The impact of the Syrian conflict on population well-being

The Longitudinal Relationship Between Close Friendship and Subjective Well-Being: The Chain Mediation Model of Interpersonal Trust and Perceived Social Support

Adolescence is a critical period for developing interpersonal relationships and plays a significant role in the growth of subjective well-being. Establishing positive friendships is one of the most important predictors of subjective well-being. This study employs a longitudinal method, tracking Chinese adolescents to investigate the impact of individuals' number of close friends on subjective well-being by examining the chain mediating roles of interpersonal trust and perceived social support. Data were collected from 987 junior high school students across five schools in Shandong Province and analysed using SPSS 27.0. The results indicate that the number of close friends at Time 1 (T1) significantly positively affects the level of subjective well-being at Time 3 (T3). At Time 2 (T2), perceived social support mediates the relationship between the number of close friends at T1 and subjective well-being at T3. Furthermore, the number of close friends at T1 has a longitudinal mediating effect on subjective well-being at T3. This effect is mediated by interpersonal trust and perceived social support at T2. This study reveals the mechanisms by which the number of close friends influences subjective well-being among Chinese adolescents. The findings highlight the significance of fostering healthy interpersonal relationships among adolescents in China. This can be achieved by promoting initiatives that enhance levels of interpersonal trust and perceived social support within communities, thereby improving overall subjective well-being among adolescents.

Mediating effect of intolerance of uncertainty between feeling of unsafety and depression/well-being among a sample of Lebanese adults

BACKGROUND

Eastern Mediterranean countries, particularly Lebanon, have seen a significant rise in mental disorders, primarily driven by ongoing economic instability, political unrest, and regional conflicts. These conditions fuel feelings of unsafety, which are linked to lower psychological well-being and increased depressive symptoms. Unsafe circumstances inflate apprehension and uncertainty, leaving individuals unable to foresee a stable, secure tomorrow and often trapped in an anticipatory negative thinking state. Therefore, this study posits that in unsafe environments, Intolerance of Uncertainty (IU) may mediate the relationships between the feeling of unsafety and depression/well-being and aims to test this hypothesis among a sample of adults from Lebanon, a frequently crisis-ridden country.

METHODS

A one-time-point online survey was conducted among Lebanese adults from the general population (N = 905; mean age = 27.38 (SD: 9.28); 60% females), recruited anonymously via snowball sampling. The questionnaire included socio-demographic variables and the following Arabic validated scales: Feeling of Unsafety Scale- Arabic (FUSA), World Health Organization Well-Being Index (WHO-5), Patient Health Questionnaire-9 (PHQ-9), and Intolerance of Uncertainty Scale (IUS-12). Statistical analysis was performed using SPSS v.27 with mediation analysis via PROCESS MACRO v3.4 Model 4.

RESULTS

After adjusting for potential confounders, mediation analysis showed that both prospective and inhibitory anxiety fully mediated the association between the feeling of unsafety and depression and partially mediated the association between the feeling of unsafety and well-being. Higher feeling of unsafety was significantly associated with higher prospective and inhibitory anxiety (Beta = 0.32; p < 0.001; 95% CI 0.27; 0.37 and Beta = 0.19; p < 0.001; 95% CI 0.15; 0.23 respectively), which in turn were significantly associated with higher depression (Beta = 0.42; p < 0.001; 95% CI 0.35; 0.48 and Beta = 0.62; p < 0.001; 95% CI 0.54; 0.70 respectively) and lower well-being (Beta = - 0.39; p < 0.001; 95% CI -0.44; -0.33 and Beta = - 0.39; p < 0.001; 95% CI -0.47; -0.32 respectively). It is of note that while higher feeling of unsafety did not show a direct association with higher depression (Beta = - 0.03; p = 0.187; 95% CI -0.09; 0.02 and Beta = -0.02; p = 0.399; 95% CI -0.07; 0.03 respectively), it was significantly and directly associated with lower well-being (Beta = - 0.07; p < 0.01; 95% CI -0.12; -0.03 and Beta = - 0.12; p < 0.001; 95% CI -0.17; -0.07 respectively).

