ResearchPad - war-and-civil-unrest https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[National and regional prevalence of posttraumatic stress disorder in sub-Saharan Africa: A systematic review and meta-analysis]]> https://www.researchpad.co/article/elastic_article_14691 Repeated and prolonged exposure to violence, armed conflict, and mass-casualty events, combined with a lack of access to mental health treatment, may result in a substantial effect on the population burden of posttraumatic stress disorder (PTSD) in sub-Saharan Africa (SSA).While many studies of PTSD have been conducted in SSA, most of these studies derived their estimates from nonrepresentative samples or specific populations.Population-representative epidemiologic data are critical to understand the burden of PTSD in SSA and develop national and regional policies to address that burden.What did the researchers do and find?We conducted a systematic review and meta-analysis of the prevalence of PTSD from representative national and regional studies in SSA.Pooled prevalence estimates were calculated across all studies, and then within subgroups including by sex, assessment time frame (i.e., 1 week, 1 month, 1 year), use of a screening or diagnostic measure, and whether populations were affected or not affected by mass-casualty war or armed conflict.We identified 25 unique studies (N = 58,887) across 10 of the 48 SSA countries.The pooled prevalence of probable PTSD across all studies was 22% (95% CI 13%–32%).The pooled prevalence of probable PTSD in participants from war-exposed regions was 30% (95% CI 20%–40%), while the estimate from war-unexposed regions was 8% (95% CI 3%–15%; p = 0.01).What do these findings mean?These data suggest that PTSD symptoms and probable PTSD are common in SSA.However, information was only found on 10 of the 48 SSA countries, and only 6 studies provided national-level data.Only one study used a measure of PTSD symptoms whose reliability and validity had been assessed previously in the population of interest.Our results suggest both that PTSD is a major public health problem in SSA and that large gaps in our knowledge of this problem remain. ]]> <![CDATA[Resisting hostility generated by terror: An agent-based study]]> https://www.researchpad.co/article/5c466585d5eed0c484519942

We propose an agent-based model leading to a decrease or an increase of hostility between agents after a major cultural threat such as a terrorist attack. The model is inspired from the Terror Management Theory and the Social Judgement Theory. An agent has a cultural identity defined through its acceptance segments about each of three different cultural worldviews (i.e., Atheist, Muslim, Christian) of the considered society. An agent’s acceptance segment is composed from its acceptable positions toward a cultural worldview, including its most acceptable position. An agent forms an attitude about another agent depending on the similarity between their cultural identities. When a terrorist attack is perpetrated in the name of an extreme cultural identity, the negatively perceived agents from this extreme cultural identity point of view tend to decrease the width of their acceptance segments in order to differentiate themselves more from the threatening cultural identity. We generated a set of populations with cultural identities compatible with data from a survey on attitudes among a large sample representative of the population of France; we then simulated the reaction of these agents facing a terrorist attack from Muslim extremists. For most populations, the average attitude toward Muslims becomes more negative. However, for some specific populations, we noticed the opposite effect as the average attitude of the population toward Muslims becomes less negative. In these populations, the Muslim agents strongly differentiate themselves from the terrorists’ extreme cultural identity, and the other agents are aware of these changes. These reactions are due to particular properties of their cultural identities that are identified in this paper.

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<![CDATA[Development and implementation of a pediatric adverse childhood experiences (ACEs) and other determinants of health questionnaire in the pediatric medical home: A pilot study]]> https://www.researchpad.co/article/5c1ab855d5eed0c4840279c7

Adverse Childhood Experiences (ACEs) are associated with poor health outcomes, underlining the significance of early identification and intervention. Currently, there is no validated tool to screen for ACEs exposure in childhood. To fill this gap, we designed and implemented a pediatric ACEs questionnaire in an urban pediatric Primary Care Clinic. Questionnaire items were selected and modified based on literature review of existing childhood adversity tools. Children twelve years and under were screened via caregiver report, using the developed instrument. Cognitive interviews were conducted with caregivers, health providers, and clinic staff to assess item interpretation, clarity, and English/Spanish language equivalency. Using a rapid cycle assessment, information gained from the interviews were used to iteratively change the instrument. Additional questions assessed acceptability of screening within primary care and preferences around administration. Twenty-eight (28) caregivers were administered the questionnaire. Cognitive interviews conducted among caregivers and among 16 health providers and clinic staff resulted in the changes in wording and addition of examples in the items to increase face validity. In the final instrument, no new items were added; however, two items were merged and one item was split into three separate items. While there was a high level of acceptability of the overall questionnaire, some caregivers reported discomfort with the sexual abuse, separation from caregiver, and community violence items. Preference for methods of administration were split between tablet and paper formats. The final Pediatric ACE and other Determinants of Health Questionnaire is a 17-item instrument with high face validity and acceptability for use within primary care settings. Further evaluation on the reliability and construct validity of the instrument is being conducted prior to wide implementation in pediatric practice.

