The effects of political protests on youth human capital and well-being in Egypt.

Protests are one of the most common expressions of modern political conflict, and the wave of demonstrations that marked the onset of the Arab Spring contributed to a global increase in protest activity. Yet few studies have examined the effects of exposure to protests on population well-being even though such exposure may have profound and lasting effects, especially if experienced at critical stages of development over the life course. The aim of our study is to estimate the effects of exposure to political protests on the human capital accumulation and well-being of youth during the tumultuous political transition experienced in Egypt from 2011 to 2014. For a nationally representative panel of youth captured in the 2009 and 2013/2014 waves of the Survey of Young People in Egypt (SYPE), we exploit exogenous geospatial variation in the occurrence of political protests from the Armed Conflict Location & Event Data (ACLED) Project to estimate individual-level changes in social trust, uncertainty, education, and health outcomes for youth exposed to protests. In our panel, 31.1% of the sample lived in districts where riots or protests occurred. Exposure to protests increased overall perceptions of uncertainty about the future. Young men ever exposed to protests were slightly more likely to report good overall health, but experienced sizable worsening in mental health compared to young women ever exposed. Differences by own and family participation in protest events were found for perceptions of uncertainty and mental health. In the aftermath of the Arab Spring and other mass protest movements around the globe, these findings highlight the importance of examining the population-level impacts of different forms of political conflict, particularly as substantial numbers of youth in Middle East and North Africa and elsewhere progress to adulthood under conditions of political instability.

Axiological-Identitary Collective Action Model (AICAM): A new integrative perspective in the analysis of protest.

Current predictive models of collective action have devoted little attention to personal values, such as morals or ideology. The present research addresses this issue by incorporating a new axiological path in a novel predictive model of collective action, named AICAM. The axiological path is formed by two constructs: ideology and moral obligation. The model has been tested for real normative participation (Study 1) and intentional non-normative participation (Study 2). The sample for Study 1 included 531 randomly selected demonstrators and non-demonstrators at the time of a protest that took place in Madrid, May 2017. Study 2 comprised 607 randomly selected participants who filled out an online questionnaire. Structural equation modelling analysis was performed in order to examine the fit and predictive power of the model. Results show that the model is a good fit in both studies. It has also been observed that the new model entails a significant addition of overall effect size when compared with alternative models, including SIMCA. The present research contributes to the literature of collective action by unearthing a new, independent path towards collective action that is nonetheless compatible with previous motives. Implications for future research are discussed, mainly stressing the need to include moral and ideological motives in the study of collective action engagement.

Civil conflict, domestic violence, and poverty as predictors of corporal punishment in Colombia.

BACKGROUND: With lingering effects from more than 50 years of war, young children in Colombia are exposed to multiple risk factors such as poverty, civil conflict, and domestic violence. In addition to these environmental stressors, public and legal support for corporal punishment remains high, which is shown by the high prevalence of young children exposed to corporal punishment in Colombia. OBJECTIVE: The purpose of this study is to identify individual, family, and municipality-level predictors of corporal punishment (i.e., hitting with objects and spanking) in Colombia in order to inform prevention and intervention strategies. PARTICIPANTS AND SETTING: We use information gathered in 2015 from a representative sample of 11,759 mothers of children younger than five in Colombia. METHODS: We employed multi-level models to account for the clustering of families in 217 municipalities. RESULTS: Results show that mothers' prior exposure to corporal punishment by their own parents (ß=0.229;p<0.01), attitudes towards domestic violence ß=0.013;p<0.05, municipality homicide rates ß=0.028;p<0.05 and presence of armed groups ß=0.031;p<0.05, household poverty ß=0.030;p<0.01 and poverty of the municipality ß=0.022;p<0.05 predicted mothers' hitting their young children with an object. However, family ß=-0.028;p<0.05 and municipality poverty ß=-0.016;p<0.05 had a negative association with mothers' use of spanking. CONCLUSIONS: These findings suggest that both family and neighborhood level factors have simultaneous associations with parents' use of corporal punishment. Given the accumulating evidence concerning the adverse effects of corporal punishment on child well-being and development, legislative efforts aimed at reducing and ultimately banning corporal punishment are warranted.

Suicidal Risk evolution in Tunisia, five years after the Jasmine Revolution.

