The new humanitarian crisis in Ukraine: Coping with the public health impact of hybrid warfare, mass migration, and mental health trauma

Compassionate engagement of communities in support of palliative and end-of-life care: challenges in post-pandemic era

Over the years, humanity has faced various global crises of different kinds that have caused great suffering in the community, such as wars, slavery, torture or the Holocaust, but also climate change, economic crises, or sanitary disasters. The recent pandemic posed a barrier to palliative and End-of-Life (EoL) care, as the need for physical distance made it difficult to retain essential human interactions while minimizing the risk of viral transmission. During the COVID-19 pandemic, the robustness of supportive networks (i.e., family, friends, neighbors, and community members) determined whether someone experienced a calm death at home or an unnecessary hospital admission, labeled as an 'emergency'. In this vein, active establishment and strengthening of such networks are the foundation of compassionate community efforts. Firstly, providing both physical and emotional support to the entire network of caregivers enhances their ability to care for others and improves the overall experience of death, including the process of dying and the ensuing bereavement period. Furthermore, individuals can enhance their own physical and mental health by practicing compassion. The ability of networks to withstand and recover from physical and emotional challenges, while maintaining strong and supportive relationships among its members, depends on the health and overall well-being of those members. Therefore, we argue that active community participation and death education can strengthen a community's capacity to assist people facing death, dying, and bereavement.

Disinformation and the Brussels bubble: EU correspondents’ concerns and competences in a digital age

European Union (EU) political actors have been heavily affected by the so-called disinformation crisis, leading to intense worries about how EU citizens may be guaranteed access to trustworthy information in the years to come. While there is increasing research on how EU officials, platforms, and political parties react to the threat of disinformation, less attention has been paid to how another crucial group of actors in Brussels copes with this threat: EU correspondents. This paper presents one of the first empirical observations of EU correspondents’ perceptions of the disinformation crisis. We conducted a survey with Brussels-based correspondents ahead of a politicized 2019 European Parliament election campaign, and asked: What are (a) the concerns and (b) self-perceived competences these correspondents have in dealing with disinformation? Our study offers two main take-aways: First, we recommend further studying EU journalism as a complex organism whose concerns and competences are influenced by intra-European differences in press freedom and journalistic professionalisation. Second, disinformation studies in the EU context must no longer neglect the challenges professional journalism faces when aiming to stop false content.

Effects of stress on pain in females using a mobile health app in the Russia-Ukraine conflict

The chronic and acute effects of stress can have divergent effects on health; long-term effects are associated with detrimental physical and mental health sequelae, while acute effects may be advantageous in the short-term. Stress-induced analgesia, the attenuation of pain perception due to stress, is a well-known phenomenon that has yet to be systematically investigated under ecological conditions. Using Flo, a women's health and wellbeing app and menstrual cycle tracker, with a world-wide monthly active usership of more than 57 million, women in Ukraine were monitored for their reporting of stress, pain and affective symptoms before, and immediately after, the onset of the Russian-Ukrainian conflict. To avoid potential selection (attrition) or collider bias, we rely on a sample of 87,315 users who were actively logging multiple symptoms before and after the start of the war. We found an inverse relationship between stress and pain, whereby higher reports of stress predicted lower rates of pain. Stress did not influence any other physiological symptoms with a similar magnitude, nor did any other symptom have a similar effect on pain. This relationship generally decreased in magnitude in countries neighbouring and surrounding Ukraine, with Ukraine serving as the epicentre. These findings help characterise the relationship between stress and health in a real-world setting.

A Qualitative Exploration of the Experience of Child Feeding Among Ukrainian Refugee and Immigrant Mothers During Escape and Relocation

INTRODUCTION

With the continued armed conflict impacting Ukrainian families, it is important to understand the influence of escape, displacement, and relocation on the disruption to daily life, particularly on young child feeding.

METHOD

A phenomenological study explored 16 refugee mothers' experiences and perceptions of feeding young children since the onset of the conflict and following relocation to America or Israel.

RESULTS

Four themes were identified from the narratives: culturally-based perceptions of young child nutrition; breastfeeding during the conflict and relocation; challenges with accessing nutritious food during the conflict and relocation; and food adaptation on relocation.

DISCUSSION

These findings deepen our understanding of the impact of culture on child-feeding beliefs and practices and can be used to develop a population-focused approach to formulate recommendations for health professionals in providing culturally relevant feeding education and support for refugee mothers and their children.

Intervening on Global Emergencies: The Value of Human Interactions for People's Health

Literature about global emergencies and their impact on people's health underlines the need to improve the social cohesion of human community and the availability of tools to support people and foster community interactions. This paper illustrates research aimed at describing and measuring human interactions in the Veneto community and its changing during the COVID-19 pandemic. 50,000 text occurrences from social media and newspapers about these topics were analyzed between December 2021 and January 2022. People present themselves as members of different teams, pursuing conflicting aims, and attributing the decision-making responsibility of emergencies management exclusively to governments, without considering themselves as active parts of the community. This delegation process on citizens' behalf can affect their health: by taking minor responsibility in handling the repercussions of these events on the community and by arguing over the most effective way to deal with them, they risk freezing and waiting for action by third parties, thus leaving mutual interactions and the promotion of their own health at a standstill. Local institutions can use these data to shape prevention policies to manage the community's emergencies and use them as opportunities to promote public health.

