US Marines Research Articles

An Ofrenda to Sacred Waters

44 WLT SEPTEMBER–OCTOBER 2016 special section Gulf Lit Mexico, the US South, and Cuba Guest-edited by Dolores Flores-Silva & Keith Cartwright featuring Jesús J. Barquet 47 Charo Guerra 48 Feliciano Sánchez Chan 49 LeAnne Howe 50 Jay Wright 52 Agustín del Moral Tejeda 53 Luis Lorente 57 Brenda Marie Osbey 58 José Luis Rivas 60 Bárbara Renaud González 61 Arturo Montoto (Cuba), En algún lugar de la ciudad, 2015, oil on canvas, 60x60 cm T he idea for this Gulf feature of World Literature Today goes back almost fifteen years to end-of-the-day conversations with my colleague (and co-editor of this section) Keith Cartwright in the building that some of Roanoke College’s English professors shared with my own Modern Languages Department. We talked about what our college’s first international students —coming from Choctaw Nation and Tamaulipas (Mexico) in the 1870s—might have discussed together as well as what might have kept them apart. I sometimes shared nostalgic stories of sirenas, cimarrones , curanderas, fiestas of carnaval and Todos Santos, as well as descriptions of music, dance, and food from my Veracruz home. Keith had no shortage of stories to share from his own souths, but he also mentioned stories by Kate Chopin, Zora Neale Hurston, and Eudora Welty that brought my own Gulf shores a little closer. Since we both teach Caribbean literatures, Cuba started to emerge as a Gulf-connector. Of course, we talked of the book we could write and a host of imagined projects linking Veracruz, New Orleans, and Havana. Since—as historian Matthew Pratt Guterl has argued—the Gulf has been an unacknowledged “American Mediterranean ” constituting what José Martí called “our Greece,” we ask how contemporary writers from the region respond to this nigh-mythic cross-cultural heritage and its gulfs of perspective. Beyond our triangulated port cities (Veracruz, New Orleans, and Havana), we showcase writers from the Gulf states of Mexico, the US South (including the Rio Grande basin), and western Cuba. Today’s Gulf still holds a complexly cosmopolitan and volatile legacy. The Gulf of Mexico has been navigated by Arawak and Mayan and Mississippian peoples, by Columbus and Cortés and Cabeza de Vaca, by slave ships and by refugees of slavery and white supremacy, by US marines invading both Mexico and Cuba, by drug traffickers and petroleum industries in a long process of globalization and localized resistance, and by climatic forces like the deity Hurakan who activated our deepest origins in the Popul Vuh. The Gulf’s loop currents of resistant countercultures— whether in jazz or blues, Mexican or Cuban son, counterclockwise ritual dances and flying bird-men, carnival parades or grassroots community activism —work from traditions of creolization and indigeneity that have shaped the world. Our special section of World Literature Today brings a number of the region’s writers into conversations that hardly take place apart from a forum such as this. Such a forum or “bridge” is in no way parochial. We began with an interest in how Gulf writers handle some of the following questions : (1) What responses do these writers offer to standardizing forces of globalization (going back to old colonizations of An Ofrenda to Sacred Waters by Dolores Flores-Silva The Gulf’s loop currents of resistant countercultures—whether in jazz or blues, Mexican or Cuban son, counterclockwise ritual dances and flying bird-men, carnival parades or grassroots community activism—work from traditions of creolization and indigeneity that have shaped the world. WORLDLIT.ORG 45 46 WLT SEPTEMBER–OCTOBER 2016 thought and power in the region) from this matrix of cross-cultural origin-ality? (2) How do the poetics and ritual or festive traditions inherited from Creole and Indigenous ancestors help writers speak from the margins of accredited thought across borders that threaten to silence or zombify the imagination? (3) How do these writers respond to environmental destruction and the traumas wrought by global capital in the wake of the oil industry, the Cuban Revolution, post-NAFTA development, and migration or exile all along the Gulf rim? (4) Can an imaginative literature of the Gulf bridge frontiers and help voices and readers cross over, return...

