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PubMed1997

Medical support for Operation Cooperative Nugget '95: joint readiness training in the post-cold war era.

The purpose of this paper is to report the demographic characteristics, injury and illness profiles, and dispositions of patients seen at the 249th General Hospital during its month-long deployment in support of Operation Cooperative Nugget '95 at the Joint Readiness Training Center (JRTC), Fort Polk, Louisiana. A descriptive analysis of patient demographic, diagnostic, and disposition data was performed. A total of 769 patient contacts were made, with orthopedic injuries (31%), dermatologic disorders (17%), upper respiratory infections (6%), and heat injuries (5%) accounting for the majority of visits. Because of aggressive preventive medicine interventions, there were no cases of heat stroke despite daily heat indices of 110 to 120 degrees F. In addition to emphasizing the importance of anticipating environmental medical threats, the authors relate some lessons learned, which should be valuable to medical providers tasked for future multinational operations other than war at the JRTC and elsewhere.

Adolescent↗
PubMed2000

Fatality trends in United Nations Peacekeeping Operations, 1948-1998.

CONTEXT: The rising number of deaths among United Nations (UN) peacekeeping forces after the Cold War has made some troop-contributing countries hesitant to participate in peacekeeping operations. While the number and scale of missions have increased, no data have demonstrated a parallel increase in risks to peacekeepers. OBJECTIVE: To determine the association of characteristics of UN peacekeeping operations with risks and mortality rates among UN peacekeeping forces in both the Cold War and post-Cold War periods. DESIGN, SETTING, AND PARTICIPANTS: Descriptive analysis of 1559 personnel deaths during 49 UN peacekeeping missions from 1948-1998 based on the casualty database maintained by Department of Peacekeeping Operations, UN Headquarters. MAIN OUTCOME MEASURES: Number and percentage of deaths by circumstance, total crude death rate, and crude death rate and relative risk of death by circumstance (hostile acts, unintentional violence, and illness or other causes) and time period (Cold War vs post-Cold War), geographic region, and nature of peacekeeping response; and regression analysis of mission variables (strength, duration, and humanitarian mandate) associated with total number of deaths. RESULTS: More deaths have occurred among UN peacekeeping forces in the past decade alone than in the previous 40 years of UN peacekeeping (807 vs 752), but crude death rates did not differ significantly by time period (Cold War vs post-Cold War, 21.8 vs 21. 2 deaths per 10,000 person-years; P =.58), level of peacekeeping response, or for geographic regions other than East Europe and Central America, where rates were lower (P<.001 for both regions). Unintentional violence accounted for 41.2% of deaths, followed by hostile acts (36.1%), and illness or other causes (22.7%). Deaths from hostile acts increased after the Cold War (relative risk [RR] 1. 51; 95% confidence interval [CI], 1.22-1.88), while rates for deaths caused by unintentional violence decreased (RR, 0.79; 95% CI, 0.67-0. 94) but remain high, particularly in the Middle East and Asia (RR, 1. 39; 95% CI, 1.15-1.69). Regression analysis showed a significant association between number of deaths and the strength (P<.001) and duration (P<.001) of a peacekeeping mission. CONCLUSION: The increase in number of deaths among UN peacekeeping personnel since 1990 can be attributed to the increased number and scale of missions after the Cold War rather than increased RR of death. Post-Cold War peacekeeping personnel have a higher risk of dying from hostile acts in missions where more force is required. In missions providing or facilitating humanitarian assistance, both the RR of deaths from all causes and deaths from hostile acts are increased. JAMA. 2000;284:598-603

Humans↗
PubMedDate not supplied

Japan's anti-nuclear weapons policy misses its target, even in the war on terrorism.

While actively working to promote the abolition of all nuclear weapons from the world since the end of the cold war, Japan's disarmament policies are not without problems. Promoting the elimination of nuclear weapons as Japan remains under the US nuclear umbrella creates a major credibility problem for Tokyo, since this decision maintains a Japanese deterrence policy at the same time that officials push for disarmament. Tokyo also advocates a gradual approach to the abolition of nuclear weapons, a decision that has had no effect on those countries that have been conducting sub-critical nuclear testing, nor stopped India and Pakistan from carrying out nuclear tests. Consistent with Article 9 of the Constitution, the Japanese war-renouncing constitutional clause, Tokyo toughened Japan's sizeable Official Development Assistance (ODA) programme in the early 1990s. Because of the anti-military guidelines included in Japan's ODA programme, Tokyo stopped new grant and loan aid to India and Pakistan in 1998 after these countries conducted nuclear tests. However, because of the criticism Japan faced from its failure to participate in the 1991 Gulf War, Tokyo has been seeking a new Japanese role in international security during the post-cold war period. Deepening its commitment to the security alliance with the US, Tokyo has become increasingly influenced by Washington's global polices, including the American war on terrorism. After Washington decided that Pakistan would be a key player in the US war on terrorism, Tokyo restored grant and loan aid to both Islamabad and New Delhi, despite the unequivocal restrictions of Japan's ODA programme.

