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PubMed2001

Case studies of violations of workers' freedom of association: service sector workers.

Workers' rights violations in the United States are widespread and growing. The bulk of the National Labor Relations Board's work now involves unfair labor practices, most related to employers' violations of workers' rights. Numerous research studies document these violations. As part of its report "Unfair Advantage: Workers' Freedom of Association in the United States under International Human Rights Standards," Human Rights Watch conducted a series of case studies in a dozen states, covering a variety of industries and employment sectors, analyzing the U.S. experience in the light of both national law and international human rights and labor rights norms. The article presented here includes a discussion of the general context of increased workers' rights violations under U.S. law and the first of the case studies: service sector workers.

Capitalism↗

PubMed2002

Case studies of violations of workers' freedom of association: manufacturing workers.

As part of its report "Unfair Advantage: Workers' Freedom of Association in the United States under International Human Rights Standards," Human Rights Watch conducted a series of case studies in a dozen states, covering a variety of industries and employment sectors, analyzing the U.S. experience in the light of both national law and international human rights and labor rights norms. Presented here are the case studies of manufacturing workers.

Civil Rights↗

PubMed2002

Case studies of violations of workers' freedom of association: food processing workers and contingent workers.

Contract Services↗

PubMed2006

Perceived reachability in single- and multiple-degree-of-freedom workspaces.

In comparisons of perceived (imagined) and actual reaches, investigators consistently find a tendency to overestimate. A primary explanation for that phenomenon is that individuals reach as a "whole-body engagement" involving multiple degrees of freedom (m-df). The authors examined right-handers (N = 28) in 1-df and m-df workspaces by having them judge the reachability of targets at midline, right, and left visual fields. Response profiles were similar for total error. Both conditions reflected an overestimation bias, although the bias was significantly greater in the m-df condition. Midline responses differed (greater overestimation) from those of right and left visual fields, which were similar. Although the authors would have predicted better performance in the m-df condition, it seems plausible that if individuals think in terms of m-df, they may feel more confident in that condition and thereby exhibit greater overestimation. Furthermore, the authors speculate that the reduced bias at the side fields may be attributed to a more conservative strategy based in part on perceived reach constraints.

Adult↗

PubMed2002

More power to you: simple power calculations for treatment effects with one degree of freedom.

Although numerous computer programs for statistical power analysis are available, power is an under-used aspect of experimental analysis, perhaps because of the perceived difficulty of performing the necessary calculations or because existing computer software can be expensive or complicated to learn. For single-degree-of-freedom tests, however, it is possible to calculate power in a straightforward manner, using the t distribution. Because these calculations are based on t, they use easily understood and readily available quantities. These calculations can be performed with a desk calculator; we also present a simple-to-use program called MorePower that will perform the necessary calculations. The straightforward nature of the calculations potentially will enable more researchers to consider issues of power when planning and reporting their experiments.

Humans↗

PubMed1999

[Functional mobility measurement of removable partial dentures using newly-developed analyzing system in six degrees of freedom--effect of cusp inclination of molar artificial teeth on denture displacement in function].

A measuring system to record three-dimensional displacement of removable partial dentures (RPDs) in six degrees of freedom has been developed. The system employed three pairs of photodiode and LED that were set up in a triangle. This system was capable of recording the in vivo RPD displacement with a recording sensitivity of 0.1 mm. In vivo displacement of upper RPDs with unilateral distal extension saddle was investigated using this measuring system to determine the effect of artificial cusp inclination of molar teeth on denture mobility. Two groups of different artificial dentition were switched to be attached to each of three experimental RPDs. The artificial teeth with cusp inclinations were calibrated to contact with opposing natural dentition during lateral grinding of the mandible, while the other artificial teeth were prepared to disclude with the mandibular teeth (flat-cusp group). Displacement range and average position of a reference point at the first molar of the RPDs during mastication were measured and analyzed as a function of the cusp inclination and the test food. As a result, the average displacement of the RPDs toward the edentulous ridge was smaller in the cusp group than that in the flat-cusp group, while the range of horizontal displacement in the buccal-palatal direction was greater in the former group than the latter. The denture wearers demonstrated typical grinding strokes at the end of the closing phase of the mandiblar movements when they chewed a peanut, which was attributed to a wide range of horizontal displacement of the dentures.

