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1.
Int J Health Serv ; 52(1): 5-8, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34463182

RESUMEN

The recent events in Palestine-Israel once again have brought anger and frustration to people inside and outside the medical community. Especially for the pediatric community, the recent wars' toll of at least 67 children in the Gaza Strip and two children in Israel killed warrants attention. Armed conflicts have both direct effects on children's physical health and indirect harms through toxic stress and deprivation. During these troubling times, when civilians, including children, are dying and being mutilated because of conflict, it is crucial to understand the role of structural violence in perpetuating immediate violence. This article will shed light on the historical context of the recurrent wars and military aggressions in Palestine-Israel and contextualize them from a broader public health perspective.


Asunto(s)
Árabes , Guerra , Conflictos Armados , Niño , Humanos , Medio Oriente/epidemiología , Violencia
2.
J Spec Oper Med ; 21(4): 46-53, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34969126

RESUMEN

BACKGROUND: Despite being a well-supported strategy, Stress Inoculation Training (SIT) has not been fully incorporated in the advancement of human performance among most military personnel. The RAND Study recommendations for maximizing SIT's potential within high-risk/ high-intensity occupational groups were used in designing the Core Training protocol targeting psychological performance, SIT-NORCAL (Part 1). PURPOSE: The current project (Part 2) sought to further develop the protocol as a health and human performance hybrid through quality improvement analysis of the content, process, and measurement elements for use in the human performance context. METHODS: Evidence-based/evidence-driven methodologies were used in collaborative design tailored to the unique needs of special warfare enablers specializing in Explosive Ordnance Disposal (n = 17). The resultant three-phase training was conducted with a novice group (n = 10) using standardized measurements of collaboration, human performance, and adaptive capabilities on identified training targets. RESULTS: Process elements demonstrated high feasibility, resulting in high collaboration and trainee satisfaction. Significant improvements in psychological performance targets were observed pre- to post-training, and during an Adaptive Environmental Simulation designed by unit members. Two weeks post-training, unit members (n = 5) responded to an actual crash of an F-16 aircraft; measurements indicated maintenance of skill set from training to real-world events. CONCLUSION: Deployment of the elements in the SIT-NORCAL protocol demonstrated early feasibility and positive training impact on occupationally relevant skills that carried over into real-world events.


Asunto(s)
Sustancias Explosivas , Personal Militar , Humanos , Proyectos Piloto , Guerra
3.
PLoS One ; 16(12): e0259985, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34905540

RESUMEN

Situated at a geographic crossroads, the eastern Tianshan Mountain region in northwest China is crucial to understanding various economic, social, and cultural developments on the Eurasian Steppes. One promising way to gain a better knowledge of ancient subsistence economy, craft production, and social change in the eastern Tianshan Mountain region is to study the artifact assemblages from archaeological contexts. Here, we present an analysis of 488 worked animal bones from the large site of Shirenzigou (ca. 1300-1 BCE), to date the largest assemblage of this kind uncovered in the eastern Tianshan Mountain region. We classified these worked bones into six categories, including "ritual objects", "ornaments", "tools", "worked astragali", "warfare and mobility", and "indeterminate". The identification of animal species and skeletal elements indicates that worked bones from Shirenzigou are characterized by a predominance of caprine products, particularly worked astragali, which is consistent with the large proportion of caprine fragments found in animal remains associated with food consumption. This demonstrates the contribution of caprine pastoralism to bone working activities at Shirenzigou. The making of most worked bones does not appear to have required advanced or specialized skills. Considering the absence of dedicated bone working space, alongside the variability in raw material selection and in dimensions of certain types of artifacts, we infer that worked bone production at Shirenzigou was not standardized. In terms of raw material selection and mode of production, Shirenzigou differed from their settled, farming counterparts in the Yellow River valley of northern China. In addition, along with the evidence for violence and horseback riding, the increasing use of bone artifacts associated with warfare and mobility during the late occupation phase of Shirenzigou reflects growing social instability and implies the likely emergence of single mounted horsemen, equipped with light armors, in the region during the late first millennium BCE. Our results provide new insights into animal resource exploitation and changing lifeways of early pastoral societies in the eastern Tianshan Mountain region, expanding our knowledge of the economic, social, and political milieu of late Bronze Age and early Iron Age eastern Eurasia.


