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Molyneux J. Armed Conflicts and Increasing Violence Against Health Care. Am J Nurs 2024; 124:15-17. [PMID: 38661692 DOI: 10.1097/01.naj.0001016340.08758.b7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
The Geneva Conventions remain an invaluable, universal standard.
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2
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Iacobucci G. Gaza-Israel conflict: World Medical Association backs BMA's call for sustainable ceasefire. BMJ 2024; 385:q945. [PMID: 38658044 DOI: 10.1136/bmj.q945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
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Abstract
This Viewpoint suggests that medical and public health journals should publish articles focused singularly on health without political bias when reporting on the health consequences of war.
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Affiliation(s)
- Philip Greenland
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Oren Lakser
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
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4
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Khatir AG, Ge T, Ariyo T, Jiang Q. Armed conflicts and experience of intimate partner violence among women in Afghanistan: analysis of the 2015 Afghanistan DHS data. BMJ Open 2024; 14:e075957. [PMID: 38582531 PMCID: PMC11002416 DOI: 10.1136/bmjopen-2023-075957] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 03/19/2024] [Indexed: 04/08/2024] Open
Abstract
OBJECTIVE Armed conflicts and intimate partner violence (IPV) impose a burden on individual and societal well-being. Given the history of armed conflict in Afghanistan and the high prevalence of IPV, this study aims to examine the influence of armed conflicts on IPV among Afghan women. METHODS Multilevel logistic regression models were applied to the 2015 Afghanistan Demographic and Health Survey (N=10 414 women aged 15-49). Armed conflict severity was measured using the conflict index issued by the Office for the Coordination of Humanitarian Affairs, IPV was measured by three types of violence, including emotional, physical and sexual violence. All analyses were conducted by using STATA V.15.1. RESULTS Over 52% of women experienced at least one type of IPV, with 33.01%, 49.07%, and 8.99% experiencing emotional, physical, and sexual violence, respectively. The regression results show that armed conflicts were significantly and positively associated with the experience of all types of IPV. In addition, the association between armed conflicts and the experience of emotional IPV was positively moderated by women's attitudes towards IPV. CONCLUSION Our findings suggest that women living in high-conflict regions were more prone to experience IPV, particularly women with positive attitudes towards IPV. Promoting progressive gender roles, women's empowerment, awareness of IPV and inclusion of women in conflict resolution will help deal with the issue of IPV.
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Affiliation(s)
- Abdul Ghani Khatir
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Tingshuai Ge
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Tolulope Ariyo
- School of Health Management, Shangluo University, Shangluo, Shaanxi, China
| | - Quanbao Jiang
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, Shaanxi, China
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Schneider RH, Dillbeck MC, Yeola G, Nader T. Peace through health: traditional medicine meditation in the prevention of collective stress, violence, and war. Front Public Health 2024; 12:1380626. [PMID: 38633233 PMCID: PMC11021781 DOI: 10.3389/fpubh.2024.1380626] [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: 02/01/2024] [Accepted: 03/08/2024] [Indexed: 04/19/2024] Open
Abstract
In the midst of global armed conflicts, notably the Israel-Hamas and Ukraine-Russia wars, there is an urgent need for innovative public health strategies in peacebuilding. The devastating impact of wars, including mortality, injury, disease, and the diversion of healthcare resources, necessitates effective and durable interventions. This perspective aligns with WHO recommendations and examines the role of evidence-based meditation from Ayurveda and Yoga in public health to mitigate collective stress and prevent collective violence and war. It highlights the Transcendental Meditation program, recognized for reducing stress, with contemporary evidence supporting its effectiveness in mental health, mind-body disorders, cardiovascular disease, and public health. Empirical studies with cross-cultural replications indicate that these Traditional Medicine meditation practices can reduce collective stress and prevent collective violence and war activity while improving quality of life. The mechanisms of group meditation in mitigating collective violence are explored through public health models, cognitive neuroscience, population neuroscience, quantum physics principles, and systems medicine. This perspective suggests that Transcendental Meditation and the advanced TM-Sidhi program, as a component of Traditional Medicine, can provide a valuable platform for enhancing societal well-being and peace by addressing brain-based factors fundamental to collective stress and violence.
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Affiliation(s)
- Robert H. Schneider
- Institute for Prevention Research, Vedic City, IA, United States
- College of Integrative Medicine, Maharishi International University, Fairfield, IA, United States
| | - Michael C. Dillbeck
- Dr. Tony Nader Institute for Consciousness and Its Applied Technologies, Maharishi International University, Fairfield, IA, United States
| | - Gunvant Yeola
- Department of Kayachikitsa, Dr. D. Y. Patil College of Ayurveda and Research Center, Dr. D. Y. Patil Vidyapeeth, Pune (Deemed to be University), Pimpri, Pune, India
| | - Tony Nader
- Dr. Tony Nader Institute for Consciousness and Its Applied Technologies, Maharishi International University, Fairfield, IA, United States
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Eliopoulos C, Moraitis K, Borrini M, Irish J, Kallis X, Manoli P, Chimonas M, Cariolou M. Fatal gunshot trauma of a child: A case from colonial Cyprus. Med Sci Law 2024; 64:169-172. [PMID: 37743624 PMCID: PMC10938475 DOI: 10.1177/00258024231202563] [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: 09/26/2023]
Abstract
Forensic science has made some significant contributions to the investigation of human rights abuses related to armed conflicts, especially in the last 40 years. Some investigations are aimed at the collection of evidence in order to prosecute those responsible, while others are humanitarian in nature. This paper presents the multidisciplinary effort to recover and identify the remains of a 7-year-old child who was shot by British colonial forces in Cyprus in 1956. An investigation led to the discovery of the burial site, and archaeological methods were used to recover the remains. The anthropological examination provided information about the age of the child, as well as the nature of the skeletal trauma present. DNA results confirmed the identity of the victim, and the remains were released to the surviving family members for burial.
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Affiliation(s)
- Constantine Eliopoulos
- School of Biological and Environmental Sciences, Liverpool John Moores University, Liverpool, UK
| | - Konstantinos Moraitis
- Department of Forensic Medicine and Toxicology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Matteo Borrini
- School of Biological and Environmental Sciences, Liverpool John Moores University, Liverpool, UK
| | - Joel Irish
- School of Biological and Environmental Sciences, Liverpool John Moores University, Liverpool, UK
| | - Xenophon Kallis
- Office of the Presidential Commissioner for Humanitarian Affairs, The Republic of Cyprus, Nicosia, Cyprus
| | - Panayiotis Manoli
- Laboratory of Forensic Genetics, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Marios Chimonas
- Laboratory of Forensic Genetics, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Marios Cariolou
- Laboratory of Forensic Genetics, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
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Flomin Y, Dubenko A, Dubenko O, Sokolova L, Slobodin T, Shepotinnyk Y, Guliaieva M, Pezzella FR. Neurological Practice in the Time of War: Perspectives and Experiences from Ukraine. Semin Neurol 2024; 44:225-232. [PMID: 38485123 DOI: 10.1055/s-0044-1782515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
The full-scale Russian invasion of Ukraine has significantly impacted the country's healthcare system. Insufficient infrastructure, destruction of medical facilities, and barriers to prevention and treatment efforts hinder the provision of timely, high-quality care to our patients. We aim to describe the impact of the war on neurological care across Ukraine. In this article, leading national experts in stroke, epilepsy, multiple sclerosis, and movement disorders describe their personal experience and efforts in organizing and providing care since the war started in February 2022. A neurologist who cared for patients in Mariupol recounts the first weeks of the war when the city was under constant attacks. An international stroke expert describes the role of Task Force for Ukraine, a European Stroke Organization initiative to support the Ukrainian stroke community. We discuss a series of critical challenges facing Ukraine's neurologists, patients, and healthcare delivery system, including shortages of personnel and medical supplies, disrupted logistics, and lack of funding. In addition, we highlight various interventions and strategies aimed at counteracting these challenges, including international support, collaborations within Ukraine, and initiatives enhancing the resilience of the Ukrainian neurology community. As the war is ongoing, this article emphasizes the pressing need for continuous support and investment in the Ukrainian healthcare system to preserve guaranteed access to high-quality healthcare for the Ukrainian people during the war and in its aftermath. Insights from the essays can inform the development and implementation of effective strategies and interventions tailored to such extraordinary circumstances.
