Suchergebnisse

This chapter describes how chronic conflict, warfare, and persecution, as lived experiences, have created significant mental distress in communities on the African continent. There is a growing body of research that highlights increasing mental distress in Africa e.g., about sexuality, health, disease, modernity, climate, politics, culture, religion, ethnicities, race, economies etc. Many of these stresses and uncertainties are driven by political persecution, war, and conflict. This has shaped many African people's attitudes and government policies and an increasing scholarly interest in exploring these "uncertainties and mental distresses in Africa." The chapter will show how trauma, as seen in conflict/post-conflict settings in Africa, causes significant mental stress and associated social problems as well as medically-defined PTSD syndromes, anxiety, and depression which cause much morbidity and retard development in many African communities. Taking a classical look at post-traumatic stress disorder, PTSD, the chapter explores the presentation of the various physical and mental clinical syndromes related to war-trauma on the African continent and the consequent health-seeking behaviors of the African peoples in this regard. The term "culture-bound PTSD syndromes" will be introduced and discussed in the broader context of treatment, rehabilitation, and prevention on the continent and worldwide. It will also discuss the dilemma of the vicious cycles of trauma driven by appetitive aggression in today's Africa which portends to further retard socio-economic development and drives the trans-generational perpetuation of ethnic-based conflicts including genocides. Despite this mass traumatization, the chapter points to the virtual absence of post-conflict mental health policies in almost all African countries, hence leading to discussions of "best-practices" recommendations.

This chapter describes how chronic conflict, warfare, and persecution, as lived experiences, have created significant mental distress in communities on the African continent. There is a growing body of research that highlights increasing mental distress in Africa e.g., about sexuality, health, disease, modernity, climate, politics, culture, religion, ethnicities, race, economies etc. Many of these stresses and uncertainties are driven by political persecution, war, and conflict. This has shaped many African people's attitudes and government policies and an increasing scholarly interest in exploring these "uncertainties and mental distresses in Africa." The chapter will show how trauma, as seen in conflict/post-conflict settings in Africa, causes significant mental stress and associated social problems as well as medically-defined PTSD syndromes, anxiety, and depression which cause much morbidity and retard development in many African communities. Taking a classical look at post-traumatic stress disorder, PTSD, the chapter explores the presentation of the various physical and mental clinical syndromes related to war-trauma on the African continent and the consequent health-seeking behaviors of the African peoples in this regard. The term "culture-bound PTSD syndromes" will be introduced and discussed in the broader context of treatment, rehabilitation, and prevention on the continent and worldwide. It will also discuss the dilemma of the vicious cycles of trauma driven by appetitive aggression in today's Africa which portends to further retard socio-economic development and drives the trans-generational perpetuation of ethnic-based conflicts including genocides. Despite this mass traumatization, the chapter points to the virtual absence of post-conflict mental health policies in almost all African countries, hence leading to discussions of "best-practices" recommendations.

The objective of the study was to determine the forms of media involvement in justice for crimes against the civilian population. The research was conducted using the methods of systems approach, descriptive analysis, forecasting, systematic sampling and comparative method. The mass media as an institution of civil society have ample opportunities for active participation in justice, in particular, in the detection and documentation of crimes, social support to victims, coordination of efforts of governmental and non-governmental entities. The media is an active subject in justice for crimes against the civilian population. However, their functions are not of a legal nature; they are aimed at establishing the completeness and objectivity of the facts. It is concluded that the prospects for the development of media activities envisage the model, which focuses on the detection and documentation of crimes, in particular through the latest technologies; provision of social support and opportunities for victims to express their position while facilitating the coordination of efforts between governmental and non-governmental entities interested in justice for crimes against civilians.