Asunto(s)
Agricultura/historia , Crianza de Animales Domésticos/historia , Dieta Paleolítica/historia , Guerra/historia , Animales , Arqueología/métodos , Huesos/anatomía & histología , Conducta Ceremonial , China , Cabras , Historia Antigua , Humanos
4.
Front Public Health ; 9: 765261, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34778192

RESUMEN

Objective: To examine the possibility of estimating the number of civilian casualties in modern armed conflicts. Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, using PubMed, Scopus, and Web of Science search engines. The outcome was analyzed using a qualitative inductive thematic analysis. The scientific evidence of selected article was assessed, using the Health Evidence Quality Assessment Tool. Findings: The review of 66 included articles in this study indicates that with an increasing number of public health emergencies and the lack of vital elements of life such as water and food, emerging armed conflicts seem to be inevitable. In contrast to military-led cross-border traditional wars, modern armed conflicts affect internally on local communities and take civilian lives. Consequently, the measures and tools used in traditional military-led cross-border wars to adequately tally wounded and dead for many decades under the mandates of the International Humanitarian Law, is insufficient for modern warfare. While casualty counting during modern conflicts is deficient due to organizational, political or strategic reasons, the international organizations responsible for collecting such data (the International Federation of Red Cross and Red Crescent and International Institute of Humanitarian Law) face difficulties to access the conflict scene, resulting in under-reported, unreliable or no-reported data. Conclusion: There are challenges in estimating and counting the number of civilian casualties in modern warfare. Although the global need for such data is evident, the risks and barriers to obtaining such data should be recognized, and the need for new international involvement in future armed conflicts should be emphasized.


Asunto(s)
Conflictos Armados , Personal Militar , Urgencias Médicas , Humanos , Derecho Internacional , Guerra
5.
J Prev Med Hyg ; 62(2): E520-E528, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-34604595

RESUMEN

Introduction: Although breast cancer has a lower incidence in developing countries, mortality rates are higher, mainly due to delay in diagnosis and the poor diagnostic and therapeutic capacities. Although screening tests have been available for quite a long time, delayed and advanced presentation is still common, especially in developing countries. The decade-long Syrian crisis has severely crippled the healthcare system and depleted the already-limited capacities of the healthcare services, which under prioritized the care provided to unurgent cases like breast cancer. This study aimed to investigate the practices of breast cancer screening among breast cancer patients. Methods: A cross-sectional study conducted in Al-Beiruni Hospital at Damascus University in 2019, through personal interviews using a structured questionnaire. Results: The sample consisted of 519 patients with breast cancer. One-hundred twenty (23.2%) of them reported undergoing one or more of the different screening methods at least once every six months prior to diagnosis. Several factors had a statistically significant association with the probability of undergoing or performing screening methods including living in large cities, having fewer children, having a full-time or part-time job, and the level of education. Patients who reported having a relative diagnosed previously with breast cancer or any other malignancies were also more likely to screen themselves. Inaccessibility to healthcare services, which was exaggerated by the armed conflicts, had a significant association with less practicing of the screening methods too (OR: 0.4 [0.3-0.7]). Conclusion: The Syrian war and its direct and indirect consequences negatively affected screening practices of breast cancer.


Asunto(s)
Neoplasias de la Mama , Detección Precoz del Cáncer , Adulto , Neoplasias de la Mama/diagnóstico , Estudios Transversales , Femenino , Humanos , Tamizaje Masivo , Persona de Mediana Edad , Siria , Guerra
6.
PLoS One ; 16(10): e0258195, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34669721

RESUMEN

Although conflict, war, violence, and terrorism affect tourism, research that identifies possible channels of these effects is scarce. We explore if the adverse effects are channelled through proximity to conflict areas. We use the conflict in Kosovo in 1999 and the country Croatia as a quasi-natural experiment and take advantage of the specific north-west to south-east orientation of Croatian Adriatic counties to identify the effect of NATO bombing in Kosovo on tourism outcomes as well as the potential proximity channel. Using data on the population of Croatian firms and the difference-in-differences identification strategy we find that tourism companies' revenues decreased significantly due to NATO bombing, especially in accommodation services and in companies with 50 or more employees. However, using a synthetic control approach we find that the adverse effect is only transitory. Analysing heterogeneous effects with respect to the distance of the firm from Kosovo-using a linear and a more flexible model-we find compelling evidence that within-country proximity to conflict is not a significant channel through which the negative effect propagates.


