Male Military Service Research Articles

Research Letter: Characterizing Lifetime Mild TBI Exposure Among Female and Male Military Service Members and Veterans in the LIMBIC-CENC Study.

To (1) characterize lifetime mild traumatic brain injury (TBI) exposures among male and female US military service members and Veterans (SMVs) and (2) evaluate sex-related differences in mild TBI exposures. Clinical research laboratory. Participants were enrolled in the ongoing Long-term Impact of Military-relevant Brain Injury Consortium-Chronic Effects of Neurotrauma Consortium (LIMBIC-CENC) Prospective Longitudinal Study. Cross-sectional. Lifetime history of mild TBI was measured via structured interview. All mild TBI characteristics were collected as part of this interview, including total lifetime number; environment (deployment vs. non-deployment); timing of injury (relative to military service and age); and mechanism of injury (blast-related vs. non-blast). Most participants (n =2323; 87.5% male; 79.6% Veteran) reported ≥1 lifetime mild TBI (n =1912; 82%), among whom, many reported ≥2 lifetime mild TBIs. Female SMVs reported fewer total lifetime mild TBIs than male participants (P <0.001), including fewer deployment-related (P <0.001) and non-deployment (P <0.001) mild TBIs. There were significant sex differences for total number of mild TBIs sustained before (P =0.005) and during (P <0.001) military service but not after separation from military service (P =0.99). Among participants with a lifetime history of mild TBI, female SMVs were less likely to report ≥2 mTBIs (P =0.003); however, male SMVs were more likely to report a mild TBI during military service (P =0.03), including combat-related mild TBI (P <0.001) and mild TBI involving blast (P <0.001). These findings inform clinical and research efforts related to mild TBI in US military SMVs. It may not be sufficient to simply measure the total number of mild TBIs when seeking to compare clinical outcomes related to mild TBI between sexes; rather, it is important to measure and account for the timing, environment, and mechanisms associated with mild TBIs sustained by female and male SMVs.

Relationship Between Tinnitus and Hearing Outcomes Among US Military Personnel After Blast Injury.

To examine the association between tinnitus and hearing outcomes among US military personnel after blast injury, including any hearing loss, low-frequency hearing loss, high-frequency hearing loss, early warning shift, and significant threshold shift. In this retrospective study, the Blast-Related Auditory Injury Database was queried for male military service members who had audiometric data 2 years before and after blast injury between 2004 and 2012 with no history of hearing loss or tinnitus before injury (n = 1693). Tinnitus was defined by diagnostic codes in electronic health records. Multivariable logistic regression examined the association between tinnitus and hearing outcomes, while adjusting for covariates. Overall, 14.2% (n = 241) of the study sample was diagnosed with tinnitus within 2 years after blast injury. The proportions of all examined hearing outcomes were higher among service members with tinnitus than those without ( p < 0.001). In multivariable analysis, service members with tinnitus had higher adjusted odds of any hearing loss (odds ratio [OR] = 1.72, 95% confidence interval [CI] = 1.20-2.47), low-frequency hearing loss (OR = 2.77, 95% CI = 1.80-4.26), high-frequency hearing loss (OR = 2.15, 95% CI = 1.47-3.16), early warning shift (OR = 1.83, 95% CI = 1.36-2.45), and significant threshold shift (OR = 2.15, 95% CI = 1.60-2.89) compared with service members without tinnitus. The findings of this study demonstrate that tinnitus diagnosed within 2 years after blast injury is associated with the examined hearing outcomes in US military personnel. Service members with blast injury who subsequently experience tinnitus should receive routine audiometric hearing conservation testing and be carefully examined for poor hearing outcomes by an audiologist.