Background Armed conflict can indirectly affect population health through detrimental impacts on political and social institutions and destruction of infrastructure. This study aimed to quantify indirect mortality impacts of armed conflict in civilian populations globally, and explore differential effects by armed conflict characteristics and population groups. Methods We included 193 countries between 1990 and 2017 and constructed fixed effects panel regression models using data from the Uppsala Conflict Data Program and Global Burden of Disease study. Mortality rates were corrected to exclude battle-related deaths. We assessed separately four different armed conflict variables (capturing binary, continuous, categorical and quintile exposures) and ran models by cause-specific mortality stratified by age groups and sex. Post-estimation analyses calculated the number of civilian deaths. Results We identified 1,118 unique armed conflicts. Armed conflict was associated with increases in civilian mortality - driven by conflicts categorised as wars. Wars were associated with an increase in age-standardised all-cause mortality of 81.5 per 100.000 population (β 81.5, 95% CI 14.3-148.8) in adjusted models contributing 29.4 million civilian deaths (95% CI 22.1-36.6) globally over the study period. Mortality rates from communicable, maternal, neonatal, and nutritional diseases (β 51.3, 95% CI 2.6-99.9), non-communicable diseases (β 22.7, 95% CI 0.2-45.2) and injuries (β 7.6, 95% CI 3.4-11.7) associated with war increased, contributing 21.0 million (95% CI 16.3-25.6), 6.0 million (95% CI 4.1-8.0), and 2.4 million deaths (95% CI 1.7-3.1) respectively. War-associated increases in all-cause and cause-specific mortality were found across all age groups and both genders, but children aged 0-5 years had the largest relative increases in mortality. Conclusions Armed conflict, particularly war, is associated with a substantial indirect mortality impact among civilians globally with children most severely burdened.

BACKGROUND: Armed conflict can indirectly affect population health through detrimental impacts on political and social institutions and destruction of infrastructure. This study aimed to quantify indirect mortality impacts of armed conflict in civilian populations globally and explore differential effects by armed conflict characteristics and population groups. METHODS: We included 193 countries between 1990 and 2017 and constructed fixed effects panel regression models using data from the Uppsala Conflict Data Program and Global Burden of Disease study. Mortality rates were corrected to exclude battle-related deaths. We assessed separately four different armed conflict variables (capturing binary, continuous, categorical, and quintile exposures) and ran models by cause-specific mortality stratified by age groups and sex. Post-estimation analyses calculated the number of civilian deaths. RESULTS: We identified 1118 unique armed conflicts. Armed conflict was associated with increases in civilian mortality—driven by conflicts categorised as wars. Wars were associated with an increase in age-standardised all-cause mortality of 81.5 per 100,000 population (β 81.5, 95% CI 14.3–148.8) in adjusted models contributing 29.4 million civilian deaths (95% CI 22.1–36.6) globally over the study period. Mortality rates from communicable, maternal, neonatal, and nutritional diseases (β 51.3, 95% CI 2.6–99.9); non-communicable diseases (β 22.7, 95% CI 0.2–45.2); and injuries (β 7.6, 95% CI 3.4–11.7) associated with war increased, contributing 21.0 million (95% CI 16.3–25.6), 6.0 million (95% CI 4.1–8.0), and 2.4 million deaths (95% CI 1.7–3.1) respectively. War-associated increases in all-cause and cause-specific mortality were found across all age groups and both genders, but children aged 0–5 years had the largest relative increases in mortality. CONCLUSIONS: Armed conflict, particularly war, is associated with a substantial indirect mortality impact among civilians globally with children most severely burdened.

