Zeitschriftenartikel: „Operation Enduring Freedom-Afghanistan“

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Ismadi, Reno, Awatar Bayu Putranto und Tiffany Setyo Pratiwi. „Tinjauan Hukum Humaniter Internasional dalam Operasi Enduring Freedom Amerika Serikat ke Afghanistan dan Peran International Criminal Court (ICC)“. Nation State Journal of International Studies 2, Nr. 1 (30.06.2019): 11–24. http://dx.doi.org/10.24076/nsjis.2019v2i1.142.

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The US military invasion to Afghanistan took place when the War on Terror declared by the United States after the incident in September, 2001 at World Trade Center. One of the military operations in this invasion was called Enduring Freedom. This research will discuss the violations committed by America in the invasion of Afghanistan, particularly during the Enduring Freedom operation, which it was reviewed through Geneva Law and The Rome Statute. The author using literature studies with qualitative methods. The author found that the violations of the Geneva Conventions of 1949 and The Rome Statute Article 8 and 11 were carried out by America during the deliberate Enduring Freedom Operation. The violation was proven but the International Criminal Court (ICC) did nothing.

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Klimo, Paul, Brian T. Ragel, William H. Scott und Randall McCafferty. „Pediatric neurosurgery during Operation Enduring Freedom“. Journal of Neurosurgery: Pediatrics 6, Nr. 2 (August 2010): 107–14. http://dx.doi.org/10.3171/2010.3.peds109.

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Object Operation Enduring Freedom (OEF) is the current US military conflict against terrorist elements in Afghanistan. Deepening US involvement in this conflict and increasing coalition casualties prompted the establishment of continuous neurosurgical assets at Craig Joint Theater Hospital (CJTH) at Bagram Airfield, Afghanistan, in September 2007. As part of the military's medical mission, children with battlefield-related injuries and, on a selective case-by-case basis, non–war-related pathological conditions are treated at CJTH. Methods A prospectively maintained record was created in which all rotating neurosurgeons at CJTH recorded their personal procedures. From this record, the authors were able to extract all cases involving patients 18 years of age or younger. Variables recorded included: age, sex, and category of patient (for example, local national, enemy combatant), date, indication and description of the neurosurgical procedure, mechanism of injury, and in-hospital morbidity and mortality data. Results From September 2007 to October 2009, 296 neurosurgical procedures were performed at CJTH. Fifty-seven (19%) were performed in 43 pediatric patients (16 girls and 27 boys) with an average age of 7.5 years (range 11 days–18 years). Thirty-one of the 57 procedures (54%) were for battlefield-related trauma and 26 for humanitarian reasons (46%). The vast majority of cases were cranial (49/57, 86%) compared with spinal (7/54, 13%), with one peripheral nerve case. Craniotomies or craniectomies for penetrating brain injuries were the most common procedures. There were 5 complications (11.6%) and 4 in-hospital deaths (9.3%). Conclusions As in previous military conflicts, children are the unfortunate victims of the current Afghanistan campaign. Extremely limited pediatric neurosurgical service and care is rendered under challenging conditions and Air Force neurosurgeons provide valuable, life-saving pediatric treatment for both war-related injuries and humanitarian needs. As the conflict in Afghanistan continues, military neurosurgeons will continue to care for injured children to the best of their abilities.

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Ray, J. M., und C. Allen. „Maxillofacial Injuries Sustained in Afghanistan During Operation Enduring Freedom“. Journal of Oral and Maxillofacial Surgery 70, Nr. 9 (September 2012): e17-e18. http://dx.doi.org/10.1016/j.joms.2012.06.023.

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Ragel, Brian T., Paul Klimo, Robert J. Kowalski, Randall R. McCafferty, Jeannette M. Liu, Derek A. Taggard, David Garrett und Sidney B. Brevard. „Neurosurgery in Afghanistan during “Operation Enduring Freedom”: a 24-month experience“. Neurosurgical Focus 28, Nr. 5 (Mai 2010): E8. http://dx.doi.org/10.3171/2010.3.focus09324.

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Object “Operation Enduring Freedom” is the US war effort in Afghanistan in its global war on terror. One US military neurosurgeon is deployed in support of Operation Enduring Freedom to provide care for both battlefield injuries and humanitarian work. Here, the authors analyze a 24-month neurosurgical caseload experience in Afghanistan. Methods Operative logs were analyzed between October 2007 and September 2009. Operative cases were divided into minor procedures (for example, placement of an intracranial pressure monitor) and major procedures (for example, craniotomy) for both battle injuries and humanitarian work. Battle injuries were defined as injuries sustained by soldiers while in the line of duty or injuries to Afghan civilians from weapons of war. Humanitarian work consisted of providing medical care to Afghans. Results Six neurosurgeons covering a 24-month period performed 115 minor procedures and 210 major surgical procedures cases. Operations for battlefield injuries included 106 craniotomies, 25 spine surgeries, and 18 miscellaneous surgeries. Humanitarian work included 32 craniotomies (23 for trauma, 3 for tumor, 6 for other reasons, such as cyst fenestration), 27 spine surgeries (12 for degenerative conditions, 9 for trauma, 4 for myelomeningocele closure, and 2 for the treatment of infection), and 2 miscellaneous surgeries. Conclusions Military neurosurgeons have provided surgical care at rates of 71% (149/210) for battlefield injuries and 29% (61/210) for humanitarian work. Of the operations for battle trauma, 50% (106/210) were cranial and 11% (25/210) spinal surgeries. Fifteen percent (32/210) and 13% (27/210) of operations were for humanitarian cranial and spine procedures, respectively. Overall, military neurosurgeons in Afghanistan are performing life-saving cranial and spine stabilization procedures for battlefield trauma and acting as general neurosurgeons for the Afghan community.

