Search

Armed conflicts between drug cartels and the Mexican government have caused collateral damage to local communities while prompting various responses from civilian women. Existing studies on women’s reactions to narco-violence have focused on either their active resistance against violence or their direct participation in cartels. In reality, however, most civilian women’s actions exist on a spectrum between these two extreme poles, which has received relatively little attention in the literature. This article examines how civilian women cooperate with cartels by analyzing qualitative data, including 37 semi-structured interviews with participants from Jalisco, Mexico. Using the concept of “everyday cooperation,” we divide civilian women’s actions to cohabit with cartels in the narco-environment into three categories: keeping silent, pursuing benefits, and idealizing narco-culture. Though civilian women’s actions are shaped by the normalization of violence embedded in their local communities, they strategize their behavior through social learning processes. This study conceptually and empirically contributes to the literature on civilian agency under narco-violence by scrutinizing the array of local civilian women’s responses to pervasive criminal violence, focusing on their daily cooperation with cartels in Mexico. [ABSTRACT FROM AUTHOR]

The aim of this paper is to evaluate the effects of civilian, military and dual (both military and civilian) R&D investments on the profitability of firms. In particular, this paper analyses the role of different types of R&D investment in a sample of firms that collaborate with the Spanish Ministry of Defence. This database contains detailed information about the R&D activities taking place and accounting and financial information. Our final sample consists of 935 observations from 158 firms during the period 2011-2018. The methodology used is the Generalised Method of Moments. The results show that military R&D is more significant than civilian R&D in explaining the financial firm performance in the Spanish defence industry. Moreover, they reveal differences between military and dual R&D and suggest the increasing importance of duality technologies. Finally, taking on board market segment idiosyncrasies does not eliminate, but reinforces, the differences observed. These results help to better understand the effects of R&D expenditure in the Spanish defence sector and are relevant in the current debate about reinforcing European defence capabilities. [ABSTRACT FROM AUTHOR]

In the midst of humanitarian crises, understanding and helping hard-to-reach migrant communities, is a major challenge for researchers. This article addresses the ethical framework and dimensions of inclusivity associated with researching such populations in civilian-military setting. With the overarching aim of improving methodological discourse, this study seeks to understand the mechanisms involved in working with crisis-affected migrants who are often marginalised and geographically isolated. The significance of this research lies in its multi-layered approach to understanding the ethical considerations and inclusivity that are essential to conducting research in crisis situations. By examining existing theories in the field, including participatory research methods, ethnographic studies and community-based research frameworks, this study critically evaluates their applicability in the context of crisis-affected migrant communities. This research contributes to methodological approaches by proposing innovative strategies that emphasise ethical integrity, cultural sensitivity and inclusivity. It argues for the development of collaborative and culturally sensitive research practises that enable migrant communities to actively participate in the research process and ensure that their voices are heard, and their perspectives accurately represented. This study contributes to existing knowledge by illuminating the complexities of researching hard-to-reach migrant communities in civil military setting. This study provides researchers and practitioners with the necessary tools and perspectives required for engaging with crisis-affected migrant communities in a manner that is both ethical, respectful, and impactful. [ABSTRACT FROM AUTHOR]

Abstract In the midst of humanitarian crises, understanding and helping hard-to-reach migrant communities, is a major challenge for researchers. This article addresses the ethical framework and dimensions of inclusivity associated with researching such populations in civilian-military setting. With the overarching aim of improving methodological discourse, this study seeks to understand the mechanisms involved in working with crisis-affected migrants who are often marginalised and geographically isolated. The significance of this research lies in its multi-layered approach to understanding the ethical considerations and inclusivity that are essential to conducting research in crisis situations. By examining existing theories in the field, including participatory research methods, ethnographic studies and community-based research frameworks, this study critically evaluates their applicability in the context of crisis-affected migrant communities. This research contributes to methodological approaches by proposing innovative strategies that emphasise ethical integrity, cultural sensitivity and inclusivity. It argues for the development of collaborative and culturally sensitive research practises that enable migrant communities to actively participate in the research process and ensure that their voices are heard, and their perspectives accurately represented. This study contributes to existing knowledge by illuminating the complexities of researching hard-to-reach migrant communities in civil military setting. This study provides researchers and practitioners with the necessary tools and perspectives required for engaging with crisis-affected migrant communities in a manner that is both ethical, respectful, and impactful.

Despite the increased attention that was given to data protection laws in national jurisdictions – especially after the adoption of the General Data Protection Regulation by the European Union – international law still does not offer a higher standard of protection to the personal data of civilians in times of armed conflict, where the deletion or manipulation of personal data of the civilian population can have significant harmful effects. This article explains that at the time of the adoption of the relevant international treaties and the development of customary international law, international humanitarian law (IHL) did not protect personal data stored electronically, and even though commentators in contemporary times tend to accept the object status of electronic data, State practice still remains inconclusive, largely excluding computerized personal data from the protective regime of IHL. The article argues further that a stricter protection of personal data regulation could potentially lead to harmful effects for protected persons, such as civilians, therefore it is undesirable. The protective nature of IHL must prevail over the data protection interests.

Background: Gunshots and bomb blasts are important causes of extremity injuries in conflict zones, yet little research exists on the characteristics and outcomes of these injuries in civilian populations. Methods: We performed a prospective cohort analysis utilizing data from a randomized trial conducted at two civilian hospitals in Jordan and Iraq in 2015–2019. Adults who presented ≤72 h of sustaining an extremity injury were included. We used mechanism of injury (gunshot/bomb blast) as the exposure and wound closure by day 5 as the primary outcome measure. Results: The population predominantly comprised young men (n = 163, 94% male, and median age 29 years) injured by gunshots (61%) or bomb blasts (39%). Compared with the gunshot group, more participants in the bomb blast group had concomitant injuries (32/63 [51%] vs. 11/100 [11%], p < 0.001) and vascular injuries (9/63 [14%] vs. 4/100 [4%], p = 0.02). The wounds were larger in the bomb blast group compared with the gunshot group (median area 86 cm2 [IQR 24–161] vs. 21 cm2 [IQR 7–57], p < 0.001). Compared with the bomb blast group, significantly more participants in the gunshot group achieved wound closure by day 5 (74/100 [74%] vs. 16/63 [25%], p < 0.001). This difference remained after controlling for confounding factors (odds ratio 4.7, 95% confidence interval 1.6–13.7). Conclusions: In civilians with conflict‐related extremity injuries, bomb blast wounds had a lower likelihood of achieving closure within 5 days than gunshot wounds, independent of other factors, such as wound size and vascular injuries. Trial Registration: ClinicalTrials.gov, NCT02444598. Registered 14‐05‐2015, https://classic.clinicaltrials.gov/ct2/show/NCT02444598. [ABSTRACT FROM AUTHOR]