"Epidemics of influenza-like disease became widespread in several areas of the Eastern United States during January. The first confirmed outbreak of the season began early in the month in Robeson County in southern North Carolina. Adjacent counties in North Carolina and contiguous areas of South Carolina became progressively involved. By February 15, outbreaks of inf1uenza-like il1ness had been reported from the District of Columbia and 15 States, including North Carolina, Maryland, Virginia, Delaware, Kansas, Illinois, Georgia, Maine, Vermont, South Carolina, New York, Massachusetts, Ohio, Kentucky, and West Virginia. Influenza A2 virus had been confirmed by isolation or by serologic titer rise as the causative agent in outbreaks in the District of Columbia, North Carolina, Maryland, Kansas, New York, and at the Great Lakes Naval Training Station in Illinois. During the month of January, the pattern of spread of disease confined itself to a northerly and southerly direction along the Atlantic Seaboard. The early confirmed outbreaks in Kansas City and Chicago areas occurred in rather specialized population groups, and it was not until February that: community-wide outbreaks were seen in these areas. Figure 1 shows the distribution of outbreaks through February 15. In early February, outbreaks in West Virginia, Kentucky, and Ohio suggested the beginning of a westerly spread, which was confirmed when, by late February J large segments of Middle 'Western and South Central States became involved. By the first week of March, outbreaks of influenza-like disease had been reported from the District of Columbia and 35 States, all east of the Rocky Mountains with the exception of focal outbreaks in Montana and Arizona. Influenza A2 virus was implicated as the etiologic agent in one or more outbreaks in twelve more States including Connecticut, Delaware, Georgia, Iowa, Massachusetts, Michigan, Minnesota, New Jersey, Ohio, South Carolina, Virginia, and Wisconsin. By early March, outbreaks were subsiding in most affected areas of the East and Middle West. The pattern of epidemic spread, however, continued a westerly course, although the extensive, often state-wide, involvement which characterized earlier outbreaks on the Eastern Seaboard was not frequently observed as the epidemic moved westward. Among the Mountain States, Colorado, Idaho, and Utah reported outbreaks for the first time, and the West Coast States of Alaska and California began to experience outbreaks. In mid-March, the State of Washington reported two focal outbreaks. A small focal outbreak also occurred in Wyoming about this time. By late April, one or more outbreaks of influenza-like disease had been reported from the District of Columbia and45 States. Only the States of Florida, Hawaii, Nebraska, Nevada, and New Mexico failed to report increased incidences of this syndrome. InfluenzaA2 virus was implicated as the causative agent of one or more outbreaks in the District of Columbia and a total of 34 States, with the States of Arizona, Arkansas I California, Colorado, Indiana, Kentucky, Louisiana, Missouri, Montana, North Dakota, Pennsylvania, Rhode Island, Tennessee, I Utah, Vermont, Washington, and West Virginia, now added to the list. With the exception of the State of Alaska, where widespread community epidemics occurred during the months of March and April, the West Coast States were notable for the lack of demonstrated community involvement. The State of California represents an interesting example of this phenomenon in which the presence of influenza A2 virus was demonstrated over large areas of the State through serologic confirmation in sporadic cases, but in which outbreaks could be demonstrated largely only in institutional environments. In general, the force of the epidemic, in its capacity for large scale community involvement tended to dissipate as the epidemic moved west. Figure 2 shows the distribution of outbreaks for the epidemic as a whole. Conspicuous by its absence during this epidemic was the widespread excess secondary school absenteeism so markedly associated with the 1957 influenza A2 epidemic. This observation was, in part, confirmed by surveys of age specific attack rate in selected areas of epidemic prevalence, where a marked flattening of the attack rate curves was demonstrated in the age groups 10-19. (See Influenza Surveillance Report No. 76, page 14). For the epidemic as a whole, the only influenza agents implicated by isolation have been strains of influenza A. No isolations of influenza B strains were reported to the Influenza Surveillance Unit during the entire season. The contemporary A strains showed relation, through hemagglutination inhibition to the A2/Jap 305/57 prototype, and are clearly members of the A2 subtype. That a certain amount of .antigenic drift away from the 1957 prototype has occurred is also clearly demonstrated in reciprocal cross hemagglutination inhibition tests using both ferret and rooster immune antisera. Studies at the Respirovirus Unit, Communicable Disease Center would also indicate that this is a continuance of a drift noticed with the appearance of the A2lJap 170/62 prototype strain, in that certain contemporary U. S. isolates would appear to vary antigenical1y as much from A2lJap 170/62 as A2/ Jap 170/62 varies from A2lJap305/57. On May 27 the Surgeon General's Advisory Committee on Influenza met to consider recommendations for the coming year (See Part VII of this Influenza Surveillance Report). Of particular note was the agreement on the prediction that widespread outbreaks of influenza are not likely to occur during the coming winter season. Of further note was the decision to change the current civilian polyvalent vaccine from a four-strain to a six-strain material-with the addition of one more contemporary strain each of A2 and B. The total CCA unitage of the new vaccine will be 600 instead of the current 500, the total CCA unitage of the combined A2components remaining, as before, at 200, and the total unitage of the B components being increased by 100. Also of interest was the increased disparity between the composition of the military vaccine (continuing the old four-strain 1000 CCA unit/ml composition for the coming season) and the new civilian vaccine. The decision to incorporate a new A2 strain into the civilian vaccine, though the new AZ/Jap 170/62 prototype reflects only variation within the subtype and not a major antigenic shift, would seem to reflect an underlying assumption that variations within a subtype may affect vaccine efficacy. During the season there were few adequate studies of vaccine efficacy. However, studies, to be described later in this report, would tend to question the efficacy of the current vaccine in the specific populations considered. One of the studies, in particular, poses the question of whether influenza vaccine induced H. I. antibody is related to vaccine protection. Pneumonia-influenza deaths in the 108 cities first exceeded the epidemic threshold in early January and reached a peak during the week ending March 16. Deaths fell to below threshold levels during the week ending April 13 and have remained so to the present." - p. [1]-5 ; I. Summary -- II. Epidemic reports -- III. International summary -- IV. Special reports -- V. Laboratory report -- VI. Pneumonia influenza mortality -- VII. Surgeon General's Advisory Committee on Influenza: Recommendations for influenza immunization and control in the civilian population ; June 14, 1963. ; Produced by the Communicable Disease Center Epidemiology Branch Influenza Surveillance Unit. ; Section II called also: Influenza, United States-winter 1961-1962 ; "Summarized in this report is information received from State Health Departments, university investigators, virology laboratories and other pertinent sources, domestic and foreign. Much of the information is preliminary. It is intended primarily for the use of those with responsibility for disease control activities. Anyone desiring to quote this report should contact the original investigator for confirmation and interpretation." - preface