INTRODUCTION: Since the revolution of January 2011, there was an increase in suicide and attempted suicide in Tunisia, particularly among young people. AIM: To establish the suicide risk rate evolution eleven years after the SMPG 2005 survey in Tunisia, which was used to estimate the prevalence of suicide risk at 13.9%. METHODS: We reproduce the survey SMPG of 2005. A sample of 300 people representative of Ariana's area was determined by the method of quotas according to gender, age and level of education. The questionnaire consisted of sociodemographic data and the Mini International Neuropsychiatric Interview (M.I.N.I) in its portion suicidal risk. RESULTS: The sex ratio was 1.01. The mean age was 42 ±2.26 years. The prevalence of suicide risk was 22.7%: mild (90%), medium (6%) and high (4%). The suicide risk's prevalence had increased by 8.8% compared to the first survey SMPG in 2005. The suicide risk rate was higher among women (p = 0.01), among the unemployed (0,008) and those with an income below 850 Tunisian Dinar / month (p = 0.01). CONCLUSION: Given the increase in suicide risk between 2005 and 2016, specific preventive measures should be implemented by the Tunisian authorities to reduce this risk.

Moralization in social networks and the emergence of violence during protests.

In recent years, protesters in the United States have clashed violently with police and counter-protesters on numerous occasions1-3. Despite widespread media attention, little scientific research has been devoted to understanding this rise in the number of violent protests. We propose that this phenomenon can be understood as a function of an individual's moralization of a cause and the degree to which they believe others in their social network moralize that cause. Using data from the 2015 Baltimore protests, we show that not only did the degree of moral rhetoric used on social media increase on days with violent protests but also that the hourly frequency of morally relevant tweets predicted the future counts of arrest during protests, suggesting an association between moralization and protest violence. To better understand the structure of this association, we ran a series of controlled behavioural experiments demonstrating that people are more likely to endorse a violent protest for a given issue when they moralize the issue; however, this effect is moderated by the degree to which people believe others share their values. We discuss how online social networks may contribute to inflations of protest violence.

A decade of major vascular trauma: Lessons learned from gang and civilian warfare.

INTRODUCTION Trinidad and Tobago is a trans-shipment point for the illegal trade of drugs, arms and ammunition and, as such, has a high incidence of gang-related warfare and drug-related crimes. This has led to a high incidence of gunshot and stab wounds, with associated major vascular injuries. We describe our management strategies learned from a decade of vascular trauma experience. METHODS A retrospective analysis of age, gender, type of trauma, vessel injured, procedure and outcome for all cases of vascular trauma between 2006 and 2015 at two surgical units in Trinidad and Tobago. RESULTS There were 198 vascular trauma cases (232 procedures), involving 159 (80%) males at a mean age of 33 years. Gunshots accounted for 103 (52%) cases, followed by stabs/chops (n=50; 25%) and lacerations (n=15; 8%). The most commonly injured vessels were the radial/ulnar arteries (n=39; 20%) and the superficial femoral artery (n=37; 19%). There were seven pseudoaneurysms and three traumatic arteriovenous fistulae. Repair techniques included primary (n=82; 35%), reversed vein (n=63; 27%), polytetrafluoroethylene (n=58; 25%), oversew (n=24; 10%) and endovascular (n=5; 2%) techniques. There were eight (4%) secondary amputations and eight (4%) deaths. CONCLUSIONS Major vascular trauma causes significant morbidity and mortality in Trinidad and Tobago, with the majority of cases due to gunshot injuries secondary to gang-related warfare and civilian violence. We compare our experience with that in the literature on the epidemiology and management of vascular trauma.

The Critical Periphery in the Growth of Social Protests.

Social media have provided instrumental means of communication in many recent political protests. The efficiency of online networks in disseminating timely information has been praised by many commentators; at the same time, users are often derided as "slacktivists" because of the shallow commitment involved in clicking a forwarding button. Here we consider the role of these peripheral online participants, the immense majority of users who surround the small epicenter of protests, representing layers of diminishing online activity around the committed minority. We analyze three datasets tracking protest communication in different languages and political contexts through the social media platform Twitter and employ a network decomposition technique to examine their hierarchical structure. We provide consistent evidence that peripheral participants are critical in increasing the reach of protest messages and generating online content at levels that are comparable to core participants. Although committed minorities may constitute the heart of protest movements, our results suggest that their success in maximizing the number of online citizens exposed to protest messages depends, at least in part, on activating the critical periphery. Peripheral users are less active on a per capita basis, but their power lies in their numbers: their aggregate contribution to the spread of protest messages is comparable in magnitude to that of core participants. An analysis of two other datasets unrelated to mass protests strengthens our interpretation that core-periphery dynamics are characteristically important in the context of collective action events. Theoretical models of diffusion in social networks would benefit from increased attention to the role of peripheral nodes in the propagation of information and behavior.