The Case for Megacities

We cannot know for certain what the future operating environment will be, but we must prepare for it. To date, the US military has not paid enough attention the rise of megacities. This article argues the US Army must continue developing new concepts, capabilities, and ultimately solutions for achieving national security objectives within the current and future operational environments of the megacity. ********** The 2014 Army Operating Concept (AOC) defines the term complex as environment that is not only unknown, but unknowable and constantly changing. (1) It goes on claim that to win in a complex world, Army forces must provide the Joint Force with multiple options, integrate the efforts of multiple partners, operate across multiple domains, and present enemies and adversaries with multiple dilemmas. (2) Nowhere is this more crucial or difficult accomplish than in the complex urban environment of a megacity. Such cities present the Army and joint force with a level of complexity for which they are not fully prepared. However, many opportunities exist for the Army and joint force reinvigorate past research efforts, consolidate learning, and prepare the current and future force for operations in such environments. Historical Context Urban warfare is not a new phenomenon. For example, in the ancient Syrian city of Hamoukar, archeologists have discovered evidence of urban combat as early as 5,500 years ago. (3) Throughout the ages, urban conflicts have tended be more the rule than the exception. Previous wars centered on the sieges and defense of urban centers of all sizes, while large battles have for centuries been the exception rather than the rule. Contemporary reminders of urban warfare and its inherent challenges include the battles of Stalingrad and Aachen during World War II, Hue during Vietnam, and Grozny in 1994-1995, and again 1999-2000. There is little reason believe future conflicts will not also require some form of urban warfare. As such, the Army's capacity engage, fight, and win major urban combat operations will determine the success of future operational and strategic endeavors. The Battle of Hue during the Vietnam conflict reflected the tendency for urban combat operations blend the levels of war, creating the situation where tactical outcomes had significant strategic implications. Arguably, the bloodiest battle during the Tet Offensive took place in Hue, Vietnam's third largest city, with significant operational, cultural, and spiritual significance. The Battle for Hue involved 26 days of intense street-to-street, house-to-house fighting against a determined enemy established in a defense-in-depth. Major urban combat operations occurred in the midst of a civilian population of around 140,000 people, and against an initial enemy force estimated at 7,500 North Vietnamese Army (NVA) and Viet Cong (VC) troops, later reinforced a division-sized element. Facing them were three US Marine battalions and 11 Army of the Republic of Vietnam (ARVN) battalions. (4) Although the United States employed Army units from the 1st Cavalry Division and 101st Airborne Division during the Battle of Hue, these forces focused on the outlying areas prevent NVA reinforcement. The US Marines and ARVN conducted the majority of fighting inside the city. When the fight for Hue ended, US and ARVN forces retook the city. The US military suffered 216 killed and 1,364 wounded, while the ARVN lost 384 killed and 1,830 wounded. Civilian casualties were around 5,800 people killed or executed by NVA/VC due their political allegiances. Estimated enemy casualties were 1,042 killed and 4,000 wounded. (5) Despite the tactical gains from retaking the city and repelling enemy forces across South Vietnam, the United States and Republic of Vietnam faced the strategic repercussions of having laid in ruins an estimated 80 percent of the city, with over 116,000 persons left homeless. …

“Dead Citizen” and the Abject Nation: Social Death, Haiti, and the Strategic Power of the Image

I argue that the historical visualization of Haiti, coupled with images of dead Haitian bodies shown during the 2010 earthquake, contribute to what I call the “dead citizen,” a historically flawed, inherently sinful body lacking political agency. I analyze the 1919 photograph of the dead body of Charlemagne Péralte, one of the leaders of the oppositional fighters known as cacos , murdered by the US marines during the 1915 occupation. I draw similarities between the public display of Péralte’s corpse and the display of the images of the dead and injured bodies of the earthquake victims. I assert that these anonymously dead bodies were imprisoned in a regulatory gaze of the global world that confirmed a discourse of deviance; thereby reinforcing Haiti as a cursed nation pathologically destined to its history of suffering. I explore the discursive nature of photography and the institutional use and evidentiary value of Péralte’s image and detail the multiple “killings” of Péralte that occurred through the effective hegemonic “act of photography,” the image’s reproduction and dissemination, and the public display of his half-naked corpse.

Talking to Hezbollah

The two studies under review, by Matthew Levitt and Lina Khatib et al., present very different pictures of Hezbollah, pictures which are not necessarily conflicting and are indeed, in many ways, complementary. Levitt focuses on the group's long record of terrorism dating back more than 30 years to the early 1980s and its violent attacks on US marines and French forces then based in Lebanon. Over that period, of course, as Lina Khatib and her co-authors demonstrate, Hezbollah has grown in stature as a political party. Khatib and her colleagues portray a party that has deliberately sought to keep Lebanon a weak and divided country, despite the efforts of the West and Gulf Arab states to strengthen the Lebanese state. These two studies add immensely to our knowledge of Hezbollah and its extraordinary rise over the past three decades to become one of the major political and military actors in the Middle East.

