Military Participation Research Articles

1452 Development of a Postoperative Opioid Prescription Practice Algorithm for Benign Gynecologic Surgery (POPP Algorithm)

Study Objective To determine if gynecologic surgery patients have satisfactory postoperative pain control when the POPP algorithm is used to guide the quantity of opioid medication prescribed. The secondary aim is to see if this algorithm leads to less opioid tablets prescribed after gynecologic surgery compared to past opioid prescription records. Design Prospective observational study, with a secondary comparison to a de-identified, retrospective dataset Setting A large military medical center Patients or Participants Women ≥18 years-old undergoing benign gynecologic surgery Interventions Using existing data on opioid use after gynecologic surgery, we developed a simple algorithm to guide physicians in their opioid prescribing practices. Using the algorithm, the physician prescribes a set quantity of opioids, accounting for the type of surgery performed and the presence of certain patient characteristics. Patient demographic and background information are collected, both from a brief survey and the medical record. The researcher contacts patients 2 weeks post-operatively to conduct a brief survey to determine postoperative pain satisfaction and the quantity of opioid tablets remaining. Measurements and Main Results Upon study completion, data analysis will determine if the algorithm provided patients with adequate opioid medication by looking at the number of patients that required refills, the median number of tablets consumed after each procedure type, correlation of opioid use with other factors, and patient perception of pain control. We will compare quantity of opioids prescribed using the POPP algorithm to the quantity prescribed to a retrospective cohort of similar patients. We will adjust generalized linear models using patient and surgical co-variates to identify if algorithm prescribing is significantly lower than non-algorithm prescribing. Conclusion Preliminary data demonstrates the POPP algorithm, when used for patients undergoing benign gynecologic surgery, results in satisfactory postoperative pain control, an adequate quantity of opioid medication for most patients, and less excess opioids dispensed.

Extraperitoneal Sacral Hysteropexy by Transvaginal Natural Orifice Transluminal Endoscopic Surgery: A Single-center Case Series Study

Study Objective This study evaluated the feasibility, safety and short-term clinical outcomes from extraperitoneal sacral hysteropexy by transvaginal natural orifice transluminal endoscopic surgery in treating uterine prolapse. Design Retrospective study. Setting The First Affiliated Hospital of Third Military Medical University, Chongqing, China Patients or Participants The medical records of patients with POP-Q stage 2 or greater uterine prolapse who were treated with vNOTES-ESH between December 2016 to June 2018(to ensure 1-year follow-up or more) in the Southwest Hospital at the Third Military Medical University were reviewed retrospectively. Interventions Extraperitoneal sacral hysteropexy were performed by vNOTES. Measurements and Main Results 21 patients underwent surgery; 20 were successfully completed, and one that could not maintain pressure at the extraperitoneal cavity site due to peritoneal rupture during surgery who underwent multi-port laparoscopic surgery. Median patient age was 50 years. The body mass index (BMI) was 23.7 kg/m2, the median operative time was 126 min, and the median intraoperative blood loss was 60 mL. One case had presacral hemorrhage that was circumvented by bipolar electrocoagulation. Preoperative POP-Q scores were: Aa-0, Ba-1, C-2, Ap-3, and Bp-3. The average post-operative follow-up was 12 months. The POP-Q scores were: Aa-2, Ba-2, C-7, Ap-3, and Bp-3. Associated symptoms disappeared or improved significantly without sexual discomfort or pain on intercourse, mesh erosion, exposure, infection or other complications. The objective cure rate was 100 percent. Conclusion vNOTES was a feasible approach in completing extraperitoneal sacral hysteropexy for apical support, with promising short-term efficacy and safety. However, further studies across multiple sites are needed in evaluating long-term efficacy and safety profile of vNOTES extraperitoneal sacrocolpopexy.

