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Salazar Flórez JE, Humberto Montoya W, Giraldo Cardona LS. Risk Factors Associated With Bullying in Context of a Territory Exposed to Armed Conflict: A Cross-sectional Study. J Interpers Violence 2024; 39:2552-2575. [PMID: 38149609 DOI: 10.1177/08862605231220026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
School violence and bullying are current and problematic events during adolescence. They are likely to have a marked presence in places highly exposed to armed conflict and violent environments, representing a double public health problem. The study aims to estimate the prevalence of different types of school violence perpetrated and experienced by school adolescents in a community with a history of exposure to armed conflict. Two thousand one hundred eighty-five school adolescents from a municipality in Colombia (males = 54.1%, 14-16 years = 38.6%) participated in the study. Nine educational institutions were included. A systematic random sampling was designed, with a proportional allocation of 35% within each school year from sixth to eleventh grade. The School Coexistence and Circumstances Affecting it-ECECA survey was applied. The prevalence and risks of bully and bullying were estimated. RRa were calculated with the 95% confidence interval adjusted for the other confounding variables. Analyses were constructed from generalized linear models, under the Poisson family and a logarithmic link function. We found a 9.3% of bullying victimization and a 3.5% prevalence of bully. A higher risk of bully was found among males, persons between 10 and 14 years of age, residents of rural or urban dispersed areas, residents of violent neighborhoods, alcohol consumers at school, and victims of aggression in childhood (RRa > 1.0, p-values <.05). The risk of victimization of bullying was higher in students younger than 15 years old, as residents of urban areas, having a history of childhood aggression, suffering abuse by a close person, and as alcohol users at school. This study provides evidence of risk factors for aggression and bullying that have implications for possible prevention measures in multiple social domains, including the individual, the family, and the school environment.
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Russell CJG, Franco AMA, Atkinson PW, Väli Ü, Ashton-Butt A. Active European warzone impacts raptor migration. Curr Biol 2024; 34:2272-2277.e2. [PMID: 38772328 DOI: 10.1016/j.cub.2024.04.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 01/19/2024] [Accepted: 04/22/2024] [Indexed: 05/23/2024]
Abstract
Human conflicts can have impacts on wildlife, from direct mortality and environmental damage to the displacement of people, changing institutional dynamics and altering economies.1,2,3 Extreme anthropogenic disturbances related to conflict may act as a barrier to migrating birds and increase the energetic costs of migration.4 On February 24th, 2022, the Russian Federation invaded Ukraine, with targeted attacks on Kyiv and the eastern regions.5 By March 3rd, when the first of 19 tagged Greater Spotted Eagles entered Ukraine on migration, the conflict had spread to most major cities, including parts of western Ukraine.6 We quantified how conflict impacted the migratory behavior of this species using GPS tracks and conflict data from the Armed Conflict Location and Event Data (ACLED) project7,8 in a quasi-experimental before-after control-impact design, accounting for meteorological conditions. Migrating eagles were exposed to conflict events along their migration through Ukraine and exhibited different behavior compared with previous years, using fewer stopover sites and making large route deviations. This delayed their arrival to the breeding grounds and likely increased the energetic cost of migration, with sublethal fitness effects. Our findings provide a rare window into how human conflicts affect animal behavior and highlight the potential impacts of exposure to conflict events or other extreme anthropogenic disturbances on wildlife.
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Affiliation(s)
- Charlie J G Russell
- School of Environmental Sciences, University of East Anglia, Norwich NR4 7TJ, UK; British Trust for Ornithology, The Nunnery, Thetford IP24 1PU, UK.
| | - Aldina M A Franco
- School of Environmental Sciences, University of East Anglia, Norwich NR4 7TJ, UK
| | | | - Ülo Väli
- Institute of Agricultural and Environmental Sciences, Estonian University of Life Sciences, 51006 Tartu, Estonia
| | - Adham Ashton-Butt
- School of Environmental Sciences, University of East Anglia, Norwich NR4 7TJ, UK; British Trust for Ornithology, The Nunnery, Thetford IP24 1PU, UK.
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Kokori E, Olatunji G, Yusuf IA, Isarinade T, Moradeyo Akanmu A, Olatunji D, Akinmoju O, Aderinto N. A mini-review on safeguarding global health amidst a "Pandemic" of armed conflicts. Medicine (Baltimore) 2024; 103:e37897. [PMID: 38758853 PMCID: PMC11098207 DOI: 10.1097/md.0000000000037897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 03/22/2024] [Indexed: 05/19/2024] Open
Abstract
The year 2022 witnessed an alarming surge in state-based armed conflicts globally, reaching a staggering 56, with major hostilities in Ukraine, Myanmar, and Nigeria resulting in over 10,000 estimated conflict-related deaths. This trend continued with the onset of a significant conflict between Israel and Hamas in October 2023. The escalating frequency of armed conflicts, reaching the highest number since 1946, poses a critical threat to global health. This paper explores the multifaceted health impacts of armed conflicts, encompassing physical injuries, infectious diseases, malnutrition, and profound mental health consequences. Healthcare systems in conflict zones face severe strain, and achieving Sustainable Development Goals by 2030 becomes increasingly challenging. The surge in armed conflicts globally is characterized as a "pandemic," justifying urgent attention. The paper identifies and discusses strategies to safeguard public health in conflict zones, emphasizing humanitarian response, protecting healthcare workers and infrastructure, building preparedness and resilience, and promoting mental health support. In navigating this "pandemic" of armed conflicts, comprehensive strategies are imperative to address the intricate challenges and secure a healthier global future.
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Affiliation(s)
- Emmanuel Kokori
- Department of Medicine and Surgery, University of Ilorin, Ilorin, Nigeria
| | - Gbolahan Olatunji
- Department of Medicine and Surgery, University of Ilorin, Ilorin, Nigeria
| | - Ismaila Ajayi Yusuf
- Department of Medicine and Surgery, Obafemi Awolowo University Teaching Hospital, Ife, Nigeria
| | | | | | - Doyin Olatunji
- Department of Health Sciences, Western Illinois University, Macomb, IL
| | - Olumide Akinmoju
- Department of Medicine and Surgery, University of Ibadan, Ibadan, Nigeria
| | - Nicholas Aderinto
- Department of Medicine, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
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Wolf N. The role of the concept of solidarity for just distribution of bioethical goods in the international area. Bioethics 2024; 38:344-350. [PMID: 38367213 DOI: 10.1111/bioe.13271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 11/30/2023] [Accepted: 01/17/2024] [Indexed: 02/19/2024]
Abstract
This analysis investigates whether solidarity is an appropriate concept for thinking about justifications for a just distribution of bioethical goods in the international arena. This will be explored by looking at the national origins of the idea of justifying solidarity in the form of the health care that welfare states offer. Following that, 'life' and 'health' will be placed within a philosophical context by focusing on the main arguments of John Rawls and Amartya Sen and the role of solidarity in these two theories of justice will be analysed. It will be shown that these theories assume that solidarity is not a prerequisite for just international structures. Finally, the possibility will be discussed, that there is a degree of uncertainty surrounding justifications for fair distribution in the international context that can result when the concepts of solidarity and justice are handled imprecisely.
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Affiliation(s)
- Nadja Wolf
- Hochschule Fresenius München-University of Applied Sciences, Munich, Germany
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Spagnolello O, Aryan AK, Ahmadzai M, Dost A, Boosti AG, Ceccarelli G, Portella G, Baiardo Redaelli M. Management of severe tetanus in Afghanistan: lessons from the field. J Infect Dev Ctries 2024; 18:640-644. [PMID: 38728634 DOI: 10.3855/jidc.18739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 08/10/2023] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION Tetanus is a rather rare disease in the Western countries thanks to widespread vaccination programs and the availability of prophylactics for patients with tetanus-prone injuries. The few cases that do occur are promptly managed in intensive care units (ICUs). However, tetanus is not so rare in developing countries, where access to a suitable level of care is limited. An unstable political situation can be a significant factor influencing patient outcomes. CASE REPORT A ten-year-old boy presented at the EMERGENCY hospital in Lashkar-Gah (southern Afghanistan) with generalized tetanus after falling off his bicycle. In response to his rapidly deteriorating general conditions - respiratory failure and hemodynamic instability - the patient was urgently transferred by ambulance to the ICU at the EMERGENCY hospital in Kabul (northern Afghanistan). The patient was placed on mechanical ventilation while receiving intravenous sedation and pharmacologic paralysis for almost four weeks. A prolonged infusion of a high dose of magnesium sulphate and labetalol was also given to counteract autonomic dysfunction. Multiple complications related to the long stay in the ICU were observed and promptly addressed. During this period, several mass casualties took place in Kabul, which stretched the hospital's surge capacity. The patient was discharged and accompanied back to Lashkar-Gah three months after his admission to the hospital. CONCLUSION This case report shows some of the many difficulties that arise when managing a patient with severe tetanus in a war zone where resources are limited.
