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PubMed2001

Organization and work of the war hospital in Tomislavgrad during the war in Bosnia and Herzegovina from 1992 to 1995.

The work of the War Hospital in Tomislavgrad during the war in Bosnia and Herzegovina from 1992 to 1995 is described. The War Hospital in Tomislavgrad was one of the first medical institutions organized in Bosnia and Herzegovina, with the intention of providing surgical treatment and care to soldiers, local civilians, and refugees who found shelter in this part of the country. It was located on the main communication route connecting Bosnia and Herzegovina and the south part of Croatia. During the 4-year period, 23,191 examinations, of which 8,341 were first-time examinations, and 1,547 surgical operations were performed. The hospital provided a high level of surgical and anesthesiology service in an area where none existed before the war. All patients were treated regardless of their nationality or religion, thus mitigating the consequences of the war.

Bosnia and Herzegovina↗
PubMed2001

War head injury score: an outcome prediction model in War casualties with acute penetrating head injury.

OBJECTIVE: To evaluate in war casualties with acute penetrating head injury whether the summed War Head Injury Score (WHIS) is a better predictor of mortality than either the Glasgow Coma Scale (GCS) score or the Injury Severity Score (ISS) alone and to establish its specific applicability. METHODS: Sensitivity, specificity, correct outcome prediction, and discrimination were assessed in 43 patients in the war group (ballistic injuries) and 41 patients in the civil group (nonballistic injuries) during the period 1991 to 1995. The new model was generated using the sum of GCS scores and ISS, to which a coded value was applied for summation. RESULTS: In the war group, the mortality rate was 23%; the sensitivity and specificity of WHIS were 100% and 79%, the sensitivity and specificity of GCS score were 90% and 85%, and the sensitivity and specificity of ISS were 100% and 49%, respectively. In the civil group, the mortality rate was 39%; the sensitivity and specificity of WHIS were 87% and 76%, the sensitivity and specificity of GCS score were 63% and 90%, and the sensitivity and specificity of ISS were 100% and 56%, respectively. CONCLUSION: With regard to civilians, war casualties with acute penetrating head injury more often have multiple injuries. WHIS represents a new scoring system that incorporates both GCS score and ISS.

Adult↗
PubMed2005

Is testicular cancer related to Gulf War deployment? Evidence from a pilot population-based study of Gulf War era veterans and cancer registries.

The possible relationship between military deployment and the subsequent increase in cancer rates has been prominent since the Vietnam War. The objective of this study was to investigate whether any form of cancer was increased among veterans deployed to the Persian Gulf in the 1991 conflict. This study matched data from central cancer registries in the District of Columbia and New Jersey with the records for 1.4 million Gulf War era veterans, i.e., 621,902 veterans who arrived in the Persian Gulf before March 1, 1991, and 746,248 non-Gulf veterans. Using a proportional incidence ratio, testicular cancer was found to be the only significantly increased malignancy among deployed Persian Gulf War veterans. The increase became apparent 2 to 3 years after the Persian Gulf War and peaked 4 to 5 years afterward. Our data and those of investigators studying Vietnam veterans suggest that testicular cancer may be related to military deployment.

Adult↗
PubMed2001

Thinking through war: the social thought of Richard T. Ely, John R. Commons, and Edward A. Ross during the First World War.

This paper examines the social thought of University of Wisconsin professors Richard T. Ely, John R. Commons, and Edward A. Ross during World War I. Like many of their fellow scholars, these three were actively involved in the pro-war effort. Although their support for the war was strongly conditioned by personal and occupational considerations, the impact of their wartime service was not restricted to those realms. Their social thought, which they impressed into service explaining and justifying the war, was itself altered in subtle and sometimes surprising ways by the forceful positions they took on the political, economic, and racial significance of the conflict.

Famous Persons↗
PubMed1998

The development of a scale to assess war-time atrocities: the War Events Scale.

The War Events Scale (WES) was developed to assist clinicians with the assessment of war zone veterans' exposure to, and participation in war-time atrocities distinct from combat, and their current distress from these events. Data concerning content validity, test-retest reliability, internal consistency, as well as correlational data with the Combat Exposure Scale and the Mississippi Scale are presented. Results indicate that the WES does have adequate internal consistency and test-retest reliability, and correlates moderately with the Combat Exposure and Mississippi Scales. Initial results suggest that the WES may be helpful in collecting extremely sensitive information concerning the exposure of war zone veterans to atrocities.

Combat Disorders↗
PubMed2003

Health effects of war stress on Norwegian World War II resistance groups: a comparative study.

The main aim of this study was to investigate the extent to which adverse long-term health effects of World War II stress exposure were present in 3 groups of resistance veterans. The groups had been exposed to different types of war stressors: concentration camp incarceration, resistance participation within the illegal press, and a secret military organization. With the differences in war stressors as a basis, we assumed that those incarcerated in a concentration camp would display more adverse health effect compared to the resistance veterans. The findings point to a relationship between the severity of war stressors and postwar health in all 3 groups.