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Beitler, Alan L., Glenn W. Wortmann, Luke J. Hofmann und James M. Goff. „Operation Enduring Freedom: The 48th Combat Support Hospital in Afghanistan“. Military Medicine 171, Nr. 3 (März 2006): 189–93. http://dx.doi.org/10.7205/milmed.171.3.189.

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Benini, Aldo A., und Lawrence H. Moulton. „Civilian Victims in an Asymmetrical Conflict: Operation Enduring Freedom, Afghanistan“. Journal of Peace Research 41, Nr. 4 (Juli 2004): 403–22. http://dx.doi.org/10.1177/0022343304044474.

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Stone, Wendy. „Operation Enduring Freedom: Navy Nurse Corps field experience in Afghanistan“. Journal of Emergency Nursing 28, Nr. 3 (Juni 2002): 205–8. http://dx.doi.org/10.1067/men.2002.124905.

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Olson, Peter M. „Agreement Between the North Atlantic Treaty Organization and the Islamic Republic of Afghanistan on the Status of NATO Forces and NATO Personnel Conducting MutuallyAgreed NATO-led Activities in Afghanistan & Security and Defense Cooperation Agreement Between the United States of America and the Islamic Republic of Afghanistan“. International Legal Materials 54, Nr. 2 (April 2015): 272–305. http://dx.doi.org/10.5305/intelegamate.54.2.0272.

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On September 30, 2014, Afghanistan signed agreements with the United States and NATO providing for U.S. and NATO military presences in Afghanistan following termination in December 2014 of the post-9/11 U.S. “Operation Enduring Freedom” (OEF) and NATO-led International Security Assistance Force (ISAF) military missions.

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Ravindra, Vijay M., Scott A. Wallace, Rahul Vaidya, W. Christopher Fox, Arnett R. Klugh, David Puskas und Min S. Park. „Spinal Stabilization Using Orthopedic Extremity Instrumentation Sets During Operation Enduring Freedom–Afghanistan“. World Neurosurgery 86 (Februar 2016): 503–9. http://dx.doi.org/10.1016/j.wneu.2015.09.018.

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Patel, Parantap, Davis Taylor und Min S. Park. „Characteristics of traumatic brain injury during Operation Enduring Freedom–Afghanistan: a retrospective case series“. Neurosurgical Focus 47, Nr. 5 (November 2019): E13. http://dx.doi.org/10.3171/2019.8.focus19493.

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Traumatic brain injury (TBI) is a significant cause of morbidity and mortality, especially among members of the armed services. Injuries sustained in the battlefield are subject to different mechanisms than those sustained in civilian life, particularly blast and high-velocity injury. Due to the unique nature of these injuries and the challenges associated with battlefield medicine, surgical interventions play a key role in acute management of TBI. However, the burden of chronic disease posed by TBI is poorly understood and difficult to investigate, especially in the military setting. The authors report the case logs of a United States Navy neurosurgeon, detailing the acute management and outcomes of 156 patients sustaining TBI between November 2010 and May 2011 during the war in Afghanistan. By demographics, more than half of the patients treated were local nationals. By mechanism of injury, blunt trauma (40.4%) and explosive injury (37.2%) were the most common contributors to TBI. Decompressive craniectomies (24.0%) and clot evacuations (14.7%) were the procedures most commonly performed. Nearly one-quarter of patients were transferred to receive further care, yet only 3 patients were referred for rehabilitative services. Furthermore, the data suggest that patients sustaining comorbid injuries in addition to TBI may be predisposed to worse outcomes. Improvements in documentation of military patients may improve knowledge of TBI and further identify potential variables or treatments that may affect prognosis. The increased survivability from TBI also highlights the need for additional research expenditure in the field of neurorehabilitation specifically.

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Shen-Gunther, Jane, Richard Ellison, Charles Kuhens, Christopher J. Roach und Steve Jarrard. „Operation Enduring Freedom: Trends in Combat Casualty Care by Forward Surgical Teams Deployed to Afghanistan“. Military Medicine 176, Nr. 1 (Januar 2011): 67–78. http://dx.doi.org/10.7205/milmed-d-10-00109.

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Muhammad, Imraz, Dr Saiful Islam und Qaiser Iqbal. „Afghanistan Post US Withdrawal: Security Challenges and Future Prospects“. Journal of Peace, Development & Communication me 05, issue 2 (30.06.2021): 143–53. http://dx.doi.org/10.36968/jpdc-v05-i02-13.

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After 9/11, the mission “Operation Enduring Freedom” was to root out terrorists from Afghanistan and to establish good governance in shape of democracy. However, the current internal law and order situation is worse even after years of US forces staying in Afghanistan. While President Trump has directed Pentagon to decrease nearly half of the more than 14,000 troops stationed in Afghanistan. All the regional and global powers have their interest in Afghanistan, have no clear policies for peace and development, but everyone is in struggle to solve the Afghan problem according to their own interest. To establish democracy, improve governance, rule of law and security situation in Afghanistan, the US withdrawal without proper homework will create more problems and lead to chaos. It is believed that the abrupt withdrawal may further strengthen the Taliban and increase violence in Afghanistan. This paper aims to investigate those internal and external factors which may become the cause of insecurity for Afghanistan. Furthermore, the research work enlightens over the solution of security problems in Afghanistan and suggests possible option.

