The First World War and the Arrival of Jazz

The Mayo Clinic World War II Short Course and Its Effect on Anesthesiology

Irving Millman

Like athletes, musicians and vocalists spend considerable time developing and improving specific physical skills and this may increase their risk of injury. PURPOSE: This project examined injury incidence and injury risk factors in professional instrumentalists and singers. METHODS: Subjects were 217 Soldiers who were highly skilled, full time, musicians or vocalists in the US Army Band (mean age±SD=39±8 years). Injuries occurring in a single year were obtained from a medical surveillance database. Demographics and performing group (i.e., strings, keyboard, winds, brass, percussion, or vocal) were obtained from administrative databases. Direct measurements included weight, height, maximum push-ups in 2 minutes, maximum sit-ups in 2 minutes, and a two-mile run for time. Body mass index (BMI) was calculated as weight/height2. Self-reported physical activity (SRPA) was obtained from a questionnaire. For data analysis, weight, height, BMI and fitness scores were converted to four approximately equal sized quartiles (Q); six age groups were established. Univariate analysis used the chi-square test to compare injury incidence in discrete groups of each factor. Risk ratios (RR) and 95% confidence intervals (95%CI) were calculated. Multivariate analysis was conducted using logistic regression including all factors reaching p<0.10 in the univariate analysis. RESULTS: Fifty-two percent of the band members experienced one or more injuries during the year. In the univariate analysis, factors associated with injury incidence included BMI (RR (highest Q/lowest Q) =1.6, 95%CI=1.0-2.5), performing group (RR (strings/winds) =2.4, 95%CI=1.4-4.1), and SRPA (RR (low activity/high activity) =1.6, 95%CI=1.1-1.9). Not associated with injury incidence were gender (p=0.86), marital status (p=0.53), educational level (p=0.71), age group (p=0.58), height (p=0.20), weight (p=0.53), push-ups (p=0.89), sit-ups (p=0.51), and 2-mile run (p=0.86). In the multivariate analysis, performing group and SRPA were independent risk factors for injuries. CONCLUSIONS: One-year injury incidence was 52% in the US Army Band. Risk factors for injuries in this group include BMI, performing group, and SRPA. Low- fit band member might benefit from more physical activity.

This project documented injuries in the professional musical performers of the US Army Band and used a multivariate approach to determine injury risk factors. Injuries were obtained from a medical surveillance database. Administrative records from the Band provided fitness test scores, physical characteristics, performing unit (Blues, Ceremonial, Chorale, Chorus, Concert, Strings), and functional group (strings, winds, keyboard, vocal, percussion, brass). A questionnaire completed by 95% of the Band (n=205) included queries on practice time, physical activity, tobacco use, and medical care. One or more injuries were diagnosed in 44 and 53% of Band members in the years 2004 and 2005, respectively. In univariate analysis, higher injury risk was associated with higher body mass index (BMI), less physical activity, prior injury, unit, functional group, and practice duration. In multivariate analysis, less self-rated physical activity, a prior injury, and functional group were independent risk factors. In the US Army Band, about half the performers had a medical visit for an injury in a 1-year period and injury risk was associated with identifiable factors.

Maurice Albin was a pioneering figure in neuroanaesthesia and devoted his life to improving patient care. Born in Brooklyn, New York, he was the son of immigrant Jewish parents. His...

Theoretical basis The authors believe the theoretical foundations for this case study lie in the following two disciplines, primarily, but could be expanded to religion and organizational culture:i. Ethical decision-makingii. Cross-cultural competenceiii. Leadership Research methodology This is an actual case, and the fact pattern and timeline occurred as depicted. The first author is the protagonist, Lieutenant Colonel (LTC) Shawn Browning. The names of case characters have been disguised. The second and third authors are colleagues of the first author. This case was tested in three undergraduate organizational behavior and leadership classes at the United States Military Academy at West Point. Case overview/synopsis This disguised case follows US Army Officer LTC Shawn Browning, leader of a prominent US Army base located in Germany. As the commander of US Army Garrison Schweinfurt, LTC Browning was responsible for the health and welfare of 10,000 residents, including soldiers, family members and civilian employees. A community member lodged a complaint against a brothel named Haus One (a legal establishment under German law) located adjacent to the base and near family housing and the base elementary school. LTC Browning had the authority to render the brothel off-limits to US personnel, and he took the necessary steps prior to rendering a decision, including the appointment of a review board to investigate the situation and provide a recommendation. The board recommended not placing Haus One off-limits. The case focuses on LTC Browning’s values and his desire to ensure the welfare of his community while adhering to local legal and cultural norms. Cross-cultural and ethical issues surface throughout the case, which concludes with LTC Browning’s pondering of how to make a final decision. Complexity academic level The authors believe this is targeted at undergraduate students with some background in ethical decision-making, organizational culture and cross-cultural competence.