Health Status↗
PubMed1991

War-related stress. Addressing the stress of war and other traumatic events.

A task force on war-related stress was convened to develop strategies for prevention and treatment of psychological, psychosocial, and psychosomatic disorders associated with the Persian Gulf War and other extreme stressors facing communities in general. The task force focused on the return home, reunion, and reintegration of service personnel with their families and work. Although the Persian Gulf War was won with relative ease, negative psychological sequelae may develop in some individuals because of the stress of war, family disruption, financial difficulty, and changes in family routines. Typical stress reactions and modes of coping that are usually unsuccessful or destructive were outlined, and suggestions were made for monitoring these. In addition, guidelines for successful coping were developed. Special attention was given to children's reactions and needs. Recommendations were made for outreach and intervention on the policy, systems (e.g., schools, businesses, governmental agencies), family, and individual levels.

Adaptation, Psychological↗
PubMed1995

War zone stress, personal resources, and PTSD in Persian Gulf War returnees.

Posttraumatic stress disorder (PTSD) can occur subsequent to war stress, but not all troops are negatively affected. A discriminant function model was used to study associations between personal and environmental resources and psychological outcomes subsequent to war zone stress. Among 775 Persian Gulf War exposed troops, 2 subsets were identified: 97 with PTSD diagnoses and 484 who had no psychological distress. A discriminant function, double cross-validated in random subsamples, classified 87% of troops, and demographic and stress severity variables did not alter results significantly. Personality hardiness commitment, avoidance coping, and perceived family cohesion emerged as consistent predictors of PTSD diagnosis. Findings suggest personal characteristics and environmental factors may alter vulnerability to negative war stress outcomes. Work is needed to identify mechanisms and causal pathways by which resource factors enhance or lower stress resistance.

Adaptation, Psychological↗
PubMed2001

War time experiences of triage and resuscitation: Australian Army nurses in the Vietnam War, 1967-1971.

The experiences of nurses in war is prolifically described in the North American scholarly literature, and in the Australian nursing literature to a lesser extent. The literature describes the plights and achievements of nurses caring for soldiers and civilians often under the most undesirable of circumstances. A central focus of war time nursing is the resuscitation of critically wounded soldiers. This paper addresses the experiences of the Australian Army nurses who were involved in the triage and resuscitation of critically wounded allied and enemy soldiers in the Vietnam War between 1967 and 1971. As part of a research study to explore and analyse the nature of nursing work in the Vietnam War, seventeen Vietnam veteran nurses were interviewed about their experiences. This paper explores the progression of the triage department in the Australian military hospital in Vung Tau, and it highlights that the majority of the nurses who took part in this study were clinically unprepared, particularly as emergency nurses.

Australia↗
PubMed2006

Survive, help, learn: experience of a medical journal in war and post-war times.

Medical journals and their editors have a unique responsibility in armed conflicts. The experience of the Croatian Medical Journal during and after the 1991-1995 war in Croatia shows how a medical journal can survive, help others and learn in times of war. The first duty of a medical journal in such circumstances is to publish scientific articles on various aspects of war medicine, and to document cases of human rights abuses. In small scientific communities, editors can offer their expertise and assist authors in writing and publishing war-related research and reports. In post-conflict period, medical journals have a responsibility to participate in peace-building and reconciliation efforts. They can do so by publishing good scientific articles regardless of their place or country of origin, re-establishing contacts with colleagues from the opposing sides, striving for the multiethnic or multinational Editorial and Advisory Boards, and engaging in collaborative research and regional initiatives.

Croatia↗
PubMedDate not supplied

After the war in Nicaragua: a psychosocial study of war wounded ex-combatants.

Despite 150 wars in the Third World since 1945, there have been virtually no psychosocial studies of war wounded ex-combatants. This community study of 72 such men, on average 4.9 years post-injury, had both quantitative (General Health Questionnaire [GHQ] and clinical interview) and qualitative (personal narrative) components. Most men were coping adaptively. However their overall GHQ scores were significantly higher than an ex-combatant control group, suggesting relative psychological vulnerability (P = 0.001). 13 (18 per cent) had post-traumatic stress disorder (PTSD) though in only three was this clinically significant, two of whom were aggressive alcoholics. Social dysfunction was a better indicator of the minority who needed psychological help than a diagnosis of PTSD. The one in three with a severe physical disability were not at greater risk than the rest of the group. Personal narratives illuminated the ways subjects had registered and responded to their war experiences. Identification with the social ideals being defended by the war effort had been psychologically bolstering. Ten severely disabled ex-Contra guerrillas, who had fought on the other side, were also interviewed. The availability of appropriate training/work, and thus the economic fortunes of the whole society, are likely to be major determinants of long-term psychosocial outcomes. Six illustrative personal histories are appended.

Adolescent↗
PubMedDate not supplied

With war in mind: a dialogical analysis of the mindset underlying Blair's case for war with Iraq in 2003.