Navigating and resisting the compulsory military service in Iran: embodied experiences of non-heterosexual Iranian men

Abstract In the homosocial space of the all male military service, (hetero)masculinity and gender normativity are promoted and bravery and warrior mentality are highly valued. On this basis, policing gender and sexuality is a relevant issue, aiming to reward heteronormativity and hyper masculinity and marginalize non heterosexuality and gender nonconforming performances. In the Iranian context, since the Iran Iraq war (1980–1988), military service has produced a feature of militarized (hetero)masculinities through the cult of martyrdom. It enforces soldiers to stand up against the enemy, be willing to seek martyrdom and sacrifice themselves in order to protect the Islamic Iranian homeland. It is a symbol of entering adulthood and during that time young men are expected to embody the official ideology which revolves around heteronormativity and strict gender norms. In this context, the focus of this paper is the embodied experiences of those young conscripts who do not embody the (hetero)masculine ideal, because they are either non heterosexual or do not fit into the strict regime of gender. Drawing on ethnographic data, and policy documents, this paper shows how the idea of the (hetero)masculine ideal has been translated into practice through the dispositif of the sarbazi and how some young Iranian non heterosexual men try to resist conscription while others try to find ways to carve out a liminal heterotopic space during their military service.

What Little We Know: Peer-Reviewed Articles on the Impact of United States Military Culture on Male Victims of Military Sexual Trauma

Conduct a narrative review study to identify, evaluate, and summarize pertinent published literature on the influence of U.S. military culture on male victims of military sexual assault (MSA) and military sexual trauma (MST). Various aspects of military culture have been shown to contribute significantly to barriers of reporting, prevention, and social support for male service members who have experienced MST and MSA in the U.S. military forces. A variety of U.S. military cultural factors associated with barriers to reporting MST/MSA among male military service members and veterans were assessed and identified in this narrative review. Overall study findings suggest that increasing research on the impact of military culture and male MST and MSA is imperative in the effort to reduce and prevent sexual violence within the U.S. military armed forces. Various aspects of the U.S. military culture play a significant role in the influence of sexual assault occurrences that take place within U.S. military service units. Supporting evidence suggests that the U.S. military culture impacts the overall severity of barriers to reporting sexual assault and/or trauma among male military service members and veterans.

Efficacy and Harms of Pharmacological Interventions for Anxiety after Traumatic Brain Injury: Systematic Review.

After a traumatic brain injury (TBI), many persons experience significant and debilitating problems with anxiety. The aim of this systematic review was to critically evaluate the evidence regarding efficacy of pharmacological interventions for anxiety after TBI. We reviewed studies published in English before July 2020 and included original research on pharmacological interventions for anxiety after TBI in adults ≥16 years of age. MEDLINE, PubMed, CINAHL, EMBASE, PsycINFO, and CENTRAL databases were searched, with additional searching of key journals, clinical trials registries, and international drug regulators. The primary outcomes of interest were reduction in symptoms of anxiety and occurrence of harms. The secondary outcomes of interest were changes in depression, cognition, quality of life, and participation. Data were summarized in a narrative synthesis, and evidence quality was assessed using the Cochrane Risk of Bias tool. Only a single non-peer-reviewed, randomized controlled trial of 19 male military service members with mild TBI met inclusion criteria. This study found no significant effect of citalopram on anxiety symptoms over a 12-week intervention. The trial was stopped early because of poor recruitment, and much of the study detail was not included in the report. The methodological quality of the study was difficult to assess because of the lack of detail. No recommendations could be drawn from this review. There is a critical need for adequately powered and controlled studies of pharmacological interventions for anxiety after TBI across all severities that examine side-effect profiles and consider issues of comorbidity and effects of long-term pharmacotherapy.

Advances in PTSD Treatment Delivery: the Role of Digital Technology in PTSD Treatment

Post-traumatic stress disorder (PTSD) is a common mental health disorder affecting about 7% of the general population during their lifetime. PTSD typically has a chronic course, is often comorbid with other psychiatric disorders, and negatively impacts functioning and quality of life. This review examines the evidence for several digital technology–based applications being used to deliver PTSD interventions, including video telehealth, Internet-based interventions, virtual reality exposure therapy, and mobile apps. A number of randomized controlled trials (RCTs) have examined the use of video telehealth, Internet-based interventions, and virtual reality exposure therapy for PTSD. Relatively few RCTs have investigated mobile apps for PTSD. Evidence reviewed shows that PTSD therapy delivered by video telehealth is as good as that delivered in person, but samples were almost exclusively comprised of military veterans. Internet-based interventions as well evidence strong support for their use. There is strong evidence for virtual reality exposure therapy as well, but it is limited by small samples mostly of male military service members and veterans. Lastly, the evidence for mobile apps is promising but inconclusive given the lack of published full-scale RCTs. The implications of these findings for future research directions and clinical practice are discussed.