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Affiliation(s)
| | | | | | | | | | - Giancarlo Ceccarelli
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | | | - Martina Baiardo Redaelli
- Department of Anesthesia and Intensive Care, San Raffaele Scientific Institute (IRCCS), Milan, Italy
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Kvasnevska Y, Faustova M, Voronova K, Basarab Y, Lopatina Y. Impact of war-associated factors on spread of sexually transmitted infections: a systemic review. Front Public Health 2024; 12:1366600. [PMID: 38645454 PMCID: PMC11026856 DOI: 10.3389/fpubh.2024.1366600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 03/25/2024] [Indexed: 04/23/2024] Open
Abstract
Introduction Statistical data indicate a link between war and the spread of sexually transmitted infections (STIs), then it is necessary to carefully analyze the factors that directly affect the identified pattern in order to overcome this problem. Therefore, the purpose of the study was to systematically analyze the factors that influence the spread of STIs during war. Methods The study included all original research articles and meta-analyses on the impact of war on the spread of sexually transmitted infections that met the following eligibility criteria: (1) articles published exclusively in English; (2) articles published in the period 2013-2023; (3) studies with quantitative, qualitative or mixed design. The search for relevant literature was conducted using four databases: PubMed, Embase, Web of Science, and Ebsco. Results The articles selected for our systematic review had different research designs and were mainly published as original studies (n = 8) and literature reviews (n = 6). As a result of the evaluation of the selected articles for the systematic review, the authors identified migration, a decrease in access to health care, difficult access to contraception, sexual violence as the most frequent factors directly affecting the spread of STIs during the war. Conclusion This systematic review systematizes data on the impact of hostilities on the spread of STIs and outlines the main factors that contribute to the dissemination of pathogens far beyond the territory at the epicenter of the conflict.Systematic review registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023479808, CRD42023479808.
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Affiliation(s)
| | - Mariia Faustova
- Microbiology, Virology and Immunology Department, Poltava State Medical University, Poltava, Ukraine
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Doutchi M, Ghousmane A, Zampaligre F, Moussa B, Ishagh EK, Talatou Marc O, Oumarou B, Kaya MS, Diawara GA, Camara AM, Moussa S, Bienvenu K, Toko J, Harouna H, Moussa H, Kofi N, Tamuzi JL, Katoto PDMC, Wiysonge CS, Melanga Anya BP. Health transformation toward universal healthcare coverage amidst conflict: examining the impact of international cooperation in Niger. Front Public Health 2024; 12:1303168. [PMID: 38515600 PMCID: PMC10956617 DOI: 10.3389/fpubh.2024.1303168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 02/05/2024] [Indexed: 03/23/2024] Open
Abstract
Background Approximately 70% of Sub-Saharan African countries have experienced armed conflicts with significant battle-related fatalities in the past two decades. Niger has witnessed a substantial rise in conflict-affected populations in recent years. In response, international cooperation has aimed to support health transformation in Niger's conflict zones and other conflict-affected areas in Sub-Saharan Africa. This study seeks to review the available evidence on health interventions facilitated by international cooperation in conflict zones, with a focus on Niger. Methods We conducted a systematic literature review (SLR) adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search was conducted from 2000 to 4 September 2022 using MeSH terms and keywords to identify relevant studies and reports in Sub-Saharan Africa and specifically in Niger. Databases such as PubMed (Medline), Google Scholar, Google, and gray literature were utilized. The findings were presented both narratively and through tables and a conceptual framework. Results Overall, 24 records (10 studies and 14 reports) that highlighted the significant role of international cooperation in promoting health transformation in conflict zones across Sub-Saharan Africa, including Niger, were identified. Major multilateral donors identified were the World Health Organization (WHO), United Nations Children's Fund (UNICEF), United Nations Fund for Population Activities (UNFPA), World Bank, United States Agency for International Development (USAID), European Union, European Commission Humanitarian Aid (ECHO), Global Fund, and Global Alliance for Vaccines and Immunization (GAVI). Most supports targeted maternal, newborn, child, adolescent, and youth health, nutrition, and psycho-social services. Furthermore, interventions were in the form of public health initiatives, mobile clinic implementation, data management, human resource capacity building, health information systems, health logistics, and research funding in conflict zones. Conclusion This literature review underscores the significant engagement of international cooperation in strengthening and transforming health services in conflict-affected areas across Sub-Saharan Africa, with a particular focus on Niger. However, to optimize the effectiveness of healthcare activities from short- and long-term perspectives, international partners and the Ministry of Public Health need to re-evaluate and reshape their approach to health intervention in conflict zones.
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Affiliation(s)
| | | | | | - Bizo Moussa
- Bureau de l'Organisation Mondiale de la Santé (OMS), Niamey, Niger
| | - El Khalef Ishagh
- Bureau de l'Organisation Mondiale de la Santé (OMS), Niamey, Niger
| | | | - Batouré Oumarou
- Bureau de l'Organisation Mondiale de la Santé (OMS), Niamey, Niger
| | | | | | | | - Seyni Moussa
- Bureau de l'Organisation Mondiale de la Santé (OMS), Niamey, Niger
| | | | - Joseph Toko
- Bureau de l'Organisation Mondiale de la Santé (OMS), Niamey, Niger
| | - Hamidou Harouna
- Direction de la Surveillance et la Réponse aux Epidémies du Ministère de la Santé Publique, de la Population et des Affaires Sociale, Chargé de la Surveillance, Niamey, Niger
| | - Haladou Moussa
- Bureau de l'Organisation Mondiale de la Santé (OMS), Niamey, Niger
| | - N’Zue Kofi
- Bureau de l'Organisation Mondiale de la Santé (OMS), Niamey, Niger
| | - Jacques Lukenze Tamuzi
- Department of Public Health, Université de Zinder, Zinder, Niger
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Patrick D. M. C. Katoto
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Office of the President and CEO, South African Medical Research Council, Cape Town, South Africa
- Centre for Tropical Diseases and Global Health, Department of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of Congo
| | - Charles S. Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
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Ferrara P, Cammisa I, Zona M, Corsello G, Giardino I, Vural M, Pastore M, Bali D, Pettoello-Mantovani M. The Global Issue of Violence toward Children in the Context of War. J Pediatr 2024:114007. [PMID: 38458606 DOI: 10.1016/j.jpeds.2024.114007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 03/01/2024] [Indexed: 03/10/2024]
Affiliation(s)
- Pietro Ferrara
- European Pediatric Association, Union of National European Pediatric Societies and Associations. Berlin, Germany; Department of Medicine and Surgery & Operative Research Unit of Pediatrics, Campus Bio-Medico University, Rome, Italy; Italian Academy of Pediatrics, Milan, Italy
| | | | | | - Giovanni Corsello
- European Pediatric Association, Union of National European Pediatric Societies and Associations. Berlin, Germany; Italian Academy of Pediatrics, Milan, Italy
| | - Ida Giardino
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Mehmet Vural
- European Pediatric Association, Union of National European Pediatric Societies and Associations. Berlin, Germany; Department of Pediatrics. Cerrahpaşa University, Istanbul, Turkey
| | - Maria Pastore
- European Pediatric Association, Union of National European Pediatric Societies and Associations. Berlin, Germany; Chair of Pediatrics, Institute for Scientific research "Casa Sollievo",University of Foggia, Foggia, Italy
| | - Donjeta Bali
- European Pediatric Association, Union of National European Pediatric Societies and Associations. Berlin, Germany; Albanian Society of Pediatrics, Tirana, Albania
| | - Massimo Pettoello-Mantovani
- European Pediatric Association, Union of National European Pediatric Societies and Associations. Berlin, Germany; Italian Academy of Pediatrics, Milan, Italy; Chair of Pediatrics, Institute for Scientific research "Casa Sollievo",University of Foggia, Foggia, Italy.