CONCLUSION

The hypothesis that IU mediates the relationships between the feeling of unsafety and depression/well-being is confirmed. This finding highlights a key target for interventions. Psychotherapeutic and public mental health initiatives could enhance psychological well-being by dedicating efforts to promoting uncertainty tolerance, particularly in vulnerable populations facing unstable settings.

The early warning and response systems in Syria: A functionality and alert threshold assessment

Objectives

this study aims to provide an updated evaluation of the functional characteristics of the two Early Warning Systems (EWS) in Syria, EWARS (Early Warning, Alert, and Response System) and EWARN (Early Warning, Alert, and Response Network), and to test different alert threshold methods using World Health Organization guidelines against the data of selected diseases.

Methods

A retrospective analysis of EWARN and EWARS surveillance data assessed functional characteristics. The World Health Organization alert thresholds for measles, acute bloody diarrhea, acute jaundice syndrome, and severe acute respiratory infections were tested using three methods. Sensitivity, specificity, and Youden index determined threshold suitability for each syndrome.

Results

The annual average number of reported cases was 1,140,717 for EWARS and 10,189,415 for EWARN. This study found that the optimal alert thresholds varied among different diseases. The percentile method showed promising results with good sensitivity and specificity. For measles, the 85th percentile threshold had the best results (Youden index = 0.443), whereas for acute bloody diarrhea, it was 75th percentile (Y = 0.532) and for severe acute respiratory infections, it was 90th percentile (Y = 0.653).

Conclusions

This study supports the use of adaptable disease-specific alert thresholds such as the percentile approach. Further research is required to develop statistical methods that can be applied to various early warning systems in conflict contexts.

The Impact of the Ukraine Conflict on the Quality of Life of the Young Population in Romania from a Societal Security Perspective

BACKGROUND/OBJECTIVES

This study examines the perception of young Romanians (aged 18-35) regarding the Ukraine conflict's impact on Romania's national security and quality of life. It focuses on societal security dimensions, analyzing the conflict's regional and international implications, alongside sentiments toward global support for Ukraine.

METHODS

Data were collected via structured questionnaires administered to 848 participants in 2024 and 747 in 2022. Respondents' perceptions of the Ukraine conflict, its influence on national security, and the direct consequences for quality of life were evaluated using the WHOQOL-BREF instrument. Statistical analyses (descriptive, bivariate, multivariate) were employed to explore variations across socio-demographic factors.

RESULTS

The findings indicate that young Romanians appreciate international solidarity with Ukraine but remain cautious about military escalation. While the conflict heightened perceptions of personal and national insecurity, WHOQOL-BREF assessments revealed significant declines in psychological, social, and environmental quality of life indicators from 2022 to 2024. Variations were observed based on age, gender, education level, and residence, with young rural women and those with lower educational attainment experiencing the most pronounced impacts.

CONCLUSIONS

The study underscores the dual challenges of maintaining regional stability and addressing the socio-psychological fallout of conflicts. Despite resilience mechanisms tempering subjective perceptions, objective measures indicate deteriorations in the quality of life among Romania's young population. These findings emphasize the need for targeted policies to support vulnerable groups through mental health initiatives, social support systems, and equitable access to resources.

Influence of Ukraine war on the foreign medical students

Background

Wars are escalating globally with devastating impacts on all aspects of life. The conflict between Ukraine and Russia began on February 24, 2022. Approximately 80,000 students of 155 nationalities were studying in Ukraine when the war started, disrupting their education and forcing many to leave the country. We aimed to determine the physical, emotional, and moral effects of the Ukrainian war on foreign medical students, as well as the secondary impacts of the war on the students due to the ongoing conflict.