In recent years, the NATO member nations have committed to a coordinated approach to strengthening resilience among the Allies, including the development of National Resilience Plans (NRPs). The Allies outlined the extent to which the robustness of their respective military capacities requires the designed resilience of systems that bridge civilian and military domains. This article outlines the role that resilience plays in supporting tactical and strategic measures of national security and defense within military and civilian domains. This exploration provides an outline of how resilience is currently applied in practice by the U.S. Department of Defense (DOD) and NATO. Building on this diversity of applications, various categorical forms of resilience drawn from the empirical science of resilience are positioned within NATO’s emerging frame for ‘layered’ resilience. This article reinforces the scientific debate that an optimal orientation to resilience leaves open the door for the transformative adaptation of function and identity when the single-equilibrium processes of resilience reach their limits. This article concludes with a normative perspective on how military and civilian resilience planning could support the development of NRPs that would amplify the Allies’ collective capacity to face shared security threats. [ABSTRACT FROM AUTHOR]

Armed conflicts result in the release of toxic chemicals into the surrounding environment and civilians are commonly exposed to these toxicants. This paper reviews the evidence on civilian exposure to toxic chemicals, including but not limited to inhaled toxic substances, in post-World War II armed conflicts, and proposes a framework for the implementation of long-term surveillance programs for these populations. Four databases of peer-reviewed health articles were searched for all English-language articles with a primary focus on toxic chemical exposures among civilians in armed conflicts since World War II. The review was supplemented substantially by the gray literature. In the 66 articles that met the inclusion criteria, the authors categorized the chemical toxicants to which civilians have been exposed in modern armed conflicts as ubiquitous (e.g. smoke, dust, and munitions components present in all conflicts) or particular agents (e.g. specific chemical agents used in a few conflicts). While most studies focused on particular agents, the vast majority of civilians are in fact exposed to ubiquitous agents both in the acute conflict phase and through persistent environmental exposures after the cessation of hostilities. There is a dearth of research concerning civilian exposures to toxic chemicals during armed conflicts. In line with principles of equity, justice, and accountability, robust research and surveillance programs are urgently needed to document exposures and provide ongoing assessments and any necessary treatment for these long-ignored populations, most of whom live in the Global South. [ABSTRACT FROM AUTHOR]

Purpose: Determine the prevalence of otological symptoms and tympanic membrane perforation, healing rates of tympanic membrane perforation with surgical and conservative management, and hearing function in civilian victims of terrorist explosions. Methods: A systematic review was conducted with searches on Medline, Embase, EMCare and CINAHL for publications between the 1st January 1945 and 26th May 2023. Studies with quantitative data addressing our aims were included. This review is registered with PROSPERO: CRD42020166768. Among 2611 studies screened, 18 studies comprising prospective and retrospective cohort studies were included. Results: The percentage of eardrums perforated in patients admitted to hospital, under ENT follow up and attending the emergency department is 69.0% (CI 55.5–80.5%), 38.7% (CI 19.0–63.0%, I2 0.715%) and 21.0% (CI 11.9–34.3%, I2 0.718%) respectively. Perforated eardrums heal spontaneously in 62.9% (CI 50.4–73.8%, I2 0.687%) of cases and in 88.8% (CI 75.9–96.3%, I2 0.500%) of cases after surgery. Common symptoms present within one month of bombings are tinnitus 84.7% (CI 70.0–92.9%, I2 0.506%), hearing loss 83.0% (CI 64.5–92.9%, I2 0.505%) and ear fullness 59.7% (CI 13.4–93.4%, I2 0.719). Symptomatic status between one and six months commonly include no symptoms 57.5% (CI 46.0–68.3%), hearing loss 35.4% (CI 21.8–51.8%, I2 0.673%) and tinnitus 15.6% (CI 4.9–40.0%, I2 0.500%). Within one month of bombings, the most common hearing abnormality is sensorineural hearing loss affecting 26.9% (CI 16.9–40.1%, I2 0.689%) of ears 43.5% (CI 33.4–54.2%, I2 0.500) of people. Conclusion: Tympanic membrane perforation, subjective hearing loss, tinnitus, ear fullness and sensorineural hearing loss are common sequelae of civilian terrorist explosions. [ABSTRACT FROM AUTHOR]

Within international humanitarian law (IHL) the legal figure of the civilian is conceived as a passive victim of war in need of protection, while civilians who become actively involved in hostilities lose their protections. The distinction between civilians and combatants is accordingly a fundamental principle informing IHL and is considered a standard of civilisation and humane warfare. This paper interrogates what happens when this standard is applied to anticolonial wars, where entire civilian populations participated in self-emancipatory violence and actively blurred this distinction in order to advance their own liberation. Advancing a theory aimed at decolonising the legal figure of the civilian, I analyse the specific nature of anticolonial violence and the call of anticolonial thinkers to deliberately undermine the distinction between civilians and combatants. Building on the ethos of civilian participation articulated by different anticolonial thinkers and adopting a 'revisionist' approach, I argue that the passive conception of the civilian at the heart of the Geneva Conventions and the Additional Protocols faces the risk of outlawing anticolonial violence and its political ethos of liberation. Décoloniser la figure du civil dans les guerres de libération nationale du tiers monde [ABSTRACT FROM AUTHOR]