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Melau J, Bergan-Skar P, Callender N, Rognhaug M, Bekkestad E. 3D-Printed Tourniquets Used at the Battlefront in Ukraine: A Pilot Study. J Spec Oper Med 2023; 23:87-91. [PMID: 38133635 DOI: 10.55460/7nii-vt7t] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/01/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The war in Ukraine urged a need for prompt deliv- erance and resupply of tourniquets to the front. Producing tour- niquets near the battlefront was a feasible option with respect to resupply and cost. METHODS A locally produced 3D-printed tourniquet (Ukrainian model) from the "Tech Against Tanks" charity was tested against commercially available and Committee of Tactical Combat Casualty Care (CoTCCC)- recommended tourniquets (C-A-T™ and SOF™TT-W). We tested how well the tourniquets could hold pressure for up to 2 hours. RESULTS A Kruskal-Wallis test revealed significant differences between the groups (p<.05). Post-hoc testing revealed a signif- icant difference between the C-A-T and the Ukrainian tourni- quet (p=.004). A similar significance was not found between the SOF™TT-W Wide and the Ukrainian model (p=.08). Dis- cussion: The Ukrainian model can hold pressure as well as the commercially available tourniquets. There is much value if this can be produced close to the battlefield. Factors including lo- gistics, cost, and self-sufficiency are important during wartime. CONCLUSION We found that our sample of 3D-printed tourni- quets, currently used in the war in Ukraine, could maintain pressure as well as the commercially available tourniquets. In- deed, our tests demonstrated that it could maintain a signifi- cantly higher pressure.
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Kwak HY, Leem J, Seung HB, Kwon CY, Jeong HS, Kim SH. Acupuncture Therapy for Military Veterans Suffering from Posttraumatic Stress Disorder and Related Symptoms: A Scoping Review of Clinical Studies. Healthcare (Basel) 2023; 11:2957. [PMID: 37998449 PMCID: PMC10671227 DOI: 10.3390/healthcare11222957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/10/2023] [Accepted: 11/12/2023] [Indexed: 11/25/2023] Open
Abstract
Military personnel in combat face a high risk of developing posttraumatic stress disorder (PTSD). In this study, a protocol-based scoping review was conducted to identify the current status of research on the efficacy of acupuncture for treating combat-related PTSD in military personnel. A literature search was conducted across 14 databases in November 2022, and data from the included studies were collected and descriptively analyzed. A total of eight studies were included. Participants were assessed for core PTSD symptoms using the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-5 and the Clinician-Administered PTSD Scale, as well as related symptoms, such as sleep issues. Although the efficacy of acupuncture has been substantiated in numerous studies, certain metrics did not exhibit improvement. Auricular acupuncture was the most commonly used treatment (50%) followed by manual acupuncture (25%) and a combination of both (25%). Shenmen and Kidney points were frequently targeted at auricular acupoints. The treatment period varied between 5 days and 2 months. While adverse events were reported in two of the fifty-five patients in the intervention group and in four of the sixty-four patients in the control group in the randomized controlled trial studies, no fatal adverse events were reported.
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Affiliation(s)
- Hui-Yong Kwak
- Republic of Korea Army, Capital Defense Command, Gwacheon-daero, Gwanak-gu, Seoul 08801, Republic of Korea;
| | - Jungtae Leem
- Research Center of Traditional Korean Medicine, College of Korean Medicine, Wonkwang University, 460 Iksan-daero, Iksan 54538, Republic of Korea;
| | - Hye-bin Seung
- College of Korean Medicine, Daegu Haany University, 1, Hanuidae-ro, Gyeongsan 38578, Republic of Korea;
| | - Chan-Young Kwon
- Department of Oriental Neuropsychiatry, College of Korean Medicine, Dong-Eui University, Busan 47227, Republic of Korea;
| | - Hye-Seon Jeong
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemoon-gu, Seoul 02447, Republic of Korea;
| | - Sang-Ho Kim
- Department of Neuropsychiatry of Korean Medicine, Pohang Korean Medicine Hospital Affiliated to Daegu Haany University, Pohang 37685, Republic of Korea
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Saw HW, Owens V, Morales SA, Rodriguez N, Kern C, Bach RL. Population mental health in Burma after 2021 military coup: online non-probability survey - CORRIGENDUM. BJPsych Open 2023; 9:e204. [PMID: 37937976 PMCID: PMC10753964 DOI: 10.1192/bjo.2023.584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2023] Open
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Colesar MT, Baker JB. Yugoslav Guerrilla Hospital Design Features and Operation in World War II. J Spec Oper Med 2023; 23:24-31. [PMID: 37224389 DOI: 10.55460/t4a2-py3c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/01/2023] [Indexed: 05/26/2023]
Abstract
In the most austere combat conditions, Yugoslav guerillas of World War II (WWII) demonstrated an innovative and effective hospitalization system that saved countless lives. Yugoslav Partisans faced extreme medical and logistical challenges that spurred innovation while waging a guerrilla war against the Nazis. Partisans used concealed hospitals ranging between 25 to 215 beds throughout the country with wards that were often subterranean. Concealment and secrecy prevented discovery of many wards, which prototypically contained two bunk levels and held 30 patients in a 3.5 × 10.5-meter space that included storage and ventilation. Backup storage and treatment facilities provided critical redundancy. Intra-theater evacuation relied on pack animals and litter bearers while partisans relied on Allied fixed wing aircraft for inter-theater evacuation.
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Saw HW, Owens V, Morales SA, Rodriguez N, Kern C, Bach RL. Population mental health in Burma after 2021 military coup: online non-probability survey. BJPsych Open 2023; 9:e156. [PMID: 37575042 PMCID: PMC10594092 DOI: 10.1192/bjo.2023.550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 07/04/2023] [Accepted: 07/12/2023] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND Humanitarian crises and armed conflicts lead to a greater prevalence of poor population mental health. Following the 1 February 2021 military coup in Burma, the country's civilians have faced humanitarian crises that have probably caused rising rates of mental disorders. However, a dearth of data has prevented researchers from assessing the extent of the problem empirically. AIMS To better understand prevalence of depressive and anxiety disorders among the Burmese adult population after the February 2021 military coup. METHOD We fielded an online non-probability survey of 7720 Burmese adults aged 18 and older during October 2021 and asked mental health and demographic questions. We used the Patient Health Questionnaire-4 to measure probable depression and anxiety in respondents. We also estimated logistic regressions to assess variations in probable depression and anxiety across demographic subgroups and by level of trust in various media sources, including those operated by the Burmese military establishment. RESULTS We found consistently high rates of probable anxiety and depression combined (60.71%), probable depression (61%) and probable anxiety (58%) in the sample overall, as well as across demographic subgroups. Respondents who 'mostly' or 'completely' trusted military-affiliated media sources (about 3% of the sample) were significantly less likely than respondents who did not trust these sources to report symptoms of anxiety and depression (AOR = 0.574; 95% CI 0.370-0.889), depression (AOR = 0.590; 95% CI 0.383-0.908) or anxiety (AOR = 0.609; 95% CI 0.390-0.951). CONCLUSIONS The widespread symptoms of anxiety and depression we observed demonstrate the need for both continuous surveillance of the current situation and humanitarian interventions to address mental health needs in Burma.
