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At least 19 recordsLinked to original sources
PubMedDate not supplied

Demographics of and diagnoses in Operation Enduring Freedom and Operation Iraqi Freedom personnel who were psychiatrically evacuated from the theater of operations.

OBJECTIVE: The objective of this study was to characterize the demographic and clinical information of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) military personnel who were psychiatrically evacuated from the theater of operations. METHOD: Records of 1264 consecutive OEF/OIF patients who were medically evacuated for primarily psychiatric reasons between November 4, 2001, and July 30, 2004, were reviewed to collect demographic information and psychiatric diagnoses. RESULTS: When compared with all returned OEF/OIF veterans (N=213,150), psychiatric evacuees were more likely to be: female, under the age of 31 years, African-American or Hispanic, enlisted and National Guard/Reserve. Over 80% of patients were evacuated during the first 6 months, compared with 17% during the second 6 months of deployment. The most common diagnostic categories were adjustment disorders (37.6%), mood disorders (22.1%), personality disorders (15.7%) and anxiety disorders (15.4%); 16.5% received no psychiatric diagnosis. Only 5% of evacuees were returned to OEF/OIF duty. CONCLUSION: Almost half of evacuated patients received no diagnosis or no adjustment disorder diagnosis, suggesting clinical improvement since a decision for evacuation was made. Potential areas of focus for preventing psychiatric evacuations are identifying service members who are at risk during early stages of deployment and studying whether there are gender-specific deployment stressors.

Adjustment Disorders↗
PubMedDate not supplied

Pain among veterans of Operations Enduring Freedom and Iraqi Freedom.

OBJECTIVE: Pain is one of the most frequently reported symptoms by veterans returning from recent overseas military actions. The purpose of the current study was to obtain a preliminary estimate of the prevalence and severity of pain among veterans of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF; N=970). The demographic, etiologic, and diagnostic characteristics of 100 veterans with moderate to severe chronic pain conditions were examined in order to provide a description of this new group of pain patients. DESIGN: This was a historical cohort study that utilized electronic medical record review for all data collection. PATIENTS: All registered OEF/OIF veterans seeking treatment at a Southeastern Veterans' Affairs medical center were included in the initial cohort. In order to describe the characteristics of those with clinically significant pain, 100 veterans were randomly sampled from the subset of patients who reported moderate to severe chronic pain intensity during a medical visit (N=219). RESULTS: Approximately 47% of veterans whose charts included pain score documentation (N=793) reported at least a mild level of current pain. Moderate to severe pain intensity was recorded for 28% (N=219) of those in the initial cohort with pain scores. Diagnoses of musculoskeletal and connective tissue disorders were recorded for 82% of those with chronic conditions (i.e., duration>or=1 month). CONCLUSIONS: The results of this preliminary study suggest that a substantial percentage of OEF/OIF veterans will experience clinically significant pain following their military service.

Adult↗
PubMed2006

A review of 41 upper extremity war injuries and the protective gear worn during Operation Enduring Freedom and Operation Iraqi Freedom.

Forty-one patients with upper extremity war injuries sustained during combat operations Operation Enduring Freedom and Operation Iraqi Freedom were reviewed to report on protective gear availability and usage at the time of injury. Participants treated at the Madigan Army Medical Center occupational therapy clinic from August 2004 until February 2005 completed a questionnaire regarding injuries sustained during deployment. Overall, 6 injuries were to upper extremity regions that were covered with issued protective gear; 21 injuries were to areas not covered with issued protective gear (i.e., participant was not wearing issued gear), and 22 injuries were to regions that were not covered because no protective gear was issued for that body area. Although this study is limited, future research would provide valuable insights about the efficacy of current body armor and the need for additional or modified gear.

Adult↗
PubMed1997

Revision of Department of Justice Freedom of Information Act and Privacy Act Regulations and Implementation of Electronic Freedom of Information Act Amendments of 1996--DoJ. Proposed Rule.

