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1.
Artigo em Russo | MEDLINE | ID: mdl-32119227

RESUMO

The article considers the features of the impact of epidemics on the course of hostilities and the fate of the states of Antiquity. Three cases are presented as examples. The first one is related to the invasion of the Assyrian King Sennacherib in Judea and the attempt of his troops to take Jerusalem. The second case is related to the epidemic in Athens in the early years of the Peloponnesian war. The third one - with the epidemic in the Roman Empire in the 2nd half of the 2nd century AD. The analysis, based on information from extant sources, permitted to conclude that the intensity and destructive effect of epidemics in the Ancient World increased gradually. To this fact is attributed the effect of "closing" the Oikumena into a single whole. However, the degree of influence of epidemics on the fate of ancient states is greatly exaggerated by the historical tradition, which developed under the influence of emotional descriptions of the tragedies and mass deaths of people.


Assuntos
Conflitos Armados , Epidemias , Conflitos Armados/história , Epidemias/história , História Antiga
4.
Forensic Sci Int ; 306: 110062, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31786514

RESUMO

The renowned work of Clyde Snow and the development of the Equipo Argentino de Anthropología Forense (EAAF) team has inspired the use of forensic anthropological and archaeological skills in human rights interventions around the world. Whether for medico-legal intervention and acquisition of evidence or humanitarian repatriation and identification of human remains, forensic expertise has garnered attention in the global arena. Arguably fulfilling evidentiary and psychosocial needs, there has been growing interest in this post-conflict redress. However, as part of the critique of these interventions, scholars and practitioners have pointed out - primarily in medico-legal investigations - a lack of sensitization of local communities regarding forensic work, increasing the potential for re-traumatization, unrealistic expectations, or an unintentional increase in political tensions. Research regarding forensic intervention and human remains have permeated social sciences, peace and conflict studies, and science and technology studies, revealing both intentional and unintentional impacts of forensic sciences after mass violence. In an effort to mitigate negative impacts of medico-legal or humanitarian interventions, the research described here sought to sensitize communities in Uganda about forensic methods. Findings from this study suggest that sensitization is necessary and desired, and that a multi-step approach can assist in managing expectations.


Assuntos
Conflitos Armados , Antropologia Forense/organização & administração , Sobreviventes/psicologia , Altruísmo , Arqueologia , Recursos Audiovisuais , Sepultamento , Relações Comunidade-Instituição , Grupos Focais , Antropologia Forense/educação , Direitos Humanos , Humanos , População Rural , Uganda
7.
Disasters ; 44(1): 63-84, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31538674

RESUMO

The 2017 Gulf crisis is one of the most challenging episodes faced by Qatar since its independence in 1971, with major economic, social, and political impacts on the Arab Gulf nation. Its economic prognosis has been brought into doubt, the map of regional alliances has been redrawn, and any prospects of deeper regional integration have been dashed. This paper analyses the little-documented impact of the crisis on Qatar's humanitarian sector, which has unfolded as the small, gas-rich emirate has striven to become a major humanitarian donor. It concludes that while there have been disruptions to humanitarian operations and regional coordination, the Gulf crisis has triggered and in some cases accelerated already intended reforms across the Qatari humanitarian sector. In the long term, the reorganisation and adaptation implemented to weather the storm of the crisis may help Qatar to emerge from the crisis with a more sustainable and resilient humanitarian sector.


Assuntos
Conflitos Armados , Socorro em Desastres/organização & administração , Humanos , Catar
8.
PLoS Negl Trop Dis ; 13(12): e0007827, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31830034

RESUMO

BACKGROUND: Cutaneous leishmaniasis (CL) has historically been reported from Syria. Since 2011, the country has been affected by a war, which has impacted health and health services. Over the same period, an increase in the number of cases of CL has been reported from several areas across the country and by a number of authors. This study aims to provide the first quantitative evidence of the epidemiological evolution of CL in Syria during the war. MATERIALS AND METHODS: Data on number of CL cases for the period 2011-2018 were extracted from three different surveillance systems: the Ministry of Health (MoH) routine surveillance system, the MoH/WHO sentinel-syndromic Early Warning Alert and Response System (EWARS), and surveillance data collected by the international nongovernmental organization (NGO) the MENTOR Initiative. Data were cleaned and merged to generate the best possible estimates on number of CL cases; incidence of CL was also calculated based on data on resident population. Data reported from the years preceding the conflict (2007-2010) were also added to the analysis for comparative purposes. RESULTS: The analysis of data from the three available sources over the period considered indicates that number of reported cases progressively grew from prewar levels to reach a peak in 2015, decreased in 2016, remained stable in 2017, and increased again in 2018. Such a trend was mirrored by changes in incidence of infection. Some governorates, which used to report low numbers of CL cases, started recording higher number of cases after the onset of the war. CONCLUSION: The war coincided with a major rise in reported number of CL cases and incidence of infection, although an increasing trend was already appreciable before its onset.


