Nagorno-Karabakh conflict: Mental health repercussions and challenges in Azerbaijan

Impact of COVID-19 on the Health of Migrant Children in the United States: From Policy to Practice

In this article, the authors provide an overview how the COVID-19 pandemic impacted the health and wellbeing of migrant children in conflict zones, in transit and post-settlement in the United States. In particular, the authors explore how policies implemented during the pandemic directly and indirectly affected migrant children and led to widening disparities in the aftermath of the pandemic. Given these circumstances, the authors provide recommendations for child health care providers caring for migrant children to mitigate and bolster resilience and health.

The prevalence and determinants of PTSD, anxiety, and depression in Ukrainian civilian physicians and paramedics in wartime-An observational cross-sectional study six months after outbreak

Russia's invasion of Ukraine is the largest European land offensive since World War II. Individuals affected by conflicts such as war are at an increased risk of mental disorders, which result from frequent exposure to traumatic events and the breakdown of supportive social networks. The aim of the study was to assess the prevalence and determinants of PTSD, anxiety, and depression in Ukrainian civilian physicians and paramedics six months after the Russian invasion of Ukraine. A cross-sectional study was conducted using validated questionnaires: The Life Events Checklist, PTSD Checklist for DSM-5, The International Trauma Questionnaire (ICD-11), The Generalized Anxiety Disorder-7, The Patient Health Questionnaire-9, The World Health Organization Disability Assessment Schedule 2.0. The study showed that 61.1 % of participants indicated combat or exposure to a war zone as the most bothersome event in their experience. Physicians and paramedics did not differ in the prevalence of PTSD according to the DSM-5 diagnostic rule and of depression (criteria met by 14.5 % and 9 % of participants, respectively). However, more physicians than paramedics met the criteria of PTSD according to the ICD-11 diagnostic rule (5.1 % vs. 1.2 %) and of anxiety (16.5 % vs. 10.0 %). The risk factors for the mental health problems included personal combat experience, total trauma exposure, parenthood, and economic situation. Despite the differences found in the prevalence of PTSD depending on the criteria used, the severity of mental problems and disability in this group is significant. It is advisable to monitor the mental state and need for help among Ukrainian civilian medical personnel.

Early disruptions to syringe services programs during the Russian invasion of Ukraine

Introduction

The widespread HIV epidemic in Ukraine is concentrated among people who inject drugs (PWID), making access to sterile injection paraphernalia (SIP) like sterile needles and syringes a critical method of HIV/AIDS prevention; however, the Russian invasion has threatened to disrupt the operations of syringe services programs (SSPs), creating a risk of HIV outbreaks among PWID.

Methods

We conducted 10 semi-structured interviews with outreach workers from SSPs. Interviews were purposively sampled to cover three prototypic regions of Ukraine: temporarily Russian-controlled, frontline, and destination. Qualitative results from interviews were then compared against a standardized, nationwide harm reduction database.

Results

We found that the Russian invasion triggered both supply and demand challenges for SSPs. Demand increased for all regions due to client transitions from pharmacies that closed to SSPs, increases in illicit drug use, greater client openness to NGO support, and displacement of clients to destination regions. Supply decreased for all areas (except for remote destination regions) due to battle-related barriers like curfews, roadblocks, and Internet disruptions; diminished deliveries of SIP and funding; and staff displacement. Time series plots of the number of unique clients accessing harm reduction services showed that an initial decrease in service provision occurred at the start of the war but that most regions recovered within several months except for Russian-controlled regions, which continued to provide services to fewer clients relative to previous years.

Conclusion

To ensure continued scale-up of SIP and other HIV prevention services, the SyrEx database should be leveraged to serve as a streamlined harm reduction locator that can inform workers and clients of open site locations and other pertinent information.

Social integration, solidarity, and psychological health of internally displaced persons in Cameroon: Exploring the role of community satisfaction

Background/Introduction

Conflict-induced displacement continue to be a pressing public policy concern due to the adverse effects on the well-being of internally displaced persons (IDPs). Understanding the integration process of these individuals, particularly the role of solidarity and social integration in fostering a sense of belonging and improving their community experiences and psychological well-being, remains unclear. This study investigates the role of community satisfaction in the relationship among social integration, solidarity, and psychological health of IDPs in Cameroon.

Methods

Cross-sectional data from 428 displaced individuals in the Ntui subdivision, Cameroon, were analyzed using structural equation modeling (SEM). This technique tested four latent variables: social integration, solidarity, community satisfaction, and psychological health.

Results

The results show a direct association between solidarity and both community satisfaction (β = 0.282; p < 0.001) and psychological health (β = 0.137; p < 0.01). Community satisfaction also has a direct relationship with the psychological health of the IDPs (β = 0.292; p < 0.001). An indirect effect of solidarity on psychological health through community satisfaction was observed (β = 0.084 (SE = 0.025, CI = [0.047, 0.129], p < 0.001)). However, no mediational effect of community satisfaction was found on the association between social integration and psychological health. The model accounted for 7% of the variance in community satisfaction (R2 = 0.07) and 20% of the variance in psychological health (R2 = 0.20). Conclusion: The findings indicate a strong sense of solidarity among the displaced persons in the studied communities in Cameroon, which promotes their psychological health via community satisfaction. As such, interventions should aim to foster solidarity among displaced persons to enhance their community experiences and psychological health.