Gulf War Syndrome: A Reaction to Psychiatry’s Invasion of the Military?

Following the 1991 Gulf War, a number of soldiers who fought there began to complain of various symptoms and disorders, the collection of which came to be known as Gulf War syndrome (GWS). A debate has raged about the nature and cause of this illness, with many suggesting that it is a psychiatric condition. GWS continues to be a contested illness, yet there is no disputing that many Gulf veterans are ill. This article considers the way in which GWS sufferers understand their illness to be physical in nature and the way in which they negotiate and resist psychological theories of their illness. Based on 14 months of ethnographic fieldwork in the United Kingdom, data for this article were collected mainly by in-depth, semistructured interviews with GWS sufferers, their family members, doctors, and scientists, as well as healthy Gulf veterans. A total of 93 informants were interviewed, including 67 UK Gulf veterans, most of whom were ill. The paper argues that despite the increasing presence of psychiatry in military discourse, GWS reveals the way that people are able to transform, negotiate and even negate its power and assumptions.     

A normative construction of Gulf War syndrome

In early 1992, U.S. troops returning from the Gulf War began reporting a variety of nonspecific symptoms such as fatigue, skin rash, headache, muscle and joint pain, and loss of memory.These reports marked the beginning of what was to be identified as the Gulf War Syndrome (GWS). In the years since the war, as many as 100,000 troops have claimed they suffer from this mysterious disease. In our culture, the existence of disease as a specific entity is fundamental to ensuring the validity of that disease.The legitimacy of GWS has been repeatedly called into question because no specific physiological etiology has been confirmed, and it is becoming more and more likely that the origin of GWS will never be clearly delineated. The purpose of this paper is to illustrate the complicated process of defining GWS as a legitimate illness in the absence of etiological evidence and to suggest a method of treatment for individuals who still suffer from its sequelae.     

Population dynamics and life-history styles of Nile tilapia,Oreochromis niloticus,in Ferguson's Gulf,Lake Turkana,Kenya

Synopsis Three observed dynamic aspects of the Nile tilapia population around Ferguson's Gulf at Lake Turkana, Kenya are evaluated and discussed: the seasonality in catch rates, the enormous inter-annual abundance variations, and the large changes in median size at first maturity. A clear understanding of the regulating mechanisms behind these features has never been achieved, although seasonal changes in the hydrology of shallow sheltered refuges seems to play an important role. This paper suggests a further holistic approach taking the impacts and interrelationships of both the primary productivity and the various predators into account. A synthesizing ecological hypothesis is elaborated, which concludes that most observations on the tilapia dynamics can be explained from changes in the oxygen concentrations and size-specific mortality pressures. Variations in these two proximate factors can ultimately be explained by the floodplain-type fluctuations in the Ferguson's Gulf environment.     

Toxicological assessments of Gulf War veterans

Concerns about unexplained illnesses among veterans of the 1991 Gulf War appeared soon after that conflict ended. Many environmental causes have been suggested, including possible exposure to depleted uranium munitions, vaccines and other drugs used to protect troops, deliberate or accidental exposure to chemical warfare agents and pesticides and smoke from oil-well fires. To help resolve these issues, US and UK governments have sought independent expert scientific advice from prestigious, independent scientific and public health experts, including the US National Academies of Science and the UK Royal Society and Medical Research Council. Their authoritative and independent scientific and medical reviews shed light on a wide range of Gulf War environmental hazards. However, they have added little to our understanding of Gulf War veterans' illnesses, because identified health effects have been previously well characterized, primarily in the occupational health literature. This effort has not identified any new health effects or unique syndromes associated with the evaluated environmental hazards. Nor do their findings provide an explanation for significant amounts of illnesses among veterans of the 1991 Gulf War. Nevertheless, these independent and highly credible scientific reviews have proven to be an effective means for evaluating potential health effects from deployment-related environmental hazards.     