Moral injury among civilians has garnered increased recognition in recent years. However, most moral injury measures have focused on military experiences, with language being military specific. This study aimed to further validate two self-report measures of civilian moral injury, the Moral Injury Events Scale - Civilian (MIES-C) and Expressions of Moral Injury Scale - Civilian (EMIS-C). Participants were 312 adults (99 males, 212 females, Mage = 37.24) who completed the MIES-C, EMIS-C, and a battery of associated measures on two occasions. For the MIES-C, four Confirmatory Factor Analysis (CFA) models were examined. A three-factor model, with covaried items, provided the best fit to the data. For the EMIS-C, three CFAs were examined. A two-factor model, with covaried items, and the bi-factor model provided the best fit to the data, with the two-factor model being preferred for reasons of parsimony and its absence of weak and negative item loadings. Both measures demonstrated acceptable test-retest reliability and convergent validity with associated measures of psychological distress. This study provides psychometrically sound tools for clinicians and researchers of civilian moral injury. [ABSTRACT FROM AUTHOR]

This article analyses the politics of seeing as a way to examine the elision of civilian casualty in the War on Terror. The author particularly focuses on the ambiguities and paradoxes at play in this discussion: the question of distance, the question of visibility and the role of the body. In doing so, she tells the story of how terrorism has emerged as a form of violence that centralizes bodies, focused on the figure of the innocent victim whose body has been destroyed by the body of another, even as the technology of drone strikes also operates by exploding bodies, but through the purported precision of techno-military operations. Such technology re-categorizes civilian death as collateral damage, defining these deaths as technological effects rather than as biological, embodied ones. This acts to disembody dead civilians even as increased attention is being given to soldier bodies (both dead and injured). In this sense, the author is not arguing that civilian death has become disembodied by virtue of the distancing caused by the drone apparatus. Rather, she seeks to tell a more complicated story of how the drone gaze functions as a perpetrator gaze, and who and what it sees. [ABSTRACT FROM AUTHOR]

BackgroundIn April 2017, the Thai Ministry of Public Health (MoPH) was alerted to a potential malaria outbreak among civilians and military personnel in Sisaket Province, a highly forested area bordering Cambodia. The objective of this study was to present findings from the joint civilian-military outbreak response.MethodsA mixed-methods approach was used to assess risk factors among cases reported during the 2017 Sisaket malaria outbreak. Routine malaria surveillance data from January 2013 to March 2018 obtained from public and military medical reporting systems and key informant interviews (KIIs) (n = 72) were used to develop hypotheses about potential factors contributing to the outbreak. Joint civilian-military response activities included entomological surveys, mass screen and treat (MSAT) and vector control campaigns, and scale-up of the "1-3-7" reactive case detection approach among civilians alongside a pilot "1-3-7" study conducted by the Royal Thai Army (RTA).ResultsBetween May-July 2017, the monthly number of MoPH-reported cases surpassed the epidemic threshold. Outbreak cases detected through the MoPH mainly consisted of Thai males (87%), working as rubber tappers (62%) or military/border police (15%), and Plasmodium vivax infections (73%). Compared to cases from the previous year (May-July 2016), outbreak cases were more likely to be rubber tappers (OR = 14.89 [95% CI: 5.79-38.29]; p

In the second year of the full-scale armed aggression of the Russian Federation against Ukraine, the question of bringing the perpetrators to criminal responsibility for committing war crimes is urgent. At the same time, the criminal law qualification of actions within the scope of the provisions of Article 438 of the Criminal Code of Ukraine stays debatable. The purpose of this study was to investigate the content of some verdicts in proceedings on violations of the laws and customs of war, which were passed after February 24, 2022 in Ukraine, to identify the problems of law enforcement and the performance of procedural requirements regarding their content, since they acquired not only social significance and resonance, but also international ones, and the requirements for their quality can be defined as increased. The study used various methods of scientific research, the most effective and active among which were as follows: systemic-structural, comparative, analysis, and terminological. According to the results of processing the verdicts of the courts of first instance in the proceedings under Article 438 of the Criminal Code of Ukraine, some issues were identified regarding the procedural order of special court proceedings. A causal connection between the violation of the laws and customs of war and the particular situation of a military conflict was established. The circumstances subject to proof for the commission of the specified criminal offence were substantiated and investigated, and the need to specify particular circumstances was argued. Emphasis was placed on the need to consider the particular war situation, the difference and the nature of the connection between these violations and the crime of aggression when proving a violation of the laws and customs of war, with the assumption of the possibility of their influence on political, legal, and other processes, even after its end. The practical significance of this study lies in the need to reflect the results of the application of legal norms related to the implementation of in absentia proceedings in verdicts, primarily regarding the procedure for informing the suspect, the accused about criminal proceedings, ensuring the right to defence and the effectiveness of its implementation

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The number of civilian crime investigators (CIs) has been increasing among the police, a trend that is called civilianisation. However, conflicts have arisen from perceptions that civilian CIs undermine professional police efforts. The purpose of this study was to investigate the intersection of doing gender and professional identity in narratives on inclusion and/or exclusion in CIs' professional practices. Because professional background and gender composition change with the civilianisation of the police, this study included interviews with 48 female CIs from Sweden. The study showed that aspects of belongingness and uniqueness interact in complex ways and conclude that the intersection of being a civilian CI and a woman is at the core, especially in narratives on exclusion. Taken together, this means that civilian CIs' narratives are important to learn from and can help the police become aware of obstacles to and opportunities for civilian employees' full participation in the criminal investigation practice. Aspects of belongingness and uniqueness are discussed to contribute knowledge of how gender and professional identity can be redone in a way that helps reduce future barriers to full inclusion of female and civilian CIs in police work. [ABSTRACT FROM AUTHOR]

Objective: Fingers, hands, and wrists (FHW) are the most frequently injured body parts in work-related injuries. This study described and compared FHW injuries among enlisted, officer, and civilian US Air Force (USAF) personnel to those in the US workforce. Methods: All work-related, noncombat FHW injuries (=1 lost workday) and demographics among USAF personnel and US workforce (2008-2018) were included. The USAF FHW injury rates were age adjusted to the US employment and compared by sex, source, event, and nature of the injuries. Results: Finger, hand, and wrist injuries were significantly lower among the USAF personnel and among females. In both populations, FHW injuries from falls were higher and increased with age group among females. Males had higher overall FHW injuries from contact with objects and equipment. Conclusions: Prevention efforts should focus on understanding risk factors and sharing successful prevention activities. [ABSTRACT FROM AUTHOR]