Methods

The participants were non-Ukrainian medical students aged 18 years and over, studying at a medical school in Ukraine before the war started. A survey including the depression anxiety stress scales-21 (DASS-21) scale variables, a validated and reliable measure of depression, anxiety, and stress dimensions, and other questions on participants' demographics, education, and current socio-economic status was sent to all eligible students via their registered university emails and distributed using an online link.

Results

A total of 99 students were included in the study. 52 (52.5%) of the students were female and 49 (49.5%) were between the ages of 23 and 24 years old. Participants reported high levels of depression (86.9%) and anxiety (82.8%), with significant percentages experiencing extreme levels: 40.4% for depression and 55.6% for anxiety. Additionally, 74.7% reported feeling stressed, with 18.2% indicating extreme stress. Reasons for leaving Ukraine included safety concerns (67.7%), seeking a more secure educational environment (63.6%), the impact of the ongoing war and conflict on their future (56.6%), and the loss of educational opportunities (28.3%).

Conclusion

It is not easy to predict how the war in Ukraine will affect the education of international students in the near future. This uncertainty situation may explain students' depression, anxiety, and stress. As a result, it is necessary to design effective strategies to maintain the training of health professionals during wartime. Research should be conducted on how to rebuild health education systems after the wartime crises stabilize, both for students who are citizens of the country exposed to war and for foreign students who went to that country to receive education, and solutions for this should be put forward.

Psychological well-being in Europe after the outbreak of war in Ukraine

The Russian invasion of Ukraine on February 24, 2022, has had devastating effects on the Ukrainian population and the global economy, environment, and political order. However, little is known about the psychological states surrounding the outbreak of war, particularly the mental well-being of individuals outside Ukraine. Here, we present a longitudinal experience-sampling study of a convenience sample from 17 European countries (total participants = 1,341, total assessments = 44,894, countries with >100 participants = 5) that allows us to track well-being levels across countries during the weeks surrounding the outbreak of war. Our data show a significant decline in well-being on the day of the Russian invasion. Recovery over the following weeks was associated with an individual's personality but was not statistically significantly associated with their age, gender, subjective social status, and political orientation. In general, well-being was lower on days when the war was more salient on social media. Our results demonstrate the need to consider the psychological implications of the Russo-Ukrainian war next to its humanitarian, economic, and ecological consequences.

Lesser in Lebanon: Reflections on a Short-Term Mission Experience

ABSTRACT

During the aftermath of the Syrian civil war conflict, a short-term mission trip to Lebanon brought insight to this author. Reflection on the ministry of Jesus Christ allowed the author to consider how engagement in a short-term mission affects the individuals one has the intention to serve. Similarities between short-term missions and nursing practice through a biblical lens are considered.

Turkey-Syria Earthquake: The Importance of Providing a Direct Cross-border Support

The 7.8 magnitude earthquake that occurred in southern Turkey on February 6, 2023, has resulted in over 40,000 and 5,000 confirmed deaths in Turkey and Syria, respectively, including substantial infrastructure damage. While Turkey has received assistance from various countries and international organizations, the level of support Syria has received remains unclear. The Assad regime has demanded that aid be sent to the capital Damascus, but this may hinder the delivery of assistance to the areas most severely affected by the earthquake because the affected regions were mainly controlled by rebel forces. One of the biggest challenges in providing aid is accessing the affected region, as the earthquake occurred close to the border between Syria and Turkey, where roads and other infrastructure are poorly constructed. Furthermore, the northwest area of Syria shelters many internally displaced people, and more than 50% of medical facilities are not functioning due to the ongoing conflict, making the situation more hazardous. In light of the experience of the Great East Japan Earthquake, securing direct support routes and dispatching medical personnel to the affected areas is crucial for a gradual recovery from the disaster. Therefore, it is essential for the international community, including Japan, to negotiate with the Assad regime to expand direct support routes and provide support for the dispatch of medical personnel who will remain and work in the affected areas. Humanitarian assistance and political issues should be kept separate to avoid further hindrances to aid delivery.