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Affiliation(s)
- Htay-Wah Saw
- Michigan Program in Survey and Data Science, University of Michigan, Ann Arbor, USA
| | | | - Stephanie A. Morales
- Michigan Program in Survey and Data Science, University of Michigan, Ann Arbor, USA
| | - Nicolas Rodriguez
- Michigan Program in Survey and Data Science, University of Michigan, Ann Arbor, USA
| | | | - Ruben L. Bach
- Mannheim Centre for European Social Research (MZES), University of Mannheim, Mannheim, Germany
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Gutema G, Kaba M, Birhanu Z, Diribi J, Elemo I. Impact of Armed Conflicts on Public Health Infrastructure and Services in Oromia, Ethiopia. Cureus 2023; 15:e40653. [PMID: 37476107 PMCID: PMC10356178 DOI: 10.7759/cureus.40653] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2023] [Indexed: 07/22/2023] Open
Abstract
Background Oromia is the largest national regional state in the Ethiopian federation. It covers over a third of the country's landmass. In terms of sheer geography, Oromia is about the size of the sovereign European state of Germany. Demographically, Oromia closely matches with Poland among other European countries. Since early 2019, there are actively ongoing armed conflicts in Oromia damaging the public health infrastructure and hampering the provision of healthcare services. Objective The objective of this study is to assess and document the impacts of armed conflicts in Oromia on the public health infrastructure. Method The study is a quantitative review of administrative records and reports employing a qualitative analytical prism. Results Oromia has 22 administrative zones of which 11 (50%) host 142 sites sheltering about 1.5 million Internally Displaced Persons (IDPs). A total of 1072 public healthcare facilities sustained attacks in areas of armed conflicts across Oromia. Among the 159 motor vehicles attacked (ambulances, district health office cars and motorbikes), 44% were ambulances. Only for the first two weeks of January 2023, 25,580 Severe Acute Malnutrition (SAM) cases were reported by healthcare facilities from the areas affected by armed conflicts in Oromia. In these areas, 11,740 patients with malnutrition were enrolled into the Outpatient Therapeutic Program (OTP), 1050 were put on subcutaneous infusion (SC) and seven died due to SAM only in the first two weeks of January 2023. Severe droughts that happened for five consecutive rainy seasons over the last three years have hit hard 10 administrative zones in Oromia, thereby compounding the impacts of the armed conflicts. Conclusions Armed conflicts are damaging the public health infrastructure and hampering healthcare provisions in Oromia. Such conflicts are evicting people from their residential places thereby forcing them to live in poorly thatched out temporary shelters with clear implication for serious health crises. When compounded with natural calamities such as climate-change-driven drought, the impacts of such conflicts on public health infrastructure and the resultant constraints on provision of vital public healthcare services would be paramount. The authors recommend for further detailed studies on the sustained impacts that these armed conflicts can possibly bring on the provision of vital public health services in Oromia.
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Affiliation(s)
- Girma Gutema
- Pharmacology, Rift Valley University, Adama, ETH
| | - Mirgissa Kaba
- Community Health, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, ETH
| | - Zewdie Birhanu
- Epidemiology and Public Health, School of Public Health, Jimma University, Jimma, ETH
| | - Jilcha Diribi
- General Practice, Oromia Physicians Association, Addis Ababa, ETH
| | - Ibrahim Elemo
- Hospital Medicine, University of Minnesota Medical Center, Minnesota, USA
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15
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Sundaram M, Filion A, Akaribo BE, Stephens PR. Footprint of war: integrating armed conflicts in disease ecology. Trends Parasitol 2023; 39:238-241. [PMID: 36803860 PMCID: PMC10194412 DOI: 10.1016/j.pt.2023.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 02/18/2023]
Abstract
War is an understudied and yet significant contributor to disease outbreaks, necessitating approaches incorporating conflicts into disease studies. We discuss mechanisms by which war affects disease dynamics, and supply an illustrative example. Lastly, we provide relevant data sources and pathways for incorporating metrics of armed conflict into disease ecology.
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Affiliation(s)
- Mekala Sundaram
- Department of Integrative Biology, 501 Life Sciences West, Oklahoma State University, Stillwater, OK 74078, USA
| | - Antoine Filion
- Department of Integrative Biology, 501 Life Sciences West, Oklahoma State University, Stillwater, OK 74078, USA.
| | - Benedicta E Akaribo
- Department of Integrative Biology, 501 Life Sciences West, Oklahoma State University, Stillwater, OK 74078, USA
| | - Patrick R Stephens
- Department of Integrative Biology, 501 Life Sciences West, Oklahoma State University, Stillwater, OK 74078, USA
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16
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Parkhomenko A. Russia's War in Ukraine and Cardiovascular Health Care. Circulation 2023; 147:779-781. [PMID: 36877770 DOI: 10.1161/circulationaha.122.063196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Affiliation(s)
- Alexander Parkhomenko
- Emergency Cardiology Department, National Scientific Center named after M.D. Strazhesko of the National Academy of Medical Sciences, Kyiv, Ukraine
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17
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Riad A, Drobov A, Alkasaby MA, Peřina A, Koščík M. Nuclear Anxiety Amid the Russian-Ukrainian War 2022 (RUW-22): Descriptive Cross-Sectional Study. Int J Environ Res Public Health 2023; 20:3551. [PMID: 36834256 PMCID: PMC9962827 DOI: 10.3390/ijerph20043551] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
Nuclear anxiety, which refers to the fear of nuclear war and its consequences, is expected to increase amid the Russian-Ukrainian War of 2022 (RUW-22). This study aimed to evaluate the prevalence of nuclear anxiety and its associated variables among university students in the Czech Republic during the first weeks of RUW-22. A cross-sectional survey-based study was carried out from March-April 2022, utilizing a digital self-administered questionnaire (SAQ) to collect data from the target population. The SAQ consisted of multiple-choice items inquiring about demographic characteristics; generalized anxiety symptoms using generalized anxiety disorder-7 (GAD-7); depressive symptoms using patient health questionnaire-9 (PHQ-9); and attitudes towards civilian uses of nuclear power, and nuclear war-related anxiety. Of the 591 participating students, 67.7% were females, 68.2% were Czech nationals, and 61.8% followed the RUW-22 news at least once daily. The mean GAD-7 score of our participants was 7.86 ± 5.32 (0-21); and their mean PHQ-9 score was 8.66 ± 6.29 (0-27). Regarding the civilian uses of nuclear power, most participants agreed that nuclear power was safe (64.5%), denied being afraid that civilian use of nuclear power might deteriorate their health (79.7%), and thought that public acceptance was important for building new nuclear power plants (56.9%). About 42.1% and 45.5% of the participants reported feeling depressed at the possibility of nuclear war and agreed that the chances that there would be a nuclear war in their lifetime were very high, respectively. When asked about their preparedness measures during the previous four weeks, less than one quarter (23.9%) reported looking for recommendations for protection against nuclear accidents, and less than one-fifth (19.3%) were looking for the nearest bomb shelter. The depression about nuclear war possibility was positively and relatively strongly correlated with the level of "feeling concerned about the RUW-22" (rs = 0.401), and it was moderately correlated with GAD-7 (rs = 0.377) and PHQ-9 (rs = 0.274) scores and weakly correlated with RUW-2-related news-following frequency (rs = 0.196). Within the limitations of the present study, nuclear anxiety was common among Czech university students. Its associated factors may include but are not limited to the female gender; common psychological disorders such as generalized anxiety and depression; RUW-22-related news following-frequency; and the level of "feeling concerned".
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Affiliation(s)
- Abanoub Riad
- Department of Public Health, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Anton Drobov
- Department of Public Health, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | | | - Aleš Peřina
- Department of Public Health, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Michal Koščík
- Department of Public Health, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
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18
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Carpiniello B. The Mental Health Costs of Armed Conflicts-A Review of Systematic Reviews Conducted on Refugees, Asylum-Seekers and People Living in War Zones. Int J Environ Res Public Health 2023; 20:2840. [PMID: 36833537 PMCID: PMC9957523 DOI: 10.3390/ijerph20042840] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/31/2023] [Accepted: 02/03/2023] [Indexed: 06/18/2023]
Abstract
AIMS Armed conflicts produce a wide series of distressing consequences, including death, all of which impact negatively on the lives of survivors. This paper focuses specifically on the mental health consequences of war on adults and child/adolescent refugees or those living in war zones through a review of all systematic reviews and/or meta-analyses published from 2005 up until the current time. RESULTS Fifteen systematic reviews and/or meta-analyses conducted in adult populations, and seven relating to children and adolescents, were selected for the purpose of this review. Prevalence rates of anxiety, depression and post-traumatic stress disorder (PTSD) were two- to three-fold higher amongst people exposed to armed conflict compared to those who had not been exposed, with women and children being the most vulnerable to the outcome of armed conflicts. A series of war-related, migratory and post-migratory stressors contribute to short- and long-term mental health issues in the internally displaced, asylum seekers and refugees. CONCLUSION It should be a required social responsibility for all psychiatrists and psychiatric associations to commit to raising awareness amongst political decision-makers as to the mental health consequences caused by armed conflicts, as part of their duty of care for people experiencing the consequences of war.