The effects of temperature on political violence: global evidence at the subnational level.

A number of studies have demonstrated an empirical relationship between higher ambient temperatures and substate violence, which have been extrapolated to make predictions about the security implications of climate change. This literature rests on the untested assumption that the mechanism behind the temperature-conflict link is that disruption of agricultural production provokes local violence. Using a subnational-level dataset, this paper demonstrates that the relationship: (1) obtains globally, (2) exists at the substate level--provinces that experience positive temperature deviations see increased conflict; and (3) occurs even in regions without significant agricultural production. Diminished local farm output resulting from elevated temperatures is unlikely to account for the entire increase in substate violence. The findings encourage future research to identify additional mechanisms, including the possibility that a substantial portion of the variation is brought about by the well-documented direct effects of temperature on individuals' propensity for violence or through macroeconomic mechanisms such as food price shocks.

Has protest increased since the 1970s? How a survey question can construct a spurious trend.

The literature on political participation asserts that protest has increased over the last four decades, all over the world. This trend is derived from surveys asking questions about participation in various forms of protest, including demonstrations, boycotts, and unofficial strikes. The latter question made sense in the context in which it was formulated, Britain in the early 1970s, and with regard to the original methodological aim, measuring 'protest potential'. The absence of a generic question on strikes, however, distorts our understanding of protest. Two sources of data on Britain in the 1980s and 1990 s - a population survey and an event catalogue - comprehensively measure strikes. They show that strikes greatly outnumbered demonstrations and other forms of protest. Another claim in the literature, that protesters are highly educated, no longer holds once strikes are properly counted. Strikes in Britain, as in many countries, have dramatically declined since the 1980s. This decline more than offsets any increase in demonstrations and boycotts, meaning that the total volume of protest has decreased. The episode illustrates how survey questions, when replicated without scrutiny, can misconstrue social trends.

The impact of post-election violence on HIV and other clinical services and on mental health-Kenya, 2008.

INTRODUCTION: In December 2007, civil disruption and violence erupted in Kenya following national elections, displacing 350,000 people and affecting supply chains and services. The Kenyan government and partners were interested in assessing the extent of disruption in essential health services, especially HIV treatment. METHODS: A two-stage cluster sampling for patients taking antiretroviral therapy (ART) was implemented ten weeks after elections, March 10-21, 2008, at twelve health facilities providing ART randomly selected in each of the three provinces most affected by post-election disruption-Rift Valley, Nyanza, and Central Provinces. Convenience samples of patients with tuberculosis, hypertension, or diabetes were also interviewed from the same facilities. Finally, a convenience sampling of internally displaced persons (IDPs) in the three provinces was conducted. RESULTS: Three hundred thirty-six IDPs in nine camps and 1,294 patients in 35 health facilities were interviewed. Overall, nine percent of patients reported having not returned to their routine health care facility; 9%-25% (overall 16%) reported a temporary inability for themselves or their children to access care at some point during January-February 2008. Less than 15% of patients on long-term therapies for HIV, tuberculosis, diabetes, or hypertension had treatment interruptions compared with 2007. The proportion of tuberculosis patients receiving a ≥45-day supply of medication increased from five percent in November 2007 to 69% in December 2007. HIV testing decreased in January 2008 compared with November 2007 among women in labor wards and among persons tested through voluntary counseling and testing services in Nyanza and Rift Valley Provinces. Patients and their family members witnessed violence, especially in Nyanza and Rift Valley Provinces (54%-59%), but few patients (2.5%-14%, 10% overall) personally experienced violence. More IDPs reported witnessing (80%) or personally experiencing (38%) violence than did patients. About half of patients and three-quarters of IDPs interviewed had anxiety or depression symptoms during the four weeks before the assessment. There was no association among patients between the presence of HIV, tuberculosis, diabetes, and hypertension and the prevalence of anxiety or depression symptoms. CONCLUSION: More than 85% of patients in highly affected provinces avoided treatment interruptions; this may be in part related to practitioners anticipating potential disruption and providing patients with medications for an extended period. During periods of similar crisis, anticipating potential limitations on medication access and increased mental health needs could potentially prevent negative health impacts.