Healthcare utilization and mortality among veterans of the Gulf War

The authors conducted an extensive search for published works concerning healthcare utilization and mortality among Gulf War veterans of the Coalition forces who served during the 1990-1991 Gulf War. Reports concerning the health experience of US, UK, Canadian, Saudi and Australian veterans were reviewed. This report summarizes 15 years of observations and research in four categories: Gulf War veteran healthcare registry studies, hospitalization studies, outpatient studies and mortality studies. A total of 149728 (19.8%) of 756373 US, UK, Canadian and Australian Gulf War veterans received health registry evaluations revealing a vast number of symptoms and clinical conditions but no suggestion that a new unique illness was associated with service during the Gulf War. Additionally, no Gulf War exposure was uniquely implicated as a cause for post-war morbidity. Numerous large, controlled studies of US Gulf War veterans' hospitalizations, often involving more than a million veterans, have been conducted. They revealed an increased post-war risk for mental health diagnoses, multi-symptom conditions and musculoskeletal disorders. Again, these data failed to demonstrate that Gulf War veterans suffered from a unique Gulf War-related illness. The sparsely available ambulatory care reports documented that respiratory and gastrointestinal complaints were quite common during deployment. Using perhaps the most reliable data, controlled mortality studies have revealed that Gulf War veterans were at increased risk of injuries, especially those due to vehicular accidents. In general, healthcare utilization data are now exhausted. These findings have now been incorporated into preventive measures in support of current military forces. With a few diagnostic exceptions such as amyotrophic lateral sclerosis, mental disorders and cancer, it now seems time to cease examining Gulf War veteran morbidity and to direct future research efforts to preventing illness among current and future military personnel.     

Between the individual and the community: the impact of genetics on ethical models

This paper discusses how genetics is influencing ethical frameworks with particular focus on the effectiveness and appropriateness of individual and communal models. It suggests that genetics supports a relational understanding of the person and therefore that genetic ethics requires ethical models which respect both individuals and groups. First, the inadequacy of individualistic frameworks – at conceptual, ethical and practical levels – is outlined. Second, the “communal turn” in genetic ethics in both clinical and population ethics is considered. Third, it is claimed that this communal turn is applicable to genetic ethics in general and to illustrate this two further examples are explored: those of UK Biobank and personalized medicine. The paper concludes that ethical frameworks in genetic ethics must accommodate both group and individual concerns.     

Genetic susceptibility in Parkinson's disease

It is hoped that an understanding of the genetic basis of Parkinson's disease (PD) will lead to an appreciation of the molecular pathogenesis of disease, which in turn will highlight potential points of therapeutic intervention. It is also hoped that such an understanding will allow identification of individuals at risk for disease prior to the onset of motor symptoms. A large amount of work has already been performed in the identification of genetic risk factors for PD and some of this work, particularly those efforts that focus on genes implicated in monogenic forms of PD, have been successful, although hard won. A new era of gene discovery has begun, with the application of genome wide association studies; these promise to facilitate the identification of common genetic risk loci for complex genetic diseases. This is the first of several high throughput technologies that promise to shed light on the (likely) myriad genetic factors involved in this complex, late-onset neurodegenerative disorder.     

A vertically transmitted amalgavirus is present in certain accessions of the bryophyte Physcomitrium patens

In the last few years, next-generation sequencing techniques have started to be used to identify new viruses infecting plants. This has allowed to rapidly increase our knowledge on viruses other than those causing symptoms in economically important crops. Here we used this approach to identify a virus infecting Physcomitrium patens that has the typical structure of the double-stranded RNA endogenous viruses of the Amalgaviridae family, which we named Physcomitrium patens amalgavirus 1, or PHPAV1. PHPAV1 is present only in certain accessions of P. patens, where its RNA can be detected throughout the cell cycle of the plant. Our analysis demonstrates that PHPAV1 can be vertically transmitted through both paternal and maternal germlines, in crosses between accessions that contain the virus with accessions that do not contain it. This work suggests that PHPAV1 can replicate in genomic backgrounds different from those that actually contain the virus and opens the door for future studies on virus–host coevolution.     

Adaptable individuals and innovative lineages

This paper suggests (i) that while work on animal innovation has made good progress in understanding some of the proximate mechanisms and selective regimes through which innovation emerges, it has somewhat neglected the role of the social environment of innovation; a neglect manifest in the fact that innovation counts are almost always counts of resource-acquisition innovations; the invention of social tools is rarely considered. The same is true of many experimental projects, as these typically impose food acquisition tasks on their experimental subjects. (ii) That neglect is important, because innovations often pose collective action problems; the hominin species were technically innovative because they were also socially adaptable. (iii) In part for this reason, there remains a disconnect between research on hominin innovation and research on animal innovation. (iv) Finally, the paper suggests that there is something of a disconnect between the theoretical work on innovation in hominin evolution (based on theories of cultural evolution) and the experimental tradition on human innovation. That disconnect is largely due to the theoretical work retreating from strong claims about the proximate mechanisms of human cultural accumulation.     