Minimum depths to essential structures in a UK military population using computed tomography: application to stab-resistant body armour.

Edged weapons are a known domestic threat to the police forces of the UK. This threat is mitigated by wearing stab-resistant body armour that is either worn overtly or covertly depending on role. Although the UK military have traditionally focused their body armour design upon ballistic and fragmentation threats, future roles may require protection against an edged weapon threat. Since 2017, UK police body armour requirements for anatomical coverage for both edged weapon and ballistic threats are now based upon the requirements of UK military. This revised coverage may need additional research to determine minimum distances to essential structures. Three entry locations and penetration vectors were chosen using the limited available information in the literature, in combination with a specialist in edged weapons defence. One hundred twenty CT trauma scans of male military service personnel were subsequently analysed to ascertain minimum distances from skin surface to the first structure encountered that is included in essential coverage (heart, aorta, vena cava, liver and spleen) at 3 specific entry points. Individuals ranged between 18 and 46years, with a mean body mass index of 24.8. The absolute minimum depth from skin surface to a structure within the auspice of essential coverage was 17mm to the liver in entry point 3 and 19mm to the heart in entry point 2. Minimum distances to critical structures were significantly larger than those described in previous studies on civilians. This study will be used to supplement existing evidence to support existing UK police requirements for stab-resistant body armour. Using the weapon entry sites and vectors described in this study, overmatching to a behind armour depth of 17mm would cover all of this population in this study.

Infertility and the Military Male.

Male infertility is a condition that affects approximately 50% of infertile couples and about 30% of those couples have only male factor infertility identified. There has been speculation that male military service members may have an even greater lifetime prevalence of infertility as compared to the general population, but very few scientific publications focus on male factor infertility in the military population specifically. This review will discuss many of the unique considerations regarding male infertility in the military and highlight future opportunities for research. The military/federal health system has the potential to serve as a leader in both the delivery of health care for male factor infertility and in the clinical investigation into the etiologies of and treatments for male factor infertility.

Left Knee Synovial Osteochondromatosis.

A 28-year-old male military service member reported to a physical therapist with progressively worsening left knee pain during impact activity and with work duties. Following examination, he physical therapist ordered radiographs of the knee, which revealed severe osteochondromatosis and tricompartmental arthritis. J Orthop Sports Phys Ther 2017;47(4):294. doi:10.2519/jospt.2017.7016.

Core Temperature in Service Members With and Without Traumatic Amputations During a Prolonged Endurance Event.

Service members with traumatic amputations may be at an increased risk of elevated core body temperature, since their ability to dissipate heat may decrease with the reduction in body surface area (BSA) after injury. Elevated core temperature can impair physical performance during combat operations potentially putting the service members and their teams at risk. The purpose of this study was to compare core temperature between individuals with and without amputations during a prolonged endurance event. Twenty healthy male military service members (10 with amputations, 10 without) participated in the Bataan Memorial Death March 26.2-mile event on March 27, 2011. Data collected include BSA, body mass index, body composition, body weight before and after the event, core temperature during the event, and postevent hydration status. Body composition was measured by dual-energy X-ray absorptiometry. Body weight was measured by digital scale. Core temperature was measured by ingestible sensor. Hydration was measured by urine specific gravity. The Walter Reed Army Medical Center Institutional Review Board approved this study and participants provided written informed consent. Three participants' data were not included in the analyses. No significant differences in core temperature were found between participants in both groups, and no correlation was found between core temperature and either BSA or hydration status. There was no significant difference in maximal core temperature between the groups (p = 0.27). Nearly all participants (8 control, 6 amputation) reached 38.3°C, the threshold for increased risk of heat exhaustion. No subjects reached 40.0°C, the threshold for increased risk of heat stroke. Time spent above the 38.3°C threshold was not significantly different between groups, but varied widely by participant in relation to the duration of the event. Participants without amputations finished the event faster than participants with amputations (7.9 ± 1.4 vs. 9.6 ± 0.96, p < 0.01), possibly indicating that participants with amputations self-selected a slower pace to attenuate increased core temperature. Until conclusive evidence is accumulated, it is prudent for military leaders, trainers, and military service members to closely monitor this population during physical activity to prevent heat injuries.