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Affiliation(s)
- Bernardo Carpiniello
- Section of Psychiatry, Department of Medical Science and Public Health, University of Cagliari & Psychiatric Unit, University Hospital, 09127 Cagliari, Italy
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19
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Massag J, Diexer S, Klee B, Costa D, Gottschick C, Broda A, Purschke O, Opel N, Binder M, Sedding D, Frese T, Girndt M, Hoell J, Moor I, Rosendahl J, Gekle M, Mikolajczyk R. Anxiety, depressive symptoms, and distress over the course of the war in Ukraine in three federal states in Germany. Front Psychiatry 2023; 14:1167615. [PMID: 37181901 PMCID: PMC10172594 DOI: 10.3389/fpsyt.2023.1167615] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 04/06/2023] [Indexed: 05/16/2023] Open
Abstract
Introduction The Russian invasion of Ukraine and the resulting consequences are in the center of political discussions, media, and likely individual thinking of the population in Germany. Yet, the impact of this prolonged exposure on mental health is not known hitherto. Methods Using the population based cohort study DigiHero from three federal states (Saxony-Anhalt, Saxony, and Bavaria), we assessed anxiety levels (GAD-7), depressive symptoms (PHQ-9), and distress (modified PDI) in the first weeks of war and 6 months later. Results Of those 19,432, who responded in the first weeks of war, 13,934 (71.1%) responded also 6 months later. While anxiety and emotional distress decreased during the 6 months, their average scores were still elevated, and a substantial fraction of respondents displayed clinically relevant sequelae. Persons from low-income households were especially affected, specifically by fears related to the personal financial situation. Those who reacted with a particularly strong fear in the beginning of war were more likely to have persistent clinically relevant symptoms of depression and anxiety also 6 months later. Discussion The Russian invasion of Ukraine is accompanied by continuing impairment of mental health in the German population. Fears surrounding the personal financial situation are a strong determinant.
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Affiliation(s)
- Janka Massag
- Institute for Medical Epidemiology, Biometry and Informatics (IMEBI), Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Sophie Diexer
- Institute for Medical Epidemiology, Biometry and Informatics (IMEBI), Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Bianca Klee
- Institute for Medical Epidemiology, Biometry and Informatics (IMEBI), Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Daniela Costa
- Institute for Medical Epidemiology, Biometry and Informatics (IMEBI), Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Cornelia Gottschick
- Institute for Medical Epidemiology, Biometry and Informatics (IMEBI), Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Anja Broda
- Institute for Medical Epidemiology, Biometry and Informatics (IMEBI), Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Oliver Purschke
- Institute for Medical Epidemiology, Biometry and Informatics (IMEBI), Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Nils Opel
- Department for Psychiatry and Psychotherapy, University Hospital, Friedrich Schiller University Jena, Jena, Germany
- German Center for Mental Health, Site Jena-Magdeburg-Halle, Jena, Germany
| | - Mascha Binder
- Department of Internal Medicine IV, Oncology/Haematology, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Daniel Sedding
- Department of Cardiology and Intensive Care Medicine, Mid-German Heart Centre, University Hospital, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Thomas Frese
- Institute of General Practice and Family Medicine, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Matthias Girndt
- Department of Internal Medicine II, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Jessica Hoell
- Paediatric Haematology and Oncology, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Irene Moor
- Institute for Medical Sociology, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Jonas Rosendahl
- Department of Internal Medicine I, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Michael Gekle
- Julius-Bernstein-Institute of Physiology, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Rafael Mikolajczyk
- Institute for Medical Epidemiology, Biometry and Informatics (IMEBI), Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
- German Center for Mental Health, Site Jena-Magdeburg-Halle, Jena, Germany
- *Correspondence: Rafael Mikolajczyk,
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20
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Riad A, Drobov A, Krobot M, Antalová N, Alkasaby MA, Peřina A, Koščík M. Mental Health Burden of the Russian-Ukrainian War 2022 (RUW-22): Anxiety and Depression Levels among Young Adults in Central Europe. Int J Environ Res Public Health 2022; 19:ijerph19148418. [PMID: 35886269 PMCID: PMC9318466 DOI: 10.3390/ijerph19148418] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/01/2022] [Accepted: 07/07/2022] [Indexed: 12/28/2022]
Abstract
Armed conflicts are public health emergencies that affect human lives at multiple levels. The mental health of adolescents and young adults is at high risk during crisis settings; therefore, this cross-sectional survey-based study aimed to evaluate anxiety and depressive symptoms among university students in the Czech Republic following the Russian-Ukrainian war of 2022 (RUW-22). The study used standardized screening instruments; the Generalized Anxiety Disorder (GAD-7) for anxiety and the Patient Health Questionnaire (PHQ-9) for depression. Of 591 students who participated in this study, 67.7% were females, 68.2% held Czech citizenship, and 63.8% were enrolled in medical or healthcare programs. The participants were highly concerned about the RUW-22 news, with a mean score of 7.17 ± 2.50 (0–10). While 34% and 40.7% of the participants in this study manifested moderate to severe levels of anxiety and depression, respectively, the mental health burden of the RUW-22 was confirmed by the positive correlation between “feeling concerned”, GAD-7 (ρ = 0.454), and PHQ-9 (ρ = 0.326). Female gender, higher frequency of news following, and social media use were associated with higher levels of anxiety and depressive symptoms; thus, proposing them to be risk factors for psychological disorders following the RUW-22.
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Affiliation(s)
- Abanoub Riad
- Department of Public Health, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic; (A.D.); (M.K.); (N.A.); (A.P.)
- Correspondence: (A.R.); (M.K.)
| | - Anton Drobov
- Department of Public Health, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic; (A.D.); (M.K.); (N.A.); (A.P.)
| | - Martin Krobot
- Department of Public Health, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic; (A.D.); (M.K.); (N.A.); (A.P.)
| | - Natália Antalová
- Department of Public Health, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic; (A.D.); (M.K.); (N.A.); (A.P.)
- Department of Health Sciences, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic
| | | | - Aleš Peřina
- Department of Public Health, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic; (A.D.); (M.K.); (N.A.); (A.P.)
| | - Michal Koščík
- Department of Public Health, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic; (A.D.); (M.K.); (N.A.); (A.P.)
- Correspondence: (A.R.); (M.K.)
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21
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Beauté J, Kramarz P. Public health surveillance in countries hosting displaced people from Ukraine. Euro Surveill 2022; 27:2200430. [PMID: 35656833 PMCID: PMC9164672 DOI: 10.2807/1560-7917.es.2022.27.22.2200430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Indexed: 11/20/2022] Open
Affiliation(s)
- Julien Beauté
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Piotr Kramarz
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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22
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Moreno-Chaparro J, Piñeros-Ortiz S, Rodríguez-Ramírez L, Urrego-Mendoza Z, Samacá-Samacá D, Garzón-Orjuela N, Eslava-Schmalbach J. Mental health consequences of armed conflicts in adults: an overview. Actas Esp Psiquiatr 2022; 50:68-91. [PMID: 35312994 PMCID: PMC10803861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 03/01/2022] [Indexed: 06/14/2023]
Abstract
Armed conflicts (AC) in the world are still active and lead to the growth of violence, with a possible impact on mental health (MH).