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<![CDATA[Progressive structural capacity loss assessment—A framework for modern reinforced concrete buildings]]> https://www.researchpad.co/article/5c0ed78dd5eed0c484f14393

By the virtue of burgeoning terrorism, the exponential growth of advanced weaponry, and allied aids for explosions, it is quite evident that infrastructural facilities in the world have increasingly become more susceptible to sabotaging activities. The ever enhancing employment of reinforced concrete (RC) in the construction industry around the globe, the progressive collapse mechanisms, and respective mitigation strategies in the context of terrorism have garnered quite an attraction by the structural engineering community. The proficiency to envisage the complete collapse under the chain reaction of structural failures, partial collapse of key structural members, or the strength degradation of fundamental structural elements under the blast or impact loading can deliver significant information to cope with partial or complete structural failure. It is quite convenient to say that during the service life, a structure may experience extreme loading conditions. The current study has proposed a new methodology to cover the effect of uncertainty involved in loading on key structural elements of new and complex structures by emphasizing a very realistic structural capacity loss mechanism that allows the incremental reduction in the structural capacities of pivotal structural elements against any sort of impact loading instead of their complete annihilation. To demonstrate the application of the proposed methodology, a 13-story complex structure was selected that was comprised of a diverse structural configuration. The outcomes and results ensured the structural integrity against the applied loadings, as well as the effectiveness of the proposed methodology.

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<![CDATA[The Cost of War on Public Health: An Exploratory Method for Understanding the Impact of Conflict on Public Health in Sri Lanka]]> https://www.researchpad.co/article/5989da75ab0ee8fa60b96361

Purpose

The direct impact of protracted conflict on population health and development is well understood. However, the extent of a war's impact on long-term health, and the opportunity costs, are less well understood. This research sought to overcome this gap by asking whether or not health outcomes in Sri Lanka would have been better in the absence of a 26-year war than they were in the presence of war.

Methods

A counterfactual model of national and district-level health outcomes was created for Sri Lanka for the period 1982 to 2002. At the national level, the model examined life expectancy, infant mortality rate (IMR), and maternal mortality ratios (MMR). At the district level, it looked at IMR and MMR. The model compared outcomes generated by the counterfactual model to actual obtained health outcomes. It looked at the rate of change and absolute values.

Results

The analysis demonstrated that war altered both rate of change and absolute health outcomes for the worse. The impact was most clearly evident at the district level. IMR was poorer than predicted in 10 districts; of these 8 were outside of the conflict zone. The MMR was worse than expected in 11 districts of which 9 were not in the conflict zone. Additionally, the rate of improvement in IMR slowed as a result of war in 16 districts whereas the rate of improvement in MMR slowed in 9.

Conclusion

This project showed that protracted conflict degraded the trajectory of public health in Sri Lanka and hurt population health outside of the conflict zone. It further provided a novel methodology with which to better understand the indirect impact of conflict on population health by comparing what is to what could have been achieved in the absence of war. In so doing, this research responded to two public health challenges by providing a tool through which to better understand the human and opportunity costs of war and by answering a call for new methodologies.

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<![CDATA[The contribution of gender-based violence and network trauma to gender differences in Post-Traumatic Stress Disorder]]> https://www.researchpad.co/article/5989db51ab0ee8fa60bdc281

Background

Posttraumatic stress disorder (PTSD) occurs twice as commonly amongst women as men. Two common domains of trauma, network trauma and gender based violence (GBV), may contribute to this gender difference in PTSD rates. We examined data from a nationally representative sample of the Australian population to clarify the characteristics of these two trauma domains in their contributions to PTSD rates in men and women.