No More Uncertain: The Future of the Gurkhas in the British Army

Nepalese soldiers, known as the Gurkhas, have been serving in the British Army for over 200 years and have become to be considered an integral part of this military organization. Their long history of service includes participation in the two world wars, as well as the more recent combat missions in the Middle East. However, some call the existence of their military participation a colonial legacy of British imperialism. The aim of this paper is to answer the question on the future of the Nepalese soldiers in the United Kingdom. The study is primarily based on the findings of the 1989 Defence Committee Report regarding the situation and prospects of the Brigade of the Gurkhas, which is juxtaposed with the most recent dispatches and research dealing with the British Army in general and with the Gurkhas themselves.

Neurocognitive Performance Deficits Related to Immediate and Acute Blast Overpressure Exposure.

Addressing the concerns surrounding blast injury for the military community is a pressing matter. Specifically, sub-concussive blast effects, or those blast effects which do not yield a medical diagnosis but can result in symptom reporting and negative self-reported outcomes, are becoming increasingly important. This work evaluates explosive blast overpressure and impulse effects at the sub-concussive level on neurocognitive performance assessed with the Defense Automated Neurobehavioral Assessment (DANA) across seven breacher training courses conducted by the US Military. The results reported here come from 202 healthy, male military volunteer participants. Findings indicate that the neurocognitive task appearing most sensitive to identifying performance change is the DANA Procedural Reaction Time (PRT) subtask which may involve a sufficient level of challenge to reliably detect a small, transient cognitive impairment among a healthy undiagnosed population. The blast characteristic that was consistently associated with performance change was peak overpressure. Overall, this study provides evidence that increasing blast overpressure, defined as peak overpressure experienced in a training day, can lead to transient degradations in neurocognitive performance as seen on the DANA PRT subtask, which may generalize to other capabilities.

The Virtues of Military Politics

Sociologists and political scientists have long fretted over the dangers that a politicized military poses to democracy. In recent times, however, civil–military relations experts in the United States accepted retired or indeed still serving generals and admirals in high-ranking political posts. Despite customary revulsion from scholars, the sudden waivers are an indicator that military participation in momentous national security decisions is inherently political without necessarily being partisan, including when civilian authority defers to a largely autonomous sphere for objective military expertise. Military politics is actually critical for healthy civil–military collaboration, when done prudently and moderately. Janowitz and Huntington, founders of the modern study of civil–military relations, understood the U.S. military’s inevitable invitation to political influence. Here, we elaborate on two neglected dimensions, implicit in their projects, of military politics under objective civilian control based on classical virtues of civic republicanism: Aristotle’s practical wisdom and Machiavelli’s virtú.

Assessing success of the Global War on Terror: terrorist attack frequency and the backlash effect

ABSTRACTDo states contributing military forces to the Global War on Terror leave their citizens vulnerable to retaliatory terrorist attacks? Despite the vast amount of coverage dedicated to the wars in Afghanistan and Iraq, few studies have empirically tested whether this is the case. Taking a country-specific approach, this research investigates the military success of the Global War on Terror on a very specific objective − reducing the frequency of terrorist attacks from Al-Qaeda and its affiliates against the citizens of coalition states − to determine if military participation makes a state a target for retaliatory attacks via a backlash effect. Examining terrorist attack data against 53 contributing nations from 1998–2011, this study constructs a general framework for terrorist vulnerability from transnational attacks at the state level and tests whether military contributions to the GWOT, specifically boots on the ground in Afghanistan and Iraq, result in a greater frequency of terrorist attacks from Al-Qaeda and Al-Qaeda-affiliated organizations. The results show evidence of a backlash effect from Al-Qaeda core and affiliates, casting doubt on the effectiveness of military interventions to reduce transnational terrorism.

Do Battlefield Injury-acquired Indwelling Metal Fragments Induce Metal Immunogenicity?