Using the therapy and enhancement distinction in law and policy

In a first major study, the UK’s Royal Society found that 76% of people in the UK are in favour of therapeutic germline genomic editing to correct genetic diseases in human embryos, but found there was little appetite for germline genomic editing for non-therapeutic purposes. Assuming the UK and other governments acted on these findings, can lawmakers and policymakers coherently regulate the use of biomedical innovations by permitting their use for therapeutic purposes but prohibiting their use for enhancement purposes? This paper examines the very common claim in the enhancement literature that the therapy v enhancement distinction does little meaningful work in helping us think through the ethical issues, a claim that has significant implications for these lawmakers and policymakers who may wish to regulate genomic editing techniques to reflect the findings of this important study. The focus of this paper is on germline genomic editing as one of the main themes in this special issue.     

The dual role of the potyvirus P3 protein of Turnip mosaic virus as a symptom and avirulence determinant in brassicas

Two isolates of the potyvirus Turnip mosaic virus (TuMV), UK 1 and CDN 1, differ both in their general symptoms on the susceptible propagation host Brassica juncea and in their ability to infect B. napus lines possessing a variety of dominant resistance genes. The isolate CDN 1 produces a more extreme mosaic in infected brassica leaves than UK 1 and is able to overcome the resistance genes TuRB01, TuRB04, and TuRB05. The resistance gene TuRB03, in the B. napus line 22S, is effective against CDN 1 but not UK 1. The nucleic acid sequences of the UK 1 and CDN 1 isolates were 90% identical. The C-terminal half of the P3 protein was identified as being responsible for the differences in symptoms in B. juncea. A single amino acid in the P3 protein was found to be the avirulence determinant for TuRB03. Previous work already has identified the P3 as an avirulence determinant for TuRB04. Our results increase the understanding of the basis of plant-virus recognition, show the importance of the potyviral P3 gene as a symptom determinant, and provide a role in planta for the poorly understood P3 protein in a normal infection cycle.     

Evaluation of genome-wide selection efficiency in maize nested association mapping populations

In comparison to conventional marker-assisted selection (MAS), which utilizes only a subset of genetic markers associated with a trait to predict breeding values (BVs), genome-wide selection (GWS) improves prediction accuracies by incorporating all markers into a model simultaneously. This strategy avoids risks of missing quantitative trait loci (QTL) with small effects. Here, we evaluated the accuracy of prediction for three corn flowering traits days to silking, days to anthesis, and anthesis-silking interval with GWS based on cross-validation experiments using a large data set of 25 nested association mapping populations in maize (Zea mays). We found that GWS via ridge regression-best linear unbiased prediction (RR-BLUP) gave significantly higher predictions compared to MAS utilizing composite interval mapping (CIM). The CIM method may be selected over multiple linear regression to decrease over-estimations of the efficiency of GWS over a MAS strategy. The RR-BLUP method was the preferred method for estimating marker effects in GWS with prediction accuracies comparable to or greater than BayesA and BayesB. The accuracy with RR-BLUP increased with training sample proportion, marker density, and heritability until it reached a plateau. In general, gains in accuracy with RR-BLUP over CIM increased with decreases of these factors. Compared to training sample proportion, the accuracy of prediction with RR-BLUP was relatively insensitive to marker density.     

The superior colliculus, a neuronal network resistant to the Gaba withdrawal syndrome

Chronic intracortical perfusion of GABA (Gamma Amino Butyric Acid) and its subsequent withdrawal generates the GABA withdrawal syndrome (GWS). This particular epileptic model has been observed in the motor cortex of monkeys and rats. Our purpose was to study the GWS in the motor cortex (MC), dorsal hippocampus (DH), and superior colliculus (SC). Thirty chronically-implanted adult Wistar rats were separated into 3 groups of 10 (8 experimental and 2 controls). The first group received GABA in MC, the second in the DH and the third in the SC. GABA was released in doses of 10 to 60 micrograms/microliter/h for 6 days employing osmotic mini-pumps. Two control rats per group received saline solution in the above-mentioned structures. Rats perfused in the MC showed GWS after interruption of the GABA flow. The group perfused in the DH showed paroxysmal discharges and epileptic seizures during perfusion. They also later showed GWS. No epileptic effects were observed in the SC-perfused group during either the GABA perfusion or during withdrawal. None of the six control animals showed epileptic effects. Our results show that the SC offers a strong resistance to GWS. This could be explained by the particular neuronal network structure of rat SC.     