Methods

We drew on data from the 2007 Australian National Survey of Mental Health and Well-being to assess gender differences across a comprehensive range of trauma domains, including (1) prevalence of lifetime exposure; (2) identification of an index trauma or DSM-IV Criterion A event; and (3) the likelihood of developing full DSM-IV PTSD symptoms once an index trauma was identified.

Results

Men reported more traumatic events (TEs) overall but women reported twice the prevalence of lifetime PTSD (women, 13.4%; men, 6.3%). Women reported a threefold higher level of exposure to GBV and were seven times more likely to nominate GBV as the index trauma as compared to men. Women were twice more likely than men to identify a network trauma as the index trauma and more likely to meet full PTSD symptoms in relation to that event (women, 20.6%; men, 14.6%).

Conclusion

Women are more likely to identify GBV and network trauma as an index trauma. Women’s far greater exposure to GBV contributes to their higher prevalence of PTSD. Women are markedly more likely to develop PTSD when network trauma is identified as the index trauma. Preventing exposure to GBV and providing timely interventions for acute psychological reactions following network trauma may assist in reducing PTSD rates amongst women.

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<![CDATA[What Is the Relationship of Medical Humanitarian Organisations with Mining and Other Extractive Industries?]]> https://www.researchpad.co/article/5989daaeab0ee8fa60baa6ed

Philippe Calain discusses the health and environmental hazards of extractive industries like mining and explores the tensions that arise when medical humanitarian organizations are called to intervene in emergencies involving the extractive sector.

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<![CDATA[War and Bereavement: Consequences for Mental and Physical Distress]]> https://www.researchpad.co/article/5989da74ab0ee8fa60b95dca

Background

Little is known about the long-term impact of the killing of a parent in childhood or adolescence during war on distress and disability in young adulthood. This study assessed current prevalence rates of mental disorders and levels of dysfunction among young adults who had lost their father due to war-related violence in childhood or adolescence.

Methods

179 bereaved young adults and 175 non-bereaved young adults were interviewed a decade after experiencing the war in Kosovo. Prevalence rates of Major Depressive Episode (MDE), anxiety, and substance use disorders, and current suicide risk were assessed using the Mini–International Neuropsychiatric Interview. The syndrome of Prolonged Grief Disorder (PGD) was assessed with the Prolonged Grief Disorder Interview (PG-13). Somatic symptoms were measured with the Patient Health Questionnaire. General health distress was assessed with the General Health Questionnaire.

Findings

Bereaved participants were significantly more likely to suffer from either MDE or any anxiety disorder than non-bereaved participants (58.7% vs. 40%). Among bereaved participants, 39.7% met criteria for Post-Traumatic Stress Disorder, 34.6% for PGD, and 22.3% for MDE. Bereaved participants with PGD were more likely to suffer from MDE, any anxiety disorder, or current suicide risk than bereaved participants without PGD. Furthermore, these participants reported significantly greater physical distress than bereaved participants without PGD.

Conclusion

War-related loss during middle childhood and adolescence presents significant risk for adverse mental health and dysfunction in young adulthood in addition to exposure to other war-related traumatic events. Furthermore, the syndrome of PGD can help to identify those with the greatest degree of distress and dysfunction.

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<![CDATA[What Determines the Duration of War? Insights from Assessment Strategies in Animal Contests]]> https://www.researchpad.co/article/5989db35ab0ee8fa60bd2f38

Interstate wars and animal contests both involve disputed resources, restraint and giving up decisions. In both cases it seems illogical for the weaker side to persist in the conflict if it will eventually lose. In the case of animal contests analyses of the links between opponent power and contest duration have provided insights into what sources of information are available to fighting animals. I outline the theory of information use during animal contests and describe a statistical framework that has been used to distinguish between two strategies that individuals use to decide whether to persist or quit. I then apply this framework to the analysis of interstate wars. War duration increases with the power of winners and losers. These patterns provide no support for the idea that wars are settled on the basis of mutual assessment of capabilities but indicate that settlement is based on attrition. In contrast to most animal contests, war duration is as closely linked to the power of the winning side as to that of the losing side. Overall, this analysis highlights a number of similarities between animal contests and interstate war, indicating that both could be investigated using similar conceptual frameworks.