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Affiliation(s)
- Jaime Moreno-Chaparro
- Health Equity Research Group, Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia
- School of Medicine, Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Sandra Piñeros-Ortiz
- Violence and Health Research Group, Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia
- Department of Psychiatry, Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Laura Rodríguez-Ramírez
- Health Equity Research Group, Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Zulma Urrego-Mendoza
- Violence and Health Research Group, Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia
- Department of Public Health, Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Daniel Samacá-Samacá
- Health Equity Research Group, Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Nathaly Garzón-Orjuela
- Health Equity Research Group, Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Javier Eslava-Schmalbach
- Health Equity Research Group, Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia
- Hospital Universitario Nacional de Colombia, Bogotá, Colombia
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23
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Khorram-Manesh A, Burkle FM, Goniewicz K, Robinson Y. Estimating the Number of Civilian Casualties in Modern Armed Conflicts-A Systematic Review. Front Public Health 2021; 9:765261. [PMID: 34778192 PMCID: PMC8581199 DOI: 10.3389/fpubh.2021.765261] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/01/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: To examine the possibility of estimating the number of civilian casualties in modern armed conflicts. Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, using PubMed, Scopus, and Web of Science search engines. The outcome was analyzed using a qualitative inductive thematic analysis. The scientific evidence of selected article was assessed, using the Health Evidence Quality Assessment Tool. Findings: The review of 66 included articles in this study indicates that with an increasing number of public health emergencies and the lack of vital elements of life such as water and food, emerging armed conflicts seem to be inevitable. In contrast to military-led cross-border traditional wars, modern armed conflicts affect internally on local communities and take civilian lives. Consequently, the measures and tools used in traditional military-led cross-border wars to adequately tally wounded and dead for many decades under the mandates of the International Humanitarian Law, is insufficient for modern warfare. While casualty counting during modern conflicts is deficient due to organizational, political or strategic reasons, the international organizations responsible for collecting such data (the International Federation of Red Cross and Red Crescent and International Institute of Humanitarian Law) face difficulties to access the conflict scene, resulting in under-reported, unreliable or no-reported data. Conclusion: There are challenges in estimating and counting the number of civilian casualties in modern warfare. Although the global need for such data is evident, the risks and barriers to obtaining such data should be recognized, and the need for new international involvement in future armed conflicts should be emphasized.
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Affiliation(s)
- Amir Khorram-Manesh
- Institute of Clinical Sciences, Gothenburg University, Sahlgrenska Academy, Gothenburg, Sweden.,Department of Research and Development, Armed Forces Center for Defense Medicine, Gothenburg, Sweden
| | - Frederick M Burkle
- Harvard Humanitarian Initiative, T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
| | - Krzysztof Goniewicz
- Department of Aviation Security, Military University of Aviation, Dȩblin, Poland
| | - Yohan Robinson
- Institute of Clinical Sciences, Gothenburg University, Sahlgrenska Academy, Gothenburg, Sweden.,Department of Research and Development, Armed Forces Center for Defense Medicine, Gothenburg, Sweden
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24
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Piñeros-Ortiz S, Moreno-Chaparro J, Garzón-Orjuela N, Urrego-Mendoza Z, Samacá-Samacá D, Eslava-Schmalbach J. Mental health consequences of armed conflicts in children and adolescents: An overview of literature reviews. Biomedica 2021; 41:424-448. [PMID: 34559491 PMCID: PMC8525875 DOI: 10.7705/biomedica.5447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 02/24/2021] [Indexed: 11/21/2022]
Abstract
Introduction: Armed conflicts affect the mental health of children and adolescents. Their outcomes in these populations have been documented identifying vulnerability and significant biopsychosocial damage as the most common factors. Objective: To identify and synthesize the mental health consequences of armed conflicts in children and adolescents. Materials and methods: We carried out a comprehensive and systematic search of reviews published until July 2019 in the MEDLINE (Ovid), EMBASE, Cochrane Central Register of Controlled Trials, and LILACS databases, as well as in additional sources. The information was retrieved and analyzed narratively by describing the characteristics and objectives of the studies and the mental health consequences of armed conflicts in three periods of time: pre-armed conflict, during the armed conflict, and post-conflict. Results. Out of 587 potentially relevant studies, we finally selected 72. In the pre-armed conflict period, we described in detail the psychological experiences and the anticipatory somatic symptoms. During the conflict, we identified regressive, behavioral, and cognitive symptoms such as enuresis, fear, sadness, aggression, hyperactivity, and inattention, among others. Direct mental health consequences such as adjustment disorders, depression, anxiety, and post-traumatic stress were also identified. Finally, in the postconflict period, we referred to the transmission of mental health consequences and resilience processes. On the other hand, we reviewed in depth the potential consequences of armed conflicts on biopsychosocial development, morality, identity, culture, education, and society. Conclusion. The development of mental health consequences due to the exposure to armed conflicts in these populations is a complex process that depends on the stage of the exposure, the length of the conflict, and contextual factors.
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Affiliation(s)
- Sandra Piñeros-Ortiz
- Grupo de Investigación Violencia y Salud, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia; Departamento de Psiquiatría, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia.
| | - Jaime Moreno-Chaparro
- Grupo de Investigación en Equidad en Salud, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia; Escuela de Medicina, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D. C., Colombia.
| | - Nathaly Garzón-Orjuela
- Grupo de Investigación en Equidad en Salud, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia.
| | - Zulma Urrego-Mendoza
- Grupo de Investigación Violencia y Salud, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia; Departamento de Salud Pública, Facultad de Medicina, Universidad Nacional de Colombia,Bogotá, D.C., Colombia.
| | - Daniel Samacá-Samacá
- Grupo de Investigación en Equidad en Salud, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia.
| | - Javier Eslava-Schmalbach
- Grupo de Investigación en Equidad en Salud, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia; Hospital Universitario Nacional de Colombia, Universidad Nacional de Colombia, Bogotá, D. C., Colombia.
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25
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Zhai Y, Jiang D, Gozgor G, Cho E. The Amplifying Effect of Conflicts on Case Fatality Rate of COVID-19: Evidence From 120 Countries. Front Public Health 2021; 9:681604. [PMID: 34422745 PMCID: PMC8371391 DOI: 10.3389/fpubh.2021.681604] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 06/29/2021] [Indexed: 12/19/2022] Open
Abstract
Using the COVID-19 database of Johns Hopkins University, this study examines the determinants of the case fatality rate of COVID-19. We consider various potential determinants of the mortality risk of COVID-19 in 120 countries. The Ordinary Least Squares (OLS) and the Kernel-based Regularized Least Squares (KRLS) estimations show that internal and external conflicts are positively related to the case fatality rates. This evidence is robust to the exclusion of countries across different regions. Thus, the evidence indicates that conflict may explain significant differences in the case fatality rate of COVID-19 across countries.
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Affiliation(s)
- Yonghui Zhai
- School of Business, Henan Normal University, Xinxiang, China
| | - Dayang Jiang
- School of Economics, Tianjin University of Commerce, Tianjin, China
| | - Giray Gozgor
- Faculty of Political Sciences, Istanbul Medeniyet University, Istanbul, Turkey
| | - Eunho Cho
- Accounting and Finance Department, North Carolina Agricultural and Technical State University, Greensboro, NC, United States
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Mirzekhanov VS, Trunov PO. Germany's Approach to Resolving the Conflict in Mali. Her Russ Acad Sci 2021; 91:223-229. [PMID: 34131374 PMCID: PMC8192110 DOI: 10.1134/s1019331621020167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/01/2021] [Accepted: 03/24/2021] [Indexed: 06/12/2023]
Abstract
In this century the nature of many conflicts has changed: instead of common interstate feuds, the world has faced intrastate conflicts but with an international background. The active participation of nonstate actors in modern conflicts has made them much less manageable and their resolution much more complicated, including the efforts undertaken by international intermediaries. In the middle and the second half of the 2010s, the countries of the West, first of all, France and Germany, focused enormous efforts on resolving an armed conflict in the Republic of Mali. At first glimpse, these efforts contradict the uprising of Mali's military in August 2020 which removed from power the national civil government headed by the incoming president. The questions raised in this article concern what new elements appeared in the course of relaunching the peace settlement in Mali in 2020 and to what extent nonstandard practices meet the interests of the members of the Euroatlantic Community represented by Germany. This country is chosen as an example due to the long-term trend for the growth of its influence in Africa and the World in general.