Asunto(s)
Bombas (Dispositivos Explosivos) , Turismo , Guerra , Bebidas , Alimentos , Geografía , Humanos , Industrias , Kosovo , Estadística como Asunto , Yugoslavia
7.
J Spec Oper Med ; 21(3): 72-77, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34529809

RESUMEN

PURPOSE: This study evaluated the musculoskeletal injury (MSKI) self-reporting behaviors among active-duty Air Force Special Warfare personnel to explore potential limitations of injury surveillance approaches. METHODS: Participants completed a 47-item survey between December 2018 and March 2019 regarding their MSKI history. Participants were asked if they sought medical care for symptoms consistent with MSKIs and reasons they did or did not report their injuries. Injury reporting rates were calculated with descriptive statistics and rank ordering was utilized to determine frequency. RESULTS: A total of 398 airmen reported 1,057 injuries occurring in the previous 12-month period, including 508 (48%) injuries identified as not reported to medical personnel. Approximately 55% (N = 579) of all injuries were described as gradual onset. The most common reason for not reporting injuries (28.8%, N = 62) was "fear of potential impact on future career opportunities." CONCLUSION: Approximately half of MSKIs in this sample of US Air Force Special Warfare personnel were not reported to medical personnel. The underreporting of injuries may pose unknown levels of risk and negatively impact military readiness levels.


Asunto(s)
Personal Militar , Enfermedades Musculoesqueléticas , Atención a la Salud , Humanos , Enfermedades Musculoesqueléticas/epidemiología , Enfermedades Musculoesqueléticas/terapia , Autoinforme , Estados Unidos/epidemiología , Guerra
8.
Global Health ; 17(1): 111, 2021 09 19.
Artículo en Inglés | MEDLINE | ID: mdl-34538248

RESUMEN

Ten years of the Syrian war had a devastating effect on Syrian lives, including millions of refugees and displaced people, enormous destruction in the infrastructure, and the worst economic crisis Syria has ever faced. The health sector was hit hard by this war, up to 50% of the health facilities have been destroyed and up to 70% of the healthcare providers fled the country seeking safety, which increased the workload and mental pressure for the remaining medical staff. Five databases were searched and 438 articles were included according to the inclusion criteria, the articles were divided into categories according to the topic of the article.Through this review, the current health status of the Syrian population living inside Syria, whether under governmental or opposition control, was reviewed, and also, the health status of the Syrian refugees was examined according to each host country. Public health indicators were used to summarize and categorize the information. This research reviewed mental health, children and maternal health, oral health, non-communicable diseases, infectious diseases, occupational health, and the effect of the COVID - 19 pandemic on the Syrian healthcare system. The results of the review are irritating, as still after ten years of war and millions of refugees there is an enormous need for healthcare services, and international organization has failed to respond to those needs. The review ended with the current and future challenges facing the healthcare system, and suggestions about rebuilding the healthcare system.Through this review, the major consequences of the Syrian war on the health of the Syrian population have been reviewed and highlighted. Considerable challenges will face the future of health in Syria which require the collaboration of the health authorities to respond to the growing needs of the Syrian population. This article draws an overview about how the Syrian war affected health sector for Syrian population inside and outside Syria after ten years of war which makes it an important reference for future researchers to get the main highlight of the health sector during the Syrian crisis.


Asunto(s)
Salud Pública/normas , Refugiados/estadística & datos numéricos , Guerra/estadística & datos numéricos , Altruismo , Países en Desarrollo/estadística & datos numéricos , Recursos en Salud/provisión & distribución , Recursos en Salud/tendencias , Accesibilidad a los Servicios de Salud/normas , Humanos , Salud Pública/estadística & datos numéricos , Salud Pública/tendencias , Siria
9.
Hist Cienc Saude Manguinhos ; 28(3): 685-708, 2021.
Artículo en Español, Inglés | MEDLINE | ID: mdl-34495112

RESUMEN

An analysis of the relationship between health and war in the context of the Caste War in Yucatan, Mexico, during the second half of the nineteenth century. Using qualitative and quantitative sources, this article reconstructs the main critical health events and argues that the health/disease process at the time can necessarily only be explained in relation to variables connected to the conflict, such as arms trafficking, displacements, diasporas and migrations, food shortages, violence and administrative chaos.


Asunto(s)
Violencia , Guerra , Conflictos Armados , México , Clase Social
11.
Hist. ciênc. saúde-Manguinhos ; 28(3): 685-708, jul.-set. 2021. tab, graf
Artículo en Español | LILACS | ID: biblio-1339962

RESUMEN

Resumen Análisis de la relación entre sanidad y guerra en el contexto de la Guerra de Castas, en Yucatán, México, durante la segunda mitad del siglo XIX. A partir de fuentes cualitativas y cuantitativas, se reconstruyen los principales eventos sanitarios críticos y se plantea que el proceso salud/enfermedad de la época se explica única y necesariamente en relación a variables propias del conflicto, como tráfico de armas, desplazamientos, diásporas y migraciones, falta de alimentos, violencia y caos administrativo.