“I Don’t Think I Would Have Recovered”

Ethnographic research among US Marines shows resilience is in their practices, not biology. Empirical evidence supports our claim that a personal-social understanding of resilience has superior explanatory power and plausibility over mechanistic and reductive frameworks that treat resilience as automated functions of human biopsychological systems. Marines dynamically pursue their values in context, and this resilience can only be defined in local, variable context, not globally and generally. USMC resilience training should focus on skills and concepts needed to resolve challenges to values in the lives of Marines. Technical-medical interventions should be reserved for clinical populations.

Risk Factors for Back-Related Disability in the US Army and Marine Corps

Matched case-control epidemiological study. To identify pre-enlistment, demographic, and service-related risk factors for back-related disability in enlisted US soldiers and Marines comparing those who were deployed with those who did not deploy during the service term. Back conditions are a major cause of morbidity and lost work days in both the US working population and military. Back-related conditions are among the most prevalent causes of military disability discharge but little research has been conducted to identify risk factors for back-related disabilities in this population. Cases included enlisted Army and Marine Corps service members evaluated for back-related disability. Controls, frequency matched by year of military entrance and service, were selected from the enlisted service member population. Pre-enlistment demographic and medical characteristics, deployment, and ambulatory care data collected from existing military databases were used. Crude and adjusted odds of back-related disability were modeled using conditional logistic regression. In adjusted models, service members who were overweight (odds ratio [OR]: 1.17; 95% confidence interval [95% CI]: 1.12-1.23) and obese (OR: 1.35; 95% CI: 1.26-1.44), between ages 25 and 29 years (OR: 1.23; 95% CI: 1.16-1.31), or 30 years or older (OR: 1.43; 95% CI: 1.34-1.52) at military entrance were at increased odds of a back-related disability. History of a back diagnosis at the pre-enlistment medical examination (OR: 1.94; 95% CI: 1.50-2.50) and deploying once (OR: 1.09; 95% CI: 1.05-1.14) were also associated with increased odds of a back-related disability. Enlisted soldiers and marines with back-related disabilities were more likely to be older, have a higher body mass index, have a history of pre-enlistment back conditions, and were deployed once, compared with controls without a back-related disability. Additional research is necessary to further examine the complex relationship between deployment to combat zones, onset of musculoskeletal symptoms, and back-related disability in soldiers and marines. 4.

The prospects of combined action: Lessons from Vietnam

Military commanders, policymakers, and analysts have recently embraced the concept of combined action as a powerful tool to improve the effectiveness of Afghan security forces in the fight against the Taliban. In doing so, they explicitly draw inspiration from the Combined Action Program employed by US Marines during the Vietnam War. This program is widely considered to have greatly improved the effectiveness of South Vietnamese government forces and contributed to increased population security in its area of operations and is considered a model worthy of emulation. This study finds that the success of the Vietnam-era Combined Action Program was more qualified than contemporary proponents argue. It argues that successes were tempered, and conditioned, by the choice of junior commanders, the level of operational control enjoyed by the US Marines, and the way the local forces were recruited and deployed. These conditions offer valuable lessons for those seeking to employ combined action not only in present-day Afghanistan, but also in future counterinsurgency campaigns.

The Effect of Pre‐Travel Advice on Sexual Risk Behavior Abroad: A Systematic Review

Travelers often have casual sex abroad and the risk of acquiring a sexually transmitted infection (STI) associated with casual travel sex is considered to be threefold higher compared to the risk of casual sex in the home country. Consequently, international guidelines recommend including STI advice in the pre-travel consultation. We performed a systematic review on the effect of a pre-travel STI intervention on sexual risk behavior abroad. In September 2012, a systematic analysis and meta-analysis of peer reviewed literature were performed on the relation between pre-travel STI advice for travelers and sexual risk behavior abroad. Primary outcome measure consisted of the number of travelers with a new sexual partner abroad; secondary outcome measure entailed the proportion of consistent condom use. Six studies were identified for inclusion in the review, of which three clinical trials on the effect of a motivational intervention compared to standard pre-travel STI advice qualified for the meta-analysis. Two of these trials were performed in US marines deployed abroad and one in visitors of a travel clinic. The extensive motivational training program of the marines led to a reduction in sexual risk behavior, while the brief motivational intervention in the travel clinic was not superior to standard advice. The meta-analysis established no overall effect on risk behavior abroad. No clinical trials on the effect of a standard pre-travel STI discussion were found, but a cohort study reported that no relation was found between the recall of a nonstructured pre-travel STI discussion and sexual risk behavior, while the recall of reading the STI information appeared to be related to more consistent condom use. Motivational pre-travel STI intervention was not found to be superior to standard STI advice, while no clinical trials on the effect of standard pre-travel STI advice were found.