Purpose: Healthcare provision in the United Kingdom (UK) falls primarily to the National Health Service (NHS) which is free at the point of access. In the UK, there is currently no national marker to identify military veterans in electronic health records, nor a requirement to record it. This study aimed to compare the sociodemographic characteristics and recorded mental health diagnoses of a sample of veterans and civilians accessing secondary mental health services. Methods: The Military Service Identification Tool, a machine learning computer tool, was employed to identify veterans and civilians from electronic health records. This study compared the sociodemographic characteristics and recorded mental health diagnoses of veterans and civilians accessing secondary mental health care from South London and Maudsley NHS Foundation Trust, UK. Data from 2,576 patients were analysed; 1288 civilians and 1288 veterans matched on age and gender. Results: Depressive disorder was the most prevalent across both groups in the sample (26.2% veterans, 15.5% civilians). The present sample of veterans accessing support for mental health conditions were significantly more likely to have diagnoses of anxiety, depressive, psychosis, personality, and stress disorders (AORs ranging 1.41–2.84) but less likely to have a drug disorder (AOR = 0.51) than age- and gender-matched civilians. Conclusion: Veterans accessing secondary mental health services in South London had higher risks for many mental health problems than civilians accessing the same services. Findings suggest that military career history is a key consideration for probable prognosis and treatment, but this needs corroborating in other geographical areas including national population-based studies in the UK. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to compare therapeutic strategies and outcomes, following isolated gunshot wounds of the head, between military and civilian populations. Background: Recent military conflicts introduced new concepts in trauma care, including aggressive surgical intervention in severe head trauma. Methods: This was a cohort-matched study, using the civilian Trauma Quality Improvement Program (TQIP) database of the American College of Surgeons (ACS) and the Department of Defense Trauma Registry (DoDTR), during the period 2013 to 2016. Included in the study were patients with isolated gunshots to the head. Exclusion criteria were dead on arrival, civilians transferred from other hospitals, and patients with major extracranial associated injuries (body area Abbreviated Injury Scale >3). Patients in the military database were propensity score–matched 1:3 with patients in the civilian database. Results: A total of 136 patients in the DoDTR database were matched for age, sex, year of injury, and head Abbreviated Injury Scale with 408 patients from TQIP. Utilization of blood products was significantly higher in the military population (P <0.001). In the military group, patients were significantly more likely to have intracranial pressure monitoring (17% vs 6%, P <0.001) and more likely to undergo craniotomy or craniectomy (34% vs 13%, P <0.001) than in the civilian group. Mortality in the military population was significantly lower (27% vs 38%, P =0.013). Conclusions: Military patients are more likely to receive blood products, have intracranial pressure monitoring and undergo craniectomy or craniotomy than their civilian counterparts after isolated head gunshot wounds. Mortality is significantly lower in the military population. Level of Evidence: Level III—therapeutic. [ABSTRACT FROM AUTHOR]

To reveal post-traumatic stress disorder (PTSD) genetic risk influences on tissue-specific gene expression, we use brain and non-brain transcriptomic imputation. We impute genetically regulated gene expression (GReX) in 29,539 PTSD cases and 166,145 controls from 70 ancestry-specific cohorts and identify 18 significant GReX-PTSD associations corresponding to specific tissue-gene pairs. The results suggest substantial genetic heterogeneity based on ancestry, cohort type (military versus civilian), and sex. Two study-wide significant PTSD associations are identified in European and military European cohorts; ZNF140 is predicted to be upregulated in whole blood, and SNRNP35 is predicted to be downregulated in dorsolateral prefrontal cortex, respectively. In peripheral leukocytes from 175 marines, the observed PTSD differential gene expression correlates with the predicted differences for these individuals, and deployment stress produces glucocorticoid-regulated expression changes that include downregulation of both ZNF140 and SNRNP35. SNRNP35 knockdown in cells validates its functional role in U12-intron splicing. Finally, exogenous glucocorticoids in mice downregulate prefrontal Snrnp35 expression.

Introduction: Patients with trauma-induced coagulopathies may benefit from the use of antifibrinolytic agents, such as tranexamic acid (TXA). This study evaluated the safety and efficacy of TXA in civilian adults hospitalized with traumatic hemorrhagic shock.Methods: Patients who sustained blunt or penetrating trauma with signs of hemorrhagic shock from June 2014 through July 2018 were considered for TXA treatment. A retrospective control group was formed from patients seen in the same past five years who were not administered TXA and matched based on age, gender, Injury Severity Score (ISS), and mechanism of injury (blunt vs penetrating trauma). The primary outcome of this study was mortality measured at 24 hours, 48 hours, and 28 days. Secondary outcomes included total blood products transfused, hospital length of stay (LOS), intensive care unit LOS, and adverse events. We conducted three pre-specified subgroup analyses to assess outcomes of patients, including (1) those who were severely injured (ISS >15), (2) those who sustained significant blood loss (≥10 units of total blood products transfused), and (3) those who sustained blunt vs penetrating trauma.Results: Propensity matching yielded two cohorts: the hospital TXA group (n = 280) and a control group (n = 280). The hospital TXA group had statistically lower mortality at 28 days (1.1% vs 5%, odds ratio [OR] [0.21], (95% confidence interval [CI], 0.06, 0.72)) and used fewer units of blood products (median = 4 units, interquartile range (IQR) = [1, 10] vs median=7 units, IQR = [2, 12.5] for the hospital TXA and control groups, respectively, (95% CI for the difference in median, -3 to -1). There were no statistically significant differences between groups with regard to 24-hour mortality (1.1% vs 1.1%, OR = 1, 95% CI, 0.20, 5.00), 48-hour mortality (1.1% vs 1.4%, OR [0.74], 95% CI, 0.17, 3.37), hospital LOS (median= 9 days, IQR = (5, 16) vs median =12 days IQR = (6, 22.5) for the hospital TXA and control groups, respectively, 95% CI for the difference in median = (-5 to 0)), and incidence of thromboembolic events (eg, deep vein thrombosis, pulmonary embolism) during hospital stay (0.7% vs 0.7% for the hospital TXA and control group, respectively, OR [1], 95% CI, 0.14 to 7.15). We conducted subgroup analyses on patients with ISS>15, patients transfused with ≥10 units of blood products, and blunt vs penetrating trauma. The results indicated lower 28-day mortality for ISS>15 (1.8% vs 7.1%, OR [0.23], 95% CI, 0.06 to 0.81) and blunt trauma  (0.6% vs 6.3%, OR [0.09], 95% CI, 0.01 to 0.75); fewer units of blood products for penetrating trauma (median = 2 units, IQR = (1, 8) vs median = 8 units, IQR = (5, 15) for the hospital TXA and control groups, respectively, 95% CI for the difference in median = (-6 to -3)), and ISS>15 (median = 7 units, IQR = (2, 14) vs median = 8.5 units, IQR = (4, 16) for the hospital TXA and control groups, respectively, 95% CI for the difference in median, -3 to 0).Conclusion: The current study demonstrates a statistically significant reduction in mortality after TXA administration at 28 days, but not at 24 and 48 hours, in patients with traumatic hemorrhagic shock.