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Soltis, Kathryn, Ron Acierno, Daniel F. Gros, Matthew Yoder und Peter W. Tuerk. „Post-Traumatic Stress Disorder: Ethical and Legal Relevance to the Criminal Justice System“. Journal of Law, Medicine & Ethics 42, Nr. 2 (2014): 147–54. http://dx.doi.org/10.1111/jlme.12130.

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New coverage of the recent wars in Afghanistan and Iraq, and the ensuing public education campaigns by the Department of Veterans Affairs and private veterans advocacy groups combine to call the public's attention to the many potential mental health problems associated with traumatic event exposure. Indeed, since 2001, Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) combat and peacekeeping missions have been characterized by high levels of exposure to acts of extreme violence, with often gruesome effects. Less publically discussed is the fact that a surprisingly large number of United States civilians also report exposure to traumatic events, such as severe interpersonal violence, natural disasters, and serious automobile accidents. In fact, approximately 70% of randomly sampled respondents indicated that they have experienced an incident characterized by significant perceived life threat at some point during their lives.

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Chivers, Sally. „Disabled Veterans in the Americas: Canadians “Soldier On” after Afghanistan—Operation Enduring Freedom and the Canadian Mission“. Canadian Review of American Studies 39, Nr. 3 (Januar 2009): 321–42. http://dx.doi.org/10.3138/cras.39.3.321.

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Ordóñez, Lucía Martínez, und Jörg Schimmelpfennig. „The War against the Taliban“. International Journal of Strategic Decision Sciences 6, Nr. 3 (Juli 2015): 18–27. http://dx.doi.org/10.4018/ijsds.2015070102.

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Operation Enduring Freedom was hampered by a chronic shortage of attack helicopters available to ISAF forces in Afghanistan. Tactical operations into Taliban-held territory were launched even though close air support capable of dealing with “danger close” situations could not be assigned in advance. It led to significant ISAF casualties if the Taliban decided to fight back rather than withdraw. Departing from a Clausewitz-style, i.e. second-mover advantage, mixed-strategy equilibrium and taking account of the “Irregular Warfare” nature of the pay-offs, the paper looks into the existence of strategic moves. In particular, as playing a mixed strategy if rotary wing air support is unavailable merely incentivises a more aggressive Taliban response to any kind of operation due to the information asymmetry, it is argued that by moving away from the mixed-strategy equilibrium ISAF casualties in properly supported operations could be reduced, thus handing a first-mover advantage to ISAF.

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Uphold, Constance R., Meggan Jordan und Magaly Freytes. „Family Caregivers of Veterans: A Critical Review of the Empirical Literature and Recommendations for Future Research“. Annual Review of Nursing Research 32, Nr. 1 (Oktober 2014): 155–202. http://dx.doi.org/10.1891/0739-6686.32.155.

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In recent years, research on caregiving has grown in both quality and quantity. Caregivers play an important role in supporting and promoting the health and recovery of injured, disabled, and ill family members in their care. Although researchers have made a substantial contribution to our understanding of family caregiving, less is known about family caregivers of U.S. Veterans. The purpose of this review is to identify and evaluate the research surrounding caregivers of U.S. Veterans, particularly two populations of Veterans: those who returned from the wars in Iraq and Afghanistan and those who had suffered a stroke. A search of the available literature from 1987 to present day resulted in a review of 18 publications on Operation Enduring Freedom/Operation Iraqi Freedom caregivers and 19 publications on caregivers of Veterans with stroke. We summarize empirical findings, critique the study methods, and provide our recommendations to improve the quality of care of Veterans and their caregivers.

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MacEachron, Ann, und Nora Gustavsson. „Peer Support, Self-efficacy, and Combat-related Trauma Symptoms among Returning OIF/OEF Veterans“. Advances in Social Work 13, Nr. 3 (13.11.2012): 586–602. http://dx.doi.org/10.18060/2391.

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The incidence of PTSD and other combat-related trauma symptoms among more than 2 million veterans returning from Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) in Afghanistan suggests that many will experience psychological challenges in adjusting to civilian life. However, the literature is sparse about this new group of veterans. This study examined the relationships between peer support, self-efficacy, and PTSD symptoms among 216 OIF/OEF veterans who had attended 1 of 17 Vets4Vets peer support weekend retreats. Vets4Vets is a national grassroots program whose mission is to improve the psychological well-being of returning OIF/OEF veterans. Analysis of posttest changes indicate the generalizability of previous research findings, based on other groups of trauma-affected groups, to OIF/OEF veterans. As predicted, increased perceived peer support and self-efficacy reduced PTSD symptoms. From a theoretical perspective, we found that both models of self-efficacy, situation-specific (Bandura, 1997; Benight & Bandura, 2004) and general self-efficacy (Schwarzer & Fuchs, 1996), mediated or explained the relationship between peer support and PTSD symptoms. Implications for social work are discussed.

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de Riesthal, Michael. „Treatment of Cognitive-Communicative Disorders Following Blast Injury“. Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders 19, Nr. 2 (Juni 2009): 58–64. http://dx.doi.org/10.1044/nnsld19.2.58.

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Abstract Purpose: Mild traumatic brain injury (mTBI) following exposure to a blast is the signature injury of Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). The purposes of this article are to describe the characteristics of the service members who experience blast injuries, the cognitive-communicative deficits they present, and the role of the speech-language pathologist (SLP) in managing these deficits. Method: Demographic data for the service members who have experienced blast injuries in OIF/OEF are reviewed and reported. The literature on treating cognitive-communicative disorders following mTBI is reviewed and is discussed in the context of managing the deficits reported by service members returning from Iraq and Afghanistan. Results and conclusions: Information regarding the effects of blast exposure on the human body continues to emerge. Data regarding the most effective treatment for cognitive-communicative deficits following blast injury are needed. For now, SLPs must rely on the best evidence from the civilian mTBI literature, clinical expertise, and the personal values of the individual with TBI to develop effective treatment programs targeting the cognitive-communicative disorders experienced by these individuals.

