Wartime Environment Research Articles

The Persian Gulf Experience and Health

FOLLOWING the return of US and coalition forces from the complex environment of the Persian Gulf region during Operations Desert Shield and Desert Storm and the operational conditions of the military deployment, a variety of health effects have been reported. Many troops were exposed to potentially adverse substances and experiences present in this wartime environment, fumes and smoke from military operations, oil well fires, diesel exhaust, toxic paints, pesticides, sand, depleted uranium, infectious agents, chemoprophylactic agents, and multiple immunizations; some troops are convinced they were exposed to chemical or biological weapons. Few combat casualties occurred, but substantial transient gastrointestinal and respiratory symptoms were seen during the troop buildup and immediately after the short conflict. Since then, there have been increasing reports of illness from troops who were participants in these operations, and many attribute their health problems to these experiences. Many of the cases include combinations of nonspecific symptoms of

Modeling in-house vs. contract maintenance, with fixed costs and learning effects

Most companies perform a mix of in-house repair and contract repair. Some operations that need to be performed regularly are done by plant personnel as a part of routine preventive maintenance. Other operations require equipment or skills that the plant personnel do not possess, and these are routinely handled by contracts. A third category is made up of those repairs or maintenance actions which could be done either in-house or by contract. Such a situation arises in many vehicle fleet maintenance shops, in a manufacturing environment where both contractors and skilled technicians are available, and in a wartime environment where repairs are either performed by highly skilled enlisted personnel or by vendors. In addition to assisting in such problems, a good analytical structure for solving such problems has potential value in determining the number of employees with each skill level that the manufacturer has to keep in the work force. In situations where a maintenance operation can be done either in-house or by contract to an outside firm, it is natural to ask how many units of the operation should be done in-house (or by contract) so as to minimize the total maintenance cost. One formulation of this problem assumes that the time per unit is a constant for each craft and for each repair type. This leads to a linear programming model which is easily formulated and solved. In a real maintenance environment, however, learning takes place, and the per unit times decrease as the number of units repaired increases. Including this learning in the problem formulation gives a nonlinear objective function and nonlinear constraints. The objective function is further complicated by including a fixed cost (for diagnostic equipment and one-time training) for each maintenance operation performed in-house. The resulting problem with all these nonlinearities can be solved using a Monte Carlo improvement technique. The problem and its formulation together with the solution algorithm are described.

Successful Treatment of Multiple Organ System Failure in a Wartime Environment: A Case Report from Operation Desert Storm

Military weapons produce massive traumatic injuries. Multiple organ system failure can be expected to occur frequently as a result of such injuries. This case report from the recent conflict with Iraq is representative of wartime injuries and complications and the positive impact of modern intensive care capability on such injuries. Availability of critical care in future conflicts is essential.