A battlefield-related injury results in increased local and systemic innate immune inflammatory responses, resulting in wound-specific complications and an increased incidence of osteoarthritis. However, little is known about whether severe injuries affect long-term systemic homeostasis, for example, immune function. Moreover, it also remains unknown whether battlefield-acquired metal fragments retained over the long term result in residual systemic effects such as altered immune reactivity to metals. Does a retained metal fragment from a battlefield injury contribute to increased (1) adaptive metal-specific immune responses, (2) systemically elevated metal ion serum levels, and (3) serum immunoglobulin levels compared with combat injuries that did not result in a retained metal fragment? In this pilot study, we analyzed metal-immunogenicity in injured military personnel and noninjured control participants using lymphocyte transformation testing (LTT, lymphocyte proliferation responses to cobalt, chromium and nickel challenge at 0.001, 0.01 and 0.1-mM concentrations in triplicate for each participant), serum metal ion analysis (ICP-mass spectroscopy), and serum immunoglobulin analysis (IgE, IgG, IgA, and IgM ). Military personnel with a battlefield-sustained injury self-recruited without any exclusion for sex, age, degree of injury. Those with battlefield injury resulting in retained metal fragments (INJ-FRAG, n = 20 male, mean time since injury ± SD was 12 ± 10 years) were compared with those with a battlefield injury but without retained metal fragments (INJ-NO-FRAG, n = 12 male, mean time since injury ± SD was 13 ± 12 years). A control group comprised of male noninjured participants was used to compare measured immunogenicity metrics (n = 11, males were selected to match battlefield injury group demographics). Military participants with sustained metal fragments had increased levels of metal-induced lymphocyte responses. The lymphocyte stimulation index among military participants with metal fragments was higher than in those with nonretained metal fragments (stimulation index = 4.2 ± 6.0 versus stimulation index = 2.1 ± 1.2 (mean difference 2.1 ± 1.4 [95% confidence interval 5.1 to 0.8]; p = 0.07) and an average stimulation index = 2 ± 1 in noninjured controls. Four of 20 participants injured with retained fragments had a lymphocyte proliferation index greater than 2 to cobalt compared with 0 in the group without a retained metal fragment or 0 in the control participants. However, with the numbers available, military personnel with retained metal fragments did not have higher serum metal ion levels than military participants without retained metal fragment-related injuries or control participants. Military personnel with retained metal fragments had lower serum immunoglobulin levels (IgG, IgA, and IgM) than military personnel without retained metal fragments and noninjured controls, except for IgE. Individuals who were metal-reactive positive (that is, a stimulation index > 2) with retained metal fragments had higher median IgE serum levels than participants who metal-reactive with nonmetal injuries (1198 ± 383 IU/mL versus 171 ± 67 IU/mL, mean difference 1027 ± 477 IU/mL [95% CI 2029 to 25]; p = 0.02). We found that males with retained metal fragments after a battlefield-related injury had altered adaptive immune responses compared with battlefield-injured military personnel without indwelling metal fragments. Military participants with a retained metal fragment had an increased proportion of group members and increased average lymphocyte reactivity to common implant metals such as nickel and cobalt. Further studies are needed to determine a causal association between exposure to amounts of retained metal fragments, type of injury, personnel demographics and general immune function/reactivity that may affect personal health or future metal implant performance. Level IV, therapeutic study.

Radicalization in arms? Exploring armed violence capital in the context of Quebec’s civilian military simulation communities

ABSTRACTIntroducing the concept of ‘armed violence capital’, this paper intends to explore radicalisation leading to violence through the acquisition of knowledge and skills of violence without active ideological indoctrination. Using civilian communities practicing specific military simulations as a case study, it assesses how this type of training might be used for a deviant and extremist purpose. Based on a mixed-method approach of ethnographic observations, surveys, and interviews of civilian military simulation participants, it first describes this activity before explaining how such training can allow participants to acquire knowledge, skills, and attitudes towards the use of violence. Showing the observed members of this community are not violent extremists, this study suggests that an ideological motivation is needed for the use of extreme violence, but that a violent radicalisation process can evolve without this ideological aspect.

Who follows whom? A coincidence analysis of military action, public opinion and threats

Does public opinion act as a constraint on military action, are ordinary citizens the easily manipulated targets of the public relations efforts of their governments, or does the general public react as assertively to threats as decisionmakers? This article examines the causal connection between military action, public opinion and threats. Empirically, it focuses on the pattern of EU member state participation in two recent military operations: the 2011 intervention in Libya and the operation against the self-proclaimed Islamic State (IS). Three competing causal models on the relationship between threats, public opinion and military action were derived from the scholarly literature and tested with coincidence analysis. The results of the analysis show that public opinion acted as a constraint on executives during the Libya operation. However, there was no direct causal link between public opinion and military participation in the operation against IS, in which both military action and public support were an effect of threat. More generally, the results suggest that the context of the intervention is decisive for the relation between threat, military action and public support. More specifically, whether public opinion constitutes a constraint on military action or is an effect of threats to national interests depends on whether these threats are clear and tangible.