An isolated police officer executing an arrest can be placed in a dangerous situation should the subject become non-compliant. Further research is needed to ascertain the position that a subject can be placed in that takes the longest time to rise from the ground. Twenty-four college-aged participants (15 men, 9 women) were recruited for this study. Four prone positions were examined in one session: hands hidden under the chest (PHC); arms perpendicular to the torso and palms of the hand facing up (PPU); arms perpendicular to the torso, palms of the hand facing up, with ankles crossed on the ground (PPUAC); and arms perpendicular to the torso, palms of the hand facing up, with ankles crossed but elevated toward the lower back (PACKB). The order of these positions was randomized amongst participants. Participants were instructed to rise to an athletic position from each position as quickly as possible, with the movements recorded by a video camera. Times were calculated via a frame-by-frame analysis using motion analysis soft - ware from movement initiation until participants were standing. A 2 (sex) x 4 (position) repeated measures ANOVA with Bonferroni post hoc calculated between-position differences. There was a significant ANOVA for position (p = 0.003) but not sex (p = 0.415). The PACKB position was significantly slower than the PHC and PPUAC positions (p ≤ 0.045) and had the slowest movement time to stand (~2.019 s). As reaction time could influence an officer's safety, the PACKB position required the most time for a subject to stand and potentially engage an officer.

Abstract Background Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a damage control tool with a potential role in the hemodynamic resuscitation of severely ill patients in the civilian pre-hospital setting. REBOA ensures blood flow to vital organs by early proximal control of the source of bleeding. However, there is no consensus on the use of REBOA in the pre-hospital setting. This article aims to perform a systematic review of the literature about the feasibility, survival, indications, complications, and potential candidates for civilian pre-hospital REBOA. Methods A literature search was conducted using Medline, EMBASE, LILACS and Web of Science databases. Primary outcome variables included overall survival and feasibility. Secondary outcome variables included complications and potential candidates for endovascular occlusion. Results The search identified 8 articles. Five studies described the use of REBOA in pre-hospital settings, reporting a total of 47 patients in whom the procedure was attempted. Pre-hospital REBOA was feasible in 68–100% of trauma patients and 100% of non-traumatic patients with cardiac arrest. Survival rates and complications varied widely. Pre-hospital REBOA requires a coordinated and integrated emergency health care system with a well-trained and equipped team. The remaining three studies performed a retrospective analysis identifying 784 potential REBOA candidates. Conclusions Pre-hospital REBOA could be a feasible intervention for a significant portion of severely ill patients in the civilian setting. However, the evidence is limited. The impact of pre-hospital REBOA should be assessed in future studies.

Within the context of increasingly digital work, it appeared interesting to look at how military leaders and their leadership style will have to adapt to remain “up-to-speed” with current challenges. It is qualitative research based on interviews with military and civilian experts. Four interviews have been conducted, but there would be the potential to interview many more experts and look deeper into the matter. Within the context of digitalised military leadership, the importance of communication and mutual trust has been underscored by the experts. They agreed that leaders nowadays must embrace digital developments and include them in their leadership styles. The civilian world can learn from the military when it comes to leadership approaches, which is happening at the time of publication of this article with practical examples (senior military leaders assigned to lead the pandemic task force in some countries). Overall, the outcome of the research is that a relevant and resilient military leadership style in the 21st century resembles the elements of the situational leadership style developed by Hersey-Blanchard.

Abstract Background The proportion of patients with post-traumatic stress disorder (PTSD) that remain undiagnosed may be substantial. Without an accurate diagnosis, these patients may lack PTSD-targeted treatments and experience adverse health outcomes. This study used a machine learning approach to identify and describe civilian patients likely to have undiagnosed PTSD in the US commercial population. Methods The IBM® MarketScan® Commercial Subset (10/01/2015–12/31/2018) was used. A random forest machine learning model was developed and trained to differentiate between patients with and without PTSD using non–trauma-based features. The model was applied to patients for whom PTSD status could not be confirmed to identify individuals likely and unlikely to have undiagnosed PTSD. Patient characteristics, symptoms and complications potentially related to PTSD, treatments received, healthcare costs, and healthcare resource utilization were described separately for patients with PTSD (Actual Positive PTSD cohort), patients likely to have PTSD (Likely PTSD cohort), and patients without PTSD (Without PTSD cohort). Results A total of 44,342 patients were classified in the Actual Positive PTSD cohort, 5683 in the Likely PTSD cohort, and 2,074,471 in the Without PTSD cohort. While several symptoms/comorbidities were similar between the Actual Positive and Likely PTSD cohorts, others, including depression and anxiety disorders, suicidal thoughts/actions, and substance use, were more common in the Likely PTSD cohort, suggesting that certain symptoms may be exacerbated among those without a formal diagnosis. Mean per-patient-per-6-month healthcare costs were similar between the Actual Positive and Likely PTSD cohorts ($11,156 and $11,723) and were higher than those of the Without PTSD cohort ($3616); however, cost drivers differed between cohorts, with the Likely PTSD cohort experiencing more inpatient admissions and less outpatient visits than the Actual Positive PTSD cohort. Conclusions These findings suggest that the lack of a PTSD diagnosis and targeted management of PTSD may result in a greater burden among undiagnosed patients and highlights the need for increased awareness of PTSD in clinical practice and among the civilian population.