Assuntos
Conflitos Armados , Leishmaniose Cutânea/epidemiologia , Humanos , Incidência , Prevalência , Síria/epidemiologia
10.
Pediatrics ; 144(6)2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31771960

RESUMO

Millions of children are subjected to abuse, neglect, and displacement, and millions more are at risk for not achieving their developmental potential. Although there is a global movement to change this, driven by children's rights, progress is slow and impeded by political considerations. The United Nations Convention on the Rights of the Child, a global comprehensive commitment to children's rights ratified by all countries in the world except the United States (because of concerns about impingement on sovereignty and parental authority), has a special General Comment on "Implementing Child Rights in Early Childhood." More recently, the World Health Organization and United Nations Children's Fund have launched the Nurturing Care Framework for Early Childhood Development (ECD), which calls for public policies that promote nurturing care interventions and addresses 5 interrelated components that are necessary for optimal ECD. This move is also complemented by the Human Capital Project of the World Bank, providing a focus on the need for investments in child health and nutrition and their long-term benefits. In this article, we outline children's rights under international law, the underlying scientific evidence supporting attention to ECD, and the philosophy of nurturing care that ensures that children's rights are respected, protected, and fulfilled. We also provide pediatricians anywhere with the policy and rights-based frameworks that are essential for them to care for and advocate for children and families to ensure optimal developmental, health, and socioemotional outcomes. These recommendations do not necessarily reflect American Academy of Pediatrics policy.


Assuntos
Defesa da Criança e do Adolescente/legislação & jurisprudência , Desenvolvimento Infantil , Política de Saúde , Conflitos Armados , Criança , Maus-Tratos Infantis/prevenção & controle , Trabalho Infantil , Crianças com Deficiência , Disparidades em Assistência à Saúde , Humanos , Necessidades Nutricionais , Pediatras , Papel do Médico , Pobreza , Nações Unidas , Estados Unidos
11.
Global Health ; 15(1): 81, 2019 11 28.
Artigo em Inglês | MEDLINE | ID: mdl-31779660

RESUMO

BACKGROUND: In conflict settings, research capacities have often been de-prioritized as resources are diverted to emergency needs, such as addressing elevated morbidity, mortality and health system challenges directly and/or indirectly associated to war. This has had an adverse long-term impact in such protracted conflicts such as those found in the Middle East and North Africa region (MENA), where research knowledge and skills have often been compromised. In this paper, we propose a conceptual framework for health research capacity strengthening that adapts existing models and frameworks in low- and middle-income countries and uses our knowledge of the MENA context to contextualise them for conflict settings. METHODS: The framework was synthesized using "best fit" framework synthesis methodology. Relevant literature, available in English and Arabic, was collected through PubMed, Google Scholar and Google using the keywords: capacity building; capacity strengthening; health research; framework and conflict. Grey literature was also assessed. RESULTS: The framework is composed of eight principal themes: "structural levels", "the influence of the external environment", "funding, community needs and policy environment", "assessing existing capacity and needs", "infrastructure and communication", "training, leadership and partnership", "adaptability and sustainability", and "monitoring and evaluation"; with each theme being supported by examples from the MENA region. Our proposed framework takes into consideration safety, infrastructure, communication and adaptability as key factors that affect research capacity strengthening in conflict. As it is the case more generally, funding, permissible political environments and sustainability are major determinants of success for capacity strengthening for health research programmes, though these are significantly more challenging in conflict settings. Nonetheless, health research capacity strengthening should remain a priority. CONCLUSION: The model presented is the first framework that focuses on strengthening health research capacity in conflict with a focus on the MENA region. It should be viewed as a non-prescriptive reference tool for health researchers and practitioners, from various disciplines, involved in research capacity strengthening to evaluate, use, adapt and improve. It can be further extended to include representative indicators and can be later evaluated by assessing its efficacy for interventions in conflict settings.


Assuntos
Conflitos Armados , Pesquisa Biomédica/organização & administração , Fortalecimento Institucional/organização & administração , Modelos Organizacionais , África do Norte , Humanos , Oriente Médio
12.
AANA J ; 87(1): 65-70, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31587746

RESUMO

The US Army's 541st Forward Surgical Team (FST) deployed in support of Operation Inherent Resolve- Syria in 2017. Throughout the deployment the 541st FST provided surgical and anesthesia services to US, coalition, and partner forces in numerous austere environments. Following an enemy attack, the FST received multiple casualties and provided a total of 7 critical medication infusions to 3 patients without the aid of electronic-controlled intravenous (IV) infusion pumps or syringes for 10 hours while the wounded soldiers waited for evacuation to a higher level of care. The team administered propofol, norepinephrine, tranexamic acid, and ketamine by individual gravity infusions relying solely on counting drops. An infusion rate monitor (DripAssist, Shift Labs Inc) was used to assist in initial IV rate setup and maintenance. The medics and nurses of the 541st FST found that the infusion rate monitor improved the speed of setting the IV infusion rate, drop counting accuracy, and the team's ability to monitor the continuous delivery of gravity IV infusions.