Talk like a Marine: USMC linguistic acculturation and civil–military argument

This study examines the relationship between US Marine discourse and civil–military public argument. A computer-aided semantic analysis of public record speech from senior Marine officers shows a style of cohesion, marked by future-oriented, inclusive, highly certain language. An appraisal theory discourse analysis of interviews with US Marines conducted during an ethnography of communication shows their talk argues discursively for cohesion. This way of speaking may constrain Marines in public argument, as they repeat ways of talking appropriate within the community, even when situationally inappropriate for civilian audiences.

Pixelizing atrocity

Abstract A digital solution to the problems caused by US military personnel misusing their digital cameras, pixelization (the intentional post-production enlargement of pixels to obscure potentially disturbing content) has become a defining feature of newsmedia visualizations of American military atrocity during the War on Terror. Here, I consider the ethics and politics of pixelizing photographs depicting torture at Abu Ghraib, the exploits of the American ‘Kill Team’ in Afghanistan, and the carnality of US Marines urinating on the corpses of Taliban soldiers. Ostensibly, as a technique applied to those parts of the photograph that reveal the corporeal truth of war most graphically, such redaction is meant to protect the victims. But it also renders their appearance variable, subject to editorial whim, and pixelization alters not only the appearance of the photograph, but how it signifies. I query whether pixelization offers any meaningful redress for the victims and the extent to which it blunts photography’s capacity to document harm.

Linking a throughput simulation to a systems dynamics simulation to assess the utility of a US Navy foreign humanitarian aid mission

The success of any humanitarian aid mission is generally measured by the timeliness of critical supplies that are delivered to the affected area. However, a more interesting analysis may be to determine the effect of the aid on the overall satisfaction of the local population. The authors' research focused on the delivery of humanitarian aid to a notional region that was decimated by flooding with ships, landing craft and security personnel provided by the US Navy and Marines. While the research effort addressed naval force structure, the focus of the research was: (1) to assess different delivery methods for the aid; and (2) to determine how the aid delivery impacted the overall satisfaction of the local population. To examine both concerns, two simulation models were developed, with one examining the throughput of aid delivered during the operation, and the other the satisfaction of the population based on the humanitarian aid effort.

Education and the Need for Heroes

O ne of the key features of effective learning is emulation. It is not enough to encourage learners to memorize information or develop motor skills. We cannot simply ‘‘download’’ such abilities. Instead, they need to see what such knowledge and abilities look like in realworld practice and to have an opportunity to develop and practice them under the supervision of a dedicated teacher. Yet many teachers have little theoretical understanding of emulation. To help provide a practical standpoint from which to understand it, we need to explore the phenomenon of heroism, and in particular the important role of heroes as ideals toward which learners can strive. This article focuses on a particular 20th-century hero of the United States Marine Corps. In ancient Greece, heroes were demigods, the product of mortal and divine parents, such as Heracles. With time, the idea evolved to refer to human beings who managed to exhibit great courage and dedication in service to others. At times when discouragement and cynicism seem to hold sway, it is especially important that we reflect on heroes and heroism. More than reviewing policy and procedure manuals or codes of ethics, reflecting on heroes invites us to shift our focus from what we should do to who we should be. Moreover, it is often in the attempt to emulate our heroes that we most enhance our own performance and character. Yet heroes are never perfect, and there are lessons to be learned from their weaknesses as well as their strengths. Lewis ‘‘Chesty’’ Puller is the most decorated of all US Marines, and the only one to be awarded five Navy Crosses. Born in Virginia in 1898, Puller grew up listening to the stories of Civil War veterans who held Stonewall Jackson in high regard. Puller enrolled in the Virginia Military Institute but left after a year to serve as a marine in World War I. He grad-