Denture, Partial, Removable↗

PubMed2004

Orthopedic injuries during Operation Enduring Freedom.

Orthopedic injuries comprise a majority of combat injuries seen in recent U.S. military conflicts. Interventions in the forward deployed area have played an important role in improving mortality rates of soldiers as well as outcome at a medical center level. A retrospective review was conducted on orthopedic injuries from Operation Enduring Freedom evaluated at Walter Reed Army Medical Center (WRAMC). Patients were grouped into one of five injury categories (open fracture, amputation, arterial injuries, neurological injuries, and soft tissue injury) with evacuation time (days from time of injury to arrival at WRAMC) and procedures performed before arrival at WRAMC evaluated. The average evacuation time for all orthopedic casualties was 7.9 days. There was an average of 2.6 procedures performed per patient before arrival at WRAMC. There was no difference in evacuation time among the injury groups. Those with only soft tissue injuries underwent fewer procedures than the other injury groups; however, there was no difference among the injury groups in terms of procedures performed. The number of procedures performed did not affect the evacuation time. Fifty-six percent of casualties required operative intervention after arrival at WRAMC. With the unavoidable evacuation time that all casualties must endure regardless of severity of the injury, early operative intervention in forward deployed medical assets, such as the forward surgical team and combat support hospital, remains a necessity for rehabilitative and reconstructive efforts of the soldiers at the medical center level.

Adult↗

PubMed2004

U.S. Army Reserve (Medical) soldier prescription challenges during Operation Iraqi Freedom.

The continuous requirement to mobilize and deploy reserve soldiers presents numerous challenges for the Army Medical Department. One of the challenges in the preparation for deployment of reserve soldiers is the assessment of chronic prescription medication requirements and the eventual filling of these requirements during deployment. The assigned unit pharmacy officer can provide a value-added service through the identification and coordination of the pharmaceutical needs of an activated deploying unit. A unit pharmacy officer conducted a prescription medication use analysis on an activated Army Reserve Medical Unit before deployment in support of Operation Iraqi Freedom. The study population consisted of 181 soldiers identified through a volunteer survey administered by the assigned pharmacy officer. The prescription medication requirements for the unit were identified in a predeployment status and an evaluation was conducted to determine the ability to sustain the medication requirements once the unit was to be deployed. Gaps in the availability of prescription medication requirements in a predeployed status were identified indicating potential deficiencies in the capability to replenish prescription medication requirements during deployment.

Adult↗

PubMed2004

In-flight transfusion of packed red blood cells on a combat search and rescue mission: a case report from operation enduring freedom.

Injuries on the battlefield can occur far from the nearest medical treatment facility. This is especially likely for downed pilots and special operations personnel. Some of these injuries lead to significant blood loss requiring transfusion. We present two cases of injured coalition force members during Operation Enduring Freedom that illustrate the potential need for a transfusion capability at the site of injury to prevent death. Consideration should be given to augmenting transfusion capabilities in military environments with predictably long evacuation times.

Afghanistan↗

PubMed2004

Dental emergency rates at an expeditionary medical support facility supporting Operation Enduring Freedom.

The purpose of this study was to report the dental emergency rate and the distribution of cause of dental emergencies at an Expeditionary Medical Support +25 medical facility during a 6-month deployment in support of Operation Enduring Freedom. A retrospective cohort analysis of 1,972 soldiers stationed at Seeb Air Base, Sultanate of Oman, was accomplished from a phased deployment from March to September 2002. Procedures were divided into 11 categories: endodontic, extraction of teeth other than third molars, extraction of third molar teeth, restoration of teeth (caries), restoration of broken teeth (not caries), orthodontic bracket/wire problem, sensitive teeth, temperomandibular pain, periodontal, oral pathology, and prosthodontic. One hundred thirty-five dental emergency visits were recorded, corresponding to a rate of 137 dental emergencies per 1,000 soldiers per year. Most of the emergencies (34.8%) were due to caries. Pain from third molars was the second most common reason for visiting the dental clinic (19.3%).

Dental Care↗

PubMed2004

Visceral leishmaniasis in a soldier returning from Operation Enduring Freedom.

