and Non-Elite Soldiers.

PubMed

Tornero-Aguilera, José Francisco; Robles-Pérez, José Juan; Clemente-Suárez, Vicente Javier

2017-06-01

We aimed to analyse the effect of combat stress in the psychophysiological responses of elite and non-elite soldiers. We analysed heart rate, cortical arousal, skin temperature, blood lactate concentration and lower body muscular strength before and after a tactical combat simulation in 40 warfighters divided in two groups: elite (n: 20; 28.5 ± 6.38 years) and non-elite (n:20; 31.94 ± 6.24 years) group. Elite presented a significantly higher lactate concentration after combat than non elite soldiers (3.8 ± 1.5 vs 6.6 ± 1.3 mmol/L). Non-elite soldiers had a higher heart rate pre and post the simulation than elite (82.9 ± 12.3 vs 64.4 ± 11. pre non elite and elite respectively; 93.0 ± 12.8 vs 88 ± 13.8 bpm post non elite and elite respectively). Elite soldiers presented higher lower muscular strength than elite in all test and before and after the combat simulation. Cortical arousal was not modified significantly in both groups. We conclude elite soldiers presented in combat a higher anaerobic metabolism activation and muscular strength than non-elite soldiers, but cardiovascular, cortical, and muscular strength manifestation presented the same response in both elite and non-elite soldiers.

The Course and Correlates of Combat-Related PTSD in Australian Vietnam Veterans in the Three Decades After the War.

PubMed

O'Toole, Brian I; Catts, Stanley V

2017-02-01

Australian male Vietnam veterans (N = 388) were assessed 22 and 36 years after their return to Australia using standardized diagnostic interviews, with added data from Army records and self-report questionnaires. Among veterans who ever had posttraumatic stress disorder (PTSD), 50.3% had a current diagnosis at the second assessment; of those who had a current diagnosis at Wave 1, 46.9% were also current at Wave 2. Late onset occurred for 19.0% of veterans, of whom 60.8% were current at Wave 2. Multivariate analysis compared veterans with no history of PTSD (n = 231) with veterans who had ever had PTSD (n = 157) to assess risk factors for PTSD incidence; and veterans with a history, but not current PTSD (n = 78) with veterans who had current PTSD at the second assessment (n = 79) to assess risk factors for failure to remit. Incidence was associated with lower education, shorter Army training predeployment, higher combat, excess drinking, and help-seeking after return to Australia. Prevalence was associated with having a father who saw combat in World War II, being injured in battle, having a lower intelligence test score, experiencing higher combat, and having a diagnosis of phobia at the first assessment. Only combat was common to incidence and prevalence. Copyright © 2017 International Society for Traumatic Stress Studies.

Combat exposure, posttraumatic stress symptoms and risk-taking behavior in veterans of the Second Lebanon War.

PubMed

Svetlicky, Vlad; Solomon, Zahava; Benbenishty, Rami; Levi, Ofir; Lubin, Gadi

2010-01-01

Prior research has revealed heightened risk-taking behavior among veterans with posttraumatic stress disorder (PTSD). This study examined whether the risktaking behavior is a direct outcome of the traumatic exposure or whether this relationship is mediated by posttraumatic stress symptoms. The sample was comprised of 180 traumatized Israeli reserve soldiers, who sought treatment in the wake of the Second Lebanon War. Combat exposure was indirectly associated with risk-taking behavior primarily through its relationship with posttraumatic stress symptoms. Results of the multivariate analyses depict the implication of posttraumatic stress symptoms in risk taking behavior, and the role of self-medication and of aggression in traumatized veterans.

War exposure and post-traumatic stress as predictors of Portuguese colonial war veterans' physical health.

PubMed

Maia, Angela; McIntyre, Teresa; Pereira, M Graça; Ribeiro, Eugènia

2011-05-01

The relationship between war exposure and post-traumatic stress disorder (PTSD) has been largely investigated but the impact of the combat experience on physical health has only recently merited attention. The authors investigated the relationship between war exposure and psychological and physical health among 350 Portuguese colonial war veterans. The role of current PTSD symptoms as a mediator of these relationships was also investigated. The results showed that 39% of the veterans met criteria for current PTSD diagnosis and psychological distress was present in half of the sample. Pain, fatigue, and sleep problems were the most reported physical symptoms and mental health and gastro-intestinal problems, the most reported illnesses. Combat exposure variables were significant predictors of current health. The results indicated that veterans with higher exposure to war trauma maintained higher current levels of psychological distress and presented more physical health problems and physical symptoms than those less exposed. Mediation analyses showed that current PTSD was a full mediator of the relationship between war exposure and physical health outcomes.

War, Journalism, and Oral History.

ERIC Educational Resources Information Center

Rice, Gary

2000-01-01

Describes a project where students conducted oral history with either a war correspondent or a U.S. combat veteran for the course "War and the News Media: From Vietnam through Desert Storm and Beyond." Discusses how the students prepared for the interviews and the evaluation of their projects. (CMK)

Catalog of War Games

DTIC Science & Technology

1992-10-09

PROGRAM CATALOG OF WAR GAMES 92-30805 U *3fl91\\k~o 9 2 SECURITY CLASSIFICATION OF THIS PAGE I ,i REPORT DOCUMENTATION PAGE la. REPORT SECURITY...4401 Ford Ave ELEMENT NO. NO. NO. ACCESSION NO. AIyxndriA. VA 229i2-14O1 --. 11. TITLE (Include Security Classification) Catalog of War Games 12...SCURITY CLASSIFICATiON OF THIS PAGE DECLARATION OF ACCORD 1. PURPOSE This catalog provides information on the primary war games , combat simulations

Psychodynamic Treatment of Combat Veterans with PTSD at Risk for Suicide.

PubMed

Hendin, Herbert

2017-01-01

Posttraumatic stress disorder is a condition associated with suicide in both military personnel and combat veterans. Most veterans with PTSD, however, are not at risk of suicide. The major factor distinguishing those who attempted or were preoccupied with suicide is persistent severe guilt over behavior in combat while emotionally out of control. A 12-session short-term, psychodynamic psychotherapy, presented here, showed promise of success in dissipating the guilt from combat-related actions in veterans of the war in Vietnam. Preliminary work with combat veterans of the wars in Iraq and Afghanistan indicates it may be equally successful in treating them. Basic aspects of the psychodynamic approach could also be incorporated into current therapies and should improve their ability to treat veterans with PTSD at risk for suicide. Case examples are provided.

Impact of the Manning, Training, and Utilization of Black Combat Units during World War II on the Racial Integration of the Army

DTIC Science & Technology

2010-12-10

still originated at the beaches of Normandy. In September 1944, Allies captured the ports of Brest , France and Antwerp, Belgium; however it would...the origins and implementation of the US Army’s segregationist policies and practices for the formation and utilization of black combat units from... originally opposed creating more black divisions based upon feedback about their ineffectiveness in World War I, it approved this action to

Anxiety, post-traumatic stress disorder and depression in Korean War veterans 50 years after the war.

PubMed

Ikin, Jillian F; Sim, Malcolm R; McKenzie, Dean P; Horsley, Keith W A; Wilson, Eileen J; Moore, Michael R; Jelfs, Paul; Harrex, Warren K; Henderson, Scott

2007-06-01

There has been no comprehensive investigation of psychological health in Australia's Korean War veteran population, and few researchers are investigating the health of coalition Korean War veterans into old age. To investigate the association between war service, anxiety, post-traumatic stress disorder (PTSD) and depression in Australia's 7525 surviving male Korean War veterans and a community comparison group. A survey was conducted using a self-report postal questionnaire which included the PTSD Checklist, the Hospital Anxiety and Depression scale and the Combat Exposure Scale. Post-traumatic stress disorder (OR 6.63, P<0.001), anxiety (OR 5.74, P<0.001) and depression (OR 5.45, P<0.001) were more prevalent in veterans than in the comparison group. These disorders were strongly associated with heavy combat and low rank. Effective intervention is necessary to reduce the considerable psychological morbidity experienced by Korean War veterans. Attention to risk factors and early intervention will be necessary to prevent similar long-term psychological morbidity in veterans of more recent conflicts.

Belief in exposure to chemical and biological agents in Persian Gulf War soldiers.

PubMed

Stuart, John A; Ursano, Robert J; Fullerton, Carol S; Wessely, Simon

2008-02-01

This is the first longitudinal cohort study of Persian Gulf War US soldiers to examine belief in exposure to chemical and biological weapons before and shortly after combat. A longitudinal sample of n = 1250 male Persian Gulf War US Army soldiers were surveyed 3 to 4 months before and 6 to 10 months after the 1991 War. Six to 10 months after combat, 4.6% of the cohort believed they had been exposed to chemical and biological weapons. Adjusting for demographics only, those who reported a greater number of combat exposures (odds ratio, OR: 18.8), or higher combat stress (OR: 12.27) were more likely to believe they were exposed. Adjusting for all variables soldiers who reported higher combat stress continued to be most likely (OR: 6.58) to believe they had been exposed to chemical and biological weapons. Individuals reporting higher combat stress are at substantially greater risk of reporting they have been exposed to chemical or biological weapons.

Trauma-Induced Weight Loss and Cognitive Deficits among Former Prisoners of War.

ERIC Educational Resources Information Center

Sutker, Patricia B.; And Others

1990-01-01

Compared former prisoners of war (POWs) reporting confinement weight losses greater than 35 percent (N=60), less than 35 percent (N=113), and non-POW combat veterans (N=50) on Wechsler Adult Intelligence Scale-Revised and Wechsler Memory Scale Logical Memory indices. Findings suggest that severe POW confinement stress reflected by trauma-induced…

13 CFR 120.434 - What are SBA's requirements for loan pledges?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false What are SBA's requirements for loan pledges? 120.434 Section 120.434 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Lenders Other Conveyances § 120.434 What are SBA's requirements for loan pledges? (a) Except...

Providing for the Casualties of War: The American Experience Through World War II

DTIC Science & Technology

2013-01-01

Freud sug- gested that this may be an inherent trait, that “conflicts of interest between man and man are resolved, in principle, by the recourse to...violence” (Einstein and Freud , 1931– 1932). Although people have not been able to overcome their essential proclivity to make war on one another over...and methods of treatment of combat casualties. (Bliss, 1949) Army Psychiatry on the Eve of World War II After World War I, the writings of Sigmund

Atypical Modulations of N170 Component during Emotional Processing and Their Links to Social Behaviors in Ex-combatants.

PubMed

Trujillo, Sandra P; Valencia, Stella; Trujillo, Natalia; Ugarriza, Juan E; Rodríguez, Mónica V; Rendón, Jorge; Pineda, David A; López, José D; Ibañez, Agustín; Parra, Mario A

2017-01-01

Emotional processing (EP) is crucial for the elaboration and implementation of adaptive social strategies. EP is also necessary for the expression of social cognition and behavior (SCB) patterns. It is well-known that war contexts induce socio-emotional atypical functioning, in particular for those who participate in combats. Thus, ex-combatants represent an ideal non-clinical population to explore EP modulation and to evaluate its relation with SCB. The aim of this study was to explore EP and its relation with SCB dimensions such as empathy, theory of mind and social skills in a sample of 50 subjects, of which 30 were ex-combatants from illegally armed groups in Colombia, and 20 controls without combat experience. We adapted an Emotional Recognition Task for faces and words and synchronized it with electroencephalographic recording. Ex-combatants presented with higher assertion skills and showed more pronounced brain responses to faces than Controls. They did not show the bias toward anger observed in control participants whereby the latter group was more likely to misclassify neutral faces as angry. However, ex-combatants showed an atypical word valence processing. That is, words with different emotions yielded no differences in N170 modulations. SCB variables were successfully predicted by neurocognitive variables. Our results suggest that in ex-combatants the links between EP and SCB functions are reorganized. This may reflect neurocognitive modulations associated to chronic exposure to war experiences.

Atypical Modulations of N170 Component during Emotional Processing and Their Links to Social Behaviors in Ex-combatants

PubMed Central

Trujillo, Sandra P.; Valencia, Stella; Trujillo, Natalia; Ugarriza, Juan E.; Rodríguez, Mónica V.; Rendón, Jorge; Pineda, David A.; López, José D.; Ibañez, Agustín; Parra, Mario A.

2017-01-01

Emotional processing (EP) is crucial for the elaboration and implementation of adaptive social strategies. EP is also necessary for the expression of social cognition and behavior (SCB) patterns. It is well-known that war contexts induce socio-emotional atypical functioning, in particular for those who participate in combats. Thus, ex-combatants represent an ideal non-clinical population to explore EP modulation and to evaluate its relation with SCB. The aim of this study was to explore EP and its relation with SCB dimensions such as empathy, theory of mind and social skills in a sample of 50 subjects, of which 30 were ex-combatants from illegally armed groups in Colombia, and 20 controls without combat experience. We adapted an Emotional Recognition Task for faces and words and synchronized it with electroencephalographic recording. Ex-combatants presented with higher assertion skills and showed more pronounced brain responses to faces than Controls. They did not show the bias toward anger observed in control participants whereby the latter group was more likely to misclassify neutral faces as angry. However, ex-combatants showed an atypical word valence processing. That is, words with different emotions yielded no differences in N170 modulations. SCB variables were successfully predicted by neurocognitive variables. Our results suggest that in ex-combatants the links between EP and SCB functions are reorganized. This may reflect neurocognitive modulations associated to chronic exposure to war experiences. PMID:28588462

United States: challenges filed to anti-prostitution pledge requirement.

PubMed

Schleifer, Rebecca

2005-12-01

Two separate lawsuits were filed recently in US federal courts challenging a provision of US law requiring that non-governmental organizations have a policy "explicitly opposing prostitution" as a condition of receiving funding under the United States Leadership against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (US Global AIDS Act). US-based plaintiffs in both cases argue that the anti-prostitution pledge requirement in the Act violates US Constitutional guarantees of free speech and due process, and undermines proven, effective efforts to fight HIV/AIDS among sex workers.

E Pluribus Unum: Mohawk Indian Students' Views Regarding the U.S. Pledge of Allegiance

ERIC Educational Resources Information Center

Martin, Leisa A.; Lauzon, Glenn P.; Benus, Matthew J.; Livas, Pete, Jr.

2017-01-01

This study examined 191 high school students' willingness to recite the Pledge of Allegiance, their reasons for participating or not participating in saying the Pledge, and their thoughts about the Pledge during this daily school ritual. The study was conducted in a rural town next to the Akwesasne Mohawk reservation. The majority of the students…

[Epidemiology of war injuries, about two conflicts: Iraq and Afghanistan].

PubMed

Pasquier, P; de Rudnicki, S; Donat, N; Auroy, Y; Merat, S

2011-11-01

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 war injuries. 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 war injury 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 war injuries prevention and treatment. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

The mental health of UK ex-servicemen with a combat-related or a non-combat-related visual impairment: does the cause of visual impairment matter?

PubMed

Stevelink, Sharon A M; Malcolm, Estelle M; Gill, Pashyca C; Fear, Nicola T

2015-08-01

Since the start of the conflicts in Iraq and Afghanistan, the numbers of young service personnel who have sustained a combat-related visual impairment have increased. This cross-sectional study examined the mental well-being of ex-servicemen (aged 22-55 years) with a visual impairment and determined if the mental health of those with a combat-related visual impairment differed from those whose visual impairment is not combat-related. Male ex-service personnel with a visual impairment completed a telephone interview assessing the presence of depressive symptomatology, probable anxiety disorder, post-traumatic stress disorder (PTSD) symptomatology and alcohol misuse. Data were analysed using descriptive statistics. 77 participants were included in the study, reflecting a response rate of 76.2%. Of those with complete data (n=74), 20 ex-servicemen had a combat-related visual impairment. Among ex-service personnel with a combat-related visual impairment, 10.0% (95% CI 0 to 23.2) screened positive for a probable depression, 25.0% (95% CI 6.0 to 44.0) for probable anxiety and 10.0% (95% CI 0 to 23.2) for probable PTSD. The prevalence of probable depression and probable PTSD differed among those with a non-combat-related visual impairment, namely 18.5% (95% CI 8.1 to 28.9) and 16.7% (95% CI 6.8 to 26.7), respectively. Probable anxiety was 18.5% (95% CI 8.1 to 28.9) among non-combat-related visually impaired ex-service personnel. 45.0% (95% CI 23.2 to 66.8) of combat-related visually impaired personnel reported hazardous drinking, compared with 20.4% (95% CI 9.7 to 31.2) of those with a non-combat-related visual impairment. Mental health problems were prevalent among visually impaired younger ex-servicemen. No statistically significant differences were found in the prevalence of mental health problems among ex-servicemen with a combat-related visual impairment compared with those with a non-combat-related visual impairment. Published by the BMJ Publishing Group Limited

7 CFR 1434.16 - Release of the honey pledged as collateral for a loan.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Release of the honey pledged as collateral for a loan... MARKETING ASSISTANCE LOAN AND LDP REGULATIONS FOR HONEY § 1434.16 Release of the honey pledged as collateral for a loan. (a)(1) A producer shall not move or dispose of any honey pledged as collateral for a loan...

7 CFR 1434.16 - Release of the honey pledged as collateral for a loan.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 10 2011-01-01 2011-01-01 false Release of the honey pledged as collateral for a loan... MARKETING ASSISTANCE LOAN AND LDP REGULATIONS FOR HONEY § 1434.16 Release of the honey pledged as collateral for a loan. (a)(1) A producer shall not move or dispose of any honey pledged as collateral for a loan...

26 CFR 1.166-6 - Sale of mortgaged or pledged property.

Code of Federal Regulations, 2010 CFR

2010-04-01

...-6 Sale of mortgaged or pledged property. (a) Deficiency deductible as bad debt—(1) Principal amount... been returned by him) as a bad debt for the taxable year in which it becomes wholly worthless or is... mortgaged or pledged property by certain mutual savings banks, domestic building and loan associations, and...

Just War Theory and Presidential Discourse Prior to Conflict

DTIC Science & Technology

2014-12-04

Case for Combat , Edward J. Lordan lists last resort as a theme, among others, that has been used to persuade Americans to enter conflicts from the...Topic This paper studies the public statements of US presidents to ascertain justifications for war or armed intervention. Edward J. Lordan used a...similar approach in his book The Case for Combat : How Presidents Persuade Americans to go to War. In it, he examines presidential messaging and the

5 CFR 950.402 - Pledge form.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) SOLICITATION OF FEDERAL CIVILIAN AND UNIFORMED SERVICE PERSONNEL FOR CONTRIBUTIONS TO PRIVATE VOLUNTARY ORGANIZATIONS Campaign Information § 950.402 Pledge form. (a) The Director will make available each campaign...

5 CFR 950.402 - Pledge form.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) SOLICITATION OF FEDERAL CIVILIAN AND UNIFORMED SERVICE PERSONNEL FOR CONTRIBUTIONS TO PRIVATE VOLUNTARY ORGANIZATIONS Campaign Information § 950.402 Pledge form. (a) The Director will make available each campaign...

5 CFR 950.402 - Pledge form.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) SOLICITATION OF FEDERAL CIVILIAN AND UNIFORMED SERVICE PERSONNEL FOR CONTRIBUTIONS TO PRIVATE VOLUNTARY ORGANIZATIONS Campaign Information § 950.402 Pledge form. (a) The Director will make available each campaign...

5 CFR 950.402 - Pledge form.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) SOLICITATION OF FEDERAL CIVILIAN AND UNIFORMED SERVICE PERSONNEL FOR CONTRIBUTIONS TO PRIVATE VOLUNTARY ORGANIZATIONS Campaign Information § 950.402 Pledge form. (a) The Director will make available each campaign...

From Combat to Legacies: Novels of the Vietnam War.

ERIC Educational Resources Information Center

Johannessen, Larry R.

1995-01-01

Discusses novels of the Vietnam War, their usefulness, and the interest they hold for students. Considers four categories of Vietnam novels: the Vietnam experience, the war at home, the refugee experience, and the war's effect on the next generation. (SR)

Objective Versus Subjective Measurement of Stress and Social Support: Combat-Related Reactions.

ERIC Educational Resources Information Center

Solomon, Zahava; And Others

1987-01-01

Studied combat intensity, social support, and related stress reactions among soldiers who fought in the 1982 Israeli-Lebanon War, comparing those who experienced combat stress reaction (N=382) and those who did not (N=344). Subjective indicators were found to be stronger predictors than were objective indicators. Combat stress reaction was clearly…

The Combatant Commander and Effective Operational HUMINT: Lessons From the Double Cross System of World War II and the CJ2X of Operation Joint Guard

DTIC Science & Technology

2003-05-19

www.bbc.co.uk/cgi-bin/history/renderplain.pl?file=history/war/wwtwo/spying/sis_0/> [27 March 2003]. 37 Ibid. 38 “Operation Overlord,” Saving Private Ryan Online...Security, (Washington, DC: 2002), 17; National Strategy for Combating Terrorism. Washington, DC: 2003. “Operation Overlord,” Saving Private Ryan Online

Middle School Students' Views on the United States Pledge of Allegiance

ERIC Educational Resources Information Center

Martin, Leisa A.

2011-01-01

Although the United States Pledge of Allegiance is a ritual in many schools, research on middle school students' views about this tradition is limited. Therefore, this grounded theory study included a survey of 100 middle school students on the Pledge with 33 follow-up interviews. Socialization and counter-socialization served as the theoretical…

The Civil-Military Gap and Women in Combat: The Elite’s Attitude Transformation, 1991-2013

DTIC Science & Technology

2015-02-12

women in combat, a social issue at the heart of the civil-military gap, as the US regrouped after the Gulf War then fought in Afghanistan and Iraq. The...the issue of women in combat (WIC), the first of three social issues cited by RAND.6 This study examines WIC from the end of the Gulf War through...US laws prevented women from serving in combat.41 It is apparent the two groups worked together to find common ground that addressed the tension

[Psychiatric aid during the Great Patriotic War].

PubMed

2010-05-01

The article presents an observe of questions of organization of psychiatric aid during the Great Patriotic War, main disadvantages of the first period of war, their dependence from circumstances of prewar period, ignoring of experience of last war. There was marked the role of famous native psychiatrists in organization of psychiatric aid to military servicemen in theatre of combat actions.

Combat Neurosis in the Battered Teacher.

ERIC Educational Resources Information Center

Science News, 1978

1978-01-01

Investigates the effect of school violence on classroom teachers. The study of 253 Los Angeles inner city classroom teachers reveals that many of them have developed conditions similar to the combat neurosis found in soldiers at war. (HM)

U. S.-Thailand Combatant Commander Considerations for the Asia-Pacific Rebalance

DTIC Science & Technology

2015-05-01

ADDRESS(ES) 8. PERFORMING ORGANIZATION REPORT NUMBER Joint Military Operations Department Naval War ...paper submitted to the Naval War College faculty in partial satisfaction of the requirements of the Joint Military Operations Department. The contents...Standard Form 298 (Rev. 8-98) NAVAL WAR COLLEGE Newport, R.I. U.S. – Thailand: Combatant Commander Considerations for the Asia

Mortality of first world war military personnel: comparison of two military cohorts.

PubMed

Wilson, Nick; Clement, Christine; Summers, Jennifer A; Bannister, John; Harper, Glyn

2014-12-16

To identify the impact of the first world war on the lifespan of participating military personnel (including in veterans who survived the war). Comparison of two cohorts of military personnel, followed to death. Military personnel leaving New Zealand to participate in the first world war. From a dataset of the New Zealand Expeditionary Forces, we randomly selected participants who embarked on troopships in 1914 and a comparison non-combat cohort who departed on troopships in late 1918 (350 in each group). Lifespan based on dates of birth and death from a range of sources (such as individual military files and an official database of birth and death records). A quarter of the 1914 cohort died during the war, with deaths from injury predominating (94%) over deaths from disease (6%). This cohort had a significantly shorter lifespan than the late 1918 "non-combat" cohort, with median ages of death being 65.9 versus 74.2, respectively (a difference of 8.3 years shown also in Kaplan-Meier survival curves, log rank P<0.001). The difference for the lifespan of veterans in the postwar period was more modest, with median ages of death being 72.6 versus 74.3, respectively (a difference of 1.7 years, log rank P=0.043). There was no evidence for differences between the cohorts in terms of occupational class, based on occupation at enlistment. Military personnel going to the first world war in 1914 from New Zealand lost around eight years of life (relative to a comparable military cohort). In the postwar period they continued to have an increased risk of premature death. © Wilson et al 2014.

Family cohesion and posttraumatic intrusion and avoidance among war veterans: a 20-year longitudinal study.

PubMed

Zerach, Gadi; Solomon, Zahava; Horesh, Danny; Ein-Dor, Tsachi

2013-02-01

The bi-directional relationships between combat-induced posttraumatic symptoms and family relations are yet to be understood. The present study assesses the longitudinal interrelationship of posttraumatic intrusion and avoidance and family cohesion among 208 Israeli combat veterans from the 1982 Lebanon War. Two groups of veterans were assessed with self-report questionnaires 1, 3 and 20 years after the war: a combat stress reaction (CSR) group and a matched non-CSR control group. Latent Trajectories Modeling showed that veterans of the CSR group reported higher intrusion and avoidance than non-CSR veterans at all three points of time. With time, there was a decline in these symptoms in both groups, but the decline was more salient among the CSR group. The latter also reported lower levels of family cohesion. Furthermore, an incline in family cohesion levels was found in both groups over the years. Most importantly, Autoregressive Cross-Lagged Modeling among CSR and non-CSR veterans revealed that CSR veterans' posttraumatic symptoms in 1983 predicted lower family cohesion in 1985, and lower family cohesion, in turn, predicted posttraumatic symptoms in 2002. The findings suggest that psychological breakdown on the battlefield is a marker for future family cohesion difficulties. Our results lend further support for the bi-directional mutual effects of posttraumatic symptoms and family cohesion over time.

Operational Artillery in the Korean War

DTIC Science & Technology

2013-05-23

employ artillery in a war of annihilation requires adherence to specific principles to maximize the effectiveness of combat power at the right time and...Policy (Bloomington: Indiana University Press, 1977), xxii. 24 “The Korean War rescued NSC-68 from oblivion and made it the foundation of American...multiple firing units at the right time and place with the purpose of supporting the decisive operations of maneuver. Fire planning in the Korean War

Combat exposure severity as a moderator of genetic and environmental liability to post-traumatic stress disorder.

PubMed

Wolf, E J; Mitchell, K S; Koenen, K C; Miller, M W

2014-05-01

Twin studies of veterans and adults suggest that approximately 30-46% of the variance in post-traumatic stress disorder (PTSD) is attributable to genetic factors. The remaining variance is attributable to the non-shared environment, which, by definition, includes combat exposure. This study used a gene by measured environment twin design to determine whether the effects of genetic and environmental factors that contribute to the etiology of PTSD are dependent on the level of combat exposure. The sample was drawn from the Vietnam Era Twin Registry (VETR) and included 620 male-male twin pairs who served in the US Military in South East Asia during the Vietnam War era. Analyses were based on data from a clinical diagnostic interview of lifetime PTSD symptoms and a self-report measure of combat exposure. Biometric modeling revealed that the effects of genetic and non-shared environment factors on PTSD varied as a function of level of combat exposure such that the association between these factors and PTSD was stronger at higher levels of combat exposure. Combat exposure may act as a catalyst that augments the impact of hereditary and environmental contributions to PTSD. Individuals with the greatest exposure to combat trauma were at increased risk for PTSD as a function of both genetic and environmental factors. Additional work is needed to determine the biological and environmental mechanisms driving these associations.

Incidence and epidemiology of combat injuries sustained during "the surge" portion of operation Iraqi Freedom by a U.S. Army brigade combat team.

PubMed

Belmont, Philip J; Goodman, Gens P; Zacchilli, Michael; Posner, Matthew; Evans, Clifford; Owens, Brett D

2010-01-01

A prospective, longitudinal analysis of injuries sustained by a large combat-deployed maneuver unit has not been previously performed. A detailed description of the combat casualty care statistics, distribution of wounds, and mechanisms of injury incurred by a U.S. Army Brigade Combat Team during "The Surge" phase of Operation Iraqi Freedom was performed using a centralized casualty database and an electronic medical record system. Among the 4,122 soldiers deployed, there were 500 combat wounds in 390 combat casualties. The combat casualty rate for the Brigade Combat Team was 75.7 per 1,000 soldier combat-years. The % killed in action (KIA) was 22.1%, and the %died of wounds was 3.2%. The distribution of these wounds was as follows: head/neck 36.2%, thorax 7.5%, abdomen 6.9%, and extremities 49.4%. The percentage of combat wounds showed a significant increase in the head/neck region (p < 0.0001) and a decrease in the extremities (p < 0.03) compared with data from World War II, Korea, and Vietnam. The percentage of thoracic wounds (p < 0.03) was significantly less than historical data from World War II and Vietnam. The %KIA was significantly greater in those soldiers injured by an explosion (26.3%) compared with those soldiers injured by a gunshot wound (4.6%; p = 0.003). Improvised explosive devices accounted for 77.7% of all combat wounds. There was a significantly higher proportion of head/neck wounds compared with previous U.S. conflicts. The 22.1% KIA was comparable with previous U.S. conflicts despite improvements in individual/vehicular body armor and is largely attributable to the lethality of improvised explosive devices. The lethality of a gunshot wound in Operation Iraqi Freedom has decreased to 4.6% with the use of individual body armor.

Basic Citizenship Concepts: 1. Learning the Meaning of the Pledge of Allegiance.

ERIC Educational Resources Information Center

Elmore, L. JoAnne

The curriculum guide provides background information and a wide variety of activities designed to help elementary students understand the meaning of and gain an appreciation of the Pledge of Allegiance. The guide contains the following eight lessons: The Meaning of the Word "Pledge"; What is Allegiance? The History of the Flag; Symbols…

Postdischarge Cause-of-Death Analysis of Combat-Related Burn Patients

PubMed Central

Escolas, Sandra M.; Orman, Jean A.; Chung, Kevin K.; Renz, Evan M.

2017-01-01

Combat operations in Iraq and Afghanistan have resulted in up to 8.8% of combat-related casualties suffering burns. From World War I through Desert Storm, burns have been associated with approximately 4% of the combat-related deaths. Experiencing a blast injury and exposure to killing and death while deployed has been shown to increase suicide risk. Although several studies of military populations have investigated risk factors for death among burn patients during the acute phase, no studies have reported mortality rates, cause-of-death, or the prevalence of suicide after hospital discharge. This study examined the case fatality rate, causes of death, and the prevalence of suicide among 830 combat burn patients discharged from the sole burn center in the U.S. Department of Defense, between March 7, 2003 and March 6, 2013. Cause-of-death was determined through the Armed Forces Medical Examiner’s Office and the Office of the Secretary of Defense’s National Death Index. A total of 11 deaths occurred among the 830 burn survivors, for an overall case fatality rate of 1.3%. Of the 11 who died, five deaths were related to accidental poisoning by exposure to drugs; three were related to operations of war (two after returning to the war zone), and the remaining three died from other accidental causes (one explosion and two vehicle crashes). There was no indication of suicide or suspicion of suicide as a cause-of-death for the former patients included in this study, suggesting that combat burn injury did not appear to increase the risk of death by suicide in our study population. Further research is needed to understand the factors that contribute to the apparent resilience of combat burn survivors. PMID:26629656

Development of the Murdoch Chiropractic Graduate Pledge

PubMed Central

Simpson, J. Keith; Losco, Barrett; Young, Kenneth J.

2010-01-01

Purpose: This paper reviews the origins of the learned professions, the foundational concepts of professionalism, and the common elements within various healer's oaths. It then reveals the development of the Murdoch Chiropractic Graduate Pledge. Methods: A committee comprised of three Murdoch academics performed literature searches on the topic of professionalism and healer's oaths and utilized the Quaker consensus process to develop the Murdoch Chiropractic Graduate Pledge. Results: The committee in its deliberations utilized over 200 relevant papers and textbooks to formulate the Murdoch Chiropractic Graduate Pledge that was administered to the 2010 Murdoch School of Chiropractic and Sports Science graduates. The School of Chiropractic and Sports Science included professionalism as one of its strategic goals and began the process of curriculum review to align it with the goal of providing a curriculum that recognizes and emphasizes the development of professionalism. Conclusions: The reciting of a healer's oath such as the Hippocratic Oath is widely considered to be the first step in a new doctor's career. It is seen as the affirmation that a newly trained health care provider will use his or her newfound knowledge and skill exclusively for the benefit of mankind in an ethical manner. Born from the very meaning of the word profession, the tradition of recitation of a healer's oath is resurgent in health care. It is important for health care instructors to understand that the curriculum must be such that it contributes positively to the students' professional development. PMID:21048880

Combat Exposure Severity as a Moderator of Genetic and Environmental Liability to Posttraumatic Stress Disorder

PubMed Central

Wolf, Erika J.; Mitchell, Karen S.; Koenen, Karestan C.; Miller, Mark W.

2014-01-01

Background Twin studies of veterans and adults suggest that approximately 30–46% of the variance in posttraumatic stress disorder (PTSD) is attributable to genetic factors. The remaining variance is attributable to the non-shared environment, which, by definition, includes combat exposure. This study used a gene by measured environment twin design to examine if the effect of genetic and environmental factors that contribute to the etiology PTSD were dependent on level of combat exposure. Methods The sample was drawn from the Vietnam Era Twin Registry and included 620 male-male twin pairs who served in the U.S. Military in South East Asia during the Vietnam War era. Analyses were based on data from a clinical diagnostic interview of lifetime PTSD symptoms and a self-report measure of combat exposure. Results Biometric modeling revealed that the effect of genetic and non-shared environment factors on PTSD varied as a function of level of combat exposure such that the association between these factors and PTSD was stronger at higher levels of combat exposure. Conclusions Combat exposure may act as a catalyst that augments the impact of hereditary and environmental contributions to PTSD. Individuals with the greatest exposure to combat trauma were at increased risk for PTSD as a function of both genetic and other environmental factors. Additional work is needed to determine the biological and environmental mechanisms driving these associations. PMID:24001428

Posttraumatic Stress in U.S. Marines: The Role of Unit Cohesion and Combat Exposure

ERIC Educational Resources Information Center

Armistead-Jehle, Patrick; Johnston, Scott L.; Wade, Nathaniel G.; Ecklund, Christofer J.

2011-01-01

Combat exposure is a consistent predictor of posttraumatic stress (PTS). Understanding factors that might buffer the effects of combat exposure is crucial for helping service members weather the stress of war. In a study of U.S. Marines returning from Iraq, hierarchical multiple regression analyses revealed that unit cohesion and combat exposure…

Abductive networks applied to electronic combat

NASA Astrophysics Data System (ADS)

Montgomery, Gerard J.; Hess, Paul; Hwang, Jong S.

1990-08-01

A practical approach to dealing with combinatorial decision problems and uncertainties associated with electronic combat through the use of networks of high-level functional elements called abductive networks is presented. It describes the application of the Abductory Induction Mechanism (AIMTM) a supervised inductive learning tool for synthesizing polynomial abductive networks to the electronic combat problem domain. From databases of historical expert-generated or simulated combat engagements AIM can often induce compact and robust network models for making effective real-time electronic combat decisions despite significant uncertainties or a combinatorial explosion of possible situations. The feasibility of applying abductive networks to realize advanced combat decision aiding capabilities was demonstrated by applying AIM to a set of electronic combat simulations. The networks synthesized by AIM generated accurate assessments of the intent lethality and overall risk associated with a variety of simulated threats and produced reasonable estimates of the expected effectiveness of a group of electronic countermeasures for a large number of simulated combat scenarios. This paper presents the application of abductive networks to electronic combat summarizes the results of experiments performed using AIM discusses the benefits and limitations of applying abductive networks to electronic combat and indicates why abductive networks can often result in capabilities not attainable using alternative approaches. 1. ELECTRONIC COMBAT. UNCERTAINTY. AND MACHINE LEARNING Electronic combat has become an essential part of the ability to make war and has become increasingly complex since

The role of sexual assault on the risk of PTSD among Gulf War veterans.

PubMed

Kang, Han; Dalager, Nancy; Mahan, Clare; Ishii, Erick

2005-03-01

The 1991 Gulf War was the first major military deployment where female troops were integrated into almost every military unit, except for combat ground units. We evaluated the impact of reported sexual trauma during this deployment on the risk of post-traumatic stress disorder (PTSD) after the war. A nested case-control analysis was conducted using the data collected in a population-based health survey of 30,000 Gulf War era veterans. A total of 1381 Gulf War veterans with current PTSD were compared with 10,060 Gulf veteran controls without PTSD for self-reported in-theater experiences of sexual harassment/assault and combat exposure. The adjusted odds ratio (aOR) for PTSD associated with a report of sexual assault was 5.41 (95% confidence interval [CI], 3.19-9.17) in female veterans and 6.21 (95% CI, 2.26-17.04) in male veterans. The aOR for PTSD associated with "high" combat exposure was also statistically significant (aOR, 4.03 [95% CI, 1.97-8.23] for females; aOR, 4.45 [95% CI, 3.54-5.60] for males). Notwithstanding a possibility of recall bias of combat and sexual trauma, for both men and women, sexual trauma as well as combat exposure appear to be strong risk factors for PTSD.

Evaluation and management of combat-related spinal injuries: a review based on recent experiences.

PubMed

Schoenfeld, Andrew J; Lehman, Ronald A; Hsu, Joseph R

2012-09-01

The current approach to the evaluation and treatment of military casualties in the Global War on Terror is informed by medical experience from prior conflicts and combat encounters from the last 10 years. In an effort to standardize the care provided to military casualties in the ongoing conflicts, the Department of Defense (DoD) has published Clinical Practice Guidelines (CPGs) that deal specifically with the combat casualty sustaining a spinal injury. However, the combat experience with spine injuries in the present conflicts remains incompletely described. To describe the CPGs for the care of the combat casualty with suspected spine injuries and discuss them in light of the published military experience with combat-related spinal trauma. Literature review. A literature review was conducted regarding published works that discussed the incidence, epidemiology, and management of combat-related spinal trauma. The CPGs, established by the DoD, are discussed in light of actual military experiences with spine trauma, the present situation in the forward surgical teams and combat support hospitals treating casualties in theater, and recent publications in the field of spine surgery. In the conventional wars fought by the United States between 1950 and 1991 (Korea, Vietnam, Gulf War I), the incidence of spine injuries remained close to 1% of all combat casualties. However, in the Global War on Terror, the enemy has relied on implements of asymmetric warfare, including sniper attacks, ambush, roadside bombs, and improvised explosive devices. The increase in explosive mechanisms of injury has elevated the number of soldiers exposed to blunt force trauma and, consequently, recent publications reported the highest incidence of combat-related spinal injuries in American military history. Wounded soldiers are expeditiously evacuated through the echelons of care but typically do not receive surgical management in theater. The current CPGs for the care of soldiers with combat

The Life-Long Mortality Risks Of World War II Experiences

PubMed Central

Elder, Glen H.; Brown, James Scott; Martin, Leslie R.; Friedman, Howard W.

2009-01-01

Objective This longitudinal study of American veterans investigated the mortality risks of five World War II military experiences (i.e., combat exposure) and their variation among veterans in the post-war years. Methods The male subjects (N=854) are members of the Stanford-Terman study, and 38 percent served in World War II. Cox models (proportional hazards regressions) compared the relative mortality risk associated with each military experience. Results Overseas duty, service in the Pacific and exposure to combat significantly increased the mortality risks of veterans in the study. Individual differences in education, mental health in 1950, and age at entry into the military, as well as personality factors made no difference in these results. Conclusions A gradient is observable such that active duty on the home front, followed by overseas duty, service in the Pacific, and combat exposure markedly increased the risk of relatively early mortality. Potential linking mechanisms include heavy drinking. PMID:20161074

The effects of combat exposure, abusive violence, and sense of coherence on PTSD and depression in Portuguese colonial war veterans.

PubMed

Ferrajão, Paulo Correia; Oliveira, Rui Aragão

2016-01-01

We analyzed the effects of 3 war components-combat exposure (CES), observation of abusive violence (OBS), and participation in abusive violence (PARTC)-and sense of coherence (SOC) on the development of both posttraumatic stress disorder (PTSD) and depression among a sample of war veterans. We also analyzed the role of SOC as a mediator of the effects of CES, OBS, and PARTC on both depression and PTSD symptoms. Sample was composed of 120 Portuguese Colonial War veterans. A binomial logistic regression analysis was performed to determine the effects of these variables on depression and PTSD diagnosis. Mediation test was performed by conducting several hierarchical regression analyses. Results showed that OBS and PARTC, and lower levels of SOC were associated with increased odds for exceeding the clinical cutoff scores for diagnosis of depression. All variables were associated with increased odds for exceeding the clinical cutoff scores for diagnosis of PTSD. In mediation analysis, at first step, PARTC was not a significant predictor of both PTSD and depression symptoms, and PARTC did not enter in subsequent analysis. SOC was a full mediator of the effects of OBS and CES on both depression and PTSD symptoms. We propose that treatment of war veterans should aim the reconciliation of traumatic incongruent experiences in veterans' personal schemas to strengthen veterans' sense of coherence, especially for those exposed to acts of abusive violence. (c) 2016 APA, all rights reserved).

Voices from Vietnam: The New Literature from America's Longest War.

ERIC Educational Resources Information Center

Kneeshaw, Stephen

1988-01-01

Provides an essay review of seven books, written since 1983, on the Vietnam War. The titles include: THE BAD WAR: AN ORAL HISTORY OF THE VIETNAM WAR (1987); IN THE COMBAT ZONE: AN ORAL HISTORY OF AMERICAN WOMEN IN VIETNAM, 1966-1975 (1987); and DEAR AMERICA: LETTERS HOME FROM VIETNAM (1985). (JDH)

Installing an Ethics Pledge within K-12 Academia: A Restoration of Humanism

ERIC Educational Resources Information Center

McBath, Gabrielle

2012-01-01

In May 2009, 33 Harvard M.B.A. Candidates proposed and published an ethics pledge entitled the M.B.A. Oath. It is a "voluntary student-led pledge that the goal of business managers is to 'serve the greater good.' It promises that Harvard M.B.A.[s] will act responsibly, ethically, and refrain from advancing their 'own narrow ambitions' at the…

Casualties of War: Combat Trauma and the Return of the Combat Veteran

ERIC Educational Resources Information Center

Kiely, Denis O.; Swift, Lisa

2009-01-01

The experience of the combat soldier and the road back to civilian life are recurrent themes in American literature and cinema. Whether the treatment is tragic (Stephen Crane's "Red Badge of Courage", Tim O'Brien's "The Things They Carried", or Tony Scott's "Blackhawk Down"), satirical (Joseph Heller's "Catch Twenty-Two" and Robert Altman's…

12 CFR 347.209 - Pledge of assets.

Code of Federal Regulations, 2011 CFR

2011-01-01

... to the risk-based assessment schedule contained in this paragraph, of the insured branch's average... most recent calendar quarter. (2) Risk-based assessment schedule. The risk-based asset pledge required by paragraph (b)(1) will be determined by utilizing the following risk-based assessment schedule...

12 CFR 347.209 - Pledge of assets.

Code of Federal Regulations, 2012 CFR

2012-01-01

... to the risk-based assessment schedule contained in this paragraph, of the insured branch's average... most recent calendar quarter. (2) Risk-based assessment schedule. The risk-based asset pledge required by paragraph (b)(1) will be determined by utilizing the following risk-based assessment schedule...

Winning the War and the Relationships: Preparing Military Officers for Negotiations With Non-Combatants

DTIC Science & Technology

2007-08-01

that Iraqis make “great poker players,” and “Every thing is gray. They never say yes or no. Every thing is open for negotiation.” This made it...U.S. Army Research Institute for the Behavioral and Social Sciences Research Report 1877 Winning the War and...United States Military Academy, West Point August 2007 Approved for public release; distribution is unlimited. U.S. Army

Effectiveness of battlefield-ethics training during combat deployment: a programme assessment.

PubMed

Warner, Christopher H; Appenzeller, George N; Mobbs, Angela; Parker, Jessica R; Warner, Carolynn M; Grieger, Thomas; Hoge, Charles W

2011-09-03

Breakdowns in the ethical conduct of soldiers towards non-combatants on the battlefield are of grave concern in war. Evidence-based training approaches to prevent unethical conduct are scarce. We assessed the effectiveness of battlefield-ethics training and factors associated with unethical battlefield conduct. The training package, based on movie vignettes and leader-led discussions, was administered 7 to 8 months into a 15-month high-intensity combat deployment in Iraq, between Dec 11, 2007, and Jan 30, 2008. Soldiers from an infantry brigade combat team (total population about 3500) were randomly selected, on the basis of company and the last four digits of each soldier's social security number, and invited to complete an anonymous survey 3 months after completion of the training. Reports of unethical behaviour and attitudes in this sample were compared with a randomly selected pre-training sample from the same brigade. The response patterns for ethical behaviour and reporting of ethical violations were analysed with chi-square analyses. We developed two logistic regression models using self-reported unethical behaviours as dependent variables. Factors associated with unethical conduct, including combat experiences and post-traumatic stress disorder (PTSD), were assessed with validated scales. Of 500 randomly selected soldiers 421 agreed to participate in the anonymous post-training survey. A total of 397 soldiers of the same brigade completed the pre-training survey. Training was associated with significantly lower rates of unethical conduct of soldiers and greater willingness to report and address misconduct than in those before training. For example, reports of unnecessary damage or destruction of private property decreased from 13·6% (54 of 397; 95% CI 10·2-17·0) before training to 5·0% (21 of 421; 2·9-7·1) after training (percent difference -63·2%; p<0·0001), and willingness to report a unit member for mistreatment of a non-combatant increased from

The EU pledge for responsible marketing of food and beverages to children: implementation in food companies.

PubMed

Jensen, J D; Ronit, K

2015-08-01

Increasing political pressure on the food industry's marketing activities stimulated the formation of the collective EU Pledge for responsible marketing of foods and beverages to children. The objective of the study is to evaluate the commitments made by companies in joining the pledge for the purpose of assessing its effectiveness in regulating signatory companies' marketing activities. Data on company commitments in relation to the EU Pledge were collected, analyzed and recalculated in order to enable comparison across companies and with general nutritional recommendations. Data on companies' product portfolio and market orientation were collected from their most recent available annual reports. Data on the companies' product profiles were generated via review of the companies' main websites. Similar data were generated for a reference group of companies outside the EU Pledge. Compared with a reference group of large food and beverage companies, EU Pledge signatory companies have a public image strongly based on products with appeal to children. The EU Pledge sets common standards for regulating signatory companies' marketing behaviour towards children. Further scrutiny of the companies' stated commitments revealed considerable variation in their actual content and in their de facto bindingness on the companies' marketing behavior--for example, in the definition of target audience for advertising or in nutritional characteristics making products eligible for advertising to children. In order for voluntary self-regulation schemes such as the EU Pledge to be a credible alternative to public regulation of marketing behaviour, more transparency and stringency are needed.

Food Companies’ Calorie-Reduction Pledges to Improve U.S. Diet

PubMed Central

Slining, Meghan M.; Ng, Shu Wen; Popkin, Barry M.

2013-01-01

Heretofore, corporate voluntary pledges to improve the health of Americans have been linked neither to explicit measurable commitments nor to a framework for an independent evaluation. The Healthy Weight Commitment Foundation (HWCF), whose members include 16 of the nation’s leading consumer packaged goods food and beverage manufacturers, voluntarily pledged to collectively remove 1 trillion calories from their products by 2012 (against a 2007 baseline), and 1.5 trillion calories by 2015. The pledge is designed to reduce the calorie gap commensurate with the HWCF companies’ role in the U.S. diet. To date, no system exists for documenting the nutritional and public health impacts of industry-led changes in the food supply on individual diets. The current study represents a unique opportunity to understand how the consumer packaged goods food and beverage sector is changing and how these changes are associated with changes in the American diet. It presents data on national caloric sales from this sector, purchases of these goods by various subpopulations, and methods linking these to individual intakes of Americans. Findings show that HWCF companies accounted for approximately 25% of calories consumed in the U.S. in 2007 and that the 1.5 trillion–calorie pledge (about 14 calories/day/capita) accounts for 0.8% of the calories sold across all consumer packaged goods food and beverage brands in 2007. The authors hope that this evaluation will continue to create models and methods for demonstrating the effects of changes in the food supply on individual diets, particularly among those from vulnerable subpopulations. PMID:23332336

DefenseLink.mil - Honoring the Pledge

Science.gov Websites

gone about the business of bringing them home one by one. They're honoring the nation's pledge to leave no one behind. Army Sgt. Jared Michalek, a JPAC recovery team noncommissioned officer, looks for any prepare bone and tooth samples for DNA extraction. The DNA lab is one of the oldest and largest labs in

Mental health care in the Lebanon War, 1982.