Dr. Smartphone, can you support my trauma? An informatics analysis study of App Store apps for trauma- and stressor-related disorders

Background

Psychological trauma is prevalent in developed countries, with prevalence rates and treatment needs exceeding health system capacity. As telemedicine and out-of-patient care are promoted, there has been an expansion of digital apps to compliment therapeutic stages in psychological trauma. To date there are no reviews that have compared these apps and their clinical utility. This study aims to identify the availability of trauma- and stressor-related mhealth apps, assess their functionality, and review their therapeutic abilities.

Methodology

The authors conducted a systematic search using an iPhone 13 Pro in the Australian IOS App Store to extract trauma- and stressor-related apps that resulted from the search criteria. A cross-adaptation of the Mobile App Rating Scale (MARS) and the Comprehensive App Evaluation Model (CAEM) were used as a framework to produce the mTrauma App Evaluation Conceptual Model and Informatics Framework. App content descriptors were analysed based on their general characteristics, usability, therapeutic focus, clinical utility, data integration. Following an applicability in concordance with psychological trauma-informed delivery.

Results

A total of 234 apps resulting from the search strategy were screened, with 81 apps that met the inclusion criteria. The majority of apps were marketed to 4+ to 17+ years of age, categorised as 'health and fitness', with the highest target markets observed for adolescents, children, parents, clinicians, and clients. A total of 43 apps (53.1%) contained a trauma-informed specified section, and 37 (45.7%) incorporated a section useful to support trauma-related symptoms. A significant number of apps there was an absence of therapeutic utility (in 32 apps (39.5%)). Most apps were supporting post-traumatic stress disorder-informed, cognitive behavioural therapy and eye movement desensitisation and reprocessing. Provision of psychoeducation, courses, guided sessions, trainings, self-reflection/journaling, symptom management and progress tracking were highly present.

Conclusions

Trauma-informed mobile apps are available in the App Store, expanding in its target market reach and usability, with an increase of creative psychotherapies being introduced alongside conventional modalities. However, based on the app descriptors, the scarcity of evidenced-based testimonials and therapeutic applicability remains questionable for clinical validity. Although mhealth tools are marketed as trauma-related, current available apps employ a multifunctional approach to general psychological symptomatology, through to associated comorbid conditions and emphasizes on passive activity. For higher uptake on user engagement, clinical application and validity, trauma-apps require curated specification to fulfil its role as complimentary psychological treatment.

HEPATITIS A. THE FEATURES OF DISEASE COURSE IN ADULTS

OBJECTIVE

The aim: To analyze the incidence of Hepatitis A in Ukraine and Poltava region and to study the clinical and epidemiological features of the course of Hepatitis A in adult patients.

PATIENTS AND METHODS

Materials and methods: The course of HA in 96 hospitalized patients was analyzed. The diagnosis of HA was established on the basis of clinical and epide¬miological data and confirmed by the results of laboratory studies (serological and molecular biological).

RESULTS

Results: In 2019, in the Poltava region, there was an increase in the incidence of Hepatitis A with a predominance among sick people of working age, among the urban population. This part of people aged from 60 to 75 years old constitutes 9.4%. This study showed that the waterway was the dominant way of HA transmission. The course of the disease in most hospitalized patients was typical and cyclic, with a predominance of a mixed variant of the pre-jaundice period and jaundice. One third of patients survey that they had fever, which persisted with jaundice.

CONCLUSION

Conclusions: The findings of this study indicates that the patients older than 40 years were more likely to have concomitant chronic pathology than younger patients, and Hepatitis A was more severe with the development of prolonged cholestasis, wave-like course and recurrence. In most patients under the age of 40, the course of Hepatitis A was mild, but splenomegaly and severe cytolytic syndrome were more common.

Current War in Ukraine: Lessons from the Impact of War on Combatants' Mental Health during the Last Decade

Ukrainian Military Hospital retrospective analysis during a decade of conflicts (3995 records) unveils specific mental health ICD-10-CM distribution per rank and the long-lasting impact of active conflict or trench warfare. Most hospitalizations in all years of observation were among soldiers. Anxiety-related disorders have been present since 'peacetime', mainly among professional soldiers and high ranks, pointing to the need for rank-tailored psychological training in skills to reduce the anxiety burden. High frequency of psychoactive substance use emerged with acute conflicts and in nonprofessional soldiers during wartime. This dictates the need to strengthen the selection of military personnel, considering the tendency to addiction. Military operations multiply the hospitalizations in psychiatric hospitals. The data warn about a 'need for free beds effect', which is worse for soldiers. This is relevant to estimating and planning the need for hospital resources for the current situation where the general population has been recruited for defense. In the current war, tightening the rules of sobriety in units and up to a ban on the sale of alcoholic beverages in areas where hostilities are taking place is recommended. The specific impact on nonprofessional soldiers is relevant to the current war, with the general population of Ukraine recruited for defense and combat.