This document sets forth proposed revision of the Department's regulations under both the Freedom of Information Act (FOIA) and the Privacy Act of 1974. The FOIA and Privacy Act regulations have been streamlined and condensed, in accordance with the principles of the National Performance Reviews. With more "user-friendly" language wherever possible. These revisions also reflect the principles established by President Clinton and Attorney General Reno in their FOIA Policy Memoranda of October 4, 1993. The new statement of discretionary disclosure policy will supercede the existing regulation regarding discretionary access to records of historical interest. Additionally, the regulations have been updated to reflect developments in the case law and to include updated cost figures to be used in calculating and charging fees. These proposed revisions also contain new provisions implementing the Electronic Freedom of Information Act Amendments of 1996.

Government Agencies↗
PubMed2006

Trauma system development in a theater of war: Experiences from Operation Iraqi Freedom and Operation Enduring Freedom.

BACKGROUND: Medical lessons learned from Vietnam and previous military conflicts led to the development of civilian trauma systems in the United States. Operation Iraqi Freedom represents the first protracted, large-scale, armed conflict since the advent of civilian trauma systems in which to evaluate a similar paradigm on the battlefield. METHODS: Collaborative efforts between the joint military forces of the United States initiated development of a theater trauma system in May 2004. Formal implementation of the system occurred in November 2004, the collaborative effort of the three Surgeons General of the U.S. military, the United States Army Institute of Surgical Research, and the American College of Surgeons Committee on Trauma. One trauma surgeon (Trauma System Director) and a team of six trauma nurse coordinators were deployed to theater to evaluate trauma system component issues. Demographic, mechanistic, physiologic, diagnostic, therapeutic, and outcome data were gathered for 4,700 injured patients using the Joint Theater Trauma Registry. Interview and survey methods were utilized to evaluate logistic aspects of the system. RESULTS: System implementation identified more than 30 systemic issues requiring policy development, research, education, evaluation of medical resource allocation, and alterations in clinical care. Among the issues were transfer of casualties from point of injury to the most appropriate level of care, trauma clinical practice guidelines, standard forms, prophylactic antibiotic regimens, morbidity/mortality reporting, on-line medical evacuation regulation, improved data capture for the trauma registry, and implementation of a performance improvement program. CONCLUSIONS: The implementation of a theater trauma system demonstrated numerous opportunities to improve the outcome of soldiers wounded on the battlefield.

Hospitals, Packaged↗
PubMed2004

The epidemiology of self-reported diarrhea in operations Iraqi freedom and enduring freedom.

Diarrhea remains a potential cause of compromised military effectiveness. To assess diarrhea rates and mission impact in operations in Iraq and Afghanistan, a survey was administered to soldiers participating in the "Rest and Recuperation" program in Doha, Qatar. Between October and December 2003, 2,389 volunteers completed a questionnaire designed to assess the occurrence and impact of diarrhea. The median length of deployment was 7.2 months, 70% reported at least one episode, and 56% had multiple episodes of diarrhea. Overall, 43% reported decreased job performance for a median of 2 days, and 17% reported being on bed rest for a median of 2 days. While this survey showed high rates of diarrhea associated with decreased operational effectiveness, the results are consistent with prior military operations in this region. Further research is needed to develop better methods for illness prevention and its minimization on operational impact.

Adult↗
PubMed2006

Comparison between civilian burns and combat burns from Operation Iraqi Freedom and Operation Enduring Freedom.