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Affiliation(s)
- Yuriy Flomin
- Stroke Center, Medical Center 'Universal Clinic 'Oberig' and Bogomolets National Medical University, Kyiv, Ukraine
- Department of Neurology, Bogomolets National Medical University, Kyiv, Ukraine
| | - Andriy Dubenko
- Department of Child Neurology and Paroxismal States, Institute of Neurology, Psychiatry and Narcology, National Academy of Medical Science of Ukraine, Kharkiv, Ukraine
| | - Olga Dubenko
- Department of Neurology and Child Neurology, Kharkiv National Medical University, Kharkiv, Ukraine
| | - Larysa Sokolova
- Department of Neurology, Bogomolets National Medical University, Kyiv, Ukraine
| | - Tatyana Slobodin
- Department of Neurology, Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine
| | - Yevhen Shepotinnyk
- Stroke Unit, Matsuk Mariupol Municipal Hospital No. 4, Mariupol, Ukraine
| | - Maryna Guliaieva
- Stroke Center, Medical Center 'Universal Clinic 'Oberig' and Bogomolets National Medical University, Kyiv, Ukraine
- Department of Neurology, Bogomolets National Medical University, Kyiv, Ukraine
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8
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Borda D, Rivadeneira J, Peret P, Laxe S. [Rehabilitation progress: A journey of lessons from the past through the armed conflicts]. Rehabilitacion (Madr) 2024; 58:100843. [PMID: 38387298 DOI: 10.1016/j.rh.2024.100843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 01/22/2024] [Indexed: 02/24/2024]
Affiliation(s)
- D Borda
- Servicio de Medicina Física y Rehabilitación Instituto ICEMEQ, Hospital Clínic, Barcelona, España
| | - J Rivadeneira
- Servicio de Medicina Física y Rehabilitación Instituto ICEMEQ, Hospital Clínic, Barcelona, España
| | - P Peret
- Servicio de Medicina Física y Rehabilitación Instituto ICEMEQ, Hospital Clínic de Barcelona, Barcelona, España
| | - S Laxe
- Servicio de Medicina Física y Rehabilitación Instituto ICEMEQ, Hospital Clínic de Barcelona, Clinical and Experimental Respiratory Immunoallergy (IRCE), Clinic Foundation for Biomedical Research-August Pi Sunyer Biomedical Research Institute (FRCB-IDIBAPS), Barcelona, Universitat de Barcelona, WHOFIC Academic CC, Barcelona, España.
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Research highlight: exploring the health consequences of armed conflict: the perspective of Northeast Ethiopia, 2022: a qualitative study. BMC Public Health 2024; 24:837. [PMID: 38500126 DOI: 10.1186/s12889-024-17900-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024] Open
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Shuaib YA. Zoonotic disease vulnerability escalates amid Sudan's armed conflict. Lancet 2024; 403:1019-1020. [PMID: 38492932 DOI: 10.1016/s0140-6736(23)02458-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 10/31/2023] [Indexed: 03/18/2024]
Affiliation(s)
- Yassir Adam Shuaib
- Department of Preventive Veterinary Medicine and Public Health, College of Veterinary Medicine, Sudan University of Science and Technology, Khartoum North 13321, Sudan.
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11
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Kaseya J, Dereje N, Raji T, Ngongo AN, Fallah MP, Ndembi N. Public health emergencies in war and armed conflicts in Africa: What is expected from the global health community? BMJ Glob Health 2024; 9:e015371. [PMID: 38458758 DOI: 10.1136/bmjgh-2024-015371] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 02/26/2024] [Indexed: 03/10/2024] Open
Affiliation(s)
- Jean Kaseya
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Nebiyu Dereje
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Tajudeen Raji
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | | | - Mosoka Papa Fallah
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Nicaise Ndembi
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
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Gebreyohannes EA, Wolde HF, Akalu TY, Clements ACA, Alene KA. Impacts of armed conflicts on tuberculosis burden and treatment outcomes: a systematic review. BMJ Open 2024; 14:e080978. [PMID: 38453196 PMCID: PMC10921481 DOI: 10.1136/bmjopen-2023-080978] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 02/26/2024] [Indexed: 03/09/2024] Open
Abstract
OBJECTIVES This systematic review aimed to summarise existing literature on the impacts of armed conflicts on tuberculosis burden and treatment outcomes. DESIGN A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. DATA SOURCES PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature Plus, Scopus, ScienceDirect, Embase and medRxiv. DATA EXTRACTION AND SYNTHESIS Three reviewers independently screened, selected eligible studies and extracted data. A narrative review was undertaken to summarise the findings qualitatively. RESULTS Eleven studies were included in this review, reporting on tuberculosis incidence rates, prevalence and treatment outcomes, including mortality. Overall, the impact of armed conflicts on case notifications was variable. Six studies reported overall increases in tuberculosis case notifications following the onset of conflicts, while three studies reported overall decreases in tuberculosis case notifications. Factors, including limited access to healthcare services, challenges in surveillance and laboratory confirmation, the destruction of health systems and incapacitating the healthcare workforce, contributed to a decrease in the number of notified cases. The higher tuberculosis notification in some of the studies could be attributed to the disruption of tuberculosis prevention and control programmes as well as increased socioeconomic deprivation, including malnutrition, mass migration, poor living conditions and overcrowding that are worsened during conflicts. Armed conflicts without effective interventions were associated with worse tuberculosis treatment outcomes, including lower proportions of people with treatment success and higher proportions of people with loss to follow-up, mortality and treatment failure. However, implementing various interventions in conflict settings (such as establishing a National Tuberculosis Control Programme) led to higher tuberculosis notification rates and treatment success. CONCLUSION The impact of armed conflicts on tuberculosis notification is complex and is influenced by multiple factors. The findings of this review underscore the importance of concerted efforts to control tuberculosis in conflict settings using available resources.
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Affiliation(s)
- Eyob Alemayehu Gebreyohannes
- Geospatial and Tuberculosis Research Team, Telethon Kids Institute, Perth, Western Australia, Australia
- School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Haileab Fekadu Wolde
- Geospatial and Tuberculosis Research Team, Telethon Kids Institute, Perth, Western Australia, Australia
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Temesgen Yihunie Akalu
- Geospatial and Tuberculosis Research Team, Telethon Kids Institute, Perth, Western Australia, Australia
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara, Ethiopia
| | - Archie C A Clements
- Geospatial and Tuberculosis Research Team, Telethon Kids Institute, Perth, Western Australia, Australia
- Penninsula Medical School, University of Plymouth, Playmouth, UK
| | - Kefyalew Addis Alene
- Geospatial and Tuberculosis Research Team, Telethon Kids Institute, Perth, Western Australia, Australia
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
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Hanafi I, Abo Samra D, Alsaqqa R, Naeem A, Shebli B, Ajlyakin G. Lung Cancer Diagnoses and Outcomes During the Syrian War, 2011-2018. JAMA Netw Open 2024; 7:e242091. [PMID: 38477917 PMCID: PMC10938179 DOI: 10.1001/jamanetworkopen.2024.2091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 01/22/2024] [Indexed: 03/14/2024] Open
Abstract
Importance Protracted wars, which disproportionately affect low-resource countries, exacerbate the challenges faced by cancer care systems, with lung cancer being the most affected as the most fatal oncological condition. Objective To characterize the presentation and survival of patients with lung cancer during the decade-long Syrian war. Design, Setting, and Participants This cohort study included patients at a large oncology center in Syria during the first 8 years of the Syrian armed conflict (2011-2018). All patients with a new diagnosis of lung cancer were included. Variables investigated included histological subtypes, TNM classification (tumor, lymph nodes, and metastasis), and staging at diagnosis as well as the yearly follow-ups up to 5 years after presentation. Exposure The Syrian war divided the country into temporary regions with different political influences and heterogeneously impacted health care accessibility among these regions. Main Outcomes and Measures Change in prevalence of advanced lung cancer cases at presentation; change in overall survival odds. Results The study included 5160 patients from all Syrian governorates (mean [SD] age, 59.6 [10.8] years; 4399 men [85.3%]). New diagnoses sharply declined during the first 3 years of the war, with partial recovery afterward. Regardless of their tempo-geographical regions, 60% to 80% of the yearly diagnoses presented with metastases. The 1-year and 5-year survival rates were 13.1% (423 of 3238 patients with follow-up results) and 0.1% (2 of 1853 patients), respectively. Patients who presented from regions more involved in the armed conflicts showed poorer survival rates with odds ranging between 0.51 (95% CI, 0.44-0.59) and 0.61 (95% CI, 0.49-0.74) across follow-ups for up to 2 years in comparison with patients presenting from safer regions. War-related health care inaccessibility explained a greater percentage of the variability in survival (Nagelkerke R2 = 7.5%; P < .001) than both patients' age and the stage of the disease combined (Nagelkerke R2 = 3.9%; P < .001). Conclusions and Relevance The Syrian war has been associated with a marked decline in the management of patients with lung cancer, with limited access to specialized care, delayed diagnoses, and substantial decrease in survival rates correlating with the intensity of armed conflict in the respective regions. The profound repercussions of the prolonged armed conflict on patients with lung cancer in Syria necessitates urgent comprehensive strategies to improve the accessibility and quality of health care services, especially in conflict-ridden zones.