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Calhoun, Patrick S., Amie R. Schry, Paul A. Dennis, H. Ryan Wagner, Nathan A. Kimbrel, Lori A. Bastian, Jean C. Beckham, Harold Kudler und Kristy Straits-Tröster. „The Association Between Military Sexual Trauma and Use of VA and Non-VA Health Care Services Among Female Veterans With Military Service in Iraq or Afghanistan“. Journal of Interpersonal Violence 33, Nr. 15 (21.01.2016): 2439–64. http://dx.doi.org/10.1177/0886260515625909.

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Military sexual trauma (MST) has been linked with increased rates of mental health disorders among veterans. Few studies have addressed how MST is related to use of VA and non-VA health care. The purpose of the current study was to (a) examine the association between MST, combat experiences, and mental health outcomes (i.e., posttraumatic stress disorder [PTSD] and depression) and (b) examine the association of MST and use of VA and non-VA health care services among female veterans who served in Iraq and Afghanistan. Female respondents to a survey assessing Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) veterans’ needs and health ( N = 185) completed measures of demographic variables, military history, combat exposure, MST, PTSD, and depression symptoms, and use of VA and non-VA health care. Overall, 70% of the sample experienced one or more combat-related experiences and 15.7% endorsed MST during deployment to Iraq or Afghanistan. MST and combat exposure were both positively associated with PTSD and depression symptoms even after controlling for the effects of demographic and military history variables. MST was associated with increased use of VA mental health services in bivariate results but was not independently related to VA service utilization after accounting for PTSD and depression symptoms. Approximately half of the women who reported MST had not used VA health care. Continued outreach and education initiatives may be needed to ensure veterans understand the resources available to address MST-related mental and physical health problems through the VA.

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Durakovic, Asaf. „The Quantitative Analysis of Uranium Isotopes in the Urine of the Civilian Population of Eastern Afghanistan after Operation Enduring Freedom“. Military Medicine 170, Nr. 4 (April 2005): 277–84. http://dx.doi.org/10.7205/milmed.170.4.277.

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Peoples, George E., Tad Gerlinger, Robert Craig und Brian Burlingame. „Combat Casualties in Afghanistan Cared for by a Single Forward Surgical Team during the Initial Phases of Operation Enduring Freedom“. Military Medicine 170, Nr. 6 (Juni 2005): 462–68. http://dx.doi.org/10.7205/milmed.170.6.462.

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Davis, Patrick, Justin J. Stewart, Nancy G. Hoover, Billie J. Matthews, Douglas W. Pahl und John A. Bojescul. „Use of CT-Arthrography and Ultrasound in ACL Surgery During Operation Enduring Freedom in Afghanistan: A Case Report and Practice Recommendations“. Military Medicine 179, Nr. 2 (Februar 2014): e240-e244. http://dx.doi.org/10.7205/milmed-d-13-00248.

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Gray, Christine. „A Crisis of Legitimacy for the UN Collective Security System?“ International and Comparative Law Quarterly 56, Nr. 1 (Januar 2007): 157–70. http://dx.doi.org/10.1093/iclq/lei154.

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The role of the UN and the legitimacy of its collective security system have been seriously challenged in recent years. First, because of the Security Council.s failure to act in cases of genocide or other humanitarian disaster. There has been much criticism of the limited and delayed response of the Security Council to events in Bosnia-Herzegovina and Rwanda, somewhat unfairly in so far as it was the lack of political will on the part of the Member States rather than any institutional failure that was responsible for the failure to act. Secondly, the UN's central role in collective security has been undermined by unilateral use of force by States. After the terrorist attacks of 11 September 2001 the UN was sidelined with regard to the forcible response against Afghanistan: in Operation Enduring Freedom the USA preferred not to act through the UN or even through NATO. Subsequently, the US National Security Strategy (September 2002) famously made no mention of the UN as a means of addressing perceived new threats from global terrorists. Most seriously, the US Operation Iraqi Freedom in 2003 was undertaken unilaterally, that is, without express Security Council authorization.1 This was often portrayed as a crisis of legitimacy for the UN as much as for the USA and the States which participated in the invasion. As the Deputy Secretary-General put it recently:

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Featherstone, Kerry. „"Picnics with the Mujaheddin"“. Journeys 20, Nr. 2 (01.12.2019): 1–19. http://dx.doi.org/10.3167/jys.2019.200201.

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This article considers the stated motivations for travel in the case of three examples of travel writing about Afghanistan. Jason Elliot’s An Unexpected Light documents his travel in 1984 during the war between the Afghan Mujaheddin and the Soviets; Jonny Bealby’s For a Pagan Song, first published in 1998, takes place during the civil war between Mujaheddin and the Taleban; Rory Stewart’s The Places In Between was written about travel between 2000 and 2002, during which time Operation Enduring Freedom was launched against the Taleban. The article deploys Genette’s concept of paratexts in order to show how the acknowledgments, blurbs, and other paratextual material, when read against the grain, undermine the relationship between the writer and their stated motivations and, thus, destabilize the self-representation of each writer in the course of the narrative. The outcome of these readings is a critique of the three texts, arguing that each one works to justify their travel through a combination of self-narration and paratextual material but that none of them address the implications of their travel for the Afghan people or that the purpose of the travel is to write the text.