Global civil unrest: contagion, self-organization, and prediction.

Civil unrest is a powerful form of collective human dynamics, which has led to major transitions of societies in modern history. The study of collective human dynamics, including collective aggression, has been the focus of much discussion in the context of modeling and identification of universal patterns of behavior. In contrast, the possibility that civil unrest activities, across countries and over long time periods, are governed by universal mechanisms has not been explored. Here, records of civil unrest of 170 countries during the period 1919-2008 are analyzed. It is demonstrated that the distributions of the number of unrest events per year are robustly reproduced by a nonlinear, spatially extended dynamical model, which reflects the spread of civil disorder between geographic regions connected through social and communication networks. The results also expose the similarity between global social instability and the dynamics of natural hazards and epidemics.

Managing the urban commons: the relative influence of individual and social incentives on the treatment of public space.

All communities have common resources that are vulnerable to selfish motives. The current paper explores this challenge in the specific case of the urban commons, defined as the public spaces and scenery of city neighborhoods. A theoretical model differentiates between individual incentives and social incentives for caring for the commons. The quality of a commons is defined as the level of physical (e.g., loose garbage) and social (e.g., public disturbances) disorder. A first study compared levels of disorder across the census block groups of a single city; the second compared the disorder generated by individual addresses in two neighborhoods. Each study found that homeownership, an individual incentive, was the main predictor of disorder. Owner-occupied parcels generated less disorder than their renter-occupied neighbors, but both parcel types produced less disorder in a neighborhood with greater homeownership. The results emphasize the need for considering both individual and social incentives for group-beneficial behaviors.

Ethnicity and conflict: theory and facts.

Over the second half of the 20th century, conflicts within national boundaries became increasingly dominant. One-third of all countries experienced civil conflict. Many (if not most) such conflicts involved violence along ethnic lines. On the basis of recent theoretical and empirical research, we provide evidence that preexisting ethnic divisions do influence social conflict. Our analysis also points to particular channels of influence. Specifically, we show that two different measures of ethnic division--polarization and fractionalization--jointly influence conflict, the former more so when the winners enjoy a "public" prize (such as political power or religious hegemony), the latter more so when the prize is "private" (such as looted resources, government subsidies, or infrastructures). The available data appear to strongly support existing theories of intergroup conflict. Our argument also provides indirect evidence that ethnic conflicts are likely to be instrumental, rather than driven by primordial hatreds.

Lifetime prevalence of mental health disorders and delay in treatment following initial onset: evidence from the Northern Ireland Study of Health and Stress.

BACKGROUND: The current study provides the first epidemiological estimates of lifetime mental disorders across NI based on DSM-IV criteria. Risk factors, delays in treatment and the experience of conflict are also examined. METHOD: Nationally representative face-to-face household survey of 4340 individuals aged > or =18 years in NI using the composite international diagnostic interview. Analyses were implemented using SAS and STATA software. RESULTS: Lifetime prevalence of any disorder was 39.1% while projected lifetime risk was 48.6%. Individuals who experienced conflict were more likely to have had an anxiety, mood or impulse-control disorder. Treatment delays were substantial for anxiety and substance disorders. CONCLUSIONS: Results from this study show that mental disorders are highly prevalent in Northern Ireland. The elevated rates of post-traumatic stress disorder in relation to other countries and the association of living 'in a region of terror' disorders suggests that civil conflict has had an additional impact on mental health. Given substantial delays in treatment, further research is required to investigate the factors associated with failure and delay in treatment seeking.

A heroin prescription trial: case studies from Montreal and Vancouver on crime and disorder in the surrounding neighbourhoods.