PubMed

Noy, S; Levy, R; Solomon, Z

1984-04-01

Lessons in mental health care learned from the October 1973 War were applied in the Lebanon War 1982. A three-echelon system of management was followed according to the practices prevalent in Western armies. The clinical pictures were essentially similar to those observed in other wars. Combat stress reactions (CSR) comprised 15 to 20% of the total casualties during the active phase of the war; the rate of late reactions was 30 to 40% of the total CSR. Treatment on the battlefield was more effective than treatment following airlift to the rear, in returning soldiers to their units. The role of stress in causing CSR, and the importance of leadership and cohesion in its prevention were evident. The important lessons learned from the Lebanon War are discussed and include: 1) the need for a broad definition of CSR; 2) the importance of forward unit intervention; 3) the necessity of mobility and divisibility of mental health treatment units; 4) fighting units should not be dispersed immediately after combat; and 5) the management of stress reactions to be the responsibility not only of the mental health services, but of all sections of the medical corps, both in treatment and prevention.

The Impact of Combat Status on Veterans' Attitudes Toward Help Seeking: The Hierarchy of Combat Elitism.

PubMed

Ashley, Wendy; Brown, Jodi Constantine

2015-01-01

Many veterans do not seek assistance for mental health concerns despite the staggering prevalence of trauma-related symptomatology. Barriers to service provision include personal and professional stigma and inter-veteran attitudes that dictate who is more or less deserving of services. Veteran attitudes are shaped by military culture, which promotes a hyper-masculine paradigm upholding combat experience as the defining feature of the "ideal soldier." The stratification of soldiers into combat or non-combat status creates a hierarchy of combat elitism that extends far beyond active duty. This pilot study surveyed veterans (n = 24) to explore how combat experience may affect attitudes toward help seeking. Findings indicate combat and non-combat veterans are less accepting of non-combat veterans' help-seeking behavior, supporting the notion that veterans' attitudes toward help seeking are influenced by combat status. Despite limitations, the results of this study reflect a need for increased attention to the attitudes veterans have about each other and themselves.

[Combined burn trauma in the array of modern civilian and combat burns].

PubMed

Ivchenko, E V; Borisov, D N; Golota, A S; Krassiĭ, A B; Rusev, I T

2015-02-01

The current article positions the combined burn and non-burn injuries in the general array of civilian and combat burns. For that purpose the official state statistics and scientific medical publications, domestic as well as foreign, have been analyzed. It has been shown that in peace time the combined burn/trauma injuries are infrequent. But the same type of injury becomes routine especially among the civilian population in the conditions of the modern so called "hybrid war". And the medical service should be prepared for it.

39 CFR 761.4 - Transfer or pledge.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) have the effect of a delivery in bearer form of definitive Postal Service securities; (2) have the... holder; and (4) if a pledge, effect a perfected security interest therein in favor of the pledgee. A...; no such conversion shall effect existing interests in such Postal Service securities. (e) A transfer...

12 CFR 811.3 - Transfer or pledge.

Code of Federal Regulations, 2010 CFR

2010-01-01

... effect of a delivery in bearer form of definitive Federal Financing Bank securities; (2) have the effect... holder; and (4) if a pledge, effect a perfected security interest therein in favor of the pledgee. A... accepts in the course of its business Federal Financing Bank securities as a custodial service for...

Even Wars Have Laws: Upholding an American Tradition

ERIC Educational Resources Information Center

Adhihetty, T. J.

2010-01-01

Since the founding of this nation, Americans have lived by the belief that wars have laws. Even in the most morally-challenging times, the principles of international humanitarian law (IHL)--which provide basic protections for the vulnerable, such as civilians, prisoners of war, and sick and injured combatants--have been championed by leaders like…

Concomitant use of isotretinoin and contraceptives before and after iPledge in the United States.

PubMed

Pinheiro, Simone P; Kang, Elizabeth M; Kim, Clara Y; Governale, Laura A; Zhou, Esther H; Hammad, Tarek A

2013-12-01

The major concern associated with isotretinoin treatment is its high teratogenic potential. Therefore, ensuring use of contraception while on therapy is an important strategy for at-risk patients and has been emphasized in all risk management programs. iPledge, the latest and most rigorous isotretinoin program, requires, among other stipulations, monthly assessments of contraceptive use for patients undergoing isotretinoin treatment. The purpose of this study is to evaluate isotretinoin usage patterns and assess concomitant use of isotretinoin and contraceptives before and after iPledge. Female patients aged 13-45 years with a new prescription for isotretinoin products during 2004-2008 were identified in the IMS Health longitudinal prescription claims database. Monthly concomitant use of isotretinoin and contraceptives was estimated. Segmented regression analysis of interrupted time series data was used to assess changes in monthly proportion of concomitant use in the 24 months preceding versus following iPledge implementation. The number of isotretinoin prescriptions decreased after iPledge implementation. A small but significant increase in monthly proportion of patients concomitantly using isotretinoin and contraceptive therapies was observed immediately after iPledge implementation (1.3%, p-value = 0.02), particularly among younger patients (2.5%, p-value < 0.01). No changes in the proportion of concomitancy over time (i.e. slope) between the periods before and after iPledge implementation were observed. The findings of this pharmacy prescription claims-based study suggest a small increase in concomitant use of isotretinoin and contraceptives coincident with the time of implementation of iPledge, particularly among younger women. Published 2013. This article is a U. S. Government work and is in the public domain in the USA. Published 2013. This article is a U. S. Government work and is in the public domain in the USA.

War-related experiences of former child soldiers in northern Uganda: comparison with non-recruited youths.

PubMed

Vindevogel, Sofie; Schryver, Maarten de; Broekaert, Eric; Derluyn, Ilse

2013-11-01

Armed conflict imposes huge hardship on young people living in war zones. This study assessed former child soldiers' experience and perception of stress in common war events during the armed conflict in northern Uganda and compares it with their non-recruited counterparts. To investigate whether child soldiers experienced more severe exposure to war events, and explore how war might affect youths differently, depending on the co-occurrence of these events. The study was undertaken in four northern Ugandan districts in 22 secondary schools with a sample size of 981 youths, about half of whom had been child soldiers. The participants completed a questionnaire on socio-demographic characteristics and stressful war events which was analyzed using descriptive statistics, a probabilistic index and correlation network analysis. Former child soldiers had significantly greater experience of war events than their non-recruited counterparts. The violence of war is more central in their experience and perception of stress, whereas the scarcity of resources and poor living conditions are most central for non-recruited participants. The extent to which a war event, such as separation from the family, is perceived as stressful depends on the experience and perception of other stressful war events, such as confrontation with war violence for former child soldiers and life in an Internally Displaced Persons' camp for non-recruited participants. The network approach permitted demonstration of the many ways in which war-affected youths encounter and appraise stressful war events. War events might function as moderators or mediators of the effect that other war events exert on the lives and well-being of young people living in war zones. This demands comprehensive and individualized assessment.

Preventing war through non-violent direct involvement in conflict: I. Principles and background.

PubMed

2001-01-01

International Physicians for Prevention of Nuclear War now considers prevention of all violent armed conflict as one of its core objectives, as such conflict is incompatible with health. Health professionals have long been involved in this area with an inclination towards non-violent means. The growth of interest in the area of non-military peacemaking, the growth of knowledge and research in the last few years and the post-cold-war nature of most contemporary wars mean that IPPNW needs to approach war prevention in a systematic way, benefiting and co-operating with other creative forces in the field. In this first of two articles we present some important work by contemporary non-violent researchers. We seek to develop an imagination and a mode of thinking to enable health professionals to prepare to engage in Non-violent Direct Involvement in Conflict (NVDIC).

Food companies' calorie-reduction pledges to improve U.S. diet.

PubMed

Slining, Meghan M; Ng, Shu Wen; Popkin, Barry M

2013-02-01

Heretofore, corporate voluntary pledges to improve the health of Americans have been linked neither to explicit measurable commitments nor to a framework for an independent evaluation. The Healthy Weight Commitment Foundation (HWCF), whose members include 16 of the nation's leading consumer packaged goods food and beverage manufacturers, voluntarily pledged to collectively remove 1 trillion calories from their products by 2012 (against a 2007 baseline), and 1.5 trillion calories by 2015. The pledge is designed to reduce the calorie gap commensurate with the HWCF companies' role in the U.S. diet. To date, no system exists for documenting the nutritional and public health impacts of industry-led changes in the food supply on individual diets. The current study represents a unique opportunity to understand how the consumer packaged goods food and beverage sector is changing and how these changes are associated with changes in the American diet. It presents data on national caloric sales from this sector, purchases of these goods by various subpopulations, and methods linking these to individual intakes of Americans. Findings show that HWCF companies accounted for approximately 25% of calories consumed in the U.S. in 2007 and that the 1.5 trillion-calorie pledge (about 14 calories/day/capita) accounts for 0.8% of the calories sold across all consumer packaged goods food and beverage brands in 2007. The authors hope that this evaluation will continue to create models and methods for demonstrating the effects of changes in the food supply on individual diets, particularly among those from vulnerable subpopulations. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

The Effects of Alcohol Problems, PTSD, and Combat Exposure on Nonphysical and Physical Aggression Among Iraq and Afghanistan War Veterans

PubMed Central

Stappenbeck, Cynthia A.; Hellmuth, Julianne C.; Simpson, Tracy; Jakupcak, Matthew

2014-01-01

Aggression among combat veterans is of great concern. Although some studies have found an association between combat exposure and aggressive behavior following deployment, others conclude that aggression is more strongly associated with symptoms of posttraumatic stress disorder (PTSD), and that alcohol misuse may influence this association. Many of these studies have assessed aggression as a single construct, whereas the current study explored both nonphysical aggression only and physical aggression in a sample of Iraq and Afghanistan war veterans (N = 337; 91% male). We found that alcohol problems interacted with PTSD symptom severity to predict nonphysical aggression only. At low levels of PTSD symptoms, veterans with alcohol problems were more likely to perpetrate nonphysical aggression only, as compared with no aggression, than veterans without an alcohol problem. There was no difference in the likelihood of nonphysical aggression only between those with and without alcohol problems at high levels of PTSD symptoms. The likelihood of nonphysical aggression only, as compared with no aggression, was also greater among younger veterans. Greater combat exposure and PTSD symptom severity were associated with an increased likelihood of perpetrating physical aggression, as compared with no aggression. Ethnic minority status and younger age were also associated with physical aggression, as compared with no aggression. Findings suggest that a more detailed assessment of veterans’ aggressive behavior, as well as their alcohol problems and PTSD symptoms, by researchers and clinicians is needed in order to determine how best to intervene. PMID:25225593

Reaction of Vietnam Veterans to the Persian Gulf War.

ERIC Educational Resources Information Center

Kobrick, Felice R.

1993-01-01

Reviews evolution of the concept of combat-related posttraumatic stress disorder and analyzes reports of Vietnam veterans' reactions to the Persian Gulf War. Presents case study of Vietnam veteran whose traumatic memories were reawakened with the onset of the Persian Gulf War, and discusses implications for social work practice. (Author/NB)

Nuclear war effects studied

NASA Astrophysics Data System (ADS)

Widespread starvation resulting from changes in climate in the aftermath of a large-scale nuclear war could kill far more people than would the bombs themselves. That prediction was made in a recent study by the Scientific Committee on Problems of the Environment (SCOPE), an a rm of the International Council of Scientific Unions (ICSU). “Noncombatant and combatant countries alike” would risk mass starvation; SCOPE predicted that all told, 2.5 billion people could die as a result of crop failures and breakdowns in food distribution after a nuclear war.

Transitions: Combat Veterans as College Students

ERIC Educational Resources Information Center

Ackerman, Robert; DiRamio, David; Garza Mitchell, Regina L.

2009-01-01

The experience of war makes those who fight a special group within the general population. The purpose of this study was to investigate how combat veterans who become college students make the transition to campus life, in order to identify how administrators can acknowledge and support them. A total of six women and 19 men were interviewed; 24…

"Under God" and the Pledge of Allegiance: Examining a 1954 Sermon and Its Meaning

ERIC Educational Resources Information Center

Groce, Eric C.; Heafner, Tina; Bellows, Elizabeth

2013-01-01

A lesson exploring the Pledge of Allegiance, its history, and the addition of the phrase "under God," can serve as a jumping off point into major themes of U.S. history and First Amendment freedoms. Although the Pledge is ubiquitous in contemporary America, educators and students are often uninformed about the history and meaning of the…

DefenseLink Special: Remember the Flying Tigers of World War II

Science.gov Websites

Us Remembering The Flying Tigers The Flying Tigers of World War II Americans have not always waited during the early days of World War II before the United States officially became a combatant. Some them as heroes during the early period of World War II when Japan had the upper hand. The Flying Tigers

Children and war.

PubMed

Pearn, J

2003-04-01

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

Parameters, U.S. Army War College Quarterly. Volume 17, Number 3, September 1987,

DTIC Science & Technology

1987-09-01

officers and men were not rootless mercenaries operating in a political vacuum. They were American citizens Dr. Edward M. Coffman is a professor of...34according to the articles of war" to the second. Obviously, the men in Congress considered the first oath superfluous. For the next 70 years officers...and enlisted men entered the Army by pledging their allegiance to the United States of America without reference to the Constitution. In August 1861

A war psychiatry approach to warfare in the Middle Byzantine period.

PubMed

Ntafoulis, Pavlos

2016-12-01

Combat stress cases were traced in historical texts and military manuals on warfare from the Middle Byzantine period; they were mainly labelled as cowardice. Soldiers suffered from nostalgia or exhaustion; officers looked stunned, or could not speak during the battle. Cruel punishments were often enforced. Suicide and alcohol abuse were rarely mentioned. The Byzantines' evacuation system for battle casualties was well organized. Psychological operations were conducted and prisoners-of-war were usually part of them. The Byzantine army had 'parakletores', officers assigned to encourage soldiers before combat. The leaders dealt with combat stress by using their rhetoric skills and emphasizing religious faith in eternal life. The treatment of the 'cowards' was rather similar to modern war psychiatry principles of treatment. No description of PTSD was found. © The Author(s) 2016.

On the Effectiveness of Military Institutions: Historical Case Studies from World War I, The Interwar Period, and World War II. Volume 3. World War II

DTIC Science & Technology

1986-04-01

ting the claims of U the tortured economy against those et the reeling military organization. I I I_ I I I I I I U I U 21. i II. S.rateqic...1 25. Henry I. Shaw, et . 41., History of u. S. Marine operaCions in World I war r (5 vols., Washington, DC, 1958-2971); Jeter A. Zsley and Philip A...Combat Troops, Bruce Jacobs, Soldiers (New 3 York, 1958), pp. 169-560; Stouffer, et al., The American Soldier: Combat and Its Afternath (New York, 1965

Empirical research on complex networks modeling of combat SoS based on data from real war-game, Part I: Statistical characteristics

NASA Astrophysics Data System (ADS)

Chen, Lei; Kou, Yingxin; Li, Zhanwu; Xu, An; Wu, Cheng

2018-01-01

We build a complex networks model of combat System-of-Systems (SoS) based on empirical data from a real war-game, this model is a combination of command & control (C2) subnetwork, sensors subnetwork, influencers subnetwork and logistical support subnetwork, each subnetwork has idiographic components and statistical characteristics. The C2 subnetwork is the core of whole combat SoS, it has a hierarchical structure with no modularity, of which robustness is strong enough to maintain normal operation after any two nodes is destroyed; the sensors subnetwork and influencers subnetwork are like sense organ and limbs of whole combat SoS, they are both flat modular networks of which degree distribution obey GEV distribution and power-law distribution respectively. The communication network is the combination of all subnetworks, it is an assortative Small-World network with core-periphery structure, the Intelligence & Communication Stations/Command Center integrated with C2 nodes in the first three level act as the hub nodes in communication network, and all the fourth-level C2 nodes, sensors, influencers and logistical support nodes have communication capability, they act as the periphery nodes in communication network, its degree distribution obeys exponential distribution in the beginning, Gaussian distribution in the middle, and power-law distribution in the end, and its path length obeys GEV distribution. The betweenness centrality distribution, closeness centrality distribution and eigenvector centrality are also been analyzed to measure the vulnerability of nodes.

The implication of combat-induced stress reaction, PTSD, and attachment in parenting among war veterans.

PubMed

Cohen, Estee; Zerach, Gadi; Solomon, Zahava

2011-10-01

This study examined parental functioning, parental satisfaction, and concern for offspring during their child's military service, among war veterans, some of whom suffered from acute combat-induced stress reaction (CSR) and posttraumatic stress disorder (PTSD). In addition, we examined the additive and interactive contributions of CSR, PTSD and attachment dimensions to parenting measures. The sample consisted of 477 participants divided into two groups: a clinical group of veterans who had been diagnosed with CSR on the battlefield (N = 267), and a matched control group of veterans who did not suffer from CSR (NCSR; N = 210). CSR, PTSD, avoidant-attachment, and anxious-attachment, were all related to lower levels of parental functioning and satisfaction. Veterans who suffered from both CSR and PTSD reported more concern for their offspring during their child's military service compared to veterans with PTSD but without antecedent CSR. Attachment dimensions and specifically attachment-avoidance, made the greatest contribution to parenting measures, followed by posttraumatic symptoms. In addition, attachment-avoidance moderated the relationship between posttraumatic symptoms and parental functioning. Theoretical and clinical implications of these results are discussed.

Amicicide: The Problem of Friendly Fire in Modern War

DTIC Science & Technology

1982-12-01

episodes of the Korean War was the stubborn, defense of the British 29th Brigade along the Imjin River north of Seoul in April 1951.67 Faced by a...antiaircraft fire over Paestum beach in Italy. Amicicide: The Problem of Friendly Fire in Modern War by Lieutenant Colonel Charles R. Shrader, U.S...Data Shrader, Charles R. Amicieide: the problem of friendly fire in modern war . (Research survey/Combat Studies Institute, U.S. Army Command and

78 FR 40953 - Loan Participations; Purchase, Sale and Pledge of Eligible Obligations; Purchase of Assets and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-09

...; Purchase, Sale and Pledge of Eligible Obligations; Purchase of Assets and Assumption of Liabilities...- day effective date, a final rule titled Loan Participations; Purchase, Sale and Pledge of Eligible Obligations; Purchase of Assets and Assumption of Liabilities, effective July 25, 2013. The Board extends the...

Walking the walk? Experiments on the effect of pledging to vote on youth turnout

PubMed Central

Prevost, Alicia

2018-01-01

Psychological theories of political behavior suggest that commitments to perform a certain action can significantly increase the likelihood of such action, but this has rarely been tested in an experimental context. Does pledging to vote increase turnout? In cooperation with the Environmental Defense Fund during the 2016 election, we conduct the first randomized controlled trials testing whether young people who pledge to vote are more likely to turn out than those who are contacted using standard Get-Out-the-Vote materials. Overall, pledging to vote increased voter turnout by 3.7 points among all subjects and 5.6 points for people who had never voted before. These findings lend support for theories of commitment and have practical implications for mobilization efforts aimed at expanding the electorate. PMID:29813075

The Military Casualty with Combat Related Acute Post Traumatic Stress Disorder

DTIC Science & Technology

1984-05-01

explored. A researcher designed "Combat Fatigue Questionnaire" was mailed to 600 USAF nurses selected randomly. Three hundred sixty one USAF nurses...psychiatry noted: "Exhaustion was selected because it best described the appearance of most psychia- tric casualties" (p. xvii). Ernie Pyle, a World War II...Haber & Runyon, PL 1977), 600 (13.3% of the total USAF nurse population) names were selected . The "Combat Fatigue Questionnaire" was mailed between

The Antibiotic Guardian campaign: a qualitative evaluation of an online pledge-based system focused on making better use of antibiotics.

PubMed

Kesten, Joanna May; Bhattacharya, Alex; Ashiru-Oredope, Diane; Gobin, Maya; Audrey, Suzanne

2017-07-11

The Antibiotic Guardian Campaign was developed to increase commitment to reducing Antimicrobial Resistance (AMR), change behaviour and increase knowledge through an online pledge system for healthcare professionals and members of the public to become Antibiotic Guardians (AG). This qualitative evaluation aimed to understand AG experiences of the campaign and perceived impact on behaviour. Ninety-four AGs (48 via a survey and 46 who had agreed to future contact) were invited to participate in a telephone semi-structured interview. The sample was based on self-identification as a healthcare professional or a member of the public, pledge group (e.g. adults, primary care prescribers etc.), pledge and gender. Interviews explored how participants became aware of the campaign, reasons for joining, pledge choices, responses to joining and views about the campaign's implementation. Interviews were analysed using the Framework Method. Twenty-two AGs (10 healthcare professionals and 12 members of the public) were interviewed. AGs became aware of the campaign through professional networks and social media, and were motivated to join by personal and professional concern for AMR. Choice of pledge group and pledge were attributed to relevance and potential impact on AMR and the behaviour of others through pledge enactment and promotion of the campaign. Most AGs could not recall their pledge unprompted. Most felt they fulfilled their pledge, although this reflected either behaviour change or the pledge reinforcing pre-existing behaviour. The campaign triggered AGs to reflect on AMR related behaviour and reinforced pre-existing beliefs. Several AGs promoted the campaign to others. Responding collectively as part of the campaign was thought to have a greater impact than individual action. However, limited campaign visibility was observed and the campaign was perceived to have restricted ability to reach those unaware of AMR. AGs were motivated to reduce AMR and most felt they

High Court Hesitant to Bar Pledge in Schools

ERIC Educational Resources Information Center

Hendrie, Caroline

2004-01-01

This article reports on a lawsuit filed by Michael A. Newdow, a California atheist, on behalf of his daughter, against inclusion of the words "under God" in public schools' recitals of the United States Pledge of Allegiance. He said that the words "under God" represent "religious dogma" that is needlessly divisive.…

77 FR 22183 - National Former Prisoner of War Recognition Day, 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-12

... Former Prisoner of War Recognition Day, 2012 By the President of the United States of America A... combat and pressing onward in the face of tremendous adversity. Their extraordinary service reflects our... Prisoner of War Recognition Day, we pay solemn tribute to those patriots who gave their freedom to preserve...

Learning from Lebanon: Airpower and Strategy in Israels 2006 War against Hezbollah

DTIC Science & Technology

2012-01-01

challenge that entailed a fundamentally new paradigm of combat. Nasrallah, for his part, as the IAF’s Brigadier General Itai Brun later pointed out...Department during Operation CHANGE OF L A M B E T H 103 DIRECTION, interview, IAF Headquarters, Tel Aviv, 26 March 2008. 8. Brig. Gen. Itai Brun...Ibid. 40. Quoted in Arkin, Divining Victory, p. 242. 41. Brig. Gen. Itai Brun, IAF, “The Second Leba- non War, 2006,” in A History of Air Warfare

One hundred years of lessons about the impact of war on mental health; two steps forward, one step back.

PubMed

McFarlane, Alexander C

2015-08-01

This paper outlines the substantial stigmatization of soldiers who suffered psychiatric disorders during World War I, and how there was little acceptance of the enduring impact of prolonged combat exposure once the war ended. Recent decades of research highlight the delayed impact of combat exposure and its long-term neurobiological consequences. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Gastrointestinal problems in modern wars: clinical features and possible mechanisms.

PubMed

Wang, Wei-Feng; Guo, Xiao-Xu; Yang, Yun-Sheng

2015-01-01

Gastrointestinal problems are common during wars, and they have exerted significant adverse effects on the health of service members involved in warfare. The spectrum of digestive diseases has varied during wars of different eras. At the end of the 20th century, new frontiers of military medical research emerged due to the occurrence of high-tech wars such as the Gulf War and the Kosovo War, in which ground combat was no longer the primary method of field operations. The risk to the military personnel who face trauma has been greatly reduced, but disease and non-battle injuries (DNBIs) such as neuropsychological disorders and digestive diseases seemed to be increased. Data revealed that gastrointestinal symptoms such as constipation, diarrhea, dyspepsia, and noncardiac chest pain are common among military personnel during modern wars. In addition, a large number of deployed soldiers and veterans who participated in recent wars presented with chronic gastrointestinal complaints, which fulfilled with the Rome III criteria for functional gastrointestinal disorders (FGIDs). It was also noted that many veterans who returned from the Gulf War suffered not only from chronic digestive symptoms but also from neuropsychological dysfunction; however, they also showed symptoms of other systems. Presently, this broad range of unexplained symptoms is known as "Gulf War syndrome". The mechanism that underlies Gulf War syndrome remains unclear, but many factors have been associated with this syndrome such as war trauma, stress, infections, immune dysfunction, radiological factors, anthrax vaccination and so on. Some have questioned if the diagnosis of FGIDs can be reached given the complexity of the military situation. As a result, further studies are needed to elucidate the pathogenesis of gastrointestinal disease among military personnel.

Pledge Stays Intact as Justices Dismiss Atheist's Challenge

ERIC Educational Resources Information Center

Hendrie, Caroline

2004-01-01

This article reports on the fiery California atheist who lost his bid at the U.S. Supreme Court to get "under God" stricken from the Pledge of Allegiance. Dr. Michael A. Newdow, an emergency-room physician with a law degree who represented himself before the Supreme Court in the high-profile case against the Elk Grove, California, school…

Pledge Debate Taken to Heart in California District

ERIC Educational Resources Information Center

Hendrie, Caroline

2004-01-01

Pledging allegiance to the flag--and the "one nation under God" it is said to represent--has been second nature to generations of American schoolchildren. Yet few have had as much reason to reflect on the practice as those in Sacramento, California. Since March 2000, California's Elk Grove school district has faced a legal challenge to…

Personnel Attrition Rates in Historical Land Combat Operations: An Annotated Bibliography

DTIC Science & Technology

1993-06-01

1986, Combat Casualties Among US Navy Personnel in Vietnam. Cochrane-1959, The 3rd Division at Chateau Thierry , July 1918. Cockrell-1974, Research Study...Chateau Thierry , July 1918. CIVIL Fox-1889, Regimental Losses in the American Civil War, 1861-1865. Livermore-1900, Numbers and Losses in the Civil War... Thierry , July 1918. Wainstein-1973b, Rates of Advance in Infantry Division Attacks in the Normandy-Northern France and Siegfried Line Campaigns. DURATION

"Take the Volume Pledge" may result in disparity in access to care.

PubMed

Blanco, Barbara A; Kothari, Anai N; Blackwell, Robert H; Brownlee, Sarah A; Yau, Ryan M; Attisha, John P; Ezure, Yoshiki; Pappas, Sam; Kuo, Paul C; Abood, Gerard J

2017-03-01

"Take the Volume Pledge" proposes restricting pancreatectomies to hospitals that perform ≥20 per year. Our purpose was to identify those factors that characterize patients at risk for loss of access to pancreatic cancer care with enforcement of volume standards. Using the Healthcare Cost and Utilization Project State Inpatient Database from Florida, we identified patients who underwent pancreatectomy for pancreatic malignancy from 2007-2011. American Hospital Association and United States Census Bureau data were linked to patient-level data. High-volume hospitals were defined as performing ≥20 pancreatic resections per year. Univariable and multivariable statistics compared patient characteristics and utilization of high-volume hospitals. Classification and Regression Tree modeling was used to predict patients at risk for losing access to care. Our study included 1,663 patients. Five high-volume hospitals were identified, and they treated 1,056 (63.5%) patients. Patients residing far from high-volume hospitals, in areas with the highest population density, non-Caucasian ethnicity, and greater income had decreased odds of obtaining care at high-volume hospitals. Using these factors, we developed a Classification and Regression Tree-based predictive tool to identify these patients. Implementation of "Take the Volume Pledge" is an important step toward improving pancreatectomy outcomes; however, policymakers must consider the potential impact on limiting access and possible health disparities that may arise. Copyright © 2016 Elsevier Inc. All rights reserved.

Antibiotic-non-antibiotic combinations for combating extremely drug-resistant Gram-negative 'superbugs'.

PubMed

Schneider, Elena K; Reyes-Ortega, Felisa; Velkov, Tony; Li, Jian

2017-02-28

The emergence of antimicrobial resistance of Gram-negative pathogens has become a worldwide crisis. The status quo for combating resistance is to employ synergistic combinations of antibiotics. Faced with this fast-approaching post-antibiotic era, it is critical that we devise strategies to prolong and maximize the clinical efficacy of existing antibiotics. Unfortunately, reports of extremely drug-resistant (XDR) Gram-negative pathogens have become more common. Combining antibiotics such as polymyxin B or the broad-spectrum tetracycline and minocycline with various FDA-approved non-antibiotic drugs have emerged as a novel combination strategy against otherwise untreatable XDR pathogens. This review surveys the available literature on the potential benefits of employing antibiotic-non-antibiotic drug combination therapy. The apex of this review highlights the clinical utility of this novel therapeutic strategy for combating infections caused by 'superbugs'. © 2017 The Author(s). Published by Portland Press Limited on behalf of the Biochemical Society.

Does Combat Exposure Make You a More Violent or Criminal Person? Evidence from the Vietnam Draft

ERIC Educational Resources Information Center

Rohlfs, Chris

2010-01-01

This study exploits the differential effects of the Vietnam War across birth cohorts to measure the effects of combat exposure on later violence and crime. Combat exposure and violent acts are measured using self-reports from the National Vietnam Veterans Readjustment Study. I find large positive effects on violence for blacks, suggestive evidence…

13 CFR 120.435 - Which loan pledges do not require notice to or consent by SBA?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false Which loan pledges do not require notice to or consent by SBA? 120.435 Section 120.435 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Lenders Other Conveyances § 120.435 Which loan pledges do not require notice to or...

13 CFR 120.435 - Which loan pledges do not require notice to or consent by SBA?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Which loan pledges do not require notice to or consent by SBA? 120.435 Section 120.435 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Lenders Other Conveyances § 120.435 Which loan pledges do not require notice to or...

Treatment seeking for posttraumatic stress in Israel Defense Forces veterans deployed in the Second Lebanon War (2006) and "Operation Cast Lead" in the Gaza Strip (2009): a comparative study.

PubMed

Levi, Ofir; Lubin, Gadi

2018-05-01

The goal of the study was to determine the long-term prevalence of combat-related treatment seeking and posttraumatic stress disorder (PTSD) in Israel's veterans deployed to the Second Lebanon War (2006) and "Operation Cast Lead" in the Gaza Strip (2009). The prevalence of treatment seeking and DSM-IV-TR diagnoses among Israel Defense Force (IDF) veterans was assessed using seven and five year's surveillance and records. The whereabouts and combat exposure of veterans during the war was determined based on the IDF's Operations Directorate records. Overall prevalence of treatment seeking was 1.32% and 0.38% in the Second Lebanon War and "Operation Cast Lead", respectively. The prevalence of treatment-seeking veterans from the Second Lebanon War and in "Operation Cast Lead" was significantly higher in soldiers deployed to high combat-exposure zones (2.19% and 3.1%, respectively), relative to low combat-exposure zones (0.24% and 0.06%, respectively), and relative to soldiers deployed elsewhere (0.26% and 0.02%, respectively). PTSD prevalence was similar among treatment-seeking veterans deployed in high combat-exposure zones in both combats. There is a gap of anywhere between 3% and 11% between treatment seeking by IDF veterans following war deployment and the actual prevalence of PTSD in this soldier population.

Plastic Surgery Challenges in War Wounded I: Flap-Based Extremity Reconstruction

PubMed Central

Sabino, Jennifer M.; Slater, Julia; Valerio, Ian L.

2016-01-01

Scope and Significance: Reconstruction of traumatic injuries requiring tissue transfer begins with aggressive resuscitation and stabilization. Systematic advances in acute casualty care at the point of injury have improved survival and allowed for increasingly complex treatment before definitive reconstruction at tertiary medical facilities outside the combat zone. As a result, the complexity of the limb salvage algorithm has increased over 14 years of combat activities in Iraq and Afghanistan. Problem: Severe poly-extremity trauma in combat casualties has led to a large number of extremity salvage cases. Advanced reconstructive techniques coupled with regenerative medicine applications have played a critical role in the restoration, recovery, and rehabilitation of functional limb salvage. Translational Relevance: The past 14 years of war trauma have increased our understanding of tissue transfer for extremity reconstruction in the treatment of combat casualties. Injury patterns, flap choice, and reconstruction timing are critical variables to consider for optimal outcomes. Clinical Relevance: Subacute reconstruction with specifically chosen flap tissue and donor site location based on individual injuries result in successful tissue transfer, even in critically injured patients. These considerations can be combined with regenerative therapies to optimize massive wound coverage and limb salvage form and function in previously active patients. Summary: Traditional soft tissue reconstruction is integral in the treatment of war extremity trauma. Pedicle and free flaps are a critically important part of the reconstructive ladder for salvaging extreme extremity injuries that are seen as a result of the current practice of war. PMID:27679751

An Investigation of the Combat Attitudes of Air Force Civil Engineers.

DTIC Science & Technology

1986-04-01

Leadership Management and Development Center (LMDC) at Maxwell AFB, Alabama, to develop the Potential for Combat Effectiveness Model (PCEM) and its...Barracks, PA: US Army War College. Leadership Management Development Center. (1986). Organizational Assessment Package Survey# Factors and Variables

Getting England to be more physically active: are the Public Health Responsibility Deal's physical activity pledges the answer?

PubMed

Knai, C; Petticrew, M; Scott, C; Durand, M A; Eastmure, E; James, L; Mehrotra, A; Mays, N

2015-09-18

The Public Health Responsibility Deal (RD) in England is a public-private partnership involving voluntary pledges between government, industry, and other organisations to improve public health by addressing alcohol, food, health at work, and physical activity. This paper analyses the RD physical activity (PA) pledges in terms of the evidence of their potential effectiveness, and the likelihood that they have motivated actions among organisations that would not otherwise have taken place. We systematically reviewed evidence of the effectiveness of interventions proposed in four PA pledges of the RD, namely, those on physical activity in the community; physical activity guidelines; active travel; and physical activity in the workplace. We then analysed publically available data on RD signatory organisations' plans and progress towards achieving the physical activity pledges, and assessed the extent to which activities among organisations could be attributed to the RD. Where combined with environmental approaches, interventions such as mass media campaigns to communicate the benefits of physical activity, active travel in children and adults, and workplace-related interventions could in principle be effective, if fully implemented. However, most activities proposed by each PA pledge involved providing information or enabling choice, which has limited effectiveness. Moreover, it was difficult to establish the extent of implementation of pledges within organisations, given that progress reports were mostly unavailable, and, where provided, it was difficult to ascertain their relevance to the RD pledges. Finally, 15 % of interventions listed in organisations' delivery plans were judged to be the result of participation in the RD, meaning that most actions taken by organisations were likely already under way, regardless of the RD. Irrespective of the nature of a public health policy to encourage physical activity, targets need to be evidence-based, well

31 CFR 225.5 - Pledge of definitive Government obligations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Government obligations held by the custodian will be held at the risk of the custodian. (e) Conversion to... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Pledge of definitive Government... (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE ACCEPTANCE OF BONDS...

31 CFR 225.5 - Pledge of definitive Government obligations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Government obligations held by the custodian will be held at the risk of the custodian. (e) Conversion to... 31 Money and Finance:Treasury 2 2011-07-01 2011-07-01 false Pledge of definitive Government... (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE ACCEPTANCE OF BONDS...

Soviet Non-Linear Combat: The Challenge of the 90s

DTIC Science & Technology

1990-09-01

with powerful air and artillery fire strikes, will allow a combatanL to rapidly insert ground units, air-assault forces, and other specially-trained Q...dynamic and highly maneuverable, forcing subunits to change rapidly from attack to defense and back again, and to change frequently its combat formation...two. Team members rapidly coalesce into temporary attack or defensive groups and then disperse again. The Soviets see non-linear battle as one in which

At War, with Shakespeare - Student Development.

ERIC Educational Resources Information Center

Derrick, Thomas J.

2003-01-01

Discusses one professor's decision, in the aftermath of the destruction of the World Trade Center, to use a Shakespeare course to help students' process their feelings about military combat and cultural conflict. The professor uses Baxter Magolda's student development theory to understand student attitudes about war as presented in student…

Combat Multipliers: African-American Soldiers in Four Wars

DTIC Science & Technology

2003-01-01

historical record should also be commended. Reginal G. Clemmons Major General, U.S. Army Commandant, National War College Washington, DC May 2003 ii...Adjutant and Inspector General Maurice Grivot had approved and endorsed, respectively, the raising of the Native Guards in May 1861, they never

Adaptive Disclosure: A Combat Specific PTSD Treatment

DTIC Science & Technology

2017-03-31

to determine whether AD is as least as effective as CPT, cognitive only version (CPT-C), in terms of its impact on deployment-related psychological ...be used to determine treatment efficacy. 15. SUBJECT TERMS Active-duty, Marine Corps, Posttraumatic stress disorder, Cognitive Therapy 16...the early stages of the wars suggest that 10-18% of combat troops experience deployment-related psychological health problems, such as posttraumatic

Quantitative electroencephalography during rapid eye movement (REM) and non-REM sleep in combat-exposed veterans with and without post-traumatic stress disorder.

PubMed

Cohen, Daniel J; Begley, Amy; Alman, Jennie J; Cashmere, David J; Pietrone, Regina N; Seres, Robert J; Germain, Anne

2013-02-01

Sleep disturbances are a hallmark feature of post-traumatic stress disorder (PTSD), and associated with poor clinical outcomes. Few studies have examined sleep quantitative electroencephalography (qEEG), a technique able to detect subtle differences that polysomnography does not capture. We hypothesized that greater high-frequency qEEG would reflect 'hyperarousal' in combat veterans with PTSD (n = 16) compared to veterans without PTSD (n = 13). EEG power in traditional EEG frequency bands was computed for artifact-free sleep epochs across an entire night. Correlations were performed between qEEG and ratings of PTSD symptoms and combat exposure. The groups did not differ significantly in whole-night qEEG measures for either rapid eye movement (REM) or non-REM (NREM) sleep. Non-significant medium effect sizes suggest less REM beta (opposite to our hypothesis), less REM and NREM sigma and more NREM gamma in combat veterans with PTSD. Positive correlations were found between combat exposure and NREM beta (PTSD group only), and REM and NREM sigma (non-PTSD group only). Results did not support global hyperarousal in PTSD as indexed by increased beta qEEG activity. The correlation of sigma activity with combat exposure in those without PTSD and the non-significant trend towards less sigma activity during both REM and NREM sleep in combat veterans with PTSD suggests that differential information processing during sleep may characterize combat-exposed military veterans with and without PTSD. © 2012 European Sleep Research Society.

The Quest for a Helicopter Suitable for Combat Rescue, 1967-1983.

DTIC Science & Technology

1985-04-01

the war draqged on" (2:7). From this need came the development of the helicopter as a - ascue -,hicle, a development that came late in World War 11. Even...question of future conflicts and the coming jet age forced policy makers to consider the reorganization and expansion of a rescue force capable of...to existing aging H-3s" (6:92). The inadequacies of the USAF’s combat rescue helicopter force, both in terms of mission capabiitic: and number of

A Decade of War: Prospective Trajectories of Posttraumatic Stress Disorder Symptoms Among Deployed US Military Personnel and the Influence of Combat Exposure.

PubMed

Donoho, Carrie J; Bonanno, George A; Porter, Ben; Kearney, Lauren; Powell, Teresa M

2017-12-15

Posttraumatic stress disorder (PTSD) is a common psychiatric disorder among service members and veterans. The clinical course of PTSD varies between individuals, and patterns of symptom development have yet to be clearly delineated. Previous studies have been limited by convenience sampling, short follow-up periods, and the inability to account for combat-related trauma. To determine the trajectories of PTSD symptoms among deployed military personnel with and without combat exposure, we used data from a population-based representative sample of 8,178 US service members who participated in the Millennium Cohort Study from 2001 to 2011. Using latent growth mixture modeling, trajectories of PTSD symptoms were determined in the total sample, as well as in individuals with and without combat exposure, respectively. Overall, 4 trajectories of PTSD were characterized: resilient, pre-existing, new-onset, and moderate stable. Across all trajectories, combat-deployed service members diverged from non-combat-deployed service members, even after a single deployment. The former also generally had higher PTSD symptoms. Based on the models, nearly 90% of those without combat exposure remained resilient over the 10-year period, compared with 80% of those with combat exposure. Findings demonstrate that although the clinical course of PTSD symptoms shows heterogeneous patterns of development, combat exposure is uniformly associated with poor mental health. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

The influence of war on the development of neurosurgery.

PubMed

Dowdy, Justin; Pait, T Glenn

2014-01-01

The treatment of craniospinal war wounds proved to be a significant driving force in the early growth of neurosurgery as a specialty. This publication explores the historical relationship between the evolution of combat methodology from antiquity through modern conflicts as it dovetails with and drives corresponding advancements in the field of neurosurgery. Whether it's the basic management principles for intracranial projectile wounds derived from World War I experiences, the drastic improvement in the outcomes and management of spinal cord injuries observed in World War II, or the fact that both of these wars played a crucial role in the development of a training system that is the origin of modern residency programs, the influence of wartime experiences is pervasive.

Boston College Case Shows Weakness of Researchers' Confidentiality Pledges

ERIC Educational Resources Information Center

Schmidt, Peter

2012-01-01

The author reports on a legal battle over oral-history records housed at Boston College that casts light on how little legal weight pledges of confidentiality to research subjects actually have. As a federal court weighs whether to let the federal government seize, and hand over to British authorities, the college's records of confidential…

The Effect of a "Class Smoke Free Pledge" on Breath Carbon Monoxide in Arabic Male Adolescents.

PubMed

Al-Sheyab, Nihaya A; Khader, Yousef S; Shah, Smita; Roydhouse, Jessica K; Gallagher, Robyn

2018-04-02

Arabic male adolescents have a high smoking prevalence. Introduction of "Class smoke-free" pledges have been successful amongst European adolescents but have not been evaluated using objective valid measures. We tested the impact of adding a smoke free pledge strategy to a proven peer-led asthma and smoking prevention program on breath carbon monoxide level (BCO) in male high-school students in Jordan. We enrolled male students from four high-schools in Irbid, Jordan. Schools were randomly assigned to receive either TAJ (Triple A in Jordan, n = 218) or TAJ-Plus (with added class smoke-free pledge, n = 215). We hypothesized that students receiving TAJ-Plus would have greater reduction in BCO levels than those only receiving the TAJ intervention. Asthma and smoking status were assessed by self-administered questionnaires. Smoking outcomes were collected using a BCO Monitor. Both groups had significant reductions in BCO levels post-intervention (p < .0001), however, decreases were greater in TAJ-Plus group (3.9 ± 0.2 vs. 4.8 ± 0.2, p < .0001). Intervention effects on BCO over time did not vary by smoking status (p = .085), asthma status (p = .602), or a combination of the two (p = .702). An added smoke-free pledge strategy to a proven peer-led asthma education program appears to be a promising approach to motivate adolescents to abstain from smoking in Jordan. Future research is required to determine if these results can be extended to Jordanian adolescent females. A commitment by students via a "class smoke-free" pledge can be an added incentive to motivate adolescents in Arabic-speaking countries to abstain from smoking. Social influence approaches in schools can be useful in countering the aggressive tobacco marketing campaigns targeting Jordanian and other Arabic-speaking youth. The combination of "class smoke-free" pledges and an evidence-based peer-led asthma and smoking education can be implemented in schools to influence adolescents with asthma to abstain

A League of Airmen: IU. S. Air Power in the Gulf War

DTIC Science & Technology

1994-01-01

the urgency of the situation in early August 1990 persuaded General Schwarzkopf to deploy combat power to the Gulf rapidly and take a calculated risk...of the early 1980s. However, the urgency of this threat was gradually attenuated as a result of the Iran-Iraq War. Alter initial Iranian successes...ta:tics during the Gulf War were, for the most part, a depar - ture from post-Word War II experience. The closest analog was the breakout from the

Leveraging Trauma Lessons from War to Win in a Complex Global Environment.

PubMed

Remick, Kyle N

2016-01-01

The US military has made great strides in combat casualty care since 2001. As the Army concludes combat operations in Iraq and Afghanistan, it faces new operational challenges in trauma care. The military medical community must stay ahead of the curve through sustaining current investments in combat casualty care research. This article describes lessons learned at war from a Joint Trauma System perspective in order to place in context how we should proceed in order to provide optimal care for our Warfighters in the future.

The Estimation of Lanchester Attrition-Rate Coefficients for an Aggregated Combat Model

DTIC Science & Technology

1976-06-01

34 This was the beginning of the war game as a serious -- miäui ..^.^.,,-..^„..-^■.■^■^-^..^■^■-^^^■-■■^^-■.^■.w^^,^^^^^.--1- ■ ■ .^.aiaaggijjMattajagaa...war games , assessments regarding tit effects of combat and other decisions were made subjectively by a control team of experienced military...single game , it is not a feasible mechanism for analyzing a broid spectrum of system alternatives in a responsive manner to meet planning cycle

A modern combat trauma.

PubMed

Popivanov, Georgi; Mutafchiyski, V M; Belokonski, E I; Parashkevov, A B; Koutin, G L

2014-03-01

The world remains plagued by wars and terrorist attacks, and improvised explosive devices (IED) are the main weapons of our current enemies, causing almost two-thirds of all combat injuries. We wished to analyse the pattern of blast trauma on the modern battlefield and to compare it with combat gunshot injuries. Analysis of a consecutive series of combat trauma patients presenting to two Bulgarian combat surgical teams in Afghanistan over 11 months. Demographics, injury patterns and Injury Severity Scores (ISS) were compared between blast and gunshot-injured casualties using Fisher's Exact Test. The blast victims had significantly higher median ISS (20.54 vs 9.23) and higher proportion of ISS>16 (60% vs 33.92%, p=0.008) than gunshot cases. They also had more frequent involvement of three or more body regions (47.22% vs 3.58%, p<0.0001). A significantly higher frequency of head (27.27% vs 3.57%), facial (20% vs 0%) and extremities injuries (85.45% vs 42.86%) and burns (12.72% vs 0%) was noted among the victims of explosion (p<0.0001). Based on clinical examination and diagnostic imaging, primary blast injury was identified in 24/55 (43.6%), secondary blast injury in 37 blast cases (67.3%), tertiary in 15 (27.3%) and quaternary blast injury (all burns) in seven (12.72%). Our results corroborate the 'multidimensional' injury pattern of blast trauma. The complexity of the blast trauma demands a good knowledge and a special training of the military surgeons and hospital personnel before deployment.

"Heroes' invisible wounds of war:" constructions of posttraumatic stress disorder in the text of US federal legislation.

PubMed

Purtle, Jonathan

2016-01-01

Public policies contribute to the social construction of mental health problems. In this study, I use social constructivist theories of policy design and the methodology of ethnographic content analysis to qualitatively explore how posttraumatic stress disorder (PTSD) has been constructed as a problem in US federal legislation. I analyzed the text of 166 bills introduced between 1989 and 2009 and found that PTSD has been constructed as a problem unique to combat exposures and military populations. These constructions were produced through combat-related language and imagery (e.g., wounds, war, heroism), narratives describing PTSD as a military-specific phenomenon, and reinforced by the absence of PTSD in trauma-focused legislation targeting civilians. These constructions do not reflect the epidemiology of PTSD-the vast majority of people who develop the disorder have not experienced combat and many non-combat traumas (e.g., sexual assault) carry higher PTSD risk-and might constrain public and political discourse about the disorder and reify sociocultural barriers to the access of mental health services. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Effects of World War II on Economic and Health Outcomes across Europe.

PubMed

Kesternich, Iris; Siflinger, Bettina; Smith, James P; Winter, Joachim K

2014-03-01

We investigate long-run effects of World War II on socio-economic status and health of older individuals in Europe. We analyze data from SHARELIFE, a retrospective survey conducted as part of SHARE in Europe in 2009. SHARELIFE provides detailed data on events in childhood during and after the war for over 20,000 individuals in 13 European countries. We construct several measures of war exposure-experience of dispossession, persecution, combat in local areas, and hunger periods. Exposure to war and more importantly to individual-level shocks caused by the war significantly predicts economic and health outcomes at older ages.

The Effects of World War II on Economic and Health Outcomes across Europe

PubMed Central

Kesternich, Iris; Siflinger, Bettina; Smith, James P.; Winter, Joachim K.

2013-01-01

We investigate long-run effects of World War II on socio-economic status and health of older individuals in Europe. We analyze data from SHARELIFE, a retrospective survey conducted as part of SHARE in Europe in 2009. SHARELIFE provides detailed data on events in childhood during and after the war for over 20,000 individuals in 13 European countries. We construct several measures of war exposure—experience of dispossession, persecution, combat in local areas, and hunger periods. Exposure to war and more importantly to individual-level shocks caused by the war significantly predicts economic and health outcomes at older ages. PMID:24850973

The Silent Enemy. Combat Stress Reaction.

DTIC Science & Technology

1986-04-01

intense anxiety, thus the term "shell shock." Such men were thought to have brain damage resulting from the concussion of high explosive shell blasts...French casualties returning to combat. (23:989) Upon the entrance of United States forces into World War I, Thomas W. Salmon, who held the job as...that battle stress is directly related to battle intensity. This was clearly 9 Shown in the Battle of Metz from September to November, 1944. The 5th

Association of combatant status and sexual violence with health and mental health outcomes in postconflict Liberia.