Humans↗
PubMed1998

Medicine and nuclear war: from Hiroshima to mutual assured destruction to abolition 2000.

To determine how physicians might participate in the prevention of nuclear war in the post-Cold War era, we review, from a medical perspective, the history of the nuclear weapons era since Hiroshima and the status of today's nuclear arsenals and dangers. In the 1950s, physicians were active partners in governmental civil defense planning. Since 1962, physicians have stressed prevention of nuclear war as the only effective medical intervention. Public advocacy by physicians helped end both atmospheric nuclear testing in the 1960s and superpower plans for fighting a nuclear war in the 1980s. Today's dangers include nuclear arms proliferation, an increasing risk of nuclear terrorism, and the 35000 warheads that remain in superpower-nuclear arsenals, many still on hair-trigger alert. Physicians have recently joined with military and political leaders and over 1000 citizens' organizations in calling for the complete elimination of nuclear weapons. Global medical collaboration in support of a verifiable and enforceable Nuclear Weapons Convention would be a major contribution to safeguarding health in the 21st century.

Civil Defense↗
PubMed2004

Bioethics and the national security state.

In previous work, I have described the history and ethics of human experiments for national security purposes during he cold war and developed the bioethical issues that will be apparent in the "war on terror". This paper is an attempt to bring these two previous lines of work together under the rubric of the "national security state," a concept familiar to Cold War historians and political scientists. The founding of the national security state was associated with the first articulations of informed consent requirements by national security agencies. My analysis indicates that strengthened consent standards, though conventionally thought to be antithetical crisis, can be seen as an attempt by the postwar national security state to protect itself from critics of expanded governmental power. During the coming years the renewed mission of the national security state in the war on terror should impel students of bioethics to consider its implications for the field.

Bioethics↗
PubMedDate not supplied

The United Nations and the promotion of peace.

Despite the end of the cold war, many other conflicts persisted in the 1990s. The hope that a peace dividend would help to alleviate poverty was replaced by doubts regarding the effects of free market globalization and environmental constraints. Future concerns include the continuing aftermath of the cold war, the increased destructiveness of modern warfare, despite the increased sophistication of modern weaponry, the widening poverty gap between a wealthy elite and the majority of the world's population and developing global economic and environmental threats. The response to all this should be economic co-operation for sustainable development, including trade reform, and radical change in the environmental impact of the industrialized countries. Yet it appears that the response of the US, and to a lesser extent Europe, is to maintain the status quo in its own interests by military means, an attitude that seems to have been reinforced by the events of 11 September 2001. Nevertheless, these developments are opposed by citizen groups in the developed world and by analysts in the South. The United Nations and its agencies have been at the forefront of analysis and proposals for action in many of these fields. Its role is likely to increase in the next 30 years and it must be made as effective a global body as possible.

Environment↗
PubMed2000

Thinking about Russia: plausible pasts and probable futures.

This paper uses both correlational and experimental methods to explore the power of counterfactual cognitions about the past to constrain judgments about the future as well as policy preferences. Study 1 asked 47 specialists on the Soviet Union to assess both the plausibility of controversial counterfactuals and the probability of controversial conditional forecasts. The results reveal deep ideological schisms, with liberals much more likely than conservatives to believe that Stalinism was not inevitable, that the Cold War could have ended earlier, and that Gorbachev might have succeeded in democratizing the Soviet Union if he had been a better tactician, among others. Reactions to these counterfactuals proved to be highly predictive of positions that experts in early 1992 endorsed concerning the advisability of 'shock therapy', expanding NATO eastward, and economic aid to Russia. Study 2 manipulated the salience and plausibility of counterfactual scenarios concerning (a) why the Cold War ended as it did, and (b) how close the US and USSR came to nuclear war. Changes in the counterfactual scenarios that non-experts endorsed produced significant changes in their policy preferences in the direction suggested by the salient counterfactual. Experts, however, were unswayed, often generating counter-arguments against dissonant counterfactuals. Taken together, the studies show that assumptions about what happened in the missing control conditions of history are highly subjective, largely theory-driven and profoundly consequential.

Adult↗
PubMed2000

Radiation hormesis: the demise of a legitimate hypothesis.