GENDER INTEGRATION IN THE MILITARY: GENDER-NEUTRAL STANDARDS AND COED SPORTS

This paper focuses on the socio-cultural aspects of gender integration in the Armed Forces, arguing for gender-neutral standards. It begins with a detailed literature review relevant to women’s integration in the military, subsequently focusing on Greece, and in the final analysis arguing that coed military sport participation and exercises serve as a means of bridging the gender-divide and eliminating gender harassment. Though coed sport (mixed-gender teams) as a tool for women’s inclusion and integration in the military seems to be part of the solution, it is a topic on which research is scarce (Kefi Chatzichamperi, 2018, 2019). This study does not examine physiologic attributes: biological and anatomical differences or research on sex hormones and how they affect the nervous system and physical strength, and subsequently soldier performance (Tenan, 2017). Using a qualitative theoretical approach, it discusses the social dimensions of evidence-based research on why and how gender integration is relevant. It includes current and ongoing studies presented at the 14 th Conference of the European Research Group on Military and Society (ERGOMAS), hosted by the Hellenic Army Academy in Athens, indicating that a main challenge in the military today is to ensure a gender balance through women’s inclusion, active engagement and retention. Research emphasizes the need for change in the military culture on all levels—legal and organizational—including gender-awareness and diversity training, especially on the complimentary skills that both genders bring to the table as opposed to the "wastage of talent" (Kamberidou, 2013). Certainly, establishing gender-neutral standards to eliminate sexism, and promote inclusion and integration is a complex and multifaceted process, the reason researchers in the social sciences use a variety of theoretical approaches (Patsantaras, 2015, 2013; Seagrave, 2016). The results indicate that the gender participation gap continues in all current military organizations : Hungary holding the highest female participation rate (19.3%) and Turkey the lowest (0.8%). Article visualizations:

GENDER INTEGRATION IN THE MILITARY: GENDER-NEUTRAL STANDARDS AND COED SPORTS

This paper focuses on the socio-cultural aspects of gender integration in the Armed Forces, arguing for gender-neutral standards. It begins with a detailed literature review relevant to women’s integration in the military, subsequently focusing on Greece, and in the final analysis arguing that coed military sport participation and exercises serve as a means of bridging the gender-divide and eliminating gender harassment. Though coed sport (mixed-gender teams) as a tool for women’s inclusion and integration in the military seems to be part of the solution, it is a topic on which research is scarce (Kefi Chatzichamperi, 2018, 2019). This study does not examine physiologic attributes: biological and anatomical differences or research on sex hormones and how they affect the nervous system and physical strength, and subsequently soldier performance (Tenan, 2017). Using a qualitative theoretical approach, it discusses the social dimensions of evidence-based research on why and how gender integration is relevant. It includes current and ongoing studies presented at the 14 th Conference of the European Research Group on Military and Society (ERGOMAS), hosted by the Hellenic Army Academy in Athens, indicating that a main challenge in the military today is to ensure a gender balance through women’s inclusion, active engagement and retention. Research emphasizes the need for change in the military culture on all levels—legal and organizational—including gender-awareness and diversity training, especially on the complimentary skills that both genders bring to the table as opposed to the wastage of talent (Kamberidou, 2013). Certainly, establishing gender-neutral standards to eliminate sexism, and promote inclusion and integration is a complex and multifaceted process, the reason researchers in the social sciences use a variety of theoretical approaches (Patsantaras, 2015, 2013; Seagrave, 2016). The results indicate that the gender participation gap continues in all current military organizations : Hungary holding the highest female participation rate (19.3%) and Turkey the lowest (0.8%). Article visualizations:

Analysis of Military-Civil Interaction in Emergency Management based on C2 Model

In recent years, with the frequent occurrence of emergencies in China, more urgent requirements have been put forward for the improvement of emergency management system. As one of the important forms of emergency management, military-civilian joint action plays an important role in emergency rescue. However, in the past cases, there are still many problems in the process of local and military participation in emergency rescue, resulting in poor rescue effect. Command and Control (C2) model is a classical model in military command and control. It can analyze the military-civilian linkage system intuitively and systematically, and summarize the characteristics of each maturity level of C2 model to form a table. Based on this, the maturity of the military-civilian linkage accident rescue process is evaluated and the existing problems are analyzed, and the needle is put forward. The measures for sexual improvement and further optimization of the military-civilian linkage system provide experience support for the improvement of emergency management system in China.

Historical policies affecting women’s military and family roles

Purpose The US military depends on women to meet recruiting goals, but women participate at lower rates than men. Theorists suggest that military and family policies affect women’s lower participation. Research has confirmed the impact of policy changes on women’s military service during specific time periods. The purpose of this paper is to examine how and when military policies affecting women developed over the course of history, exploring two related hypotheses: first, when women’s military participation is vital, policies affecting their military and family roles punctuate in tandem, and second, cultural values impact policy solutions to reconcile women’s roles. Design/methodology/approach Punctuated equilibrium and a women’s military participation theory informed the hypotheses. US Census and Defense Department data were used to identify periods of service when women’s military participation was vital. Historical policies were mapped and analyzed to identify policy patterns and themes affecting women’s military participation 1895–2015. Findings Evidence supports both hypotheses. When women are needed during wartimes, policies simultaneously encourage their service and regulate their family roles. However, policies evolved from separating servicewomen’s roles prior to the 1970s (e.g. prohibiting motherhood), to supporting their families (e.g. maternity leave) – a shift precipitated by sweeping changes in broader society and the military’s change from the draft to an All-Volunteer Force. Originality/value Findings elucidate the link between military and family policies affecting US women’s military participation and retention. Results may inform policy advocacy aimed at optimizing the US Department of Defense’s diversity efforts.

Personality Disorders and Value Orientation as Predictors for Male Depression in Military and Civilian Patients

The aim of this clinical study was to detect differences between a civil and a military inpatient population with depressive disorders with respect to traits of male depression, personality disorders and value orientations. Fifty civil and fifty military participants answered various psychometric testings at the beginning of treatment. No differences were found concerning male depression. Personality traits and value orientations were found to be predictive for severity and frequency of depressive disorders in different depression inventories.

Pharmaceutical Services Preparedness of Military Units in an Institution of Brazilian Armed Forces

Introduction:Military participation in humanitarian operations, both in cases of armed conflict and in response to natural disasters, is a common phenomenon in several countries. In Brazil, the Armed Forces have a history in providing humanitarian assistance to victims of emergencies through their field hospitals, such as medical and dental care, laboratory and imaging diagnosis, and pharmaceutical services.Aim:To verify pharmaceutical services preparedness of military units in an institution of Brazilian Armed Forces to disaster response and humanitarian aid.Methods:A transversal study was carried out. The methodological approach was based on a logical model and indicators related to the preparedness of pharmaceutical services. Field research was carried out and good storage practices were investigated in loco. Key stakeholders were interviewed based on an open-ended questionnaire on the preparedness of pharmaceutical services. Interviews were transcribed and analyzed for overall content, according to analytical categories stemming from the literature and indicators prior defined.Results:Key stakeholders of three military units were interviewed, and official documents and guidelines were also analyzed. Some pronounced shortcomings were identified, such as the lack of a specific budget for medicines management, no surplus of health supplies, lack of appropriate transports, and need of capacity building of health professionals and support team. The existence of a disaster plan, selection of essential medicines for primary reaction, forecasting of medicines, field hospitals as mobile and adaptable health structures, and a system for military mobilization are some of the strengths identified. Two military units are better structured in the management of pharmaceutical service. The third unit still needs to mature its processes to fit the health purposes of its mission.Discussion:These findings can subsidize the improvement of pharmaceutical services’ efficiency and quality in means of providing better response in emergency situations supported by the Brazilian Armed Forces.