Battling on the Home Front: Posttraumatic Stress Disorder and Conflict Behavior Among Military Couples

This study evaluated interpersonal behavior differences among male military service members with and without PTSD and their female partners. Couples (N = 64) completed a 17-minute videotaped conflict discussion, and their interaction behavior was coded using the circumplex-based Structural Analysis of Social Behavior model (SASB; Benjamin, 1979, 1987, 2000). Within couples, the behavior of partners was very similar. Compared to military couples without PTSD, couples with PTSD displayed more interpersonal hostility and control. Couples with PTSD also exhibited more sulking, blaming, and controlling behavior, and less affirming and connecting behavior, than couples without PTSD. Results advance our understanding of the relational impacts of PTSD on military service members and their partners, and underscore the value of couple-based interventions for PTSD in the context of relationship distress.

Characterisation of interface astroglial scarring in the human brain after blast exposure: a post-mortem case series

No evidence-based guidelines are available for the definitive diagnosis or directed treatment of most blast-associated traumatic brain injuries, partly because the underlying pathology is unknown. Moreover, few neuropathological studies have addressed whether blast exposure produces unique lesions in the human brain, and if those lesions are comparable with impact-induced traumatic brain injury. We aimed to test the hypothesis that blast exposure produces unique patterns of damage, differing from that associated with impact-induced, non-blast traumatic brain injuries. In this post-mortem case series, we investigated several features of traumatic brain injuries, using clinical histopathology techniques and markers, in brain specimens from male military service members with chronic blast exposures and from those who had died shortly after severe blast exposures. We then compared these results with those from brain specimens from male civilian (ie, non-military) cases with no history of blast exposure, including cases with and without chronic impact traumatic brain injuries and cases with chronic exposure to opiates, and analysed the limited associated clinical histories of all cases. Brain specimens had been archived in tissue banks in the USA. We analysed brain specimens from five cases with chronic blast exposure, three cases with acute blast exposure, five cases with chronic impact traumatic brain injury, five cases with exposure to opiates, and three control cases with no known neurological disorders. All five cases with chronic blast exposure showed prominent astroglial scarring that involved the subpial glial plate, penetrating cortical blood vessels, grey-white matter junctions, and structures lining the ventricles; all cases of acute blast exposure showed early astroglial scarring in the same brain regions. All cases of chronic blast exposure had an antemortem diagnosis of post traumatic stress disorder. The civilian cases, with or without history of impact traumatic brain injury or a history of opiate use, did not have any astroglial scarring in the brain regions analysed. The blast exposure cases showed a distinct and previously undescribed pattern of interface astroglial scarring at boundaries between brain parenchyma and fluids, and at junctions between grey and white matter. This distinctive pattern of scarring may indicate specific areas of damage from blast exposure consistent with the general principles of blast biophysics, and further, could account for aspects of the neuropsychiatric clinical sequelae reported. The generalisability of these findings needs to be explored in future studies, as the number of cases, clinical data, and tissue availability were limited. Defense Health Program of the United States Department of Defense.