Conflict and exchange rate valuation: Evidence from the Russia-Ukraine conflict

The Russian-Ukraine conflict is decisive in determining the course of contemporary global politics. The war has a spillover effect, with potentially considerable direct and indirect consequences on economic activity. Therefore, the study evaluates the causal impact of the Russian-Ukraine conflict on the exchange rate of Russia. The results explore that the conflict has a negative effect on the exchange rate and observed rapid depreciation. The outcomes show a rapid divergence from counterfactual predictions, and the actual exchange rate is consistently lower than would have been expected in the absence of conflict. The point-wise causal effect displays an estimate of the exchange rate depreciation following the conflict. In relative terms, the response variable decrease, suggesting that currency depreciation is observed during the intervention period. The counterfactual prediction provides a robust technique for evaluating the size of shocks and can be used as a reference to estimate the genuine impact of the conflict in various ways.

Assessment of the incubating environment for investment in biogas technology in Syria by using AHP and SWOT

In light of the massive energy supply shortage due to the Syrian war since 2011, renewable energy adoption has a high potential to cover the actual energy demand. Hence, this study aims to shed light on the factors that affect investment in biogas technology. With the scarcity of research on alternative energies in Syria, this paper focused on the characteristics of the Syrian environment toward biogas technology adoption. The results show that Syrian society accepts and desires to adopt new technologies, representing an optimal strategy to stimulate biogas technology use and the need to spread awareness about its benefits. The SWOT model was applied to identify strengths, weaknesses, opportunities, and threats facing biogas technology adoption. The analytical hierarchy process model was applied to set priorities and make better decisions related to the knowledge of biogas, acceptance of biogas technology, desire for and common approach for its use, the resulting organic fertilizer, and administrative and financial aspects. The work concludes that the southern region was at the forefront in the areas studied in terms of weights of biogas technology investment criteria, subsequently, the central and later the coastal regions. By presenting a systematic and comprehensive approach, this study represents a roadmap to assist decision-makers in inking decisions related to adopting and deploying biogas technology on a larger scale and contributes to developing a criterion for selecting biogas sites in Syria.

Predicting Social Events with Multimodal Fusion of Spatial and Temporal Dynamic Graph Representations

Big data has been satisfactorily used to solve social issues in several parts of the word. Social event prediction is related to social stability and sustainable development. However, current research rarely takes into account the dynamic connections between event actors and learning robust feature representations of social events. Inspired by the graph neural network, we propose a novel Siamese Spatial and Temporal Dynamic Network for predicting social events. Specifically, we use multimodal data containing news articles and global events to construct dynamic graphs based on word co-occurrences and interactions between event actors. Dynamic graphs can model the evolution of social events. By employing the fusion of spatial and temporal dynamic graph representations from heterogeneous historical data, our proposed model predicts the occurrence of future social events for the target country. Qualitative and quantitative analysis of experiment results on multiple real-word datasets shows that our proposed method is competitive against several approaches for social event prediction.

Risk assessment of the continuity of essential medications for low socioeconomic patients in Syria: a case study of diabetes mellitus

Objectives

During the past decade, the health system in Syria has been devastated due to the ongoing conflict which affected the production of pharmaceuticals as well. Patients of chronic diseases, such as diabetes mellitus, were significantly affected by the shortages of oral anti-diabetic medications, especially those of lower socioeconomic status. The objective of this paper is to study the causes and effects of the shortage of oral anti-diabetic agents in the Syrian market on patients with low socioeconomic status who find difficulties in accessing these medications.

Methods

The methodology of the study includes determining the availability of nationally produced oral anti-diabetic agents in different local pharmacies. Then, it studied the effects of this availability on low socioeconomic status patients whose prescriptions were registered in a local NGO and analysed using Microsoft Excel (Microsoft, USA).