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<![CDATA[Twin Town in South Brazil: A Nazi's Experiment or a Genetic Founder Effect?]]> https://www.researchpad.co/article/5989da1dab0ee8fa60b7d96e

Cândido Godói (CG) is a small municipality in South Brazil with approximately 6,000 inhabitants. It is known as the “Twins' Town” due to its high rate of twin births. Recently it was claimed that such high frequency of twinning would be connected to experiments performed by the German Nazi doctor Joseph Mengele. It is known, however, that this town was founded by a small number of families and therefore a genetic founder effect may represent an alternatively explanation for the high twinning prevalence in CG. In this study, we tested specific predictions of the “Nazi's experiment” and of the “founder effect” hypotheses. We surveyed a total of 6,262 baptism records from 1959–2008 in CG catholic churches, and identified 91 twin pairs and one triplet. Contrary to the “Nazi's experiment hypothesis”, there is no spurt in twinning between the years (1964–1968) when Mengele allegedly was in CG (P = 0.482). Moreover, there is no temporal trend for a declining rate of twinning since the 1960s (P = 0.351), and no difference in twinning among CG districts considering two different periods: 1927–1958 and 1959–2008 (P = 0.638). On the other hand, the “founder effect hypothesis” is supported by an isonymy analysis that shows that women who gave birth to twins have a higher inbreeding coefficient when compared to women who never had twins (0.0148, 0.0081, respectively, P = 0.019). In summary, our results show no evidence for the “Nazi's experiment hypothesis” and strongly suggest that the “founder effect hypothesis” is a much more likely alternative for explaining the high prevalence of twinning in CG. If this hypothesis is correct, then this community represents a valuable population where genetic factors linked to twinning may be identified.

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<![CDATA[Somalia: A Nation at the Crossroads of Extreme Poverty, Conflict, and Neglected Tropical Diseases]]> https://www.researchpad.co/article/5989da0eab0ee8fa60b78c75 ]]> <![CDATA[The Developmental Dynamics of Terrorist Organizations]]> https://www.researchpad.co/article/5989da3fab0ee8fa60b895ce

We identify robust statistical patterns in the frequency and severity of violent attacks by terrorist organizations as they grow and age. Using group-level static and dynamic analyses of terrorist events worldwide from 1968–2008 and a simulation model of organizational dynamics, we show that the production of violent events tends to accelerate with increasing size and experience. This coupling of frequency, experience and size arises from a fundamental positive feedback loop in which attacks lead to growth which leads to increased production of new attacks. In contrast, event severity is independent of both size and experience. Thus larger, more experienced organizations are more deadly because they attack more frequently, not because their attacks are more deadly, and large events are equally likely to come from large and small organizations. These results hold across political ideologies and time, suggesting that the frequency and severity of terrorism may be constrained by fundamental processes.

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<![CDATA[A Novel Method for Verifying War Mortality while Estimating Iraqi Deaths for the Iran-Iraq War through Operation Desert Storm (1980-1993)]]> https://www.researchpad.co/article/5989d9f5ab0ee8fa60b6fd25

Objectives

We estimated war-related Iraqi mortality for the period 1980 through 1993.

Method

To test our hypothesis that deaths reported by siblings (even dating back several decades) would correspond with war events, we compared sibling mortality reports with the frequency of independent news reports about violent historic events. We used data from a survey of 4,287 adults in 2000 Iraqi households conducted in 2011. Interviewees reported on the status of their 24,759 siblings. Death rates were applied to population estimates, 1980 to 1993. News report data came from the ProQuest New York Times database.

Results

About half of sibling-reported deaths across the study period were attributed to direct war-related injuries. The Iran-Iraq war led to nearly 200,000 adult deaths, and the 1990–1991 First Gulf War generated another approximately 40,000 deaths. Deaths during peace intervals before and after each war were significantly lower. We found a relationship between total sibling-reported deaths and the tally of war events across the period, p = 0.02.

Conclusions

We report a novel method to verify the reliability of epidemiological (household survey) estimates of direct war-related injury mortality dating back several decades.

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<![CDATA[Dynamics of Conflicts in Wikipedia]]> https://www.researchpad.co/article/5989da9fab0ee8fa60ba549c

In this work we study the dynamical features of editorial wars in Wikipedia (WP). Based on our previously established algorithm, we build up samples of controversial and peaceful articles and analyze the temporal characteristics of the activity in these samples. On short time scales, we show that there is a clear correspondence between conflict and burstiness of activity patterns, and that memory effects play an important role in controversies. On long time scales, we identify three distinct developmental patterns for the overall behavior of the articles. We are able to distinguish cases eventually leading to consensus from those cases where a compromise is far from achievable. Finally, we analyze discussion networks and conclude that edit wars are mainly fought by few editors only.