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Affiliation(s)
- V. S. Mirzekhanov
- Institute of World History, Russian Academy of Sciences, 119334 Moscow, Russia
- Institute of Scientific Information for Social Sciences, Russian Academy of Sciences (INION RAS), 117418 Moscow, Russia
| | - Ph. O. Trunov
- Institute of Scientific Information for Social Sciences, Russian Academy of Sciences (INION RAS), 117418 Moscow, Russia
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Al-Makhamreh H, Alkhulaifat D, Al-Ani A, Mafrachi B, Saadeh A, Al-Ani H, Bani Hani A, AlRyalat SA. The Impact of War-Related Stress on Coronary Artery Disease Severity in War Survivors: A SYNTAX Study. Int J Environ Res Public Health 2021; 18:3233. [PMID: 33800972 DOI: 10.3390/ijerph18063233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/16/2021] [Accepted: 03/18/2021] [Indexed: 12/13/2022]
Abstract
Background: Due to the strong relationship between stress and heart disease, particularly acute myocardial infarction (MI), this study investigated the complexity of coronary artery disease (CAD) among Syrian refugee patients referred to Jordan University Hospital and its relation to war-related stressors. Methods: This is a retrospective study that utilized the SYNTAX I score in order to evaluate all Syrian refugees that underwent coronary artery catheterization at Jordan University Hospital during the period between May of 2014 and December of 2017. Results: There was a significant association between war-related stressors and high SYNTAX score (SX score), thus indicating a higher complexity of CAD in Syrian war survivors with higher stress scores. The strongest war-related correlation was observed with crossing green-lines, in which Syrian refugee patients who had crossed such lines had significantly higher SYNTAX scores. Regression analysis demonstrated that war stressors were positive predictors of increased SYNTAX scores even when adjusted for conventional CAD risk factors. Surprisingly, none of the CAD risk factors were significantly associated with SYNTAX score. Conclusion: Our findings suggest that exposure to multiple war-related stressors may increase the complexity and severity of CAD in Syrian war survivors. Thus, special attention, efforts, and resources should be allocated to screen for such vulnerable patients in order to provide them with the appropriate healthcare.
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Mani ZA, Kuhn L, Plummer V. Common Domains of Core Competencies for Hospital Health Care Providers in Armed Conflict Zones: A Systematic Scoping Review. Prehosp Disaster Med 2020; 35:442-6. [PMID: 32338234 DOI: 10.1017/S1049023X20000503] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
INTRODUCTION High rates of mortality and morbidity result from disasters of all types, including armed conflicts. Overwhelming numbers of casualties with a myriad of illnesses and patterns of injuries are common in armed conflicts, leading to unpredictable workloads for hospital health care providers (HCPs). Identifying domains of hospital HCPs' core competency for armed conflicts is essential to inform standards of care, educational requirements, and to facilitate the translation of knowledge into safe and quality care. OBJECTIVE The objective of this study is to identify the common domains of core competencies among HCPs working in hospitals in armed conflict areas. METHODS A scoping review was conducted using the Joanna Briggs Institute framework. The review considered primary research and peer-reviewed literature from the following databases: Ovid Medline, Ovid EmCare, Embase, and CINAHL, as well as the reference lists of articles identified for full-text review. Eligibility criteria were outlined a priori to guide the literature selection. RESULTS Four articles met the inclusion criteria. The studies were conducted in different countries and were published from 2011 through 2017. The methods included three surveys and one Delphi study. CONCLUSION This review maps the scope of knowledge, skills, and attitudes required by HCPs who are practicing in hospitals in areas of major armed conflict. Incorporation of identified core competency domains can improve the future planning, education, and training, and may enhance the HCPs' response in armed conflicts.
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Gale HL, Borgman MA, April MD, Schauer SG. Pediatric Trauma Patient Intensive Care Resource Utilization in U.S. Military Operations in Iraq and Afghanistan. Crit Care Explor 2019; 1:e0062. [PMID: 32166243 DOI: 10.1097/CCE.0000000000000062] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Children represent a unique patient population treated by military personnel during wartime, as seen in the recent conflicts in Iraq and Afghanistan. We sought to describe ICU resource utilization by U.S. military personnel treating pediatric trauma patients in Iraq and Afghanistan.
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Cuesta JG, Trelles M, Naseer A, Momin A, Mulamira LN, Caluwaerts S, Guha-Sapir D. Does the presence of conflict affect maternal and neonatal mortality during Caesarean sections? Public Health Action 2019; 9:107-112. [PMID: 31803582 DOI: 10.5588/pha.18.0045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 06/21/2019] [Indexed: 11/10/2022] Open
Abstract
Introduction Conflicts frequently occur in countries with high maternal and neonatal mortality and can aggravate difficulties accessing emergency care. No literature is available on whether the presence of conflict influences the outcomes of mothers and neonates during Caesarean sections (C-sections) in high-mortality settings. Objective To determine whether the presence of conflict was associated with changes in maternal and neonatal mortality during C-sections. Methods We analysed routinely collected data on C-sections from 17 Médecins Sans Frontières (MSF) health facilities in 12 countries. Exposure variables included presence and intensity of conflict, type of health facility and other types of access to emergency care. Results During 2008-2015, 30,921 C-sections were performed in MSF facilities; of which 55.4% were in areas of conflict. No differences were observed in maternal mortality in conflict settings (0.1%) vs. non-conflict settings (0.1%) (P = 0.08), nor in neonatal mortality between conflict (12.2%) and non-conflict settings (11.5%) (P = 0.1). Among the C-sections carried out in conflict settings, neonatal mortality was slightly higher in war zones compared to areas of minor conflict (P = 0.02); there was no difference in maternal mortality (P = 0.38). Conclusions Maternal and neonatal mortality did not appear to be affected by the presence of conflict in a large number of MSF facilities. This finding should encourage humanitarian organisations to support C-sections in conflict settings to ensure access to quality maternity care.
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Affiliation(s)
- J Gil Cuesta
- Operational Centre Brussels, Médecins Sans Frontières, Brussels, Belgium
| | - M Trelles
- Operational Centre Brussels, Médecins Sans Frontières, Brussels, Belgium
| | - A Naseer
- Timurgara Hospital, Operational Centre Brussels, Médecins Sans Frontières, Timurgara, Pakistan
| | - A Momin
- Operational Centre Brussels, Médecins Sans Frontières, Ahmad Shah Baba Hospital, Kabul, Afghanistan
| | - L Ngabo Mulamira
- Masisi Hospital, Operational Centre Brussels, Médecins Sans Frontières, Masisi, Democratic Republic of Congo
| | - S Caluwaerts
- Operational Centre Brussels, Médecins Sans Frontières, Brussels, Belgium
| | - D Guha-Sapir
- Centre for Research on the Epidemiology of Disasters, Université Catholique de Louvain, Brussels, Belgium
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Spiegel P, Ratnayake R, Hellman N, Ververs M, Ngwa M, Wise PH, Lantagne D. Responding to epidemics in large-scale humanitarian crises: a case study of the cholera response in Yemen, 2016-2018. BMJ Glob Health 2019; 4:e001709. [PMID: 31406596 PMCID: PMC6666825 DOI: 10.1136/bmjgh-2019-001709] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 06/06/2019] [Accepted: 06/08/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Large epidemics frequently emerge in conflict-affected states. We examined the cholera response during the humanitarian crisis in Yemen to inform control strategies. METHODS We conducted interviews with practitioners and advisors on preparedness; surveillance; laboratory; case management; malnutrition; water, sanitation and hygiene (WASH); vaccination; coordination and insecurity. We undertook a literature review of global and Yemen-specific cholera guidance, examined surveillance data from the first and second waves (28 September 2016-12 March 2018) and reviewed reports on airstrikes on water systems and health facilities (April 2015-December 2017). We used the Global Task Force on Cholera Control's framework to examine intervention strategies and thematic analysis to understand decision making. RESULTS Yemen is water scarce, and repeated airstrikes damaged water systems, risking widespread infection. Since a cholera preparedness and response plan was absent, on detection, the humanitarian cluster system rapidly developed response plans. The initial plans did not prioritise key actions including community-directed WASH to reduce transmission, epidemiological analysis and laboratory monitoring. Coordination was not harmonised across the crisis-focused clusters and epidemic-focused incident management system. The health strategy was crisis focused and was centralised on functional health facilities, underemphasising less accessible areas. As vaccination was not incorporated into preparedness, consensus on its use remained slow. At the second wave peak, key actions including data management, community-directed WASH and oral rehydration and vaccination were scaled-up. CONCLUSION Despite endemicity and conflict, Yemen was not prepared for the epidemic. To contain outbreaks, conflict-affected states, humanitarian agencies, and donors must emphasise preparedness planning and community-directed responses.