The psychological effects of ionizing radiation

This paper presents a case study of eleven men who were exposed to non-background ionizing radiation as active participants in the United States' atmospheric nuclear tests. Each of the subjects has developed a virtually identical complex of debilitating psychiatric symptoms. The content of these symptoms is almost entirely focused upon the health effects of the radiation to which each of the subjects was exposed. This symptom complex appears to comprise a syndrome. The symptom structure and course of this syndrome suggests three hypotheses: The syndrome appears to be a pathological development of the self diagnostic belief (that one has been physically harmed by radiation) into a set of symptoms that elaborate upon and express this belief. The self diagnostic belief develops as a means of resolving any one of the various medical mysteries that an individual can experience subsequent to exposure to radiation. Development of the syndrome is a consequence of exposure to non-background ionizing radiation. The paper discusses the evidence for these hypotheses and suggests future research directions.     

The ‘Antiretrovirals,Sexual Transmission Risk and Attitudes’ (ASTRA) Study. Design,Methods and Participant Characteristics

Life expectancy for people diagnosed with HIV has improved dramatically however the number of new infections in the UK remains high. Understanding patterns of sexual behaviour among people living with diagnosed HIV, and the factors associated with having condom-less sex, is important for informing HIV prevention strategies and clinical care. In addition, in view of the current interest in a policy of early antiretroviral treatment (ART) for all people diagnosed with HIV in the UK, it is of particular importance to assess whether ART use is associated with increased levels of condom-less sex. In this context the ASTRA study was designed to investigate current sexual activity, and attitudes to HIV transmission risk, in a large unselected sample of HIV-infected patients under care in the UK. The study also gathered background information on demographic, socio-economic, lifestyle and disease-related characteristics, and physical and psychological symptoms, in order to identify other key factors impacting on HIV patients and the behaviours which underpin transmission. In this paper we describe the study rationale, design, methods, response rate and the demographic characteristics of the participants. People diagnosed with HIV infection attending 8 UK HIV out-patient clinics in 2011-2012 were invited to participate in the study. Those who agreed to participate completed a confidential, self-administered pen-and-paper questionnaire, and their latest CD4 count and viral load test results were recorded. During the study period, 5112 eligible patients were invited to take part in the study and 3258 completed questionnaires were obtained, representing a response rate of 64% of eligible patients. The study includes 2248 men who have sex with men (MSM), 373 heterosexual men and 637 women. Future results from ASTRA will be a key resource for understanding HIV transmission within the UK, targeting prevention efforts, and informing clinical care of individuals living with HIV.     

Exercise Challenge in Gulf War Illness Reveals Two Subgroups with Altered Brain Structure and Function

Nearly 30% of the approximately 700,000 military personnel who served in Operation Desert Storm (1990–1991) have developed Gulf War Illness, a condition that presents with symptoms such as cognitive impairment, autonomic dysfunction, debilitating fatigue and chronic widespread pain that implicate the central nervous system. A hallmark complaint of subjects with Gulf War Illness is post-exertional malaise; defined as an exacerbation of symptoms following physical and/or mental effort. To study the causal relationship between exercise, the brain, and changes in symptoms, 28 Gulf War veterans and 10 controls completed an fMRI scan before and after two exercise stress tests to investigate serial changes in pain, autonomic function, and working memory. Exercise induced two clinical Gulf War Illness subgroups. One subgroup presented with orthostatic tachycardia (n = 10). This phenotype correlated with brainstem atrophy, baseline working memory compensation in the cerebellar vermis, and subsequent loss of compensation after exercise. The other subgroup developed exercise induced hyperalgesia (n = 18) that was associated with cortical atrophy and baseline working memory compensation in the basal ganglia. Alterations in cognition, brain structure, and symptoms were absent in controls. Our novel findings may provide an understanding of the relationship between the brain and post-exertional malaise in Gulf War Illness.     