The dominant public discourse regarding the recruitment and retention of teachers is one that is often framed in terms such as 'crisis'. Data from the Department for Education, the National Audit Office and bodies such as the Education and Training Foundation highlight challenges in filling vacancies across each part of the education sector. This is particularly acute in subject areas relating to Science, Engineering and Technology (SET). This paper analyses discourses relating to teacher training amongst tri-service personnel in the English context. Sources from publications such as FE Week and CTP (Career Transition Partnership) are addressed. In doing so, the paper compares educational and military sources in order to examine how the representation of a civilian teaching career varies between the two. This is about adding to the wider societal narrative regarding the ways in which military to civilian transition can be aided by the reframing of skills and experience acquired during military service. [ABSTRACT FROM AUTHOR]

The term hybrid regime has recently become very popular in the Pakistani politics. Not many people outside the select group of political scientists were even aware of concept only a decade ago. This paper discusses this concept in detail in context of Pakistan's political history to prove that hybrid regime is not an anomaly but a norm in Pakistan's political system and that Pakistan's regimes throughout the history were neither pure democracies nor absolute stratocracies. It proves that from inception till this day Pakistan has always had hybrid regimes. Government is framed apparently by civilian political people, but somewhere the role of establishment in governmental affairs is absolutely undeniable. This study aimed to explore the leading issues that are considered as significant contributors towards the political regime along with its implication towards desired change. In this connection, present study uses the qualitative content analysis technique for data analysis for finding the answers of the research questions and reaching the desired conclusion of study. Thus, the findings reveals that the government in Pakistan is neither liberal democracy nor authoritarian rather; the government in our country is hybrid regime. [ABSTRACT FROM AUTHOR]

As political scientist Tarak Barkawi has argued, studying wars of decolonization demands a readiness to decolonize previously Eurocentric approaches to war. To do that, we need first to think about how the study of violent decolonization has evolved over the past generation or so. This brief essay offers a few answers. It focuses on three issues: the recognition of decolonization's wars, the place of unarmed civilians in such conflicts, and the inter-connection between violent decolonization and civil war. [ABSTRACT FROM AUTHOR]

This paper uses alchemical metaphor to examine the psychological challenges United States military veterans face as they attempt to reintegrate into civilian society. The arc of the research tracks a military member's progression from Basic Training to the transition back into civilian life. In particular, it pinpoints the psychological harm inflicted by the military's collective consciousness on the individual psyche. Examining the process of military training from the perspective of a Jungian understanding of the psychological stages of alchemy, the paper illuminates a process that presents each military member with profound difficulties related to identity, the ability to engage in a vibrant relationship with the Self, and the ability to reenter civilian life. In conclusion, it highlights the need for civilians, elected officials, and the mental healthcare community to help military veterans address the psychological pain of their service through practices that support their adjustment to civilian life from a holistic perspective that includes image, soul, and conscious connection fostered between the ego and archetypal forces that animate human life. [ABSTRACT FROM AUTHOR]

Copyright of Estudios Atacameños is the property of Estudios Atacamenos and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The purpose of the research is to assess the state of protection of the rights of workers of industrial enterprises from the viewpoint of both international and national legislation in the conditions of a full-scale invasion of the Russian Federation on the territory of Ukraine. The research was conducted using qualitative analysis, formal-legal, logical-legal, system-functional methods, as well as the method of interpreting legal norms (method of legal hermeneutics). The paper states the insufficient effectiveness of the norms of modern international humanitarian law regarding the protection of the rights of workers of industrial enterprises in the conditions of martial law in Ukraine. The paper describes the general and special regime of regulation of the rights of workers of industrial enterprises in the conditions of martial law in Ukraine. For the first time, the authors proposed to understand the protection of the rights of individuals by international humanitarian law in both a broad and a narrow sense, and the meaning of such approaches was revealed. The publication developed recommendations for the protection of the rights of workers of industrial enterprises in the conditions of armed conflicts, recommendations which are important for the development of regulations, which indicates the practical significance of the paper. [ABSTRACT FROM AUTHOR]

Purpose: Penetrating injuries to the perineum and associated pelvic organs have largely been reported in the military. Given the rarity of presentation and unique clinical characteristics of these injuries, we set out to address the gap in the literature in civilian settings. Methods: A systematic review of studies addressing penetrating perineal trauma from January 2000 to April 2021 was performed. Outcomes of interest were the epidemiology, associated injuries, management, follow-up, and patient outcomes. Results: 26 studies were included in this review, reporting on a total of 2316 patients. Most injuries occurred in males (88.1%), with gunshot wounds (88.2%) representing the most common aetiology, followed by knife wounds (5.0%), impalement (3.1%), coital injuries/sexual assault (1.5%), and others (2.4%). Regarding associated injuries, anorectal (n = 1419, 69.4%), bladder (n = 351, 32.4%), penile (n = 282, 20.8%), scrotal (n = 375, 27.7%), and testicular (n = 229, 16.9%) occurred frequently. Bony injuries involved the pelvis (n = 88, 8.1%) and femoral fractures (n = 5, 0.5%), while soft-tissue injuries involved the inguinal region (n = 19, 1.6%) and buttocks (n = 14, 1.3%). Vascular injuries occurred in 79 (7.8%) patients. Regarding patient outcomes, 65 (4.8%) deaths were reported, and significant morbidity was detected with a mean injury severity score of 18.4 detected in the cohort. In terms of complications of injury, wound/infective complications (n = 135, 61.3%) and fistula formation/leakage (n = 16, 0.7%) featured prominently. Conclusion: Penetrating perineal trauma in the civilian population poses a considerable challenge to clinicians, compounded by the potential for multisystem injury requiring involvement of different medical and surgical specialties. [ABSTRACT FROM AUTHOR]

In the 21st century, biotechnology is no doubt one of the fields in science and technology with the most developmental potential. Modern-day biotechnology is a multidisciplinary field where its utility has grown from traditional uses like agriculture and medicine. The ongoing revolution in biotechnology has great potential for application for both civilian and military uses. This review describes the major biotechnological revolution as well as some aspects of their general usefulness. Furthermore the application of the major research breakthroughs in biotechnology to military operations is discussed. Major militaristic utility of biotechnology are in therapeutics, electronics and computing, materials and logistics and biodefence.