Dialogical Analysis, a tool from Cognitive Analytic Therapy, is used to discover how the mindset of war silences dialogue. The savage costs of war were hidden whilst the United Kingdom government expected to attract the admiration of a grateful world. This article looks at an example of this mindset expressed through Tony Blair MP's speech to the House of Commons on 18 March 2003. The speech aimed at convincing parliament that war was inevitable, necessary and the only obvious choice. It offered an extremely narrow presentation of options available to the government, in which 'staying firm' was coupled with the case for war whilst alternative, peaceful methods of conflict resolution were identified as 'weak and feeble' and viewed as encouraging terrorists.

Humans↗
PubMed2003

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

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.

Adult↗
PubMed1987

Precursors of depression in World War II veterans 40 years after the war.

The impact of wartime stress and other psychosocial and health variables on depressive illness in the 40 years since the Second World War is examined in this study of Australian male prisoners of the Japanese and other veterans. A random sample of 170 surviving members of the captured Eighth Division of the Australian Army residing in Sydney in 1983 (POWs) was compared with a similar sample of 172 veterans who fought in Southeast Asia during the war but were not imprisoned (non-POWs). Multiple regression analysis involving nine predictor variables revealed that self-reported nervous illness during the war and depressive illness since the war had pronounced independent effects on current depression as measured by the Zung Scale. Being married and better educated had significant protective effects against depression for the non-POWs while being employed and having higher socioeconomic status were protective for POWs. A clear linkage was shown from wartime nervous illness to postwar depressive illness to present-day depression.

Aged↗
PubMed1993

Psychopathology and psychiatric diagnoses of World War II Pacific theater prisoner of war survivors and combat veterans.

OBJECTIVE: This study assessed current and long-term psychological and psychiatric sequelae of war trauma in World War II Pacific theater combat veterans, some of whom had been Japanese prisoners of war (POWs). METHOD: A group of 36 POW survivors and a group of 29 combat veterans, all of whom had seen fierce fighting and heavy unit casualties, were compared approximately 40 years later on psychological instruments assessing psychopathology constructs, negative mood states, and symptoms of posttraumatic stress disorder (PTSD) and on the computer-administered National Institute of Mental Health Diagnostic Interview Schedule. RESULTS: Although similar in personal backgrounds and in having suffered catastrophic war trauma, the two groups differed in the severity and type of psychiatric symptoms and in the occurrence of psychiatric disorders. Anxiety and depressive disorders were common in both groups, but there were differences in the frequency of PTSD diagnoses. Among the POW survivors, 70% fulfilled the criteria for a current diagnosis and 78% for a lifetime diagnosis of PTSD, compared to 18% and 29%, respectively, of the combat veterans. CONCLUSIONS: The findings point to the persistent nature of symptoms thought to be residuals of extraordinary stress and the relation between severity of psychiatric sequelae and characteristics of the stressors.

Aged↗
PubMed1986

Australian prisoners of war of the Japanese: post-war psychiatric hospitalisation and psychological morbidity.

Evidence of chronic psychiatric and psychosomatic morbidity was found in a randomly selected sample of Australian prisoners of war (POWs) of the Japanese over the 40-year period following the Second World War. A clinical interview revealed more contemporary depressive and anxiety disorders and more post-war psychiatric illness overall than in a comparison group of randomly selected combatant veterans of the Pacific and South East Asian campaign. The POWs were no more likely to have had psychiatric admissions than non-POWs and fewer of them had had multiple psychiatric admissions. POWs had more duodenal ulcers than controls but otherwise their physical health was similar, as was their age-adjusted mortality in the post-war years. Finally, POWs were more likely to have Totally and Permanently Incapacitated Service Pensions than controls.

Aged↗
PubMed2002

The effect of war on children: the children of Europe after World War II.

In war, children are inevitably innocent victims. In the carnage that was World War II, more children were killed or orphaned than at any other time in history. This article gives a brief history of the place of children within the conflagration, then describes the effects of war on the children. We concentrate on postwar life, placing children in the context of the environment in which they were living at the time. Our article outlines the work carried out by relief agencies and how Europe began to rebuild itself, how the children were fed and made healthy, and how, where possible, they were reunited with their families. We report briefly on the physical and psychological damage children suffered, both during the war and in its aftermath. History such as this is relevant to nurses in the 21st century, as it provides insight upon which nursing care for both our present ageing population and for children of the future can be based.

Child↗
PubMed2002

Psychiatry in the Korean War: perils, PIES, and prisoners of war.

In the initial months of the Korean War, very high numbers of psychological casualties occurred among American troops, 250 per 1,000 per annum. Initially, these men were evacuated to Japan or the United States, and very few of them were returned to duty. Then the principles of early and far-forward treatment, learned in the previous world wars, were reinstituted. Up to 80% of neuropsychiatric casualties were returned to duty. During and after the war, the prisoners of war were believed to have been "brainwashed," have "give-it-upitis," and exhibit apathy and depression. Mistakenly believed to be signs of moral decay, the psychiatric symptoms during and after release were probably a result of extended inhumane treatment and vitamin deficiencies.

History, 20th Century↗