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<![CDATA[Fortune Favours the Bold: An Agent-Based Model Reveals Adaptive Advantages of Overconfidence in War]]> https://www.researchpad.co/article/5989dadeab0ee8fa60bbacd6

Overconfidence has long been considered a cause of war. Like other decision-making biases, overconfidence seems detrimental because it increases the frequency and costs of fighting. However, evolutionary biologists have proposed that overconfidence may also confer adaptive advantages: increasing ambition, resolve, persistence, bluffing opponents, and winning net payoffs from risky opportunities despite occasional failures. We report the results of an agent-based model of inter-state conflict, which allows us to evaluate the performance of different strategies in competition with each other. Counter-intuitively, we find that overconfident states predominate in the population at the expense of unbiased or underconfident states. Overconfident states win because: (1) they are more likely to accumulate resources from frequent attempts at conquest; (2) they are more likely to gang up on weak states, forcing victims to split their defences; and (3) when the decision threshold for attacking requires an overwhelming asymmetry of power, unbiased and underconfident states shirk many conflicts they are actually likely to win. These “adaptive advantages” of overconfidence may, via selection effects, learning, or evolved psychology, have spread and become entrenched among modern states, organizations and decision-makers. This would help to explain the frequent association of overconfidence and war, even if it no longer brings benefits today.

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<![CDATA[Understanding the Dynamics of Violent Political Revolutions in an Agent-Based Framework]]> https://www.researchpad.co/article/5989da11ab0ee8fa60b79997

This paper develops an agent-based computational model of violent political revolutions in which a subjugated population of citizens and an armed revolutionary organisation attempt to overthrow a central authority and its loyal forces. The model replicates several patterns of rebellion consistent with major historical revolutions, and provides an explanation for the multiplicity of outcomes that can arise from an uprising. The relevance of the heterogeneity of scenarios predicted by the model can be understood by considering the recent experience of the Arab Spring involving several rebellions that arose in an apparently similar way, but resulted in completely different political outcomes: the successful revolution in Tunisia, the failed protests in Saudi Arabia and Bahrain, and civil war in Syria and Libya.

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<![CDATA[Intimate partner violence in the post-war context: Women’s experiences and community leaders’ perceptions in the Eastern Province of Sri Lanka]]> https://www.researchpad.co/article/5989db51ab0ee8fa60bdc23c

Background

Exposure to armed conflict and/or war have been linked to an increase in intimate partner violence (IPV) against women. A substantial body of work has focused on non-partner rape and sexual violence in war and post-war contexts, but research about IPV is limited, particularly in Asian settings. This paper presents the finding of a study conducted in the Eastern Province of Sri Lanka. The study explored women’s experiences of and responses to IPV as well as how health and social service providers perceive the problem. It also explored the IPV-related services and supports available after the end of a 30-year civil war.

Method

We conducted in-depth, qualitative interviews with 15 women who had experienced IPV and 15 service providers who were knowledgeable about IPV in the Eastern Province of Sri Lanka. Interviews were translated into English, coded and organized using NVivo8, and analyzed using inductive thematic analysis.

Results

Participants described IPV as a widespread but hidden problem. Women had experienced various forms of abusive and controlling behaviours, some of which reflect the reality of living in the post-war context. The psychological effects of IPV were common, but were often attributed to war-related trauma. Some men used violence to control women and to reinstate power when their gender roles were reversed or challenged due to war and post-war changes in livelihoods. While some service providers perceived an increase in awareness about IPV and more services to address it, this was discordant with women’s fears, feelings of oppression, and perception of a lack of redress from IPV within a highly militarized and ethnically-polarized society. Most women did not consider leaving an abusive relationship to be an option, due to realistic fears about their vulnerability to community violence, the widespread social norms that would cast them as outsiders, and the limited availability of related services and supports.

Implications

These findings revealed the need for more research about IPV in post-war contexts. Women’s experiences in such contexts are influenced and may be masked by a complex set of factors that intersect to produce IPV and entrap women in violence. A more nuanced understanding of the context-specific issues that shape women’s experiences of IPV- and community responses to it—is needed to develop more comprehensive solutions that are relevant to the local context.