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VAN STEENBERGHE, RAPHAËL. „Self-Defence in Response to Attacks by Non-state Actors in the Light of Recent State Practice: A Step Forward?“ Leiden Journal of International Law 23, Nr. 1 (02.02.2010): 183–208. http://dx.doi.org/10.1017/s0922156509990380.

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AbstractThis article analyses the recent state practice in which the right of self-defence has been invoked in order to justify the use of force in response to attacks by non-state actors. The main purpose of this analysis is to determine whether the law of self-defence has evolved through this practice. It is submitted that the latter confirms the tendency, evidenced by the US operation ‘Enduring Freedom’ in Afghanistan in 2001, towards allowing states to respond in self-defence to private armed attacks, that is, attacks which are committed by non-state actors only. The article also aims to shed some light on other fundamental conditions of the law of self-defence which played a significant role in the legal assessment of the recent state practice. It is argued in this respect that this practice confirms that any armed attack must reach some level of gravity – which may be assessed by accumulating minor uses of force – in order to trigger the right of self-defence, and that proportionality of the action taken in self-defence may be assessed in quantitative terms, but only as a means of making a prima facie judgement about the necessity of this action.

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Stephens, Frederick L., Correy M. Mossop, Randy S. Bell, Teodoro Tigno, Michael K. Rosner, Anand Kumar, Leon E. Moores und Rocco A. Armonda. „Cranioplasty complications following wartime decompressive craniectomy“. Neurosurgical Focus 28, Nr. 5 (Mai 2010): E3. http://dx.doi.org/10.3171/2010.2.focus1026.

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Object In support of Operation Iraqi Freedom (OIF) and Operation Enduring Freedom-Afghanistan (OEF-A), military neurosurgeons in the combat theater are faced with the daunting task of stabilizing patients in such a way as to prevent irreversible neurological injury from cerebral edema while simultaneously allowing for prolonged transport stateside (5000–7000 miles). It is in this setting that decompressive craniectomy has become a mainstay of far-forward neurosurgical management of traumatic brain injury (TBI). As such, institutional experience with cranioplasty at the Walter Reed Army Medical Center (WRAMC) and the National Naval Medical Center (NNMC) has expanded concomitantly. Battlefield blast explosions create cavitary injury zones that often extend beyond the border of the exposed surface wound, and this situation has created unique reconstruction challenges not often seen in civilian TBI. The loss of both soft-tissue and skull base support along with the need for cranial vault reconstruction requires a multidisciplinary approach involving neurosurgery, plastics, oral-maxillofacial surgery, and ophthalmology. With this situation in mind, the authors of this paper endeavored to review the cranial reconstruction complications encountered in these combat-related injuries. Methods A retrospective database review was conducted for all soldiers injured in OIF and OEF-A who had undergone decompressive craniectomy with subsequent cranioplasty between April 2002 and October 2008 at the WRAMC and NNMC. During this time, both facilities received a total of 408 OIF/OEF-A patients with severe head injuries; 188 of these patients underwent decompressive craniectomies in the theater before transfer to the US. Criteria for inclusion in this study consisted of either a closed or a penetrating head injury sustained in combat operations, resulting in the performance of a decompressive craniectomy and subsequent cranioplasty at either the WRAMC or NNMC. Excluded from the study were patients for whom primary demographic data could not be verified. Demographic data, indications for craniectomy, as well as preoperative, intraoperative, and postoperative parameters following cranioplasty, were recorded. Perioperative and postoperative complications were also recorded. Results One hundred eight patients (male/female ratio 107:1) met the inclusion criteria for this study, 93 with a penetrating head injury and 15 with a closed head injury. Explosive blast injury was the predominant mechanism of injury, occurring in 72 patients (67%). The average time that elapsed between injury and cranioplasty was 190 days (range 7–546 days). An overall complication rate of 24% was identified. The prevalence of perioperative infection (12%), seizure (7.4%), and extraaxial hematoma formation (7.4%) was noted. Twelve patients (11%) required prosthetic removal because of either extraaxial hematoma formation or infection. Eight of the 13 cases of infection involved cranioplasties performed between 90 and 270 days from the date of injury (p = 0.06). Conclusions This study represents the largest to date in which cranioplasty and its complications have been evaluated in a trauma population that underwent decompressive craniectomy. The overall complication rate of 24% is consistent with rates reported in the literature (16–34%); however, the perioperative infection rate of 12% is higher than the rates reported in other studies. This difference is likely related to aspects of the initial injury pattern—such as skull base injury, orbitofacial fractures, sinus injuries, persistent fluid collection, and CSF leakage—which can predispose these patients to infection.

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SANDERS, JOHN W., ROBERT W. FRENCK, CARLA FRANKART, SHANNON D. PUTNAM, TRUEMAN W. SHARP, MARK S. RIDDLE, MARSHALL R. MONTEVILLE, DAVID M. ROCKABRAND und DAVID R. TRIBBLE. „IMPACT OF ILLNESS AND NON-COMBAT INJURY DURING OPERATIONS IRAQI FREEDOM AND ENDURING FREEDOM (AFGHANISTAN)“. American Journal of Tropical Medicine and Hygiene 73, Nr. 4 (01.10.2005): 713–19. http://dx.doi.org/10.4269/ajtmh.2005.73.713.