PubMed

Johnson, Kirsten; Asher, Jana; Rosborough, Stephanie; Raja, Amisha; Panjabi, Rajesh; Beadling, Charles; Lawry, Lynn

2008-08-13

Liberia's wars since 1989 have cost tens of thousands of lives and left many people mentally and physically traumatized. To assess the prevalence and impact of war-related psychosocial trauma, including information on participation in the Liberian civil wars, exposure to sexual violence, social functioning, and mental health. A cross-sectional, population-based, multistage random cluster survey of 1666 adults aged 18 years or older using structured interviews and questionnaires, conducted during a 3-week period in May 2008 in Liberia. Symptoms of major depressive disorder (MDD) and posttraumatic stress disorder (PTSD), social functioning, exposure to sexual violence, and health and mental health needs among Liberian adults who witnessed or participated in the conflicts during the last 2 decades. In the Liberian adult household-based population, 40% (95% confidence interval [CI], 36%-45%; n = 672/1659) met symptom criteria for MDD, 44% (95% CI, 38%-49%; n = 718/1661) met symptom criteria for PTSD, and 8% (95% CI, 5%-10%; n = 133/1666) met criteria for social dysfunction. Thirty-three percent of respondents (549/1666) reported having served time with fighting forces, and 33.2% of former combatant respondents (182/549) were female. Former combatants experienced higher rates of exposure to sexual violence than noncombatants: among females, 42.3% (95% CI, 35.4%-49.1%) vs 9.2% (95% CI, 6.7%-11.7%), respectively; among males, 32.6% (95% CI, 27.6%-37.6%) vs 7.4% (95% CI, 4.5%-10.4%). The rates of symptoms of PTSD, MDD, and suicidal ideation were higher among former combatants than noncombatants and among those who experienced sexual violence vs those who did not. The prevalence of PTSD symptoms among female former combatants who experienced sexual violence (74%; 95% CI, 63%-84%) was higher than among those who did not experience sexual violence (44%; 95% CI, 33%-53%). The prevalence of PTSD symptoms among male former combatants who experienced sexual violence was higher

Some problems associated with war experience in men of the Vietnam generation.

PubMed

Yager, T; Laufer, R; Gallops, M

1984-04-01

A national sample of men who were of military age during the Vietnam War (n = 1,342) was interviewed six to 15 years after veterans in the sample had left the service. Our findings showed that violent experiences in war were associated with a variety of behavioral and emotional problems. When preservice background factors were statistically controlled, combat exposure showed an association with arrests and convictions (generally for nonviolent offenses), with drinking, and with symptoms of traumatic stress. Participants in atrocities reported more stress symptoms and greater use of heroin and marijuana than did other veterans. Veterans who experienced no combat and did not take part in atrocities, however, did not differ appreciably from nonveterans. Not all men who experienced combat or took part in atrocities reported personal difficulties; almost three fourths of heavy-combat veterans were not arrested after the service. Tape recorded responses of the ten blacks and 18 whites who took part in atrocities suggested that soldiers' emotional responses may have been determined by their ability or inability to dehumanize the victims. Future research would benefit from a closer coordination of clinical and epidemiologic approaches.

Health effects of the war in two rural communities in Nicaragua. Nicaragua Health Study Collaborative at Harvard, CIES, and UNAN.

PubMed Central

1989-01-01

We report on a pilot study to assess the effects of low intensity war in Nicaragua on the health of the civilian population. The study compared data from two regions in Nicaragua, one in an area of intense conflict, the other further removed from the war's violence. Information was obtained from a questionnaire administered to female heads of randomly selected households; structured interviews with community leaders and health workers; group discussions with community residents; and a review of regional and municipal death records. Height and mid-upper arm circumference of children were measured, and immunization records reviewed. The war has had a serious negative effect on the lives of the civilian population in both the war zone and the non-war zone, with the effects most severe in the war zone. In both communities, over half of the respondents reported the death of a friend or relative. In the war zone community, over one-fourth of respondents reported attacks on family members in non-combat situations around their homes. Death by firearms was the leading cause of death in persons over age 6 in the war zone. Vaccination coverage, nutritional indices, and familial disruption were worse in the war zone community. The findings suggest that continued funding of the Nicaraguan contra forces by the United States may be harming the ostensible beneficiaries of that policy, and that use of such low intensity conflict as a foreign policy tool should be questioned. PMID:2929801

U.S. Army War College Guide to National Security Issues. Volume 1. Theory of War and Strategy

DTIC Science & Technology

2012-06-01

273 Tami Davis Biddle 21. John Warden’s Five Ring Model and the Indirect Approach to War ..........................295 Clayton K. S. Chun...266 Chapter 21 Figure 21-1. John Warden’s Five Ring Model...strategy from the battlefield to the civilian rear, thus blur- ring the difference between combatant and noncombatant.22 At the same time, the military

The Law of War and the Operational Commander

DTIC Science & Technology

1994-02-08

includes law that governs the decision to go to war and that governing the conducts of combatants: this paper focuses on the latter body. It is not the ...Hays Parks, "Rolling Thunder and the Law of War," Air University Review, Winter 1971, p. 3. ś .Ikd., pp. 17-19. 20 command structure and a lack of...apply to the USCG. Two other federal statutes (14 USC 89 and 19 USC 1581(a)) permit USCG personnel to go on board vessels and make inquiries

Emergency Physicians at War.

PubMed

Muck, Andrew E; Givens, Melissa; Bebarta, Vikhyat S; Mason, Phillip E; Goolsby, Craig

2018-05-01

Operation Enduring Freedom (OEF-A) in Afghanistan and Operation Iraqi Freedom (OIF) represent the first major, sustained wars in which emergency physicians (EPs) fully participated as an integrated part of the military's health system. EPs proved invaluable in the deployments, and they frequently used the full spectrum of trauma and medical care skills. The roles EPs served expanded over the years of the conflicts and demonstrated the unique skill set of emergency medicine (EM) training. EPs supported elite special operations units, served in medical command positions, and developed and staffed flying intensive care units. EPs have brought their combat experience home to civilian practice. This narrative review summarizes the history, contributions, and lessons learned by EPs during OEF-A/OIF and describes changes to daily clinical practice of EM derived from the combat environment.

Bodily Pain, Combat, and the Politics of Memoirs: Between the American Civil War and the War in Vietnam.

PubMed

Bourke, Joanna

2013-05-01

This article analyses the languages of wartime pain as seen in British and American memoirs from the American Civil War to the present. How did the rhetoric of wounding in these war memoirs change over time? One of the central shifts lies in the way that wounded men presented themselves as stoic in spite of severe wounding. From 1939, and in an even more dramatic fashion by the war in Vietnam, physical suffering remained a test of manliness, but the tone was defiant and aggressive rather than stoic or resigned. The article also looks at the role of individual publishers and the introduction of psychological dimensions of wounding in latter memoirs.

Posttraumatic Stress Disorder in Institutionalized World War II Veterans.

PubMed

Herrmann, Nathan; Eryavec, Goran

1994-01-01

Relatively little is known about posttraumatic stress disorder (PTSD) in World War II (WWII) veterans, despite the significant number of studies on this problem in Vietnam veterans. The authors document the prevalence of PTSD and other psychiatric disorders and investigate the etiological correlates of the syndrome in elderly, institutionalized WWII veterans. Sixty-two cognitively intact subjects (mean age 74.2 years), residents in a veterans' long-term care facility, were assessed for past and present psychopathology. A second investigator, blind to patients' psychiatric status, determined the degree of combat exposure and administered a checklist of pre-war and wartime variables. The lifetime prevalence of PTSD was 23%. Of those veterans with PTSD, 57% experienced chronic symptoms. The lifetime prevalence of other diagnoses was also high, including 3 7% for major depression and 53% for alcohol abuse. There was a strong correlation between the severity of the combat stressor and the development of PTSD. Significant correlations between PTSD and some pre-war variables were also found: more family histories of alcohol abuse, more deaths of close family members in early life, and less likelihood of having held a job for more than 1 year prior to the war. PTSD in elderly, institutionalized WWII veterans is a common, serious problem that is often unrecognized. Copyright © 1994 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Bodily Pain, Combat, and the Politics of Memoirs: Between the American Civil War and the War in Vietnam

PubMed Central

Bourke, Joanna

2014-01-01

This article analyses the languages of wartime pain as seen in British and American memoirs from the American Civil War to the present. How did the rhetoric of wounding in these war memoirs change over time? One of the central shifts lies in the way that wounded men presented themselves as stoic in spite of severe wounding. From 1939, and in an even more dramatic fashion by the war in Vietnam, physical suffering remained a test of manliness, but the tone was defiant and aggressive rather than stoic or resigned. The article also looks at the role of individual publishers and the introduction of psychological dimensions of wounding in latter memoirs. PMID:24489402

Unethical battlefield conduct reported by soldiers serving in the Iraq war.

PubMed

Wilk, Joshua E; Bliese, Paul D; Thomas, Jeffrey L; Wood, Michael D; McGurk, Dennis; Castro, Carl A; Hoge, Charles W

2013-04-01

Research involving military service members has shown a strong relationship between combat experiences and increased risk for posttraumatic stress disorder (PTSD) and other mental health problems. Comparatively little research has examined the relationship between combat experiences, PTSD, aggression, and unethical conduct on the battlefield, although news stories sometimes suggest links between unethical conduct and disorders such as PTSD. This study systematically examined whether unethical conduct is a proxy for aggression and whether specific combat experiences and PTSD are independently associated with unethical behavior. The results of this study indicate that aggression (β = 0.30) and specific combat experiences (particularly, witnessing war atrocities [β = 0.14] and fighting [β = 0.13]) are much more strongly associated with unethical conduct than is PTSD (β = 0.04).

White matter abnormalities in Gulf War veterans with posttraumatic stress disorder: A pilot study.

PubMed

Bierer, Linda M; Ivanov, Iliyan; Carpenter, David M; Wong, Edmund W; Golier, Julia A; Tang, Cheuk Y; Yehuda, Rachel

2015-01-01

Gulf War veterans were exposed to environmental toxins not present in other combat theaters resulting in a unique biological signature that only partially resembles that seen in other combat veterans with PTSD. Thus it is important to determine if brain abnormalities seen in non-Gulf War veterans with PTSD are also present in Gulf War veterans. In this pilot study, diffusion tensor imaging (DTI) tractography was used to assess the ultra-structural integrity of fronto-limbic white matter connections in Gulf War veterans with and without PTSD. The effects of chronic multisymptom illness on DTI measures was also evaluated. Subjects were 20 previously studied Gulf War veterans on whom MRIs had been obtained. Mean diffusivity (MD) and fractional anisotropy (FA) were determined for left and right cingulum bundle by DTI tractography and compared in separate analyses for 12 veterans with, and 8 without PTSD. The effect of chronic multisymptom illness and it's interaction with PTSD, were similarly investigated using multivariate ACOVA. Partial correlations were used to test the associations of both DTI indices with PTSD severity and plasma cortisol, controlling for whole brain volume. Significantly lower MD was demonstrated in the right cingulum bundle among Gulf War veterans with PTSD. There were no significant differences in MD or FA in the left cingulum bundle. The presence of chronic multisymptom illness significantly attenuated the PTSD associated decrement in right cingulum MD. Clinician and self-rated PTSD symptom severity scores were significantly associated with reduced MD and increased FA in the right cingulum. Similar associations were observed for 8am plasma cortisol in a subset of participants. The preliminary findings indicate increased structural integrity - supporting enhanced connectivity - between right amygdala and anterior cingulate cortex in PTSD. This effect was strongest among Gulf War veterans without chronic multisymptom illness. The association of

Combat science: the emergence of Operational Research in World War II.

PubMed

Rau, Erik P

2005-12-01

World War II became known as the "wizard war" because the cycles of developing countermeasures and counter-countermeasures to the weapons deployed by all sides drove rapid technological change. However, technological innovation was not the only contribution scientists made to the war effort. Through Operational Research (OR)--the scientific scrutiny of new weapons, their deployment and relative efficiency--scientists also influenced how warfare itself was conducted. This new scientific field emerged in the UK, where it helped to tighten the defense against the Luftwaffe. It quickly spread to other aspects of the military machine, improving both antisubmarine campaigns and bombing strategy. But although this analytical approach to warfare offered military commanders a factual basis on which to base difficult decisions and deal with tactical and strategic uncertainty, it was not without controversy. Indeed, several recommendations that came out of OR sparked disputes over the allocation of resources and strategic priorities.

Littoral Combat Ship Open Ocean Anti-Submarine Warfare

DTIC Science & Technology

2014-06-01

maintain stealth and its defense in order to properly conduct an attack on a surface vessel (Sternhell and Thorndike 2014, 102). This statement...its target, the surface combatants can counter by increasing their speed (Sternhell and Thorndike 2014). While the maximum speed of the current...120316_PS.pdf Sternhell, Charles M, and Alan M Thorndike . 2014. “Antisubmarine Warfare in World War II.” CNA Analysis & Solutions. Accessed April 14, 2014

The Image of War Correspondents in Anglo-American Fiction. Journalism Monographs Number Ninety-Seven.

ERIC Educational Resources Information Center

Good, Howard

The work of war correspondents involves violence, danger, and drama; and what they endure to get a story is often as interesting as the actual news itself. Anglo-American fiction tends toward an ironic, even cynical, view of combat reporting that serves as a corrective to the notion, fostered in journalists' autobiographies, that war is fun. It…

Sexual Healthcare for Wounded Warriors with Serious Combat-Related Injuries and Disabilities.

PubMed

Tepper, Mitchell S

2014-04-01

Short of the rich literature on sexuality in men following spinal cord injury, started largely by physicians and mental health professionals within the United States Department of Veterans Affairs (VA) system following earlier wars, little attention has been paid to the sexual healthcare of wounded warriors with other serious combat-related injuries. The recent wars in Iraq and Afghanistan-Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND)-resulted in physical injuries including traumatic brain injuries (TBIs), amputations, and serious burns. There are wounded warriors who are left blind or deaf, and a significant percent of OEF/OIF/OND warriors acquire other "invisible" injuries. While the signature injury of the war in Iraq is said to be TBI, there are a substantial number of service members surviving with posttraumatic stress disorder (PTSD). Many with serious injury are struggling with co-occurring depression. Furthermore, many of our wounded warriors are surviving with polytrauma (multiple traumatic injuries, i.e., amputation plus burns). One specific constellation of injuries seen too frequently among our service members in Afghanistan is referred to as a Dismounted Complex Blast Injury (DCBI) sometimes resulting in orchiectomy and/or penile injury. As with other blast injuries, burns, shrapnel injuries, vision loss, hearing loss, TBI, and PTSD often accompany DCBIs. All of the above injuries have significant sexual, endocrine, psychological, and relationship issues that need to be addressed. This article presents an overview of the effects of serious, combat-related injuries on sexual health and provides medical and other health professionals a framework within which to address comprehensive sexual healthcare using a medical rehabilitation model. Sexual healthcare for persons with combat-related disabilities presents a complex array of biopsychosocial and relational issues that call for a coordinated

The War in Vietnam: A Story in Photographs. The Constitution Community: Postwar United States (1945 to Early 1970s).

ERIC Educational Resources Information Center

Clark, Linda Darus

During the Vietnam War, the U.S. military gave the press unprecedented freedom of access to combat zones. This allowed newspaper reporters, photographers, and television crews to document a war involving U.S. sons and daughters on the other side of the world. This willingness to allow war documentation also was extended to the military's own…

Self-Compassion as a Prospective Predictor of PTSD Symptom Severity Among Trauma-Exposed U.S. Iraq and Afghanistan War Veterans

PubMed Central

Hiraoka, Regina; Meyer, Eric C.; Kimbrel, Nathan A.; DeBeer, Bryann B.; Gulliver, Suzy Bird; Morissette, Sandra B.

2016-01-01

U. S. combat veterans of the Iraq and Afghanistan wars have elevated rates of posttraumatic stress disorder (PTSD) compared to the general population. Self-compassion, characterized by self-kindness, a sense of common humanity when faced with suffering, and mindful awareness of suffering, is a potentially modifiable factor implicated in the development and maintenance of PTSD. We examined the concurrent and prospective relationship between self-compassion and PTSD symptom severity after accounting for level of combat exposure and baseline PTSD severity. Participants at baseline assessment were 115 Iraq and Afghanistan war veterans exposed to 1 or more traumatic events during deployment (n = 101 at follow-up). PTSD symptoms were assessed using the Clinician Administered PTSD Scale for DSM-IV at baseline and 12 months. Self-compassion and combat exposure were assessed at baseline via self-report. Self-compassion was associated with baseline PTSD symptoms after accounting for combat exposure (β = −.59; p < .001; ΔR2 = .34; f2 = .67; large effect) and predicted 12-month PTSD symptom severity after accounting for combat exposure and baseline PTSD severity (β = −.24; p = .008; ΔR2 = .03; f2 = .08; small effect). Findings suggest that interventions that increase self-compassion may be beneficial for treating chronic PTSD symptoms among some Iraq and Afghanistan war veterans. PMID:25808565

Self-Compassion as a prospective predictor of PTSD symptom severity among trauma-exposed U.S. Iraq and Afghanistan war veterans.

PubMed

Hiraoka, Regina; Meyer, Eric C; Kimbrel, Nathan A; DeBeer, Bryann B; Gulliver, Suzy Bird; Morissette, Sandra B

2015-04-01

U.S. combat veterans of the Iraq and Afghanistan wars have elevated rates of posttraumatic stress disorder (PTSD) compared to the general population. Self-compassion, characterized by self-kindness, a sense of common humanity when faced with suffering, and mindful awareness of suffering, is a potentially modifiable factor implicated in the development and maintenance of PTSD. We examined the concurrent and prospective relationship between self-compassion and PTSD symptom severity after accounting for level of combat exposure and baseline PTSD severity in 115 Iraq and Afghanistan war veterans exposed to 1 or more traumatic events during deployment. PTSD symptoms were assessed using the Clinician Administered PTSD Scale for DSM-IV (CAPS-IV) at baseline and 12 months (n =101). Self-compassion and combat exposure were assessed at baseline via self-report. Self-compassion was associated with baseline PTSD symptoms after accounting for combat exposure (β = -.59; p < .001; ΔR(2) = .34; f(2) = .67; large effect) and predicted 12-month PTSD symptom severity after accounting for combat exposure and baseline PTSD severity (β = -.24; p = .008; ΔR(2) = .03; f(2) = .08; small effect). Findings suggest that interventions that increase self-compassion may be beneficial for treating chronic PTSD symptoms among some Iraq and Afghanistan war veterans. Copyright © 2015 Wiley Periodicals, Inc., A Wiley Company.

Assessing Lebanese Children's Reactions to War-Related Stress

ERIC Educational Resources Information Center

El Zein, Heyam Lutfi; Ammar, Diala F.

2011-01-01

This exploratory study investigates the psychological effect of the 2006 war on Lebanese children. A sample of 110 exposed and 105 nonexposed children (9-12 years) balanced for age and gender were assessed using Spielberger's State-Trait Anxiety Inventory. The analysis aimed at investigating the effect of proximity, exposure to combat, and family…

Gulf War Air Power Survey.

DTIC Science & Technology

1993-01-01

Because a Coalition frontal assault raised the likelihood of heavy Coalition losses , the President authorized the addition of more ground and air forces...although the greatest weight of effort was directed against air defenses, airfields, and command elements of the Iraqi regime. Although sortie rates remained...first week of the war, most on the first night and only sparingly after that. Not surprisingly, most Iraqi air combat sorties and air-to-air losses (14

Amygdala volume in combat-exposed veterans with and without posttraumatic stress disorder: a cross-sectional study.

PubMed

Kuo, Janice R; Kaloupek, Danny G; Woodward, Steven H

2012-10-01

Data from animal models demonstrate a link between stress exposure and hypertrophic changes in the amygdala; however, studies of adults with posttraumatic stress disorder (PTSD) have failed to find analogous structural alterations. To compare amygdala volumes between a sample of combat veterans with and without PTSD (analysis 1) and examine whether our observation of larger amygdala volume in individuals with PTSD could be accounted for by the presence of trauma exposure in childhood and the severity of combat exposure in adulthood (analysis 2). Cross-sectional magnetic resonance imaging. Veterans Affairs Palo Alto Health Care System Inpatient Trauma Recovery Program and Veterans Affairs New England Health Care System Outpatient PTSD program. Ninety-nine combat-exposed veterans from the Vietnam Conflict or the Persian Gulf War who had been exposed to substantial military operational stress. Amygdala volume adjusted for total cerebral volume, Life Events Checklist, and the Combat Exposure Scale. Analysis 1 indicated that combat-exposed individuals with PTSD exhibited larger total amygdala volume compared with their non-PTSD counterparts (99 individuals, P = .047). Analysis 2 indicated that greater severity of combat exposure (87 individuals, P = .02), as well as the interaction between the presence of early life trauma and the severity of combat exposure (87 individuals, P = .008), were significantly associated with smaller total amygdala volume. The PTSD diagnosis continued to explain larger amygdala volume (87 individuals, P = .006). Posttraumatic stress disorder is associated with enlarged amygdala volume, above the variance accounted for by a history of early life trauma and severity of adult trauma exposure. The discrepancy between our and prior findings may be explained by variability in these trauma indices in previous investigations. These findings support additional study of amygdala structure in human stress disorders and further delineation of the role of

Are injuries from terror and war similar? A comparison study of civilians and soldiers.

PubMed

Peleg, Kobi; Jaffe, Dena H

2010-08-01

To compare injuries and hospital utilization and outcomes from terror and war for civilians and soldiers. Injuries from terror and war are not necessarily comparable, especially among civilians and soldiers. For example, civilians have less direct exposure to conflict and are unprepared for injury, whereas soldiers are psychologically and physically prepared for combat on battlefields that are often far from trauma centers. Evidence-based studies distinguishing and characterizing differences in injuries according to conflict type and population group are lacking. A retrospective study was performed using hospitalization data from the Israel National Trauma Registry (10/2000-12/2006). Terror and war accounted for trauma hospitalizations among 1784 civilians and 802 soldiers. Most civilians (93%) were injured in terror and transferred to trauma centers by land, whereas soldiers were transferred by land and air. Critical injuries and injuries to multiple body regions were more likely in terror than war. Soldiers tended to present with less severe injuries from war than from terror. Rates of first admission to orthopedic surgery were greater for all casualties with the exception of civilians injured in terror who were equally likely to be admitted to the intensive care unit. In-hospital mortality was higher among terror (7%) than war (2%) casualties, and particularly among civilians. This study provides evidence that substantial differences exist in injury characteristics and hospital resources required to treat civilians and soldiers injured in terror and war. Hospital preparedness and management should focus on treating combat injuries that result from specific causes-terror or war.

3 CFR 8799 - Proclamation 8799 of April 9, 2012. National Former Prisoner of War Recognition Day, 2012

Code of Federal Regulations, 2013 CFR

2013-01-01

... Prisoner of War Recognition Day, 2012 8799 Proclamation 8799 Presidential Documents Proclamations Proclamation 8799 of April 9, 2012 Proc. 8799 National Former Prisoner of War Recognition Day, 2012By the...’s call with courage and valor, braving the peril of combat and pressing onward in the face of...

An evaluation of the Public Health Responsibility Deal: Informants' experiences and views of the development, implementation and achievements of a pledge-based, public-private partnership to improve population health in England.

PubMed

Durand, Mary Alison; Petticrew, Mark; Goulding, Lucy; Eastmure, Elizabeth; Knai, Cecile; Mays, Nicholas

2015-11-01

The Coalition Government's Public Health Responsibility Deal (RD) was launched in England in 2011 as a public-private partnership designed to improve public health in the areas of food, alcohol, health at work and physical activity. As part of a larger evaluation, we explored informants' experiences and views about the RD's development, implementation and achievements. We conducted 44 semi-structured interviews with 50 interviewees, purposively sampled from: RD partners (businesses, public sector and non-governmental organisations); individuals with formal roles in implementing the RD; and non-partners and former partners. Data were analysed thematically: NVivo (10) software was employed to manage the data. Key motivations underpinning participation were corporate social responsibility and reputational enhancement. Being a partner often involved making pledges related to work already underway or planned before joining the RD, suggesting limited 'added value' from the RD, although some pledge achievements (e.g., food reformulation) were described. Benefits included access to government, while drawbacks included resource implications and the risk of an 'uneven playing field' between partners and non-partners. To ensure that voluntary agreements like the RD produce gains to public health that would not otherwise have occurred, government needs to: increase participation and compliance through incentives and sanctions, including those affecting organisational reputation; create greater visibility of voluntary agreements; and increase scrutiny and monitoring of partners' pledge activities. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Profiteering on the Iran-Iraq war

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brzoska, M.

1987-06-01

The military gear delivered from the US in the Iran-contra affair represents only a minor portion of arms sales to the combatants in the Iraq-Iran war. That war has now lasted more than six years and has deeply influenced the international arms market. Occurring during a period when other demand for arms has been relatively low, the war has nourished new suppliers and has revived both the legal and illegal private arms market. The erratic behavior of the USSR and the US, until recently by far the most important arms suppliers to the Third World, has pushed Iran and Iraqmore » toward more commercially oriented sources, including many in the Third World. Both countries have had ample supplies of weapons during the war, and these weapons have served their purpose. Mainly because of its duration, the war already ranks third among post-World War II wars - after the Vietnam war and the Biafra war - in battlefield victims, with 300,000-500,000 casualties. The economic cost has risen to nearly $500 billion in weapons, destruction, and lost income. While it is hard to see anything but losers on the battlefield, the arms traffickers are profiting. Total Iranian arms imports since August 1980 have been higher than $10 billion, while Iraq has imported more than $30 billion worth. It is difficult to know whether making arms more difficult to obtain would have stopped the war, but judging from other recent wars, such as those between India and Pakistan, between Uganda and Tanzania, and in the Middle East, it seems likely that hostilities could have been stopped long ago. 12 references.« less

posttraumatic stress and its relationship to physical health functioning in a sample of Iraq and Afghanistan War veterans seeking postdeployment VA health care.

PubMed

Jakupcak, Matthew; Luterek, Jane; Hunt, Stephen; Conybeare, Daniel; McFall, Miles

2008-05-01

The relationship between posttraumatic stress and physical health functioning was examined in a sample of Iraq and Afghanistan War veterans seeking postdeployment VA care. Iraq and Afghanistan War veterans (N = 108) who presented for treatment to a specialty postdeployment care clinic completed self-report questionnaires that assessed symptoms of posttraumatic stress disorder (PTSD), chemical exposure, combat exposure, and physical health functioning. As predicted, PTSD symptom severity was significantly associated with poorer health functioning, even after accounting for demographic factors, combat and chemical exposure, and health risk behaviors. These results highlight the unique influence of PTSD on the physical health in treatment seeking Iraq and Afghanistan War veterans.

The Fluidic Metaphor: A View into the Nature and Future of War

DTIC Science & Technology

2008-01-01

United States Marine Corps School of Advanced Warfighting Marine Corps University 2076 South Street Marine Corps Combat Command Development ...internal environment.14 It is this definition and concept of war that serves as the basis for development of the fluidic metaphor. Side 1 Side 2 D I M...some technological or doctrinal development has given one side a distinct if not decisive advantage in the next war. The advantage afforded by an RMA

Prevention of Infections Associated with Combat-Related Extremity Injuries

DTIC Science & Technology

2011-08-01

benefit over NPWT alone in a complex ortho- pedic injury goat model using P. aureuginosa. Instillation of an antiseptic, hypochlorous acid solution...antispectic has not been widely assessed clinically, and data discouraged hypochlorous acid (Dakin’s) solution use during World War I.247 The use of NPWT with...Abstract: During combat operations , extremities continue to be the most common sites of injury with associated high rates of infectious complications

Physical and mental health costs of traumatic war experiences among Civil War veterans.

PubMed

Pizarro, Judith; Silver, Roxane Cohen; Prause, JoAnn

2006-02-01

Hundreds of thousands of soldiers face exposure to combat during wars across the globe. The health effects of traumatic war experiences have not been adequately assessed across the lifetime of these veterans. To identify the role of traumatic war experiences in predicting postwar nervous and physical disease and mortality using archival data from military and medical records of veterans from the Civil War. An archival examination of military and medical records of Civil War veterans was conducted. Degree of trauma experienced (prisoner-of-war experience, percentage of company killed, being wounded, and early age at enlistment), signs of lifetime physician-diagnosed disease, and age at death were recorded. The US Pension Board surgeons conducted standardized medical examinations of Civil War veterans over their postwar lifetimes. Military records of 17,700 Civil War veterans were matched to postwar medical records. Signs of physician-diagnosed disease, including cardiac, gastrointestinal, and nervous disease; number of unique ailments within each disease; and mortality. Military trauma was related to signs of disease and mortality. A greater percentage of company killed was associated with signs of postwar cardiac and gastrointestinal disease (incidence risk ratio [IRR], 1.34; P < .02), comorbid nervous and physical disease (IRR, 1.51; P < .005), and more unique ailments within each disease (IRR, 1.14; P < .005). Younger soldiers (<18 years), compared with older enlistees (>30 years), showed a higher mortality risk (hazard ratio, 1.52), signs of comorbid nervous and physical disease (IRR, 1.93), and more unique ailments within each disease (IRR, 1.32) (P < .005 for all), controlling for time lived and other covariates. Greater exposure to death of military comrades and younger exposure to war trauma were associated with increased signs of physician-diagnosed cardiac, gastrointestinal, and nervous disease and more unique disease ailments across the life of Civil War

Arming Commanders to Combat PTSD: A Time for Change - Attacking the Stressors Vice the Symptoms

DTIC Science & Technology

2009-01-01

using psychiatric, developmental, psychodynamic, family support, cognitive-behavioral, and existential - humanistic approaches either individually or in...relates to coping with the fiscal, and humanistic challenges that manifest within a nation at war, and those who experience the trauma of combat. The

Global Comparison of Warring Groups in 2002–2007: Fatalities from Targeting Civilians vs. Fighting Battles

PubMed Central

Hicks, Madelyn Hsiao-Rei; Lee, Uih Ran; Sundberg, Ralph; Spagat, Michael

2011-01-01

Background Warring groups that compete to dominate a civilian population confront contending behavioral options: target civilians or battle the enemy. We aimed to describe degrees to which combatant groups concentrated lethal behavior into intentionally targeting civilians as opposed to engaging in battle with opponents in contemporary armed conflict. Methodology/Principal Findings We identified all 226 formally organized state and non-state groups (i.e. actors) that engaged in lethal armed conflict during 2002–2007: 43 state and 183 non-state. We summed civilians killed by an actor's intentional targeting with civilians and combatants killed in battles in which the actor was involved for total fatalities associated with each actor, indicating overall scale of armed conflict. We used a Civilian Targeting Index (CTI), defined as the proportion of total fatalities caused by intentional targeting of civilians, to measure the concentration of lethal behavior into civilian targeting. We report actor-specific findings and four significant trends: 1.) 61% of all 226 actors (95% CI 55% to 67%) refrained from targeting civilians. 2.) Logistic regression showed actors were more likely to have targeted civilians if conflict duration was three or more years rather than one year. 3.) In the 88 actors that targeted civilians, multiple regressions showed an inverse correlation between CTI values and the total number of fatalities. Conflict duration of three or more years was associated with lower CTI values than conflict duration of one year. 4.) When conflict scale and duration were accounted for, state and non-state actors did not differ. We describe civilian targeting by actors in prolonged conflict. We discuss comparable patterns found in nature and interdisciplinary research. Conclusions/Significance Most warring groups in 2002–2007 did not target civilians. Warring groups that targeted civilians in small-scale, brief conflict concentrated more lethal behavior into

Masculinities in the Motherland: Gender and Authority in the Soviet Union during the Cold War, 1945-1968

ERIC Educational Resources Information Center

Fraser, Erica L.

2009-01-01

This dissertation starts from the premise that World War II changed Soviet ideas about manhood. The Soviet Union lost twenty-seven million combatants and civilians in World War II--twenty million of whom were men. Delineating, performing, negotiating, and resisting a variety of cultural ideas about manliness shaped Soviet militarism and ideology…

World War II War Production-Why Were the B-17 and B-24 Produced in Parallel?

DTIC Science & Technology

1997-03-01

Winton, A Black Hole in the Wild Blue Yonder: The Need for a Comprehensive Theory of Airpower (Air Command and Staff College War Theory Coursebook ... statistical comparisons made, of which most are summarized as follows2: 1. Statistical data compiled on the utilization of both planes showed that the B-17 was...easier to maintain and therefore more available for combat. 2. Statistical data on time from aircraft acceptance to delivery in theater showed that

12 CFR 701.23 - Purchase, sale, and pledge of eligible obligations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... the dealer or leasing company. (c) Sale. A Federal credit union may sell, in whole or in part, to any... 12 Banks and Banking 7 2012-01-01 2012-01-01 false Purchase, sale, and pledge of eligible... AFFECTING CREDIT UNIONS ORGANIZATION AND OPERATION OF FEDERAL CREDIT UNIONS § 701.23 Purchase, sale, and...

Are the Public Health Responsibility Deal alcohol pledges likely to improve public health? An evidence synthesis.

PubMed

Knai, Cécile; Petticrew, Mark; Durand, Mary Alison; Eastmure, Elizabeth; Mays, Nicholas

2015-08-01

The English Public Health Responsibility Deal (RD) is a public-private partnership involving voluntary pledges between industry, government and other actors in various areas including alcohol, and designed to improve public health. This paper reviews systematically the evidence underpinning four RD alcohol pledges. We conducted a systematic review of reviews of the evidence underpinning interventions proposed in four RD alcohol pledges, namely alcohol labelling, tackling underage alcohol sales, advertising and marketing alcohol, and alcohol unit reduction. In addition, we included relevant studies of interventions where these had not been covered by a recent review. We synthesized the evidence from 14 reviews published between 2002 and 2013. Overall, alcohol labelling is likely to be of limited effect on consumption: alcohol unit content labels can help consumers assess the alcohol content of drinks; however, labels promoting drinking guidelines and pregnancy warning labels are unlikely to influence drinking behaviour. Responsible drinking messages are found to be ambiguous, and industry-funded alcohol prevention campaigns can promote drinking instead of dissuading consumption. Removing advertising near schools can contribute to reducing underage drinking; however, community mobilization and law enforcement are most effective. Finally, reducing alcohol consumption is more likely to occur if there are incentives such as making lower-strength alcohol products cheaper. The most effective evidence-based strategies to reduce alcohol-related harm are not reflected consistently in the RD alcohol pledges. The evidence is clear that an alcohol control strategy should support effective interventions to make alcohol less available and more expensive. © 2015 Society for the Study of Addiction.

Three Generations, Three Wars: African American Veterans.

PubMed

Black, Helen K

2016-02-01

This article emerged from pilot research exploring experiences of war and suffering among African American veterans who served in World War II, Korean War, and Vietnam War. Men's experiences as soldiers reflected both racism and the social change that occurred in the Unites States while they served. We used techniques of narrative elicitation, conducting qualitative, ethnographic interviews with each of five veterans in his home. Interviews focused on unique and shared experiences as an African American man and a soldier. Three important themes emerged: (a) Expectations related to War--Although men viewed service to country as an expected part of life, they also expected equal treatment in war, which did not occur; (b) Suffering as an African American--Informants interpreted experiences of suffering in war as related to the lower status of African American servicemen; and (c) Perception of present identity--Each man was honed by the sum of his experiences, including those of combat, racism, and postwar opportunities and obstacles. From 40 to 70 years after the wars were fought, there are few scholarly narrative studies on African American veterans, despite the fact that Korean War Veterans are entering old-old age and few World War II Veterans are alive. The value of pilot research that offers narratives of unheard voices is significant; larger studies can interview more African American veterans to advance knowledge that might soon be lost. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Analysis of Life-Saving Interventions Performed by Out-of-Hospital Combat Medical Personnel

DTIC Science & Technology

2011-07-01

emergency medicine physician assistants who completed a formal 1-year fellowship in emergency medi- cine ). Combat medics certified as National...war on terror 2001–2004. Ann Surg. 2007;245:986–991. 3. Kelly JF, Ritenour AE, McLaughlin DF, et al. Injury severity and causes of death from

13 CFR 107.450 - Notification to SBA of pledge of Licensee's shares.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Notification to SBA of pledge of Licensee's shares. 107.450 Section 107.450 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION SMALL BUSINESS INVESTMENT COMPANIES Changes in Ownership, Control, or Structure of Licensee; Transfer of...

Cost effectiveness of virtual reality graded exposure therapy with physiological monitoring for the treatment of combat related post traumatic stress disorder.

PubMed

Wood, Dennis Patrick; Murphy, Jennifer; McLay, Robert; Koffman, Robert; Spira, James; Obrecht, Robert E; Pyne, Jeff; Wiederhold, Brenda K

2009-01-01

Virtual Reality Graded Exposure Therapy (VRGET) is an effective treatment for combat-related PTSD. We summarize the outcomes of a VRGET pilot study with 12 participants who completed one to multiple combat tours in support of the War on Terrorism and who were subsequently diagnosed with combat-related PTSD. Details of the collaborative program amongst the Virtual Reality Medical Center (VRMC), Office of Naval Research, the Naval Medical Center San Diego (NMCSD) and the Navy Hospital Camp Pendleton are discussed as is the VRGET outcomes of significant reductions in PTSD symptoms severity. We also described the estimated cost-effectiveness of VRGET for the treatment of combat-related PTSD, as contrasted to Treatment as Usual (TAU) for combat-related PTSD.

Acute respiratory distress syndrome in combat casualties: military medicine and advances in mechanical ventilation.

PubMed

Morris, Michael James

2006-11-01

Military medicine has made numerous enduring contributions to the advancement of pulmonary medicine. Acute respiratory distress syndrome was first recognized as a complication in battlefield casualties in World War I and continued to play a significant role in the treatment of casualties through the Vietnam War. Innovative surgeons during World War II devised methods to assist their patients with positive pressure breathing. This concept was later adopted and applied to the development of mechanical ventilation in the late 1940s and early 1950s. The continued treatment of acute respiratory distress syndrome in combat casualties by military physicians has provided a major impetus for advances in modern mechanical ventilation and intensive care unit medicine.

U.S. War Costs: Two Parts Temporary, One Part Permanent.

PubMed

Edwards, Ryan D

2014-05-01

Military spending, fatalities, and the destruction of capital, all of which are immediately felt and are often large, are the most overt costs of war. They are also relatively short-lived. But the costs of war borne by combatants and their caretakers, which includes families, communities, and the modern welfare state, tend instead to be lifelong. In this paper I show that a significant component of the budgetary costs associated with U.S. wars is long-lived. One third to one half of the total present value of historical war costs are benefits distributed over the remaining life spans of veterans and their dependents. Even thirty years after the end of hostilities, typically half of all benefits remain to be paid. Estimates of the costs of injuries and deaths suggest that the private burden of war borne by survivors, namely the uncompensated costs of service-related injuries, are also large and long-lived.

U.S. War Costs: Two Parts Temporary, One Part Permanent

PubMed Central

Edwards, Ryan D.

2014-01-01

Military spending, fatalities, and the destruction of capital, all of which are immediately felt and are often large, are the most overt costs of war. They are also relatively short-lived. But the costs of war borne by combatants and their caretakers, which includes families, communities, and the modern welfare state, tend instead to be lifelong. In this paper I show that a significant component of the budgetary costs associated with U.S. wars is long-lived. One third to one half of the total present value of historical war costs are benefits distributed over the remaining life spans of veterans and their dependents. Even thirty years after the end of hostilities, typically half of all benefits remain to be paid. Estimates of the costs of injuries and deaths suggest that the private burden of war borne by survivors, namely the uncompensated costs of service-related injuries, are also large and long-lived. PMID:25221367

Aviators and Air Combat: A Study of the U.S. Eighth Air Force and R.A.F. Bomber Command

DTIC Science & Technology

1992-07-01

These were the human qualities, above all others, that air war seemed to demand . The reasons for this are apparent from the nature of the conflict. If we...are fundamentally similar with respect to the human dimension. Even so, the terrific demands placed on aerial combatants in a Clausewitzian sense...Bomber Offensive. Subsequent chapters of the thesis deal directly with issues arising out of the extraordinarily demanding nature of air combat

Emergency Department Patients Support the Use of Combat Medics in Their Clinical Care

DTIC Science & Technology

2015-07-01

indirect supervision is the growing complexity of modern medi- cine . If this level of supervised and controlled training is required of aviation and...readiness of brigade combat teams fighting the Global War on Terror . J Surg Res. 2007;138:25–31. 4. Mabry RL, Apodaca A, Penrod J, et al. Impact of

Guessing right for the next war: streamlining, pooling, and right-timing force design decisions for an environment of uncertainty

DTIC Science & Technology

2017-05-25

Guessing Right for the Next War: Streamlining, Pooling, and Right-Timing Force Design Decisions for an Environment of Uncertainty A...JUN 2016 – MAY 2017 4. TITLE AND SUBTITLE Guessing Right for the Next War: Streamlining, Pooling, and Right- Timing Force Design Decisions for an...committing to one force design solution to modern combat. The Army after World War II shied away from temporary organizational systems like these in

Stochastic Lanchester-type Combat Models I.

DTIC Science & Technology

1979-10-01

necessarily hold when the attrition rates become non- linear in b and/or r. 13 iL 4. OTHER COMBAT MODELS In this section we briefly describe how other...AD-A092 898 FLORIDA STATE UNIV TALLAHASSEE DEPT OF STATISTICS F/6 12/2 STOCHASTIC LANCHESTER-TYPE COMBAT MODELS I.(U) OCT 79 L BILLARD N62271-79-M...COMBAT MODELS I by L. BILLARD October 1979 Approved for public release; distribution unlimited. Prepared for: Naval Postgraduate School Monterey, CA 93940

Cultural shift in mental illness: a comparison of stress responses in World War I and the Vietnam War.

PubMed

Skinner, Rasjid; Kaplick, Paul M

2017-12-01

Post-traumatic stress disorder is an established diagnostic category. In particular, over the past 20 years, there has been an interest in culture as a fundamental factor in post-traumatic stress disorder symptom manifestation. However, only a very limited portion of this literature studies the historical variability of post-traumatic stress within a particular culture. Therefore, this study examines whether stress responses to violence associated with armed conflicts have been a culturally stable reaction in Western troops. We have compared historical records from World War I to those of the Vietnam War. Reference is also made to observations of combat trauma reactions in pre-World War I conflicts, World War II, the Korean War, the Falklands War, and the First Gulf War. The data set consisted of literature that was published during and after these armed conflicts. Accounts of World War I Shell Shock that describe symptom presentation, incidence (both acute and delayed), and prognosis were compared to the observations made of Vietnam War post-traumatic stress disorder victims. Results suggest that the conditions observed in Vietnam veterans were not the same as those which were observed in World War I trauma victims. The paper argues that the concept of post-traumatic stress disorder cannot be stretched to cover the typical battle trauma reactions of World War I. It is suggested that relatively subtle changes in culture, over little more than a generation, have had a profound effect on how mental illness forms, manifests itself, and is effectively treated. We add new evidence to the argument that post-traumatic stress disorder in its current conceptualisation does not adequately account, not only for ethnocultural variation but also for historical variation in stress responses within the same culture.

A group therapy approach to treating combat posttraumatic stress disorder: interpersonal reconnection through letter writing.

PubMed

Keenan, Melinda J; Lumley, Vicki A; Schneider, Robert B

2014-12-01

Many who have served in a war zone carry deep emotional wounds that go beyond the typical symptom clusters of reexperiencing, avoidance/numbing, and hyperarousal that comprise a diagnosis of posttraumatic stress disorder (PTSD). Specifically, many combatants experience unresolved grief, guilt, and shame caused by losses and traumatic experiences suffered in war, called "moral injury" by some clinicians and researchers (e.g., Litz et al., 2009; Shay, 1994). We describe the aspects of human attachment that set the stage for grief, guilt, and shame, and outline the 3-phase group therapy model we have implemented in a clinical setting to foster the reconnection of severed human bonds. Special attention is paid to killing and related phenomena that are unique to combat PTSD. The program phases include psychoeducation, trauma-focused therapy, and aftercare, which focuses on assisting the veterans in reconnecting with their families and communities. The use of letter writing as an intervention is illustrated through case examples, and clinical outcomes are anecdotally described.

The Calculus of War: The Role and Use of Quantitative Decision Aids at the Tactical Level of War

DTIC Science & Technology

1993-01-01

significantly. Ceilings of unbroken clouds came down to only several hundred feet altitude. Blowing sand mixed with heavy oil smoke to further obscure...Analysts go off into the murky world of materiel marketing . Allow the OR scientists return to the pure mode of enhancing combat operations. If necessary...Roots of Stategy , Book 2 (Harrisburg, Pa.: Stackpole Books, 1987), p. 66. 36 Larry H. Addington, The Patterns of War Since the 18th Century

Evaluating GPA and Satisfaction Rates for Veteran Populations Transitioning from Combat to College Classrooms

ERIC Educational Resources Information Center

Lemos, Fernando Fuentes, Jr.

2013-01-01

Nationwide, colleges and universities are bracing for an influx of military veterans returning to their hometowns after having served their country, many after serving in combat operations. Regional universities have long prepared for this anticipated increase in college attendance by men and women who have served the country during times of war.…

The relationship between posttraumatic stress disorder symptoms and paternal parenting of adult children among ex-prisoners of war: a longitudinal study.

PubMed

Zerach, Gadi; Greene, Talya; Ein-Dor, Tsachi; Solomon, Zahava

2012-04-01

The aversive impact of combat and combat-induced posttraumatic stress disorder (PTSD) on parenting of young children has been examined in a few studies. Nevertheless, the toll of war captivity on parenting and the long-term relations between posttraumatic symptoms and paternal parenting of adult children remains unknown. This longitudinal study examined paternal parenting of adult children among war veterans, some of whom were held in captivity. Furthermore, we examined the mediating role of PTSD symptoms in the association between captivity and parenting. The sample included two groups of male Israeli veterans from the 1973 Yom Kippur War: ex-prisoners of war (ex-POWs) and comparable veterans who had not been held captive. Both groups were assessed via self-report measures of PTSD at three time points: Time 1 (18 after the war), Time 2 (30 after the war), and Time 3 (35 after the war) years after the war. Results shows that ex-POWs reported lower levels of positive parenting compared to comparison group veterans at Time 3. Furthermore, PTSD symptoms at Time 1, Time 2, and Time 3 mediated the association between captivity experience and parenting at Time 3. In addition, it was found that increases in the levels of PTSD symptom clusters over time were associated with lower levels of positive parenting at Time 3. (c) 2012 APA, all rights reserved.

Use of inpatient psychiatric services on a U.S. Army combat support post during Operations Desert Shield and Desert Storm: the stress of non-deployment.

PubMed

Koshes, R J; Rothberg, J M

1994-06-01

We studied the utilization of inpatient psychiatric services during Operations Desert Shield and Desert Storm (the Persian Gulf War of 1990-1991) on a U.S. Army combat support post. Inpatient psychiatric admissions and dispositions for the post's catchment area were tallied before, during, and after Operations Desert Shield and Desert Storm. Subjects included active duty soldiers (deployed soldiers were not studied while they were away from the post), their families, and retirees. Overall, there was no increase in psychiatric hospitalizations for active duty soldiers, their family members, or retirees. However, coincident with the return of soldiers from Operations Desert Shield and Desert Storm, the psychiatric proportion of all hospitalizations increased in the subpopulation of soldiers not deployed who had served less than 1 year. These soldiers in training may be more susceptible to increased stress levels associated with the return of soldiers from war because of their inadequate group bonding.

A formulation and analysis of combat games

NASA Technical Reports Server (NTRS)

Heymann, M.; Ardema, M. D.; Rajan, N.

1985-01-01

Combat is formulated as a dynamical encounter between two opponents, each of whom has offensive capabilities and objectives. With each opponent is associated a target in the event space in which he endeavors to terminate the combat, thereby winning. If the combat terminates in both target sets simultaneously or in neither, a joint capture or a draw, respectively, is said to occur. Resolution of the encounter is formulated as a combat game; namely, as a pair of competing event-constrained differential games. If exactly one of the players can win, the optimal strategies are determined from a resulting constrained zero-sum differential game. Otherwise the optimal strategies are computed from a resulting non-zero-sum game. Since optimal combat strategies frequencies may not exist, approximate of delta-combat games are also formulated leading to approximate or delta-optimal strategies. To illustrate combat games, an example, called the turret game, is considered. This game may be thought of as a highly simplified model of air combat, yet it is sufficiently complex to exhibit a rich variety of combat behavior, much of which is not found in pursuit-evasion games.

Plastic Surgery Challenges in War Wounded II: Regenerative Medicine

PubMed Central

Valerio, Ian L.; Sabino, Jennifer M.; Dearth, Christopher L.