Assuntos
Anestésicos Intravenosos/administração & dosagem , Conflitos Armados , Infusões Intravenosas/instrumentação , Medicina Militar , Monitorização Fisiológica/instrumentação , Dor/prevenção & controle , Ferimentos e Lesões , Adulto , Feminino , Humanos , Masculino , Síria , Estados Unidos , Adulto Jovem
13.
Colomb Med (Cali) ; 50(2): 52-66, 2019 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-31607763

RESUMO

Objective: To describe the experiences of older adults around forced displacement due to the Colombian armed conflict. Methods: Interpretive-comprehensive study, with a hermeneutical approach; several types of sampling were carried out. The participants were 12 people aged over 60 years, who reported having being displaced and who participated in the SABE Colombia Survey. The data were encoded using the Atlas.ti software. A process of condensation of central analytical, support and emerging categories was made. Results: The displacement generated by the armed conflict has been decisive in the current life conditions of the participants. They know that they are survivors of someone else's violence; there is dislocation, loss of territory, de-anchoring, lack of protection and insecurity. To the stigma of old age, it is added being displaced and being strangers in a place where they don't belong. They live the violent uprooting of their lands and the confusion of their identity; they found themselves in a foreign scene where they were the unusual and the strangers; from receiving threats, they passed to be labeled as 'threatening'. This forced displacement stems from violence, but also from fear, and it marks the trajectory of life for older people who experience a prolonged struggle for survival in often hostile environments, living "permanently" displaced. Conclusion: When there is displacement, older people are not only shed of their land and their home, but also from their cosmos and their vital referents; in addition, it changes their life trajectory and their place in the world. Interventions should be designed based on specific particular and contextual analyses.


Assuntos
Conflitos Armados/psicologia , Refugiados/psicologia , Violência/psicologia , Idoso , Idoso de 80 Anos ou mais , Colômbia , Medo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
14.
Environ Monit Assess ; 191(11): 643, 2019 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-31598800

RESUMO

Today, armed conflict affects some twenty countries, covering an area making up 11% of the surface area of the Earth. Any degradation of nature in these areas represents a harmful depletion of the world's natural heritage. Despite this, environmental issues are neglected during these periods of conflict, considered secondary to the urgency of restoring peace and safeguarding human life. Yet their consequences are potentially severe. In these areas, it is future generations who will suffer the effects of the current devastation for a very long time. In this context, the method developed in this study, named (Geographic Information System) for Environmental Monitoring in Wartime, can be used to calculate a risk indicator for environmental degradation, spatial monitoring and risk management. This will make it possible to identify the main threats to protected areas, catalogue the damage caused to the environment by armed conflicts and create a dynamic risk map. In this paper, GIS-EMW has been applied to calculate a risk indicator for environmental degradation in Syria.


Assuntos
Conflitos Armados , Monitoramento Ambiental/métodos , Sistemas de Informação Geográfica , Humanos , Gestão de Riscos , Condições Sociais , Síria
15.
Int Health ; 11(5): 358-360, 2019 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-31529116

RESUMO

Attacks on humanitarianism are threefold. First, in conflict zones, over the past decade attacks on humanitarian health facilities and personnel are increasingly documented, along with a decline in respect for core humanitarian principles by state and non-state actors, and this will continue. Second, growing instrumentalisation, a failure to adequately fund the sector, antimigrant/refugee populism on the rise and the protracted nature of many crises are provoking a shift away from humanitarian to development healthcare aid over the next decade, intended to keep refugees far away from developed countries by encouraging their integration into immediate neighbouring states. This undermines humanitarian healthcare emergency response capacity. Third, the climate crisis will massively increase humanitarian healthcare needs among the most vulnerable over the next decade and challenge the sector to respond across all its programmes, not least as it absorbs a renewed youthful agency elsewhere in climate protest.