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Affiliation(s)
- Ibrahem Hanafi
- Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Damascus University, Damascus, Syria
| | - Dana Abo Samra
- Department of Oncology, Faculty of Medicine, Damascus University, Damascus, Syria
| | - Rama Alsaqqa
- Faculty of Medicine, Damascus University, Damascus, Syria
| | - Ahmad Naeem
- Faculty of Medicine, Damascus University, Damascus, Syria
| | - Baraa Shebli
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, University of Aleppo, Aleppo, Syria
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Arage MW, Kumsa H, Asfaw MS, Kassaw AT, Mebratu E, Tunta A, Kassahun W, Adissu A, Yigzaw M, Hailu T, Tenaw LA. Assessing the health consequences of northern Ethiopian armed conflict, 2022. J Public Health Policy 2024; 45:43-57. [PMID: 38310169 PMCID: PMC10920422 DOI: 10.1057/s41271-023-00464-z] [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] [Accepted: 12/28/2023] [Indexed: 02/05/2024]
Abstract
Armed conflict is a complicated topic with multidimensional impact on population health. This study aimed to assess of the health consequences of the northern Ethiopian conflict, 2022. We used a mixed method study design with a retrospective cross-sectional study supplemented by a qualitative study conducted from May to June 2022. We interviewed 1806 individuals from 423 households and conducted 100 in-depth interviews and focused group discussion. We identified 224 people who self-reported cases of illness (124/1000 people) with only 48 (21%) people who fell ill visited a health institution. We also detected 27 cases of deaths (15/1000 people) during the conflict. The collapse of the health system, evacuation of health personnel, and shortage of medical supplies, and instability with a lack of transportation were consequences of the conflict. The northern Ethiopian conflict has greatly affected the community's health through the breakdown of the health system and health-supporting structures.
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Affiliation(s)
- Mulugeta Wodaje Arage
- School of Midwifery, College of Health Sciences, Woldia University, North Wollo, Amhara Region, Ethiopia.
| | - Henok Kumsa
- School of Midwifery, College of Health Sciences, Woldia University, North Wollo, Amhara Region, Ethiopia
| | - Mulu Shiferaw Asfaw
- School of Medicine, College of Health Sciences, Woldia University, North Wollo, Amhara Region, Ethiopia
| | - Abebe Tarekegn Kassaw
- Department of Pharmacy, College of Health Sciences, Woldia University, North Wollo, Amhara Region, Ethiopia
| | - Ephrem Mebratu
- Department of Pharmacy, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Amhara Region, Ethiopia
| | - Abayneh Tunta
- School of Medicine, College of Health Sciences, Woldia University, North Wollo, Amhara Region, Ethiopia
| | - Woldeteklehymanot Kassahun
- Department of Medical Laboratory, College of Health Sciences, Woldia University, North Wollo, Amhara Region, Ethiopia
| | - Amanuel Adissu
- Department of Public Health, College of Health Sciences, Injibara University, Injibara, Amhara Region, Ethiopia
| | - Molla Yigzaw
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Amhara Region, Ethiopia
| | - Tilahun Hailu
- School of Public Health, College of Health Sciences, Woldia University, North Wollo, Amhara Region, Ethiopia
| | - Lebeza Alemu Tenaw
- School of Public Health, College of Health Sciences, Woldia University, North Wollo, Amhara Region, Ethiopia
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Ojeleke O, Groot W, Bonuedi I, Pavlova M. The impact of armed conflicts on the nutritional status of children: Evidence from Northern Nigeria. Int J Health Plann Manage 2024; 39:502-529. [PMID: 38051002 DOI: 10.1002/hpm.3742] [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: 02/19/2023] [Revised: 11/05/2023] [Accepted: 11/10/2023] [Indexed: 12/07/2023] Open
Abstract
Armed conflicts often significantly exacerbate the magnitude and severity of malnutrition by increasing food insecurity. Evidence shows that malnutrition is among the leading causes of morbidity and mortality among children during conflicts. This study examines the impact of the armed conflicts in Northern Nigeria on nutritional status of children under the age of five. Three waves (2008, 2013, and 2018) of individual-level birth records data from the Nigeria Demographic and Health Survey (NDHS) dataset are spatially merged with information on conflict events drawn from the Armed Conflict Location and Events Dataset. All fatal incidents in the study region during the 5-year intervals 2004-2008, 2009-2013 and 2014-2018 are aggregated and mapped to the 2008, 2013 and 2018 NDHS clusters, respectively. A cluster is classified to be exposed to conflict if located within 5-10 km radius of an incident with at least 1 fatality. We use matching analysis in a difference-in-differences approach to estimate the effects of the conflicts on stunting, wasting, and underweight. We find that the impact of conflict exposure differs by the dimension of child nutritional status. While it significantly lowers the risk of stunting, it has no discernible significant effect on the likelihood of wasting or being underweight among under-fives. Though nutritional support/interventions in the conflict-affected areas are crucial and must be prioritised, an all-inclusive strategy for a long-term resolution of the conflict is needed to engender development, improve food security, reduce vulnerability to malnutrition, and improve the health and wellbeing of the residents of the region.
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Affiliation(s)
- Olabayo Ojeleke
- Department of Health Services Research (HSR), Care and Public Health Institute (CAPHRI), Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Wim Groot
- Department of Health Services Research (HSR), Care and Public Health Institute (CAPHRI), Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Isaac Bonuedi
- Bureau of Integrated Rural Development (BIRD), Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Milena Pavlova
- Department of Health Services Research (HSR), Care and Public Health Institute (CAPHRI), Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Helfand I. Nuclear war and the public health community: the responsibility to act. J Public Health Policy 2024; 45:186-190. [PMID: 38316864 DOI: 10.1057/s41271-023-00456-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Affiliation(s)
- Ira Helfand
- International Physicians for the Prevention of Nuclear War, Boston, MA, USA.
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Dohál M, Dvořáková V, Šperková M, Pinková M, Ghodousi A, Omrani M, Porvazník I, Rasmussen EM, Škereňová M, Krivošová M, Wallenfels J, Konstantynovska O, Walker TM, Nikolayevskyy V, Cirillo DM, Solovič I, Mokrý J. Tuberculosis in Ukrainian War Refugees and Migrants in the Czech Republic and Slovakia: A Molecular Epidemiological Study. J Epidemiol Glob Health 2024; 14:35-44. [PMID: 38048026 PMCID: PMC11043285 DOI: 10.1007/s44197-023-00166-5] [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: 10/12/2023] [Accepted: 11/08/2023] [Indexed: 12/05/2023] Open
Abstract
BACKGROUND The war in Ukraine has led to significant migration to neighboring countries, raising public health concerns. Notable tuberculosis (TB) incidence rates in Ukraine emphasize the immediate requirement to prioritize approaches that interrupt the spread and prevent new infections. METHODS We conducted a prospective genomic surveillance study to assess migration's impact on TB epidemiology in the Czech Republic and Slovakia. Mycobacterium tuberculosis isolates from Ukrainian war refugees and migrants, collected from September 2021 to December 2022 were analyzed alongside 1574 isolates obtained from Ukraine, the Czech Republic, and Slovakia. RESULTS Our study revealed alarming results, with historically the highest number of Ukrainian tuberculosis patients detected in the host countries. The increasing number of cases of multidrug-resistant TB, significantly linked with Beijing lineage 2.2.1 (p < 0.0001), also presents substantial obstacles to control endeavors. The genomic analysis identified the three highly related genomic clusters, indicating the recent TB transmission among migrant populations. The largest clusters comprised war refugees diagnosed in the Czech Republic, TB patients from various regions of Ukraine, and incarcerated individuals diagnosed with pulmonary TB specialized facility in the Kharkiv region, Ukraine, pointing to a national transmission sequence that has persisted for over 14 years. CONCLUSIONS The data showed that most infections were likely the result of reactivation of latent disease or exposure to TB before migration rather than recent transmission occurring within the host country. However, close monitoring, appropriate treatment, careful surveillance, and social support are crucial in mitigating future risks, though there is currently no evidence of local transmission in EU countries.
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Affiliation(s)
- Matúš Dohál
- Comenius University Bratislava, Malá Hora 4A, 036 01, Martin, Slovak Republic.
| | - Věra Dvořáková
- National Institute of Public Health, Prague, Czech Republic
| | | | | | - Arash Ghodousi
- IRCCS San Raffaele Scientific Institute, Milan, Italy
- San Raffaele University, Milan, Italy
- University of Milan, Milan, Italy
| | - Maryam Omrani
- IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Igor Porvazník
- National Institute of Tuberculosis, Lung Diseases and Thoracic Surgery, Vyšné Hágy, Slovak Republic
- Catholic University, Ružomberok, Slovak Republic
| | | | - Mária Škereňová
- Comenius University Bratislava, Malá Hora 4A, 036 01, Martin, Slovak Republic
| | - Michaela Krivošová
- Comenius University Bratislava, Malá Hora 4A, 036 01, Martin, Slovak Republic
| | | | | | - Timothy M Walker
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- University of Oxford, Oxford, UK
| | | | | | - Ivan Solovič
- National Institute of Tuberculosis, Lung Diseases and Thoracic Surgery, Vyšné Hágy, Slovak Republic
- Catholic University, Ružomberok, Slovak Republic
| | - Juraj Mokrý
- Comenius University Bratislava, Malá Hora 4A, 036 01, Martin, Slovak Republic
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Cappelli F, Costantini V, D'Angeli M, Marin G, Paglialunga E. Local sources of vulnerability to climate change and armed conflicts in East Africa. J Environ Manage 2024; 355:120403. [PMID: 38428181 DOI: 10.1016/j.jenvman.2024.120403] [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: 07/05/2023] [Revised: 10/13/2023] [Accepted: 02/13/2024] [Indexed: 03/03/2024]
Abstract
While socioeconomic and institutional factors are crucial in explaining the onset and evolution of conflicts, recent research suggests that climate change is a further indirect driver acting as a "threat multiplier". This paper focuses on the concept of vulnerability to both climate change and conflicts to explain why some locations are more likely to engage in armed conflicts than others in the presence of a similar level of exposure to climatic changes. In particular, by means of a Spatial Autoregressive Model, we identify a set of local-specific vulnerability factors that increase conflict risk in East Africa. We employ a georeferenced database with a resolution of 25 × 25 km, covering the period 1997-2016. Results from our analysis provide some interesting insights: first, climate change does not increase conflict risk per se, but only in the presence of pre-existing vulnerabilities. Second, resource access and socioeconomic factors play a key role in driving the climate-conflict nexus especially in urban areas. In particular, vulnerability is increased whenever power is not distributed in such a way as to ensure an equitable distribution of resources. Overall, our findings suggest that, by addressing vulnerability factors that prevent adaptive capacity and an equitable distribution of resources, societies may benefit in terms of both diminished conflict risk and alleviation of climate change impacts.