OBJECTIVE: To assess outcome differences between locally burned civilians and military personnel burned in a distant combat zone treated in the same facility. SUMMARY BACKGROUND DATA: The United States Army Institute of Surgical Research (USAISR) Burn Center serves as a referral center for civilians and is the sole center for significant burns in military personnel. We made the hypothesis that outcomes for military personnel burned in the current conflict in Iraq and Afghanistan would be poorer because of delays to definitive treatment, other associated injury, and distance of evacuation. METHODS: We reviewed the civilian and military records of patients treated at the USAISR from the outset of hostilities in Iraq in April 2003 to May 2005. Demographics, injury data, mortality, and clinical outcomes were compared. RESULTS: : We cared for 751 patients during this time period, 273 of whom were military (36%). Military injuries occurred in a younger population (41 +/- 19 vs. 26 +/- 7 years for civilian and military respectively, P < 0.0001) with a longer time from injury to burn center arrival (1 +/- 5 days vs. 6 +/- 5, P < 0.0001), a higher Injury Severity Score (ISS 5 +/- 8 vs. 9 +/- 11, P < 0.0001), and a higher incidence of inhalation injury (8% vs. 13%, P = 0.024). Total burn size did not differ. Mortality was 7.1% in the civilian and 3.8% in the military group (P = 0.076). When civilians outside the age range of the military cohort were excluded, civilian mortality was 5.0%, which did not differ from the military group (P = 0.57). Total body surface area (TBSA) burned, age > or =40 years, presence of inhalation injury, and ventilator days were found to be important predictors of mortality by stepwise regression, and were used in a final predictive model with the area under receiver operator characteristic curve of 0.97 for both populations considered together. No significant effect of either group was identified during development. CONCLUSIONS: Mortality does not differ between civilians evacuated locally and military personnel injured in distant austere environments treated at the same center.

Adolescent↗
PubMedDate not supplied

Self-reported description of diarrhea among military populations in operations Iraqi Freedom and Enduring Freedom.

BACKGROUND: Infectious diarrhea is among the most common medical problems associated with military deployments and has been reported as a frequent problem for troops currently deployed to Iraq and Afghanistan. Lacking is information describing clinical presentation, risk behaviors, and treatment of travelers' diarrhea in this population. METHODS: An anonymous cross-sectional survey was conducted among 15,459 US military personnel deployed to Southwest Asia during 2003 to 2004. RESULTS: Overall, diarrhea was commonly reported (76.8% in Iraq and 54.4% in Afghanistan) and was frequently severe (more than six stools/d) (20.8% in Iraq and 14.0% in Afghanistan) or associated with fever (25.8%), vomiting (18% with diarrhea and 16.5% without), persistent symptoms (>14 d, 9.8%), or chronic symptoms (>30 d, 3.3%). Diarrhea was associated with time spent off military compounds and eating local food. Over 80% of respondents sought care for their symptoms, usually at the lowest echelon of care (field medic), and were most often treated with either loperamide or an antibiotic. Self-treatment with loperamide or Pepto-Bismol was also common and successful with only 9% of self-treated individuals reporting seeking further medical care. CONCLUSIONS: Infectious diarrhea is a common problem for US military personnel, and associated fevers and vomiting are more common than in past conflicts in the region. As with past studies, time spent off base and local food consumption, both more common in Iraq than Afghanistan, continue to be the most important risk factors for acquiring diarrhea. The majority of soldiers reported seeking care for diarrhea, but appropriate treatment, including self-treatment with over-the-counter medicines, was generally successful. Further studies should be conducted to evaluate appropriate treatment algorithms, including the use of self-treatment, for deployed military personnel.

Adult↗
PubMed2004

Dental satisfaction survey at an expeditionary dental clinic in support of Operations Enduring Freedom and Iraqi Freedom.

This study used a survey to gather information about soldiers' perceptions of the quality of dental treatment delivered at a deployed clinic. An ordinal scale of 1 through 5 scored access, dental facility and equipment, pain control, technical skill, and interpersonal skills of the provider. Four additional items identified whether the respondent was new to military or deployment dentistry, was in pain before arriving at the clinic, or had any concerns about being treated at a deployed dental clinic. Percentages for each type of response were recorded. Data were further analyzed by the Mann-Whitney U test to investigate the relationship between respondent variables and how they rated the attributes of quality. Deployed service members reported a high degree of satisfaction with the quality of care they received. Ninety-seven percent of respondents believed that the care they received was as good as the care they would have received at their regular stateside military dental facility.

Data Collection↗