Key findings

The study shows that many of the anti-diabetic medications included in the study have less than 50% availability in the pharmacies. Metformin, which is considered as a first-line treatment in diabetes has 40% availability. In addition, metformin was the most prescribed medication with about 57% frequency followed by gliclazide with 37% prescription frequency.

Conclusion

This study raises concerns about the continuity of supply of some of the oral anti-diabetic agents in the Syrian market. This can impact patient commitment to treatment, where patients from low socioeconomic status can be most affected by medication unavailability in nearby pharmacies or increased pricing due to high demand with low supply.

Refugees in Brazil: An investigation of Syrian refugees' psychological experiences

Although there is a strong body of literature on the psychosocial distress of refugees from Global South to Global North, there is limited literature on refugees who migrate from Global South (i.e., Syria) to Global South (i.e., Brazil). The present study aims to investigate Syrian refugees in Brazil. Participants were 202 Syrians. Most respondents were men (62.9%), with an average age of 35.9 years old (SD = 11.13). Results suggest an effect of positive ethnic identity in psychological and physical distress, who also perceive more discrimination than individuals who negatively identify with their ethnicity. Structural equation model suggests the fit of the proposed mediation model. Our findings add to the much-needed line of investigations examining Syrian refugees settling in Brazil.

Pandemic and Typhoon: Positive Impacts of a Double Disaster on Mental Health of Female Students in the Philippines

Humanitarian emergencies pose a great challenge to how all sectors perform their functions in society. In several countries, these emergencies combined the pandemic and other man-made and natural disasters: "double disaster", which affected the health, safety, and well-being of both individuals and communities. Students are a particularly vulnerable population for mental health problems considering the challenges with their transitions to adulthood. Using narrative analysis, this study explored the impacts of a double disaster on the mental health of students and how they cope up with these emergencies. The results showed that the occurrence of natural disasters during the lockdowns from pandemic brought stress to students in adjusting to distance education, completing academic requirements, and accessing technology for online learning. Participants expressed their anxieties about the spread of the virus in the community, particularly in the disaster evacuation centers with less strictly observed social distancing, insufficient hygiene and sanitation facilities, and lack of basic needs. Participants described their learnings and coping strategies that included helping one another, following the government protocols, finding additional sources of income, using energy for important purposes only, and leaning on faith. The findings of this study would be instrumental in formulating policies and strategic measures that best complement the needs of community members during a double disaster, particularly in addressing the mental health impacts of humanitarian emergencies.

Depression, Anxiety, and Post-Traumatic Stress Disorder Following Orthopedic War Injuries

Introduction

There are ongoing wars worldwide, during which significant numbers of people are injured. Several studies have indicated that high rates of depression and anxiety are seen in war-injured patients.

Methods

Eighty-one male patients treated between November 2019 and January 2021 far from home in a Turkish hospital due to war injuries that happened in the Libyan Civil War were investigated. Demographic characteristics and injury data of the patients were evaluated regarding age, Injury Severity Score (ISS), location of injuries, type and mechanism of injuries, operations, and accompanying traumas. The psychological statuses of the patients were evaluated with the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and post-traumatic stress disorder (PTSD) records filled out at the first admission to the hospital.

Results

The mean age of the patients was 29.8±7.7 (19-56) years. While 59 patients had fractures, 22 patients had only soft tissue injuries. Eighteen patients suffered from other accompanying injuries. While 85.2% of the patients showed symptoms of depression, 82.7% of the patients suffered from anxiety and PTSD symptoms were seen in 86.4% of the patients. Statistical analysis was performed to investigate the effects of injury severity, duration of hospitalization, number of operations, and age on depression, anxiety, and PTSD among these patients with war injuries. The results did not indicate any significant effect of injury severity, hospitalization duration, or operations.

Conclusion

Depression, anxiety, and PTSD are common in patients injured in wars. Injury severity does not seem to affect depression, anxiety, or PTSD in these patients.