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Concept: Iraq War

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Previous estimates of mortality in Iraq attributable to the 2003 invasion have been heterogeneous and controversial, and none were produced after 2006. The purpose of this research was to estimate direct and indirect deaths attributable to the war in Iraq between 2003 and 2011.

Concepts: Sample, Gulf War, Cluster sampling, Iraq War, 2003 invasion of Iraq, Invasion, Iraq, Saddam Hussein

121

In August 2014, the so-called Islamic State of Iraq and Syria (ISIS) attacked the Yazidi religious minority living in the area of Mount Sinjar in Nineveh governorate, Iraq. We conducted a retrospective household survey to estimate the number and demographic profile of Yazidis killed and kidnapped.

Concepts: Demography, Islam, Iraq War, Arabic language, Iraq, Kurdish language, Mosul, Yazidi

106

American physicians have not widely criticized medical policies at the Guantanamo Bay detainment camp that violate medical ethics. We believe they should. Actions violating medical ethics, taken on behalf of the government, devalue medical ethics for all physicians. The ongoing hunger strike at Guantanamo by as many as 100 of the 166 remaining prisoners presents a stark challenge to the U.S. Department of Defense (DOD) to resist the temptation to use military physicians to “break” the strike through force-feeding. President Barack Obama has publicly commented on the hunger strike twice. On April 26, he said, “I don’t want these individuals . . .

Concepts: Health care, United States, President of the United States, Barack Obama, Iraq War, Illinois, Democratic Party, Guantanamo Bay detention camp

54

Just over 5 years ago, on March 23, 2010, President Barack Obama signed the Affordable Care Act (ACA) into law. Its enactment may constitute the most important event of the Obama presidency and could fundamentally affect the future of health care in the United States. From a historical perspective, 5 years is a very short time, far too short to assess definitively the effects of the ACA. Still, the 5-year mark seems to be a logical point to pause and take stock of how the ACA has fared to date - to review what we know now of its effect . . .

Concepts: Health care, United States, President of the United States, Barack Obama, Iraq War, Illinois, Democratic Party, Inauguration of Barack Obama

38

Gulf War exposures in 1990 and 1991 have caused 25% to 30% of deployed personnel to develop a syndrome of chronic fatigue, pain, hyperalgesia, cognitive and affective dysfunction.

Concepts: Medicine, Gulf War, Israel, Iraq War, 2003 invasion of Iraq, Gulf War syndrome, Depleted uranium, Iran–Iraq War

34

Introduction The number of civilians killed in Iraq following the 2003 invasion has proven difficult to measure and contentious in recent years. The release of the Wikileaks War Logs (WL) has created the potential to conduct a sensitivity analysis of the commonly-cited Iraq Body Count’s (IBC’s) tally, which is based on press, government, and other public sources. Hypothesis The 66,000 deaths reported in the Wikileaks War Logs are mostly the same events as those previously reported in the press and elsewhere as tallied by iraqbodycount.org. METHODS: A systematic random sample of 2500 violent fatal War Log incidents was selected and evaluated to determine whether these incidents were also found in IBC’s press-based listing. Each selected event was ranked on a scale of 0 (no match present) to 3 (almost certainly matched) with regard to the likelihood it was listed in the IBC database. RESULTS: Of the two thousand four hundred and nine War Log records, 488 (23.8%) were found to have likely matches in IBC records. Events that killed more people were far more likely to appear in both datasets, with 94.1% of events in which ≥20 people were killed being likely matches, as compared with 17.4% of singleton killings. Because of this skew towards the recording of large events in both datasets, it is estimated that 2035 (46.3%) of the 4394 deaths reported in the Wikileaks War Logs had been previously reported in IBC. CONCLUSIONS: Passive surveillance systems, widely seen as incomplete, may also be selective in the types of events detected in times of armed conflict. Bombings and other events during which many people are killed, and events in less violent areas, appear to be detected far more often, creating a skewed image of the mortality profile in Iraq. Members of the press and researchers should be hesitant to draw conclusions about the nature or extent of violence from passive surveillance systems of low or unknown sensitivity. Carpenter D , Fuller T , Roberts L . WikiLeaks and Iraq Body Count: the sum of parts may not add up to the whole-a comparison of two tallies of Iraqi civilian deaths. Prehosp Disaster Med. 2013;28(3):1-7 .

Concepts: Violence, Iraq War, 2003 invasion of Iraq, Iraq, War, Laws of war, Iraq Body Count project, International humanitarian law

29

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.

Concepts: Medical ethics, United States, United Arab Emirates, Gulf War, Iraq War, 2003 invasion of Iraq, Iran–Iraq War, Laws of war

26

We described the risk for maltreatment among toddlers of US Army soldiers over different deployment cycles to develop a systematic response within the US Army to provide families appropriate supports.

Concepts: Menstrual cycle, Vietnam War, United States Army, Iraq War, Differential, Army, Continental Army, Brigade

25

Hearing loss and tinnitus are the 2 most prevalent service-connected disabilities among veterans in the United States. Veterans of Operations Enduring Freedom, Iraqi Freedom, and New Dawn have been exposed to multiple hazards associated with these conditions, such as blasts/explosions, ototoxic chemicals, and most notably high levels of noise. We conducted a systematic literature review of evidence on 1) prevalence of, 2) risk and protective factors for, and 3) functional and quality-of-life outcomes of hearing impairment and tinnitus in US Operations Enduring Freedom, Iraqi Freedom, and New Dawn veterans and military personnel. We identified studies published from 2001 through 2013 using PubMed, PsycINFO, REHABDATA, Cochrane Library, pearling, and expert recommendation. Peer-reviewed English language articles describing studies of 30 or more adults were included if they informed one or more key questions. A total of 839 titles/abstracts were reviewed for relevance by investigators trained in critical analysis of literature; 14 studies met inclusion criteria. Of these, 13 studies presented data on prevalence and 4 on risk/protective factors, respectively. There were no included studies reporting on outcomes. Findings from this systematic review will help inform clinicians, researchers, and policy makers on future resource and research needs pertaining to hearing impairment and tinnitus in this newest generation of veterans.

Concepts: Systematic review, United States, Hearing impairment, Tinnitus, Audiogram, Operation Enduring Freedom, Iraq War, Iraq

25

Surgeons general of the United States have often championed important causes that improve the nation’s health. Leroy Burney and Luther Terry took on the issue of smoking and health. C. Everett Koop championed the treatment of HIV-AIDS as a medical condition. With the nomination of Dr. Vivek Murthy, who aims to take on the epidemic of obesity, President Barack Obama is striving to continue this tradition. Murthy, whose parents immigrated to the United States from India, has lived the American dream. He was educated at two of our nation’s most prestigious universities, earning his undergraduate degree at Harvard and both . . .

Concepts: Hawaii, United States, President of the United States, Barack Obama, Iraq War, Illinois, Democratic Party, Surgeon General of the United States