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Affiliation(s)
- Federica Cappelli
- Department of Economics and Management, University of Ferrara, via Voltapaletto, 11 - 44121, Ferrara, Italy.
| | - Valeria Costantini
- Department of Economics, University of Roma Tre, Via Silvio D'Amico 77, 00145, Rome, Italy.
| | - Mariagrazia D'Angeli
- Department of Economics, University of Roma Tre, Via Silvio D'Amico 77, 00145, Rome, Italy.
| | - Giovanni Marin
- Department of Economics, Society, Politics, University of Urbino Carlo Bo, Via Aurelio Saffi, 42, 61029, Urbino, Italy.
| | - Elena Paglialunga
- Department of Economics, University of Roma Tre, Via Silvio D'Amico 77, 00145, Rome, Italy.
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Pattanshetty S, Dsouza VS, Shekharappa A, Yagantigari M, Raj R, Inamdar A, Alsamara I, Rajvanshi H, Brand H. A Scoping Review on Malaria Prevention and Control Intervention in Fragile and Conflict-Affected States (FCAS): A Need for Renewed Focus to Enhance International Cooperation. J Epidemiol Glob Health 2024; 14:4-12. [PMID: 38224386 PMCID: PMC11043240 DOI: 10.1007/s44197-023-00180-7] [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: 08/21/2023] [Accepted: 12/11/2023] [Indexed: 01/16/2024] Open
Abstract
Malaria is a major public health problem in developing countries. The burden of malaria in fragile and conflict-affected states (FCAS) is increasing year by year. Moreover, the population living in FCAS is often the most vulnerable and at high risk of malaria due to factors, such as deteriorating healthcare system, mass relocations, and reduced resilience to shocks. Therefore, this scoping review aims to map the interventions that are conducted at the FCAS on malaria prevention among the general population. In addition, this review can help policy-makers and international health bodies, providing a comprehensive overview that can lead to more targeted, effective, and context-specific interventions. Databases, such as PubMed, EBSCO-CINAHL, Web of Science, ProQuest, and Cochrane Central Register of Controlled Trials, were searched using specified search terms. A total of 3601 studies were retrieved from the search. After screening, 62 studies were included in the synthesis that met the eligibility criteria. Narrative analysis of the findings was done. The results revealed that in fragile countries, interventions for children below 5 years of age included IPTi, TDA, and ACT. In conflicted countries, interventions for children below 5 years of age included TDA, LLINs, SMC, drug trials, and vaccination. Similar interventions were reported for other age groups and populations. Despite ongoing conflicts, malaria interventions have been maintained in these countries, but a persistent high burden of malaria remains. To achieve the goals of malaria elimination, the results of the review highlight the need for continued research and evaluation of malaria control interventions to assess their effectiveness and impact. Strengthening health systems, building partnerships, utilizing digital health technologies, and conducting context-specific research are recommended to improve healthcare access and reduce the burden of malaria in FCAS.
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Affiliation(s)
- Sanjay Pattanshetty
- Department of Global Health Governance, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Centre for Health Diplomacy, Department of Global Health Governance, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Department of International Health, Faculty of Health Medicine and Life Sciences, Care and Public Health Research Institute-CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - Viola Savy Dsouza
- Centre for Regulatory Science, Department of Health Information, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Anupama Shekharappa
- Department of Global Health Governance, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | | | - Rohit Raj
- Department of Community Medicine, Manipal Tata Medical College, Manipal Academy of Higher Education, Jamshedpur, India
| | - Aniruddha Inamdar
- Centre for Health Diplomacy, Department of Global Health Governance, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Issam Alsamara
- Department of International Health, Faculty of Health Medicine and Life Sciences, Care and Public Health Research Institute-CAPHRI, Maastricht University, Maastricht, The Netherlands
| | | | - Helmut Brand
- Department of International Health, Faculty of Health Medicine and Life Sciences, Care and Public Health Research Institute-CAPHRI, Maastricht University, Maastricht, The Netherlands
- Department of Health Policy, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Asfaw ZK, Greisman JD, Comuniello B, Shlobin NA, Etienne M, Zuckerman SL, Laeke T, Al-Sharshahi ZF, Barthélemy EJ. Global Neurosurgery Advances From Trenches to Bedside: Lessons From Neurosurgical Care in War, Humanitarian Assistance, and Disaster Response. Mil Med 2024; 189:e532-e540. [PMID: 37261884 DOI: 10.1093/milmed/usad170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 03/20/2023] [Accepted: 05/03/2023] [Indexed: 06/02/2023] Open
Abstract
INTRODUCTION War has influenced the evolution of global neurosurgery throughout the past century. Armed conflict and mass casualty disasters (MCDs), including Humanitarian Assistance Disaster Relief missions, require military surgeons to innovate to meet extreme demands. However, the military medical apparatus is seldom integrated into the civilian health care sector. Neurosurgeons serving in the military have provided a pragmatic template for global neurosurgeons to emulate in humanitarian disaster responses. In this paper, we explore how wars and MCD have influenced innovations of growing interest in the resource-limited settings of global neurosurgery. METHODS We performed a narrative review of the literature examining the influence of wars and MCD on contemporary global neurosurgery practices. RESULTS Wartime innovations that influenced global neurosurgery include the development of triage systems and modernization with airlifts, the implementation of ambulance corps, early operation on cranial injuries in hospital camps near the battlefield, the use of combat body armor, and the rise of damage control neurosurgery. In addition to promoting task-shifting and task-sharing, workforce shortages during wars and disasters contributed to the establishment of the physician assistant/physician associate profession in the USA. Low- and middle-income countries (LMICs) face similar challenges in developing trauma systems and obtaining advanced technology, including neurosurgical equipment like battery-powered computed tomography scanners. These challenges-ubiquitous in low-resource settings-have underpinned innovations in triage and wound care, rapid evacuation to tertiary care centers, and minimizing infection risk. CONCLUSION War and MCDs have catalyzed significant advancements in neurosurgical care both in the pre-hospital and inpatient settings. Most of these innovations originated in the military and subsequently spread to the civilian sector as military neurosurgeons and reservist civilian neurosurgeons returned from the battlefront or other low-resource locations. Military neurosurgeons have utilized their experience in low-resource settings to make volunteer global neurosurgery efforts in LMICs successful. LMICs have, by necessity, responded to challenges arising from resource shortages by developing innovative, context-specific care paradigms and technologies.