Assuntos
Altruísmo , Conflitos Armados , Mudança Climática , Assistência à Saúde/economia , Assistência à Saúde/organização & administração , Humanos , Refugiados
16.
Tohoku J Exp Med ; 249(1): 33-41, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31548492

RESUMO

Modern day health care providers have traditionally only focused on meeting the response phase requirements of disasters. The emergence of complex global public health crises such as climate change and extremes, biodiversity loss, emergencies of scarcity, rapid unsustainable urbanization, migrant and refugee surges, domestic and international terrorism, cyber-security, the civilianization of war and conflict, and the global rise of resistant antibiotics has resulted in an unprecedented rise in direct and indirect mortality and morbidity. These crises are beyond the current decision-making and operational capabilities of traditional disaster management and its providers most of who are community level practitioners representing every discipline. The 1930s "disaster cycle" concept describes a phase-related approach to meeting the strategic, operational, research, educational, and training components required of disasters; and, presents an opportunity for the structured development of a Health Crisis Management Framework to oversee the phase-related strategic and operational requirements for prevention, preparedness, response, recovery and rehabilitation challenges of major global public health crises. Whereas this approach mimics the manner in which practitioners at every level of society identify with in their daily practices, this approach deserves the support of every clinician, researcher, academic, and ancillary health care provider. Interestingly, this was also the intent of the original 1930 disaster cycle concept.


Assuntos
Gestão de Recursos da Equipe de Assistência à Saúde , Emergências , Saúde Global , Saúde Pública , Conflitos Armados , Guerra Biológica , Guerra Química , Mudança Climática , Segurança Computacional , Humanos
17.
Sex Reprod Health Matters ; 27(1): 1601965, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31533572

RESUMO

There is a paucity of data on violence against women and girls (VAWG) during times of conflict in general and even less information specifically on violence against adolescent girls. Based on secondary analysis of a larger study on VAWG in South Sudan, this article highlights the specific experience of conflict-affected adolescent girls resident in the Juba Protection of Civilian sites. Quantitative data from a cross-sectional household survey shows that the prevalence of non-partner sexual violence (NPSV) (26.5%) and intimate partner violence (IPV) (43.1% of partnered respondents) was high among a cohort of girls who were of adolescent age during the 2013 crisis. Direct exposure to armed conflict increased the odds of respondents experiencing NPSV (AOR: 7.21; 95%CI: 3.94-13.17) and IPV (AOR: 2.37; 95%CI: 1.07-5.29). Quantitative and qualitative data also showed that patriarchal practices, compounded by poverty and unequal power relationships within the home, remain some of the primary drivers of VAWG even in conflict-affected settings. Prevention activities need to consider these wider underlying drivers of VAWG during times of armed conflict, as they remain key factors affecting violence against adolescent girls.


Assuntos
Conflitos Armados/psicologia , Abuso Sexual na Infância/psicologia , Abuso Sexual na Infância/estatística & dados numéricos , Violência por Parceiro Íntimo/psicologia , Violência por Parceiro Íntimo/estatística & dados numéricos , Adolescente , Estudos Transversais , Feminino , Humanos , Masculino , Análise Multivariada , Fatores de Risco , Parceiros Sexuais/psicologia , Sudão do Sul , Inquéritos e Questionários , Adulto Jovem
18.
Sex Reprod Health Matters ; 27(2): 1610279, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31533590

RESUMO

The political situation in Yemen has been precarious since 2011 when popular protest broke out amid the Arab Spring, calling for President Saleh to step down. In March 2015, a Houthi insurgency took control of the capital, Sana'a and ignited a civil conflict that is now characterised by foreign political and military involvement. Since 2015, health facilities have been a primary target for airstrikes and bombing. Seaports have been blockaded barring the delivery of essential medicines and supplies, contributing to the near collapse of an already fragile health system. Since 2012, Save the Children (SC) has been implementing a Family Planning (FP) and Post-abortion Care (PAC) programme in two governorates heavily affected by the conflict. Despite the risks associated with the conflict, there remains a strong demand for SC's FP and PAC services. Ongoing programmatic support and capacity strengthening have allowed quality FP and PAC services to continue for Yemenis even when humanitarian access is impeded. Since the onset of conflict in March 2015, 16 facilities provided services to 43,218 new FP clients (with 23% accepting a long-acting method) and treated 3627 women with PAC. Over 93% of FP clients would recommend FP services at the facility to a friend or family member. Findings support growing evidence that women affected by conflict require family planning services, and that demand does not decline as long as quality services remain accessible. An adaptable reproductive health programme model that embraces innovative approaches is necessary for establishing services and maintaining quality during acute conflict.


Assuntos
Serviços de Planejamento Familiar , Acesso aos Serviços de Saúde , Serviços de Saúde Reprodutiva/estatística & dados numéricos , Aborto Induzido , Adolescente , Adulto , Conflitos Armados , Anticoncepção , Serviços de Planejamento Familiar/estatística & dados numéricos , Feminino , Humanos , Entrevistas como Assunto , Pessoa de Meia-Idade , Satisfação do Paciente , Política , Gravidez , Socorro em Desastres , Iêmen , Adulto Jovem
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