Sex differences in coping strategies in military survival school

A wealth of research has examined psychological responses to trauma among male military service members, but few studies have examined sex differences in response to trauma, such as coping strategies. This study assessed coping strategies used by male and female U.S. service members completing an intensely stressful mock-captivity exercise, compared strategies by sex, and assessed the relationship between coping and posttraumatic stress symptoms (PTSS). Two hundred service members (78% male) completed self-report surveys before and after mock captivity. Surveys assessed demographics, service characteristics, PTSS, and coping strategies used during mock captivity. Participants used seven coping strategies: denial, self-blame, religion, self-distraction, behavioral disengagement, positive reframing, and planning. Women used denial (p≤.05), self-blame (p≤.05), and positive reinterpretation (p≤.05) strategies more frequently than men, and they had higher PTSS levels following the exercise. Structural equation modeling showed that the relationship between sex and PTSS was fully mediated by coping strategies. The results of this study suggest that reducing the use of maladaptive coping strategies may mitigate PTSS among females. Future efforts should target improving coping during highly stressful and traumatic experiences.

Task-specific fall prevention training is effective for warfighters with transtibial amputations.

Key factors limiting patients with lower extremity amputations to achieve maximal functional capabilities are falls and fear of falling. A task-specific fall prevention training program has successfully reduced prospectively recorded trip-related falls that occur in the community by the elderly. However, this program has not been tested in amputees. In a cohort of unilateral transtibial amputees, we aimed to assess effectiveness of a falls prevention training program by (1) quantifying improvements in trunk control; (2) measuring responses to a standardized perturbation; and (3) demonstrating retention at 3 and 6 months after training. Second, we collected patient-reported outcomes for balance confidence and falls control. Fourteen male military service members (26 ± 3 years) with unilateral transtibial amputations and who had been walking without an assistive device for a median of 10 months (range, 2-106 months) were recruited to participate in this prospective cohort study. The training program used a microprocessor-controlled treadmill designed to deliver task-specific postural perturbations that simulated a trip. The training consisted of six 30-minute sessions delivered over a 2-week period, during which task difficulty, including perturbation magnitude, increased as the patient's ability progressed. Training effectiveness was assessed using a perturbation test in an immersive virtual environment. The key outcome variables were peak trunk flexion and velocity, because trunk kinematics at the recovery step have been shown to be a determinant of fall likelihood. The patient-reported outcomes were also collected using questionnaires. The effectiveness of the rehabilitation program was also assessed by collecting data before perturbation training and comparing the key outcome parameters with those measured immediately after perturbation training (0 months) as well as both 3 and 6 months posttraining. Mean trunk flexion angle and velocity significantly improved after participating in the training program. The prosthetic limb trunk flexion angle improved from pretraining (42°; 95% confidence interval [CI], 38°-47°) to after training (31°; 95% CI, 25°-37°; p < 0.001). Likewise, the trunk flexion velocity improved from pretraining (187°/sec; 95% CI, 166°-209°) to after training (143°/sec; 95% CI, 119°-167°; p < 0.004). The results display a significant side-to-side difference for peak trunk flexion angle (p = 0.01) with perturbations of the prosthetic limb resulting in higher peak angles. Prosthetic limb trips also exhibited significantly greater peak trunk flexion velocity compared with trips of the prosthetic limb (p = 0.005). These changes were maintained up to 6 months after the training. The peak trunk flexion angle of the subjects when the prosthetic limb was perturbed had a mean of 31° (95% CI, 25°-37°) at 0 month, 32° (95% CI, 28°-37°) at 3 months, and 30° (95% CI, 25°-34°) at 6 months. Likewise, the peak trunk flexion velocity for the prosthetic limb was a mean of 143°/sec (95% CI, 118°-167°) at 0 months, 143°/sec (95% CI, 126°-159°) at 3 months, and 132° (95% CI, 115°-149°) at 6 months. The peak trunk flexion angle when the nonprosthetic limb was perturbed had a mean of 22° (95% CI, 18°-24°) at 0 months, a mean of 26° (95% CI, 20°-32°) at 3 months, and a mean of 23° (95% CI, 19°-28°) at 6 months. The peak trunk flexion velocity for the nonprosthetic limb had a mean of 85°/sec (95% CI, 71°-98°) at 0 months, a mean of 96° (95% CI, 68°-124°) at 3 months, and 87°/sec (95% CI, 68°-105°) at 6 months. There were no significant changes in the peak trunk flexion angle (p = 0.16) or peak trunk flexion velocity (p = 0.35) over time after the training ended. The skill retention was present when either the prosthetic or nonprosthetic limb was perturbed. There were side-to-side differences in the trunk flexion angle (p = 0.038) and trunk flexion velocity (p = 0.004). Perturbations of the prosthetic side resulted in larger trunk flexion and higher trunk flexion velocities. Subjects prospectively reported decreased stumbles, semicontrolled falls, and uncontrolled falls. These results indicate that task-specific fall prevention training is an effective rehabilitation method to reduce falls in persons with lower extremity transtibial amputations.