Abstract An analysis of the relationship between health and war in the context of the Caste War in Yucatan, Mexico, during the second half of the nineteenth century. Using qualitative and quantitative sources, this article reconstructs the main critical health events and argues that the health/disease process at the time can necessarily only be explained in relation to variables connected to the conflict, such as arms trafficking, displacements, diasporas and migrations, food shortages, violence and administrative chaos.


Asunto(s)
Violencia , Guerra , Clase Social , Conflictos Armados , México
12.
Rev. colomb. anestesiol ; 49(3): e200, July-Sept. 2021. tab, graf
Artículo en Inglés | LILACS, COLNAL | ID: biblio-1280176

RESUMEN

Abstract Introduction: Although the peace process in Colombia resulted in a significant reduction in the number of anti-personnel mines across the country, there are no reliable data on the effects of this phenomenon on outcomes for patients who were victims of these devices. Objective: The objective of this study was to assess mortality from landmine injuries before and during the Colombian peace process. Furthermore possible associations between peace negotiations and mortality were explored. Methods: For this study, we used the "Colombian Victims of Antipersonnel Mines Injuries registry" (MAP/MUSE database) data from 2002 to 2018. This registry was launched in 2001 by the government of Colombia with the aim of prospectively and systematically collect information on all the cases of anti-personnel mine injuries in the country. The period between 2002-2012 was classified as the pre-negotiation period (período de guerra), and 2014-2018 as the peace negotiations period, with 2013 classified as a washout year. Multivariate logistic regression was used to explore the association between peace negotiations and mortality among anti-personnel landmine injured individuals. Results: A total of 10306 landmine injury cases were registered. Of these, 1180 (11.4%) occurred in the peace-negotiation period. Mortality was significantly lower during the period of peace negotiations. After adjusting for sex, age group, race, active duty soldier status, rural area, and geographic Departamentos case volumes, the peace negotiation period was found to be associated with lower risk-adjusted odds of mortality after suffering a landmine injury (OR= 0.6, 95% CI, 0.5-0.7; p<0.001). Conclusions: Our findings suggest an association between the period of peace negotiation and a lower likelihood of mortality among victims of anti-personnel landmines.


Resumen Introducción: Aunque el proceso de paz colombiano produjo una reducción en la cantidad de minas antipersona en el país, no hay estimativos sobre el efecto de este fenómeno en los desenlaces de los pacientes víctimas de estos artefactos. Objetivo: Nuestro objetivo fue evaluar la mortalidad por minas antipersona antes y durante la negociación del proceso de paz en Colombia. Además, exploramos posibles asociaciones entre las negociaciones de paz y la mortalidad. Métodos: Para este estudio utilizamos los datos del "Registro de víctimas colombianas de lesiones de minas antipersona" (base de datos MAP / MUSE) de 2002 a 2018. Este registro fue lanzado en 2001 por el gobierno de Colombia con el objetivo de recolectar información de manera prospectiva y sistemática de los casos de trauma por minas antipersona en el país. Clasificamos el período comprendido entre 2002 y 2012 como el período previo a la negociación (período de guerra), el comprendido entre 2014 y 2018 como el período de negociaciones de paz y el año 2013 como período de "depuración". Se utilizaron modelos de regresión logística multivariados para explorar las asociaciones entre las negociaciones de paz y la mortalidad. Resultados: Se registraron un total de 10306 casos de lesiones por minas antipersona. De estos, 1180 (11.4%) ocurrieron en el período de negociación de paz. La mortalidad fue significativamente menor durante el período de negociaciones de paz. El análisis de regresión logística multivariado determinó que el período de negociación de paz se asoció con una menor probabilidad de mortalidad después de sufrir una lesión por minas antipersona (OR = 0,6, IC 95%, 0,5-0,7; p <0,001). Conclusiones: Nuestros hallazgos sugieren una asociación entre el período de negociación de paz y una menor probabilidad de mortalidad entre las víctimas de las minas antipersona.


Asunto(s)
Humanos , Masculino , Adolescente , Guerra , Heridas y Lesiones , Mortalidad , Artefactos , Amputación , Personal Militar , Alprostadil , Análisis de Regresión , Colombia , Atención a la Salud , Gobierno , Minería , Grupos Profesionales
16.
Health Econ ; 30(9): 2287-2295, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34085365

RESUMEN

We study the impact of conflict exposure on health in the Gaza Strip using individual-level longitudinal data and geo-localized information on conflict-related violent events. Results show that individuals living in localities exposed to more conflict events have a higher probability of suffering from a physical impairment and a chronic disease. Two mechanisms contribute to explain why living in conflict-affected area increases the incidence of physical impairment: conflict increases the difficulty to reach health facilities and it decreases individual income. The conflict-induced increase in the probability of having high blood pressure is instead consistent with the development of Post-Traumatic Stress Disorder (PTSD) due to the exposure to conflict-related violent events.