Introduction: Hemorrhage is one of the leading causes of death in trauma victims. Historically, paramedics have not had access to medications that specifically target the reversal of trauma-induced coagulopathies. The California Prehospital Antifibrinolytic Therapy (Cal-PAT) study seeks to evaluate the safety and efficacy of tranexamic acid (TXA) use in the civilian prehospital setting in cases of traumatic hemorrhagic shock.  Methods: The Cal-PAT study is a multi-centered, prospective, observational cohort study with a retrospective comparison. From March 2015 to July 2017, patients ≥ 18 years-old who sustained blunt or penetrating trauma with signs of hemorrhagic shock identified by first responders in the prehospital setting were considered for TXA treatment. A control group was formed of patients seen in the five years prior to data collection cessation (June 2012 to July 2017) at each receiving center who were not administered TXA. Control group patients were selected through propensity score matching based on gender, age, Injury Severity Scores, and mechanism of injury. The primary outcome assessed was mortality recorded at 24 hours, 48 hours, and 28 days. Additional variables assessed included total blood products transfused, the hospital and intensive care unit length of stay, systolic blood pressure taken prior to TXA administration, Glasgow Coma Score observed prior to TXA administration, and the incidence of known adverse events associated with TXA administration. Results: We included 724 patients in the final analysis, with 362 patients in the TXA group and 362 in the control group. Reduced mortality was noted at 28 days in the TXA group in comparison to the control group (3.6% vs. 8.3% for TXA and control, respectively, odds ratio [OR]=0.41 with 95% confidence interval [CI] [0.21 to 0.8]). This mortality difference was greatest in severely injured patients with ISS >15 (6% vs 14.5% for TXA and control, respectively, OR=0.37 with 95% CI [0.17 to 0.8]). Furthermore, a significant reduction in total blood product transfused was observed after TXA administration in the total cohort as well as in severely injured patients. No significant increase in known adverse events following TXA administration were observed.  Conclusion: Findings from the Cal-PAT study suggest that TXA use in the civilian prehospital setting may safely improve survival outcomes in patients who have sustained traumatic injury with signs of hemorrhagic shock.

The human visual system is still an important factor in military warfare; military personnel receive training on effective search strategies, and camouflage that can effectively conceal objects and personnel is a key component of a successful integrated survivability strategy. Previous methods of camouflage assessment have, amongst others, used psychophysics to generate distinctiveness metrics. However, the population from which the human observers are drawn is often not well defined, or necessarily appropriate. In this experiment we designed a new platform for testing multiple patterns based on a camouflaged object detection task, and investigate whether trained military observers perform better than civilians. We use a two-alternative forced choice paradigm, with participants searching images of woodland for a replica military helmet displaying Olive Green, Multi Terrain Pattern, US Marine Pattern or, as a conspicuous control, UN Peacekeeper Blue. Our data show that there is no difference in detection performance between the two observer groups but that there are clear differences in the effectiveness of the different helmet colour patterns in a temperate woodland environment. We conclude that when tasks involve very short stimulus presentation times, task-specific training has little effect on the success of target detection and thus this paradigm is particularly suitable for robust estimates of camouflage efficacy.

Abstract Background In April 2017, the Thai Ministry of Public Health (MoPH) was alerted to a potential malaria outbreak among civilians and military personnel in Sisaket Province, a highly forested area bordering Cambodia. The objective of this study was to present findings from the joint civilian-military outbreak response. Methods A mixed-methods approach was used to assess risk factors among cases reported during the 2017 Sisaket malaria outbreak. Routine malaria surveillance data from January 2013 to March 2018 obtained from public and military medical reporting systems and key informant interviews (KIIs) (n = 72) were used to develop hypotheses about potential factors contributing to the outbreak. Joint civilian-military response activities included entomological surveys, mass screen and treat (MSAT) and vector control campaigns, and scale-up of the “1–3–7” reactive case detection approach among civilians alongside a pilot “1–3–7” study conducted by the Royal Thai Army (RTA). Results Between May–July 2017, the monthly number of MoPH-reported cases surpassed the epidemic threshold. Outbreak cases detected through the MoPH mainly consisted of Thai males (87%), working as rubber tappers (62%) or military/border police (15%), and Plasmodium vivax infections (73%). Compared to cases from the previous year (May–July 2016), outbreak cases were more likely to be rubber tappers (OR = 14.89 [95% CI: 5.79–38.29]; p

Abstract The role of implicit processes during police-civilian encounters is well studied from the perspective of the police. Decades of research on the “shooter bias” suggests that implicit Black-danger associations potentiate the perception of threat of Black individuals, leading to a racial bias in the decision to use lethal force. Left understudied are civilians’ possible associations of police with danger and how such associations pervade behavior and explicit views of the police. The current work begins to address this gap. In two within-subjects studies, we separately assess police-threat (i.e., safety/danger) and police-valence (i.e., good/bad) associations as well as their relative influences on explicit perceptions of police. Study 1 revealed that implicit threat evaluations (police-danger associations) more strongly predicted negative explicit views of the police compared to implicit valence evaluations (police-negative associations). Study 2 replicated these findings and suggests that individuals evaluate the police as more dangerous versus negative when each response is pitted against each other within single misattribution procedure trials. The possible implications for explicit attitudes toward police reform and behavior during police-civilian encounters are discussed.

Summary: Background: Terrorism and armed conflict cause blast and ballistic casualties that are unusual in civilian practice. The immediate surgical response to mass casualty events, with civilians injured by these mechanisms, has not been systematically characterised. Standardising an approach to reacting to these events is challenging but is essential to optimise preparation for them. We aimed to quantify and assesses the surgical response to blast and ballistic injuries managed in a world-class trauma unit paradigm. Methods: This was an observational study conducted at the UK-led military Medical Treatment Facility, Camp Bastion, Afghanistan from original theatre log-book entries between Nov 5, 2009, and Sept 21, 2014; a total of 10,891 consecutive surgical cases prospectively gathered by surgical teams were catalogued. Patients with combatant status/wearing body-armour to various degrees including interpreters were excluded from the study. Civilian casualties that underwent primary trauma surgery for blast and ballistic injuries were included (n=983). Surgical activity was analysed as a rate per 100 casualties, and patients were grouped according to adult vs. paediatric and ballistic vs. blast injury mechanisms to aid comparison. Findings: The three most common surgical procedures for civilian blast injuries were debridement, amputation, and laparotomy. For civilian ballistic injuries, these were debridement, laparotomy and vascular procedures. Blast injuries generated more amputations in both adults and children compared to ballistic injuries. Blast injuries generated more removal of fragmentation material compared to ballistics injuries amongst adult casualties. Ballistic injuries lead to more chest drain insertions in adults. As a rate per 100 casualties, adults injured by blast underwent significantly more debridement (63·5); temporary skeletal stabilisation (13·2) and vascular procedures (12·8) compared to children (43·4, z=4·026, p=0·00007; 5·7, z=2·230, p=0·022; 4·9, z=2·468, p=0·014). Adults injured by ballistics underwent significantly more debridement (63·4); chest drain (12·3) and temporary skeletal fixation procedures (11·4) compared to children (50·0, z=2·058, p=0.040, p