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<![CDATA[The Effect on Mental Health of a Large Scale Psychosocial Intervention for Survivors of Mass Violence: A Quasi-Experimental Study in Rwanda]]> https://www.researchpad.co/article/5989d9d4ab0ee8fa60b651eb

Background

War has serious and prolonged mental health consequences. It is argued that post-emergency mental health interventions should not only focus on psychological factors but also address the social environment. No controlled trials of such interventions exist. We studied the effect on mental health of a large scale psychosocial intervention primarily aimed at social bonding in post-genocide Rwanda. The programme is implemented at population level without diagnostic criteria for participation. It is open to any person older than 15 years, and enables participation of over 1500 individuals per year. We postulated that the mental health of programme participants would improve significantly relative to non-participants.

Methods and Findings

We used a prospective quasi-experimental study design with measurement points pre and post intervention and at 8 months follow-up. 100 adults from both sexes in the experimental condition entered the study; follow-up measurements were taken from 81. We selected a control group of 100 respondents with similar age, sex and symptom score distribution from a random community sample in the same region; of these, 73 completed the study. Mental health was assessed by use of the Self Reporting Questionnaire (SRQ-20), a twenty item instrument to detect common mental disorders in primary health care settings. Mean SRQ-20 scores decreased by 2.3 points in the experimental group and 0.8 in the control group (p = 0.033). Women in the experimental group scoring above cut-off at baseline improved with 4.8 points to below cut-off (p<0.001). Men scoring above cut-off at baseline showed a similar trend which was statistically non-significant. No adverse events were observed.

Conclusions

A large scale psychosocial intervention primarily aimed at social bonding caused a lasting improvement of mental health in survivors of mass violence in Rwanda. This approach may have a similar positive effect in other post-conflict settings.

Trial Registration

Nederlands Trial Register 1120

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<![CDATA[Economic Feasibility of a New Method to Estimate Mortality in Crisis-Affected and Resource-Poor Settings]]> https://www.researchpad.co/article/5989dab3ab0ee8fa60bac1f0

Introduction

Mortality data provide essential evidence on the health status of populations in crisis-affected and resource-poor settings and to guide and assess relief operations. Retrospective surveys are commonly used to collect mortality data in such populations, but require substantial resources and have important methodological limitations. We evaluated the feasibility of an alternative method for rapidly quantifying mortality (the informant method). The study objective was to assess the economic feasibility of the informant method.

Methods

The informant method captures deaths through an exhaustive search for all deaths occurring in a population over a defined and recent recall period, using key community informants and next-of-kin of decedents. Between July and October 2008, we implemented and evaluated the informant method in: Kabul, Afghanistan; Mae La camp for Karen refugees, Thai-Burma border; Chiradzulu District, Malawi; and Lugufu and Mtabila refugee camps, Tanzania. We documented the time and cost inputs for the informant method in each site, and compared these with projections for hypothetical retrospective mortality surveys implemented in the same site with a 6 month recall period and with a 30 day recall period.

Findings

The informant method was estimated to require an average of 29% less time inputs and 33% less monetary inputs across all four study sites when compared with retrospective surveys with a 6 month recall period, and 88% less time inputs and 86% less monetary inputs when compared with retrospective surveys with a 1 month recall period. Verbal autopsy questionnaires were feasible and efficient, constituting only 4% of total person-time for the informant method's implementation in Chiradzulu District.

Conclusions

The informant method requires fewer resources and incurs less respondent burden. The method's generally impressive feasibility and the near real-time mortality data it provides warrant further work to develop the method given the importance of mortality measurement in such settings.

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<![CDATA[Have LEGO Products Become More Violent?]]> https://www.researchpad.co/article/5989d9f3ab0ee8fa60b6f53f

Although television, computer games and the Internet play an important role in the lives of children they still also play with physical toys, such as dolls, cars and LEGO bricks. The LEGO company has become the world’s largest toy manufacturer. Our study investigates if the LEGO company’s products have become more violent over time. First, we analyzed the frequency of weapon bricks in LEGO sets. Their use has significantly increased. Second, we empirically investigated the perceived violence in the LEGO product catalogs from the years 1978–2014. Our results show that the violence of the depicted products has increased significantly over time. The LEGO Company’s products are not as innocent as they used to be.

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