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Affiliation(s)
- Zerubabbel K Asfaw
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Jacob D Greisman
- Department of Neurology, New York Medical College, Valhalla, NY 10595, USA
| | - Briana Comuniello
- Department of Neurology, New York Medical College, Valhalla, NY 10595, USA
| | - Nathan A Shlobin
- Department of Neurosurgery, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Mill Etienne
- Department of Neurology, New York Medical College, Valhalla, NY 10595, USA
| | - Scott L Zuckerman
- Department of Neurosurgery, Vanderbilt School of Medicine, Nashville, TN 37232, USA
| | - Tsegazeab Laeke
- Neurosurgery Division, Department of Surgery, Addis Ababa University, Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
| | - Zahraa F Al-Sharshahi
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Ernest J Barthélemy
- Division of Neurosurgery, SUNY Downstate College of Medicine, Brooklyn, NY 11203, USA
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Boukari Y, Kadir A, Waterston T, Jarrett P, Harkensee C, Dexter E, Cinar EN, Blackett K, Nacer H, Stevens A, Devakumar D. Gaza, armed conflict and child health. BMJ Paediatr Open 2024; 8:e002407. [PMID: 38350977 PMCID: PMC10868171 DOI: 10.1136/bmjpo-2023-002407] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2024] Open
Affiliation(s)
- Yamina Boukari
- Institute of Health Informatics, University College London, London, UK
| | | | - Tony Waterston
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
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Mani Z, Kuhn L, Plummer V. Emergency Nurse Roles, Challenges, and Preparedness in Hospitals in the Context of Armed Conflict. Disaster Med Public Health Prep 2024; 18:e21. [PMID: 38344868 DOI: 10.1017/dmp.2024.7] [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] [Indexed: 02/15/2024]
Abstract
INTRODUCTION An understanding of emergency nurses' roles, challenges, and preparedness in the context of armed conflict is necessary to capture in-depth insights into this specialty and their preparational needs when working in these unique environments. Unfortunately, the evidence about emergency nurses' work in the context of armed conflict is scant. METHOD Semi-structured interviews were conducted with 23 participants and analyzed using qualitative content analysis. The COREQ guideline for reporting qualitative research was followed. RESULTS The emergency nurses' roles, challenges, and preparedness in hospitals in the context of armed conflict were explored in detail. The main challenges that these nurses faced included poor orientation, access block, and communication barriers. Various perspectives about preparation, including education, training, and strategies for preparing emergency nurses were identified. The most striking findings in these settings were the diversity of armed conflict injuries, clinical profiles of patients, triage of mass casualties, trauma care, surge capacity, orientation, communication, and strategies for preparing nurses. CONCLUSIONS This study provided an exploration of the scope of emergency nurses' roles, and how they were prepared and expected to function across multiple hospitals in armed conflict areas. The resultant snapshot of their experiences, challenges, and responsibilities provides an informative resource and outlines essential information for future emergency nursing workforce preparedness. There is a broad range of preparational courses being undertaken by emergency nurses to work effectively in settings of armed conflict; however, required education and training should be carefully planned according to their actual roles and responsibilities in these settings.
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Affiliation(s)
- Zakaria Mani
- Jazan University, Jazan, Saudi Arabia
- Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, Australia
| | - Lisa Kuhn
- Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, Australia
- Australian Catholic University, Faculty of Health Sciences, Fitzroy, Victoria, Australia
| | - Virginia Plummer
- Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, Australia
- Federation University Australia, Ballarat, Victoria, Australia
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Vancini RL, Andrade MS, Knechtle B, Weiss K, DE Lira CA. Could war among nations decrease physical activity levels? J Sports Med Phys Fitness 2024; 64:211-212. [PMID: 37987712 DOI: 10.23736/s0022-4707.23.15625-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Affiliation(s)
- Rodrigo L Vancini
- Center of Physical Education and Sports (CEFD), Federal University of Espírito Santo (UFES), Vitória, Brazil -
| | - Marilia S Andrade
- Department of Physiology, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Beat Knechtle
- Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Katja Weiss
- Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Claudio A DE Lira
- Section of Human Physiology and Exercise, Faculty of Physical Education, Federal University of Goiás (UFG), Goiânia, Brazil
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Bruffaerts R, Axinn WG, Ghimire DJ, Benjet C, Chardoul S, Scott KM, Kessler RC, Schulz P, Smoller JW. Community exposure to armed conflict and subsequent onset of alcohol use disorder. Addiction 2024; 119:248-258. [PMID: 37755324 PMCID: PMC10872606 DOI: 10.1111/add.16343] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 08/17/2023] [Indexed: 09/28/2023]
Abstract
AIMS To measure the independent consequences of community-level armed conflict beatings on alcohol use disorders (AUD) among males in Nepal during and after the 2000-2006 conflict. DESIGN A population-representative panel study from Nepal, with precise measures of community-level violent events and subsequent individual-level AUD in males. Females were not included because of low AUD prevalence. SETTING Chitwan, Nepal. PARTICIPANTS Four thousand eight hundred seventy-six males from 151 neighborhoods, systematically selected and representative of Western Chitwan. All residents aged 15-59 were eligible (response rate 93%). MEASUREMENTS Measures of beatings in the community during the conflict (2000-2006), including the date and distance away, were gathered through neighborhood reports, geo-location and official resources, then linked to respondents' life histories of AUD (collected in 2016-2018) using the Nepal-specific Composite International Diagnostic Interview with life history calendar. Beatings nearby predict the subsequent onset of AUD during and after the armed conflict. Data were analyzed in 2021-2022. FINDINGS Cohort-specific, discrete-time models revealed that within the youngest cohort (born 1992-2001), those living in neighborhoods where armed conflict beatings occurred were more likely to develop AUD compared with those in other neighborhoods (odds ratio = 1.66; 95% confidence interval = 1.02-2.71). In this cohort, a multilevel matching analysis designed to simulate a randomized trial showed the post-conflict incidence of AUD for those living in neighborhoods with any armed conflict beatings was 9.5% compared with 5.3% in the matched sample with no beatings. CONCLUSIONS Among male children living in Chitwan, Nepal during the 2000-2006 armed conflict, living in a neighborhood where armed conflict beatings occurred is associated with increased odds of developing subsequent alcohol use disorder. This association was independent of personal exposure to beatings and other mental disorders.
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Affiliation(s)
- Ronny Bruffaerts
- Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum KU Leuven, Leuven, Belgium
| | - William G Axinn
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Dirgha J Ghimire
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Corina Benjet
- Department of Epidemiology and Psychosocial Research, National Institute of Psychiatry Instituto Nacional de Psiquiatría Ramón de La Fuente Muñiz, Mexico City, Mexico
| | - Stephanie Chardoul
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Kate M Scott
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Paul Schulz
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Jordan W Smoller
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
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Yen CF, Lin YH, Hsiao RC, Chen YY, Chen YL. Associations of China's military activities in the peripheries of Taiwan with suicide death and internet searches for depression, suicide, and emigration among individuals in Taiwan. Asian J Psychiatr 2024; 92:103889. [PMID: 38194725 DOI: 10.1016/j.ajp.2023.103889] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/16/2023] [Accepted: 12/19/2023] [Indexed: 01/11/2024]
Affiliation(s)
- Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; College of Professional Studies, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - Yu-Hsuan Lin
- Institute of Population Health Sciences, National Health Researches Institutes, Zhunan, Miaoli County, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan; Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ray C Hsiao
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA; Department of Psychiatry, Seattle Children's, Seattle, WA, USA
| | - Ying-Yeh Chen
- Taipei City Psychiatric Centre, Taipei City Hospital, Taipei City, Taiwan; Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei City, Taiwan
| | - Yi-Lung Chen
- Department of Healthcare Administration, Asia University, Taichung, Taiwan; Department of Psychology, Asia University, Taichung, Taiwan
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Makhovych I. 'Education is possible in any situation' - what I've learnt from teaching in Kyiv amid a war. Nature 2024; 626:929. [PMID: 38413757 DOI: 10.1038/d41586-024-00588-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
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Yoo JWS, Barmanray RD. The role of medical students in humanitarian responses to armed conflict. Lancet Diabetes Endocrinol 2024; 12:92-94. [PMID: 38184000 DOI: 10.1016/s2213-8587(23)00366-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 11/29/2023] [Indexed: 01/08/2024]
Affiliation(s)
- Ji Won Susie Yoo
- Department of Medicine, The Royal Melbourne Hospital, Melbourne, VIC 3050, Australia; TeleHelp Україна (TeleHelp Ukraine), Stanford University, Palo Alto, CA, USA.
| | - Rahul D Barmanray
- Department of Medicine, The Royal Melbourne Hospital, Melbourne, VIC 3050, Australia; Department of Diabetes & Endocrinology, The Royal Melbourne Hospital, Melbourne, VIC 3050, Australia
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Khairy A, Bashier H, Nuh H, Ahmed N, Ali Y, Izzoddeen A, Mohamed S, Osman M, Khader Y. The role of the Field Epidemiology Training Program in the public health emergency response: Sudan armed conflict 2023. Front Public Health 2024; 12:1300084. [PMID: 38356953 PMCID: PMC10864643 DOI: 10.3389/fpubh.2024.1300084] [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: 09/23/2023] [Accepted: 01/09/2024] [Indexed: 02/16/2024] Open
Abstract
Background On April 15, 2023, the armed conflict between the Sudanese Armed Forces (SAF) and the Rapid Support Forces (RSF) started in Khartoum state, Sudan. This conflict was complicated by the preexisting complicated epidemiological situation and fragile health system in Sudan. This study endeavors to illuminate the pivotal role essayed by the Sudan FETP (SFETP) in enhancing the nation's public health response, particularly amidst the tumultuous backdrop of armed conflicts that have left their indelible mark on the region. Methods Employing a blend of quantitative and qualitative methodologies, we investigated the SFETP's contributions to the public health response during the initial 4 months of the conflict (April-July 2023). Sixty-four SFETP residents and graduates were invited to participate, and data were gathered through semi-structured questionnaires. Results A total of 44 (69%) SFETP residents and graduates were included in this study. Out of 38 SFETPs present in the states, 32 have considerably contributed to the crisis response at state and locality levels. Three-quarters of them have played key leadership, planning, and management roles. In essence, 38% (n = 12) of them have contributed to public health surveillance, particularly in data management, reports, Early Warning Alert and Response System (EWAR) establishment, and epidemic investigation. SFETPs have made special contributions to crisis response at the community level. The involved SFETPs supported WASH interventions (n = 4), and almost one-third of them strengthened risk communication and community engagement (n = 9). Despite their physical presence at the subnational level, 27% of graduates were not deployed to the crisis emergency response. Notably, throughout this time, half of the total SFETPs were formally retained during this response. Conclusion The study highlighted the importance of FETP engagement and support during public health crises. SFETP residents and graduates played diverse roles in the various levels of public health emergency response to the crisis. However. Strategies to improve the deployment and retention of FETP residents are necessary to ensure their availability during crises. Overall, FETP has proven to be an asset in public health crisis management in Sudan.