2016-01-01

Background: A large volume of service members have sustained complex injuries during Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF). These injuries are complicated by contamination with particulate and foreign materials, have high rates of bacterial and/or fungal infections, are often composite-type defects with massive soft tissue wounds, and usually have multisystem involvement. While traditional treatment modalities remain a mainstay for optimal wound care, traditional reconstruction approaches alone may be inadequate to fully address the scope and magnitude of such massive complex wounds. As a result of these difficult clinical problems, the use of regenerative medicine therapies, such as autologous adipose tissue grafting, stem cell therapies, nerve allografts, and dermal regenerate templates/extracellular matrix scaffolds, is increased as adjuncts to traditional reconstructive measures. Basic and Clinical Science Advances: The beneficial applications of regenerative medicine therapies have been well characterized in both in vitro studies and in vivo animal studies. The use of these regenerative medicine techniques in the treatment of combat casualty injuries has been increasing throughout the recent war conflicts. Clinical Care Relevance: Military medicine has shown positive results when utilizing certain regenerative medicine modalities in treating complex war wounds. As a result, multi-institution clinical trials are underway to further evaluate these observations and reconstruction measures. Conclusion: Successful combat casualty wound care often requires a combination of traditional aspects of the reconstructive ladder/elevator with adoption of various regenerative medicine therapies. Due to the recent OIF/OEF conflicts, a high volume of combat casualties have benefited from adoption of regenerative medicine therapies and increased access to innovative clinical trials. Furthermore, many of these patients have had long-term follow-up to report

The implicit rules of combat.

PubMed

Romero, Gorge A; Pham, Michael N; Goetz, Aaron T

2014-12-01

Conspecific violence has been pervasive throughout evolutionary history. The current research tested the hypotheses that individuals implicitly categorize combative contexts (i.e., play fighting, status contests, warfare, and anti-exploitative violence) and use the associated contextual information to guide expectations of combative tactics. Using U.S. and non-U.S. samples, Study 1 demonstrated consistent classification of combative contexts from scenarios for which little information was given and predictable shifts in the acceptability of combative tactics across contexts. Whereas severe tactics (e.g., eye-gouging) were acceptable in warfare and anti-exploitative violence, they were unacceptable in status contests and play fights. These results suggest the existence of implicit rules governing the contexts of combat. In Study 2, we explored the reputational consequences of violating these implicit rules. Results suggest that rule violators (e.g., those who use severe tactics in a status contest) are given less respect. These are the first studies to implicate specialized mechanisms for aggression that use contextual cues of violence to guide expectations and behavior.

Health care utilization, somatic and mental health distress, and well-being among widowed and non-widowed female survivors of war.

PubMed

Morina, Nexhmedin; Emmelkamp, Paul M G

2012-05-11

The aim of the study was to assess levels of somatic and mental health distress, well-being, AS WELL AS utilization of primary and specialist health care services among war-related widowed and non-widowed female civilian survivors of war. 100 war-related widowed lone mothers and 106 non-widowed mothers who had experienced the Kosovo war ten years previously participated in the study. Measures of somatic, depressive, post-traumatic stress, anxiety, and grief complaints, subjective well-being, and utilization of health care services during the previous three months were used. Compared to non-widowed mothers, widowed lone mothers reported significantly higher levels of somatic, depressive, post-traumatic stress, and anxiety complaints. Further, they reported significantly lower levels of subjective well-being as composed of positive and negative affect and satisfaction with life. More than half of both widowed and non-widowed mothers reported utilization of health care services during the last three months, without significant differences between the groups. However, only three percent of widowed lone mothers and four percent of non-bereaved mothers reported utilization of mental health services during the last three months, despite high levels of mental health distress especially among widowed lone mothers. Among widowed lone mothers, severity of prolonged grief symptoms significantly predicted number of contacts of specialist health care use over and above sociodemographic variables, number of war-related events, and other psychopathology. War-related widowed lone mothers suffer from elevated somatic and mental distress even a decade after the war. The tiny proportion of widowed lone mothers in use of mental health services can be seen as a reflection of lack of previous and current mental health services to meet mental health needs of this population.

Health care utilization, somatic and mental health distress, and well-being among widowed and non-widowed female survivors of war

PubMed Central

2012-01-01

Background The aim of the study was to assess levels of somatic and mental health distress, well-being, AS WELL AS utilization of primary and specialist health care services among war-related widowed and non-widowed female civilian survivors of war. Methods 100 war-related widowed lone mothers and 106 non-widowed mothers who had experienced the Kosovo war ten years previously participated in the study. Measures of somatic, depressive, post-traumatic stress, anxiety, and grief complaints, subjective well-being, and utilization of health care services during the previous three months were used. Results Compared to non-widowed mothers, widowed lone mothers reported significantly higher levels of somatic, depressive, post-traumatic stress, and anxiety complaints. Further, they reported significantly lower levels of subjective well-being as composed of positive and negative affect and satisfaction with life. More than half of both widowed and non-widowed mothers reported utilization of health care services during the last three months, without significant differences between the groups. However, only three percent of widowed lone mothers and four percent of non-bereaved mothers reported utilization of mental health services during the last three months, despite high levels of mental health distress especially among widowed lone mothers. Among widowed lone mothers, severity of prolonged grief symptoms significantly predicted number of contacts of specialist health care use over and above sociodemographic variables, number of war-related events, and other psychopathology. Conclusion War-related widowed lone mothers suffer from elevated somatic and mental distress even a decade after the war. The tiny proportion of widowed lone mothers in use of mental health services can be seen as a reflection of lack of previous and current mental health services to meet mental health needs of this population. PMID:22578096

[Psychiatric, Cognitive and Emotional Profile in Ex-combatants of Illegal Armed Groups in Colombia].

PubMed

Tobón, Carlos; Aguirre-Acevedo, Daniel Camilo; Velilla, Lina; Duque, Jon; Ramos, Claudia Patricia; Pineda, David

2016-01-01

Exposure to armed conflict produces biological adaptations oriented to handle the highly stressful conditions in war environments. The special features of The Colombian armed create a special scenario to evaluate the human behavior. In this study, psychiatric, cognitive and emotional processing characteristics of a group of Colombian armed illegal forces of ex-combatants are described. Sixty-three ex combatants and 22 controls were assessed with WAIS (IQ), INECO frontal screening (executive functions), Interpersonal Reactivity Index (empathy), emotional features recognition and MINI (psychiatric profile). When compared to the control group, ex-combatants showed higher frequency of antisocial personality disorder (P=.031) and behavioral dissocial disorder (P=.017). In cognitive profile, the ex-combatants showed a lower score in the executive function test (Me=18.50; RQ=4.00), control (Me=23.00; RQ=5.25), with a poor personal distress in emphatic profile (Me=10.00; RQ=5.00) compared to control group (Me=37.00; RQ=7.25). We found differences in cognitive and psychiatric profile in ex-combatants in comparison with controls. Copyright © 2015 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

CACDA JIFFY III War Game. Volume II. Methodology

DTIC Science & Technology

1980-09-01

Devens , MA 01433 Commandant USA Air ,Defense School ATTN:’ ATSA-CD-SC-S Fort Bliss, TX 79916 Commandant USA Intelligence Center and School Fort Huachuca...RELEASE: DISTRIBUTION UNLIMITED 0 801030o 033 1 Technical Report TR 6-80, Septenber 1980 US Army Combined Arms Studies and Analysis Activity Fort ...manual war game developed and operated at the USATRADOC Combined Arms Combat Developments Activity (CACDA),, Fort Leavenworth, Kansas, for scenzrio

Effectiveness of brief VR treatment for PTSD in war-fighters: a case study.

PubMed

Miyahira, Sarah D; Folen, Raymond A; Hoffman, Hunter G; Garcia-Palacios, Azucena; Schaper, Kim M

2010-01-01

War-fighters exposed to combat are at high risk for developing posttraumatic stress disorder (PTSD), a complex and challenging condition to treat. Cognitive behavioral therapies (CBT) have been empirically validated as effective treatments for PTSD resulting from sexual assault, vehicular accidents, and disasters. Exposure, imaginal or in vivo, to the traumatic event is a central component of successful CBT treatment. Early studies indicate that CBT with brief virtual reality exposure (VRE) is beneficial in treating PTSD. The case study examined the effectiveness of brief VRE in treating combat-related PTSD.

Combat Search and Rescue: Searching the History; Rescuing the Doctrine

DTIC Science & Technology

2003-06-01

crew search effort KIA 23-Feb USMC Pride 16 AV-8 Capt Wilbourn none KIA 25-Feb USMC Jump 42 AV-8 Capt Walsh none Recovered by USMC in minutes USMC...61 Hallion, Richard P. Storm Over Iraq Air Power and the Gulf War. Washington, D.C.: Smithsonian Institution Press, 1992. Hampton, Lt Col Joseph C...Operation DESERT SHIELD Combat SAR Plan, 1 November 1990, in JPRA library. (Secret) Hampton, Lt Col Joseph C. Joint Universal Lessons Learned

The epidemiology of vascular injury in the wars in Iraq and Afghanistan.

PubMed

White, Joseph M; Stannard, Adam; Burkhardt, Gabriel E; Eastridge, Brian J; Blackbourne, Lorne H; Rasmussen, Todd E

2011-06-01

Blood vessel trauma leading to hemorrhage or ischemia presents a significant cause of morbidity and mortality after battlefield injury. The objective of this study is to characterize the epidemiology of vascular injury in the wars of Iraq and Afghanistan, including categorization of anatomic patterns, mechanism, and management of casualties. The Joint Theater Trauma Registry was interrogated (2002-2009) for vascular injury in US troops to identify specific injury (group 1) and operative intervention (group 2) groups. Battle-related injuries (nonreturn to duty) were used as the denominator to establish injury rates. Mechanism of injury was compared between theaters of war and the management strategies of ligation versus revascularization (repair and interposition grafting) reported. Group 1 included 1570 Troops injured in Iraq (OIF) (n = 1390) and Afghanistan (OEF) (n = 180). Mechanism included explosive (73%), gunshot (27%), and other (<1%) with explosive more common in OIF than OEF (P < 0.05). During this period, 13,076 battle-related injuries occurred resulting in a specific rate of 12% (1570 of 13,076), which was higher in OIF than OEF (12.5% vs 9% respectively; P < 0.05). Of group 1, 60% (n = 940) sustained injury to major or proximal vessels and 40% (n = 630) to minor or distal vessels (unknown vessel, n = 27). Group 2 (operative) comprised 1212 troops defining an operative rate of 9% (1212 of 13,076) and included ligation (n = 660; 54%) or repair (n = 552; 46%). Peak rates in OIF and OEF occurred in November 2004 (15%) and August 2009 (11%), respectively and correlated with combat operational tempo. The rate of vascular injury in modern combat is 5 times that reported in previous wars and varies according to theater of war, mechanism of injury and operational tempo. Methods of reconstruction are now applied to nearly half of the vascular injuries and should be a focus of training for combat surgery. Selective ligation of vascular injury remains an important

Embitterment in War Veterans with Posttraumatic Stress Disorder.

PubMed

Sabic, Dzevad; Sabic, Adela; Batic-Mujanovic, Olivera

2018-04-01

The aim of this study was to analyze frequency of embitterment in war veterans with Posttraumatic stress disorder (PTSD). It was analyzed 174 subjects (from Health Center Zivinice/ Mental Health Center) through a survey conducted in the period from March 2015 to June 2016, of witch 87 war veterans with PTSD and control subjects 87 war veterans without PTSD. The primary outcome measure was the Post-Traumatic Embitterment Disorder Self-Rating Scale (PTED Scale) who contains 19 items designed to assess features of embitterment reactions to negative life events. Secondary efficacy measures included the Clinician-Administered PTSD Scale - V (CAPS), the PTSD CheckList (PCL), the Combat Exposure Scale (CES), the Hamilton Depression Rating Scale (HAM-D), the Hamilton Anxiety Rating Scale (HAM-A) and the World Health Organization Quality of Life Scale ( WHOQOL-Bref). All subjects were male. The average age of patients in the group war veterans with PTSD was 52·78 ± 5·99. In the control group average age was 51·42 ± 5·98. Statistical data were analyzed in SPSS statistical program. Comparing the results, t tests revealed significant difference between group veterans with PTSD and control group (t=-21·216, p<0·0001). War veterans group with PTSD (X= 51·41 SD= 8·91), war veterans without PTSD (X=14·39, SD=13·61). Embitterment is frequent in war veterans with PTSD.

Embitterment in War Veterans with Posttraumatic Stress Disorder

PubMed Central

Sabic, Dzevad; Sabic, Adela; Batic-Mujanovic, Olivera

2018-01-01

Aim The aim of this study was to analyze frequency of embitterment in war veterans with Posttraumatic stress disorder (PTSD). Patients and Methods It was analyzed 174 subjects (from Health Center Zivinice/ Mental Health Center) through a survey conducted in the period from March 2015 to June 2016, of witch 87 war veterans with PTSD and control subjects 87 war veterans without PTSD. The primary outcome measure was the Post-Traumatic Embitterment Disorder Self-Rating Scale (PTED Scale) who contains 19 items designed to assess features of embitterment reactions to negative life events. Secondary efficacy measures included the Clinician-Administered PTSD Scale - V (CAPS), the PTSD CheckList (PCL), the Combat Exposure Scale (CES), the Hamilton Depression Rating Scale (HAM-D), the Hamilton Anxiety Rating Scale (HAM-A) and the World Health Organization Quality of Life Scale (WHOQOL-Bref). All subjects were male. The average age of patients in the group war veterans with PTSD was 52·78 ± 5·99. In the control group average age was 51·42 ± 5·98. Statistical data were analyzed in SPSS statistical program. Results Comparing the results, t tests revealed significant difference between group veterans with PTSD and control group (t=–21·216, p<0·0001). War veterans group with PTSD (X= 51·41 SD= 8·91), war veterans without PTSD (X=14·39, SD=13·61). Conclusion Embitterment is frequent in war veterans with PTSD. PMID:29736102

Serving the Cause: Duty Concepts and Combat Effectiveness in War

DTIC Science & Technology

2010-06-01

War II.10 Like moral factors, the notion of military effectiveness is complex and multi-faceted. Murray and Millet argue that military...The insights derived from this synthesis will provide the common reference point for analysis of the historical examples. Alan Millet and...1988). 4 Allan Millet and Williamson Murray, Military Effectiveness, Vol I, 2. 9 This dynamic interaction is particularly pronounced at the

Gulf War Syndrome: a review of current knowledge and understanding.

PubMed

Minshall, D

2014-01-01

The 1991 Persian Gulf War was a resounding military success for coalition forces, who liberated Kuwait following the Iraqi invasion. The medical legacy we have from the conflict is the poorly understood, yet remarkable, phenomenon of Gulf War Syndrome, which surfaced soon after. Epidemiological research has proven beyond doubt that Gulf War veterans report a wide variety of symptoms, in excess of appropriately matched control subjects, and experience worse general health. Numerous toxic environmental hazards have been suggested as causes of Gulf War Syndrome, yet exhaustive scientific study has failed to provide conclusive proof of any link. No novel or recognised disease has been found to account for the symptomatic burden of veterans, and the optimal treatment remains uncertain. This understanding can be added to from an anthropological perspective, where the narratives of those afflicted provide further insight. The nature of military life was changing at the time of the Gulf War, challenging the identity and beliefs of some veterans and causing socio-cultural distress. The symptomatic presentation of Gulf War Syndrome can be considered an articulation of this disharmony. Gulf War Syndrome can also be considered within the group of post-combat disorders such as shellshock, the like of which have occurred after major wars in the last century. With the current withdrawal from Afghanistan, the Defence Medical Services (DMS) should heed the lessons of history.

Gene-environment interaction of ApoE genotype and combat exposure on PTSD.

PubMed

Lyons, Michael J; Genderson, Margo; Grant, Michael D; Logue, Mark; Zink, Tyler; McKenzie, Ruth; Franz, Carol E; Panizzon, Matthew; Lohr, James B; Jerskey, Beth; Kremen, William S

2013-10-01

Factors determining who develops PTSD following trauma are not well understood. The €4 allele of the apolipoprotein E (apoE) gene is associated with dementia and unfavorable outcome following brain insult. PTSD is also associated with dementia. Given evidence that psychological trauma adversely affects the brain, we hypothesized that the apoE genotype moderates effects of psychological trauma on PTSD pathogenesis. To investigate the moderation of the relationship between PTSD symptoms and combat exposure, we used 172 participants with combat trauma sustained during the Vietnam War. PTSD symptoms were the dependent variable and number of combat experiences, apoE genotype, and the combat experiences × apoE genotype interaction were predictors. We also examined the outcome of a diagnosis of PTSD (n = 39) versus no PTSD diagnosis (n = 131). The combat × apoE genotype interaction was significant for both PTSD symptoms (P = .014) and PTSD diagnosis (P = .009). ApoE genotype moderates the relationship between combat exposure and PTSD symptoms. Although the pathophysiology of PTSD is not well understood, the €4 allele is related to reduced resilience of the brain to insult. Our results are consistent with the €4 allele influencing the effects of psychological trauma on the brain, thereby affecting the risk of PTSD. © 2013 Wiley Periodicals, Inc.

Posttraumatic Intrusion, Avoidance, and Social Functioning: A 20-Year Longitudinal Study

ERIC Educational Resources Information Center

Solomon, Zahava; Mikulincer, Mario

2007-01-01

The study assesses posttraumatic intrusion, avoidance, and social functioning among 214 Israeli combat veterans from the first Lebanon War with and without combat stress reaction (CSR) 1, 2, 3, and 20 years after the war. CSR veterans reported higher intrusion and avoidance than did non-CSR veterans. With time, there was a decline in these…

The nature and extent of war injuries sustained by combat specialty personnel killed and wounded in Afghanistan and Iraq, 2003-2011.

PubMed

Schoenfeld, Andrew J; Dunn, John C; Bader, Julia O; Belmont, Philip J

2013-08-01

Previous studies regarding combat wounding have a limited translational capacity due to inclusion of soldiers from all military branches and occupational specialties as well as a lack of information regarding soldiers who died in theater. A search was performed of the Department of Defense Trauma Registry and Armed Forces Medical Examiner data set for the years 2003 to 2011 to identify all injured personnel with the military specialty 19D (cavalry scout). A manual search was conducted for each record identified, and age, rank, location and manner of injury, mechanism of injury, Injury Severity Score (ISS), and extent of wounding were abstracted. The incidence of injuries by body region and rates for specific types of wounds were determined. Statistically significant associations between rank, location of injury, manner of injury, body region involved, and injury mechanism were assessed using χ2 analysis. Associations between ISS, rank, manner of injury, and survival were evaluated by t test with Satterthwaite correction. A total of 701 casualties were identified with 3,189 distinct injuries. Mean (SD) age of injured personnel was 25.9 (6.0) years. Thirty-five percent of the cohort was composed of soldiers who died in theater. Explosions were the most common mechanism of injury (70%), while 18% of wounds occurred owing to gunshot. Extremity wounds and injuries to the head and neck represented 34% of casualty burden. Thoracic trauma occurred in 16%, and abdominal injuries occurred in 17%. Wounds with a frequency exceeding 5% included skin, extremity, facial, brain, and gastrointestinal injuries. Vascular injury occurred in 4%. Gunshot wounds were a greater cause of injury in Afghanistan (p = 0.001) and resulted in a higher percentage of thoracic injuries (p < 0.001). The nature and extent of trauma sustained by combat-specific personnel seems to be different from that experienced by all soldiers deployed to a war zone.

Impunity: Countering Illicit Power in War and Transition

DTIC Science & Technology

2016-05-01

Post -Conflict: The Lessons from Timor-Leste..........347 Deniz Kocak CHAPTER 17 A Granular Approach to Combating Corruption and Illicit Power Structures...transregional security,” and central to our task “is strengthening our global network of allies and partners.”4 In the current post -“Big Footprint” era...after the post -2001 political settlement, which was built on the distribution of political power between factions formed during the country’s civil war

Penetrating eye injury in war.

PubMed

Biehl, J W; Valdez, J; Hemady, R K; Steidl, S M; Bourke, D L

1999-11-01

The percentage of penetrating eye injuries in war has increased significantly in this century compared with the total number of combat injuries. With the increasing use of fragmentation weapons and possibly laser weapons on the battle-field in the future, the rate of eye injuries may exceed the 13% of the total military injuries found in Operations Desert Storm/Shield. During the Iran-Iraq War (1980-1988), eye injuries revealed that retained foreign bodies and posterior segment injuries have an improved prognosis in future military ophthalmic surgery as a result of modern diagnostic and treatment modalities. Compared with the increasing penetrating eye injuries on the battlefield, advances in ophthalmic surgery are insignificant. Eye armor, such as visors that flip up and down and protect the eyes from laser injury, needs to be developed. Similar eye protection is being developed in civilian sportswear. Penetrating eye injury in the civilian sector is becoming much closer to the military model and is now comparable for several reasons.

Injuries due to firearms and air guns among U.S. military members not participating in overseas combat operations, 2002-2011.

PubMed

2012-09-01

During 2002-2011, active component U.S. service members sustained 4,657 firearm-related injuries in circumstances other than deployment to the wars in Iraq/Afghanistan; 35 percent of the injuries were fatal. The highest firearm-related injury rates reflected service members in law enforcement/security and combat occupations. Of fatal injuries, 28 percent and 24 percent were suicides and homicides, respectively; among service members 30 and older, 84 percent of noncombat firearm-related deaths were suicides and 14 percent were homicides. In circumstances other than war, rates of both fatal and nonfatal firearm- related injuries are much lower among military members than civilian males aged 18-44. During the period, rates of nonfatal firearm-related injuries among non-deployed military members increased sharply, peaking in 2008. The trend reflects that among U.S. civilian males aged 18-44. However, firearm-related fatality rates were stable among civilians but increased among military members. The increase in rates of firearm-related fatalities among non-deployed military members reflects the increase in rates of suicides by firearms. Rates of injuries due to BB, pellet or paintball guns also increased during the period.

Can we prevent a second 'Gulf War syndrome'? Population-based healthcare for chronic idiopathic pain and fatigue after war.

PubMed

Engel, Charles C; Jaffer, Ambereen; Adkins, Joyce; Riddle, James R; Gibson, Roger

2004-01-01

systems for combatants and their families are already being put to pragmatic tests as troops return from war in Iraq and Afghanistan and from other military challenges.

Media triggers of post-traumatic stress disorder 50 years after the Second World War.

PubMed

Hilton, C

1997-08-01

Post-traumatic stress disorder (PTSD) may present many years after the original trauma. Case studies of two elderly patients are described. Both had experienced life-threatening combat situations and witnessed intense suffering during the Second World War. Marked distress was triggered by the media commemorating the fiftieth anniversary of the end of the war. PTSD patients often avoid talking of their traumatic experiences because of associated distress. Without taking a military and trauma history from elderly patients the diagnosis is likely to be missed.

Prevention of combat-related infections: antimicrobial therapy in battlefield and barrier measures in French military medical treatment facilities.

PubMed

Mérens, Audrey; Rapp, Christophe; Delaune, Deborah; Danis, Julien; Berger, Franck; Michel, Remy

2014-01-01

Infection is a major complication associated with combat-related injuries. Beside immobilization, wound irrigation, surgical debridement and delayed coverage, post-injury antimicrobials contribute to reduce combat-related infections, particularly those caused by bacteria of the early contamination flora. In modern warfare, bacteria involved in combat-related infections are mainly Gram-negative bacteria belonging to the late contamination flora. These bacteria are frequently resistant or multiresistant to antibiotics and spread through the deployed chain of care. This article exposes the principles of war wounds antimicrobial prophylaxis recommended in the French Armed Forces and highlights the need for high compliance to hygiene standard precautions, adapted contact precautions and judicious use of antibiotics in French deployed military medical treatment facilities (MTF). Copyright © 2014 Elsevier Ltd. All rights reserved.

Epidemiological findings of major chemical attacks in the Syrian war are consistent with civilian targeting: a short report.

PubMed

Rodriguez-Llanes, Jose M; Guha-Sapir, Debarati; Schlüter, Benjamin-Samuel; Hicks, Madelyn Hsiao-Rei

2018-01-01

Evidence of use of toxic gas chemical weapons in the Syrian war has been reported by governmental and non-governmental international organizations since the war started in March 2011. To date, the profiles of victims of the largest chemical attacks in Syria remain unknown. In this study, we used descriptive epidemiological analysis to describe demographic characteristics of victims of the largest chemical weapons attacks in the Syrian war. We analysed conflict-related, direct deaths from chemical weapons recorded in non-government-controlled areas by the Violation Documentation Center, occurring from March 18, 2011 to April 10, 2017, with complete information on the victim's date and place of death, cause and demographic group. 'Major' chemical weapons events were defined as events causing ten or more direct deaths. As of April 10, 2017, a total of 1206 direct deaths meeting inclusion criteria were recorded in the dataset from all chemical weapons attacks regardless of size. Five major chemical weapons attacks caused 1084 of these documented deaths. Civilians comprised the majority ( n  = 1058, 97.6%) of direct deaths from major chemical weapons attacks in Syria and combatants comprised a minority of 2.4% ( n  = 26). In the first three major chemical weapons attacks, which occurred in 2013, children comprised 13%-14% of direct deaths, ranging in numbers from 2 deaths among 14 to 117 deaths among 923. Children comprised higher proportions of direct deaths in later major chemical weapons attacks, forming 21% ( n  = 7) of 33 deaths in the 2016 major attack and 34.8% ( n  = 32) of 92 deaths in the 2017 major attack. Our finding of an extreme disparity in direct deaths from major chemical weapons attacks in Syria, with 97.6% of victims being civilians and only 2.4% being combatants provides evidence that major chemical weapons attacks were indiscriminate or targeted civilians directly; both violations of International Humanitarian Law (IHL). Identifying and

Delayed-onset PTSD among war veterans: the role of life events throughout the life cycle.

PubMed

Horesh, Danny; Solomon, Z; Zerach, G; Ein-Dor, T

2011-09-01

The underlying mechanisms of delayed-onset PTSD are yet to be understood. This study examines the role of stressful life events throughout the life cycle in delayed-onset PTSD following combat. 675 Israeli veterans from the 1982 Lebanon War, 369 with antecedent combat stress reaction (CSR) and 306 without CSR were assessed prospectively, 1, 2 and 20 years after the war. Veterans were divided into four groups, according to the time of first PTSD onset (first onset at 1983, 1984, and 2002 and no PTSD onset). They were assessed for post-, peri- and pre-traumatic life events, as well as military and socio-demographic characteristics. Our findings indicate that shorter delays in PTSD onset were associated with a higher risk for CSR, a higher number of pre- and post-war life events, more severe subjective battle exposure, greater perceived danger during combat and a more stressful military position. CSR was found to be the most powerful predictor of PTSD onset. A recency effect was also found, with more recent life events proving to be stronger predictors of PTSD onset. First, our findings validate the existence of delayed-onset PTSD, as it was found among a substantial number of participants (16.5%). Second, post-, peri- and pre-traumatic life events are associated with the time of PTSD onset. Thus, practitioners and researchers are encouraged to examine not only the original trauma, but also the stressful experiences throughout the survivors' life cycle. In particular, identification of antecedent CSR may help mental help professionals in targeting high-risk populations.

U.S. Marine Aviation in World War II: VMF 124 in the Solomons.

DTIC Science & Technology

1988-04-01

identify by block number) \\M r in e Fi jhter Squadron (’MF) 124 was formed in 1942 to fly the new F4U Corsair in combat 3 ~a jn t thie Japanese Zero to win...VNF) 124 was formed in September 1942 at Ne Camp Kearney, California. It was the first unit to fly the new F4U Corsair in combat--its purpose was to...war over the Solomons. The pilots, averaging just 21-22 years in age, each had less than 30 hours total flight time in the new Corsair before arriving

The Just War Tradition: A Model for Healthcare Ethics.

PubMed

Connolly, Chaplain John D

2018-06-01

Healthcare ethics committees, physicians, surgeons, nurses, families, and patients themselves are constantly under pressure to make appropriate medically ethical decisions concerning patient care. Various models for healthcare ethics decisions have been proposed throughout the years, but by and large they are focused on making the initial ethical decision. What follows is a proposed model for healthcare ethics that considers the most appropriate decisions before, during, and after any intervention. The Just War Tradition is a model that is thorough in its exploration of the ethics guiding a nation to either engage in or refuse to engage in combatant actions. In recent years, the Just War Tradition has expanded beyond the simple consideration of going to war or not to include how the war is conducted and what the post-war phase would look like ethically. This paper is an exploration of a healthcare ethics decision making model using the tenets of the Just War Tradition as a framework. It discusses the initial consult level of decision making prior to any medical intervention, then goes further in considering the ongoing ethical paradigm during medical intervention and post intervention. Thus, this proposal is a more holistic approach to healthcare ethics decision making that encourages healthcare ethics committees to consider alternate models and ways of processing so that ultimately what is best for patient, family, staff, and the environment is all taken into consideration.

A Non-Conventional Interdiction Strategy for the Global War on Terror

DTIC Science & Technology

2007-06-01

thesis is to explore an alternative strategic focus for the Department of Defense to implement in the conduct of the Global War on Terrorism. Our...thesis is as follows: A non-conventional approach to strategic policy, led by an enhanced Foreign Internal Defense concept, and judicious execution of...been and continues to be limited by its conventional tactical successes, when what is required is strategic application of FID, UW, and limited

Wars and suicides in Israel, 1948-2006.

PubMed

Oron Ostre, Israel

2012-05-01

This paper reports the characteristics of suicides which occurred during the existential and the non-existential wars in Israel. It provides a first approximation of whether the suicide patterns in each war are consistent with the findings of Morselli and Durkheim, and whether their theoretical interpretations can serve as a preliminary guideline to explaining the Israeli case, which is characterized by short periods of war, social integration during some of the non-existential wars, and a sharp rise in post-war male suicide rates following all of the existential wars. Implications for further studies on the subject in Israel and elsewhere are discussed.

Anger, impulsivity, and anger control in combat-related posttraumatic stress disorder.

PubMed

Chemtob, C M; Hamada, R S; Roitblat, H L; Muraoka, M Y

1994-08-01

Empirical evidence of a relationship between combat-related PTSD and increased anger is lacking. In this study, 24 veterans of the Vietnam War with posttraumatic stress disorder (PTSD) scored significantly higher on an Anger factor comprising multiple measures of anger than did comparison groups of 23 well-adjusted Vietnam combat veterans and 12 noncombat Vietnam-era veterans with psychiatric diagnoses. In contrast, the 3 groups did not differ significantly on orthogonal factors, one of which comprised cognitive impulsivity measures and the other of which reflected motor impulsivity. Changes in heart rate in response to provocation loaded positively on the Anger factor and negatively on the 2 Impulsivity factors. Concurrent depression and trait anxiety did not have an effect on level of anger in individuals with PTSD. These empirical findings support and extend the clinical evidence regarding PTSD and anger.

Edward D. Churchill as a combat consultant: lessons for the senior visiting surgeons and today's military medical corps.

PubMed

Cannon, Jeremy W; Fischer, Josef E

2010-03-01

In World War II, Edward D. Churchill volunteered as a combat consultant. In this role, he mentored many junior surgeons and challenged the Army leadership to treat hemorrhagic shock with blood rather than plasma. These lessons have continued relevance for today's Senior Visiting Surgeons and our military medical corps.

Appetitive Aggression and Adverse Childhood Experiences Shape Violent Behavior in Females Formerly Associated with Combat

PubMed Central

Augsburger, Mareike; Meyer-Parlapanis, Danie; Bambonye, Manassé; Elbert, Thomas; Crombach, Anselm

2015-01-01

This study investigated the impact of violent experiences during childhood, posttraumatic stress disorder (PTSD) and appetitive aggression on everyday violent behavior in Burundian females with varying participation in war. Moreover, group differences in trauma-related and aggression variables were expected. Appetitive aggression describes the perception of violence perpetration as fascinating and appealing and is a common phenomenon in former combatants. Semi-structured interviews were conducted with 158 females, either former combatants, supporters of armed forces or civilians during the civil war in Burundi. The PTSD Symptom Scale Interview was used to assess PTSD symptom severity, the Appetitive Aggression Scale to measure appetitive aggression and the Domestic and Community Violence Checklist to assess both childhood maltreatment and recent aggressive behavior. Former combatants had experienced more traumatic events, perpetrated more violence and reported higher levels of appetitive aggression than supporters and civilians. They also suffered more severely from PTSD symptoms than civilians but not than supporters. The groups did not differ regarding childhood maltreatment. Both appetitive aggression and childhood violence predicted ongoing aggressive behavior, whereas the latter outperformed PTSD symptom severity. These findings support current research showing that adverse childhood experiences and a positive attitude toward aggression serve as the basis for aggressive behavior and promote an ongoing cycle of violence in post-conflict regions. Female members of armed groups are in need of demobilization procedures including trauma-related care and interventions addressing appetitive aggression. PMID:26635666

A qualitative analysis of the experience and impact of killing in hand-to-hand combat.

PubMed

Jensen, Peter R; Simpson, Duncan

2014-08-01

A growing body of research suggests that killing during military combat is closely associated with posttraumatic stress disorder (PTSD), as well as a number of other adverse mental health related conditions (e.g., dissociative experiences, violent behavior, functional impairment). This article provides first-person perspectives on the experiences and impact of killing by service members with the goal of expanding our understanding of the impact of taking a life during war. In audio-recorded phenomenological interviews, 9 service members described their experiences and the subsequent impact of killing during hand-to-hand combat. A description, supported by participant quotations, was constructed to represent the participants' experiences. Results suggest the experience and aftermath of taking a life in hand-to-hand combat was disturbing, psychologically stressful, and necessitated some form of coping after the event. Service members who killed in hand-to-hand combat viewed their actions as necessary to preserve their life and that killing in hand-to-hand combat was more emotionally taxing than killing by shooting. Our findings may help to improve providers' understanding of service members' first-person experiences of killing in hand-to-hand combat and thus provide the basis for the development of a connected and genuine relationship with such military clients. Copyright © 2014 International Society for Traumatic Stress Studies.

Nursing Care of Women Veterans of the Iraq and Afghanistan Wars.

PubMed

Conard, Patricia L; Armstrong, Myrna L

2018-04-01

The Iraq and Afghanistan wars are unlike earlier wars, and the women veterans who have served in them are unlike veterans of earlier wars. Now these veterans are presenting with distinctive general, genitourinary, reproductive, and behavioral health issues. When seeking health care after deployment, they may be accessing multiple health care providers across numerous sites, including the Veterans Health Administration and civilian facilities. Enhanced levels of understanding, respect, and concern for the many combat-related health challenges experienced by these veterans will help civilian nurses and other clinicians provide optimum care. Provision of health care to women veterans should be multidisciplinary and effectively coordinated among various health care providers and facilities to ensure that their post-deployment health and wellness needs are met. © 2018 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.

Managing future Gulf War Syndromes: international lessons and new models of care

PubMed Central

Engel, Charles C; Hyams, Kenneth C; Scott, Ken

2006-01-01

After the 1991 Gulf War, veterans of the conflict from the United States, United Kingdom, Canada, Australia and other nations described chronic idiopathic symptoms that became popularly known as ‘Gulf War Syndrome’. Nearly 15 years later, some 250 million dollars in United States medical research has failed to confirm a novel war-related syndrome and controversy over the existence and causes of idiopathic physical symptoms has persisted. Wartime exposures implicated as possible causes of subsequent symptoms include oil well fire smoke, infectious diseases, vaccines, chemical and biological warfare agents, depleted uranium munitions and post-traumatic stress disorder. Recent historical analyses have identified controversial idiopathic symptom syndromes associated with nearly every modern war, suggesting that war typically sets into motion interrelated physical, emotional and fiscal consequences for veterans and for society. We anticipate future controversial war syndromes and maintain that a population-based approach to care can mitigate their impact. This paper delineates essential features of the model, describes its public health and scientific underpinnings and details how several countries are trying to implement it. With troops returning from combat in Afghanistan, Iraq and elsewhere, the model is already getting put to the test. PMID:16687273

Managing future Gulf War Syndromes: international lessons and new models of care.

PubMed

Engel, Charles C; Hyams, Kenneth C; Scott, Ken

2006-04-29

After the 1991 Gulf War, veterans of the conflict from the United States, United Kingdom, Canada, Australia and other nations described chronic idiopathic symptoms that became popularly known as 'Gulf War Syndrome'. Nearly 15 years later, some 250 million dollars in United States medical research has failed to confirm a novel war-related syndrome and controversy over the existence and causes of idiopathic physical symptoms has persisted. Wartime exposures implicated as possible causes of subsequent symptoms include oil well fire smoke, infectious diseases, vaccines, chemical and biological warfare agents, depleted uranium munitions and post-traumatic stress disorder. Recent historical analyses have identified controversial idiopathic symptom syndromes associated with nearly every modern war, suggesting that war typically sets into motion interrelated physical, emotional and fiscal consequences for veterans and for society. We anticipate future controversial war syndromes and maintain that a population-based approach to care can mitigate their impact. This paper delineates essential features of the model, describes its public health and scientific underpinnings and details how several countries are trying to implement it. With troops returning from combat in Afghanistan, Iraq and elsewhere, the model is already getting put to the test.

Musculoskeletal Injuries in Iraq and Afghanistan: Epidemiology and Outcomes Following a Decade of War.

PubMed

Belmont, Philip J; Owens, Brett D; Schoenfeld, Andrew J

2016-06-01

The combined wars in Afghanistan and Iraq represent the longest ongoing conflicts in American military history, with a combined casualty estimate of >59,000 service members. The nature of combat over the last decade has led to precipitous increases in severe orthopaedic injuries, including traumatic amputations and injuries to the spine. Nearly 75% of all injuries sustained in combat now are caused by explosive mechanisms, and fractures comprise 40% of all musculoskeletal injuries. Injuries to the axial skeleton are more frequent among personnel exposed to combat, and spinal trauma is identified in nearly 40% of those killed. Musculoskeletal injuries are expensive and generate some of the highest rates of long-term disability. Noncombat musculoskeletal injuries are endemic within deployed military service members and occur at a greater than threefold rate compared with combat musculoskeletal injuries. Service members with musculoskeletal injuries or behavioral health conditions, such as posttraumatic stress disorder, depression, and psychosis, and those occupying a low socioeconomic status, have an increased risk of inferior outcomes.

Microvascular reconstructive surgery in Operations Iraqi and Enduring Freedom: the US military experience performing free flaps in a combat zone.

PubMed

Klem, Christopher; Sniezek, Joseph C; Moore, Brian; Davis, Michael R; Coppit, George; Schmalbach, Cecelia

2013-08-01

Local nationals with complex wounds resulting from traumatic combat injuries during Operations Iraqi Freedom and Enduring Freedom usually must undergo reconstructive surgery in the combat zone. While the use of microvascular free-tissue transfer (free flaps) for traumatic reconstruction is well documented in the literature, various complicating factors exist when these intricate surgical procedures are performed in a theater of war. The microvascular experiences of six military surgeons deployed during a 30-month period between 2006 and 2011 in Iraq and Afghanistan were retrospectively reviewed. Twenty-nine patients presented with complex traumatic wounds. Thirty-one free flaps were performed for the 29 patients. Location of tissue defects included the lower extremity (15), face/neck (8), upper extremity (6). Limb salvage was successful in all but one patient. Six of eight patients with head and neck wounds were tolerating oral intake at the time of discharge. There were three flap losses in 3 patients; two patients who experienced flap loss underwent a successful second free or regional flap. Minor complications occurred in six patients. Microvascular free tissue transfer for complex tissue defects in a combat zone is a critically important task and can improve quality of life for host-nation patients. Major US combat hospitals deployed to a war zone should include personnel who are trained and capable of performing these complex reconstructive procedures and who understand the many nuances of optimizing outcomes in this challenging environment.

Challenges in war-related thoracic injury faced by French military surgeons in Afghanistan (2009-2013).

PubMed

de Lesquen, Henri; Beranger, Fabien; Berbis, Julie; Boddaert, Guillaume; Poichotte, Antoine; Pons, Francois; Avaro, Jean-Philippe

2016-09-01

This study reports the challenges faced by French military surgeons in the management of thoracic injury during the latest Afghanistan war. From January 2009 to April 2013, all of the civilian, French and Coalition casualties admitted to French NATO Combat Support Hospital situated on Kabul were prospectively recorded in the French Military Health Service Registry (OPEX(®)). Only penetrating and blunt thoracic trauma patients were retrospectively included. Eighty-nine casualties were included who were mainly civilian (61%) and men (94%) with a mean age of 27.9 years old. Surgeons dealt with polytraumas (78%), severe injuries (mean Injury Severity Score=39.2) and penetrating wounds (96%) due to explosion in 37%, gunshot in 53% and stabbing in 9%. Most of casualties were first observed or drained (n=56). In this non-operative group more than 40% of casualties needed further actions. In the operative group, Damage Control Thoracotomy (n=22) was performed to stop ongoing bleeding and air leakage and Emergency Department Thoracotomy (n=11) for agonal patient. Casualties suffered from hemothorax (60%), pneumothorax (39%), diaphragmatic (37%), lung (35%), heart or great vessels (20%) injuries. The main actions were diaphragmatic sutures (n=25), lung resections (wedge n=6, lobectomy n=4) and haemostasis (intercostal artery ligation n=3, heart injury repairs n=5, great vessels injury repairs n=5). Overall mortality was 11%. The rate of subsequent surgery was 34%. The analysis of the OPEX(®) registry reflects the thoracic surgical challenges of general (visceral) surgeons serving in combat environment during the latest Afghanistan War. Copyright © 2016 Elsevier Ltd. All rights reserved.

Combat stressors and post-traumatic stress in deployed military healthcare professionals: an integrative review.

PubMed

Gibbons, Susanne W; Hickling, Edward J; Watts, Dorraine D

2012-01-01

  While there has been a growing body of literature on the impact of combat stressors and post-traumatic stress on military service members involved in current conflicts, there has been little available information that directly examines the impact of these on healthcare providers. Aims for this integrative review included: (1) identifying exposures, experiences and other factors influencing stress responses in military healthcare providers previously engaged in a war effort and (2) describing the incidence of post-traumatic stress and related mental health problems in this population. Using Cooper's integrative review method, relevant documents were collected and analysed using content categories and a coding scheme to assist with identifying and recording data for units of analysis. Literature searches (including all years to present) were conducted using keywords for stress reaction, for healthcare provider and for military war effort involvement. Literature was obtained using the Cumulative Index to Nursing and Allied Health Literature, the National Library of Medicine and the American Psychological Association databases. Evidence suggests that similar to military combatants, military healthcare provider exposure to life-threatening situations will increase the probability of adverse psychological disorders following these traumatic experiences. The presence of a strong sense of meaning and purpose, within a supportive environment appear to help mediate the impact of these dangerous and stressful events. Results of this review and other supporting literature indicate the need for a systematic approach to studying combat stress and post-traumatic stress in deployed healthcare providers. © 2011 Blackwell Publishing Ltd.

Musculoskeletal injuries in Homer's Iliad: the War of Troy revisited.

PubMed

Kömürcü, Erkam; Tok, Fatih; Simşek, Ayşe; Ozçakar, Levent

2014-04-01

Homer's Iliad--the most famous and influential epic poem--has been previously reviewed with respect to head, craniomaxillofacial, neck, thoracic, and hand injuries in the literature. However, to the best of the authors' knowledge, there are no data regarding musculoskeletal injuries. This article describes the musculoskeletal injuries that had ensued during the war of Troy. The Turkish translation of the original epic poem Iliad was reviewed for musculoskeletal injuries, that is, their descriptions, outcome, the weapons used, and the engaged warriors. Extremity injuries were evaluated as regards the affected bones. The pertinent treatment methods were also recorded. In total, 103 musculoskeletal injuries were detected during 81 combats. The most commonly involved areas were the shoulder (15.5%), the head (14.5%), the cervical vertebrae (14.5%), and the thoracic vertebrae (8.7%). The weapons used were spear (n = 52); sword (n = 9); arrow (n = 9); stone (n = 8); and cane, animal, the hand, Chariot race, and broken yoke (n = 1 for each). Fifty-four combats (66.6%) resulted in death. Therapeutic herbs, compound of milk, and essence of fig were used as treatment alternatives. While providing a historic snapshot on the war of Troy, in this article, the authors have reviewed the musculoskeletal injuries and their management in those ancient times. Despite the long period in between, unfortunately, physicians/surgeons are still faced with war injuries in current medical practice. The authors strongly hope that, at least in the near future, physicians will be left with only natural health problems and without those artificially generated by human beings.

Mechanical, physical, and physiological analysis of symmetrical and asymmetrical combat.

PubMed

Clemente-Suárez, Vicente J; Robles-Pérez, José J

2013-09-01

In current theaters of operation, soldiers had to face a different situation as symmetrical (defined battlefield) and asymmetrical combat (non-defined battlefield), especially in urban areas. The mechanical and organic responses of soldiers in these combats are poorly studied in specific literature. This research aimed to analyze physical, mechanical, and physiological parameters during symmetrical and asymmetrical combat simulations. We analyzed 20 soldiers from the Spanish Army and Spanish Forces and Security Corps (34.5 ± 4.2 years; 176.4 ± 8.4 cm; 74.6 ± 8.7 kg; 63.3 ± 8.0 kg muscular mass; 7.6 ± 3.2 kg fat mass) during a symmetric combat (traditional combat simulation) and during an asymmetrical combat (urban combat simulation). Heart rate (HR), speed, sprints, distances, impact, and body load parameters were measured by a GPS system and a HR belt. Results showed many differences between symmetrical and asymmetrical combat. Asymmetrical combat presented higher maximum velocity movement, number of sprints, sprint distance, and average HR. By contrary, symmetric combat presented higher number of impact and body load. This information could be used to improve specific training programs for each type of combat.

The long-term implications of war captivity for mortality and health.

PubMed

Solomon, Zahava; Greene, Talya; Ein-Dor, Tsachi; Zerach, Gadi; Benyamini, Yael; Ohry, Avi

2014-10-01

The current study aims to (1) assess the long-term impact of war captivity on mortality and various health aspects and (2) evaluate the potential mediating role of posttraumatic stress disorder (PTSD) and depressive symptoms. Israeli ex-prisoners of war (ex-POWs) (N = 154) and a matched control group of combat veterans (N = 161) were assessed on health conditions and self-rated health 18 years post-war (1991: T1). The whole population of ex-POWs, and the T1 sample of controls were then contacted 35 years after the war (2008: T2), and invited to participate in a second wave of measurement (ex-POWs: N = 171; controls: N = 116) Captivity was implicated in premature mortality, more health-related conditions and worse self-rated health. PTSD and depressive symptoms mediated the relationship between war captivity and self-rated health, and partially mediated the relationship between war captivity and health conditions, and these effects were amplified with age. Aging ex-POWs who develop psychiatric symptomatology should be considered a high-risk group entering a high-risk period in the life cycle. It is important to monitor ex-POWs and provide them with appropriate medical and psychological treatment as they age.

Display integration for ground combat vehicles

NASA Astrophysics Data System (ADS)

Busse, David J.

1998-09-01

The United States Army's requirement to employ high resolution target acquisition sensors and information warfare to increase its dominance over enemy forces has led to the need to integrate advanced display devices into ground combat vehicle crew stations. The Army's force structure require the integration of advanced displays on both existing and emerging ground combat vehicle systems. The fielding of second generation target acquisition sensors, color digital terrain maps and high volume digital command and control information networks on these platforms define display performance requirements. The greatest challenge facing the system integrator is the development and integration of advanced displays that meet operational, vehicle and human computer interface performance requirements for the ground combat vehicle fleet. The subject of this paper is to address those challenges: operational and vehicle performance, non-soldier centric crew station configurations, display performance limitations related to human computer interfaces and vehicle physical environments, display technology limitations and the Department of Defense (DOD) acquisition reform initiatives. How the ground combat vehicle Program Manager and system integrator are addressing these challenges are discussed through the integration of displays on fielded, current and future close combat vehicle applications.

Small Wars 2.0: A Working Paper on Land Force Planning After Iraq and Afghanistan

DTIC Science & Technology

2011-02-01

official examination of future ground combat demands that look genetically distinct from those undertaken in the name of the WoT. The concept of...under the worst-case rubric but for very different reasons. The latter are small wars. However, that by no means aptly describes their size

Posttraumatic stress disorder, combat exposure, and carotid intima-media thickness in male twins.