This report presents a case of visceral leishmaniasis in a soldier returning from Operation Enduring Freedom. During the United States' last major military conflict, Operation Desert Storm, the diagnosis of multiple cases of visceral leishmaniasis led to policy changes, including a temporary ban on troop blood donation. This case demonstrates the applicability of recently developed Leishmania polymerase chain reaction and serological assays when conventional methods of diagnosis, such as tissue microscopy and culture, fail.

Adult↗

PubMed2005

The most frequently requested precombat refresher training by the Special Forces medics during Operation Enduring Freedom.

The tactical environment and the mission given the Special Operations Forces in Afghanistan during the initial phases of Operation Enduring Freedom placed the Special Operations Forces medics (18Ds) in a position of significant medical responsibility. The 18Ds became the primary care providers for the indigenous anti-Taliban fighters as well as U.S. military personnel; the care of the latter was further complicated by long evacuation times. Because of these issues and several events that occurred in the combat zone, the 18Ds requested their supporting forward surgical team (FST) (274th FST) to provide specific refresher training before combat deployment into Afghanistan. The areas of greatest interest and concern were orthopedics, field transfusions, and field-expedient anesthesia. It is hoped that the training prepared and given to the 18Ds by the personnel of the 274th FST and presented in this article not only was useful to them but also will be of benefit to 18Ds who find themselves in similar situations in the future.

Afghanistan↗

PubMed2005

Operation Iraqi Freedom: surgical experience of the 212th Mobile Army Surgical Hospital.

Seven hundred one patients were treated at and 394 were admitted to the 212th Mobile Army Surgical Hospital in Central Iraq during the combat phase of Operation Iraqi Freedom. Ninety of those patients underwent 100 operations, with 187 procedures in 19 days. At the peak of hostilities, 48 patients were admitted, 15 operations were performed, and 56 patients were medically evacuated during different 24-hour periods. Thirty-three patients required the surgical expertise of a general or thoracic surgeon. Although 82% of injuries and 70% of the procedures were orthopedic in nature, orthopedic operating room utilization was only 60% of total operating room time (156 hours). The general and thoracic injuries were labor-intensive, frequently requiring two surgeons. Although orthopedic injury remains the predominant reason for surgical intervention on the battlefield, there remains a need to forward-deploy general and thoracic surgeons, because of the presence and complexity of nonorthopedic trauma.

Emergency Service, Hospital↗

PubMed2005

Glucose-6-phosphate dehydrogenase deficiency in two returning Operation Iraqi Freedom soldiers who developed hemolytic anemia while receiving primaquine prophylaxis for malaria.

Use of antimalarial prophylaxis continues to be routine practice among military personnel returning from areas where malaria is endemic. Primaquine may be used for terminal prophylaxis against Plasmodium ovale and Plasmodium vivax. Serious complications of this regimen are infrequent. We report the occurrence of significant hemolytic anemia for two soldiers returning from Operation Iraqi Freedom. They presented with dark urine, headaches, and classic laboratory findings of hemolysis. Both soldiers were subsequently found to have glucose-6-phosphate dehydrogenase deficiency, and both responded to conservative treatment and cessation of medication. Although this complication is unusual, medical personnel involved in the care of recently returned deployed service members should be alert to its potential occurrence among patients who are receiving antimalarial prophylaxis. This complication could be completely avoided with prescreening of personnel for glucose-6-phosphate dehydrogenase deficiency, as is currently done in the Air Force and Navy, before the use of primaquine.

Adult↗

PubMed2005

The quantitative analysis of uranium isotopes in the urine of the civilian population of eastern Afghanistan after Operation Enduring Freedom.