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Affiliation(s)
- Amna Khairy
- Sudan Field Epidemiology Training Program, Khartoum, Sudan
- Global Health Development/Eastern Mediterranean Public Health Network, Amman, Jordan
| | - Haitham Bashier
- Global Health Development/Eastern Mediterranean Public Health Network, Amman, Jordan
| | - Hatim Nuh
- Remote Sensing Authority, National Center for Research, Khartoum, Sudan
| | - Nagla Ahmed
- Sudan Field Epidemiology Training Program, Khartoum, Sudan
| | - Yousif Ali
- Sudan Field Epidemiology Training Program, Khartoum, Sudan
| | | | - Sara Mohamed
- Sudan Field Epidemiology Training Program, Khartoum, Sudan
| | - Muntasir Osman
- Sudan Field Epidemiology Training Program, Khartoum, Sudan
| | - Yousef Khader
- Global Health Development/Eastern Mediterranean Public Health Network, Amman, Jordan
- Department of Public Health, Jordan University of Science and Technology, Irbid, Jordan
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Souza LE, Buss P, Alcázar S. Wars are never necessary: Gaza is the best example. Lancet 2024; 403:349-350. [PMID: 38242144 DOI: 10.1016/s0140-6736(24)00013-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 01/03/2024] [Indexed: 01/21/2024]
Affiliation(s)
- Luis Eugenio Souza
- World Federation of Public Health Associations, Institute of Global Health, University of Geneva Campus Biotech, Geneva 1202, Switzerland.
| | - Paulo Buss
- Fiocruz Global Health Center, Rio de Janeiro, Brazil
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31
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Homer CSE. End humanitarian catastrophe in conflict settings. Lancet 2024; 403:24-25. [PMID: 38071987 DOI: 10.1016/s0140-6736(23)02695-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 11/28/2023] [Indexed: 01/08/2024]
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32
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Boiko DI, Shyrai PO, Mats OV, Karpik ZI, Rahman MH, Khan AA, Alanazi AM, Skrypnikov AM. Mental health and sleep disturbances among Ukrainian refugees in the context of Russian-Ukrainian war: A preliminary result from online-survey. Sleep Med 2024; 113:342-348. [PMID: 38104463 DOI: 10.1016/j.sleep.2023.12.004] [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: 07/25/2023] [Revised: 11/19/2023] [Accepted: 12/05/2023] [Indexed: 12/19/2023]
Abstract
The ongoing Russian-Ukrainian conflict has caused a significant displacement of individuals, with an estimated five million Ukrainians seeking temporary refuge in other countries. We conducted a survey among Ukrainians in various countries worldwide using a convenience sample and analyzed 144 responses. The participants were divided into two groups: group 1, consisting of 92 Ukrainian refugees who were forced to leave their country due to the conflict, and group 2, comprising 52 individuals who did not change their place of residence. Data were collected through a structured online questionnaire consisting of socio-demographic questions, Depression, Anxiety, and Stress Scale-21, Insomnia Severity Index, and Symptom Checklist-90 during May-November 2022. We found that there were statistically significantly higher levels of obsessive-compulsive symptoms, depression, hostility, and overall distress in group 1. Group 1 had a higher risk of depression, anxiety, and stress, but not insomnia. In our study, refugee status, dissatisfaction with the state of health, job loss, suffering due to hostilities, and the received support from volunteers, friends, or relatives were the most important factors for the mental disorders. A bi-directional relationship was discovered between anxiety and insomnia, with both symptoms being associated with COVID-19 and subsequent psychiatric disorders. This study highlights the mental health and sleep problems faced by Ukrainian refugees as a result of the conflict linked to numerous social factors. Ukrainian refugees need social support programs and special attention to their mental health to facilitate their post-migration adaptation and integration into the host society.
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Affiliation(s)
- Dmytro I Boiko
- Department of Psychiatry, Narcology and Medical Psychology, Poltava State Medical University, Poltava, Ukraine.
| | - Polina O Shyrai
- Medical Faculty, Poltava State Medical University, Poltava, Ukraine
| | - Oksana V Mats
- Medical Faculty, Poltava State Medical University, Poltava, Ukraine
| | - Zoriana I Karpik
- Medical Faculty, Poltava State Medical University, Poltava, Ukraine
| | - Md Habibur Rahman
- Department of Global Medical Science, Yonsei University, Wonju 26426, Gangwon-do, South Korea
| | - Azmat Ali Khan
- Pharmaceutical Biotechnology Laboratory, Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Amer M Alanazi
- Pharmaceutical Biotechnology Laboratory, Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Andrii M Skrypnikov
- Department of Psychiatry, Narcology and Medical Psychology, Poltava State Medical University, Poltava, Ukraine
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Munro CL, Hope AA. Human Suffering and Armed Conflict. Am J Crit Care 2024; 33:4-6. [PMID: 38161164 DOI: 10.4037/ajcc2024997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Affiliation(s)
- Cindy L Munro
- Cindy L. Munro is coeditor in chief of the American Journal of Critical Care. She is dean and professor, School of Nursing and Health Studies, University of Miami, Coral Gables, Florida
| | - Aluko A Hope
- Aluko A. Hope is coeditor in chief of the American Journal of Critical Care. He is an associate professor and physician scientist at Oregon Health and Science University in Portland, Oregon
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Martikainen J, Sakki I. Visual humanization of refugees: A visual rhetorical analysis of media discourse on the war in Ukraine. Br J Soc Psychol 2024; 63:106-130. [PMID: 37449763 DOI: 10.1111/bjso.12669] [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: 02/15/2023] [Accepted: 06/29/2023] [Indexed: 07/18/2023]
Abstract
This study examines how news images of refugees in the context of the war in Ukraine mobilize intergroup relations. A visual rhetorical analysis is used to examine the rhetorical strategies employed in news images of Ukrainian refugees in a mainstream Finnish national newspaper from February 25 to May 31, 2022. The data consisted of 465 images. The study constructed four humanizing visual rhetorical strategies based on the visual expression in news images: maternalizing, fragilizing, agonizing, and activizing. The rhetorical strategies constructed four subject positions for Ukrainian refugees: vulnerable victims, innocent victims, suffering Ukrainians, and persistent/resilient Ukrainians. All rhetorical strategies implicitly communicated the subject position of evil to Russia. The paper contributes to the current knowledge of the humanization of refugees in media discourse and the potential of media images to mobilize intergroup relations. Methodologically, the paper elaborates visual rhetorical analysis as a means of social psychological study of refugee discourse in the context of war.
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35
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Atenstaedt RL. Do public health professionals have a role in preventing armed conflict? Public Health 2024; 226:e3. [PMID: 38072738 DOI: 10.1016/j.puhe.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 01/15/2024]
Affiliation(s)
- R L Atenstaedt
- Betsi Cadwaladr University Health Board, Abergele Hospital, Abergele, Conwy, UK; Institute of Health, Medical Sciences and Society, Wrexham University, Wrexham, UK; School of Medical Sciences, Bangor University, Bangor, Gwynedd, UK.
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36
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Hedström J, Herder T. Women's sexual and reproductive health in war and conflict: are we seeing the full picture? Glob Health Action 2023; 16:2188689. [PMID: 36927249 PMCID: PMC10026773 DOI: 10.1080/16549716.2023.2188689] [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] [Indexed: 03/18/2023] Open
Abstract
It is well established that women's sexual and reproductive health (SRHR) is negatively affected by war. While global health research often emphasises infrastructure and systematic factors as key impediments to women's SRHR in war and postwar contexts, reports from different armed conflicts indicate that women's reproduction may be controlled both by state and other armed actors, limiting women's choices and access to maternal and reproductive health care even when these are available. In addition, it is important to examine and trace disparities in sexual reproductive health access and uptake within different types of wars, recognising gendered differences in war and postwar contexts. Adding feminist perspectives on war to global health research explanations of how war affects women's sexual and reproductive health might then contribute to further understanding the complexity of the different gendered effects war and armed conflicts have on women's sexual and reproductive health.