PubMed

Goetz, Margarethe; Shah, Amit; Goldberg, Jack; Cheema, Faiz; Shallenberger, Lucy; Murrah, Nancy V; Bremner, J Douglas; Vaccarino, Viola

2014-11-15

Posttraumatic stress disorder (PTSD) is associated with an increased risk of ischemic heart disease, though the pathophysiologic mechanisms remain unclear. Carotid artery intima-media thickness (CIMT) is a measure of subclinical atherosclerosis. We examined whether PTSD and combat exposure were associated with CIMT in Vietnam War-era twins after controlling for shared genetic and childhood factors. Between 2002 and 2010, we studied 465 middle-aged twins from the Vietnam Era Twin Registry who were free from cardiovascular disease. PTSD was diagnosed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and CIMT was measured by ultrasound. Mixed-effects regression models were used to examine individual, between-pair, and within-pair associations. Approximately 13% of participants met the criteria for PTSD, and 45% served in the Vietnam Theater. PTSD was associated with 32.7 μm higher CIMT (95% confidence interval (CI): 0.9, 64.5) after adjustment for confounders. The average CIMT for the pair increased by 59.7 μm for each additional twin with PTSD (95% CI: 15.9, 104.2). We found no significant within-pair differences in CIMT when comparing PTSD-discordant co-twins. Results for combat exposure were similar, but its association with CIMT weakened after adjustment for PTSD (95% CI: 7.0, 45.3). Among Vietnam War-era veterans, combat exposure and PTSD are associated with CIMT, though the associations are largely mediated by shared childhood factors. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Epigenetic alterations of the BDNF gene in combat-related post-traumatic stress disorder.

PubMed

Kim, T Y; Kim, S J; Chung, H G; Choi, J H; Kim, S H; Kang, J I

2017-02-01

Brain-derived neurotrophic factor (BDNF) plays a crucial role in modulating resilience and vulnerability to stress. The aim of this study was to investigate whether epigenetic regulation of the BDNF gene is a biomarker of post-traumatic stress disorder (PTSD) development among veterans exposed to combat in the Vietnam War. Using the Clinician-Administered PTSD Scale, combat veterans were grouped into those with (n = 126) and without (n = 122) PTSD. DNA methylation levels at four CpG sites within the BDNF promoter I region were quantified in the peripheral blood using pyrosequencing. The effects of BDNF DNA methylation levels and clinical variables on the diagnosis of PTSD were tested using binary logistic regression analysis. Subjects with PTSD showed a higher DNA methylation of four CpG sites at the BDNF promoter compared with those without PTSD. High methylation levels at the BDNF promoter CpG site, high combat exposure, and alcohol problems were significantly associated with PTSD diagnosis. This study demonstrated an association between higher DNA methylation of the BDNF promoter and PTSD diagnosis in combat-exposed individuals. Our findings suggest that altered BDNF methylation may be a valuable biomarker of PTSD after trauma exposure. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Long-term effects of conflict-related sexual violence compared with non-sexual war trauma in female World War II survivors: a matched pairs study.

PubMed

Kuwert, Philipp; Glaesmer, Heide; Eichhorn, Svenja; Grundke, Elena; Pietrzak, Robert H; Freyberger, Harald J; Klauer, Thomas

2014-08-01

The aim of the study was to compare the long-term effects of conflict-related sexual violence experienced at the end of World War II (WWII) with non-sexual WWII trauma (e.g., being exposed to shell shock or physical violence). A total of 27 elderly wartime rape survivors were compared to age- and gender-matched control subjects who were drawn from a larger sample of subjects over 70 years of age who had experienced WWII-related trauma. A modified version of the Posttraumatic Diagnostic Scale was used to assess trauma characteristics and posttraumatic stress disorder (PTSD) symptoms and the Brief Symptom Inventory-18 was used to assess current psychopathology. Additionally, measures of posttraumatic growth (Posttraumatic Growth Inventory) and social acknowledgement as a trauma survivor (Social Acknowledgement Questionnaire) were used to assess two mediating variables in post-trauma conditions of rape victims. Women exposed to conflict-related sexual violence reported greater severity of PTSD-related avoidance and hyperarousal symptoms, as well as anxiety, compared with female long-term survivors of non-sexual WWII trauma. The vast majority (80.9 %) of these women also reported severe sexual problems during their lifetimes relative to 19.0 % of women who experienced non-sexual war trauma. Women exposed to conflict-related sexual violence also reported greater posttraumatic growth, but less social acknowledgement as trauma survivors, compared to survivors of non-sexual war trauma. The results were consistent with emerging neurobiological research, which suggests that different traumas may be differentially associated with long-term posttraumatic sequelae in sexual assault survivors than in other survivor groups and highlights the need to treat (or better prevent) deleterious effects of conflict-related sexual violence in current worldwide crisis zones.

Governing the grapevine: the study of rumor during World War II.

PubMed

Faye, Cathy

2007-02-01

Throughout the early 1940s, a host of rumors relating to the Second World War began to circulate, leading the government to establish various committees and undertake multiple projects intended to counteract rumors that were believed to threaten civilian morale and compromise national security. Simultaneously, social scientists also began taking measures to study and combat rumor. Such efforts included the institution of several community groups, deemed "rumor clinics," that aimed to decrease the prevalence of wartime rumor by educating the general public. This article outlines the rise and fall of rumor clinics, focusing specifically on the shifting boundaries and the mounting tensions between the United States government and social scientists in the study of rumor during World War II.

Deployment stressors of the Iraq War: insights from the mainstream media.

PubMed

La Bash, Heidi A J; Vogt, Dawne S; King, Lynda A; King, Daniel W

2009-02-01

A comprehensive understanding of the stressors of the Iraq War is needed to ensure appropriate postdeployment assessments and to inform empirical inquiries. Yet we are unaware of any published studies that address the range of stressors experienced by this cohort. Thus, in the present study, we report the results of an interpretive literature review of mainstream media reports published from the beginning of the Iraq War in March 2003 to March 2005. This literature revealed a combination of stressors associated with traditional combat, insurgency warfare, and peacekeeping operations. The increasing deployment of National Guard/Reservist personnel, older soldiers, and women highlights additional stressors associated with sexual harassment and assault, preparedness and training, and life and family disruptions. This is a cause for concern as war-zone stressors have been implicated in postdeployment health outcomes, including intimate partner violence and child maltreatment, immediate physical and mental health, and long-term adjustment.

Bodily matters above and below ground: the treatment of American remains from the Korean War.

PubMed

Keene, Judith

2010-02-01

Throughout most of the twentieth century, depending on the capabilities of the military mortuary services and the time limits set by government, the bodies of the American fallen in foreign wars have been repatriated home to their families. In the Korean War the conditions of combat posed large challenges to the recovery and returns of bodily remains. Almost half a century after that conflict, the American missing in Korea have become significant players within the government's expanding efforts that were prompted in answer to demands to locate American soldiers who remain unaccounted for from the Vietnam War. The essay traces the background to U.S. military mortuary services and the operation in the Korean War and in the subsequent joint expeditions in North Korea. The analysis concludes that in most of these ventures the outlay of resources has produced few remains.

Cumulative trauma and midlife well-being in American women who served in Vietnam: effects of combat exposure and postdeployment social support.

PubMed

Park, Crystal L; Wachen, Jennifer Schuster; Kaiser, Anica Pless; Mager Stellman, Jeanne

2015-01-01

Research increasingly demonstrates that trauma exposure can have cumulative effects, yet much remains to be learned about effects of cumulative trauma, particularly regarding longer term adjustment. One such trauma, combat exposure, is insufficiently understood, especially for women, who are increasingly engaged in professional combat activities. The study comprised a cross-sectional survey assessing multiple aspects of current well-being in women approximately 25 years after their service in Vietnam during the Vietnam War. Participants were 1374 women (78% military and 22% nonmilitary; mean age = 59.7). This study investigated the relations between three separate categories of trauma exposure (childhood, adulthood, and combat) and well-being and examined whether perceived social support at return from Vietnam moderated the association between combat exposure and well-being. While both childhood and adulthood trauma exposure related to midlife well-being, combat exposure still uniquely predicted outcomes. Further, postdeployment perceived social support moderated the association of combat and well-being: recollected higher perceived social support at homecoming buffered participants from the links between combat exposure and well-being. These results may have important implications for interventions to reduce the impact of traumatic experiences, particularly in light of the increasing exposure of women to direct combat events.

Suicide among war veterans.

PubMed

Rozanov, Vsevolod; Carli, Vladimir

2012-07-01

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.

Suicide among War Veterans

PubMed Central

Rozanov, Vsevolod; Carli, Vladimir

2012-01-01

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

Utilizing Telehealth to Support Treatment of Acute Stress Disorder in a Theater of War: Prolonged Exposure via Clinical Videoconferencing.

PubMed

Pelton, Dan; Wangelin, Bethany; Tuerk, Peter

2015-05-01

Posttraumatic stress disorder (PTSD) and acute stress disorder are prevalent mental health diagnoses associated with the military operations in Iraq and Afghanistan and are especially significant in service members returning from combat. Prolonged exposure (PE) therapy is a highly effective behavioral treatment for these symptoms, and providing this treatment as soon as possible, even in the midst of a soldier's combat deployment, has strong potential benefits. In the current case study, telehealth technology was used to support the delivery of PE therapy to treat a service member diagnosed with acute stress disorder in a war zone. PE was conducted face-to-face on the relatively secure Forward Operating Base for the first half of therapy and via clinical videoconferencing (CV) to the service member's remote combat outpost during the later stages of therapy. The service member exhibited marked improvements in symptoms over 10 sessions. Results are consistent with previous empirical findings and highlight the potential benefits of using telehealth to deliver evidenced-based treatment for traumatic stress disorders in a war zone. This case study provides a preliminary working model for delivering PE in a combat environment using multiple delivery systems. Benefits and clinical utility of CV-delivered exposure therapy are discussed, particularly for providers pending future operational deployments (e.g., including members of the military, independent government agencies, and first responders) and for those treating patients in remote locations.

Tactical Combat Casualty Care in the Canadian Forces: lessons learned from the Afghan war

PubMed Central

Savage, Erin; Forestier, Colleen; Withers, Nicholas; Tien, Homer; Pannell, Dylan

2011-01-01

Tactical Combat Casualty Care (TCCC) is intended to treat potentially preventable causes of death on the battlefield, but acknowledges that application of these treatments may place the provider and even the mission in jeopardy if performed at the wrong time. Therefore, TCCC classifies the tactical situation with respect to health care provision into 3 phases (care under fire, tactical field care and tactical evacuation) and only permits certain interventions to be performed in specific phases based on the danger to the provider and casualty. In the 6 years that the Canadian Forces (CF) have been involved in sustained combat operations in Kandahar, Afghanistan, more than 1000 CF members have been injured and more than 150 have been killed. As a result, the CF gained substantial experience delivering TCCC to wounded soldiers on the battlefield. The purpose of this paper is to review the principles of TCCC and some of the lessons learned about battlefield trauma care during this conflict. PMID:22099324

Combat casualty care: the Alpha Surgical Company experience during Operation Iraqi Freedom.

PubMed

Marshall, Thomas J

2005-06-01

Operation Iraqi Freedom was the first large-scale combat operation involving the U.S. Marine Corps since the Persian Gulf War in 1991. Data from a combat surgical company are presented. Records of all U.S. and Iraqi combat casualties admitted to the surgical company were reviewed. Fifty-three (57%) of 93 patients suffered penetrating injuries. Most wounds were produced by high-explosive munitions (mines, hand grenades, and rocket-propelled grenades), and the majority (51%) of wounds were to the extremities. The time to surgical care averaged 4.7 hours (range, 1.5-48 hours), and 98% of the patients seen at our facility survived. The time from injury to surgical care was considered long by civilian standards; however, this did not appear to affect outcomes substantially. A small percentage (5.2%) of injuries were to the torso. Hypothermia was commonly present. Because of the nature of their wounds, all patients required additional surgery after evacuation to rear area facilities. The outcomes of individual patients are not known, although it is known that only one Marine died after reaching medical care and, to date, no Marines have subsequently died of their wounds.

Wars and Suicides in Israel, 1948–2006

PubMed Central

Oron (Ostre), Israel

2012-01-01

This paper reports the characteristics of suicides which occurred during the existential and the non-existential wars in Israel. It provides a first approximation of whether the suicide patterns in each war are consistent with the findings of Morselli and Durkheim, and whether their theoretical interpretations can serve as a preliminary guideline to explaining the Israeli case, which is characterized by short periods of war, social integration during some of the non-existential wars, and a sharp rise in post-war male suicide rates following all of the existential wars. Implications for further studies on the subject in Israel and elsewhere are discussed. PMID:22754482

[Military psychiatry in Israel: a 50-year perspective].

PubMed

Bleich, A

2000-05-01

The history of military psychiatry in Israel may be divided into 2 main periods. The first extended from the War of Independence in 1948, through the Sinai, Six Day and Yom Kippur Wars. Its outstanding feature was avoidance of the issue of combat stress reaction (CSR). The Yom Kippur War made the recognition of CSR inescapable, assisted in breaking up denial, and served as a stimulus for development of the next phase of the system. This second phase was characterized by impressive progress in all areas of military psychiatry. The rich experience accumulated during the wars, together with the assimilation of a research culture which began blooming, especially in the wake of the Lebanon War, aided the development and crystallization of concepts related to combat and non-combat military psychiatry alike. The build-up of the mental health organization overlapped field deployment of the Medical Corps.

Chromosome aberration analysis in peripheral lymphocytes of Gulf War and Balkans War veterans.

PubMed

Schröder, H; Heimers, A; Frentzel-Beyme, R; Schott, A; Hoffmann, W

2003-01-01

Chromosome aberrations and sister chromatid exchanges (SCEs) were determined in standard peripheral lymphocyte metaphase preparations of 13 British Gulf War veterans, two veterans of the recent war in the Balkans and one veteran of both wars. All 16 volunteers suspect exposures to depleted uranium (DU) while deployed at the two different theatres of war in 1990 and later on. The Bremen laboratory control served as a reference in this study. Compared with this control there was a statistically significant increase in the frequency of dicentric chromosomes (dic) and centric ring chromosomes (cR) in the veterans' group. indicating a previous exposure to ionising radiation. The statistically significant overdispersion of die and cR indicates non-uniform irradiation as would be expected after non-uniform exposure and/or exposure to radiation with a high linear energy transfer (LET). The frequency of SCEs was decreased when compared with the laboratory control.

Prolonged Exposure Therapy for Combat-Related Posttraumatic Stress Disorder: Comparing Outcomes for Veterans of Different Wars

PubMed Central

Yoder, Matthew; Tuerk, Peter W.; Price, Matthew; Grubaugh, Anouk L.; Strachan, Martha; Myrick, Hugh; Acierno, Ron

2012-01-01

There is significant support for exposure therapy as an effective treatment for posttraumatic stress disorder (PTSD) across a variety of populations, including veterans; however, there is little empirical information regarding how veterans of different war theaters respond to exposure therapy. Accordingly, questions remain regarding therapy effectiveness for treatment of PTSD for veterans of different eras. Such questions have important implications for the dissemination of evidence based treatments, treatment development, and policy. The current study compared treatment outcomes across 112 veterans of the Vietnam War, the first Persian Gulf War, and the wars in Afghanistan and Iraq. All subjects were diagnosed with PTSD and enrolled in Prolonged Exposure (PE) treatment. Veterans from all three groups showed significant improvement in PTSD symptoms, with veterans from Vietnam and Afghanistan/Iraq responding similarly to treatment. Persian Gulf veterans did not respond to treatment at the same rate or to the same degree as veterans from the other two eras. Questions and issues regarding the effectiveness of evidence based treatment for veterans from different eras are discussed. PMID:22449084

Prolonged exposure therapy for combat-related posttraumatic stress disorder: comparing outcomes for veterans of different wars.

PubMed

Yoder, Matthew; Tuerk, Peter W; Price, Matthew; Grubaugh, Anouk L; Strachan, Martha; Myrick, Hugh; Acierno, Ron

2012-02-01

There is significant support for exposure therapy as an effective treatment for posttraumatic stress disorder (PTSD) across a variety of populations, including veterans; however, there is little empirical information regarding how veterans of different war theaters respond to exposure therapy. Accordingly, questions remain regarding therapy effectiveness for treatment of PTSD for veterans of different eras. Such questions have important implications for the dissemination of evidence based treatments, treatment development, and policy. The current study compared treatment outcomes across 112 veterans of the Vietnam War, the first Persian Gulf War, and the wars in Afghanistan and Iraq. All subjects were diagnosed with PTSD and enrolled in prolonged exposure (PE) treatment. Veterans from all three groups showed significant improvement in PTSD symptoms, with veterans from Vietnam and Afghanistan/Iraq responding similarly to treatment. Persian Gulf veterans did not respond to treatment at the same rate or to the same degree as veterans from the other two eras. Questions and issues regarding the effectiveness of evidence based treatment for veterans from different eras are discussed.

The neurological manifestations of trauma: lessons from World War I.

PubMed

Linden, Stefanie C; Hess, Volker; Jones, Edgar

2012-04-01

Changes in the clinical presentation of functional disorders and the influence of social and cultural factors can be investigated through the historical case notes from mental hospitals. World War I (WWI) was a potent trigger of functional disorders with neurological or psychiatric symptoms. We analysed 100 randomly selected case files of German servicemen admitted to the Department of Psychiatry of the Charité Medical School of Berlin University during WWI and classified them according to contemporaneous and retrospective modern diagnoses. We compared the clinical presentations with accounts in the German and British medical literature of the time. Most patients obtained the contemporaneous diagnosis of 'psychopathic constitution' or hysteria reflecting the general view of German psychiatrists that not the war but an individual predisposition was the basis for the development of symptoms. The clinical picture was dominated by pseudoneurological motor or sensory symptoms as well as pseudoseizures. Some soldiers relived combat experiences in dream-like dissociative states that partly resemble modern-day post-traumatic stress disorder. Most servicemen were classified as unfit for military service but very few of them were granted compensation. Severe functional disorders of a neurological character could develop even without traumatic exposure in combat, which is of interest for the current debate on triggers of stress disorders. The high incidence of pseudoseizures accords with the psychiatric literature of the time and contrasts with accounts of war-related disorders in Britain. The tendency of German psychiatrists not to send traumatised servicemen back to active duty also distinguished between German and British practice. Our data contribute to the debate on the changing patterns of human responses to traumatic experience and their historical and social context.

Simulation Tool for Optimizing Non-Combatant Evacuation (STONE): Optimization of Evacuation Time and Transportation Resource Utilization

DTIC Science & Technology

2015-05-01

2015 © Sa Majesté la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2015 Abstract A Non-Combatant Evacuation...Standing Senate Committee on Foreign Affairs and International Trade recommended that more frequent assessments of NEO plans be conducted...étrangères et du commerce international a recommandé que des évaluations dans ses missions à l’étranger soient faites plus fréquemment

Firing a Weapon and Killing In Combat Are Associated with Suicidal Ideation in OEF/OIF Veterans

PubMed Central

Tripp, Jessica C.; McDevitt-Murphy, Meghan E.; Henschel, Aisling V.

2016-01-01

Objective Combat veterans are at risk for several adverse outcomes such as posttraumatic stress disorder (PTSD), depression, hazardous alcohol use, and most critically, suicidal behaviors. The high rate of suicide in veterans has been understood as a correlate of PTSD and depression, but it is possible that certain specific types of combat experiences may lead to suicidal behaviors. Acts committed by the veteran in the context of war such as killing may evoke a “moral injury,” which leads to thoughts of ending one’s life. Method The present exploratory research examined relationships between combat experiences and suicidal ideation (SI) and PTSD in a sample of 68 OEF/OIF veterans (91% male, mean age = 32.31 years) who had screened positive for alcohol misuse. We examined firing a weapon/killing in combat (Firing/Killing) and killing in combat (Killing) alone as predictors of (SI) and PTSD severity in both the full sample, and in analyses that examined men only. Results Firing/Killing were associated with SI for the full sample and men only, and Killing showed a trend towards significance in predicting SI. Hierarchical regression analyses suggested that Firing/Killing did not predict PTSD for the full sample or men only, but Killing was predictive of PTSD for both samples. Conclusions These results indicate that there may be differences in Firing/Killing and Killing alone in OEF/OIF veterans who screened positive for alcohol misuse. Thorough screening of combat experiences and addressing moral injury in returning combat veterans may help reduce high rates of suicide and PTSD. PMID:26460495

Deterrence from Cold War to Long War: Lessons from Six Decades of RAND Research

DTIC Science & Technology

2008-01-01

highly credible intention. Declaring an intention to retaliate for an attack on U.S. territory was no threat in Schelling’s formulation ; it was a...unconditional commitments are not rational . We shall say 14 Deterrence—From Cold War to Long War that they represent a non- rational element in...this method is impractical. Another strategy that Schelling discussed was embracing non- rationality and simply giving the impression that U.S

[Medecine, Law, and Knowledge Production about the "Civilized" War in the Long 19th Century].

PubMed

Goltermann, Svenja

2015-01-01

The aim to 'civilize' warfare accompanied Medicine and International Law ever since the mid-19th century. However, the entanglement of Medicine and Law, crucial for such an endeavour, has not been taken into consideration so far; likewise, the huge importance of medical knowledge for the perception of wars and their ramifications did not garner much attention in historical research. Hence, by focusing on the 'long' 19th century, this paper shows, firstly, that the production of surgical knowledge during warfare aimed at measuring the effects of combat on human bodies in order to develop prognostic medical knowledge for future wars, as well as maintaining the combat strength of soldiers. Moreover, this knowledge production during warfare strived for the enhancement of medical competence in the diagnosis and treatment of wounds in general. Secondly, I show that this medical knowledge was not only relevant for warfare, but also crucial for the design of International Law: it served to nourish the debates among the so called 'civilized' nations about legitimate and illegitimate weaponry and warfare.

Breast cancer incidence in food- vs non-food-producing areas in Norway: possible beneficial effects of World War II

PubMed Central

Robsahm, T E; Tretli, S

2002-01-01

It has been suggested that World War II influenced breast cancer risk among Norwegian women by affecting adolescent growth. Diet changed substantially during the war, and the reduction in energy intake was assumed to be larger in non-food- producing than in food-producing municipalities. In the present study, we have looked at the influence of residential history in areas with and without food production on the incidence of breast cancer in a population-based cohort study consisting of 597 906 women aged between 30 and 64 years. The study included 7311 cases of breast cancer, diagnosed between 1964 and 1992. The risk estimates were calculated using a Poisson regression model. The results suggest that residential history may influence the risk of breast cancer, where the suggested advantageous effect of World War II seems to be larger in non-food-producing than in food-producing areas. Breast cancer incidence was observed to decline for the post-war cohorts, which is discussed in relation to diet. British Journal of Cancer (2002) 86, 362–366. DOI: 10.1038/sj/bjc/6600084 www.bjcancer.com © 2002 The Cancer Research Campaign PMID:11875700

Reading, Trauma and Literary Caregiving 1914-1918: Helen Mary Gaskell and the War Library.

PubMed

Haslam, Sara

2018-03-28

This article is about the relationship between reading, trauma and responsive literary caregiving in Britain during the First World War. Its analysis of two little-known documents describing the history of the War Library, begun by Helen Mary Gaskell in 1914, exposes a gap in the scholarship of war-time reading; generates a new narrative of "how," "when," and "why" books went to war; and foregrounds gender in its analysis of the historiography. The Library of Congress's T. W. Koch discovered Gaskell's ground-breaking work in 1917 and reported its successes to the American Library Association. The British Times also covered Gaskell's library, yet researchers working on reading during the war have routinely neglected her distinct model and method, skewing the research base on war-time reading and its association with trauma and caregiving. In the article's second half, a literary case study of a popular war novel demonstrates the extent of the "bitter cry for books." The success of Gaskell's intervention is examined alongside H. G. Wells's representation of textual healing. Reading is shown to offer sick, traumatized and recovering combatants emotional and psychological caregiving in ways that she could not always have predicted and that are not visible in the literary/historical record.

Girls and war: an extra vulnerability.

PubMed

Black, M

1998-01-01

It is no longer possible to consider the raping of girls as an isolated atrocity of war. In Uganda, guerrilla forces have kidnapped 6000-10,000 children and have forced the "most desirable" girls to become "wives" of warlords. Girls who manage to escape are deeply traumatized and suffer ill health as well as possible social ostracism. In refugee camps, recognition that adolescent girls face special risks of rape and of engaging in the informal prostitution that may expose them to HIV/AIDS has led to the introduction of new measures to increase female security. Families in refugee camps in Burundi and Somalia protect female honor by submitting their daughters to very early marriage, which also abuses the girls' rights. Girls conscripted to military groups are forced to transport materials, cook, or help loot villages. In conditions of war, even girls who remain at home protected by their families must assume extra responsibilities, especially if men go off to fight leaving women with the agricultural and livestock burdens. Girls will be the first children withdrawn from school to help keep the household afloat. Girls and women are also expected to tend those wounded by the very war that destroys the health care services that are vital to meet women's reproductive needs. Efforts are being made to identify rape as a specific war crime, and these efforts should be extended to the kidnapping and forced recruitment of children into combat roles. Moral codes must be reestablished, even if they are only nominal at present.

A confirmatory factor analysis of the Impact of Event Scale using a sample of World War II and Korean War veterans.

PubMed

Shevlin, M; Hunt, N; Robbins, I

2000-12-01

This study assessed the factor structure of the Impact of Event Scale (IES), a measure of intrusion and avoidance, using a sample of World War II and Korean War veterans who had experienced combat 40-50 years earlier. A series of 3 confirmatory factor analytic models were specified and estimated using LISREL 8.3. Model 1 specified a 1-factor model. Model 2 specified a correlated 2-factor model. Model 3 specified a 2-factor model with additional cross-factor loadings for Items 2 and 12. Model 3 was found to fit the data. In addition, this model was found to be a better explanation of the data than the other models. Also in addition, the correlations between the Intrusion and Avoidance factors and the 4 subscales of the 28-item General Health Questionnaire were examined to determine the distinctiveness of the two IES factors.

Impact of Prehospital Medical Evacuation (MEDEVAC) Transport Time on Combat Mortality in Patients with Non-Compressible Torso Injury and Traumatic Amputations

DTIC Science & Technology

2018-12-28

MED EV AC) transport time on combat mortality in patients with non-compressible torso injury and traumatic amputations Sb. GRANT NUMBER Sc. PROGRAM...increased morbidity and mortality. Limited data exists on the influence of transport time on patient outcomes with specific injury types. The...treatment facility on morbidity and mortality in casualties with traumatic extremity amputation and non-compressible torso injury (NCTI). Methods: We

Posttraumatic symptoms, marital intimacy, dyadic adjustment, and sexual satisfaction among ex-prisoners of war.

PubMed

Zerach, Gadi; Anat, Ben-David; Solomon, Zahava; Heruti, Rafi

2010-08-01

The aversive impact of combat and combat-induced posttraumatic stress disorder (PTSD) on marital intimacy and sexual satisfaction has been examined in several studies. Nevertheless, the toll of war captivity on marital intimacy in relation to dyadic adjustment and sexual satisfaction remains unknown. In particular, the mediating role of marital intimacy in the relationship between PTSD symptoms and dyadic adjustment and between PTSD symptoms and sexual satisfaction has not yet been systematically explored thus far. Aims.  This study aimed to examine the interrelationships of PTSD symptoms, dyadic adjustment, sexual satisfaction, and marital intimacy among ex-prisoners of war (ex-POWs). A sample of Israeli veterans ex-POWs (ex-POWs: N = 105) from the 1973 Yom Kippur War and a matched comparison group of veterans who participated in the same war but were not held captive (control: N = 94) were compared in the study variables. The PTSD inventory, dyadic adjustment scale, index of sexual satisfaction, and capacity for intimacy questionnaire. Results.  Findings revealed that ex-POWs reported higher levels of PTSD symptoms and lower levels of dyadic adjustment and sexual satisfaction than comparable controls. There were also differences between the groups in the pattern of relations between PTSD symptoms, dyadic adjustment, sexual satisfaction, and marital intimacy. Finally, for ex-POWs, marital intimacy partially mediated the relationships between PTSD symptoms and dyadic adjustment and sexual satisfaction outcome measures. PTSD symptoms are implicated in marital problems of ex-POWs. A significant relationship was found between the traumatized ex-POW's capacity for intimacy and both their sexual satisfaction and dyadic adjustment. © 2010 International Society for Sexual Medicine.

Management of colonic injuries in the combat theater.

PubMed

Cho, S David; Kiraly, Laszlo N; Flaherty, Stephen F; Herzig, Daniel O; Lu, Kim C; Schreiber, Martin A

2010-05-01

Combat injuries are more often associated with blast, penetrating, and high-energy mechanisms than civilian trauma, generating controversy about the management of combat colonic injury. Despite implementation of mandatory colostomy in World War II, recent civilian data suggest that primary repair without diversion is safe and feasible. This study describes the modern management of battle-related colonic injuries and seeks to determine whether management strategy affects early complications. Records from the combat theater (downrange) and tertiary referral center in Germany were retrospectively reviewed from 2005 to 2006. Patient characteristics, management strategy, treatment course, and early complications were recorded. Comparison groups by management strategy were as follows: primary repair, diversion, and damage control. A total of 133 (97% male) patients sustained colonic injuries from penetrating (71%), blunt (5%), and blast (23%) mechanisms. Average injury severity score was 21 and length of stay in the referral center was 7.1 days. Injury distribution was 21% ascending, 21% descending, 15% transverse, 27% sigmoid, and 25% rectum. Downrange complications for primary repair, initial ostomy, and damage control groups were 14%, 15%, and 30%, respectively. On discharge from the center, 62% of patients had undergone a diversion. The complication rate was 18% overall and was unrelated to management strategy (P = .16). Multivariate analysis did not identify independent predictors of complications. Early complications were similar by mechanism, anatomic location, severity of injury, and management strategy. More diversions were performed for rectosigmoid injury. Good surgical judgment allows for low morbidity and supports primary repair in selected cases. Damage control surgery is effective in a multinational theater of operations.

13 CFR 120.431 - Which Lenders may sell, sell participations in, or pledge 7(a) loans?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Which Lenders may sell, sell participations in, or pledge 7(a) loans? 120.431 Section 120.431 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Lenders Other Conveyances § 120.431 Which Lenders may sell, sell participations in...

13 CFR 120.431 - Which Lenders may sell, sell participations in, or pledge 7(a) loans?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false Which Lenders may sell, sell participations in, or pledge 7(a) loans? 120.431 Section 120.431 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Lenders Other Conveyances § 120.431 Which Lenders may sell, sell participations in...

Famous head injuries of the first aerial war: deaths of the "Knights of the Air".

PubMed

Koul, Prateeka; Mau, Christine; Sabourin, Victor M; Gandhi, Chirag D; Prestigiacomo, Charles J

2015-07-01

World War I advanced the development of aviation from the concept of flight to the use of aircraft on the battlefield. Fighter planes advanced technologically as the war progressed. Fighter pilot aces Francesco Baracca and Manfred von Richthofen (the Red Baron) were two of the most famous pilots of this time period. These courageous fighter aces skillfully maneuvered their SPAD and Albatros planes, respectively, while battling enemies and scoring aerial victories that contributed to the course of the war. The media thrilled the public with their depictions of the heroic feats of fighter pilots such as Baracca and the Red Baron. Despite their aerial prowess, both pilots would eventually be shot down in combat. Although the accounts of their deaths are debated, it is undeniable that both were victims of traumatic head injury.

Combat Experience and Mental Health in the Israel National Health Survey.

PubMed

Lubin, Gadi; Barash, Igor; Levinson, Daphna

2016-01-01

To compare the mental health status of those who participated in combat related activities during their service with that of soldiers whose army service did not include combat related activities Method: A representative sample extracted from the National Population Register of non-institutionalized residents aged 21 or older of Israel was used in this crosssectional survey. Data on mental health disorders, sociodemographic background and army service were collected using face-to-face computer-assisted interviews. Combat experience per se was not associated with lifetime diagnosis of PTSD. Former combat soldiers had significantly lower lifetime prevalence and 12 months prevalence of any mood or anxiety disorders including PTSD. This work is in line with previous literature showing that combat exposure, as such, has limited contribution to lifetime PTSD in some groups of veterans. The inverse relationship between combat exposure and PTSD might be explained by the selection of potential combatants among all recruits and by the heightened preparedness to military life stressors.

The Integration of the Naval Unmanned Combat Aerial System (N-UCAS) into the Future Naval Air Wing

DTIC Science & Technology

2009-12-01

5 Table 1. Aircraft Combat Radius from World War II (WWII) Through 1990s6 Period  Airframe  Distance  WW2   F6F  400nm     TBF  400nm     SB2C...override the computers, take control, and guide his two bombs to target by infrared video imagery. Otherwise, our auto piloted computer was programmed

Combat games

NASA Technical Reports Server (NTRS)

Ardema, M. D.; Heymann, M.; Rajan, N.

1985-01-01

A mathematical formulation is proposed of a combat game between two opponents with offensive capabilities and offensive objective is proposed. Resolution of the combat involves solving two differential games with state constraints. Depending on the game dynamics and parameters, the combat can terminate in one of four ways: the first player wins; the second player wins; a draw (neither wins); or joint capture. In the first two cases, the optimal strategies of the two players are determined from suitable zero-sum games, whereas in the latter two the relevant games are nonzero-sum. Further, to avoid certain technical difficulties, the concept of a delta-combat game is introduced.

Understanding combat casualty care statistics.

PubMed

Holcomb, John B; Stansbury, Lynn G; Champion, Howard R; Wade, Charles; Bellamy, Ronald F

2006-02-01

Maintaining good hospital records during military conflicts can provide medical personnel and researchers with feedback to rapidly adjust treatment strategies and improve outcomes. But to convert the resulting raw data into meaningful conclusions requires clear terminology and well thought out equations, utilizing consistent numerators and denominators. Our objective was to arrive at terminology and equations that would produce the best insight into the effectiveness of care at different stages of treatment, either pre or post medical treatment facility care. We first clarified three essential terms: 1) the case fatality rate (CFR) as percentage of fatalities among all wounded; 2) killed in action (KIA) as percentage of immediate deaths among all seriously injured (not returning to duty); and 3) died of wounds (DOW) as percentage of deaths following admission to a medical treatment facility among all seriously injured (not returning to duty). These equations were then applied consistently across data from the WWII, Vietnam and the current Global War on Terrorism. Using this clear set of definitions we used the equations to ask two basic questions: What is the overall lethality of the battlefield? How effective is combat casualty care? To answer these questions with current data, the three services have collaboratively created a joint theater trauma registry (JTTR), cataloging all the serious injuries, procedures, and outcomes for the current war. These definitions and equations, consistently applied to the JTTR, will allow meaningful comparisons and help direct future research and appropriate application of personnel.

Implications of the World Trade Organization in combating non-communicable diseases.

PubMed

Mitchell, A; Voon, T

2011-12-01

The World Health Organization (WHO) has proposed a number of strategies to combat non-communicable diseases such as cancers, cardiovascular diseases, chronic respiratory diseases and diabetes by targeting the risk factors of tobacco use, harmful use of alcohol and poor diet. A number of the domestic regulatory responses contemplated by WHO and individual countries have the potential to restrict or distort trade, raising the question of whether they are consistent with the obligations imposed on Members of the World Trade Organization (WTO). This article demonstrates that WTO rules do limit Members' flexibility in implementing public health measures to address these diseases. However, the focus of WTO provisions on preventing discrimination against or between imports and the exceptions incorporated in various WTO agreements leave sufficient scope for Members to design carefully directed measures to achieve genuine public health goals while minimizing negative effects on international trade. Copyright © 2011 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Insects as weapons of war, terror, and torture.

PubMed

Lockwood, Jeffrey A

2012-01-01

For thousands of years insects have been incorporated into human conflict, with the goals of inflicting pain, destroying food, and transmitting pathogens. Early methods used insects as "found" weapons, functioning as tactical arms (e.g., hurled nests) or in strategic habitats (e.g., mosquito-infested swamps). In the twentieth century the relationship between insects and disease was exploited; vectors were mass-produced to efficiently deliver pathogens to an enemy. The two most sophisticated programs were those of the Japanese in World War II with plague-infected fleas and cholera-coated flies and of the Americans during the Cold War with yellow fever-infected mosquitoes. With continued advances, defenses in the form of insecticides and vaccines meant that insects were no longer considered as battlefield weapons. However, in recent times sociopolitical changes have put insects back into the realm of human conflict through asymmetrical conflicts pitting combatants from nonindustrialized regions against forces from militarily and economically superior nations. Copyright © 2012 by Annual Reviews. All rights reserved.

Combat musculoskeletal wounds in a US Army Brigade Combat Team during operation Iraqi Freedom.

PubMed

Belmont, Philip J; Thomas, Dimitri; Goodman, Gens P; Schoenfeld, Andrew J; Zacchilli, Michael; Burks, Rob; Owens, Brett D

2011-07-01

A prospective, longitudinal analysis of musculoskeletal combat injuries sustained by a large combat-deployed maneuver unit has not previously been performed. A detailed description of the musculoskeletal combat casualty care statistics, distribution of wounds, and mechanisms of injury incurred by a US Army Brigade Combat Team during "The Surge" phase of Operation Iraqi Freedom was performed using a centralized casualty database and an electronic medical record system. Among the 4,122 soldiers deployed, there were 242 musculoskeletal combat wounds in 176 combat casualties. The musculoskeletal combat casualty rate for the Brigade Combat Team was 34.2 per 1,000 soldier combat-years. Spine, pelvis, and long bone fractures comprised 55.9% (33 of 59) of the total fractures sustained in combat. Explosions accounted for 80.7% (142 of 176) of all musculoskeletal combat casualties. Musculoskeletal combat casualty wound incidence rates per 1,000 combat-years were as follows: major amputation, 2.1; minor amputation, 0.6; open fracture, 5.0; closed fracture, 6.4; and soft-tissue/neurovascular injury, 32.8. Among musculoskeletal combat casualties, the likelihood of a gunshot wound causing an open fracture was significantly greater (45.8% [11 of 24]) when compared with explosions (10.6% [15 of 142]) (p = 0.0006). Long bone amputations were more often caused by explosive mechanisms than gunshot wounds. A large burden of complex orthopedic injuries has resulted from the combat experience in Operation Iraqi Freedom. This is because of increased enemy reliance on explosive devices, the use of individual and vehicular body armor, and improved survivability of combat-injured soldiers.

Chronic pain management in the active-duty military

NASA Astrophysics Data System (ADS)

Jamison, David; Cohen, Steven P.

2012-06-01

As in the general population, chronic pain is a prevalent and burdensome affliction in active-duty military personnel. Painful conditions in military members can be categorized broadly in terms of whether they arise directly from combat injuries (gunshot, fragmentation wound, blast impact) or whether they result from non-combat injuries (sprains, herniated discs, motor vehicle accidents). Both combat-related and non-combat-related causes of pain can further be classified as either acute or chronic. Here we discuss the state of pain management as it relates to the military population in both deployed and non-deployed settings. The term non-battle injury (NBI) is commonly used to refer to those conditions not directly associated with the combat actions of war. In the history of warfare, NBI have far outstripped battle-related injuries in terms not only of morbidity, but also mortality. It was not until improvements in health care and field medicine were applied in World War I that battle-related deaths finally outnumbered those attributed to disease and pestilence. However, NBI have been the leading cause of morbidity and hospital admission in every major conflict since the Korean War. Pain remains a leading cause of presentation to military medical facilities, both in and out of theater. The absence of pain services is associated with a low return-to-duty rate among the deployed population. The most common pain complaints involve the low-back and neck, and studies have suggested that earlier treatment is associated with more significant improvement and a higher return to duty rate. It is recognized that military medicine is often at the forefront of medical innovation, and that many fields of medicine have reaped benefit from the conduct of war.

The Realities of War: Assessing the Operational Risk of Revoking the Combat Exclusion Policy

DTIC Science & Technology

2013-05-23

Grenade RSOI Reception , Staging, and Onward Integration SEAD Suppression of Enemy Air Defenses SOF Special Operations Forces vii TAA Tactical Assembly...Diego Garcia[,] brought rations, cots, tents, blankets, and medical supplies, as well as refrigerated trailers , reverse-osmosis water- purification...78 In all, Desert Dragon II enabled the reception , staging, and onward integration (RSOI) of such a significant amount of combat power that the

Proposals for chemical weapons during the American Civil War.

PubMed

Hasegawa, Guy R

2008-05-01

Proposals for chemical weapons that arose during the American Civil War are described. Most incendiary and all biological agents are excluded. The described proposals appeared primarily in periodicals or letters to government officials on both sides. The weapons were usually meant to temporarily disable enemy combatants, but some might have been lethal, and Civil War caregivers were ill-prepared to deal with the weapons' effects. Evidently, none of the proposed weapons were used. In only one instance was use against civilians mentioned. Among the agents most commonly proposed were cayenne pepper or other plant-based irritants such as black pepper, snuff, mustard, and veratria. Other suggested agents included chloroform, chlorine, hydrogen cyanide, arsenic compounds, sulfur, and acids. Proponents usually suggested that the chemicals be included in explosive artillery projectiles. Less commonly proposed vehicles of delivery included fire engines, kites, and manned balloons. Some of the proposed weapons have modern counterparts.

The Utility and Consequences of Using Impressed Child Soldiers in Africa’s Contemporary Wars

DTIC Science & Technology

2000-04-01

AU/ACSC/090/2000-04 AIR COMMAND AND STAFF COLLEGE AIR UNIVERSITY THE UTILITY AND CONSEQUENCES OF USING IMPRESSED CHILD SOLDIERS IN AFRICA’S...4. TITLE AND SUBTITLE The Utility and Consequences of Using Impressed Child Soldiers in Africa’s Contemporary Wars 5a. CONTRACT NUMBER 5b...VII THE NEW ERA OF THE CHILD SOLDIERS IN AFRICA’S COMBAT ZONES.......................1

31 CFR 363.140 - May a zero-percent certificate of indebtedness be pledged or used as collateral?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance: Treasury 2 2014-07-01 2014-07-01 false May a zero-percent certificate of... SERVICE REGULATIONS GOVERNING SECURITIES HELD IN TREASURYDIRECT Zero-Percent Certificate of Indebtedness General § 363.140 May a zero-percent certificate of indebtedness be pledged or used as collateral? A zero...

31 CFR 363.140 - May a zero-percent certificate of indebtedness be pledged or used as collateral?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance:Treasury 2 2013-07-01 2013-07-01 false May a zero-percent certificate of... DEBT REGULATIONS GOVERNING SECURITIES HELD IN TREASURYDIRECT Zero-Percent Certificate of Indebtedness General § 363.140 May a zero-percent certificate of indebtedness be pledged or used as collateral? A zero...

31 CFR 363.140 - May a zero-percent certificate of indebtedness be pledged or used as collateral?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 2 2011-07-01 2011-07-01 false May a zero-percent certificate of... DEBT REGULATIONS GOVERNING SECURITIES HELD IN TREASURYDIRECT Zero-Percent Certificate of Indebtedness General § 363.140 May a zero-percent certificate of indebtedness be pledged or used as collateral? A zero...

31 CFR 363.140 - May a zero-percent certificate of indebtedness be pledged or used as collateral?

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance:Treasury 2 2012-07-01 2012-07-01 false May a zero-percent certificate of... DEBT REGULATIONS GOVERNING SECURITIES HELD IN TREASURYDIRECT Zero-Percent Certificate of Indebtedness General § 363.140 May a zero-percent certificate of indebtedness be pledged or used as collateral? A zero...

Estimating Outcomes and Consequences of Interstate Wars.

DTIC Science & Technology

1977-02-01

way to evaluate the real effectiveness of governments. Techniques for appraising the performance of national economies cannot be applied to the... outcome of any total but non-nuclear war. The four conflicts analyzed in this study are: (1) The wars between the Arabs and Israelis. (2) The war

Reporting Iraqi civilian fatalities in a time of war

PubMed Central

2009-01-01

Background In February, 2007, the Associated Press (AP) conducted a poll of 1,002 adults in the United States about their attitudes towards the war in Iraq. Respondents were remarkably accurate estimating the current death toll of US soldiers, yet were grossly inaccurate in estimating the current death toll of Iraqi civilians. We conducted a search of newspapers reports to determine the extent of the discrepancy between reporting Coalition and Iraqi civilian deaths, hypothesizing that there would be an over-representation of Coalition deaths compared to Iraqi civilian deaths. Methods We examined 11 U.S. newspapers and 5 non-U.S. newspapers using electronic databases or newspaper web-archives, to record any reports between March 2003 and March 2008 of Coalition and Iraqi deaths that included a numeric indicator. Reports were described as "events" where they described a specific occurrence involving fatalities and "tallies" when they mentioned the number of deaths over a period of time. We recorded the number of events and tallies related to Coalition deaths, Iraqi civilian deaths, and Iraqi combatant deaths Results U.S. newspapers report more events and tallies related to Coalition deaths than Iraqi civilian deaths, although there are substantially different proportions amongst the different U.S. newspapers. In four of the five non-US newspapers, the pattern was reversed. Conclusion This difference in reporting trends may partly explain the discrepancy in how well people are informed about U.S. and Iraqi civilian fatalities in Iraq. Furthermore, this calls into question the role of the media in reporting and sustaining armed conflict, and the extent to which newspaper and other media reports can be used as data to assess fatalities or trends in the time of war. PMID:19895676

These Honored Dead: The Battle of Rivers Bridge and Civil War Combat Casualties. Teaching with Historic Places.

ERIC Educational Resources Information Center

Bell, Dan

Encountering the U.S. Civil War on a smaller, human scale makes the conflict more approachable, vivid, and real. Rivers Bridge State Historic Site (South Carolina) offers a glimpse of the Civil War on such a scale. The small area allows visitors to comprehend the entire battlefield, its tactics, and to see how veteran troops near the end of the…

The Financial War on Terrorism: Grading U.S. Strategy for Combating the Financing of Terrorism

DTIC Science & Technology

2006-04-15

15 April 2006 Signature______________________________ Thesis Advisor: CAPTAIN Dave Jerabek, US Navy Report Documentation...activities to combat terrorist financing, this thesis proposes how DoD can use threat finance exploitation to meaningfully support the overall...of Terrorism FORMAT: Thesis DATE: 14 April 2006 PAGES: 94 CLASSIFICATION: Unclassified Following the September 11, 2001, attacks

[The struggle against malaria in the Ottoman Empire during World War I and the legal regulations made to this end].

PubMed

Koylu, Zafer; Doğan, Nihal

2010-01-01

One of the most important disadvantages of war environmental is infectious diseases. The Ottoman Empire combated infectious diseases in addition to the war because of Balkan wars and afterwards first world war. Because of increasing migrations to Anatolia after Balkan wars spread some epidemic diseases, such as cholera, typhoid fever, plaque, dysentery, syphilis. With the start of the First World War, malaria began to spread within civilian population as well as the military. The population fell from power because of illness and therefore could not process the land tax failed to pay taxes. Founded in 1914 with the fight against epidemic diseases was initiated by the Sıhhiye ministry. Quinine was formed as tablets which was imported from Germany by legal regulation and was distributed to the public by Ziraat Bank. However, malaria epidemic could not be prevented because of long war years, lack of population, insufficiency of the preventive methods and lack of quinine, and about three quarters of the population caught malaria and in four years 412.000 soldiers had malaria and 20.000 of them died despite of measures.

Comorbidity of PTSD and depression in Korean War veterans: prevalence, predictors, and impairment.

PubMed

Ikin, Jillian F; Creamer, Mark C; Sim, Malcolm R; McKenzie, Dean P

2010-09-01

Rates of PTSD and depression are high in Korean War veterans. The prevalence and impact of the two disorders occurring comorbidly, however, has not been investigated. This paper aims to investigate the extent to which PTSD and depression co-occur in Australian veterans of the Korean War, the symptom severity characteristics of comorbidity, the impact on life satisfaction and quality, and the association with war-related predictors. Veterans (N=5352) completed self-report questionnaires including the Posttraumatic Stress Disorder Checklist, the Hospital Anxiety and Depression Scale, the Life Satisfaction Scale, the brief World Health Organisation Quality of Life questionnaire and the Combat Exposure Scale. Seventeen percent of veterans met criteria for comorbid PTSD and depression, 15% had PTSD without depression, and a further 6% had depression without PTSD. Compared with either disorder alone, comorbidity was associated with impaired life satisfaction, reduced quality of life, and greater symptom severity. Several war-related factors were associated with comorbidity and with PTSD alone, but not with depression alone. The reliance on self-reported measures and the necessity for retrospective assessment of some deployment-related factors renders some study data vulnerable to recall bias. Comorbid PTSD and depression, and PTSD alone, are prevalent among Korean War veterans, are both associated with war-related factors 50 years after the Korean War, and may represent a single traumatic stress construct. The results have important implications for understanding complex psychopathology following trauma. 2010 Elsevier B.V. All rights reserved.

Cross (Unit)-Level Effects of Cohesion on Relationships of Suicide Thoughts to Combat Exposure, Postdeployment Stressors, and Postdeployment Social Support.

PubMed

Griffith, James

2015-01-01

A behavioral health concern for the US military has been suicide, largely due to its increased prevalence in the last several years during US involvement in the Iraq and Afghanistan wars. Using hierarchical linear modeling (HLM), the present study examined relationships among combat exposure, postdeployment stressors, social support, and unit cohesion. Survey data were obtained from 4,567 soldiers who were members of 50 company-sized units. At the individual level, combat exposure and postdeployment stressors were associated with suicidal thoughts. Postdeployment social support was associated with fewer suicidal thoughts. There was no evidence of the stress-buffering effect of social support. At the group level, reduced risk for suicidal thoughts was associated with units having higher than average cohesion. Reduced risk for suicidal thoughts in conjunction with combat experiences was observed in units having higher than average cohesion, though not reaching a traditional level of statistical significance.