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Widome, Rachel, Melissa Nelson Laska, Ashley Gulden, Steven S. Fu und Katherine Lust. „Health Risk Behaviors of Afghanistan and Iraq War Veterans Attending College“. American Journal of Health Promotion 26, Nr. 2 (November 2011): 101–8. http://dx.doi.org/10.4278/ajhp.090826-quan-278.

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Purpose. The population of military veterans attending college is rapidly growing as veterans return from Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF). We sought to describe patterns of student veterans' health-related behaviors and how they might differ from their nonveteran peers. Design. We analyzed data from the 2008 Boynton College Student Health Survey (CSHS). Setting. CSHS participants completed an anonymous online survey. Subjects. The CSHS sampled students (n = 8651) attending public, private, 2-year, and 4-year postsecondary educational institutions in Minnesota. Measures. The CSHS included items on substance use (including alcohol and tobacco), safety, nutrition, and physical activity. Analysis. We described demographics of OEF/OIF veteran, non-OEF/OIF veteran, and nonveteran students and used Poisson regression to compute adjusted relative risks (ARBs) with 95% confidence intervals (CIs) to characterize associations between veteran status and health behaviors. Results. After controlling for demographics, veteran students reported more safety-, tobacco-, and alcohol-related risk behaviors compared to nonveteran students. For instance, compared to the nonveteran reference group, the ARR for past year smokeless tobacco use and physical fighting among for OEF/OIF veterans was 1.76 (95% CI = 1.31–2.35) and 1.48 (95% CI = 1.22–1.79) respectively. Veteran and nonveteran students display similar weight-related behaviors, though OEF/OIF veteran students were more likely to engage in strengthening exercises. Conclusions. There are specific health risk behaviors that are particularly relevant for veterans attending postsecondary institutions. As veterans enroll in postsecondary education, there is a unique window of opportunity for health promotion in this population.

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Wangelin, Bethany C., und Peter W. Tuerk. „PTSD in Active Combat Soldiers: To Treat or Not to Treat“. Journal of Law, Medicine & Ethics 42, Nr. 2 (2014): 161–70. http://dx.doi.org/10.1111/jlme.12132.

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Treatment of military-related posttraumatic stress disorder (PTSD) is a major public health care concern. Since 2001 over 2.5 million troops have been deployed to Iraq or Afghanistan, many of whom have experienced direct combat and sustained threat. Estimates of PTSD rates related to these wars range from 8% to over 20%, or 192,000 to 480,000 individuals. Already, nearly 250,000 service members of Operations Enduring Freedom, Iraqi Freedom, and New Dawn (OEF/OIF/OND) have sought VA health care services for PTSD. This recent increased need for mental health services comes in addition to the ongoing needs of Vietnam-era and other veterans who continue to suffer from PTSD. PTSD is related to high co-morbidities of other mental health difficulties, poorer physical health status, and increased medical care utilization. Such high demand for services is an important contributor to the large cost associated with combat-related PTSD. Accordingly, promoting successful, cost-effective treatment strategies for PTSD is a chief public health care priority.

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Greenawalt, David S., Jack Y. Tsan, Nathan A. Kimbrel, Eric C. Meyer, Marc I. Kruse, David F. Tharp, Suzy Bird Gulliver und Sandra B. Morissette. „Mental Health Treatment Involvement and Religious Coping among African American, Hispanic, and White Veterans of the Wars of Iraq and Afghanistan“. Depression Research and Treatment 2011 (2011): 1–10. http://dx.doi.org/10.1155/2011/192186.

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Although racial/ethnic differences have been found in the use of mental health services for depression in the general population, research among Veterans has produced mixed results. This study examined racial/ethnic differences in the use of mental health services among 148 Operation Enduring/Iraqi Freedom (OEF/OIF) Veterans with high levels of depression and posttraumatic stress disorder (PTSD) symptoms and evaluated whether religious coping affected service use. No differences between African American, Hispanic, and Non-Hispanic white Veterans were found in use of secular mental health services or religious counseling. Women Veterans were more likely than men to seek secular treatment. After controlling for PTSD symptoms, depression symptom level was a significant predictor of psychotherapy attendance but not medication treatment. African American Veterans reported higher levels of religious coping than whites. Religious coping was associated with participation in religious counseling, but not secular mental health services.

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Klimo, Paul, Brian T. Ragel, G. Morgan Jones und Randall McCafferty. „Severe Pediatric Head Injury During the Iraq and Afghanistan Conflicts“. Neurosurgery 77, Nr. 1 (23.03.2015): 1–7. http://dx.doi.org/10.1227/neu.0000000000000743.

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AbstractBACKGROUND:Much has been written about injuries sustained by US and coalition soldiers during the Global War on Terrorism campaigns. However, injuries to civilians, including children, have been less well documented.OBJECTIVE:To describe the epidemiologic features and outcomes associated with isolated severe head injury in children during Operations Enduring Freedom and Iraqi Freedom (OEF and OIF).METHODS:A retrospective review of children (<18 years old) in the Joint Theater Trauma Registry with isolated head injury (defined as an Abbreviated Injury Score Severity Code >3) and treated at a US combat support hospital in Iraq or Afghanistan (2004–2012). The primary outcome was in-hospital mortality.RESULTS:We identified 647 children with severe isolated head injuries: 337 from OEF, 268 from OIF, and 42 nontheater specific. Most were boys (76%; median age = 8 years). Penetrating injuries were most common (60.6%). Overall, 330 (51%) children underwent a craniotomy/craniectomy; 156 (24.1%) succumbed to their injuries. Admission Glasgow Coma Score was predictive of survival among the entire cohort and each of the individual conflicts. Male sex also significantly increased the odds of survival for the entire group and OEF, but not for OIF. Closed-head injury improved the predictive ability of our model but did not reach statistical significance as an independent factor.CONCLUSION:This is the largest study of combat-related isolated head injuries in children. Admission Glasgow Coma Score and male sex were found to be predictive of survival. Assets to comprehensively care for the pediatric patient should be established early in future conflicts.