Above and beyond the call. Long-term real earnings effects of British male military conscription in the post-war years

We add to the literature on the long-term economic effects of male military service. We concentrate on post-war British conscription into the armed services from 1949 to 1960. It was called National Service and applied to males aged 18 to 26. Based on a regression discontinuity design we estimate the effect of military service on the earnings of those required to serve through conscription. We argue that, in general, we should not expect to find large long-term real earnings among conscripts compared to later birth cohorts of males who were not eligible for call-up. Our empirical evidence firmly rejects the view that conscription entails relative long-term real earnings differences.

United in Gratitude: Honoring Soldiers and Defining the Nation in Russia's Great War

One reason the Great War of 1914-18 was so terrible an upheaval was its unprecedented scale. Industrialized countries subscribing to the belief that modern wars were won by the in arms fielded giant conscript armies armed with weapons of unprecedented destructiveness. The huge social dislocations and staggering casualties that accompanied the outbreak of the first total war required powerful public and state responses. Millions of conscripted men needed reassurance that they and their families' sacrifice did not go unnoticed and that their sacrifice had meaning. Tens of thousands of grieving families sought consolation for their losses. As the war dragged on, local and national communities needed to reaffirm their unity and willingness to continue to sacrifice. Recognition of citizen soldiers' service and sacrifice was thus a practical and moral imperative. Moreover, identifying such service and sacrifice, investing it with a particular meaning, involving the public in commemorating and honoring it, were all potentially powerful means of promoting patriotism and a common sense of the nation. As Jay Winter has argued of the war in general, after August 1914 the very act of commemoration was an act of citizenship: To remember was to affirm community, to assert its moral character, and to exclude from it those values, groups, or individuals that placed it under threat. (1) Almost every belligerent nation of the war created ways to recognize and honor the citizen in arms; Russia was not an exception. This article explores the wartime intertwining in Russia of notions of patriotism, citizenship, and membership in a national community by examining efforts to recognize and honor the soldier. (2) First, I examine official and public discussion of the aid owed soldiers and their families at the very start of the war, as well as the subsequent decision to exclude those identified as unworthy. I then explore three wartime projects intended to nourish patriotism and a common sense of the nation by paying tribute to the country's outstanding defenders: the efforts to properly bury and commemorate fallen soldiers, to recognize and reward heroes, and to create a national holiday celebrating soldiers who shed their blood for their country. As will become evident, formal and informal appraisals of the soldier's wartime performance of duty were closely tied to discussion of what was therefore owed him by the state and his fellow-citizens. In this way, a key component of the modern understanding of citizenship, as entailing rights as well as obligations, equal for all and guaranteed by law, was disseminated and enmeshed with ideas of the patriotic national community. These ambitious projects to recognize and honor soldiers were, in many respects, innovative and well-conceived. The figure of the soldier, whether depicted as defender of the motherland or as the citizen in arms, provided a locus for national unity potentially capable of transcending differences of class, region, religion, and nationality. Patriotic and national sentiments could be forged around the soldier and mobilized on his behalf. The existence in Russia of such national projects, comparable to those being developed by the other combatant nations and publicized on a mass scale, suggests that we should rethink some of our assumptions about government attitudes toward popular mobilization and about the allegedly weak sense of national community in Russia during the war. At the same time, differential treatment of some people's service--demonstrated by reluctance to publicize Jewish soldiers' heroism--reveals the difficulty in propounding a model of Russian patriotism for a multi-ethnic, multi-confessional society. Obligations Owed Every (Worthy) Soldier In the decade following the abolition of serfdom, Russia moved closer to European practices on universal male military service by introducing much broader conscription. But it was only after the debacle against Japan that military reformers gained greater support for their efforts to more thoroughly modernize the Russian army and make it a truly national one. …