Guam

Guam Kelly G. Marsh (bio) and Tyrone J. Taitano (bio) Reviews of the Federated States of Micronesia, Kiribati, the Commonwealth of the Northern Mariana Islands, and Nauru are not included in this issue. This year as in previous years, the economy and government finances were the dominant concerns in Guam. Perhaps in some ways these issues have helped assure the continuation and revitalization of Chamorro culture and cultural events—which had a strong presence this year—as a means to provide a sense of stability and to remind Chamorros and others of their survival as a people through thousands of years of challenges. The central economic issue was the long-planned military buildup involving the redeployment of the US Marines from Okinawa to Guam. The year began with opposition in the US Congress to the redeployment from leaders like Senator John McCain (PDN, 1 Jan 2012). Military plans for a firing range near the ancient Chamorro settlement of Pågat Village, considered an extremely significant cultural site, were the subject of a court dispute. In 2010, the National Trust for Historic Preservation, the Guam Preservation Trust, and the "We are Guåhan" organization filed a lawsuit against the US Navy to protect and preserve Pågat Village. Dating to 700 AD, Pågat holds the remains of prehistoric structural stone foundations (known as latte), freshwater caves, and medicinal plants, as well as stone mortars, pottery, and tools of the Chamorro people. The National Trust and the Guam Preservation Trust asserted that a major legal victory had been scored in November 2011 when the navy publicly announced its intent to consider alternative locations for firing ranges (PreservationDirectory.com, 7 Dec 2011). Another obstacle to the redeployment was the issue of the Futenma airbase in Okinawa. The transfer of US Marines to Guam had been linked to progress in relocating the Futenma facility to a less populated part of Okinawa. However, the Japanese government had difficulties securing the consent of Okinawans to the relocation plan. In February, both the US and Japanese governments agreed to decouple the transfer of the marines from the Futenma relocation issue (Reuters, 10 Feb 2012). In April, the two governments announced that 5,000 marines would be moved to Guam in the coming years, and the military buildup price tag has been reduced to about $8.6 billion. The original plan would have brought about 8,600 marines to Guam and cost at least $10.27 billion. Despite the plans for the number of marines on Guam being reduced by more than 40 percent, the cost of the marine transfer only went down by about 15 percent. Also, although [End Page 128] Japan increased its cash contribution, Pentagon officials said that previously announced financing support by Japan is no longer necessary. Funding for some of Guam's civilian infrastructure projects related to the military buildup was supposed to have been drawn from this financing. But Guam's congresswoman, Madeleine Bordallo, characterized the move as a "better framework" for progress on the buildup. Senator Judith Guthertz, chairwoman of the Guam Legislature's Military Buildup Committee, echoed Bordallo's comments and said that the revised buildup plan is good for Guam. She went on to say that she still believed there would be a significant economic boost to the island from the buildup due to the civilian personnel and military families who would accompany the expansion of the current military presence (PDN, 25 April 2012). In May, it was further clarified that two-thirds of the marines redeployed to Guam would be on a rotational rather than permanent basis (PNC, 2 May 2012). That same month, the US Senate froze deployment funds, pending more information from the US Department of Defense on the expense of the move (UPI, 15 May 2012). Even so, US Deputy Assistant Secretary of Defense for Plans Robert Scher stated that he hopes the marines can start moving to Guam as early as 2014 (PNC, 23 May 2012). After years of determined effort, a meeting of the Guam First Commission was finally convened in April (MV, 16 April 2012). Senator Rory Respicio had in 2008 sponsored a law creating the commission in order to bring...

Smart instrumented training ranges: bringing automated system solutions to support critical domain needs

The training objective for urban warfare includes acquisition and perfection of a set of diverse skills in support of kinetic and non-kinetic operations. The US Marines (USMC) employ long-duration acted scenarios with verbal training feedback provided sporadically throughout the training session and at the end in a form of an after-action review (AAR). The inherent characteristic of training ranges for urban warfare is that they are the environments with a high level of physical occlusion, which causes many performances not to be seen by a group of instructors who oversee the training. We describe BASE-IT (Behavioral Analysis and Synthesis for Intelligent Training), a system in development that aims to automate capture of training data and their analysis, performance evaluation, and AAR report generation. The goal of this effort is to greatly increase the amount of observed behavior and improve the quality of the AAR. The system observes training with stationary cameras and personal tracking devices. It then analyzes movement and body postures, measures individual and squad-level performance, and compares it to standards and levels of performance expected in given situations. An interactive visualization component delivers live views augmented with real-time analytics and alerts; it also generates a personalized AAR review in a three-dimensional virtual or mixed reality environment, indexed by automatically extracted salient events and accompanied by summary statistics of unit performance. The approaches presented in the system have the potential to radically change the analysis and performance assessment on physical training ranges and ultimately this type of training itself.