Junk-food in marine ecosystems

The abundance and availability of food are critical determininants of reproductive success and population dynamics of marine top predators. However, recent work has indicated that the quality of the food may also be critically important for some marine predators. The 'junkfood hypothesis' was originally suggested as a potential explanation for a dramatic population decline of Stellers sea lions Eumetopias jubatus in the Gulf of Alaska. According to the hypothesis, a dietary switch to prey of low energy content led to detrimental effects on the population of sea lions. A number of observations indicate that the hypothesis is relevant for several population parameters. Recent work on piscivorous seabirds has provided substantial evidence indicating the relevance of this hypothesis in food webs in e.g. the North Pacific, the North Sea and the Baltic Sea. The emergence of 'junk-food' in these systems may be coupled to large scale changes in climatological and oceanographic forcing, although predation, fishing and competition provide additional plausible hypotheses. It may be possible to predict which kinds of animals will be particularly sensitive to food quality; these seem to be species with limited ability to carry food loads, with energetically-expensive foraging behaviour, and with digestive anatomy evolved to minimize mass at the cost of digestive efficiency. This review suggests that the junk-food hypothesis is a highly relevant factor in relation to sustaining ecosystem resilience, and is an important consideration in ecosystem management. Sustaining healthy populations of marine top-predators requires an understanding of the role of food quality, in addition to food abundance and availability.     

Post-combat syndromes from the Boer war to the Gulf war: a cluster analysis of their nature and attribution

ObjectivesTo discover whether post-combat syndromes have existed after modern wars and what relation they bear to each other.DesignReview of medical and military records of servicemen and cluster analysis of symptoms.ResultsThree varieties of post-combat disorder were identified—a debility syndrome (associated with the 19th and early 20th centuries), somatic syndrome (related primarily to the first world war), and a neuropsychiatric syndrome (associated with the second world war and the Gulf conflict). The era in which the war occurred was overwhelmingly the best predictor of cluster membership.ConclusionsAll modern wars have been associated with a syndrome characterised by unexplained medical symptoms. The form that these assume, the terms used to describe them, and the explanations offered by servicemen and doctors seem to be influenced by advances in medical science, changes in the nature of warfare, and underlying cultural forces.

What is already known on this topic

Service in the Gulf war is associated with an increased rate of reported symptoms and worsening subjective healthPost-combat syndromes have been described after most modern conflicts from the US civil war onwards

What this study adds

There seems to be no single post-combat syndrome but a number of variations on a themeThe ever changing form of post-combat syndromes seems to be related to advances in medical understanding, the developing nature of warfare, and cultural undercurrentsBecause reported symptoms are subject to bias and changing emphasis related to advances in medical science or the discovery of new diseases, the characterisation of individual syndromes has to be treated with cautionAttributions by servicemen are generally consistent with symptom characteristics, though there seems to be a growing reluctance to consider the stress of military service as a cause     

Declining chilling and its impact on temperate perennial crops

This paper examines the impacts of declining winter chill on the production of temperate perennial crops in the northern hemisphere. Recent studies have linked long-term climate data to key seasonal reproductive events in perennial plants. These studies suggest that the amount of winter chill occurring in the UK has declined and is predicted to continue to do so, based on future climate change scenarios described in the UK Climate Impacts Programme. It is apparent that there is a serious lack of mechanistic understanding of the physiological, molecular and genetical basis of winter chill requirement and dormancy-related environmental factors which affect perennial crop growth and yield. This situation exists despite knowledge of the impacts of climate on perennial plant development and an ability to model its effects, for many temperate fruit crops, on yield. The implications for future reductions in winter chill require recognition as a potential limiting factor on fruit production across Europe, particularly in the south. Within this review we describe the symptoms of lack of winter chill; these include effects on bud break, flower quality and the potential to set fruit, as well as effects on vegetative growth and development. Also included is current knowledge of developmental and physiological events which link flower initiation, anthesis, dormancy, chilling and bud break. Attention is given to what is known about dormancy induction, satisfaction of specific requirements and bud break. Possible strategies are described for mitigation of reduced winter chill, providing long-term solutions to secure perennial fruit supplies in Europe. This includes exploiting genotypic variability, within several perennial crops, through plant breeding to develop low chill-cultivars, together with opportunities to change crop management practices and growing systems to tolerate low chill.     

Phylogenetic and sequence profile analysis of Non-Ribosomal Polyketide Synthase-Adenylation (NRPS)domain from Actinobacterium dagang 5

This study aims to find out the mapping of bioactive compounds by combinational analysis of regulatory machinery pattern study and metabolomics approach. In which we isolated a highly potent Actinobacterium dagang 5 from Gulf of Manner, which shows broad-spectrum activity against several pathogens. So the isolate was used for overall metabolic profiling studies on crude extract and phylogeny pattern analysis of NRPS A-domain, which is an important gene clusters and plays vital role in production of bioactive metabolites. The result suggests that Actinobacterium dagang 5 has the potential to produce a new type of antibacterial compounds.