Anthrax vaccine does not affect semen parameters, embryo quality, or pregnancy outcome in couples with a vaccinated male military service member

Anthrax vaccination has been used in an effort to prevent infection should anthrax be used as a biological weapon, and widespread use has been considered in the event of another anthrax attack on American soil, but the long-term impact of anthrax vaccination on reproductive outcome is unknown. We found that exposure to the anthrax vaccine by males who were undergoing assisted reproduction did not negatively impact semen parameters, fertilization rate, embryo quality, or clinical pregnancy rates.

Modified Bascom's asymmetric midgluteal cleft closure technique for recurrent pilonidal disease: early experience in a military hospital.

Despite the variety of surgical techniques proposed for the treatment of pilonidal disease, recurrence after its operative management remains a common occurrence. Relatively few data exist that focus on an optimal surgical approach that should be followed in cases of recurrent pilonidal disease. The aim of this study was to describe the technical details, analyze the advantages, and present the early results of a modified Bascom asymmetric midgluteal cleft closure technique applied in patients with recurrent pilonidal disease in a military hospital setting. Among the 72 male military service patients (median age, 21; range, 18-26 years) who underwent surgery for pilonidal disease in the Military Hospital of Samos Island, Greece, there were 24 who presented with recurrent pilonidal disease eight months to four years after one to four operations each, which were performed before their enrollment in the Army (total of 43 operations). One or two midline pits were evident in 41.6 percent of the patients, whereas the rest had more complex disease. Three patients presented with acute purulent disease and required initial incision and drainage. The modified Bascom technique was applied, which involved an asymmetric ellipse-like, gluteal fat-preserving excision of the affected skin, the pilonidal sinus, and lateral tracts, a thick skin and fat tongue of tissue mobilization, and finally, complete lateralization of wound closure and flattening of midgluteal groove. All patients tolerated the procedure well, with minimal to moderate postoperative discomfort. Full return to military duty was possible in three weeks after surgery. There was one case of limited primary healing failure. No recurrences have developed in a short median follow-up period of ten months. The suggested modified Bascom technique is an attractive, safe, easily performed operation with minimal morbidity and can be reliably used as a second-line surgical option for recurrent pilonidal disease.

The anthrax vaccine does not affect semen parameters, embryo quality, or pregnancy outcome in couples with a vaccinated male military service member

The anthrax vaccine does not affect semen parameters, embryo quality, or pregnancy outcome in couples with a vaccinated male military service member

A Feminist Exploration of Military Conscription: The Gendering of the Connections Between Nationalism, Militarism and Citizenship in South Korea

Despite its political, cultural and personal saliences, military conscription in South Korea has attracted surprisingly little social research. Mainly, such research has been left to military institutions. Also,few South Korean feminist analysts, until recently, have tried to fill this notable gap in political analysis. I have become convinced that we need a deeper, more sustained and explicitly feminist exploration of the multi-layered workings of male compulsory military service. Without understanding the subtle gendering of conscription, we will not be able to make adequate sense of the persistence of a culture of militarism today, even after the end of the cold war, even after a pro-democracy movement pushed the military out of power. Therefore, I seek to demonstrate how male military conscription lies at the core of what most members of society believe it means to be an 'authentic' South Korean in the late twentieth and early twenty-first centuries. I show that compulsory male military service has played a crucial role in constructing citizenship, nationhood, masculinity, femininity, motherhood and fatherhood and in creating the essential 'glue' that binds each of these six potent ideas to the concept of the nation-state in contemporary South Korea. In addition, I reveal how employing a feminist analysis to explore the meaning and consequence of military conscription in present day South Korean society can have potential value for those researchers investigating the dynamics of political culture in other societies, past and present.