Soviet Night Operations in World War II (Leavenworth Papers, Number 6)

DTIC Science & Technology

1982-12-01

German forces in the Crimea. The battle for the bridgehead began on 1 October, pitting six and a half German divisions against three Soviet armies...FaLd of Berlin, pp, 147-51; Chaney, Zkukov, p. 312; Sukhinin, “Combat Action,” p, 52. 49 62. Vasily Yezhakov, “The Berlin Operation,” Soviet Military...August 1980. Werth, Alexander. Russia at War, 1941-1945. New York: E. P. Dutton and co., 1964. Yezhakov, Vasily . ‘“The Berlin Operation.” Soviet

United States Army Rangers in Somalia: an analysis of combat casualties on an urban battlefield.

PubMed

Mabry, R L; Holcomb, J B; Baker, A M; Cloonan, C C; Uhorchak, J M; Perkins, D E; Canfield, A J; Hagmann, J H

2000-09-01

This study was undertaken to determined the differences in injury patterns between soldiers equipped with modern body armor in an urban environment compared with the soldiers of the Vietnam War. From July 1998 to March 1999, data were collected for a retrospective analysis on all combat casualties sustained by United States military forces in Mogadishu, Somalia, on October 3 and 4, 1993. This was the largest and most recent urban battle involving United States ground forces since the Vietnam War. There were 125 combat casualties. Casualty distribution was similar to that of Vietnam; 11% died on the battlefield, 3% died after reaching a medical facility, 47% were evacuated, and 39% returned to duty. The incidence of bullet wounds in Somalia was higher than in Vietnam (55% vs. 30%), whereas there were fewer fragment injuries (31% vs. 48%). Blunt injury (12%) and burns (2%) caused the remaining injuries in Somalia. Fatal penetrating injuries in Somalia compared with Vietnam included wounds to the head and face (36% vs. 35%), neck (7% vs. 8%), thorax (14% vs. 39%), abdomen (14% vs. 7%), thoracoabdominal (7% vs. 2%), pelvis (14% vs. 2%), and extremities (7% vs. 7%). No missiles penetrated the solid armor plate protecting the combatants' anterior chests and upper abdomens. Most fatal penetrating injuries were caused by missiles entering through areas not protected by body armor, such as the face, neck, pelvis, and groin. Three patients with penetrating abdominal wounds died from exsanguination, and two of these three died after damage-control procedures. The incidence of fatal head wounds was similar to that in Vietnam in spite of modern Kevlar helmets. Body armor reduced the number of fatal penetrating chest injuries. Penetrating wounds to the unprotected face, groin, and pelvis caused significant mortality. These data may be used to design improved body armor.

The American Home Front: Revolutionary War, Civil War, World War I, World War II

DTIC Science & Technology

1983-01-01

ledgm ents ................................................... xvii WAR AND SOCIETY IN AMERICA: SOME QUESTIONS ..... I 1. THE AMERICAN REVOLUTION 5 The...Price of War ...................................... 6 A Revolutionary Society at War ............................ 8 The Revolutionary Economy...obilizing the Union for War .................................... 67 Civil War and American Society . ................................ 71 O rganizing the

Improved survival in UK combat casualties from Iraq and Afghanistan: 2003-2012.

PubMed

Penn-Barwell, Jowan G; Roberts, Stuart A G; Midwinter, Mark J; Bishop, Jon R B

2015-05-01

The United Kingdom was at war in Iraq and Afghanistan for more than a decade. Despite assertions regarding advances in military trauma care during these wars, thus far, no studies have examined survival in UK troops during this sustained period of combat. The aims of this study were to examine temporal changes of injury patterns defined by body region and survival in a population of UK Military casualties between 2003 and 2012 in Iraq and Afghanistan. The UK Military Joint Theatre Trauma Registry was searched for all UK Military casualties (survivors and fatalities) sustained on operations between January 1, 2003, and December 31, 2012. The New Injury Severity Score (NISS) was used to stratify injury severity. There were 2,792 UK Military casualties sustaining 14,252 separate injuries during the study period. There were 608 fatalities (22% of all casualties). Approximately 70% of casualties injured in hostile action resulted from explosive munitions. The extremities were the most commonly injured body region, involved in 43% of all injuries. The NISS associated with a 50% chance of survival rose each year from 32 in 2003 to 60 in 2012. An improvement in survival during the 10-year period is demonstrated. A majority of wounds are a result of explosive munitions, and the extremities are the most commonly affected body region. The authors recommend the development of more sophisticated techniques for the measuring of the performance of combat casualty care systems to include measures of morbidity and functional recovery as well as survival. Epidemiologic study, level III.

Ten years and 100,000 participants later: occupational and other factors influencing participation in US Gulf War health registries.

PubMed

Smith, Tyler C; Smith, Besa; Ryan, Margaret A K; Gray, Gregory C; Hooper, Tomoko I; Heller, Jack M; Dalager, Nancy A; Kang, Han K; Gackstetter, Gary D

2002-08-01

For more than a decade after the Gulf War, there has been concern that wartime exposures have resulted in significant morbidity among Gulf War veterans. After the end of the war, the Department of Veterans Affairs (VA) and the Department of Defense (DoD) initiated health registries to provide systematic clinical evaluations of Gulf War veterans who chose to participate. By September 1999, there were 32,876 participants in the DoD Comprehensive Clinical Evaluation Program and 70,385 participants in the VA Gulf War Registry Health Examination Program. We identified demographic and military service factors, as well as potential war-related exposures associated with subsequent registry participation after 10 years of observation. Veterans potentially exposed to oil well fire smoke, those near Khamisiyah, Reserve and National Guard, Army veterans, and veterans in the theater of operations during intense combat periods were most likely to elect to participate in a registry. These findings support the hypothesis that certain occupational factors and wartime exposures may influence subsequent health care-seeking behavior.

War-related extremity injuries in children: 89 cases managed in a combat support hospital in Afghanistan.

PubMed

Bertani, A; Mathieu, L; Dahan, J-L; Launay, F; Rongiéras, F; Rigal, S

2015-05-01

Meeting paediatric needs is among the priorities of western healthcare providers working in Afghanistan. Insufficient information is available on paediatric wartime injuries to the extremities. Our objective here was to describe these injuries and their management on the field. We retrospectively reviewed consecutive cases of injuries to the extremities in children (< 16 years of age) due to weapons and managed at the Kabul International Airport (KaIA) Combat Support Hospital between June 2009 and April 2013. We identified 89 patients with a mean age of 10.2 ± 3.5 years and a total of 137 elemental lesions. Explosive devices accounted for most injuries (78.6%) and carried a significantly higher risk of multiple lesions. There were 54 bone lesions (traumatic amputations and fractures) and 83 soft-tissue lesions. The amputation rate was 18%. Presence of bone lesions was associated with a higher risk of injury to blood vessels and nerves. Of the 89 patients, four (4.5%) died and eight (9%) were transferred elsewhere. Of the 77 remaining patients, at last follow-up (median, one month; range, 0.1-16 months), 73 (95%) had achieved a full recovery (healed wound and/or fracture) or were recovering with no expectation that further surgery would be needed. Despite the absence of paediatric surgeons, the combat support hospital provided appropriate care at the limb salvage and reconstruction phases. The highly specialised treatments needed to manage sequelae were very rarely provided. These treatments probably deserve to be developed in combat support hospitals. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

PARAMETERS, U.S. Army War College Quarterly. Volume 23, Number 1, Spring 1993

DTIC Science & Technology

1993-01-01

did join~armies and-fightdid so disguised as mfen, aiid- when discovered -were- usually -su munarily discharged-. A handful of such cases are --known...including somne during -the American Revolution =and the Civil-War. On the-offher hand -, women have-always taken~partin- rebellions -and...actually -handled rifles or threw hand -grenades was-very small. I -amunaware-of a -single Israeli- woman- who-has claimed; "I was in combat- in 1948-. I

Constant Character, Changing Nature: The Transformation of the Hollywood War Film, From 1949 - 1989

DTIC Science & Technology

2013-04-16

German. In September of 1941, a special Senate subcommittee was formed to investigate Hollywood film propaganda. Once the Japanese attacked Pearl...the patriotic World War II film would no longer suffice with audiences who were treated to a more realistic depiction of warfare in the cinema of the...late seventies. In 1978, three years after the fall of Saigon, the first Vietnam combat films were released to cinemas throughout the United

Task Force Butler: A Case Study in the Employment of an Ad Hoc Unit in Combat Operations, During Operation Dragoon, 1-30 August 1944

DTIC Science & Technology

2007-12-14

13 It was not until 2 July 1944, that General Sir Henry Maitland Wilson, the Supreme Allied Commander, Mediterranean Theater, was ordered to launch...John. I Remember, Stories of a Combat Infantrymen in World War II. Livermore: Camino Press, 1993. Summer, Ian . The French Army 1939-45 (1). Men-at

Evaluation of Why the Air Force Dedicated Personnel Recovery Mission Should Remain with Air Combat Command

DTIC Science & Technology

2016-03-01

Many of the tactics still in use today were tested and executed in combat during the Vietnam War. One of the major benefits that resulted from...AFSOF to support the planning for Project Honey Badger, the re-attempt at recovering the hostages in Iran.43 Project Honey Badger would eventually be...14 scrapped as the hostages would be released in early 1981. The damage for the ARRS had been done. Even with the termination of Project Honey

A Theoretical Study of the Hidden Wounds of War: Disenfranchised Grief and the Impact on Nursing Practice

PubMed Central

Aloi, Janice A.

2011-01-01

Combat veterans face enormous challenges upon the return to civilian life, one of which is the ability to integrate incidences of death and killing into a healthy postdeployment life. This paper presents the lived experience of grief and loss resulting from the trauma of war. Social constructionist theory, due to its emphasis on meaning-making, serves as the theoretical framework. The effects of inhibited mourning due to the inability to mourn in combat and lack of nurturing upon returning home are described. Personal excerpts derived from interviews of warfare from veterans that experienced death and killing are presented. It is suggested that combat veterans experience a unique form of grief and therefore require a style of grieving that differs from those that have not served on the battlefield. Regardless of the point of care, nurses are positioned to help with the challenges of readjustment. A better understanding of combat veterans as a disenfranchised group would enable nurses to intervene in ways that contribute to the readjustment process. PMID:22007331

Suicide Ideation and Deliberate Self-Harm among Ex-Prisoners of War.

PubMed

Levi-Belz, Yossi; Zerach, Gadi; Solomon, Zahava

2015-01-01

The current study aims to assess the relations among war captivity, PTSD, suicidal ideation (SI), and deliberate self-harm (DSH) among former prisoners of war (ex-POWs). Israeli ex-POWs (N = 176) and a matched control group of combat veterans (controls; N = 118) were assessed using self-report measures. Ex-POWs with PTSD reported higher levels of both SI and DSH compared to ex-POWs and comparable veterans without PTSD. Furthermore, captivity-related variables as well as PTSD symptom clusters were positively related to both SI and DSH. However, only loss of emotional control in captivity and posttraumatic intrusion and emotional numbing symptoms, predicted SI. Ex-POWs with PTSD endorse high levels of SI and DSH. Among ex-POWs, both SI and DSH share similar captivity-related and posttraumatic symptoms correlates but only posttraumatic intrusion and emotional numbing symptoms predict SI.

Analysis of Orthopaedic Research Produced During the Wars in Iraq and Afghanistan.

PubMed

Balazs, George C; Dickens, Jonathan F; Brelin, Alaina M; Wolfe, Jared A; Rue, John-Paul H; Potter, Benjamin K

2015-09-01

Military orthopaedic surgeons have published a substantial amount of original research based on our care of combat-wounded service members and related studies during the wars in Iraq and Afghanistan. However, to our knowledge, the influence of this body of work has not been evaluated bibliometrically, and doing so is important to determine the modern impact of combat casualty research in the wider medical community. We sought to identify the 20 most commonly cited works from military surgeons published during the Iraq and Afghanistan conflicts and analyze them to answer the following questions: (1) What were the subject areas of these 20 articles and what was the 2013 Impact Factor of each journal that published them? (2) How many citations did they receive and what were the characteristics of the journals that cited them? (3) Do the citation analysis results obtained from Google Scholar mirror the results obtained from Thompson-Reuters' Web of Science? We searched the Web of Science Citation Index Expanded for relevant original research performed by US military orthopaedic surgeons related to Operation Iraqi Freedom and Operation Enduring Freedom between 2001 and 2014. Articles citing these studies were reviewed using both Web of Science and Google Scholar data. The 20 most cited articles meeting inclusion criteria were identified and analyzed by content domain, frequency of citation, and sources in which they were cited. Nine of these studies examined the epidemiology and outcome of combat injury. Six studies dealt with wound management, wound dehiscence, and formation of heterotopic ossification. Five studies examined infectious complications of combat trauma. The median number of citations garnered by these 20 articles was 41 (range, 28-264) in Web of Science. Other research citing these studies has appeared in 279 different journals, covering 26 different medical and surgical subspecialties, from authors in 31 different countries. Google Scholar contained 97

Examining the Prospective Effects of Making a Virginity Pledge among Males across Their 4 Years of College

ERIC Educational Resources Information Center

Williams, Samantha; Thompson, Martie P.

2013-01-01

Objectives: The authors examined prospective associations of making a virginity pledge on sexual behaviors among male college students. Participants: A sample of 795 males was followed for 4 years (2008, 2009, 2010, 2011), with response rates ranging from 72% to 82% across the follow-up years. Methods: Males were surveyed at the end of each of…

Is there an Iraq war syndrome? Comparison of the health of UK service personnel after the Gulf and Iraq wars.

PubMed

Horn, Oded; Hull, Lisa; Jones, Margaret; Murphy, Dominic; Browne, Tess; Fear, Nicola T; Hotopf, Matthew; Rona, Roberto J; Wessely, Simon

2006-05-27

UK armed forces personnel who took part in the 1991 Gulf war experienced an increase in symptomatic ill health, colloquially known as Gulf war syndrome. Speculation about an Iraq war syndrome has already started. We compared the health of male regular UK armed forces personnel deployed to Iraq during the 2003 war (n=3642) with that of their colleagues who were not deployed (n=4295), and compared these findings with those from our previous survey after the 1991 war. Data were obtained by questionnaire. Graphs comparing frequencies of 50 non-specific symptoms in the past month in deployed and non-deployed groups did not show an increase in prevalence of symptoms equivalent to that observed after the Gulf war. For the Iraq war survey, odds ratios (ORs) for self-reported symptoms ranged from 0.8 to 1.3. Five symptoms were significantly increased, and two decreased, in deployed individuals, whereas prevalence greatly increased for all symptoms in the Gulf war study (ORs 1.9-3.9). Fatigue was not increased after the 2003 Iraq war (OR 1.08; 95% CI 0.98-1.19) but was greatly increased after the 1991 Gulf war (3.39; 3.00-3.83). Personnel deployed to the Gulf war were more likely (2.00, 1.70-2.35) than those not deployed to report their health as fair or poor; no such effect was found for the Iraq war (0.94, 0.82-1.09). Increases in common symptoms in the 2003 Iraq war group were slight, and no pattern suggestive of a new syndrome was present. We consider several explanations for these differences.

Architecture for an integrated real-time air combat and sensor network simulation

NASA Astrophysics Data System (ADS)

Criswell, Evans A.; Rushing, John; Lin, Hong; Graves, Sara

2007-04-01

An architecture for an integrated air combat and sensor network simulation is presented. The architecture integrates two components: a parallel real-time sensor fusion and target tracking simulation, and an air combat simulation. By integrating these two simulations, it becomes possible to experiment with scenarios in which one or both sides in a battle have very large numbers of primitive passive sensors, and to assess the likely effects of those sensors on the outcome of the battle. Modern Air Power is a real-time theater-level air combat simulation that is currently being used as a part of the USAF Air and Space Basic Course (ASBC). The simulation includes a variety of scenarios from the Vietnam war to the present day, and also includes several hypothetical future scenarios. Modern Air Power includes a scenario editor, an order of battle editor, and full AI customization features that make it possible to quickly construct scenarios for any conflict of interest. The scenario editor makes it possible to place a wide variety of sensors including both high fidelity sensors such as radars, and primitive passive sensors that provide only very limited information. The parallel real-time sensor network simulation is capable of handling very large numbers of sensors on a computing cluster of modest size. It can fuse information provided by disparate sensors to detect and track targets, and produce target tracks.

Malaria survey and malaria control detachments in the South-West Pacific Area in World War 2.

PubMed

Crocker, Denton W

2009-01-01

Malaria among troops in the South-West Pacific Area (SWPA) in World War 2 affected the military effort to the degree that special units were formed to combat it. These malaria survey detachments (MSDs) and malaria control detachments (MCDs) were self-contained and so could move quickly to wherever their services were needed. In SWPA by 25 September 1944 there were 32 MSDs and 65 MCDs. Tables of organization called for 11 enlisted men in MSDs and MCDs, two officers in MSDs and one in MCDs. Detachments served throughout the SWPA. Detailed records of the 31st MSD show that in addition to antimalarial efforts it worked at control of scrub typhus, dengue and venereal disease, at reduction of rat populations and in experimental work involving DDT and schistosomiasis. Specific locations of the 31st MSD were New Guinea (3 sites), Morotai, Leyte, Mindoro, Okinawa and Japan. The detachment served overseas for 21 months. Experience in combating malaria in SWPA in World War 2 points to the need for better and continuous training of both medical and line officers in malaria prevention and control.

The Impact of Racial Integration on the Combat Effectiveness of Eighth (US) Army during the Korean War

DTIC Science & Technology

2011-12-01

Truman K . Gibson, the Civilian Aide to the Secretary of Defense, noted in a memorandum to Assistant Secretary of War John J. McCloy, a growing belief...DC: Center for Military History, 1966), 416. 6 Truman K . Gibson to John J. McCloy, Washington, DC, 8 August 1945, in Planning for the Postwar...not eager to suffer the same fate. 143 Finally, the conditions of the post-World War II force challenged Eighth (US) Army’s ability to integrate

Airplanes, Combat and Maintenance Crews, and Air Bases. The World War II and Early Cold War Architectural Legacy of Holloman Air Force Base (ca. 1942-1962)

DTIC Science & Technology

1998-11-01

to develop and build an atomic bomb. The project was under the direction of physicist J. Robert Oppenheimer , a former student at the Los Alamos Ranch...of AAF Facilities (1942- 1943 ) 39 Victory in Sight and the Atomic Age: Consolidation and Disposition of Facilities ( 1943 - 1945 ) 42 Cold War ( 1945 ...Sight and the Atomic Age ( 1943 - 1945 ) 61 Cold War Inception (July 1945 -January 1953) 63 Nuclear Escalation (January 1953-November 1963) 72 Detente

The psychodynamic treatment of combat neuroses (PTSD) with hypnosis during World War II.

PubMed

Watkins, J G

2000-07-01

In a large Army hospital during World War II, a full-time program in hypnotherapy for battle trauma cases was developed. Symptoms included severe anxiety, phobias, conversions, hysterias, and dissociations. Many hypnoanalytic techniques were used, especially including abreactions. Good therapeutic results were frequent, as demonstrated by typical cases. There was no evidence that the abreactive procedure tended to retraumatize patients or initiate psychotic reactions.

The Impact of Captivity and Posttraumatic Stress Disorder on Cognitive Performance Among Former Prisoners of War: A Longitudinal Study.

PubMed

Aloni, Roy; Crompton, Laura; Levin, Yafit; Solomon, Zahava

2018-04-24

War captivity is a potent pathogen for various aspects of mental health, including cognitive impairments. However, little is known about the long-term impact of war captivity and posttraumatic stress disorder (PTSD) on cognitive functioning among former prisoners of war (ex-POWs). This study assesses the effect of captivity, PTSD trajectories, and the accumulating differential effect in the prediction of cognitive performance. This longitudinal research includes 4 assessments (1991 [T1], 2003 [T2], 2008 [T3], 2015 [T4]) of Israeli ex-POWs and comparable combatants from the 1973 Yom Kippur War. Accordingly, 95 ex-POWs and 26 comparable combatants were included in this study. PTSD was assessed according to the DSM-IV, and cognitive performance was assessed using the Montreal Cognitive Assessment (MoCA). Ex-POWs reported higher levels of PTSD symptoms compared to controls (P = 0.007). No difference was found between the groups regarding MoCA total score. Ex-POWs with chronic PTSD were found to have more difficulty in overall cognitive functioning, compared to ex-POWs with delayed, recovery, and resilient trajectories (P = 0.03). Finally, physical and psychological suffering in captivity and intrusion symptoms predicted cognitive performance (P < .001, R² = 37.9%). These findings support the potent pathogenic effects of war captivity on cognitive abilities, more than 4 decades after the end of the traumatic event. Our results showed captivity to be a unique and powerful traumatic experience, leading to PTSD and long-lasting and enduring neuropsychological implications. These findings highlight the importance of viewing ex-POWs, in particular those suffering from chronic PTSD, especially as they age, as a high-risk population for cognitive disorders. This requires the appropriate diagnosis and cognitive therapy as a way to preserve cognitive abilities among this population. © Copyright 2018 Physicians Postgraduate Press, Inc.

Piercing the Fog: Intelligence and Army Air Forces Operations in World War 2

DTIC Science & Technology

1996-01-01

prewar air warfare thinking was the ACTS at Maxwell Field. Most of the AAF’s World War I1 combat leaders spent one or more assignments at ACTS, and...Scanlon, Air Corps, spent most of the 1930s in London. His personal diaries were replete with an active social life, and his dispatches revealed...these periods, some SSOs spent up to nine hours daily traveling between headquarters and the SCU. Not surprisingly, service during these periods

Wartime stressors and health outcomes: women in the Persian Gulf War.

PubMed

Bell, E A; Roth, M A; Weed, G

1998-08-01

This descriptive correlational study of war time stressors and stress responses of women from the Persian Gulf War examined numerous stressors both physical and psychological. The psychological stressors more directly impacted postwar physical and psychological symptoms than did physical stressors. These findings add to our understanding of women's reactions to wartime stress and the types of stressors affecting women. The study provides more data to support the contention that sexual harassment is widely prevalent in the military. The study did not find data to support concerns about maternal guilt on leaving children, nor any significant evidence of stress symptomology from this situation. The results of this study confirmed the call by Wolfe, Brown, Furey, and Levin (1993) for more precise evaluation of wartime stressors in view of the changing gender composition of military forces and the subsequent increase of women in combat roles. Clinicians should be alerted to recognize gender-specific experiences. Education of military women about stressors and coping mechanisms should be broadened to address the development issue of intimacy versus isolation. Nurses, both military and civilian, must understand the effect of isolation and discrimination on women both in combat and in other high stress situations. The need for continued study of the problem of sexual harassment is confirmed. Understanding the scope of the problem and the health care outcomes strengthens the role of prevention and intervention for nurses and their clients.

Quantitative EEG during REM and NREM sleep in combat-exposed veterans with and without Posttraumatic Stress Disorder

PubMed Central

Cohen, Daniel J.; Begley, Amy; Alman, Jennie J.; Cashmere, J. David; Pietrone, Regina N.; Seres, Robert J.; Germain, Anne

2012-01-01

Summary Sleep disturbances are a hallmark feature of posttraumatic stress disorder (PTSD), and associated with poor clinical outcomes. Few studies have examined sleep quantitative electroencephalography (qEEG), a technique able to detect subtle differences polysomnography does not capture. We hypothesized greater high-frequency qEEG would reflect “hyperarousal” in in combat veterans with PTSD (n=16) compared to veterans without PTSD (n=13). EEG power in traditional EEG frequency bands was computed for artifact-free sleep epochs across an entire night. Correlations were performed between qEEG and ratings of PTSD symptoms and combat exposure. The groups did not differ significantly in whole night qEEG measures for either REM or NREM. Non-significant medium effect sizes suggest less REM beta (opposite to our hypothesis), less REM and NREM sigma, and more NREM gamma in combat veterans with PTSD. Positive correlations were found between combat exposure and NREM beta (PTSD group only), and REM and NREM sigma (non-PTSD group only). Results did not support global hyperarousal in PTSD as indexed by increased beta qEEG activity. The correlation of sigma activity with combat exposure in those without PTSD, and the non-significant trend towards less sigma activity during both REM and NREM sleep in combat veterans with PTSD suggests that differential information processing during sleep may characterize combat-exposed military veterans with and without PTSD. PMID:22845675

Relationship of PTSD Symptoms With Combat Exposure, Stress, and Inflammation in American Soldiers.

PubMed

Groer, Maureen W; Kane, Bradley; Williams, S Nicole; Duffy, Allyson

2015-05-01

Posttraumatic stress disorder (PTSD) is of great concern in veterans. PTSD usually occurs after a person is exposed to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence. Active duty soldiers deployed to war zones are at risk for PTSD. Psychoneuroimmunological theory predicts that PTSD, depression, and stress can lead to low-grade, chronic inflammation. We asked whether there were relationships between PTSD symptoms and chronic stress, depression and inflammation in active duty U.S. soldiers. We enrolled 52 active duty enlisted and reservist soldiers in a cross-sectional study while they participated in a week of military training in fall 2011. They completed a demographic questionnaire, the Center for Epidemiological Studies-Depression Scale, the Combat Exposure Scale, and the PTSD symptom Checklist-Military version (PCL-M). Blood samples were taken for analysis of cytokines and C-reactive protein (CRP). Hair samples shaved from the forearm were measured for cortisol. Of the soldiers, 11 had PCL-M scores in the moderate to severe range. Regression analysis demonstrated that depression and war zone deployment were strong predictors of PTSD symptoms. CRP and hair cortisol were correlated with each other and with depression and PTSD symptoms. These results suggest relationships among war zone deployment, depression, and PTSD. Chronic stress associated with depression, PTSD, and war zone experiences may be related to inflammation in active duty soldiers. © The Author(s) 2014.

Sexual violence in armed conflict: the least condemned of war crimes.

PubMed

O'Connor, Mike

2014-03-01

Sexual violence in armed conflict has traditionally received poor attention until recent years. It has been the "least condemned of war crimes" although, with the inception of the International Criminal Court and various other international courts and tribunals, convictions of high-profile aggressors are increasing. Only recently Charles Taylor, the President of Liberia, was convicted of war crimes and crimes against humanity which included rape and sexual slavery. He was sentenced to 50 years imprisonment. Is prosecution of these crimes sufficient to minimise sexual violence in war? That seems unlikely given the potential for such violence to be a cheap and effective strategy to terrorise a civilian population and "ethnically cleanse" the newly won territory. However, there is a remarkable variation in the levels of sexual violence in armed conflicts. Some, such as the Israeli-Palestinian conflict, have extremely low levels, whereas in Bosnia and many African states the prevalence of sexual violence is at epidemic levels. The reasons for such differences are many, however, some precipitating factors may be improved by strong military discipline, improved gender balance in armed forces, better political awareness by combatants of the aims of a campaign and pre-deployment ethical training.

Validity of hydration non-invasive indices during the weightcutting and official weigh-in for Olympic combat sports.

PubMed

Fernández-Elías, Valentín E; Martínez-Abellán, Alberto; López-Gullón, José María; Morán-Navarro, Ricardo; Pallarés, Jesús G; De la Cruz-Sánchez, Ernesto; Mora-Rodriguez, Ricardo

2014-01-01

In Olympic combat sports, weight cutting is a common practice aimed to take advantage of competing in weight divisions below the athlete's normal weight. Fluid and food restriction in combination with dehydration (sauna and/or exercise induced profuse sweating) are common weight cut methods. However, the resultant hypohydration could adversely affect health and performance outcomes. The aim of this study is to determine which of the routinely used non-invasive measures of dehydration best track urine osmolality, the gold standard non-invasive test. Immediately prior to the official weigh-in of three National Championships, the hydration status of 345 athletes of Olympic combat sports (i.e., taekwondo, boxing and wrestling) was determined using five separate techniques: i) urine osmolality (UOSM), ii) urine specific gravity (USG), iii) urine color (UCOL), iv) bioelectrical impedance analysis (BIA), and v) thirst perception scale (TPS). All techniques were correlated with UOSM divided into three groups: euhydrated (G1; UOSM 250-700 mOsm · kg H2O(-1)), dehydrated (G2; UOSM 701-1080 mOsm · kg H2O(-1)), and severely dehydrated (G3; UOSM 1081-1500 mOsm · kg H2O(-1)). We found a positive high correlation between the UOSM and USG (r = 0.89: p = 0.000), although this relationship lost strength as dehydration increased (G1 r = 0.92; G2 r = 0.73; and G3 r = 0.65; p = 0.000). UCOL showed a moderate although significant correlation when considering the whole sample (r = 0.743: p = 0.000) and G1 (r = 0.702: p = 0.000) but low correlation for the two dehydrated groups (r = 0.498-0.398). TPS and BIA showed very low correlation sizes for all groups assessed. In a wide range of pre-competitive hydration status (UOSM 250-1500 mOsm · kg H2O(-1)), USG is highly associated with UOSM while being a more affordable and easy to use technique. UCOL is a suitable tool when USG is not available. However, BIA or TPS are not sensitive enough to detect hypohydration at official weight

The new military medical ethics: legacies of the Gulf Wars and the War on Terror.

PubMed

Miles, Steven H

2013-03-01

United States military medical ethics evolved during its involvement in two recent wars, Gulf War I (1990-1991) and the War on Terror (2001-). Norms of conduct for military clinicians with regard to the treatment of prisoners of war and the administration of non-therapeutic bioactive agents to soldiers were set aside because of the sense of being in a 'new kind of war'. Concurrently, the use of radioactive metal in weaponry and the ability to measure the health consequences of trade embargos on vulnerable civilians occasioned new concerns about the health effects of war on soldiers, their offspring, and civilians living on battlefields. Civilian medical societies and medical ethicists fitfully engaged the evolving nature of the medical ethics issues and policy changes during these wars. Medical codes of professionalism have not been substantively updated and procedures for accountability for new kinds of abuses of medical ethics are not established. Looking to the future, medicine and medical ethics have not articulated a vision for an ongoing military-civilian dialogue to ensure that standards of medical ethics do not evolve simply in accord with military exigency. © 2011 Blackwell Publishing Ltd.

Alcohol Use and Alcohol-Related Problems Before and After Military Combat Deployment

PubMed Central

Jacobson, Isabel G.; Ryan, Margaret A. K.; Hooper, Tomoko I.; Smith, Tyler C.; Amoroso, Paul J.; Boyko, Edward J.; Gackstetter, Gary D.; Wells, Timothy S.; Bell, Nicole S.

2009-01-01

Context High rates of alcohol misuse after deployment have been reported among personnel returning from past conflicts, yet investigations of alcohol misuse after return from the current wars in Iraq and Afghanistan are lacking. Objectives To determine whether deployment with combat exposures was associated with new-onset or continued alcohol consumption, binge drinking, and alcohol-related problems. Design, Setting, and Participants Data were from Millennium Cohort Study participants who completed both a baseline (July 2001 to June 2003; n=77 047) and follow-up (June 2004 to February 2006; n=55 021) questionnaire (follow-up response rate=71.4%). After we applied exclusion criteria, our analyses included 48 481 participants (active duty, n=26 613; Reserve or National Guard, n=21 868). Of these, 5510 deployed with combat exposures, 5661 deployed without combat exposures, and 37 310 did not deploy. Main Outcome Measures New-onset and continued heavy weekly drinking, binge drinking, and alcohol-related problems at follow-up. Results Baseline prevalence of heavy weekly drinking, binge drinking, and alcohol-related problems among Reserve or National Guard personnel who deployed with combat exposures was 9.0%, 53.6%, and 15.2%, respectively; follow-up prevalence was 12.5%, 53.0%, and 11.9%, respectively; and new-onset rates were 8.8%, 25.6%, and 7.1%, respectively. Among active-duty personnel, new-onset rates were 6.0%, 26.6%, and 4.8%, respectively. Reserve and National Guard personnel who deployed and reported combat exposures were significantly more likely to experience new-onset heavy weekly drinking (odds ratio [OR], 1.63; 95% confidence interval [CI], 1.36–1.96), binge drinking (OR, 1.46; 95% CI, 1.24–1.71), and alcohol-related problems (OR, 1.63; 95% CI, 1.33–2.01) compared with nondeployed personnel. The youngest members of the cohort were at highest risk for all alcohol-related outcomes. Conclusion Reserve and National Guard personnel and younger service

Retrospective Analysis of Long-Term Outcomes After Combat Injury: A Hidden Cost of War.

PubMed

Stewart, Ian J; Sosnov, Jonathan A; Howard, Jeffrey T; Orman, Jean A; Fang, Raymond; Morrow, Benjamin D; Zonies, David H; Bollinger, Mary; Tuman, Caroline; Freedman, Brett A; Chung, Kevin K

2015-12-01

During the conflicts in Iraq and Afghanistan, 52,087 service members have been wounded in combat. The long-term sequelae of these injuries have not been carefully examined. We sought to determine the relation between markers of injury severity and the subsequent development of hypertension, coronary artery disease, diabetes mellitus, and chronic kidney disease. Retrospective cohort study of critically injured US military personnel wounded in Iraq or Afghanistan from February 1, 2002 to February 1, 2011. Patients were then followed until January 18, 2013. Chronic disease outcomes were assessed by International Classification of Diseases, 9th edition codes and causes of death were confirmed by autopsy. From 6011 admissions, records were excluded because of missing data or if they were for an individual's second admission. Patients with a disease diagnosis of interest before the injury date were also excluded, yielding a cohort of 3846 subjects for analysis. After adjustment for other factors, each 5-point increment in the injury severity score was associated with a 6%, 13%, 13%, and 15% increase in incidence rates of hypertension, coronary artery disease, diabetes mellitus, and chronic kidney disease, respectively. Acute kidney injury was associated with a 66% increase in rates of hypertension and nearly 5-fold increase in rates of chronic kidney disease. In Iraq and Afghanistan veterans, the severity of combat injury was associated with the subsequent development of hypertension, coronary artery disease, diabetes mellitus, and chronic kidney disease. © 2015 American Heart Association, Inc.

A More Nuanced Approach to the Fourth Estate

DTIC Science & Technology

2012-05-17

School of Journalism, 2004. Shepard , Alicia C. Narrowing the Gap - Military, Media and the Iraq War - Cantigny Conference Series. Chicago : The McCormick...wary of access pledge, Chicago Tribune, January 26, 2003. http://articles.chicagotribune.com/2003-01- 26/news/0301260301_1_gulf-war-iraq-vietnam-war...http://www.defense.gov/transcripts/transcript.aspx?transcriptid=2476 (accessed September 17, 2011). 149 Alicia C. Shepard , Narrowing the Gap

Postmodern Morals, Ends, and Means: Shifting Ideas About Why, How and for Whom Wars are Fought

DTIC Science & Technology

2013-05-23

from being used for humanitarian intervention. In fact, unmanned combat vehicles are well suited for such police style enforcement actions. Given...from, for example, the Chinese intervention in the Korean War, which was a political decision for national interests. The distinction between the two...fourth century to the mid seventeenth. In this era, knowledge was authoritative based on its appeal to God and revelation. The modern era, which follows

[Patterns of injury in a combat environment. 2007 update].

PubMed

Willy, C; Voelker, H-U; Steinmann, R; Engelhardt, M

2008-01-01

Epidemiological analysis of injury patterns and mechanisms help in identifying the expertise that military surgeons need in a combat setting and also in adjusting training requirements accordingly. This paper attempts to assess the surgical specialties and skills of particular importance in the management of casualties in crisis areas. MEDLINE (1949-2007) and Google search were used. Causes of death among casualties in Afghanistan and the Iraq war were analyzed. The leading causes of injury were explosive devices, gunshot wounds, aircraft crashes, and terrorist attacks. Of the casualties, 55% died in hostile action and 45% in nonhostile incidents. Chest or abdominal injuries (40%) and brain injuries (35%) were the main causes of death for soldiers killed in action. The case fatality rate in Iraq was approximately half as high as in the Vietnam War. In contrast, the amputation rate was twice as high. Approximately 8-15% of the deaths appeared to be preventable. Military surgeons must have excellent skills in the fields of thoracic, visceral, and vascular surgery as well as practical skills in neurosurgery and oral and maxillofacial surgery. It also is of vital importance to ensure the availability of sufficient medical evacuation capabilities. Furthermore, there is a need for a standardized registration system for all injuries similar to the German Trauma Registry.

Factors associated with posttraumatic stress disorder and depression in war-survivors displaced in Croatia

PubMed Central

Letica-Crepulja, Marina; Salcioglu, Ebru; Frančišković, Tanja; Basoglu, Metin

2011-01-01

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. PMID:22180270

The new front in the war on doping: Amateur athletes.

PubMed

Henning, April D; Dimeo, Paul

2018-01-01

The war on drugs is usually associated with criminal policies aimed at stemming consumption of drugs such as heroin, cocaine, and cannabis, less so with enhancement drugs like those used in sport. As drug use in sport, or doping, has become more visibly widespread, policies aimed at combating the issue have become more restrictive, intrusive, and harsh. In this article we draw new comparisons between the wider war on drugs and recent developments in sports anti-doping. We identify a growing trend towards criminalisation of traffickers and users, and associate that with another growing trend: the testing of amateur athletes. This article reviews the current anti-doping system, including the recent amateur policies, then considers of the results of one such program in amateur cycling. We then shift to consider the possible implications for amateurs of criminal doping laws and the recent debates about allowing medical exemptions for therapeutic use of banned substances. We show that drug use in sport can be understood as a new front in the war on drugs, with some extreme measures and many negative unintended consequences. To remedy this, we argue that amateur athletes require a separate anti-doping policy focused on minimising harms of use. Copyright © 2017 Elsevier B.V. All rights reserved.

Cities spearhead climate action

NASA Astrophysics Data System (ADS)

Watts, Mark

2017-08-01

Following President Trump's withdrawal from the Paris Agreement, cities worldwide have pledged support to combat climate change. Along with a growing coalition of businesses and institutions, cities represent a beacon of hope for carbon reduction in politically tumultuous times.

'Practice what you preach': Nurses' perspectives on the Code of Ethics and Service Pledge in five South African hospitals.

PubMed

White, Janine; Phakoe, Maureen; Rispel, Laetitia C

2015-01-01

A recent focus of the global discourse on the health workforce has been on its quality, including the existence of codes of ethics. In South Africa, the importance of ethics and value systems in nursing was emphasised in the 2011 National Nursing Summit. The study explored hospital nurses' perceptions of the International Code of Ethics for Nurses; their perceptions of the South African Nurses' Pledge of Service; and their views on contemporary ethical practice. Following university ethics approval, the study was done at a convenience sample of five hospitals in two South African provinces. In each hospital, all day duty nurses in paediatric, maternity, adult medical, and adult surgical units were requested to complete a self-administered questionnaire. The questionnaire focused on their perceptions of the Code of Ethics and the Pledge, using a seven-point Likert scale. STATA(®) 13 and NVIVO 10 were used to analyse survey data and open-ended responses, respectively. The mean age of survey participants (n=69) was 39 years (SD=9.2), and the majority were female (96%). The majority agreed with a statement that they will promote the human rights of individuals (98%) and that they have a duty to meet the health and social needs of the public (96%). More nuanced responses were obtained for some questions, with 60% agreeing with a statement that too much emphasis is placed on patients' rights as opposed to nurses' rights and 32% agreeing with a statement that they would take part in strike action to improve nurses' salaries and working conditions. The dilemmas of nurses to uphold the Code of Ethics and the Pledge in face of workplace constraints or poor working conditions were revealed in nurses' responses to open-ended questions. Continuing education in ethics and addressing health system deficiencies will enhance nurses' professional development and their ethical decision-making and practice.

Understanding how deployment experiences change over time: Comparison of female and male OEF/OIF and Gulf War veterans.

PubMed

Fox, Annie B; Walker, Brian E; Smith, Brian N; King, Daniel W; King, Lynda A; Vogt, Dawne

2016-03-01

Despite increased attention to the evolving nature of war, the unique challenges of contemporary deployment, and women's changing role in warfare, few studies have examined differences in deployment stressors across eras of service or evaluated how gender differences in deployment experiences have changed over time. Using data collected from two national survey studies, we examined war cohort and gender differences in veterans' reports of both mission-related and interpersonal stressors during deployment. Although Operation Enduring Freedom and Operation Iraqi Freedom veterans reported more combat experiences and greater preparedness for deployment compared to Gulf War veterans, Gulf War veterans reported higher levels of other mission-related stressors, including difficult living and working environment, perceived threat, and potential exposure to nuclear, biological, and chemical weapons. Gender differences also emerged, with men reporting greater exposure to mission-related stressors and women reporting higher levels of interpersonal stressors. However, the size and nature of gender differences did not differ significantly when comparing veterans of the two eras. By understanding how risk factors for PTSD differ based on war era and gender, veterans' experiences can be better contextualized. (c) 2016 APA, all rights reserved).

Outcome of influenza vaccination in combat-related post-traumatic stress disorder (PTSD) patients

PubMed Central

Kosor Krnic, E; Gagro, A; Kozaric-Kovacic, D; Vilibic, M; Grubisic-Ilic, M; Folnegovic-Smalc, V; Drazenovic, V; Cecuk-Jelicic, E; Gjenero-Margan, I; Kuzman, I; Jeren, T; Sabioncello, A; Kerhin-Brkljacic, V; Kaic, B; Markotic, A; Gotovac, K; Rabatic, S; Mlinaric-Galinovic, G; Dekaris, D

2007-01-01

Post-traumatic stress disorder (PTSD) is an anxiety disorder that can occur after exposure to extreme traumatic experience such as war trauma, and is accompanied by fear, helplessness or horror. Exposure to trauma can result in immune dysregulation and influence susceptibility to infectious disease as well as vaccine efficacy. The aim of the study was to determine the relation of psychological stress and the immune response to influenza vaccination in combat-related PTSD patients (n = 28). Detection of anti-viral antibody titre was performed by inhibition of haemagglutination assay. Ex vivo tetramer staining of CD8+ T lymphocytes was used to monitor T cells specific for human leucocyte antigen (HLA)-A*0201-restricted influenza A haemagglutinin antigens before and after vaccination. Twenty patients showed a fourfold antibody titre increase to one or both influenza A viral strains, and 18 of them showed the same response for both influenza B viral strains. Ten of 15 healthy controls showed a fourfold rise in antibody titre to both influenza A viral strains and eight of them showed the same response for both influenza B viral strains. HLA-A*0201+ PTSD patients (n = 10) showed a significant increase of influenza-specific CD8 T cells after vaccination. Although those PTSD patients had a lower number of influenza-specific CD8+ T cells before vaccination compared to HLA-A*0201+ healthy controls (n = 6), there was no difference in influenza A antibody titre between PTSD patients and control subjects before vaccination. The generated humoral and cellular immune response in PTSD patients argues against the hypothesis that combat-related PTSD in war veterans might affect protection following influenza vaccination. PMID:17511777

Documented suicides within the British Army during the Crimean War 1854-1856.

PubMed

Smith, Jeffrey Allen; Masuhara, Kristi L; Frueh, B Christopher

2014-07-01

We have little understanding of the increased active duty military suicide rates found in the United States, and little understanding of what is historically normative for combatants. Therefore, we examined historical records on suicides among the British Army during the Crimean War for the years 1854-1856. There were 18 documented suicides in the British Army during this period. Calculating an accurate annual suicide rate per 100,000 is impossible because it is unclear how many of the 111,313 military personnel were in country for each of the 2 years of the war. However, the range is conservatively estimated between 8 and 16 per 100,000, with the likely answer somewhere near the middle. This suggests the possibility that increasing suicide rates among active duty military may be a modern U.S. phenomenon. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Microchimerism decades after transfusion among combat-injured US veterans from the Vietnam, Korean, and World War II conflicts.

PubMed

Utter, Garth H; Lee, Tzong-Hae; Rivers, Ryan M; Montalvo, Lani; Wen, Li; Chafets, Daniel M; Reed, William F; Busch, Michael P

2008-08-01

Blood transfusion after traumatic injury can result in microchimerism (MC) of donor white cells (WBCs) in the recipient as late as 2 to 3 years postinjury, the longest prospective follow-up to date. The purpose of this study was to determine how long transfusion-associated MC lasts after traumatic injury. A group of US combat veterans who received transfusions who responded to a recruitment notice was retrospectively evaluated. Their blood was sampled, and MC was assessed by quantitative allele-specific polymerase chain reaction detection of differences at the HLA-DR locus or a panel of insertion-deletion polymorphism loci. Results of veterans were compared to those from an age- and gender-matched blood donor control group, from whom WBCs were retrieved from leukoreduction filters. Among 163 combat veterans who received transfusion and 150 control subjects who did not receive transfusions, 16 (9.8%) of the veterans and 1 (0.7%) control subject had evidence of MC (relative risk, 14.7; 95% confidence interval, 2.0-110). The veterans with MC included 3 who served in WWII (7% of subjects from that conflict), 5 in Korea (18%), and 6 in Vietnam (7%). Transfusion for combat-related injury can result in MC that lasts for 60 years, suggesting that it may involve permanent engraftment. MC is rare among male blood donors who did not receive transfusions, who are probably representative of individuals who have not had postnatal allogeneic exposures.

Meaning as a mission: a review of empirical studies on appraisals of war and peacekeeping experiences.

PubMed

Schok, Michaela L; Kleber, Rolf J; Elands, Martin; Weerts, Jos M P

2008-03-01

The aim of this article is to review the scientific literature on making sense of war and peacekeeping experiences, and it includes an analysis of empirical studies that examine appraisals of military deployment experiences among veterans. Veterans reported more positive than negative effects in the studies of this review. Furthermore, construing positive meaning from war and peacekeeping experiences, especially related to combat exposure or high perceived threat, is associated with better psychological adjustment. More insight on "normal" psychological processing of stressful and traumatic experiences is obtained when the concept of meaning is used in research. This perspective emphasizes the perception of individuals and focuses on beliefs and attitudes in making sense of threatening events instead of pathologizing the response to trauma.

Combat near-death experiences: an exploratory study.

PubMed

Goza, Tracy H; Holden, Janice M; Kinsey, Lee

2014-10-01

The purpose of this study was to add to the professional literature regarding combat near-death experiences (cNDEs) and to help clinicians and experiencers (cNDErs) recognize this phenomenon as an experience that is not indicative of mental illness. cNDErs were military personnel whose NDEs occurred during active combat or sequelae. Sixty-eight self-reported survivors of combat-related close brushes with death completed an online survey that included the Near-Death Experience Scale(1) (NDE Scale), the Life-Changes Inventory-Revised(2), and a few open-ended questions. Respondents were 20 cNDErs-participants who scored at least 7 on the NDE Scale-and 48 non-NDErs. Compared to NDErs from two methodologically similar studies, cNDErs scored lower on Bonferroni corrected t-tests than NDErs on the NDE Scale overall(3) (p < 0.0003) and on Affective and Transcendental subscales; they scored higher on the Cognitive subscale(1) (p < 0.0007). In Life-Changes Inventory-Revised total change and six of seven value clusters, cNDErs, compared to non-NDErs, scored in the same direction as numerous other studies of NDE aftereffects, but none of the differences were statistically significant and all reflected small effect sizes except total change and changes in spirituality that reflected medium effect sizes--a finding that corresponded to analysis of narrative responses. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Combating terrorism : how five foreign countries are organized to combat terrorism

DOT National Transportation Integrated Search

2000-04-01

In fiscal year 1999, the federal government spent about $10 billion to combat terrorism. Over 40 federal departments, agencies, and bureaus have a role in combating terrorism. Recognizing that other governments have had more experience dealing with t...

The Utilization of Women in Combat: An Historical and Social Analysis of Twentieth-Century Wartime and Peacetime Experience

DTIC Science & Technology

1982-01-01

training, overseen by male officers, was severe as was the dis- cipline. The women volunteers had their heads shaved and were otherwise de- feminized in...same functions as men in national defense; the removal -of some of the special laws that pro- I tect and hence restrict the use of women in employment...Use of Women in Near-Combat Roles L Since World War II? N There are three basic reasons why women have not been permitted or have been restricted in

Combating the Proliferation of Weapons of Mass Destruction.

ERIC Educational Resources Information Center

Jenkins, Bonnie

1997-01-01

Reveals the growing threat posed to all countries by the proliferation of weapons of mass destruction. Discusses the international effort combating this proliferation including the Nuclear Non-Proliferation Treaty, Strategic Arms Reduction Treaties, Biological Weapons Convention, and Chemical Weapons Convention. Also considers regional arms…

[The war at home: "war amenorrhea" in the First World War].