William Alexander Hammond

When it comes to war, I have been sheltered from the storm. Too young to have faced the draft, which was last used in the United States in 1973, I did not volunteer for the military. My father, by contrast, was conscripted into the US Army during World War II and saw action in Italy. His father was conscripted into the US Army during World War land saw action in France. My grandfather's outfit was gassed; my father dodged shells in the Tuscan hills. One of my father's cousins fought in the French Resistance; another survived Nazi concentration camps, airplane factories, and a death march, to be liberated by Patton's Third Army. In my generation, American cousins have served in the US military, foreign cousins served in the French and Israeli armies, and another American cousin was a civilian casualty of the war on terror: He died in New York City in the Twin Towers on 11 September 2001. As a student of military history, I knew well before 9/11 that I owed my freedom to the sacrifices of others. But the events of that day and the year and more since have underlined that lesson. As a student of the Classics, I also know that republican theory teaches that unless the citizens of a republic serve in their own defense, they risk losing their freedom. In the United States today, citizens of the republic do serve in their own defense. Yet only a small proportion of us do so, and a smaller proportion than in the generations that preceded us. Between 1940 and 1973, a large proportion of American males were conscripted to serve in the military. Since 1973, conscription has been replaced by recruitment of an all-volunteer force. A professional military of American men and, increasingly, women, defends the nation. On the whole, the move from conscription to volunteering is excellent news. No one is forced into service, nor is the nation burdened with an overly large military in an era when improvements in technology require ever less manpower in the armed forces. But there is a trade-off. The personal freedom that the average American gained from the end of the draft 30 years ago has unfortunately not been matched by an increase in either civic duty or sense of self-sacrifice. It is doubtful that the average person today is as knowledgeable about military realities as he was in the days of the draft, and that relative ignorance surely has something to do with the tensions in civil-military relations of recent years. Few of the politicians who have to make decisions about war and peace actually have the experience of military service. The politicians' relative ignorance is made worse by a generation-long trend in the American intellectual elite away from military studies. Furthermore, although the volunteer force is by and large representative of the American public in terms of race and class, it is lopsidedly conservative in politics and religion. All things considered, it would be better to have a more representative military. Yet, recognizing the reality of these problems does not mean advocating a return to conscription. In fact, we do not need to revive the draft. Conscripting young people means taking away their liberty, and the only justification for that is military emergency. Besides, the purpose of the American military is to defend the United States, and since the volunteer force fulfills that purpose, it would make no sense to change it. The current security crises facing the United States may indeed require a bigger military, but probably not so big as to require a draft. Yet, even if no increase in the number of soldiers proves necessary, there is a modest reform that we should consider: diversifying the number and range of civilians who do a term of service in the military. The reason has nothing to do with the patriotism or professionalism of the men and women in the military today. In fact, no one could serve their country better than they do. The target audience, rather, is those who do not currently serve in the military. …

Roger H Unger

This historical review explores Harvey Cushing's difficulties with both the British and American armies during his World War I service to definitively examine the rumor of his possible court martial. It also provides a further understanding of Cushing the man. While in France during World War I, Cushing was initially assigned to British hospital units. This service began in May 1917 and ended abruptly in May 1918 when the British cashiered him for repeated censorship violations. Returning to American command, he feared court martial. The army file on this matter (retrieved from the United States National Archives) indicates that US Army authorities recommended that Cushing be reprimanded and returned to the US for his violations. The army carried out neither recommendation, and no evidence exists that a court martial was considered. Cushing's army career and possible future academic life were protected by the actions of his surgical peers and Merritte Ireland, Chief Surgeon of the US Army in France. After this censorship episode, Cushing was made a neurosurgical consultant but was also sternly warned that further rule violations would not be tolerated by the US Army. Thereafter, despite the onset of a severe peripheral neuropathy, probably Guillian Barré's syndrome, Cushing was indefatigable in ministering to neurosurgical needs in the US sector in France. Cushing's repeated defying of censorship regulations reveals poor judgment plus an initial inability to be a "team player." The explanations he offered for his censorship violations showed an ability to bend the truth. Cushing's war journal is unclear as to exactly what transpired between him and the British and US armies. It also shows no recognition of the help he received from others who were instrumental in preventing his ignominious removal from service in France. Had that happened, his academic future and ability to train future neurosurgical leaders may have been seriously threatened. Cushing's foibles notwithstanding, all realized that he contributed greatly to both British and US war neurosurgery. United States Army surgeons who operated upon brain wounds in France recognized Cushing as their leader.