Ukrainian-US Relations in the Context of U.S. Foreign Policy Priorities

After Donald Trump was elected as the American president, significant changes were observed in the Ukrainian-American relations. These especially included the lifting of embargo on lethal arms supply and the resumption of meetings of the Ukraine-US Strategic Partnership Commission. Contrary to D. Trump’s desire to conclude a U.S. - Russia “Big Deal”, Republicans and Democrats in the U.S. Congress held a bipartisan position on Ukraine supporting the expansion of sanctions on various occasions – from the on-going conflict in Donbas and Russian attempts to influence the 2016 election campaign to imposing obstacles for the supply of Russian weapons to the third countries. Assessments of American academic and political experts do not give reason to believe that the U.S. political circles are ready to move from remote support of Ukraine in the mood of long-term deterrence doctrine to intensive forms of military and military-political participation. Acknowledging Russia’s rejection of the post-Cold War Euro-Atlantic security order, American observers are inclined to suppose that the conflict in Donbas is unlikely to be finally settled. In case of its freezing, this conflict will pose potential or acute threats to the economy and security of Ukraine. Within such a trend Ukraine will play the role of one of the major subjects of long-term tensions and discord in economic and military relations between Russia and the West.

КРИТЕРІЇ, ПОКАЗНИКИ І РІВНІ ОЦІНЮВАННЯ РОЗВИТКУ ПСИХОФІЗИЧНОЇ ВИТРИВАЛОСТІ МАЙБУТНІХ ПРОФЕСІОНАЛІВ ВІЙСЬКОВОГО УПРАВЛІННЯ

Introduction. Military experts training is one of the main tasks of providing the Armed Forces of Ukraine with highly skilled personnel. Responsibility for obtaining corresponding knowledge and abilities is assigned by persons who are carrying out their training. Mutual understanding and commitment of military professional activity’s subjects will promote diagnostics of the military training participants and will allow to define the major qualities, which are necessary to develop. Motivated military expert, who understands necessity of his official duties successful performance, will be interested to become professional and to develop important for his military professional activity qualities. Military activity is connected with impact on mentality and high fatigue. Therefore, important quality for the military personnel is a psychological and physical endurance. Thus, there is a need of determination of criteria, indicators and levels of future military professionals’ psychological and physical endurance assessment in order to begin its diagnostics.Purpose. Definition and justification of criteria and indicators of psychological and physical endurance development assessment of future military management professionals was a basis in order to determine levels of psychological and physical endurance development assessment of future military management professionals.Methods. The complex scientific analysis was carried out, synthesis of information was done using scientific references. Methods of systematization and justification of criteria, indicators and levels of psychological and physical endurance development assessment of future military management professionals were used.Results. The analysis of scientific works on criteria, indicators and levels determination of psychological and physical endurance development assessment of future military management professionals is provided in this research. Information from scientific references is generalized.Originality. Criteria, indicators and levels of psychological and physical endurance development assessment of future military management professionals are for the first time were defined and proved.Conclusion. Due to scientific research criteria and indicators psychological and physical endurance development assessment of future military management professionals have been defined and proved. The complex scientific analysis was carried out, synthesis of scientific information was obtained, promoted determination of levels of psychological and physical endurance development assessment of future military management professionals. The prospects of further scientific research are to define a research technique of psychological and physical endurance development assessment of future military management professionals.

Rates of Performance Validity Test Failure for ADHD Evaluations in a Military Population: An Exploratory Study

Objective: Investigate rates of Performance Validity Test (PVT) failures in a group of active duty (AD) military participants referred for ADHD evaluations and other characteristics of those referred for evaluation. Method: AD service members referred for ADHD evaluations were given PVTs as part of assessment. PVT pass/fail groups were compared on age, estimated premorbid intelligence, history of ADHD, other mental health problems, and functional impairment. Results: PVT failure rate was consistent with other studies. Fail group was younger and lower estimated premorbid intelligence than those that passed. Groups based on other variables did not significantly differ. Failure group also performed worse on a measure of attention. Many individuals were referred with no childhood history of ADHD or objective evidence of impaired function. Conclusion: Rates of PVT failures were similar to those found in civilian university and veteran military settings. Screening candidates for specific Diagnostic and Statistical Manual of Mental Disorders (5th ed.) criteria for ADHD was only minimally followed.