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Affiliation(s)
- Paul Spiegel
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center for Humanitarian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ruwan Ratnayake
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Nora Hellman
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center for Humanitarian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Mija Ververs
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center for Humanitarian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Moise Ngwa
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Paul H Wise
- Department of Pediatrics, Stanford University School of Medicine, Stanford University, Stanford, California, USA
- Freeman Spogli Institute for International Studies, Stanford University, Stanford, California, USA
| | - Daniele Lantagne
- Department of Civil and Environmental Engineering, Tufts University, Medford, Massachusetts, USA
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Abstract
Objective To describe the experiences of older adults around forced displacement due to the Colombian armed conflict. Methods Interpretive-comprehensive study, with a hermeneutical approach; several types of sampling were carried out. The participants were 12 people aged over 60 years, who reported having being displaced and who participated in the SABE Colombia Survey. The data were encoded using the Atlas.ti software. A process of condensation of central analytical, support and emerging categories was made. Results The displacement generated by the armed conflict has been decisive in the current life conditions of the participants. They know that they are survivors of someone else's violence; there is dislocation, loss of territory, de-anchoring, lack of protection and insecurity. To the stigma of old age, it is added being displaced and being strangers in a place where they don't belong. They live the violent uprooting of their lands and the confusion of their identity; they found themselves in a foreign scene where they were the unusual and the strangers; from receiving threats, they passed to be labeled as 'threatening'. This forced displacement stems from violence, but also from fear, and it marks the trajectory of life for older people who experience a prolonged struggle for survival in often hostile environments, living "permanently" displaced. Conclusion When there is displacement, older people are not only shed of their land and their home, but also from their cosmos and their vital referents; in addition, it changes their life trajectory and their place in the world. Interventions should be designed based on specific particular and contextual analyses.
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Affiliation(s)
- Carmen-Lucía Curcio
- Universidad de Caldas, Facultad de Ciencias para la Salud. Departamento Clínico, Grupo de Investigación en Gerontología y Geriatría. Manizales, Colombia
| | - José Hoover Vanegas
- Universidad Autónoma de Manizales, Grupo de investigación Cuerpo-Movimiento. Manizales, Colombia
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Schleussner CF, Donges JF, Donner RV, Schellnhuber HJ. Armed-conflict risks enhanced by climate-related disasters in ethnically fractionalized countries. Proc Natl Acad Sci U S A 2016; 113:9216-21. [PMID: 27457927 DOI: 10.1073/pnas.1601611113] [Citation(s) in RCA: 196] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Social and political tensions keep on fueling armed conflicts around the world. Although each conflict is the result of an individual context-specific mixture of interconnected factors, ethnicity appears to play a prominent and almost ubiquitous role in many of them. This overall state of affairs is likely to be exacerbated by anthropogenic climate change and in particular climate-related natural disasters. Ethnic divides might serve as predetermined conflict lines in case of rapidly emerging societal tensions arising from disruptive events like natural disasters. Here, we hypothesize that climate-related disaster occurrence enhances armed-conflict outbreak risk in ethnically fractionalized countries. Using event coincidence analysis, we test this hypothesis based on data on armed-conflict outbreaks and climate-related natural disasters for the period 1980-2010. Globally, we find a coincidence rate of 9% regarding armed-conflict outbreak and disaster occurrence such as heat waves or droughts. Our analysis also reveals that, during the period in question, about 23% of conflict outbreaks in ethnically highly fractionalized countries robustly coincide with climatic calamities. Although we do not report evidence that climate-related disasters act as direct triggers of armed conflicts, the disruptive nature of these events seems to play out in ethnically fractionalized societies in a particularly tragic way. This observation has important implications for future security policies as several of the world's most conflict-prone regions, including North and Central Africa as well as Central Asia, are both exceptionally vulnerable to anthropogenic climate change and characterized by deep ethnic divides.
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Meyer-Parlapanis D, Weierstall R, Nandi C, Bambonyé M, Elbert T, Crombach A. Appetitive Aggression in Women: Comparing Male and Female War Combatants. Front Psychol 2016; 6:1972. [PMID: 26779084 PMCID: PMC4700207 DOI: 10.3389/fpsyg.2015.01972] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 12/09/2015] [Indexed: 02/04/2023] Open
Abstract
Appetitive aggression refers to positive feelings being associated with the perpetration of violent behavior and has been shown to provide resilience against the development of PTSD in combatants returning from the battlefield. Until this point, appetitive aggression has been primarily researched in males. This study investigates appetitive aggression in females. Female and male combatants and civilians from Burundi were assessed for levels of appetitive aggression. In contrast to non-combatants, no sex difference in appetitive aggression could be detected for combatants. Furthermore, each of the female and male combatant groups displayed substantially higher levels of appetitive aggression than each of the male and female civilian control groups. This study demonstrates that in violent contexts, such as armed conflict, in which individuals perpetrate numerous aggressive acts against others, the likelihood for an experience of appetitive aggression increases- regardless of whether the individuals are male or female.
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Affiliation(s)
| | | | - Corina Nandi
- Department of Psychology, University of Konstanz Konstanz, Germany
| | - Manassé Bambonyé
- Department of Clinical Psychology, Université Lumière Bujumbura, Burundi
| | - Thomas Elbert
- Department of Psychology, University of Konstanz Konstanz, Germany
| | - Anselm Crombach
- Department of Psychology, University of KonstanzKonstanz, Germany; Department of Clinical Psychology, Université LumièreBujumbura, Burundi
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Kerouedan D. [Evaluation of France's contributions to the Global Fund to Fight AIDS, Tuberculosis and Malaria: Ten years later]. Med Sante Trop 2014; 24:135-9. [PMID: 24681635 DOI: 10.1684/mst.2014.0309] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
For 30 years, France has been very committed politically in the international combat against AIDS. The discovery of the AIDS virus at the Pasteur Institute in 1983, the AIDS summit meeting convened by Simone Veil in 1994, the excellence of research by French institutions on its virologic and other aspects as well as the socioeconomic and anthropological issues, and the strong commitment to international technical cooperation against this disease - all these have made (and continue to make) France a major political, technical, and financial participant in this battle against the combined pandemic of AIDS and tuberculosis. More than 10 years after the creation of the Global Fund, 5 years after the first evaluation of this Fund, and 2 years before the schedule for meeting the Millennium Development Goals, an assessment commissioned in 2013 from a French consulting firm of the French contributions is timely. The study was expected. Its results are disappointing. Why? Because the team chosen to conduct the assessment has a limited knowledge of the history of the interventions already funded by France and of the results of earlier assessments. The point was not to repeat the same observations but to move forward to see where they lead. In addition, the current and coming challenges are not considered. The countries to which France is providing cooperation are on the continent that after 30 years remains the most heavily affected by the pandemic. Several transitions are occurring there simultaneously: epidemiologic, demographic and urban. These metamorphoses influencing social values quite substantially, as well as risk factors for transmission of the AIDS virus; at the same time, they facilitate overcrowding and the propagation of tuberculosis. Nor do the authors consider the resistance of these infectious agents to the most commonly used drugs. The effects of the propagation of AIDS, of the expansion of armed conflicts in French-speaking Africa and of the sexual violence alongside them are not mentioned, while France is intervening militarily in Mali! I use the observations of this assessment to discuss all these questions.
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