How US Marines Use Intelligence to Counter Irregular Adversaries: Preliminary Thoughts on Recent Operations

How US Marines Use Intelligence to Counter Irregular Adversaries: Preliminary Thoughts on Recent Operations

"Our Mother Earth Is My Purpose": Recollections From Mr. Albert Smith, Na'ashó'ii dich'ízhii

This article is based upon interviews dating from 1999 to 2010 with Mr. Albert Smith (Na'asho'ii dich'izhii), chronicling his personal experiences, motivation, purpose, and goal in serving in World War II as a code talker. He describes the iconic significance of his Navajo Code Talker uniform, and most importantly, how it symbolizes the Sacred Home/Land he worked to protect by serving in the US Marines during World War II. The article conveys firsthand information regarding indigenous environmental practice through warrior work, the role of spirituality in maintaining health, both in the field and upon return to home, and how Navajo worldview motivated his actions.

Pre-enlistment hearing loss and hearing loss disability among US soldiers and marines

Hearing loss is a common condition among US adults, with some evidence of increasing prevalence in young adults. Noise-induced hearing loss attributable to employment is a significant source of preventable morbidity world-wide. The US military population is largely comprised of young adult males serving in a wide variety of occupations, many in high noise-level conditions, at least episodically. To identify accession and service-related risk factors for hearing-related disability, matched case-control study of US military personnel was conducted. Individuals evaluated for hearing loss disability in the US Army and Marine Corps were frequency matched to controls without history of disability evaluation on service and enlistment year. Conditional logistic regression was used to examine the association between accession and service-related factors and hearing-related disability evaluations between October 2002 and September 2010. Individuals with medically disqualifying audiograms or hearing loss diagnoses at application for military service were 8 and 4 times more likely, respectively, to have a disability evaluation related to hearing loss, after controlling for relevant accession, demographic, and service-related factors. Conservative hearing loss thresholds on pre-enlistment audiograms, stricter hearing loss medical waiver policies or qualified baseline audiograms pre-enlistment are needed in the U.S military. Industrial corporations or labor unions may also benefit from identifying individuals with moderate hearing loss at the time of employment to ensure use of personal protective equipment and engineer controls of noise.

Trends in Meningococcal Disease in the United States Military, 1971–2010

Meningococci have historically caused extensive illness among members of the United States military. Three successive meningococcal vaccine types were used from 1971 through 2010; overall disease incidence dropped by >90% during this period. During 2006-2010, disease incidence of 0.38 (cases per 100,000 person-years) among members of the US military was not significantly different from the incidence of 0.26 among the age-matched US general population. Of the 26 cases in the US military, 5 were fatal, 15 were vaccine failures (e.g., illness in a person who had been vaccinated), and 9 were caused by Neisseria meningitidis serogroup Y. Incidences among 17- to 19-year-old basic trainees and among US Marines were significantly higher than among comparison military populations (p<0.05). No apparent change in epidemiology of meningococcal disease was observed after replacement of quadrivalent polysaccharide vaccine with conjugate vaccine in 2007. The data demonstrate that vaccination with meningococcal vaccine is effective.

Anxiety and Depression in Marines Sent to War in Iraq and Afghanistan

Although the effects of combat deployment on posttraumatic stress disorder have been extensively studied, little is known about the effects of combat deployment on depression and anxiety. This study examined the factors associated with anxiety and depression in a sample of 1560 US Marines who were deployed to Iraq and Afghanistan. Eleven demographic and psychosocial factors were studied in relation to depression and anxiety. Five factors emerged as significant in relation to depression: deployment-related stressors, combat exposure, attitudes toward leadership, mild traumatic brain injury symptoms, and marital status. The same factors, with the exception of marital status, emerged as significant in relation to anxiety. Deployment-related stressors had a stronger association with both depression and anxiety than any other variable, including combat exposure. This finding is important because deployment-related stressors are potentially modifiable by the military.

Reactive Arthritis After Shigella Gastroenteritis in American Military in Afghanistan

In Afghanistan in mid June 2011, 2 US Marines developed reactive arthritis manifested by conjunctivitis, urethritis, arthritis, and circinate balanitis. Their symptoms were preceded by an outbreak in their unit of gastroenteritis caused by Shigella species after ingesting contaminated chicken. Gastroenteritis has plagued military operations for millennia. This report emphasizes that personnel can develop reactive arthritis after bouts of gastrointestinal infections that are common in deployed environments. It is highly recommended to maintain vigilance in keeping reactive arthritis on the differential diagnosis in deployed personnel after bouts of gastroenteritis.