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Coughlin, Daniel J., Jason H. Boulter, Charles A. Miller, Brian P. Curry, Jacob Glaser, Nathanial Fernandez, Randy S. Bell und Albert J. Schuette. „An Endovascular Surgery Experience in Far-Forward Military Healthcare—A Case Series“. Military Medicine 185, Nr. 11-12 (01.11.2020): 2183–88. http://dx.doi.org/10.1093/milmed/usaa219.

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Abstract Summary Introduction The advancement of interventional neuroradiology has drastically altered the treatment of stroke and trauma patients. These advancements in first-world hospitals, however, have rarely reached far forward military hospitals due to limitations in expertise and equipment. In an established role III military hospital though, these life-saving procedures can become an important tool in trauma care. Materials and Methods We report a retrospective series of far-forward endovascular cases performed by 2 deployed dual-trained neurosurgeons at the role III hospital in Kandahar, Afghanistan during 2013 and 2017 as part of Operations Resolute Support and Enduring Freedom. Results A total of 15 patients were identified with ages ranging from 5 to 42 years old. Cases included 13 diagnostic cerebral angiograms, 2 extremity angiograms and interventions, 1 aortogram and pelvic angiogram, 1 bilateral embolization of internal iliac arteries, 1 lingual artery embolization, 1 administration of intra-arterial thrombolytic, and 2 mechanical thrombectomies for acute ischemic stroke. There were no complications from the procedures. Both embolizations resulted in hemorrhage control, and 1 of 2 stroke interventions resulted in the improvement of the NIH stroke scale. Conclusions Interventional neuroradiology can fill an important role in military far forward care as these providers can treat both traumatic and atraumatic cerebral and extracranial vascular injuries. In addition, knowledge and skill with vascular access and general interventional radiology principles can be used to aid in other lifesaving interventions. As interventional equipment becomes more available and portable, this relatively young specialty can alter the treatment for servicemen and women who are injured downrange.

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Bell, Randy S., Corey M. Mossop, Michael S. Dirks, Frederick L. Stephens, Lisa Mulligan, Robert Ecker, Christopher J. Neal, Anand Kumar, Teodoro Tigno und Rocco A. Armonda. „Early decompressive craniectomy for severe penetrating and closed head injury during wartime“. Neurosurgical Focus 28, Nr. 5 (Mai 2010): E1. http://dx.doi.org/10.3171/2010.2.focus1022.

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Object Decompressive craniectomy has defined this era of damage-control wartime neurosurgery. Injuries that in previous conflicts were treated in an expectant manner are now aggressively decompressed at the far-forward Combat Support Hospital and transferred to Walter Reed Army Medical Center (WRAMC) and National Naval Medical Center (NNMC) in Bethesda for definitive care. The purpose of this paper is to examine the baseline characteristics of those injured warriors who received decompressive craniectomies. The importance of this procedure will be emphasized and guidance provided to current and future neurosurgeons deployed in theater. Methods The authors retrospectively searched a database for all soldiers injured in Operations Iraqi Freedom and Enduring Freedom between April 2003 and October 2008 at WRAMC and NNMC. Criteria for inclusion in this study included either a closed or penetrating head injury suffered during combat operations in either Iraq or Afghanistan with subsequent neurosurgical evaluation at NNMC or WRAMC. Exclusion criteria included all cases in which primary demographic data could not be verified. Primary outcome data included the type and mechanism of injury, Glasgow Coma Scale (GCS) score and injury severity score (ISS) at admission, and Glasgow Outcome Scale (GOS) score at discharge, 6 months, and 1–2 years. Results Four hundred eight patients presented with head injury during the study period. In this population, a total of 188 decompressive craniectomies were performed (154 for penetrating head injury, 22 for closed head injury, and 12 for unknown injury mechanism). Patients who underwent decompressive craniectomies in the combat theater had significantly lower initial GCS scores (7.7 ± 4.2 vs 10.8 ± 4.0, p < 0.05) and higher ISSs (32.5 ± 9.4 vs 26.8 ± 11.8, p < 0.05) than those who did not. When comparing the GOS scores at hospital discharge, 6 months, and 1–2 years after discharge, those receiving decompressive craniectomies had significantly lower scores (3.0 ± 0.9 vs 3.7 ± 0.9, 3.5 ± 1.2 vs 4.0 ± 1.0, and 3.7 ± 1.2 vs 4.4 ± 0.9, respectively) than those who did not undergo decompressive craniectomies. That said, intragroup analysis indicated consistent improvement for those with craniectomy with time, allowing them, on average, to participate in and improve from rehabilitation (p < 0.05). Overall, 83% of those for whom follow-up data are available achieved a 1-year GOS score of greater than 3. Conclusions This study of the provision of early decompressive craniectomy in a military population that sustained severe penetrating and closed head injuries represents one of the largest to date in both the civilian and military literature. The findings suggest that patients who undergo decompressive craniectomy had worse injuries than those receiving craniotomy and, while not achieving the same outcomes as those with a lesser injury, did improve with time. The authors recommend hemicraniectomy for damage control to protect patients from the effects of brain swelling during the long overseas transport to their definitive care, and it should be conducted with foresight concerning future complications and reconstructive surgical procedures.