BACKGROUND: This study evaluates whether the instauration of a heroin prescription trial ('NAOMI') generated an impact on the occurrence of crime and disorder in surrounding areas. The clinical trial was initiated in Vancouver and Montreal in 2005, with the aim of assessing the benefits of heroin-assisted treatment (HAT) in Canada. While experiences from other jurisdictions where HAT trials have been implemented clearly demonstrate substantial crime reduction effects for trial participants, there is overall concern that HAT clinics - similar to other interventions aiming at problematic street drug users - may induce a 'honeypot' effect, leading to increases in crime and/or disorder problems in the vicinity of interventions. It has been argued that HAT clinics will attract undesirable behaviour associated with cultures of street drug use and thereby produce negative impacts on the community. METHODS: This study examined the incidence of crime and disorder in the Vancouver and Montreal sites before and during the NAOMI trial (2002-2006), using police calls for service and arrest data. Data were analysed by autoregression analyses. RESULTS: The analysis suggested that most indicators remained stable during the pre- and implementation phase of the NAOMI trial in both sites. CONCLUSION: While the attribution of observed crime and disorder trends to the specific clinical interventions in Montreal and Vancouver is difficult and many extrinsic factors may play a role, this study has not generated any clear evidence from institutional police data to suggest increases or decreases in community-based problems associated with HAT programs in Canada.

Conflict induced internal displacement in Nepal.

Nepal has witnessed a humanitarian crisis since the Maoist conflict began ten years ago. The plight of internally displaced persons (IDPs) in Nepal has received little international attention despite being rated one of the worst displacement scenarios in the world. An estimated 200,000 people have been displaced as a result of the conflict, with the far-western districts of Nepal being the worst affected. Internal displacement has stretched the carrying capacity of several cities with adverse physical and mental health consequences for the displaced. Vulnerable women and children have been the worst affected. The government has adopted a discriminatory approach and failed to fulfil its obligations towards IDPs. Non-governmental organisations and international agencies have provided inadequate services to IDPs in their programmes. Tackling the issues of IDPs requires co-operation between government and development agencies: acknowledging the burden of the problem of IDPs, adequate registration and needs assessment, along with health and nutritional surveys, and development of short-term emergency relief packages and long-term programmes for their assistance.

Health services utilization in Jerusalem under terrorism.

OBJECTIVE: The authors explored the effects of an escalation of terrorism on the help-seeking behavior of the general population in Jerusalem, a city that offers an adequate supply of medical and psychiatric services. METHOD: Time-series analyses were applied to examine the utilization of health services (primary medical care and ambulance calls) and mental health services (clinics, hospitals, and telephone hotlines) by Jerusalem residents before and during part of the current intifada. The authors assessed seasonality, general linear trends (from factors such as health education and increased access), short-term intifada impact (reflecting reactions that peaked at the third month and ended 1 year thereafter), and long-term impact (starting at the intifada outbreak and reflecting a more stable population behavior). RESULTS: Adult psychiatric outpatient visits did not change except for the elderly in ongoing care who had both short- and long-term increases. The proportion of recorded ICD-10 diagnoses reflecting intifada-related reactions remained generally stable. Short-term effects included an increase in psychiatric readmissions. First contacts to substance abuse clinics remained unchanged. While long-term effects included a decrease in new psychiatric hospitalizations, the rate of monthly general practitioner visitors and the number of monthly ambulance and hotline calls increased. CONCLUSIONS: Except for the elderly and previously hospitalized persons, Jerusalem residents did not increase their use of psychiatric services but did increase their use of some other health services. These results suggest that this terrorism-affected population did not perceive their mental and social suffering as requiring specialized intervention.

Effects of armed conflict on access to emergency health care in Palestinian West Bank: systematic collection of data in emergency departments.

OBJECTIVE: To assess the impact of restrictions in access to hospital services imposed on the civilian population during the armed conflict in the Palestinian territories occupied by Israel. DESIGN: Consecutive registration of demographic and medical data, with information about transportation time, delay in access to hospital, and course of hospital contact. SETTING: Three hospital emergency departments in Bethlehem and Nablus, in the occupied Palestinian West Bank, during one week in each hospital. PARTICIPANTS: All patients seeking health care in the three hospitals during the study period. RESULTS: A total of 394 of the 2228 emergency department contacts reported being delayed at checkpoints or by detours on their way to the emergency department. Hospital admission was significantly more common for these patients: 32% (n = 125) compared with 13% (n = 205) among those who were not delayed. CONCLUSION: 18% of the emergency department contacts were delayed because of the occupation. The higher hospital admission rate in this group suggests that restrictions in access to hospital services influence the severity of the medical conditions presented.