Purpose: to scientifically substantiate the expediency of studying and critically analyzing the historical experience of the military medical organization of the US Army as a leading NATO country. To analyze the results of the radical modernization of the medical supply system of the American army carried out by Jonathan Letterman in the mid-1860s. Highlight the importance of these innovations on the basis of a comprehensive study and prove their relevance in the process of improving the organization of medical support of the Armed Forces of Ukraine. Materials and methods. The research used materials from English-language publications devoted to the formation and modern tasks of American military medicine. For a comparative analysis of the historical development of the military medical organization in the armies on the American and Eurasian continents, the data of the latest publications of the department of Medical Support of the Armed Forces of the Ukrainian Military Medical Academy on the subject of research and publications from the depository fund of the National Science Medical Library of Ukraine were used. Applied methods of system-historical analysis, information search, bibliographic. The results. Argued expediency of an study of the development of the medical support system of the US Army to improve the activities of the Medical Forces of the Armed Forces of Ukraine. Jonathan Letterman’s innovations in the modernization of American military medicine in the second half of the 19th century, which still remain an integral part of military medical operations implemented by the US Army, are highlighted and evaluated. It is proved, that the fundamental principles of army medicine, formed and introduced in the US army in the 1860s by Letterman, were significantly ahead of their time in understanding the priority tasks of military medicine in accordance with the requirements of modern armies. A comparison of the effectiveness of the military medical organization in the armies operating on the American and Eurasian continents during this period was made. It was established that, in contrast to the legislative approval and introduction of innovative changes in the organization of medical support of the US army, the autocratic government of the Russian Empire ignored or significantly slowed down the modernization of the military medical organization of the army after the defeat in the Crimean War (1853-1856), which led to catastrophic consequences during the First and Second World Wars. The importance of leadership in the implementation of innovative changes in such an important component of the armed forces as the military medical organization is proven on the example of Jonathan Letterman’s activities. Conclusions: The system of medical support of troops on the battlefield, developed and implemented by Jonathan Letterman in the second half of the 19th century, and today remains the basis of medical care management in the US Army in wartime conditions. The effective modernization of the military medical organization in the US army during the Civil War (1861‑1865) had a positive effect on the capabilities of American army medicine in the 20th and early 21st centuries. A critical understanding of the historical experience of the organization of medical support in the US Army as a leading country of the NATO is important for the professional growth of Ukrainian military doctors, as well as for the improvement of the military medical organization in the Armed Forces of Ukraine.

Historical research on pathology and laboratory medicine services in World War I has been limited. In the Spanish American War, these efforts were primarily focused on tropical diseases. World War I problems that could be addressed by pathology and laboratory medicine were strikingly different because of the new field of clinical pathology. Geographic differences, changing war tactics, and trench warfare created new issues. To describe the scope of pathology and laboratory medicine services in World War I and the value these services brought to the war effort. Available primary and secondary sources related to American Expeditionary Forces' laboratory services were analyzed and contrasted with the British and German approaches. The United States entered the war in April 1917. Colonel Joseph Siler, MD, a career medical officer, was the director, and Colonel Louis B. Wilson, MD, head of pathology at the Mayo Clinic, was appointed assistant director of the US Army Medical Corps Division of Laboratories and Infectious Disease, based in Dijon, France. During the next year, they organized 300 efficient laboratories to support the American Expeditionary Forces. Autopsies were performed to better understand treatment of battlefield injuries, effects of chemical warfare agents, and the influenza pandemic; autopsies also generated teaching specimens for the US Army Medical Museum. Bacteriology services focused on communicable diseases. Laboratory testing for social diseases was very aggressive. Significant advances in blood transfusion techniques, which allowed brief blood storage, occurred during the war but were not primarily overseen by laboratory services. Both Siler and Wilson received Distinguished Service Medals. Wilson's vision for military pathology services helped transform American civilian laboratory services in the 1920s.

Suicide rates among active-duty personnel in the US military have increased substantially since 2004, and numerous studies have attempted to contextualize and better understand this phenomenon. Placing contemporary examinations of suicides among active-duty personnel in the US Army in historical context provides opportunities for joint historical and epidemiological research to inform health care professionals and policy makers. To consolidate data on suicide rates among active-duty personnel in the US Army as far back as historical records allow and to identify historical trends to separate them from more acute causal factors. This cross-sectional study included all active-duty service members in the US Army from 1819 to 2017 as identified and detailed in US government publications, studies, and journal articles. Empirical data were extracted from US government publications and journal articles published from 1819 to 2017. Data collection and analysis were completed between July and August of 2019. Suicide. Suicide rates per 100 000 individuals. Starting in 1843, the overall trend in annual suicide rates among active-duty service members in the US Army increased, with a peak rate of 118.3 per 100 000 in 1883. From that historical high point, the rate decreased in 3 successive waves, each corresponding to the end of the following wars: the Spanish-American War (1898), World War I (1914-1918), and World War II (1939-1945). The latter had the historically lowest rate of 5 per 100 000 in 1944 to 1945. During the Cold War (approximately 1945-1991), the rate generally stabilized in the low teens to midteens (ie, 10-15 per 100 000). The rate increased again during the Afghanistan and Iraq Wars, increasing to 29.7 per 100 000 in 2012. From 2008 to present, the annual rate has remained within the range of 20.2 to 29.7 per 100 000. This study represents the most extensive historical examination of suicides in the US Army to date. By taking a long-term historical approach to suicide among active-duty personnel in the US Army, this study affords future researchers a new analytical tool and an additional perspective from which to better differentiate long-term and historical trends from more short-term and temporary causal factors.

Italian Politics and Culture from Fascism to Postwar Democracy in the Life and Work of Uguccione Ranieri di Sorbello (1906–1969)

Footwear in the United States Army Band: Injury incidence and risk factors associated with foot pain