PubMed

Stukenbrock, Karin

2008-01-01

In 1917, the Göttingen gynaecologist Dietrich published a short article about a phenomenon which he called "war amenorrhea" ("Kriegsamenorrhoe"). The article attracted the attention of his colleagues. While the affected women did not pay much attention to their amenorrhea, the physicians considered the phenomenon a new disease which was mainly caused by the war. This new disease gave the gynaecologists the opportunity to present their specialty as a discipline with high relevance for medicine in times of war. Nevertheless, there was no consensus about the importance, the incidence, the diagnostic criteria, the causes and the appropriate therapy of"war amenorrhea". Although the gynaecologists failed to define a uniform clinical syndrome, they maintained the construction of "war amenorrhea" after the war and subsumed it under well known types of amenorrhea. We can conclude that under the conditions of war a new disease emerged which was not sharply defined.

Validity of Hydration Non-Invasive Indices during the Weightcutting and Official Weigh-In for Olympic Combat Sports

PubMed Central

Fernández-Elías, Valentín E.; Martínez-Abellán, Alberto; López-Gullón, José María; Morán-Navarro, Ricardo; Pallarés, Jesús G.; De la Cruz-Sánchez, Ernesto; Mora-Rodriguez, Ricardo

2014-01-01

Background In Olympic combat sports, weight cutting is a common practice aimed to take advantage of competing in weight divisions below the athlete's normal weight. Fluid and food restriction in combination with dehydration (sauna and/or exercise induced profuse sweating) are common weight cut methods. However, the resultant hypohydration could adversely affect health and performance outcomes. Purpose The aim of this study is to determine which of the routinely used non-invasive measures of dehydration best track urine osmolality, the gold standard non-invasive test. Method Immediately prior to the official weigh-in of three National Championships, the hydration status of 345 athletes of Olympic combat sports (i.e., taekwondo, boxing and wrestling) was determined using five separate techniques: i) urine osmolality (UOSM), ii) urine specific gravity (USG), iii) urine color (UCOL), iv) bioelectrical impedance analysis (BIA), and v) thirst perception scale (TPS). All techniques were correlated with UOSM divided into three groups: euhydrated (G1; UOSM 250–700 mOsm·kg H2O−1), dehydrated (G2; UOSM 701–1080 mOsm·kg H2O−1), and severely dehydrated (G3; UOSM 1081–1500 mOsm·kg H2O−1). Results We found a positive high correlation between the UOSM and USG (r = 0.89: p = 0.000), although this relationship lost strength as dehydration increased (G1 r = 0.92; G2 r = 0.73; and G3 r = 0.65; p = 0.000). UCOL showed a moderate although significant correlation when considering the whole sample (r = 0.743: p = 0.000) and G1 (r = 0.702: p = 0.000) but low correlation for the two dehydrated groups (r = 0.498–0.398). TPS and BIA showed very low correlation sizes for all groups assessed. Conclusion In a wide range of pre-competitive hydration status (UOSM 250–1500 mOsm·kg H2O−1), USG is highly associated with UOSM while being a more affordable and easy to use technique. UCOL is a suitable tool when USG is not available

Experiments in Error Propagation within Hierarchal Combat Models

DTIC Science & Technology

2015-09-01

Bayesian Information Criterion CNO Chief of Naval Operations DOE Design of Experiments DOD Department of Defense MANA Map Aware Non-uniform Automata ...ground up” approach. First, it develops a mission-level model for one on one submarine combat in Map Aware Non-uniform Automata (MANA) simulation, an... Automata (MANA), an agent based simulation that can model the different postures of submarines. It feeds the results from MANA into stochastic

Injury patterns of soldiers in the second Lebanon war.

PubMed

Schwartz, Dagan; Glassberg, Elon; Nadler, Roy; Hirschhorn, Gil; Marom, Ophir Cohen; Aharonson-Daniel, Limor

2014-01-01

In the second Lebanon war in 2006, the Israeli Defense Forces fought against well-prepared and well-equipped paramilitary forces. The conflict took place near the Israeli border and major Israeli medical centers. Good data records were maintained throughout the campaign, allowing accurate analysis of injury characteristics. This study is an in-depth analysis of injury mechanisms, severity, and anatomic locations. Data regarding all injured soldiers were collected from all care points up to the definitive care hospitals and were cross-referenced. In addition, trauma branch physicians and nurses interviewed medical teams to validate data accuracy. Injuries were analyzed using Injury Severity Score (ISS) (when precise anatomic data were available) and multiple injury patterns scoring for all. A total of 833 soldiers sustained combat-related injury during the study period, including 119 fatalities (14.3%). Although most soldiers (361) sustained injury only to one Abbreviated Injury Scale (AIS) region, the average number of regions per soldier was 2.0 but was 1.5 for survivors versus 4.2 for fatalities. Current war injury classifications have limitations that hinder valid comparisons between campaigns and settings. In addition, limitation on full autopsy in war fatalities further hinders data use. To partly compensate for those limitations, we have looked at the correlation between fatality rates and number of involved anatomic regions and found it to be strong. We have also found high fatality rates in some "combined" injuries such as head and chest injuries (71%) or in the abdomen and an extremity (75%). The use of multiinjury patterns analysis may help understand fatality rates and improve the utility of war injury analysis. Epidemiologic study, level III.

Pledges of Allegiance, Bandana Wristbands, and Spanish Pig Latin: A Teacher's Reflections on Rituals, Resistance, and Working toward Multicultural Classrooms

ERIC Educational Resources Information Center

Isaac, Lauren B.

2013-01-01

The author begins this article with an anecdote describing the behavior of a few members of her ESL class, and their behavior during the morning "Pledge of Allegiance." Not only did these students not stand, they displayed a dramatic performance of "remaining seated." The narrative that follows is an attempt by the the author…

Former combatants in Liberia: the burden of possible traumatic brain injury among demobilized combatants.

PubMed

Johnson, Kirsten; Asher, Jana; Kisielewski, Michael; Lawry, Lynn

2012-05-01

To provide a better understanding of any associations between Disarmament, Demobilization, and Reintegration, previous head injury, and mental health symptoms among former combatants in Liberia. A cluster-sampled national survey of the adult household-based Liberian population. Former combatants with reported head injury were more likely to experience major depressive disorder symptoms, suicidal ideation and attempts, and current substance abuse. Former combatants with head injury are 2.83 times more likely to have major depressive disorder symptoms, and those with suspected traumatic brain injury are five times more likely to have post-traumatic stress disorder. The poor mental health of former combatants in Liberia, both child and adult, might be mitigated if Disarmament, Demobilization, and Reintegration programming assessed participants for head trauma and traumatic brain injury using simple screening methods. The specific health and mental health needs of ex-combatants--a highly vulnerable group--will need to be addressed by Liberia. If left untreated, ex-combatants with high rates of suicidal ideation and post-traumatic stress disorder might be susceptible to re-recruitment into new conflicts in the region.

An examination of the association between 5-HTTLPR, combat exposure, and PTSD diagnosis among U.S. veterans.

PubMed

Liu, Yutao; Garrett, Melanie E; Dennis, Michelle F; Green, Kimberly T; Ashley-Koch, Allison E; Hauser, Michael A; Beckham, Jean C; Kimbrel, Nathan A

2015-01-01

To examine the association between the 5-HTTLPR polymorphism of the serotonin transporter (SLC6A4) gene, combat exposure, and posttraumatic stress disorder (PTSD) diagnosis and among two samples of combat-exposed veterans. The first sample included 550 non-Hispanic Black (NHB) combat-exposed veterans. The second sample included 555 non-Hispanic White (NHW) combat-exposed veterans. Participants were genotyped for the 5-HTTLPR/rs25531 variants of the SLC6A4 gene. A structured clinical interview was used to diagnose PTSD. Combat and civilian trauma exposure were assessed with validated self-report instruments. Logistic regression was used to test for main effects of 5-HTTLPR on PTSD diagnosis as well as gene x environment (GxE) interactions after adjusting for sex, ancestry proportion scores, civilian trauma exposure, and combat exposure. Within the NHB sample, a significant additive effect was observed for 5-HTTLPR (OR = 1.502, p = .0025), such that the odds of having a current diagnosis of PTSD increased by 1.502 for each additional S' allele. No evidence for an association between 5-HTTLPR and PTSD was observed in the NHW sample. In addition, no evidence for combat x 5-HTTLPR effects were observed in either sample. The present study suggests that there may be an association between 5-HTTLPR genotype and PTSD diagnosis among NHB veterans; however, no evidence for the hypothesized 5-HTTLPR x combat interaction was found.

Moral injury: a mechanism for war-related psychological trauma in military family members.

PubMed

Nash, William P; Litz, Brett T

2013-12-01

Recent research has provided compelling evidence of mental health problems in military spouses and children, including post-traumatic stress disorder (PTSD), related to the war-zone deployments, combat exposures, and post-deployment mental health symptoms experienced by military service members in the family. One obstacle to further research and federal programs targeting the psychological health of military family members has been the lack of a clear, compelling, and testable model to explain how war-zone events can result in psychological trauma in military spouses and children. In this article, we propose a possible mechanism for deployment-related psychological trauma in military spouses and children based on the concept of moral injury, a model that has been developed to better understand how service members and veterans may develop PTSD and other serious mental and behavioral problems in the wake of war-zone events that inflict damage to moral belief systems rather by threatening personal life and safety. After describing means of adapting the moral injury model to family systems, we discuss the clinical implications of moral injury, and describe a model for its psychological treatment.

Preventive Detention in the War on Terror: A Plan for a More Moderate and Sustainable Solution

DTIC Science & Technology

2008-12-01

speeches /2004/dag6104.htm (accessed November 10, 2007). 25 Ron Suskind, The One Percent Doctrine (New York: Simon and Schuster, 2006), 95-100. 26 The 9...suspected terrorists for purposes of interrogation and/or incapacitation but also for ultimately trying them for various war crimes or violations of...conflict should be thought of as a “war” as opposed to “ crime .” This chapter serves to better define the problems with the enemy-combatant policy and

Urban Combat Advanced Training Technology Architecture (Architecture de technologie avancee pour l’entrainement au combat urbain)

DTIC Science & Technology

2018-01-01

REPORT TR-MSG-098 Urban Combat Advanced Training Technology Architecture (Architecture de technologie avancée pour l’entraînement au combat urbain...REPORT TR-MSG-098 Urban Combat Advanced Training Technology Architecture (Architecture de technologie avancée pour l’entraînement au combat...3 1-2 1.3 Illustration of the Need for UCATT by Contemporary Example Situations 1-3 1.3.1 RNLA: Connection of NLD Mobile Combat Training Centre to

Context matters: Community characteristics and mental health among war-affected youth in Sierra Leone

PubMed Central

Betancourt, Theresa S.; McBain, Ryan; Newnham, Elizabeth A.; Brennan, Robert T.

2013-01-01

Background Worldwide, over one billion children and adolescents live in war-affected settings. At present, only limited research has investigated linkages between disrupted social ecology and adverse mental health outcomes among war-affected youth. In this study, we examine three community-level characteristics—social disorder and collective efficacy within the community, as reported by caregivers, and perceived stigma as reported by youth—in relation to externalizing behaviors and internalizing symptoms among male and female former child soldiers in post-conflict Sierra Leone. Methods 243 former child soldiers (30% female, mean age at baseline: 16.6 years) and their primary caregivers participated in interviews in 2004 and 2008, as part of a larger prospective cohort study of war-affected youth in Sierra Leone. Two-point growth models were estimated to examine the relationship between community-level characteristics and externalizing and internalizing outcomes across the time points. Results Both social disorder within the community, reported by caregivers, and perceived stigma, reported by youth, positively co-varied with youths’ externalizing and internalizing scores—indicating that higher levels of each at baseline and follow-up were associated with higher levels of mental health problems at both time points (p<0.05). The relationship between collective efficacy and mental health outcomes was non-significant (p>0.05). Conclusions This study offers a rare glimpse into the role that the post-conflict social context plays in shaping mental health among former child soldiers. Results indicate that both social disorder and perceived stigma within the community demonstrate an important relationship to externalizing and internalizing problems among adolescent ex-combatants. Moreover, these relationships persisted over a four-year period of follow up. These results underscore the importance of the post-conflict social environment and the need to develop post

The food and weight combat. A problematic fight for the elite combat sports athlete.

PubMed

Pettersson, Stefan; Pipping Ekström, Marianne; Berg, Christina M

2012-10-01

Weight reduction in athletes is motivated by optimisation of performance, aesthetic reasons or to achieve a pre-designated weight. Previous research has shown that dietary restraint and short term weight regulation frequently takes place among combat sports athletes such as wrestlers and judokas. The aim of this study was to explore negative experiences related to dietary strategies and weight-making practises used by elite combat sports athletes. Using semi-structured interviews, 14 Swedish national team athletes in wrestling, judo and taekwondo were asked about their dietary intake and their engagement in both long- and short-term weight regulation practises. Content analysis of the transcribed interviews, display a constant struggle regarding nutritional standpoints. Sport demands such as achieving an optimal weight and nutritional intake were considered as central in order for excellent performance. Adhering to these demands was found to be problematic however, primarily because of; (1) negative physiological responses and (2) opposing ideals of a non-sport related nature, such as the importance of the athletes to be healthy and social in their everyday lives. Copyright © 2012 Elsevier Ltd. All rights reserved.

Comorbid Depression and Suicide Ideation in Patients with Combat-Related PTSD: The Role of Temperament, Character, and Trait Impulsivity.

PubMed

Jakšić, Nenad; Margetić, Branka Aukst; Marčinko, Darko

2017-03-01

War veterans with PTSD have a high chance of developing major depressive disorder (MDD) at some point, while they can also exhibit increased suicidal tendencies. The primary goal of this research was to investigate whether personality dimensions, including temperament, character, and trait impulsivity, were associated with comorbid MDD, as well as with suicidal ideation in psychiatric patients suffering from combat-related PTSD. The sample consisted of 148 Croatian male war veterans (mean age 49.53 years) treated for PTSD at the National Center for Psychotrauma, Department of Psychiatry, University Hospital Center Zagreb. Fifty-one (34%) of them met ICD-10 diagnostic criteria for current or lifetime MDD, while 97 (66%) were diagnosed with PTSD alone. All the participants were assessed with the M.I.N.I. diagnostic interview and they completed the following battery of self-report instruments: the Beck Depression Inventory-Second Edition (BDI-II), the Suicidal Behaviors Questionnaire-Revised (SBQ-R), the Temperament and Character Inventory-Revised (TCI-R), and the Barratt Impulsiveness Scale-11 (BIS-11). Comparisons between the two clinical groups showed that PTSD+MDD patients were more suicidal and differed with regard to temperament dimensions Harm Avoidance, Reward Dependence and Persistence, character dimension Self-Directedness, and trait impulsivity. In three multivariate regression analyses, it was revealed that character dimension Cooperativeness as well as trait impulsivity were unique predictors of suicidal ideation, while controlling for the influence of sociodemographics, length of treatment and comorbid depression. Combat-related PTSD patients with comorbid depression exhibit increased suicide thoughts and different personality profiles in comparison with those suffering from PTSD alone. Character dimension Cooperativeness and trait impulsivity seem to be uniquely predictive of suicide ideation in this population. Elucidation of individual psychological

Self-assessment of well-being as an indicator of quality of life of former war prisoners - A Croatian study.

PubMed

Loncar, Mladen; Plasć, Ivana Dijanić; Bunjevac, Tomislav; Henigsberg, Neven; Hrabac, Pero; Groznica, Ivana; Marcinko, Vesna; Jevtović, Sasa

2011-01-01

The impact of war on the population is vast, especially when it comes to those who were directly affected by war, among other things as concentration camp detainees. Because of the specific war experience of this population it is important to better understand the possible contribution of key socio-demographic variables, war traumatization and acute disturbances in mental health to their subjective assessment of their own well-being, which represents a psychological category and is based on a subjective assessment. The starting point is a theoretical precept according to which individual characteristics, together with war experience, can have repercussions on mental health, and eventually on the general well-being of an individual and their quality of life. The study comprised 184participants who had given their informed consent for participation and filled out complete questionnaires. The participants were a convenience sample of male persons who had survived war captivity in the Homeland War in the period from 1991 to 1995. The study was conducted as part of the physical examinations at the University Hospital "Fran Mihaljević" in Zagreb. The data was collected using several self-evaluation measuring instruments one of which served to collect socio-demographic data, two to collect data on the participants' mental health, one for the data on the participants' combat and war experiences and one to assess the participants' well-being. The data obtained suggest that only avoidance and arousal symptoms and psychosomatic difficulties are predictors of the well-being of persons who have experienced war captivity.

Holistic actions are essential to combat the global public health burden of non-viral sexually transmitted infections: challenges and future perspectives.

PubMed

Unemo, Magnus

2014-06-01

Sexually transmitted infections (STIs) represent a significant international public health burden. These infections result in substantial morbidity, mortality and economic costs globally, and require more attention and resources internationally. This special focus issue of Expert Review of Anti Infective Therapy invited key opinion leaders to review and discuss the challenges associated with the diagnosis and treatment of non-viral STIs. The issue also elucidates the future perspectives, ways forward and holistic actions imperative to effectively combat these STIs.

Resilience and Traumatic Brain Injury Among Iraq/Afghanistan War Veterans: Differential Patterns of Adjustment and Quality of Life.

PubMed

Elliott, Timothy R; Hsiao, Yu-Yu; Kimbrel, Nathan A; Meyer, Eric; DeBeer, Bryann B; Gulliver, Suzy Bird; Kwok, Oi-Man; Morissette, Sandra B

2017-09-01

We examined the degree to which a resilient personality prototype predicted adjustment among war Veterans with and without a traumatic brain injury (TBI) while covarying the level of combat exposure. A total of 127 war Veterans (107 men, 20 women; average age = 37 years) participated. Personality prototypes were derived from the Multidimensional Personality Questionnaire (Patrick, Curtain, & Tellegen, 2002). Measures were administered at baseline, and a subset was administered at 4- and 8-month follow-ups. Veterans with resilient personalities reported less sleep disturbance, more health-promoting behaviors, psychological flexibility, and emotional distress tolerance than Veterans with undercontrolled or overcontrolled prototypes. Path models revealed that resilience significantly predicted posttraumatic stress disorder (PTSD), depression, quality of life, and social support over time. TBI had unique and consistent effects only on PTSD. Personality characteristics influence distress and quality of life among war Veterans with and without TBI. Implications for assessment, interventions, and research are discussed. © 2016 Wiley Periodicals, Inc.

All-Cause Mortality Among US Veterans of the Persian Gulf War: 13-Year Follow-up.

PubMed

Barth, Shannon K; Kang, Han K; Bullman, Tim

2016-11-01

We determined cause-specific mortality prevalence and risks of Gulf War deployed and nondeployed veterans to determine if deployed veterans were at greater risk than nondeployed veterans for death overall or because of certain diseases or conditions up to 13 years after conflict subsided. Follow-up began when the veteran left the Gulf War theater or May 1, 1991, and ended on the date of death or December 31, 2004. We studied 621   901 veterans who served in the 1990-1991 Persian Gulf War and 746   247 veterans who served but were not deployed during the Gulf War. We used Cox proportional hazard models to calculate rate ratios adjusted for age at entry to follow-up, length of follow-up, race, sex, branch of service, and military unit. We compared the mortality of (1) Gulf War veterans with non-Gulf War veterans and (2) Gulf War army veterans potentially exposed to nerve agents at Khamisiyah in March 1991 with those not exposed. We compared standardized mortality ratios of deployed and nondeployed Gulf War veterans with the US population. Male Gulf War veterans had a lower risk of mortality than male non-Gulf War veterans (adjusted rate ratio [aRR] = 0.97; 95% confidence interval [CI], 0.95-0.99), and female Gulf War veterans had a higher risk of mortality than female non-Gulf War veterans (aRR = 1.15; 95% CI, 1.03-1.28). Khamisiyah-exposed Gulf War army veterans had >3 times the risk of mortality from cirrhosis of the liver than nonexposed army Gulf War veterans (aRR = 3.73; 95% CI, 1.64-8.48). Compared with the US population, female Gulf War veterans had a 60% higher risk of suicide and male Gulf War veterans had a lower risk of suicide (standardized mortality ratio = 0.84; 95% CI, 0.80-0.88). The vital status and mortality risk of Gulf War and non-Gulf War veterans should continue to be investigated.

Sleep quality affects cognitive functioning in returning combat veterans beyond combat exposure, PTSD, and mild TBI history.

PubMed

Martindale, Sarah L; Morissette, Sandra B; Rowland, Jared A; Dolan, Sara L

2017-01-01

The purpose of this study was to determine how sleep quality affects cognitive functioning in returning combat veterans after accounting for effects of combat exposure, posttraumatic stress disorder (PTSD), and mild traumatic brain injury (mTBI) history. This was a cross-sectional assessment study evaluating combat exposure, PTSD, mTBI history, sleep quality, and neuropsychological functioning. One hundred and nine eligible male Iraq/Afghanistan combat veterans completed an assessment consisting of a structured clinical interview, neuropsychological battery, and self-report measures. Using partial least squares structural equation modeling, combat experiences and mTBI history were not directly associated with sleep quality. PTSD was directly associated with sleep quality, which contributed to deficits in neuropsychological functioning independently of and in addition to combat experiences, PTSD, and mTBI history. Combat experiences and PTSD were differentially associated with motor speed. Sleep affected cognitive function independently of combat experiences, PTSD, and mTBI history. Sleep quality also contributed to cognitive deficits beyond effects of PTSD. An evaluation of sleep quality may be a useful point of clinical intervention in combat veterans with cognitive complaints. Improving sleep quality could alleviate cognitive complaints, improving veterans' ability to engage in treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Attentional bias for trauma-related words: exaggerated emotional Stroop effect in Afghanistan and Iraq war veterans with PTSD.

PubMed

Ashley, Victoria; Honzel, Nikki; Larsen, Jary; Justus, Timothy; Swick, Diane

2013-03-14

Post-traumatic stress disorder (PTSD) involves debilitating symptoms that can disrupt cognitive functioning. The emotional Stroop has been commonly used to examine the impact of PTSD on attentional control, but no published study has yet used it with Afghanistan and Iraq war veterans, and only one previous study has compared groups on habituation to trauma-related words. We administered the emotional Stroop, the Beck Depression Inventory (BDI), and the PTSD Checklist (PCL) to 30 veterans with PTSD, 30 military controls, and 30 civilian controls. Stroop word types included Combat, Matched-neutral, Neutral, Positive and Negative. Compared to controls, veterans with PTSD were disproportionately slower in responding to Combat words. They were also slower and less accurate overall, did not show interference on Negative or Positive words relative to Neutral, and showed a trend for delayed but successful habituation to Combat words. Higher PCL and BDI scores also correlated with larger interference effects. Because of its specificity in detecting attentional biases to trauma-related words, the emotional Stroop task may serve as a useful pre- and post task with intervention studies of PTSD patients.

Epidemiology of moderate-to-severe penetrating versus closed traumatic brain injury in the Iraq and Afghanistan wars.

PubMed

Orman, Jean A; Geyer, Dennis; Jones, John; Schneider, Eric B; Grafman, Jordan; Pugh, Mary Jo; Dubose, Joseph

2012-12-01

US combat operations in Iraq and Afghanistan have resulted in a greater proportion of service members with head and neck wounds caused by explosions compared with that of previous wars. Although penetrating traumatic brain injury (TBI) is frequently associated with these wounds, the epidemiology of penetrating TBI from these conflicts has not been well described. The Joint Theater Trauma Registry was queried for January 2003 through December 2010 to identify all patients with moderate-to-severe brain injury with a maximum Abbreviated Injury Scale (AIS) score of the head of 3 or greater and a diagnosis of penetrating or closed TBI in accordance with the Department of Defense Traumatic Brain Injury Surveillance definition. The epidemiology of these injuries was examined, including demographics, TBI severity, overall injury severity, and surgical interventions provided. A total of 1,255 TBI patients (774 penetrating, 481 closed) meeting criteria were identified. Penetrating brain injuries were more severe, more likely to be battle related, and less likely to be isolated injuries than a group of moderate-to-severe closed TBIs within the same range of anatomic injury severity. During the 5-year period of the Iraq war with the largest numbers of TBIs (2004-2008), the numbers of penetrating TBIs exceeded closed TBIs by a ratio of 2:1. During the 3-year period of the Afghanistan war with the greatest numbers of TBIs (2008-2010), the ratio of penetrating to closed TBIs was substantially lower, approximately 1.3:1. This study represents the first comprehensive report on the epidemiology of moderate-to-severe penetrating and closed TBIs resulting from the wars in Iraq and Afghanistan using Joint Theater Trauma Registry data. With the maturing theater of conflicts, penetrating TBIs were substantially less predominant compared with closed TBIs. While this finding may reflect changes in the use of protective measures and tactics or improvements in diagnosis of closed TBIs

Postal censorship of Bosnian public health institutions during the Second World War: The Independent State of Croatia versus Dr. Stanko Sielski.

PubMed

Papalas, John A; Tahirović, Husref

2016-11-01

This study aims to present evidence of censorship during World War II by the Independent State of Croatia of one of its public health officials, Dr. Stanko Sielski who was a physician trained in epidemiology and public health. During World War II, he directed the Institute for Combating Endemic Syphilis in the Bosnian town Banja Luka. The staff under his direction consisted solely of Jewish physicians. We analyzed two groups of envelopes either sent by or to Dr. Stanko Sielski during the War and found evidence of censorship only in communications with a Jewish physician dated towards the end of the War. Dr. Stanko Sielski would be posthumously recognized for his efforts to shield his Jewish colleagues. The newly available, but still limited data, which we present indicates efforts to censor Dr. Stanko Sielski's postal communications towards the War's end. The censors targeted specifically Dr. Stanko Sielski's correspondences with the Jewish physicians he was protecting. This material highlights the many challenges his public health service experienced during the time of armed conflict. Copyright © 2016 by Academy of Sciences and Arts of Bosnia and Herzegovina.

Risk factors for the development of posttraumatic stress disorder following combat trauma: a semiprospective study.

PubMed

Zohar, Joseph; Fostick, Leah; Cohen, Ayala; Bleich, Avi; Dolfin, Dan; Weissman, Zeev; Doron, Miki; Kaplan, Zeev; Klein, Ehud; Shalev, Arieh Y

2009-12-01

When positioned in a combat situation, soldiers may be subjected to extreme stress. However, only a few combat-exposed soldiers develop long-term disturbance, namely, posttraumatic stress disorder (PTSD). This study aimed to explore risk factors for developing PTSD in order to improve the psychiatric screening process of new recruits. In a semiprospective design, we compared 2,362 war veterans who developed PTSD (according to DSM-IV criteria) with an equal number of war veterans who did not develop PTSD. Controls were matched on the basis of sequential army identification numbers, that is, the soldier drafted immediately after the index PTSD veteran (usually on the same day). This method ensured similar demographic variables such as socioeconomic level and education. Data were collected from the Israeli Defense Force database and used in a comprehensive survey conducted between January 2000 and March 2001. Comparisons were made on predrafting personal factors (behavioral assessment, cognitive assessment, linguistic ability, and education) and pretrauma army characteristics (ie, rank and training). Neither behavioral assessment nor training were found to predict PTSD. The predictive factors that were found were essentially nonspecific, such as cognitive functioning, education, rank, and position during the trauma, with little effect from training. In an armed force that uses universal recruitment, carefully structured predrafting psychological assessment of social and individual qualifications (including motivation) failed to identify increased risk factors for PTSD. However, nonspecific factors were found to be associated with an increased risk for PTSD. This study suggests that the focus of future research on risk factors for PTSD should incorporate other domains rather than behavioral assessment alone. clinicaltrials.gov Identifier: NCT00229359. Copyright 2009 Physicians Postgraduate Press, Inc.

American physicians and dual loyalty obligations in the "war on terror"

PubMed Central

Singh, Jerome Amir

2003-01-01

Background Post-September 11, 2001, the U.S. government has labeled thousands of Afghan war detainees "unlawful combatants". This label effectively deprives these detainees of the protection they would receive as "prisoners of war" under international humanitarian law. Reports have emerged that indicate that thousands of detainees being held in secret military facilities outside the United States are being subjected to questionable "stress and duress" interrogation tactics by U.S. authorities. If true, American military physicians could be inadvertently becoming complicit in detainee abuse. Moreover, the American government's openly negative views towards such detainees could result in military physicians not wanting to provide reasonable care to detainees, despite it being their ethical duty to do so. Discussion This paper assesses the physician's obligations to treat war detainees in the light of relevant instruments of international humanitarian law and medical ethics. It briefly outlines how detainee abuse flourished in apartheid South Africa when state physicians became morally detached from the interests of their detainee patients. I caution U.S physicians not to let the same mindset befall them. I urge the U.S. medical community to advocate for detainee rights in the U.S, regardless of the political culture the detainee emerged from. I offer recommendations to U.S physicians facing dual loyalty conflicts of interest in the "war on terror". Summary If U.S. physicians are faced with a conflict of interest between following national policies or international principles of humanitarian law and medical ethics, they should opt to adhere to the latter when treating war detainees. It is important for the U.S. medical community to speak out against possible detainee abuse by the U.S. government. PMID:12892567

Analysis of combat sports players' injuries according to playing style for sports physiotherapy research.

PubMed

Noh, Ji-Woong; Park, Byoung-Sun; Kim, Mee-Young; Lee, Lim-Kyu; Yang, Seung-Min; Lee, Won-Deok; Shin, Yong-Sub; Kim, Ju-Hyun; Lee, Jeong-Uk; Kwak, Taek-Yong; Lee, Tae-Hyun; Kim, Ju-Young; Park, Jaehong; Kim, Junghwan

2015-08-01

[Purpose] This study describes the characteristics of injuries in strike and non-strike combat sports, and the results are intended for use in the area of sports physiotherapy research. [Subjects and Methods] The study was conducted on 159 athletes involved in a variety of combat sports. The participants included elite college players of the following sports: judo (47), ssireum (19), wrestling (13), kendo (30), boxing (16), and taekwondo (34). Of the participants, 133 were male and 26 were female. In the case of ssireum and boxing, all of the athletes were male. [Results] In the case of the combat sports, the types of injury and injured regions differed according to playing style. Dislocation and injuries to the neck, shoulders, and elbows were more frequent in the non-strike sports, while injuries to the wrists and hands were more frequent in the strike sports. There was a high incidence of sprains, strains, bruises, and injuries to the lower limbs in both groups. [Conclusion] We suggest that the characteristics of injuries in combat sports differ according to playing style, and our study will therefore provide physical therapists and researchers with information that can be used to prevent injury.

Analysis of combat sports players’ injuries according to playing style for sports physiotherapy research

PubMed Central

Noh, Ji-Woong; Park, Byoung-Sun; Kim, Mee-Young; Lee, Lim-Kyu; Yang, Seung-Min; Lee, Won-Deok; Shin, Yong-Sub; Kim, Ju-Hyun; Lee, Jeong-Uk; Kwak, Taek-Yong; Lee, Tae-Hyun; Kim, Ju-Young; Park, Jaehong; Kim, Junghwan

2015-01-01

[Purpose] This study describes the characteristics of injuries in strike and non-strike combat sports, and the results are intended for use in the area of sports physiotherapy research. [Subjects and Methods] The study was conducted on 159 athletes involved in a variety of combat sports. The participants included elite college players of the following sports: judo (47), ssireum (19), wrestling (13), kendo (30), boxing (16), and taekwondo (34). Of the participants, 133 were male and 26 were female. In the case of ssireum and boxing, all of the athletes were male. [Results] In the case of the combat sports, the types of injury and injured regions differed according to playing style. Dislocation and injuries to the neck, shoulders, and elbows were more frequent in the non-strike sports, while injuries to the wrists and hands were more frequent in the strike sports. There was a high incidence of sprains, strains, bruises, and injuries to the lower limbs in both groups. [Conclusion] We suggest that the characteristics of injuries in combat sports differ according to playing style, and our study will therefore provide physical therapists and researchers with information that can be used to prevent injury. PMID:26357420

Understanding the Importance and Practice of Credible Leadership at Program Executive Office Ground Combat Systems (PEO GCS) and Program Executive Office Combat Support and Combat Service Support (PEO CS and CSS)

DTIC Science & Technology

2017-03-30

and Program Executive Office Combat Support and Combat Service Support (PEO CS&CSS) Chad P. Stocker March 30, 2017 Submitted to...to Defense Acquisition University in partial fulfillment of the requirement of the Senior Service College Fellowship CREDIBLE LEADERSHIP AT PEO...of Credible Leadership at Program Executive Office Ground Combat Systems (PEO GCS) and Program Executive Office Combat Support and Combat Service

Health and reproductive outcomes among American legionnaires in relation to combat and herbicide exposure in Vietnam

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stellman, S.D.; Stellman, J.M.; Sommer, J.F. Jr.

1988-12-01

History of diagnosed illnesses, medical symptoms, and reproductive outcomes and their relation to combat intensity and herbicide exposure were studied, via a mailed questionnaire, among 6,810 American Legionnaires who served during the Vietnam War (42% in Southeast Asia, 58% elsewhere). Heart disease, venereal disease, and benign fatty tumors were reported significantly more often by Vietnam veterans than by controls. Combat intensity was significantly dosage-related to history of high blood pressure, ulcers, arthritis and rheumatism, genito-urinary problems, nervous system disease, major injury, hepatitis, and benign fatty tumors. Agent Orange exposure was significantly dosage-related to history of benign fatty tumors, adult acne,more » skin rash with blisters, and increased sensitivity of eyes to light. Rates of the latter two conditions and of change in skin color were especially elevated in men whose military occupations involved direct handling of herbicides. Neither combat nor Agent Orange exposure was associated with difficulty in conception, time to conception of first child, or to birthweight or sex ratio of offspring, but maternal smoking was strongly related to reduced birthweight. The percentage of spouses' pregnancies which resulted in miscarriages was significantly higher for Vietnam veterans than controls. Logistic regression analysis showed that Agent Orange exposure and maternal smoking were both independently and significantly associated with miscarriage rates in a dose-related manner.« less

Disturbed EEG sleep, paranoid cognition and somatic symptoms identify veterans with post-traumatic stress disorder

PubMed Central

Rothman, Lorne; Kleinman, Robert; Rhind, Shawn G.; Richardson, J. Donald

2016-01-01

Background Chronic post-traumatic stress disorder (PTSD) behavioural symptoms and medically unexplainable somatic symptoms are reported to occur following the stressful experience of military combatants in war zones. Aims To determine the contribution of disordered EEG sleep physiology in those military combatants who have unexplainable physical symptoms and PTSD behavioural difficulties following war-zone exposure. Method This case-controlled study compared 59 veterans with chronic sleep disturbance with 39 veterans with DSM-IV and clinician-administered PTSD Scale diagnosed PTSD who were unresponsive to pharmacological and psychological treatments. All had standardised EEG polysomnography, computerised sleep EEG cyclical alternating pattern (CAP) as a measure of sleep stability, self-ratings of combat exposure, paranoid cognition and hostility subscales of Symptom Checklist-90, Beck Depression Inventory and the Wahler Physical Symptom Inventory. Statistical group comparisons employed linear models, logistic regression and chi-square automatic interaction detection (CHAID)-like decision trees. Results Veterans with PTSD were more likely than those without PTSD to show disturbances in non-rapid eye movement (REM) and REM sleep including delayed sleep onset, less efficient EEG sleep, less stage 4 (deep) non-REM sleep, reduced REM and delayed onset to REM. There were no group differences in the prevalence of obstructive sleep apnoeas/hypopnoeas and periodic leg movements, but sleep-disturbed, non-PTSD military had more EEG CAP sleep instability. Rank order determinants for the diagnosis of PTSD comprise paranoid thinking, onset to REM sleep, combat history and somatic symptoms. Decision-tree analysis showed that a specific military event (combat), delayed onset to REM sleep, paranoid thinking and medically unexplainable somatic pain and fatigue characterise chronic PTSD. More PTSD veterans reported domestic and social misbehaviour. Conclusions Military combat

Narrative approach in understanding the drivers for resilience of military combat medics.

PubMed

Russell, Cristel Antonia; Gibbons, S W; Abraham, P A; Howe, E R; Deuster, P; Russell, D W

2017-12-10

Qualitative insights may demonstrate how combat medics (CM) deal with stressors and identify how resilience can potentially develop. Yet, qualitative research is scant in comparison to the many quantitative studies of health outcomes associated with military service. Semistructured qualitative interviews were used to collect personal narratives of US Army CMs who had previously served in Iraq or Afghanistan. Thematic analysis revealed three key driving forces for how resilience develops in the context of combat and war. The first was patriotism, which captures loyalty and full commitment to the military and its missions. The second was commitment to their family, reflecting the balance of responsibility to family of origin with the obligation one feels towards their military family. The last driving force was faith, or the drive to reach towards the transcendent to provide a moral compass and develop empathy in the face of difficult situations. An individual's commitment to country, military family and faith strengthens their resilience, and this can be used to inform future research efforts as well as current clinical practice. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Surgical Tooth Implants, Combat and Field.

DTIC Science & Technology

1977-11-01

assisted by Mr. Larry G. McCoy, We are gratefully indebted to our dental consultants from The Ohio State University , College of Dentistry: Dr...SURGICAL TOOTH IMPLANTS , COMBAT AND FIELD by Craig R. Hassler and Larry G. McCoy BACKGROUND Research interest in dental restorations has continued...terman, R.B., and Marshall , R.P. , “ Dental Anchors of Non-Natural Design Implanted In Miniature Swine ” , J. Dent. Res., 52, 124 (1973). (11) Mills

Hardships and personal strategies of Vietnam War nurses.

PubMed

Scannell-Desch, E A

2000-08-01

This study describes hardships faced in Vietnam and personal strategies used to deal with these hardships as defined by 24 female military nurses who served during the war. Purposive sampling was used, and data were generated using four core questions and in-depth interviews. The research methodology was phenomenology, incorporating data analysis procedures of Colaizzi, Lincoln and Guba, and Van Manen. Eight hardship and nine personal strategy themes were identified. This study found that caring for young, severely injured, and disfigured soldiers was a significant hardship and that nurses struggled with the moral dilemmas inherent in mass casualty situations, triage policies, and the practice of returning recovered soldiers to combat. Most nurses relied on personally proven and familiar strategies to reduce or buffer the effects of emotional hardships, whereas some discovered and used new strategies.

The effects of war on the Colombian population.

PubMed

Arboleda, Nelson

2002-01-01

In the last decade, more than 1.5 million children have died as victims of war and 2000 over 300,000 children were being used as combatants. Colombia, the fourth largest country in Latin America in terms of population and second in area, has been the site of conflict between the government and guerrilla groups, which has created over 200,000 victims and has worsened in the last five years. There is severe poverty and illegal trading in arms and narcotics is closely linked to the conflict. Kidnapping, both individual and mass and often of children, has been a particular feature. Colombia urgently needs programmes to eradicate poverty and violence and must be fully supported by international organizations. Research to suggest effective interventions is an essential part of such programmes.

Walter B. Cannon's World War I experience: treatment of traumatic shock then and now.

PubMed

Ryan, Kathy L

2018-06-01

Walter B. Cannon (1871-1945), perhaps America's preeminent physiologist, volunteered for service with the Army Expeditionary Force (AEF) during World War I. He initially served with Base Hospital No. 5, a unit made up of Harvard clinicians, before moving forward to the front lines to serve at a casualty clearing station run by the British. During his time there, he performed research on wounded soldiers to understand the nature and causes of traumatic shock. Subsequently, Cannon performed animal experimentation on the causes of traumatic shock in the London laboratory of Dr. William Bayliss before being assigned to the AEF Central Medical Laboratory in Dijon, France, where he continued his experimental studies. During this time, he also developed and taught a curriculum on resuscitation of wounded soldiers to medical providers. Although primarily a researcher and teacher, Cannon also performed clinical duties throughout the war, serving with distinction under fire. After the war, Cannon wrote a monograph entitled Traumatic Shock (New York: Appleton, 1923), which encapsulated the knowledge that had been gained during the war, both from direct observation of wounded soldiers, as well as laboratory experimentation on the causes and treatment of traumatic shock. In his monograph, Cannon elucidates a number of principles concerning hemorrhagic shock that were later forgotten, only to be "rediscovered" during the current conflicts in Iraq and Afghanistan. This paper summarizes Cannon's wartime experiences and the knowledge gained concerning traumatic shock during World War I, with a comparison of current combat casualty care practices and knowledge to that which Cannon and his colleagues understood a century ago.

Rhabdomyolysis and acute kidney injury in the injured war fighter.

PubMed

Elterman, Joel; Zonies, David; Stewart, Ian; Fang, Raymond; Schreiber, Martin

2015-10-01

Rhabdomyolysis is a recognized complication of traumatic injury. The correlation of an elevated creatine kinase (CK) level and the development of acute kidney injury (AKI) has been studied in the civilian population. We sought to review the prevalence of rhabdomyolysis in injured war fighters and determine if peak CK levels correlate with AKI. This is a retrospective cohort study of patients admitted at a US military treatment facility from January to November 2010. Inclusion criteria were active duty patients transported after explosive, penetrating, or blunt injury. Patients with burns or non-trauma-related admissions were excluded. Rhabdomyolysis was defined as a CK level greater than 5,000 U/L. AKI was defined using the Kidney Disease: Improving Global Outcomes classification. Mann-Whitney U-tests were used to determine the significance for continuous data. Correlations were determined using Spearman's ρ. Significance was set at p < 0.05. Of the 318 patients included in our analysis, 310 (98%) were male, and the median age was 24 years (21-28 years). Blast was the predominant mechanism of injury (71%), with a median Injury Severity Score (ISS) of 22 (16-29). Rhabdomyolysis developed in 79 patients (24.8%). The median peak CK for all patients was 4,178 U/L and ranged from 208 U/L to 120,000 U/L. Stage 1, 2, and 3 AKI developed in 56 (17.6%), 3 (0.9%), and 7 (2.2%) patients, respectively. There was a weak but statistically significant correlation between peak CK and AKI (r = 0.26, p < 0.05). Elevated peak CK levels in the injured war fighter are weakly associated with the development of AKI but are not predictive. The development of clinical practice guidelines would help standardize treatment for rhabdomyolysis in combat casualties and would allow for standardized comparisons in future work. Epidemiologic/prognostic study, level III.

Combat exposure, social relationships, and subjective well-being among middle-aged and older Veterans.

PubMed

Yang, Mai See; Burr, Jeffrey A

2016-01-01

This study described the association of subjective well-being with combat exposure and social relationships among middle-aged and older Veteran men in the USA. The stress-buffering hypothesis, which predicts social relationships may moderate the association between combat exposure and subjective well-being, was also examined. Data from the 2008 Health and Retirement Study (N = 2961) were used to estimate logistic regression models, focusing on three measures of subjective well-being: depression, life satisfaction, and self-reported health. In the fully adjusted models, there were no statistically significant relationships between combat exposure and the three indicators of subjective well-being. However, compared to Veterans who had lower scores on the social relationship index, Veterans who had higher scores were less likely to be depressed and less likely to report poor or fair health. Veterans who had higher scores on the social relationships index reported higher levels of life satisfaction than those Veterans who had lower scores. There was no evidence for a social relationships buffering effect. The results of this study demonstrated that combat exposure did not have a long-term relationship with subjective well-being. Longitudinal research designs with more comprehensive indicators of combat exposure may help researchers better understand some of the underlying complexity of this relationship. Complementary research with samples of women Veterans, as well as samples of Hispanic, and non-Black, non-White Veterans, is also needed.

‘Practice what you preach’: Nurses’ perspectives on the Code of Ethics and Service Pledge in five South African hospitals

PubMed Central

White, Janine; Phakoe, Maureen; Rispel, Laetitia C.

2015-01-01

Background A recent focus of the global discourse on the health workforce has been on its quality, including the existence of codes of ethics. In South Africa, the importance of ethics and value systems in nursing was emphasised in the 2011 National Nursing Summit. Objective The study explored hospital nurses’ perceptions of the International Code of Ethics for Nurses; their perceptions of the South African Nurses’ Pledge of Service; and their views on contemporary ethical practice. Methods Following university ethics approval, the study was done at a convenience sample of five hospitals in two South African provinces. In each hospital, all day duty nurses in paediatric, maternity, adult medical, and adult surgical units were requested to complete a self-administered questionnaire. The questionnaire focused on their perceptions of the Code of Ethics and the Pledge, using a seven-point Likert scale. STATA® 13 and NVIVO 10 were used to analyse survey data and open-ended responses, respectively. Results The mean age of survey participants (n=69) was 39 years (SD=9.2), and the majority were female (96%). The majority agreed with a statement that they will promote the human rights of individuals (98%) and that they have a duty to meet the health and social needs of the public (96%). More nuanced responses were obtained for some questions, with 60% agreeing with a statement that too much emphasis is placed on patients’ rights as opposed to nurses’ rights and 32% agreeing with a statement that they would take part in strike action to improve nurses’ salaries and working conditions. The dilemmas of nurses to uphold the Code of Ethics and the Pledge in face of workplace constraints or poor working conditions were revealed in nurses’ responses to open-ended questions. Conclusion Continuing education in ethics and addressing health system deficiencies will enhance nurses’ professional development and their ethical decision-making and practice. PMID:25971398

Dehydroepiandrosterone and dehydroepiandrosterone sulfate levels in combat veterans with or without a history of suicide attempt.

PubMed

Sher, L; Flory, J; Bierer, L; Makotkine, I; Yehuda, R

2018-05-22

The goal of this study was to determine whether combat veterans who have made a suicide attempt postdeployment can be distinguished from combat veterans who have never made a suicide attempt based on differences in psychological and biological variables. Demographic and clinical parameters of suicide attempters and non-attempters were assessed. Blood samples were assayed for dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEAS). Suicide attempters had higher Scale for Suicidal Ideation and Montgomery-Åsberg Depression Rating Scale (MADRS)-suicidal thoughts item scores in comparison with non-attempters. There was a trend toward higher MADRS scores in the suicide attempter group compared with non-attempters. Suicide attempters had significantly lower levels of DHEA and DHEAS compared with non-attempters. Scale for Suicidal Ideation scores in all study participants combined negatively correlate with DHEA and DHEAS levels. DHEAS levels negatively correlate with Scale for Suicidal Ideation scores in suicide non-attempters but not in suicide attempters. DHEA/DHEAS ratios positively correlate with total adolescence aggression scores, total adulthood aggression scores, and total aggression scale scores in suicide attempters but not in suicide non-attempters. There are psychobiological differences between combat veterans with or without a history of suicidal behaviour. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A formulation and analysis of combat games

NASA Technical Reports Server (NTRS)

Heymann, M.; Ardema, M. D.; Rajan, N.

1984-01-01

Combat which is formulated as a dynamical encounter between two opponents, each of whom has offensive capabilities and objectives is outlined. A target set is associated with each opponent in the event space in which he endeavors to terminate the combat, thereby winning. If the combat terminates in both target sets simultaneously, or in neither, a joint capture or a draw, respectively, occurs. Resolution of the encounter is formulated as a combat game; as a pair of competing event constrained differential games. If exactly one of the players can win, the optimal strategies are determined from a resulting constrained zero sum differential game. Otherwise the optimal strategies are computed from a resulting nonzero sum game. Since optimal combat strategies may frequently not exist, approximate or delta combat games are also formulated leading to approximate or delta optimal strategies. The turret game is used to illustrate combat games. This game is sufficiently complex to exhibit a rich variety of combat behavior, much of which is not found in pursuit evasion games.

Hearing Protection Evaluation for the Combat Arms Earplug at Idaho National Laboratory

DOE Office of Scientific and Technical Information (OSTI.GOV)

James Lovejoy

2007-03-01

The Idaho National Laboratory (INL) is managed by Battelle Energy Alliance, LLC (BEA) for the Department of Energy. The INL Protective Security Forces (Pro Force) are involved in training exercises that generate impulse noise by small arms fire. Force-on-force (FOF) training exercises that simulate real world scenarios require the Pro Force to engage the opposition force (OPFOR) while maintaining situational awareness through verbal communications. The Combat Arms earplug was studied to determine if it provides adequate hearing protection in accordance with the requirements of MIL-STD-1474C/D. The Combat Arms earplug uses a design that allows continuous noise through a critical orificemore » while effectively attenuating high-energy impulse noise. The earplug attenuates noise on a non linear scale, as the sound increases the attenuation increases. The INL studied the effectiveness of the Combat Arms earplug with a Bruel & Kjaer (B&K) head and torso simulator used with a selection of small arms to create impulse sound pressures. The Combat Arms earplugs were inserted into the B&K head and torso ears, and small arms were then discharged to generate the impulse noise. The INL analysis of the data indicates that the Combat Arms earplug does provide adequate protection, in accordance with MIL-STD-1474C/D, when used to protect against impulse noise generated by small arms fire using blank ammunition. Impulse noise generated by small arms fire ranged from 135–160 dB range unfiltered un-weighted. The Combat Arms earplug attenuated the sound pressure 10–25 dB depending on the impulse noise pressure. This assessment is consistent with the results of previously published studies on the Combat Arms earplug (see Section 5, “References”). Based upon these result, the INL intends to use the Combat Arms earplug for FOF training exercises.« less

Anaesthetic and other treatments of shell shock: World War I and beyond.