This paper examines the underlying factors that contributed to the marginalization of radiation hormesis in the early and middle decades of the 20th century. The most critical factor affecting the demise of radiation hormesis was a lack of agreement over how to define the concept of hormesis and quantitatively describe its dose-response features. If radiation hormesis had been defined as a modest overcompensation to a disruption in homeostasis as would have been consistent with the prevailing notion in the area of chemical hormesis, this would have provided the theoretical and practical means to blunt subsequent legitimate criticism of this hypothesis. A second critical factor undermining the radiation hormesis hypothesis was the generally total lack of recognition by radiation scientists of the concept of chemical hormesis which was markedly more advanced, substantiated and generalized than in the radiation domain. The third factor was that major scientific criticism of low dose stimulatory responses was galvanized at the time that the National Research Council (NRC) was organizing a national research agenda on radiation and the hormetic hypothesis was generally excluded from the future planned research opportunities. Furthermore, the criticisms of the leading scientists of the 1930s which undermined the concept of radiation hormesis were limited in scope and highly flawed and then perpetuated over the decades by other 'prestigious' experts who appeared to simply accept the earlier reports. This setting was then linked to a growing fear of radiation as a cause of birth defects, mutation and cancer, factors all reinforced by later concerns over the atomic bomb. Strongly supportive findings on hormetic effects in the 1940s by Soviet scientists were either generally not available to US scientists or disregarded as part of the Cold War mindset without adequate analysis. Finally, a massive, but poorly designed, US Department of Agriculture experiment in the late 1940s to assess the capacity for low dose plant stimulation by radionuclides failed to support the hormetic hypothesis thereby markedly lessening enthusiasm for research and funding in this area. Thus, the combination of a failed understanding of the hormetic hypothesis and its linkage with a strong chemical hormesis database, flawed analyses by prestigious scientists at the critical stage of scientific research development, reinforced by a Cold War mentality led to marginalization of an hypothesis (i.e., radiation hormesis) that had substantial scientific foundations and generalizability.

Adaptation, Physiological↗
PubMed2001

Preemptive biopreparedness: can we learn anything from history?

The treat of bioterrorism is in the public eye again, and major public health agencies are urging preparedness efforts and special federal funding. In a sense, we have seen this all before. The Centers for Disease Control and Prevention grew substantially during the Cold War era in large part because Alexander Langmuir, Chief Epidemiologist of the CDC, used an earlier generation's anxieties to revitalize the CDC, create an Epidemic Intelligence Service, and promote epidemiologic "surveillance" as part of the nation's defense. Retrospective investigation suggests that, while Langmuir contributed to efforts promoted by the Department of Defense and the Federal Civil Defense Administration, the United States did not have real cause to fear Communist biological warfare aggression. Given clear historical parallels, it is appropriate to ask, What was gained and what was lost by Langmuir's central role in that first instance of American biopreparedness? Among the conclusions drawn is that biopreparedness efforts fed the Cold War climate, narrowed the scope of public health activities, and failed to achieve sustained benefits for public health programs across the country.

Biological Warfare↗
PubMedDate not supplied

A critical assessment of boron target compounds for boron neutron capture therapy.

Boron neutron capture therapy (BNCT) has undergone dramatic developments since its inception by Locher in 1936 and the development of nuclear energy during World War II. The ensuing Cold War spawned the entirely new field of polyhedral borane chemistry, rapid advances in nuclear reactor technology and a corresponding increase in the number to reactors potentially available for BNCT. This effort has been largely oriented toward the eradication of glioblastoma multiforme (GBM) and melanoma with reduced interest in other types of malignancies. The design and synthesis of boron-10 target compounds needed for BNCT was not channeled to those types of compounds specifically required for GBM or melanoma. Consequently, a number of potentially useful boron agents are known which have not been biologically evaluated beyond a cursory examination and only three boron-10 enriched target species are approved for human use following their Investigational New Drug classification by the US Food and Drug Administration; BSH, BPA and GB-10. All ongoing clinical trials with GBM and melanoma are necessarily conducted with one of these three species and most often with BPA. The further development of BNCT is presently stalled by the absence of strong support for advanced compound evaluation and compound discovery driven by recent advances in biology and chemistry. A rigorous demonstration of BNCT efficacy surpassing that of currently available protocols has yet to be achieved. This article discusses the past history of compound development, contemporary problems such as compound classification and those problems which impede future advances. The latter include means for biological evaluation of new (and existing) boron target candidates at all stages of their development and the large-scale synthesis of boron target species for clinical trials and beyond. The future of BNCT is bright if latitude is given to the choice of clinical disease to be treated and if a recognized study demonstrating improved efficacy is completed. Eventually, BNCT in some form will be commercialized.

Animals↗
PubMed1995

Who wrote the book of life? Information and the transformation of molecular biology, 1945-55.

This paper focuses on the opening of a discursive space: the emergence of informational and scriptural representations of life and hereditiy and their self-negating consequences for the construction of biological meaning. It probes the notion of writing and the book of life and shows how molecular biology's claims to a status of language and texuality undermines its own objective of control. These textual significations were historically contingent. The informational representations of heredity and life were not an outcome of the internal cognitive momentum of molecular biology; they were not a logical necessity of the unravelling of the base-pairing of the DNA double-helix. They were transported into molecular biology still within the protein paradigm of the gene in the 1940s and permeated nearly every discipline in the life and social sciences. These information-based models, metaphors, linguistic, and semiotic tools which were central to the formulation of the genetic code were transported into molecular biology from cybernetics, information theory, electronic computing, and control and communication systems--technosciences that were deeply embedded with the military experiences of World War II and the Cold War. The information discourse thus became fixed in molecular biology not because it worked in the narrow epistemic sense (it did not), but because it positioned molecular biology within postwar discourse and culture, perhaps within the transition to a post-modern information-based society.

History, 20th Century↗