This comprehensive and detailed sourcebook offers humanitarian organizations, for the first time, essential information on how to prepare for the key un-natural disasters which they have to face in an ever more dangerous world. The possibility of a chemical, biological, radiological, nuclear or enhanced explosive (CBRNE) disaster has never been greater. Developed countries have the expert infrastructure to deal with Three Mile Island or the Tokyo subway sarin attack. In developing countries such incidents are just as - or more - likely to occur, but the emergency services may be unable to respond in the same way, and international humanitarian agencies may be called on to assist. Extreme Emergencies will be an essential tool in helping agencies plan and prepare for the worst case. Led by staff from the UK medical emergency agency Merlin, the book draws together key international expertise and experience. It explains emergency planning, management and safety issues; gives guidance on the range of hazards, their characteristics, clinical effects and required treatment; and offers detailed resource information from equipment to organizations and training issues.

ObjectiveThis article considers the sociopsychological implications of terrorism, which are sometimes neglected in preparedness plans.MethodsUsing Israeli experiences as a case study, this article briefly reviews four points of connection between terrorism and its psychological and social legacies: the sociopolitical aspects of terrorism, the unexpected nature of terrorism, normalization of terrorism and public resilience, and social aspects of medical care for terror‐related injuries.ResultsThe Israeli experience suggests preparedness plans should include planning for the sociopsychological effects of terrorism on targeted populations and may, in certain contexts, use Israeli approaches as a model.ConclusionsExperience gained in Israel and elsewhere can set the stage for an appropriate response plan striving not only for preparedness but also resilience. Efforts should be made to advance local capabilities, response plans, and resilience by drawing on the experience of others in coping with the terror threat.