PubMed

McKenzie, A G

2012-03-01

Post-traumatic stress disorder (PTSD) is an important health risk factor for military personnel deployed in modern warfare. In World War I this condition (then known as shell shock or 'neurasthenia') was such a problem that 'forward psychiatry' was begun by French doctors in 1915. Some British doctors tried general anaesthesia as a treatment (ether and chloroform), while others preferred application of electricity. Four British 'forward psychiatric units' were set up in 1917. Hospitals for shell shocked soldiers were also established in Britain, including (for officers) Craiglockhart War Hospital in Edinburgh; patients diagnosed to have more serious psychiatric conditions were transferred to the Royal Edinburgh Asylum. Towards the end of 1918 anaesthetic and electrical treatments of shell shock were gradually displaced by modified Freudian methods psychodynamic intervention. The efficacy of 'forward psychiatry' was controversial. In 1922 the War Office produced a report on shell shock with recommendations for prevention of war neurosis. However, when World War II broke out in 1939, this seemed to have been ignored. The term 'combat fatigue' was introduced as breakdown rates became alarming, and then the value of pre-selection was recognised. At the Maudsley Hospital in London in 1940 barbiturate abreaction was advocated for quick relief from severe anxiety and hysteria, using i.v. anaesthetics: Somnifaine, paraldehyde, Sodium Amytal. 'Pentothal narcosis' and 'narco-analysis' were adopted by British and American military psychiatrists. However, by 1945 medical thinking gradually settled on the same approaches that had seemed to be effective in 1918. The term PTSD was introduced in 1980. In the UK the National Institute for Health and Clinical Excellence (NICE) guidelines for management (2005) recommend trauma-focussed Cognitive Behavioural Therapy and consideration of antidepressants.

Physiological stress and performance analysis to karate combat.

PubMed

Chaabene, Helmi; Hellara, Ilhem; Ghali, Faten B; Franchini, Emerson; Neffati, Fedoua; Tabben, Montassar; Najjar, Mohamed F; Hachana, Younés

2016-10-01

This study aimed to evaluate the relationship between physiological, and parameters of performance analysis during karate contest. Nine elite-level karate athletes participated in this study. Saliva sample was collected pre- and post-karate combat. Salivary cortisol (sC) post-combat 2 raised significantly compared to that recorded at pre-combat 1 (Δ%=105.3%; P=0.04; dz=0.78). The largest decrease of the salivary T/C ratio (sR) compared to pre-combat 1 was recorded post-combat 2 (Δ%=-43.5%; P=0.03). Moreover, blood lactate concentration post-combat 1 correlated positively to sCpost-combat 1 (r=0.66; P=0.05) and negatively to both salivary testosterone (sT) (r=-0.76; P=0.01) and sRpost-combat 1 (r=-0.76; P=0.01). There was no significant relationship between hormonal measures and parameters of match analysis. Although under simulated condition, karate combat poses large physiological stress to the karateka. Additionally, physiological strain to karate combat led to a catabolic hormonal response.

Penetrating cardiothoracic war wounds.

PubMed

Biocina, B; Sutlić, Z; Husedzinović, I; Rudez, I; Ugljen, R; Letica, D; Slobodnjak, Z; Karadza, J; Brida, V; Vladović-Relja, T; Jelić, I

1997-03-01

lung), suture + extraction of the foreign body in 4 patients, 2 of them with cardiopulmonary bypass. Complications were pericardial effusion in 6 patients, arrhythmia in 2 patients, myocardial infraction in 1 patient and migration of the foreign body in 1 patient. Patients, 7, died, five of the group with concomitant injuries, two of thoracic and one of cardiac injuries (5, 1.2 and 4.2%, respectively). Penetrating cardiothoracic wounds are among the most serious injuries in war, either in combat or among civilians. In spite of their nature, they can be treated successfully with relatively low mortality and morbidity.

Psychopathological status, behavior problems, and family adjustment of Kuwaiti children whose fathers were involved in the first gulf war

PubMed Central

Al-Turkait, Fawziyah A; Ohaeri, Jude U

2008-01-01

Objectives Following the end of the Gulf War that resulted in the liberation of Kuwait, there are no reports on the impact of veterans' traumatic exposure and posttraumatic stress disorder (PTSD) on their children. We compared the severity of anxiety, depression, deviant behavior and poor family adjustment among the children of a stratified random sample of four groups of Kuwaiti military men, viz: the retired; an active -in-the-army group (AIA) (involved in duties at the rear); an in-battle group (IB) (involved in combat); and a prisoners -of- war (POWs) group. Also, we assessed the association of father's PTSD/combat status and mother's characteristics with child psychosocial outcomes. Method Subjects were interviewed at home, 6 years after the war, using: the Child Behavior Index to assess anxiety, depression, and adaptive behavior; Rutter Scale A2 for deviant behavior; and Family Adjustment Device for adjustment at home. Both parents were assessed for PTSD. Results The 489 offspring (250 m, 239 f; mean age 13.8 yrs) belonged to 166 father-mother pairs. Children of POWs tended to have higher anxiety, depression, and abnormal behavior scores. Those whose fathers had PTSD had significantly higher depression scores. However, children of fathers with both PTSD and POW status (N = 43) did not have significantly different outcome scores than the other father PTSD/combat status groups. Mother's PTSD, anxiety, depression and social status were significantly associated with all the child outcome variables. Parental age, child's age and child's level of education were significant covariates. Although children with both parents having PTSD had significantly higher anxiety/depression scores, the mother's anxiety was the most frequent and important predictor of child outcome variables. The frequency of abnormal test scores was: 14% for anxiety/depression, and 17% for deviant behavior. Conclusion Our findings support the impression that child emotional experiences in

Child psychiatric sequelae of maternal war stress.

PubMed

Meijer, A

1985-12-01

Two cohorts of boys were examined while attending a well-baby clinic and reexamined at the end of the first grade of elementary school. One cohort (n = 57) consisted of boys born in the year of the Six-Day War in 1967. The other cohort was born 2 years later (n = 63). Data on socio-demographic background, early development, behavior at school and at home were obtained from the mothers and the teachers. Statistical analysis showed that the "war children" had significant developmental delays and regressive, non-affiliative and dissocial behavior. The children, who were in their first half year of life at the time of the war, were much more disturbed than those of whom the mothers were pregnant at the time of the war. The findings suggest that a disturbed mother-child relationship existed in the former group.

A perspective on the history of health and human rights: from the Cold War to the Gold War.

PubMed

Tarantola, Daniel

2008-04-01

Through the end of the Cold War, public health policies were predominantly shaped and implemented by governments and these same governments committed themselves to meet their obligations for health under international and national laws. The post-Cold War era has witnessed the entry of new actors in public health and the sharing of power and influences with non-state actors, in particular the private sector and interest groups. This article examines the emergence of human rights and the rise of health on the international development agenda as the Cold War was ending. It highlights the convergence of health and human rights in academic and public discourse since the end of the Cold War in a context of political and economic shifts linked to the ongoing economic globalization. It describes opportunities and challenges for greater synergy between health and rights and proposes a role for health practitioners.

Cerebrospinal fluid neuropeptide Y in combat veterans with and without posttraumatic stress disorder.

PubMed

Sah, Renu; Ekhator, Nosakhare N; Jefferson-Wilson, Lena; Horn, Paul S; Geracioti, Thomas D

2014-02-01

Accruing evidence indicates that neuropeptide Y (NPY), a peptide neurotransmitter, is a resilience-to-stress factor in humans. We previously reported reduced cerebrospinal fluid (CSF) NPY concentrations in combat-related posttraumatic stress disorder (PTSD) subjects as compared with healthy, non-combat-exposed volunteers. Here we report CSF NPY in combat-exposed veterans with and without PTSD. We quantified NPY concentrations in morning CSF from 11 male subjects with PTSD from combat in Iraq and/or Afghanistan and from 14 combat-exposed subjects without PTSD. NPY-like immunoreactivity (NPY-LI) was measured by EIA. The relationship between CSF NPY and clinical symptoms, as measured by the Clinician-Administered PTSD Scale (CAPS) and Beck Depression Inventory (BDI), was assessed, as was the relationship between combat exposure scale (CES) scores and CSF NPY. As compared with the combat-exposed comparison subjects without PTSD, individuals with PTSD had significantly lower concentrations of CSF NPY [mean CSF NPY was 258. 6 ± 21.64 pg/mL in the combat trauma-no PTSD group but only 180.5 ± 12.62 pg/mL in PTSD patients (p=0.008)]. After adjusting for CES and BDI scores the two groups were still significantly different with respect to NPY. Importantly, CSF NPY was negatively correlated with composite CAPS score and intrusive (re-experiencing) subscale scores, but did not significantly correlate with CES or BDI scores. Our current findings further suggest that NPY may regulate the manifestation of PTSD symptomatology, and extend previous observations of low CSF NPY concentrations in the disorder. Central nervous system NPY may be a clinically important pharmacotherapeutic target, and/or diagnostic measure, for PTSD. Published by Elsevier Ltd.

Fear and Courage in Tim O’Brien’s if I Die in a Combat Zone, Going After Cacciato, and the Things They Carried.

DTIC Science & Technology

1998-08-07

DISTRIBUTION CODE 13. ABSTRACT (Maximum 200 words) 14 . SUBJECT TERMS 15. NUMBER OF PAGES 77 16. PRICE CODE 17. SECURITY CLASSIFICATION OF...IN A COMBAT ZONE . 14 3 GOING AFTER CACCIATO ...... 25 4 THE THINGS THEY CARRIED 44 5 CONCLUSION ..... 63 NOTES 70 WORKS CONSULTED 72 ill...with the war in varying degrees. O’Brien was born in Austin, Minnesota, in 194 6, but lived his adolescent and teenage years in Worthington

The Army Air Forces in World War II. Volume 7. Services Around the World

DTIC Science & Technology

1983-01-01

la., Maj. Gen. J. S . Stowell to Frank H. Heck, I I Sept. 1952. 64. Schedules included in SATD SOP for Green Proj., in Hist. SATD, May- 65. Ltr...E S I N W O R L D W A R I I it was the first war truly world wide in geographical scope but in that for the first time combat operations were...various mechanical ailments calling for numerous modi- fications and was a hard plane to fly and to maintain. Vii T H E A R M Y A I R F O R C E S I

Posttraumatic stress disorder in war veterans: a discussion of the Neuroevolutionary Time-depth Principle.

PubMed

Braquehais, María Dolores; Sher, Leo

2010-09-01

Trauma is a universal phenomenon. Violence is a type of trauma and war is one of the ways in which violence is expressed. The "Neuroevolutionary Time-depth Principle" of innate fears, based on prevalence data, suggests that high rates of posttraumatic stress disorder (PTSD) after combat exposure can be due to the fact that this fear-stress response appeared as a reaction to inter-group male-to-male and intra-group killings after the rising of population densities in the Neolithic period. Studies of PTSD prevalence available in MEDLINE, Institute for Scientific Information Databases (Science Citation Index Expanded, Social Sciences Citation Index, and Arts and Humanities Citation Index), EMBASE, and Cochrane Library were identified and reviewed. Prevalence data of PTSD deeply vary from one country to another, even in groups exposed to similar stressors. Moreover, war is not a uniform and unchanged phenomenon and not all war stressors are similar because some of them are known to lead to PTSD more than others. We argue that psychosocial narratives deeply influence our biological response to trauma and violence, shaping the genotypical response to trauma. Great differences in prevalence may be in part due to this fact. We also suggest that personal preconceptions and socio-cultural interests may also be playing a critical role in the theories developed to explain the nature of our response to violence. A comprehensive model for war-related PTSD should integrate both genotypical and phenotypical findings. 2009 Elsevier B.V. All rights reserved.

Physical health, mental health, and utilization of complementary and alternative medicine services among Gulf War veterans.

PubMed

Holliday, Stephanie Brooks; Hull, Amanda; Lockwood, Courtney; Eickhoff, Christine; Sullivan, Patrick; Reinhard, Matthew

2014-12-01

Gulf War veterans represent a unique subset of the veteran population. It has been challenging to identify interventions that result in improvements in physical and mental health for this population. Recently, there has been recognition of a potential role for complementary and alternative medicine (CAM) interventions. This paper examines the characteristics of Gulf War and non-Gulf War veterans referred to a CAM clinic, and explores the utilization of services by this population. Participants included 226 veterans enrolled in a CAM clinic at a Veterans Affairs medical center, 42 of whom were Gulf War veterans. Self-report measures of physical/mental health were administered, and service utilization was obtained from participants' medical records for a 6-month period. Gulf War veterans enrolled in the program reported more severe physical and mental health symptoms than non-Gulf War veterans. However, examining only veterans who participated in services in the 6 months following enrollment, the 2 groups reported similar symptom severity. Both groups were similar in their attendance of individual acupuncture and iRest yoga nidra, although Gulf War veterans attended fewer sessions of group acupuncture. Although Gulf War veterans who enroll in a CAM program may have more severe symptoms than non-Gulf War veterans, those who actually participate in services are similar to non-Gulf War veterans on these measures. These groups also differ in their pattern of service utilization. Future research should explore the reasons for these differences, and to identify ways to promote treatment engagement with this population.

EFFECT OF THE APOE ε4 ALLELE AND COMBAT EXPOSURE ON PTSD AMONG IRAQ/AFGHANISTAN-ERA VETERANS.

PubMed

Kimbrel, Nathan A; Hauser, Michael A; Garrett, Melanie; Ashley-Koch, Allison; Liu, Yutao; Dennis, Michelle F; Klein, Rebecca C; Beckham, Jean C

2015-05-01

The apolipoprotein E (APOE) ε4 allele has been implicated in a range of neuropsychiatric conditions. The present research examined if the ε4 allele of the APOE gene moderated the effect of combat exposure on posttraumatic stress disorder (PTSD) among Iraq/Afghanistan-era veterans. Participants included 765 non-Hispanic White (NHW) and 859 non-Hispanic Black (NHB) Iraq/Afghanistan-era veterans. A structured interview established psychiatric diagnoses. Combat exposure and PTSD symptom severity were assessed via self-report. The most common lifetime diagnoses were depression (39.2%), PTSD (38.4%), and alcohol dependence (24.38%). After correcting for multiple comparisons, no significant effects were observed on any of the outcomes among the NHW sample; however, within the NHB sample, significant gene × environment (G × E) interactions were observed for lifetime PTSD (P = .0029) and PTSD symptom severity (P = .0009). In each case, the APOE ε4 allele had no effect on the outcomes when combat exposure was low; however, when combat exposure was high, an additive effect was observed such that ε4 homozygotes exposed to high levels of combat reported the highest rates of PTSD (92%) and the worst symptom severity scores on the Davidson Trauma Scale (M = 79.5). Although preliminary, these findings suggest that the APOE ε4 allele, in conjunction with exposure to high levels of combat exposure, may increase veterans' risk for developing PTSD. © 2015 Wiley Periodicals, Inc.

Gulf War Illness: Challenges Persist.

PubMed

Nettleman, Mary

2015-01-01

It has been more than 20 years since the United States and coalition forces entered Kuwait and Iraq. Actual combat was of remarkably short duration: less than 1 week of sustained ground activity and 6 weeks of air missions. Thus, it was surprising when approximately 200,000 returning US veterans were affected by a chronic multi-symptom illness that came to be known as Gulf War Illness (GWI). There were many challenges in investigating GWI, not least of which was that it took several years before the condition was officially taken seriously. There were multiple exposures to potentially causal agents on and off the battlefield, but these exposures were documented incompletely if at all, leaving epidemiologists to rely on self-report for information. In the past 2 years, significant controversy has arisen over the future directions of the field. Despite these challenges, several studies have implicated exposure to acetylcholinesterase inhibitors such as pyridostigmine bromide in the genesis of the condition. The story of GWI can inform research into other conditions and guide future work on veterans' health.

Attentional bias for trauma-related words: exaggerated emotional Stroop effect in Afghanistan and Iraq war veterans with PTSD

PubMed Central

2013-01-01

Background Post-traumatic stress disorder (PTSD) involves debilitating symptoms that can disrupt cognitive functioning. The emotional Stroop has been commonly used to examine the impact of PTSD on attentional control, but no published study has yet used it with Afghanistan and Iraq war veterans, and only one previous study has compared groups on habituation to trauma-related words. Methods We administered the emotional Stroop, the Beck Depression Inventory (BDI), and the PTSD Checklist (PCL) to 30 veterans with PTSD, 30 military controls, and 30 civilian controls. Stroop word types included Combat, Matched-neutral, Neutral, Positive and Negative. Results Compared to controls, veterans with PTSD were disproportionately slower in responding to Combat words. They were also slower and less accurate overall, did not show interference on Negative or Positive words relative to Neutral, and showed a trend for delayed but successful habituation to Combat words. Higher PCL and BDI scores also correlated with larger interference effects. Conclusions Because of its specificity in detecting attentional biases to trauma-related words, the emotional Stroop task may serve as a useful pre- and post task with intervention studies of PTSD patients. PMID:23496805

Legislations combating counterfeit drugs in Hong Kong.

PubMed

Lai, C W; Chan, W K

2013-08-01

To understand legislation combating counterfeit drugs in Hong Kong. This study consisted of two parts. In part I, counterfeit drugs–related ordinances and court cases were reviewed. In part II, indepth interviews of the stakeholders were described. Hong Kong. All Hong Kong ordinances were screened manually to identify those combating counterfeit drugs. Court cases were searched for each of the identified cases. Then, the relevant judgement justifications were analysed to identify sentencing issues. Indepth interviews with the stakeholders were conducted to understand their perceptions about such legislation. Trade Marks Ordinance, Patents Ordinance, Trade Descriptions Ordinance, and Pharmacy and Poisons Ordinance were current legislative items combating counterfeit drugs. Sentencing criteria depended on: intention to deceive, quantity of seized drugs, presence of expected therapeutic effect or toxic ingredients, previous criminal records, cooperativeness with Customs officers, honest confessions, pleas of guilty, types of drugs, and precautionary measures to prevent sale of counterfeit drugs. Stakeholders’ perceptions were explored with respect to legislation regarding the scale and significance of the counterfeit drug problem, penalties and deterrents, drug-specific legislation and authority, and inspections and enforcement. To plug the loopholes, a specific law with heavy penalties should be adopted. This could be supplemented by non-legal measures like education of judges, lawyers, and the public; publishing the names of offending pharmacies; and emphasising the role of pharmacists to the public.

"It's what we're here for:" nurses caring for military personnel during the Persian Gulf Wars.

PubMed

Rushton, Patricia; Scott, Jared E; Callister, Lynn Clark

2008-01-01

Military nursing service during wartime represents significant contributions to a unique type of health care. The purposes of this study were to: (1) generate themes that elucidate combat nursing experiences, (2) honor nurses who served by sharing their stories, and (3) permanently archive accounts of nursing personnel who served during the Persian Gulf Wars during the late 20th and early 21st centuries. Eleven military nurses who provided health care to American troops in the Persian Gulf participated in a historical study as part of the ongoing Nurses at War oral history project documenting the experiences of nurses during times of armed conflict. The overriding theme, "It's what we're here for," demonstrates the commitment of nurses: a commitment to care and to sacrifice. Other themes drawn from the study included lessons learned from their wartime nursing experiences, sacrifices made, and chronicles of caring. During armed conflict in the Persian Gulf Wars, military nurses' personal stories demonstrated the importance of being engaged in making meaningful professional and historical contributions. These nurses displayed professional commitment and hardiness in the face of difficult life circumstances, saying, "We did what we had to do."

Smoking among troops deployed in combat areas and its association with combat exposure among navy personnel in Sri Lanka

PubMed Central

2012-01-01

Background Among military personnel alcohol consumption and binge-drinking have increased but cigarette smoking has declined in the recent past. Although there is a strong association between smoking and PTSD the association between combat exposure and smoking is not clear. Methods This cross sectional study was carried out among representative samples of SLN Special Forces and regular forces deployed in combat areas. Both Special Forces and regular forces were selected using simple random sampling. Only personnel who had served continuously in combat areas during the one year period prior to end of combat operations were included in the study. Females were not included in the sample. The study assessed several mental health outcomes as well as alcohol use, smoking and cannabis use. Sample was classified according to smoking habits as never smokers, past smokers (those who had smoked in the past but not within the past year) and current smokers (those smoking at least one cigarette within the past 12 months). Results Sample consisted of 259 Special Forces and 412 regular navy personnel. Prevalence of current smoking was 17.9% (95% CI 14.9-20.8). Of the sample 58.4% had never smoked and 23.7% were past smokers. Prevalence of current smoking was significantly higher among Special Forces personnel compared to regular forces. (OR 1.90 (95% CI 1.20-3.02). Personnel aged ≥35 years had the lowest prevalence of smoking (14.0%). Commissioned officers had a lower prevalence (12.1%) than non commissioned officers or other ranks. After adjustment for demographic variables and service type there was significant association between smoking and combat experiences of seeing dead or wounded [OR 1.79 (95%CI 1.08-2.9)], handling dead bodies [OR 2.47(95%CI 1.6-3.81)], coming under small arms fire [OR 2.01(95%CI 1.28-3.15)] and coming under mortar, missile and artillery fire [OR 2.02(95%CI 1.29-3.17)]. There was significant association between the number of risk events and

Self-report and longitudinal predictors of violence in Iraq and Afghanistan war era veterans.

PubMed

Elbogen, Eric B; Johnson, Sally C; Newton, Virginia M; Fuller, Sara; Wagner, H Ryan; Beckham, Jean C

2013-10-01

This study, using a longitudinal design, attempted to identify whether self-reported problems with violence were empirically associated with future violent behavior among Iraq and Afghanistan war veterans and whether and how collateral informant interviews enhanced the risk assessment process. Data were gathered from N = 300 participants (n = 150 dyads of Iraq and Afghanistan war veterans and family/friends). The veterans completed baseline and follow-up interviews 3 years later on average, and family/friends provided collateral data on dependent measures at follow-up. Analyses showed that aggression toward others at follow-up was associated with younger age, posttraumatic stress disorder, combat exposure, and a history of having witnessed parental violence growing up. Self-reported problems controlling violence at baseline had robust statistical power in predicting aggression toward others at follow-up. Collateral report enhanced detection of dependent variables: 20% of cases positive for violence toward others would have been missed relying only on self-report. The results identify a subset of Iraq and Afghanistan war veterans at higher risk for problematic postdeployment adjustment and indicate that the veterans' self-report of violence was useful in predicting future aggression. Underreporting of violence was not evidenced by most veterans but could be improved upon by obtaining collateral information.

Patterns of civilian and child deaths due to war-related violence in Syria: a comparative analysis from the Violation Documentation Center dataset, 2011-16.

PubMed

Guha-Sapir, Debarati; Schlüter, Benjamin; Rodriguez-Llanes, Jose Manuel; Lillywhite, Louis; Hicks, Madelyn Hsiao-Rei

2018-01-01

Since March, 2011, the Syrian civil war has lowered life expectancy by as much as 20 years. We describe demographic, spatial, and temporal patterns of direct deaths of civilians and opposition combatants from conflict-related violence in 6 years of war. We analysed conflict-related violent deaths with complete information on date, place, and cause of death and demographic group occurring from March 18, 2011, to Dec 31, 2016, recorded by the Violation Documentation Center (VDC). We included civilian and combatant deaths in all Syrian governorates, excluding government-controlled areas. We did not include detainees and missing persons, nor deaths from siege conditions or insufficient medical care. We categorised deaths based on VDC weapon type. We used χ 2 testing to compare deaths from different weapons in civilian men, women, boys, and girls and adult and child combatants. We analysed deaths by governorate and over time. The VDC recorded 143 630 conflict-related violent deaths with complete information between March 18, 2011, and Dec 31, 2016. Syrian civilians constituted 101 453 (70·6%) of the deaths compared with 42 177 (29·4%) opposition combatants. Direct deaths were caused by wide-area weapons of shelling and air bombardments in 58 099 (57·3%) civilians, including 8285 (74·6%) civilian women and 13 810 (79·4%) civilian children, and in 4058 (9·6%) opposition combatants. Proportions of children among civilian deaths increased from 8·9% (388 of 4254 civilian deaths) in 2011 to 19·0% (4927 of 25 972) in 2013 and to 23·3% (2662 of 11 444) in 2016. Of 7566 deaths from barrel bombs, 7351 (97·2%) were civilians, of whom 2007 (27·3%) were children. Of 20 281 deaths by execution, 18 747 (92·4%) were civilians and 1534 (7·6%) were opposition combatants. Compared with opposition child soldiers who were male (n=333), deaths of civilian male children (n=11 730) were caused more often by air bombardments (39·2% vs 5·4%, p<0·0001) and

Risperidone in psychotic combat-related posttraumatic stress disorder: an open trial.

PubMed

Kozarić-Kovacić, Dragica; Pivac, Nela; Mück-Seler, Dorotea; Rothbaum, Barbara Olasov

2005-07-01

Psychotic symptoms that frequently occur in combat-related posttraumatic stress disorder (PTSD) complicate its pharmacotherapy. We hypothesized that war veterans with psychotic PTSD, resistant to prior antidepressant treatment, would respond well to 6 weeks of treatment with the atypical antipsychotic risperidone, given as a monotherapy. Twenty-six male war veterans with psychotic PTSD (DSM-IV) completed the 6-week inpatient treatment with risperidone (2-4 mg/day) during the period from November 1999 through December 2002. The primary outcome measure was change from baseline to endpoint (6 weeks) in Positive and Negative Syndrome Scale (PANSS) total and subscale scores. Secondary outcome measures were changes in PTSD Interview (PTSD-I) and Clinical Global Impressions-Severity of Illness scale (CGI-S) total and subscale scores. Clinical improvement was assessed by CGI-S, CGI-Improvement scale, and Patient Global Impression of Improvement scale, while adverse events were recorded by Drug-Induced Extrapyramidal Symptoms Scale. Treatment with risperidone for either 3 or 6 weeks in an open trial significantly reduced total and subscales scores on the PANSS and on the PTSD-I and CGI-S when compared to baseline scores in patients with psychotic PTSD. Our preliminary data from the open trial indicate that risperidone decreased most of the psychotic and PTSD symptoms. Psychotic PTSD patients, unresponsive to antidepressant treatment, improved significantly after treatment for either 3 or 6 weeks with risperidone.

New combat laser and ballistic eye protection goggles

NASA Astrophysics Data System (ADS)

Belkin, Michael

1996-04-01

Up to 10% of all combat casualties involve eye injuries which are becoming more severe, bilateral and likely to lead to a retained intraocular foreign body. The modern battlefield is permeated with laser radiation from range finders, target designators and perhaps laser weapons aimed at producing visual incapacitation. In future wars, therefore, the likelihood of eye injuries is very high. We sought to devise means to protect the eye from military relevant injurious agents. Almost all ballistic injuries can be prevented by using polycarbonate goggles. They must not, however, interfere with the soldier's functions such as the use of binoculars or limit his visual fields. These problems are not insurmountable and we shall demonstrate new goggles design which we believe will be acceptable to the troops. The solution to laser protection is more difficult. For that purpose the goggles include outserts filters for various groups of laser wavelengths. The soldier will use the appropriate filter according to a reading from a laser detector which will indicate which filter is protective against the wavelength detected.

Cortical Thickness Reduction in Combat Exposed U.S. Veterans with and without PTSD

PubMed Central

Wrocklage, Kristen M.; Averill, Lynnette A.; Scott, J. Cobb; Averill, Christopher L.; Schweinsburg, Brian; Trejo, Marcia; Roy, Alicia; Weisser, Valerie; Kelly, Christopher; Martini, Brenda; Harpaz-Rotem, Ilan; Southwick, Steven M.; Krystal, John H.; Abdallah, Chadi G.

2017-01-01

We investigated the extent of cortical thinning in U.S. Veterans exposed to combat who varied in the severity of their posttraumatic stress disorder (PTSD) symptoms. In addition, we explored the neural correlates of PTSD symptom dimensions and the interactive effects of combat exposure and PTSD upon cortical thickness. Sixty-nine combat exposed Veterans completed high-resolution magnetic resonance imaging (MRI) scans to estimate cortical thickness. The Clinician Administered PTSD Scale (CAPS) and Combat Exposure Scale (CES) assessments were completed to measure current PTSD and historical combat severity, respectively. PTSD symptom dimensions (numbing, avoidance, reexperiencing, anxious arousal, and dysphoric arousal) were studied. Vertex-wise whole cerebrum analyses were conducted. We found widespread negative correlations between CAPS severity and cortical thickness, particularly within the prefrontal cortex. This prefrontal correlation remained significant after controlling for depression severity, medication status, and other potential confounds. PTSD dimensions, except anxious arousal, negatively correlated with cortical thickness in various unique brain regions. CES negatively correlated with cortical thickness in the left lateral prefrontal, regardless of PTSD diagnosis. A significant interaction between CES and PTSD diagnosis was found, such that CES negatively correlated with cortical thickness in the non-PTSD, but not in the PTSD, participants. The results underscore the severity of cortical thinning in U.S. Veterans suffering from high level of PTSD symptoms, as well as in Veterans with no PTSD diagnosis but severe combat exposure. The latter finding raises considerable concerns about a concealed injury potentially related to combat exposure in the post-9/11 era. PMID:28279623

Cortical thickness reduction in combat exposed U.S. veterans with and without PTSD.

PubMed

Wrocklage, Kristen M; Averill, Lynnette A; Cobb Scott, J; Averill, Christopher L; Schweinsburg, Brian; Trejo, Marcia; Roy, Alicia; Weisser, Valerie; Kelly, Christopher; Martini, Brenda; Harpaz-Rotem, Ilan; Southwick, Steven M; Krystal, John H; Abdallah, Chadi G

2017-05-01

We investigated the extent of cortical thinning in U.S. Veterans exposed to combat who varied in the severity of their posttraumatic stress disorder (PTSD) symptoms. In addition, we explored the neural correlates of PTSD symptom dimensions and the interactive effects of combat exposure and PTSD upon cortical thickness. Sixty-nine combat exposed Veterans completed high-resolution magnetic resonance imaging (MRI) scans to estimate cortical thickness. The Clinician Administered PTSD Scale (CAPS) and Combat Exposure Scale (CES) assessments were completed to measure current PTSD and historical combat severity, respectively. PTSD symptom dimensions (numbing, avoidance, reexperiencing, anxious arousal, and dysphoric arousal) were studied. Vertex-wise whole cerebrum analyses were conducted. We found widespread negative correlations between CAPS severity and cortical thickness, particularly within the prefrontal cortex. This prefrontal correlation remained significant after controlling for depression severity, medication status, and other potential confounds. PTSD dimensions, except anxious arousal, negatively correlated with cortical thickness in various unique brain regions. CES negatively correlated with cortical thickness in the left lateral prefrontal, regardless of PTSD diagnosis. A significant interaction between CES and PTSD diagnosis was found, such that CES negatively correlated with cortical thickness in the non-PTSD, but not in the PTSD, participants. The results underscore the severity of cortical thinning in U.S. Veterans suffering from high level of PTSD symptoms, as well as in Veterans with no PTSD diagnosis but severe combat exposure. The latter finding raises considerable concerns about a concealed injury potentially related to combat exposure in the post-9/11 era. Published by Elsevier B.V.

31 CFR 380.3 - What collateral may I pledge if I am a Treasury Tax and Loan depositary under 31 CFR part 203...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false What collateral may I pledge if I am a Treasury Tax and Loan depositary under 31 CFR part 203, and what value will you assign to it? 380...) FISCAL SERVICE, DEPARTMENT OF THE TREASURY BUREAU OF THE PUBLIC DEBT COLLATERAL ACCEPTABILITY AND...

Combat-related acetabular fractures: Outcomes of open versus closed injuries.

PubMed

Purcell, Richard L; Donohue, Michael A; Saxena, Sameer K; Gordon, Wade T; Lewandowski, Louis L

2018-02-01

Since the onset of the Global War on Terror close to 50,000 United States service members have been injured in combat, many of these injuries would have previously been fatal. Among these injuries, open acetabular fractures are at an increased number due to the high percentage of penetrating injuries such as high velocity gunshot wounds and blast injuries. These injuries lead to a greater degree of contamination, and more severe associated injuries. There is a significantly smaller proportion of the classic blunt trauma mechanism typically seen in civilian trauma. We performed a retrospective review of the Department of Defense Trauma Registry into which all US combat-injured patients are enrolled, as well as reviewed local patient medical records, and radiologic studies from March 2003 to April 2012. Eighty seven (87) acetabular fractures were identified with 32 classified as open fractures. Information regarding mechanism of injury, fracture pattern, transfusion requirements, Injury Severity Score (ISS), and presence of lower extremity amputations was analyzed. The mechanism of injury was an explosive device in 59% (n=19) of patients with an open acetabular fracture; the remaining 40% (n=13) were secondary to ballistic injury. In contrast, in the closed acetabular fracture cohort 38% (21/55) of fractures were due to explosive devices, and all remaining (n=34) were secondary to blunt trauma such as falls, motor vehicle collisions, or aircraft crashes. Patients with open acetabular fractures required a median of 17units of PRBC within the first 24h after injury. The mean ISS was 32 in the open group compared with 22 in the closed group (p=0.003). In the open fracture group nine patients (28%) sustained bilateral lower extremity amputations, and 10 patients (31%) ultimately underwent a hip disarticulation or hemi-pelvectomy as their final amputation level. Open acetabular fractures represent a significant challenge in the management of combat-related injuries. High

Tragedy into drama: an american history of tourniquet use in the current war.

PubMed

Kragh, John F; Walters, Thomas J; Westmoreland, Ted; Miller, Robert M; Mabry, Robert L; Kotwal, Russ S; Ritter, Brandi A; Hodge, Douglas C; Greydanus, Dominique J; Cain, Jeffrey S; Parsons, Donald S; Edgar, Erin P; Harcke, Theodore; Baer, David G; Dubick, Michael A; Blackbourne, Lorne H; Montgomery, Harold R; Holcomb, John B; Butler, Frank K

2013-01-01

Although the scientific results of recent tourniquet advances in first aid are well recorded, the process by which tourniquet use advances were made is not. The purpose of the present report is to distill historical aspects of this tourniquet story during the current wars in Afghanistan and Iraq to aid scientists, leaders, and clinicians in the process of development of future improvements in first aid. The process of how developments of this tourniquet story happened recently is detailed chronologically and thematically in a ?who did what, when, where, why, and how? way. Initially in these wars, tourniquets were used rarely or were used as a means of last resort. Such delay in tourniquet use was often lethal; subsequently, use was improved incrementally over time by many people at several organizations. Three sequential keys to success were (1) unlocking the impasse of enacting doctrinal ideas already approved, (2) reaching a critical density of both tourniquets and trained users on the battlefield, and (3) capturing their experience with tourniquets. Other keys included translating needs among stakeholders (such as casualties, combat medics, providers, trainers, and decision-makers) and problem-solving logistic snags and other issues. Eventually, refined care was shown to improve survival rates. From all medical interventions evidenced in the current wars, the tourniquet broke rank and moved to the forefront as the prehospital medical breakthrough of the war. The recorded process of how tourniquet developments in prehospital care occurred may be used as a reference for parallel efforts in first aid such as attempts to improve care for airway and breathing problems. 2013.

A model of suicidal behavior in war veterans with posttraumatic mood disorder.

PubMed

Sher, Leo

2009-08-01

Many wars have been fought during the history of civilization. About 30 armed conflicts are occurring now around the globe involving more than 25 countries. Many war veterans have symptoms of posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) including suicidal ideation and behavior. PTSD is frequently comorbid with MDD. I have previously proposed that some or all individuals diagnosed with comorbid PTSD and MDD have a separate psychobiological condition that can be termed "posttraumatic mood disorder" (PTMD). This idea was based on the fact that a significant number of studies suggested that patients suffering from comorbid PTSD and MDD differed clinically and biologically from individuals with PTSD alone or MDD alone. Individuals with comorbid PTSD and MDD are characterized by greater severity of symptoms, increased suicidality and the higher level of impairment in social and occupational functioning compared to individuals with PTSD alone or MDD alone. Neurobiological evidence supporting the concept of PTMD includes the findings from neuroendocrine challenge, cerebrospinal fluid, neuroimaging, sleep and other studies. In this paper, I propose a model of suicidal behavior in war veterans with PTMD. The model consists of the following components: (1) genetic factors; (2) prenatal development; (3) biological and psychosocial influences from birth to mobilization/deployment; (4) mobilization/pre-deployment stress; (5) combat stress, traumatic brain injury, and physical injury; (6) post-deployment stress; (7) biological and psychosocial influences after the deployment; (8) trigger (precipitant) of a suicidal act; and (9) suicidal act. The first four components determine vulnerability to combat stress. The first seven components determine predisposition to suicidal behavior, a key element that differentiates PTMD patients who are at high risk from those at lower risk. Suicidal behavior in PTMD can be attributed to the coincidence of a trigger

Probiotic (VSL 3) for Gulf War Illness

DTIC Science & Technology

2016-10-01

Award Number: W81XWH-10-1-0593 TITLE: Probiotic (VSL#3) for Gulf War Illness. PRINCIPAL INVESTIGATOR: Ashok Tuteja, M.D. M.P.H. CONTRACTING...NUMBER Probiotic (VSL#3) for Gulf War Illness. 5b. GRANT NUMBER W81XWH-10-1-0593 5c. PROGRAM ELEMENT NUMBER 6 . AUTHOR(S) 5d. PROJECT NUMBER Ashok...objective of the study is to determine whether probiotic VisbiomeTMwill improve 1) Intestinal symptoms of Irritable Bowel Syndrome and 2) Non

The effects of war on children in Africa.

PubMed

Albertyn, R; Bickler, S W; van As, A B; Millar, A J W; Rode, H

2003-06-01

There is no doubt that the effects of war extend to the most vulnerable members of society, including children. Although armed conflicts occur throughout the world, the African continent seems to be a particular background for civil and international wars. The aim of this study was to identify causes of conflict in Africa and to evaluate the effect of war on children and their health in order to make practical recommendations to health care workers dealing with children in the setting of war. All articles written in the past 5 years concerning "war" and "children" were identified by means of a literature search and internet review. Contrary to common belief, the causes of conflict are complicated and multi-factorial. The effects of war on childhood are disastrous and include severe negative effects on general paediatric health status. Short-term recommendations for health care workers working with children in war include supply of emergency medical infrastructures, basic health care, rehabilitation and education. Long-term recommendations include orchestrating the relief and support efforts from both national governments and international non-profit organisations and speeding up of economic recovery. The causes of conflict in Africa are complex and unlikely to be resolved soon. The effects of war on children are horrendous in many ways, but can be limited by providing timely and appropriate health care.

Combat injury coding: a review and reconfiguration.

PubMed

Lawnick, Mary M; Champion, Howard R; Gennarelli, Thomas; Galarneau, Michael R; D'Souza, Edwin; Vickers, Ross R; Wing, Vern; Eastridge, Brian J; Young, Lee Ann; Dye, Judy; Spott, Mary Ann; Jenkins, Donald H; Holcomb, John; Blackbourne, Lorne H; Ficke, James R; Kalin, Ellen J; Flaherty, Stephen

2013-10-01

The current civilian Abbreviated Injury Scale (AIS), designed for automobile crash injuries, yields important information about civilian injuries. It has been recognized for some time, however, that both the AIS and AIS-based scores such as the Injury Severity Score (ISS) are inadequate for describing penetrating injuries, especially those sustained in combat. Existing injury coding systems do not adequately describe (they actually exclude) combat injuries such as the devastating multi-mechanistic injuries resulting from attacks with improvised explosive devices (IEDs). After quantifying the inapplicability of current coding systems, the Military Combat Injury Scale (MCIS), which includes injury descriptors that accurately characterize combat anatomic injury, and the Military Functional Incapacity Scale (MFIS), which indicates immediate tactical functional impairment, were developed by a large tri-service military and civilian group of combat trauma subject-matter experts. Assignment of MCIS severity levels was based on urgency, level of care needed, and risk of death from each individual injury. The MFIS was developed based on the casualty's ability to shoot, move, and communicate, and comprises four levels ranging from "Able to continue mission" to "Lost to military." Separate functional impairments were identified for injuries aboard ship. Preliminary evaluation of MCIS discrimination, calibration, and casualty disposition was performed on 992 combat-injured patients using two modeling processes. Based on combat casualty data, the MCIS is a new, simpler, comprehensive severity scale with 269 codes (vs. 1999 in AIS) that specifically characterize and distinguish the many unique injuries encountered in combat. The MCIS integrates with the MFIS, which associates immediate combat functional impairment with minor and moderate-severity injuries. Predictive validation on combat datasets shows improved performance over AIS-based tools in addition to improved face

'The gut war': Functional somatic disorders in the UK during the Second World War.

PubMed

Jones, Edgar

2012-12-01

Hospital admission and mortality statistics suggested that peptic ulcer reached a peak prevalence in the mid-1950s. During the Second World War, against this background of serious and common pathology, an epidemic of dyspepsia afflicted both service personnel and civilians alike. In the absence of reliable diagnostic techniques, physicians struggled to distinguish between life-threatening illness and mild, temporary disorders. This article explores the context in which non-ulcer stomach conditions flourished. At a time when fear was considered defeatist and overt psychological disorder attracted stigma, both soldiers and civilians exposed to frightening events may have unconsciously translated their distress into gastrointestinal disorders. While the nature of army food was initially identified as the cause of duodenal ulcer in servicemen, the pre-war idea that conscientious and anxious individuals were at high risk gathered support and fed into post-war beliefs that this was a stress-related illness. Diet continued to be employed as a means of management at a time when the nation was preoccupied by food because of the constraints imposed by rationing. The peptic ulcer phenomenon set much of the medical agenda for the war years and conflicted with the commonly held view that the British people had never been healthier.

The Combat-Exclusion Policy for Military Women.

ERIC Educational Resources Information Center

Schneider, Dorothy; Schneider, Carl J.

1986-01-01

Reviews the history and meaning of the combat exclusion policy for United States servicewomen. Noting that combat duty is often essential to career advancement in the military, this article describes several cases of discrimination resulting from the effects of the combat exclusion. (JDH)

Analysis of a combat problem - The turret game

NASA Technical Reports Server (NTRS)

Ardema, M.; Heymann, M.; Rajan, N.

1987-01-01

The turret game is defined and solved to illustrate the nature of games of combat. This game represents a highly simplified version of air combat, yet it is sufficiently complex so as to exhibit a rich variety of combat phenomena. A review of the formulation of delta-combat games is included.

Injuries associated with combat sports, active component, U.S. Armed Forces, 2010-2013.

PubMed

2014-05-01

The practice of combat sports creates a potential for training- and sports-related injuries among military members. During the 4-year surveillance period, there were 12,108 cases of injuries associated with combat sports among active component service members; the overall incidence rate was 21.0 per 10,000 person-years (p-yrs). The rates were higher among service members who were male, Hispanic, in the youngest age groups, in the Army, junior enlisted, and in combat-specific occupations. The rate among recruit/ trainees (779.4 per 10,000 p-yrs) was more than 165 times the rate among all other active component service members (non-recruits) (4.7 per 10,000 p-yrs). Sprains, strains, and contusions accounted for more than one-half of the primary (first-listed) diagnoses associated with combat sports cases. More serious conditions such as concussions/head injuries and skull/face fractures/intracranial injuries were reported among 3.9% and 2.1% of all cases and were more common among boxing-related cases. Hand/wrist fractures were also common among boxing cases. Wrestling had comparatively greater proportions of dislocations and open wounds. Although the combat sport training provides many physical and mental benefits to the individual, safety practices should be enforced to reduce the most frequent and serious injuries.

Effect of Parachute Jump in the Psychophysiological Response of Soldiers in Urban Combat.

PubMed

Sánchez-Molina, Joaquín; Robles-Pérez, José J; Clemente-Suárez, Vicente J

2017-06-01

The study of organic and psychological response during combat situations has been poorly reported despite its importance for soldiers training and specific instruction, so it was proposed as aim of the present investigation to analyze the effect of a tactical parachute simulated jump in psycho-physiological response of paratroopers' warfighters during an urban combat simulation. 19 male paratroopers (31.9 ± 6.2 year old; 173.6 ± 5.3 cm; 73.8 ± 8.3 Kg) of the Spanish Army were divided in two groups: parachute jump group (n:11) that conducted a simulated parachute jump and a urban combat maneuver and a non-parachute jump group (n:8) that only conducted an urban combat maneuver. We analyzed before and after the maneuver the rated perceived exertion, legs strength manifestation, blood lactate, cortical activation, heart rate variability, blood oxygen saturation and pressure, skin temperature, fine motor skills, and anxiety state. A tactical parachute simulated jump prior to an urban combat maneuver produce significantly (p < 0.05) higher heart rate and decrease in specific fine motor skills in comparison with no jump situation in professional Army paratroopers. Independently of the parachute jump, an urban combat maneuver produces a significant increase in rated perceived exertion, blood lactate, heart rate, legs strength, sympathetic modulation and anxiety response as well as a significant decrease in blood oxygen saturation and parasympathetic modulation.

Comparison of Efficacy of Eye Movement, Desensitization and Reprocessing and Cognitive Behavioral Therapy Therapeutic Methods for Reducing Anxiety and Depression of Iranian Combatant Afflicted by Post Traumatic Stress Disorder

NASA Astrophysics Data System (ADS)

Narimani, M.; Sadeghieh Ahari, S.; Rajabi, S.

This research aims to determine efficacy of two therapeutic methods and compare them; Eye Movement, Desensitization and Reprocessing (EMDR) and Cognitive Behavioral Therapy (CBT) for reduction of anxiety and depression of Iranian combatant afflicted with Post traumatic Stress Disorder (PTSD) after imposed war. Statistical population of current study includes combatants afflicted with PTSD that were hospitalized in Isar Hospital of Ardabil province or were inhabited in Ardabil. These persons were selected through simple random sampling and were randomly located in three groups. The method was extended test method and study design was multi-group test-retest. Used tools include hospital anxiety and depression scale. This survey showed that exercise of EMDR and CBT has caused significant reduction of anxiety and depression.

[Epidemiological health surveillance among the troops during combat operations in armed conflicts].

PubMed

Mel'nichenko, P I

1997-08-01

With local wars and armed conflicts the sanitary-epidemiological situation for the troops and local population shows a tendency to worsen. The main objects of the military medical service at the period of deployment are the preventive measures against troops infection from local sources by virus hepatitis A, bacterial dysentery, typhoid, cholera etc. As a rule, combat actions result in communal service destruction, low quality of potable water, soil contamination and worsening sanitary norms and standards. Also, there is a danger of reactivation of the natural centres of infection due to large-scale defence earthworks in the region of operations. The experience of the military medical service in Afghanistan and Chechnya proves, that a multimedia approach to preventive antiepidemic measures is necessary together with the emphasis on the most important actions against infections that represent the biggest danger for the land troops.

In search of technological solutions to battlefield management of combat casualties

NASA Astrophysics Data System (ADS)

Ling, Geoffrey S. F.; Day, Keith; Rhee, Peter; Ecklund, James M.

1999-07-01

It is accepted that so long as men and women are sent into combat, some will be wounded or killed. In order to minimize those that are killed, efforts must be made to optimize medical treatment for those who are not fatally wounded. The nature of warfare is changing. The pattern of wounding is changing as well. However, what remains constant is the need to provide effective treatment as soon as possible. In war, it means acting at the level of the battlefield. To be effective demands new approaches to diagnosis and treatment. Novel diagnostic tools are needed to identify location of foreign bodies, determine extents of injury, monitor vital signs, and ascertain adequacy of resuscitation. Treatment devices that can provide hemostasis, support organ perfusion, stabilize limbs and neck and relieve a pneumothorax are lacking. Our young soldiers of tomorrow need solutions to their injuries today.

Analysis of the First 100 Patients From the Syrian Civil War Treated in an Israeli District Hospital.

PubMed

Biswas, Seema; Waksman, Igor; Baron, Shay; Fuchs, David; Rechnitzer, Hagai; Dally, Najib; Kassis, Shokrey; Hadary, Amram

2016-01-01

An analysis of the injuries and treatment of the first 100 patients from the Syrian civil war was conducted to monitor quality of care and outcome. As reports of the collapse of health care systems in regions within Syria reach the media, patients find themselves crossing the border into Israel for the treatment of war injuries. Among these patients are combatants, noncombatants, women, and children. Treatment, that is free at the point of care, is a humanitarian imperative for war wounded, and this paper reports the care in an Israeli district hospital of the first 100 patients received. With ethics committee approval, data from the Trauma Registry and electronic patient records were collected and analyzed. No identifying data are presented. Most patients (94) were male. Seventeen patients were younger than the age of 18 years; 52 patients were in their twenties. Most injuries were the results of gunshot or blast injury (50 and 29 patients, respectively). Two multiple-trauma patients died, 8 were transferred for specialist care, and 90 patients returned from Ziv Hospital to Syria after discharge. The experience of the care of patients across a hostile border has been unprecedented. Hospital protocols required adjustment to deliver quality clinical and social care to patients suffering from both the acute and chronic effects of civil war.