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Affiliation(s)
- Jenny Hedström
- Department of War Studies and Military History, Swedish Defence University, Stockholm, Sweden
| | - Tobias Herder
- Division of Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden
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37
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Rostomian L, Chiloyan A, Hentschel E, Messerlian C. Effects of armed conflict on maternal and infant health: a mixed-methods study of Armenia and the 2020 Nagorno-Karabakh war. BMJ Open 2023; 13:e076171. [PMID: 38159954 PMCID: PMC10759127 DOI: 10.1136/bmjopen-2023-076171] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 11/29/2023] [Indexed: 01/03/2024] Open
Abstract
INTRODUCTION Armed conflict worldwide and across history has harmed the health of populations directly and indirectly, including generations beyond those immediately exposed to violence. The 2020 war between Armenia and Azerbaijan over Nagorno-Karabakh, inhabited by an ethnically Armenian population, provides an example of how conflict harmed health during COVID-19. We hypothesised that crises exposure would correspond to decreased healthcare utilisation rates and worse health outcomes for the maternal and infant population in Armenia, compounded during the pandemic. METHODS Following a mixed-methods approach, we used ecological data from 1980 to 2020 to evaluate health trends in conflict, measured as battle-related deaths (BRDs), COVID-19 cases, and maternal and infant health indicators during periods of conflict and peace in Armenia. We also interviewed 10 key informants about unmet needs, maternal health-seeking behaviours and priorities during the war, collecting recommendations to mitigate the effects of future crisis on maternal and infant health. We followed a deductive coding approach to analyse transcripts and harvest themes. RESULTS BRDs totalled more in the 2020 war compared with the previous Nagorno-Karabakh conflicts. Periods of active conflict between 1988-2020 were associated with increased rates of sick newborn mortality, neonatal mortality and pre-eclampsia or eclampsia. Weekly average COVID-19 cases increased sevenfold during the 2020 Nagorno-Karabakh war. Key informants expressed concerns about the effects of stress and grief on maternal health and pregnancy outcomes and recommended investing in healthcare system reform. Participants also stressed the synergistic effects of the war and COVID-19, noting healthcare capacity concerns and the importance of a strong primary care system. CONCLUSIONS Maternal and infant health measures showed adverse trends during the 2020 Nagorno-Karabakh war, potentially amplified by the concurrent COVID-19 pandemic. To mitigate effects of future crises on population health in Armenia, informants recommended investments in healthcare system reform focused on primary care and health promotion.
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Affiliation(s)
- Lara Rostomian
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Araz Chiloyan
- Ministry of Health of the Republic of Armenia, Yerevan, Armenia
| | - Elizabeth Hentschel
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Carmen Messerlian
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Obstetrics and Gynecology, Massachusetts General Hospital Vincent Center for Reproductive Biology, Boston, Massachusetts, USA
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38
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Ursano RJ. Wars, Pandemics, Mass Shootings and Human Behavior: Disasters Across the Globe. Psychiatry 2023; 86:271. [PMID: 38149707 DOI: 10.1080/00332747.2023.2284619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
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Lopatina Y, Żakowicz AM, Shabarova Z, Ford T, Fonseca FF, Odoke W, van den Hombergh J, Avelino-Silva VI, Benzaken AS, Miles RC. Safeguarding HIV prevention and care services amidst military conflict: experiences from Ukraine. BMJ Glob Health 2023; 8:e014299. [PMID: 38148111 PMCID: PMC10753732 DOI: 10.1136/bmjgh-2023-014299] [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: 10/19/2023] [Accepted: 11/24/2023] [Indexed: 12/28/2023] Open
Abstract
Ukraine stands out among European countries concerning HIV epidemiological data. Since February 2022, the military conflict with Russian forces has posed unprecedented challenges to HIV prevention and care. AIDS Healthcare Foundation (AHF), a global non-profit organisation with operations in Ukraine since 2009, implemented a preparedness plan to protect staff members and support local facilities in the continuity of care throughout the war. In this manuscript, we describe the strategies adopted by AHF to anticipate the risk of military conflict, steps to implement a preparedness plan, main challenges faced by local staff members and managers, adaptations needed as the conflict evolved, and indicators of HIV care 1 year before and 1 year after the onset of the conflict. Our experience shows that safeguarding the organisation's human resources has been a prerequisite to sustain services throughout the war.
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Affiliation(s)
| | | | - Zoya Shabarova
- AIDS Healthcare Foundation Europe Bureau, Amsterdam, The Netherlands
| | - Terri Ford
- AIDS Healthcare Foundation Global Program, Los Angeles, California, USA
| | | | - Wilfred Odoke
- AIDS Healthcare Foundation Global Program, Los Angeles, California, USA
| | | | - Vivian I Avelino-Silva
- AIDS Healthcare Foundation Global Program, Los Angeles, California, USA
- Department of Infectious and Parasitic Diseases, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | | | - Ralph C Miles
- AIDS Healthcare Foundation Global Program, Los Angeles, California, USA
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40
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Abbasi K, Ali P, Barbour V, Bibbins-Domingo K, Olde Rikkert MGM, Gong P, Haines A, Helfand I, Horton R, Mash B, Mitra A, Monteiro C, Naumova EN, Rubin EJ, Ruff T, Sahni P, Tumwine J, Yonga P, Zielinski C. Reducing the risks of nuclear war: the role of health professionals†. Int J Epidemiol 2023; 52:1675-1676. [PMID: 37623698 PMCID: PMC10749768 DOI: 10.1093/ije/dyad115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023] Open
Affiliation(s)
| | - Parveen Ali
- Editor-in-Chief, International Nursing Review
| | | | | | | | - Peng Gong
- Editor-in-Chief, Chinese Science Bulletin
| | - Andy Haines
- London School of Hygiene and Tropical Medicine, UK
| | - Ira Helfand
- Past President, International Physicians for the Prevention of Nuclear War
| | | | - Bob Mash
- Editor-in-Chief, African Journal of Primary Health Care & Family Medicine
| | - Arun Mitra
- Past President, International Physicians for the Prevention of Nuclear War
| | | | | | - Eric J Rubin
- Editor-in-Chief, New England Journal of Medicine
| | - Tilman Ruff
- Past President, International Physicians for the Prevention of Nuclear War
| | - Peush Sahni
- Editor-in-Chief, National Medical Journal of India
| | | | - Paul Yonga
- Editor-in-Chief, East African Medical Journal
| | - Chris Zielinski
- University of Winchester, UK; World Association of Medical Editors
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41
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Rosa WE, Connor S, Downing J, Marston J, Radbruch L. Access to palliative medicine in armed conflict: a basic right and an urgent need. Lancet 2023; 402:2291-2292. [PMID: 38042169 DOI: 10.1016/s0140-6736(23)02638-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 11/22/2023] [Indexed: 12/04/2023]
Affiliation(s)
- William E Rosa
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10023, USA.
| | | | - Julia Downing
- International Children's Palliative Care Network, Bristol, UK
| | - Joan Marston
- Palliative Care in Humanitarian Aid Situations and Emergencies, Edinburgh, UK; Palliative Care for Children, Bloemfontein, South Africa
| | - Lukas Radbruch
- International Association for Hospice and Palliative Care, Houston, TX, USA; Department of Palliative Medicine, University Hospital of Bonn, Bonn, Germany
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42
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Abstract
In this Viewpoint, the author examines whether health care professionals have any responsibilities to speak out about the conflict in the Middle East.
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Affiliation(s)
- Matthew K Wynia
- University of Colorado Center for Bioethics and Humanities, Aurora
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43
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Saugstad OD, Modi N, Moretti C, Obladen M, Vento M, Speer CP. Newborns and Children in War and Terror. Neonatology 2023; 121:137-140. [PMID: 38086337 PMCID: PMC10994576 DOI: 10.1159/000535401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 11/20/2023] [Indexed: 04/04/2024]
Affiliation(s)
| | - Neena Modi
- Section of Neonatal Medicine, School of Public Health, Imperial College London, London, UK
| | - Corrado Moretti
- Department of Pediatrics, Sapienza University of Rome, Rome, Italy
| | - Michael Obladen
- Department of Neonatology, Charite University Medicine Berlin, Berlin, Germany
| | - Maximo Vento
- Division of Neonatology, University and Polytechnic Hospital La Fe, Valencia, Spain
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44
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45
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Salmiya MA. Gaza hospitals: military siege and bombings. Lancet 2023; 402:2191. [PMID: 38035877 DOI: 10.1016/s0140-6736(23)02566-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 11/14/2023] [Indexed: 12/02/2023]
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Alguacil J, Negrín-Hernández M, Bermúdez-Tamayo C, Cantarero D, Carrasco-Portiño M, Casino G, García-Calvente M, Hernán M, Posenato-García L, Ruíz-Cantero MT, Segura A, Gullón P, Juárez L, Errea M, March JC, Marcos-Marcos J, Mar J, Peiró R, Peiró S, Álvarez-Dardet C. [Armed conflicts and crimes against humanity. Why do they persist?]. Gac Sanit 2023; 37:102347. [PMID: 38052121 DOI: 10.1016/j.gaceta.2023.102347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 10/27/2023] [Indexed: 12/07/2023]
Affiliation(s)
- Juan Alguacil
- Comité Editorial de Gaceta Sanitaria; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Grupo de Investigación en Epidemiología Clínica, Ambiental y Transformación Social (EPICAS), Universidad de Huelva, Huelva, España.