Sex-specific lung cancer risk among radiation workers in the million-person study and patients TB-Fluoroscopy

Background The study of Japanese atomic bomb survivors, exposed briefly to radiation, finds the risk of radiation-induced lung cancer to be nearly three times greater for women than for men. Because protection standards for astronauts are based on individual lifetime risk projections, this sex-specific difference limits the time women can spend in space. Populations exposed to chronic or fractionated radiation were evaluated to learn whether similar differences exist when exposures occur gradually over years. Methods and materials Five occupational cohorts within the Million Person Study of Low-Dose Health Effects (MPS) and a Canadian Fluoroscopy Cohort Study (CFCS) of tuberculosis patients who underwent frequent chest fluoroscopic examinations are evaluated. Included are male and female workers at the Mound nuclear facility, nuclear power plants (NPP), and industrial radiographers (IR). Workers at the Mallinckrodt Chemical Works and military participants at aboveground nuclear weapons tests provide information on the risk among males. Cox proportional hazards and Poisson regression models were used to estimate sex-specific radiation risks for lung cancer and to compare any differences. Results Overall, 15,065 lung cancers occurred among the 443,684 subjects studied: 50,111 women and 395,573 men. The mean cumulative dose to the lung was 166.3 mGy (range 6 to 1,055 mGy) with the highest among the TB-fluoroscopy patients (mean 1,055 mGy). Mean lung dose for women in the worker cohorts was generally 4 times lower than for men. Of the 12 estimates of radiation-related risk, only one, for male IRs, showed a significant elevation (ERR 0.09; 95% CI 0.02–0.16, at 100 mGy). In contrast, the dose response for male NPP workers was negative (ERR −0.05; 95% CI −0.10, 0.01, at 100 mGy). Combined, these two cohorts provided little evidence for a radiation effect among males (ERR 0.01; 95% CI −0.04, 0.06, at 100 mGy). There was no significant dose-response among females within any cohort. There was no difference in the sex-specific estimates of lung cancer risk. Conclusions There was little evidence that chronic or fractionated exposures increased the risk of lung cancer. There were no differences in the risks of lung cancer between men and women. However, the sex-specific analyses are limited because of small numbers of women and relatively low doses. A more definitive study is ongoing of medical radiation workers which include 85,000 women and 85,000 men (overall mean dose 82 mGy, max 1,140 mGy). Additional understanding will come from the ongoing follow-up of the CFCS.

Баналност моћи и идеологија универзализма

NATO's political and - above all - military participation in secession-motivated conflicts in former Yugoslavia (1990-1995), will be remembered as a clear example of demonstration of power, intentions and (in)capability of the Victor in a decades-long global "cold war" between the "freedom-loving" West and "totalitarian East". Regardless of the expectations of liberal theoreticians and the majority of public opinion, it was soon revealed that the victory was no "triumph of freedom" and even less "the end of history". On the contrary, as historically typical, it was only an unstable resultant of relations between major actors in the modern global theater, who strive to legitimize their need for domination with varying success and vocabulary. Hence the lessons to be learned from the final act of destruction of Yugoslavia (several months of NATO bombing of Serbia in 1999) have the expected tone of banality: absolute might strives for absolute power (which remains unattainable in principle); "the mighty oppress" is true always and in any place (but with a time limit); and, finally, what everyone knows but does not (or is unable or refuses) to say aloud: the only true alternative to military threat and/or aggression of a single political actor is an equally valid (military) threat/aggression by another one. We are tempted to conclude that, despite the ideological ardor of NGO activists, the political correctness of theoreticians and the rhetorical figures of speech of politicians, the "banalities" remain valid as the only certainties, i.e., regularities in the unpredictable currents of relations between states.