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Nearly 15 years later, some 250 million dollars in United States medical research has failed to confirm a novel war-related syndrome and controversy over the existence and causes of idiopathic physical symptoms has persisted. Wartime exposures implicated as possible causes of subsequent symptoms include oil well fire smoke, infectious diseases, vaccines, chemical and biological warfare agents, depleted uranium munitions and post-traumatic stress disorder. Recent historical analyses have identified controversial idiopathic symptom syndromes associated with nearly every modern war, suggesting that war typically sets into motion interrelated physical, emotional and fiscal consequences for veterans and for society. We anticipate future controversial war syndromes and maintain that a population-based approach to care can mitigate their impact. This paper delineates essential features of the model, describes its public health and scientific underpinnings and details how several countries are trying to implement it. With troops returning from combat in Afghanistan, Iraq and elsewhere, the model is already getting put to the test.<\/jats:p>","DOI":"10.1098\/rstb.2006.1829","type":"journal-article","created":{"date-parts":[[2006,3,31]],"date-time":"2006-03-31T13:59:18Z","timestamp":1143813558000},"page":"707-720","source":"Crossref","is-referenced-by-count":32,"title":["Managing future Gulf War Syndromes: international lessons and new models of care"],"prefix":"10.1098","volume":"361","author":[{"given":"Charles C","family":"Engel","sequence":"first","affiliation":[{"name":"Department of Psychiatry, School of Medicine, Uniformed Services University of the Health Sciences4301 Jones Bridge Road, Bethesda, MD 20814-4799, USA"},{"name":"Deployment Health Clinical Center, Walter Reed Army Medical CenterBuilding 2, Room 3G01 6900 Georgia Avenue, NW, Washington, DC 20307, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth C","family":"Hyams","sequence":"additional","affiliation":[{"name":"Office of Public Health and Environmental Hazards, Department of Veterans Affairs, VA Central Office (13A)810 Vermont Avenue, NW, Washington, DC 20420, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ken","family":"Scott","sequence":"additional","affiliation":[{"name":"Directorate of Medical Policy, Canadian Forces Health Services1745 Alta Vista Drive, Ottawa, Ontario K1A 0K6, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"175","published-online":{"date-parts":[[2006,3,24]]},"reference":[{"key":"e_1_3_1_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/1096-9926(200010)62:4<195::AID-TERA5>3.0.CO;2-5"},{"key":"e_1_3_1_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a009635"},{"key":"e_1_3_1_4_1","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1136\/jrnms-91-99","article-title":"An observational study on diagnoses of 3,233 Gulf veterans (Op Granby 1990\u201391) who attended the ministry of defence's medical assessment programme 1993\u20132004","volume":"91","author":"Bale A.J","year":"2005","journal-title":"J. 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