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Salman, Necati, Onur Tezel, Atif Bayramoglu, Ulvi Mehmet Meral, Faruk Akyildiz und Mehmet Eryilmaz. „Retrospective Analysis of Role II Military Hospital Emergency Department Admissions in Operation Enduring Freedom of Afghanistan“. Journal of Archives in Military Medicine 4, Nr. 2 (27.04.2016). http://dx.doi.org/10.5812/jamm.37334.

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Bullman, Tim, und Aaron Schneiderman. „Risk of suicide among U.S. veterans who deployed as part of Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn“. Injury Epidemiology 8, Nr. 1 (16.06.2021). http://dx.doi.org/10.1186/s40621-021-00332-y.

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Abstract Background There has been concern about the risk of suicide among veterans returning from deployment to Afghanistan and Iraq as part of Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn (OEF/OIF/OND). This study assessed suicide risk among OEF/OIF/OND veterans by gender and unit component. Firearm related suicide was also briefly examined. Findings The study cohort was identified from records of the US Department of Defense. Vital status and cause of death through 2016 was obtained from the Mortality Data Repository, which obtains data from the National Death Index. Suicide risk was first assessed using standardized mortality ratios (SMR)s, comparing the rate of suicide among all veterans, both collectively and separately by gender and unit component (active vs. reserve/National Guard) to the expected based on the US population adjusted for age, race, sex, and calendar year. Risk of suicide among active duty compared to reserve/National Guard veterans and male compared to female veterans was assessed with hazard ratios (HR) s, generated by Cox proportional hazards models, that included the covariates race, age, marital status, rank, and branch of service. There was an increased risk of suicide when all OEF/OIF/OND Veterans were compared to the US population, (SMR = 1.42; 95%, C.I., 1.38,1.46). Both male and female veterans had an increased risk of suicide when compared to their gender specific non-veteran counterparts, (SMR = 1.40; 95%, C.I., 1.36,1.45 and SMR = 1.85; 95%, C.I., 1.60,2.13), respectively. Active duty veterans had an increased risk of suicide compared to reserve/National Guard veterans, (HR = 1.22; 95%, C.I., 1.14,1.30). Male veterans had an almost 3-fold increased risk compared to female veterans, (HR = 2.85; 95%, C.I., 2.47,3.29). Among all veteran suicides 68.3% involved a firearm, including 68.7% among males and 59.5% among females. Conclusions All OEF/OIF/OND veterans have an increased risk of suicide compared to non-veterans. Veterans will benefit from enhanced access to mental health services and initiatives to promote suicide prevention. Strategies that emphasize lethal means safety, an evidence based suicide prevention strategy which includes increasing safe storage practices (i.e., storing firearms unloaded and locked) can help address this increased risk of veteran suicide.

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Gauld, Jillian. „5. Applying Data Mining Methods to Blast‐Related Mild Traumatic Brain Injury“. Inquiry@Queen's Undergraduate Research Conference Proceedings, 05.02.2016. http://dx.doi.org/10.24908/iqurcp.8469.

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Mild traumatic brain injury (mTBI), or concussion, is one of the most common forms of injury sustained throughout Operations Iraqi Freedom and Enduring Freedom. Diagnosis is difficult for many of the symptoms are very common and may not manifest themselves immediately after the injury. Many studies on blast‐related mTBI have been published from research regarding the current war in Iraq and Afghanistan. Continuous work is underway to more accurately determine its causes and symptoms, as mTBI is considered difficult to diagnose. Using the Oak Ridge National Laboratory (ORNL) developed data mining software PIRANHA, an integrative literature analysis was conducted to assist and facilitate possible research on the processes of mTBI. Data were collected from academic databases as well as PIRANHA’s internet search function. The PIRANHA categories feature was employed to visualize the areas of overlapping research regarding manifestations of mTBI relating to the biological processes and behavioral changes. PIRANHA was also used to review current research on mTBI, including animal testing on mice and swine. The integrated results from these data mining analyses revealed areas that could be studied further, as well as a clearer indication of the specific processes of mTBI. These results can contribute to ORNL’s current LDRD, an mTBI‐specific project.

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Kato, Lorrie, Jeremy Jinkerson, Sarah Holland und Henry Soper. „From Combat Zones to the Classroom: Transitional Adjustment in OEF/OIF Student Veterans“. Qualitative Report, 29.11.2016. http://dx.doi.org/10.46743/2160-3715/2016.2420.

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With 600,000 veterans of Operations Enduring Freedom and Iraqi Freedom enrolled in higher education with the Post-9/11 GI Bill, recognizing and responding to their predictable adjustment issues is imperative. Existing qualitative research has identified some transitional issues encountered by small groups of veterans. Because of qualitative research’s limited generalizability, however, themes may be viewed as more generalizable when corroborated by student veterans in different regions. In order to provide an in-depth description of the themes related to the post-deployment adjustment process, the first author conducted semi-structured interviews with 19 student veterans from a Southwestern community college who were returning to civilian life after deployment to Afghanistan or Iraq. The first author and research assistant analyzed data using the grounded theory approach (including open coding, constant comparison, and axial coding), which resulted in the emergence of seven major themes. Themes consistent with prior research include (1) bridging the gap between military and civilian life, (2) rebuilding a support system outside of the military, (3) readapting to the culture of civilian life, and (4) finding meaning in a new life perspective and purpose. Themes not indicated in previous research are (5) battling the stereotypes, (6) taming the fight-or-flight response, and (7) attitudes about mental illness carry over to civilian life. Based on the results of this review, recommendations are given for college campuses to support veterans in transition.

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