Blast injuries are both complex and rare in the civilian population. This combination can often lead to missed opportunities for early, effective intervention. This is a case report of a 31-year-old male who suffered a lower extremity blast injury while using an industrial sandblaster. This blast injury presented as a closed degloving, or Morel-Lavallee lesion, which can easily be mistreated and lead to infection and further disability. Following assessment, identification, and confirmation of the Morel-Lavallee lesion via radiographic imaging, this patient underwent debridement surgery, wound vac therapy, and antibiotic treatment before being discharged home with no major physiologic or neurologic deficits. The purpose of this report is to highlight the importance of assessing for closed degloving injuries when presented with blast injury traumas in the civilian trauma setting, and outlines the process utilized for assessment and treatment. [ABSTRACT FROM AUTHOR]

Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a damage control tool with a potential role in the hemodynamic resuscitation of severely ill patients in the civilian pre-hospital setting. REBOA ensures blood flow to vital organs by early proximal control of the source of bleeding. However, there is no consensus on the use of REBOA in the pre-hospital setting. This article aims to perform a systematic review of the literature about the feasibility, survival, indications, complications, and potential candidates for civilian pre-hospital REBOA. Methods: A literature search was conducted using Medline, EMBASE, LILACS and Web of Science databases. Primary outcome variables included overall survival and feasibility. Secondary outcome variables included complications and potential candidates for endovascular occlusion. Results: The search identified 8 articles. Five studies described the use of REBOA in pre-hospital settings, reporting a total of 47 patients in whom the procedure was attempted. Pre-hospital REBOA was feasible in 68–100% of trauma patients and 100% of non-traumatic patients with cardiac arrest. Survival rates and complications varied widely. Pre-hospital REBOA requires a coordinated and integrated emergency health care system with a well-trained and equipped team. The remaining three studies performed a retrospective analysis identifying 784 potential REBOA candidates. Conclusions: Pre-hospital REBOA could be a feasible intervention for a significant portion of severely ill patients in the civilian setting. However, the evidence is limited. The impact of pre-hospital REBOA should be assessed in future studies. [ABSTRACT FROM AUTHOR]

Police services around the world are generally tasked with upholding the rule of law and maintaining order in society. However, the use of excessive force by members of police services can result in violations of human rights. For that reason, governments often introduce measures and processes to hold members of police services accountable to ensure that they execute their duties within the remit of the law and in observance of human rights. This paper presents a critical discussion of the current state of accountability within the three civilian police oversight agencies in Lesotho: the Police Directorate, the Police Complaints Authority (PCA) and the Police Inspectorate within the Ministry of Police and Public Safety. Face-to-face interviews, as well as a review of various documents such as legal frameworks, international instruments, media reports and previously conducted research, were used to obtain information. While Lesotho has taken positive steps in observing some of the principles laid down by international instruments for civilian police oversight agencies, legal loopholes and administrative challenges have reduced their effectiveness. The country's legislation emphasises the establishment of civilian police oversight mechanisms and the appointment of their senior leaders. Moreover, the lack of relevant legislation covering the powers, functions and independence of oversight agencies erodes respect for them among the various policing services. The omission of clear provisions in these key areas of accountability to oversight agencies enables political interference in policing services to the extent that politicians can take effective control over the country's police agencies. There is therefore a need for a review of the legal framework that governs the civilian police oversight agencies in Lesotho. A comprehensive Act should underpin the broad and detailed mandate, powers and independence of the agencies. [ABSTRACT FROM AUTHOR]

Background: The proportion of patients with post-traumatic stress disorder (PTSD) that remain undiagnosed may be substantial. Without an accurate diagnosis, these patients may lack PTSD-targeted treatments and experience adverse health outcomes. This study used a machine learning approach to identify and describe civilian patients likely to have undiagnosed PTSD in the US commercial population. Methods: The IBM® MarketScan® Commercial Subset (10/01/2015–12/31/2018) was used. A random forest machine learning model was developed and trained to differentiate between patients with and without PTSD using non–trauma-based features. The model was applied to patients for whom PTSD status could not be confirmed to identify individuals likely and unlikely to have undiagnosed PTSD. Patient characteristics, symptoms and complications potentially related to PTSD, treatments received, healthcare costs, and healthcare resource utilization were described separately for patients with PTSD (Actual Positive PTSD cohort), patients likely to have PTSD (Likely PTSD cohort), and patients without PTSD (Without PTSD cohort). Results: A total of 44,342 patients were classified in the Actual Positive PTSD cohort, 5683 in the Likely PTSD cohort, and 2,074,471 in the Without PTSD cohort. While several symptoms/comorbidities were similar between the Actual Positive and Likely PTSD cohorts, others, including depression and anxiety disorders, suicidal thoughts/actions, and substance use, were more common in the Likely PTSD cohort, suggesting that certain symptoms may be exacerbated among those without a formal diagnosis. Mean per-patient-per-6-month healthcare costs were similar between the Actual Positive and Likely PTSD cohorts ($11,156 and $11,723) and were higher than those of the Without PTSD cohort ($3616); however, cost drivers differed between cohorts, with the Likely PTSD cohort experiencing more inpatient admissions and less outpatient visits than the Actual Positive PTSD cohort. Conclusions: These findings suggest that the lack of a PTSD diagnosis and targeted management of PTSD may result in a greater burden among undiagnosed patients and highlights the need for increased awareness of PTSD in clinical practice and among the civilian population. [ABSTRACT FROM AUTHOR]