Asunto(s)
Trastornos por Estrés Postraumático , Guerra , Humanos , Medio Oriente/epidemiología , Trastornos por Estrés Postraumático/epidemiología
18.
J Affect Disord ; 290: 93-101, 2021 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-33993086

RESUMEN

BACKGROUND: War survivors often report symptoms of post-traumatic stress disorder (PTSD), depression, anxiety, and somatization. Hence, understanding symptom constellations among different populations of war survivors is critical. METHODS: Using the network approach to psychopathology, we examined symptom centrality for these conditions in war survivors from Balkan countries who had stayed in the area of former conflict compared to those individuals from Balkan countries who had fled to Western European countries (N = 4,167) with the Impact of Events Scale-Revised and the Brief Symptom Inventory. We further compared networks for war survivors who met criteria for PTSD-diagnosis (assessed with the MINI-International Neuropsychiatric Interview) to those without PTSD-diagnosis. RESULTS: Globally, networks were similar across the groups, whereas specific differences emerged in symptom centrality. More consistencies were found between PTSD and Western country networks, which may be partially explained by a higher prevalence of PTSD in those who had fled to Western European than in those who had stayed in the Balkan countries. LIMITATIONS: Given the cross-sectional nature of our data, the directionality of edges in our networks remains unclear. Further, higher levels of trauma exposure and symptom severity in Western country participants may have confounded results. CONCLUSIONS: The PTSD findings are in line with previous research on PTSD symptoms. They further provide novel insights into depressive, anxiety, and somatization symptoms in survivors of war. These findings need to be substantiated and call for future intervention studies that test the effects of targeting central symptoms we identified in our study.


Asunto(s)
Salud Mental , Trastornos por Estrés Postraumático , Estudios Transversales , Humanos , Trastornos por Estrés Postraumático/epidemiología , Sobrevivientes , Guerra
19.
JMIR Public Health Surveill ; 7(5): e27638, 2021 05 19.
Artículo en Inglés | MEDLINE | ID: mdl-34009132

RESUMEN

BACKGROUND: Highly sensitive acute flaccid paralysis (AFP) surveillance, which includes immediate case investigation and specimen collection, is critical for achieving global polio eradication. In Yemen, the Acute Flaccid Paralysis Surveillance System (AFPSS) was launched in 1998 to achieve the polio eradication target. Although Yemen was certified as a polio-free country in 2009, the protracted war since 2015 has placed the country at risk for polio reemergence. OBJECTIVE: The objectives of this analysis were to evaluate the performance of the Yemen AFPSS at both the national and governorate levels, and to assess the impact of the ongoing war on the performance. METHODS: Retrospective descriptive analysis was performed on Yemen secondary AFP surveillance data for the years 2014 (before the war) and 2015-2017 (during the war). Data comprising all children <15 years old reported as having AFP were included in the analysis. AFP surveillance performance was evaluated using World Health Organization-specified AFP surveillance indicators. RESULTS: At the national level, all indicators were met before and after the war except for "lab results received within ≤28 days," which was unmet since the war erupted. Furthermore, the indicator "stool specimens arriving at a central level within ≤3 days" was unmet after the war but only in 2017. At the governorate level, although the indicators "adequacy" and "stool specimens arriving at the laboratory in good condition" were met before the war in all governorates, the former indicator was unmet in 9 (41%) governorates since the war erupted and the latter indicator was also unmet in 9 governorates (41%) but only in 2017. CONCLUSIONS: The findings show that some AFP surveillance indicators were negatively impacted by eruption of the war in Yemen due to closure of the Sana'a capital airport and postponement of sample shipment to the reference laboratory, which remained under long-term poor storage conditions. To ensure rapid detection of polio cases, improving specimen collection, storage, and transportation, together with proper and timely shipment of specimens to the reference laboratory should be considered.


Asunto(s)
Poliomielitis , Vigilancia de la Población , Adolescente , Enfermedades Virales del Sistema Nervioso Central , Niño , Humanos , Mielitis , Enfermedades Neuromusculares , Poliomielitis/epidemiología , Poliomielitis/prevención & control , Estudios Retrospectivos , Guerra , Yemen/epidemiología
20.
Mil Med ; 186(9-10): 263, 2021 08 28.
Artículo en Inglés | MEDLINE | ID: mdl-34023909
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