| | - Miguel Negrín-Hernández
- Comité Editorial de Gaceta Sanitaria; Departamento de Métodos Cuantitativos, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España
| | - Clara Bermúdez-Tamayo
- Comité Editorial de Gaceta Sanitaria; Escuela Andaluza de Salud Pública, Granada, España
| | - David Cantarero
- Comité Editorial de Gaceta Sanitaria; Departamento de Economía, Universidad de Cantabria, Santander, España
| | - Mercedes Carrasco-Portiño
- Comité Editorial de Gaceta Sanitaria; Departamento de Obstetricia y Puericultura, Universidad de Concepción, Concepción, Chile; Grupo de Investigación en Salud Pública, Universidad de Alicante, Alicante, España
| | - Gonzalo Casino
- Comité Editorial de Gaceta Sanitaria; Departamento de Comunicación, Universidad Pompeu Fabra, Barcelona, España
| | - Mar García-Calvente
- Comité Editorial de Gaceta Sanitaria; Escuela Andaluza de Salud Pública, Granada, España; Epidemiología y Salud Pública, Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, España
| | - Mariano Hernán
- Comité Editorial de Gaceta Sanitaria; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Escuela Andaluza de Salud Pública, Granada, España
| | - Leila Posenato-García
- Comité Editorial de Gaceta Sanitaria; Instituto de Pesquisa Econômica Aplicada, Brasilia, Brasil
| | - María Teresa Ruíz-Cantero
- Comité Editorial de Gaceta Sanitaria; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Grupo de Investigación en Salud Pública, Universidad de Alicante, Alicante, España
| | - Andreu Segura
- Comité Editorial de Gaceta Sanitaria; Departamento de Ciencias Experimentales y de la Salud, Universidad Pompeu Fabra, Barcelona, España
| | - Pedro Gullón
- Comité Editorial de Gaceta Sanitaria; Departamento de Cirugía, Ciencias Médicas y Sociales, Universidad de Alcalá de Henares, Madrid, España
| | - Lucero Juárez
- Comité Editorial de Gaceta Sanitaria; Grupo de Investigación en Salud Pública, Universidad de Alicante, Alicante, España
| | - María Errea
- Comité Editorial de Gaceta Sanitaria; Consultora e Investigadora en Economía de la Salud, Pamplona, España
| | - Joan Carles March
- Comité Editorial de Gaceta Sanitaria; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Escuela Andaluza de Salud Pública, Granada, España
| | - Jorge Marcos-Marcos
- Comité Editorial de Gaceta Sanitaria; Departamento de Psicología de la Salud, Universidad de Alicante, Alicante, España
| | - Javier Mar
- Vocal SESPAS de Gaceta Sanitaria; Unidad de Gestión Sanitaria, Hospital Alto Deba, Arrasate (Gipuzkoa), España
| | - Rosanna Peiró
- Coordinadora del Consejo Asesor de Gaceta Sanitaria; Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana FISABIO - Salud Pública, Valencia, España
| | - Salvador Peiró
- Comité Editorial de Gaceta Sanitaria; Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana FISABIO - Salud Pública, Valencia, España
| | - Carlos Álvarez-Dardet
- Comité Editorial de Gaceta Sanitaria; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Grupo de Investigación en Salud Pública, Universidad de Alicante, Alicante, España
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47
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Abbasi K, Ali P, Barbour V, Bibbins-Domingo K, Rikkert MGMO, Horton R, Mash R, Monteiro C, Naumova EN, Rubin EJ, Sahni P, Tumwine J, Yonga P, Zielinski C, Mitra A, Ruff T, Haines A, Helfand I. Reducing the risks of nuclear war-the role of health professionals. Eur J Nucl Med Mol Imaging 2023; 51:25-26. [PMID: 37831124 DOI: 10.1007/s00259-023-06453-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Affiliation(s)
| | - Parveen Ali
- Health Sciences School, University of Sheffield, Sheffield, UK
- Doncaster and Bassetlaw Teaching Hospitals, Doncaster, UK
- Sheffield University Interpersonal Violence Research Group, Sheffield, UK
| | | | | | | | | | - Robert Mash
- Division of Family Medicine and Primary Care, Stellenbosch University, Stellenbosch, South Africa
- African Journal of Primary Health Care and Family Medicine, Stellenbosch, South Africa
| | - Carlos Monteiro
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paolo, Brazil
| | | | - Eric J Rubin
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Cambridge, MA, USA
| | - Peush Sahni
- MBBS (All India Institute of Medical Sciences [AIIMS]), New Delhi, India
| | - James Tumwine
- School of Medicine at, Kabale University, Kampala, Uganda
| | - Paul Yonga
- CA Medlynks Medical Centre and Laboratory, East African Medical Journal, Nairobi, Kenya
| | - Chris Zielinski
- World Association of Medical Editors, University of Winchester and Vice-President, Winchester, UK.
| | - Arun Mitra
- President Indian Doctors for Peace and Development, Ludhiana, India
| | - Tilman Ruff
- International Physicians for the Prevention of Nuclear War, University of Melbourne, Melbourne, VIC, Australia
| | - Andy Haines
- London School of Hygiene and Tropical Medicine, London, UK
| | - Ira Helfand
- International Physicians for the Prevention of Nuclear War, Springfield, IL, USA
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48
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Mani ZA, Kuhn L, Plummer V. Emergency care in the context of armed conflict: Nurses' perspectives of the essential core competencies. Int Nurs Rev 2023; 70:510-517. [PMID: 37534434 DOI: 10.1111/inr.12870] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 07/23/2023] [Indexed: 08/04/2023]
Abstract
AIM To identify nurses' perspectives of their core competencies for emergency care in the context of armed conflict. INTRODUCTION Emergency department's (ED) capacity is frequently overwhelmed by a sudden surge of patients when located near armed conflict. Although emergency nurses are key frontline responders, evidence detailing core competencies needed to work in these areas remains limited. METHOD The study used a cross-sectional survey design and is reported using STROBE guidelines. A validated questionnaire was administered in hospitals near the southern Kingdom of Saudi Arabia and Yemen border, where emergency nurses regularly manage large numbers of patients from armed conflict. RESULT A total of 163 questionnaires were returned (68% response rate). Most participants were female and had more than six years of ED experience. The core competencies for emergency nurses working near armed conflict were identified and highly rated by participants: the highest mean value was 9.47/10 and the lowest was 8.89/10. Analysis revealed regular education, training and drills were needed to provide quality emergency nursing care for victims of armed conflict. CONCLUSION AND IMPLICATIONS FOR NURSING AND HEALTH POLICY This study provides new evidence regarding core competencies in emergency nursing care in the context of armed conflict. The identified competencies should be incorporated into future education, curricula, training programmes and evaluations to enable emergency nurses to function effectively in the context of armed conflict. The findings will assist decision-makers to develop plans and strategies for mitigating risk and improving the future nursing response in similar contexts.
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Affiliation(s)
- Zakaria A Mani
- School of Nursing and Midwifery, Monash University, Frankston, Australia
- College of Nursing, Jazan University, Jazan, Saudi Arabia
| | - Lisa Kuhn
- School of Nursing and Midwifery, Monash University, Frankston, Australia
- Monash Health, Clayton, Australia
| | - Virginia Plummer
- School of Nursing and Midwifery, Monash University, Frankston, Australia
- Federation University Australia, Victoria, Australia
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Ponsford M. Research in Chornobyl zone restarts amid ravages of war. Nature 2023; 624:244-246. [PMID: 38092902 DOI: 10.1038/d41586-023-03861-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
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Roscoe P. Social Substitutability and the Emergence of War and Segmental, Multilevel Society. Hum Nat 2023; 34:621-643. [PMID: 38008887 DOI: 10.1007/s12110-023-09465-z] [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] [Accepted: 11/14/2023] [Indexed: 11/28/2023]
Abstract
Raymond Kelly's widely cited Warless Societies and the Origin of War (University of Michigan Press, 2000) seeks to explain the origins of two central signatures of human society: war and segmented-i.e., multilevel-societies. Both, he argues, arose with the emergence of a social-substitutability principle, a rule that establishes a collective identity among a set of individuals such that any one member becomes equivalent to, and responsible for the actions of, the others. This principle emerged during the Holocene, when population increase gave rise to the first lethal ambushes. By its nature, ambush obscures attackers' identities. Those attempting to retaliate for the ambush were therefore obliged to target members of the ambushers' group indiscriminately-i.e., based on a social-substitutability principle. Kelly's proposals draw welcome attention to a widespread, deeply influential, and unsettling human behavior, the disposition to hold everyone in a group culpable for the actions of a few, a proclivity that all too often results in mass slaughter. His general argument, however, is logically and empirically deficient, and cross-cultural evidence on ambush in contact-era New Guinea undermines his anonymity-of-ambush hypothesis. What then accounts for war and multilevel society? The New Guinea evidence strongly supports a contention that social-substitutability behavior arose not from offensive military action (i.e., ambush) but from the defensive military response to ambush. These findings render the social-substitutability argument's unconventional definition of war superfluous, undermine its chronology for the emergence of war, and underwrite an alternative scenario for the origins of multilevel, segmented society.
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Affiliation(s)
- Paul Roscoe
- Department of Anthropology, University of Maine, Orono, ME, 04469, USA.
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