The purpose of this study was to determine the concentrations and precise isotopic compositions of four uranium isotopes (234U, 235U, 236U, and 238U) in urine specimens from the civilian population of Afghanistan after Allied Forces Operation Enduring Freedom. Eight male civilians from Nangarhar-Jalalabad region who presented with symptoms of fatigue, fever, musculoskeletal and neurological alterations, headaches, and respiratory impairment after inhalation of dust during the bombing raids in June 2002 had urine samples collected under controlled conditions and analyzed in duplicate for 234U, 235U, 236U, and 238U, with multicollector, inductively coupled, plasma ionization mass spectrometry. Control samples with an internal urine standard were analyzed with the same method. The mean concentration of uranium in eight samples was found to be considerably greater (275.04 ng/L; SD, 137.80 ng/L; SE, 48.72 ng/L) than what is regarded as a reference range (1-20 ng/L). The 238U/235U ratio was 137.87 +/- 0.20, which is consistent with that of natural uranium. The 234U/238U ratio for the Afghan samples was 0.000055 +/- 0.000001, also consistent with natural uranium. 236U, which usually forms a component of depleted uranium, was not detected (measured 236U/ 238U ratio, < 10(-7)). Our results demonstrate that contamination in Afghanistan with a source consistent with natural uranium has resulted in total uranium concentrations up to 100 times higher than the normal range for various geographic and environmental areas throughout the world. The cause of our findings is currently being evaluated as a part of our ongoing research.

Afghanistan↗

PubMed2005

The U.S. Navy's forward resuscitative surgery system during Operation Iraqi Freedom.

The forward resuscitative surgery system (FRSS) is the Navy's most forward-deployed echelon II medical unit. Between March and August 2003, six FRSS teams were deployed in support of Operation Iraqi Freedom (OIF). During the combat phase of OIF (March 21 to May 1, 2003), a total of 34 Marine Corps and 62 Iraqi patients underwent treatment at a FRSS. FRSS teams were assigned two distinct missions; "forward" FRSS teams operated with combat service support elements in direct support of regimental combat teams, and "jump" FRSS teams served as a forward element of a surgical company. This article presents the experiences of the FRSS teams in OIF, including a discussion of time to presentation from wounding, time to operation, time to evacuation, and lessons learned from the deployment of the FRSS.

Humans↗

PubMed2005

Medical and physical readiness of the U.S. Army Reserve for Noble Eagle/Enduring Freedom/Iraqi Freedom: recommendations for future mobilizations.

The U.S. Army Reserve plays an important role in the war-fighting capabilities of the U.S. military. There have been concerns, however, regarding the health and physical readiness of this force. Recently Army Reservists were mobilized for Operation Noble Eagle/Iraqi Freedom. We report on both the medical waivers requested and issues related to soldiers found medically nonavailable for deployment on data collected and analyzed from several mobilization sites. Four hundred thirty-one medical waivers were requested. Of 60,000 mobilized, approximately 2.7% were found to be medically nonavailable for deployment, predominately enlisted and male. The most common problems identified were orthopedic, psychiatric, diabetes, asthma, obstetrical-gynecological, and cardiac. The overall prevalence of medically nonavailable for deployment of Army Reservists was low. Most of the conditions leading to nondeployable troops were attributable to chronic disease. Interventions to decrease the level of medically nonavailable for deployment and to lessen mobilization site operations are being implemented.

Adolescent↗

PubMed2005

Combat casualties in Afghanistan cared for by a single Forward Surgical Team during the initial phases of Operation Enduring Freedom.

BACKGROUND: The 274th Forward Surgical Team (FST) was the first FST deployed to Bagram, Afghanistan, to provide surgical care for combat casualties during the initial phases of Operation Enduring Freedom. This is an analysis of the distribution, cause, and severity of wounds for combat casualties and the surgical procedures they required. METHODS: A prospective database was maintained for combat casualties cared for by the 274th FST. The database included demographic data, vital status, mechanism of injury, distribution and severity of wounds, and surgical care provided. RESULTS: The FST cared for 224 combat casualties, including 153 U.S. soldiers, 19 coalition soldiers, 32 Afghan militia forces soldiers, and 20 detainees. Fragments were the most common mechanism of injury (49%), and the extremity was the most common location of injury (58%), whereas gunshot wounds were the most common cause of death (57%). There were few significant head, chest, or abdominal wounds (13%). The FST treated 103 surgical cases (73 with combat wounds), including neurosurgical, thoracic, general, orthopedic, and vascular cases, with a total of 180 procedures. CONCLUSIONS: The distribution, cause, and severity of wounds were similar to those in the Persian Gulf War, despite the obvious differences between these conflicts. The use of modern technologies, such as compact, portable, ultrasound and digital X-ray systems, expanded the capabilities of the FST. Even low-intensity conflicts can produce significant numbers of combat casualties, and the FST must be manned, trained, equipped, and supplied to treat a wide variety of combat wounds.

Afghanistan↗